丙型肝炎病毒重组蛋白抗原联合免疫的免疫原性和保护性研究

目的 研究两个丙型肝炎病毒(HCV)多表位重组抗原联合免疫后诱导的细胞免疫和体液免疫应答,以及对小鼠的保护作用.方法 用两个多表位抗原HCV-T和HCV-E1联合免疫BALB/c小鼠3次,ELISA检测血清中抗体IgG、IgG1和IgG2a滴度;最后一次免疫后10 d杀死一半小鼠,取脾细胞,用乳酸脱氢酶(LDH)释放法检测细胞毒性T淋巴细胞(CTL)活性;ELISPOT法检测分泌IFN-γ和IL4的细胞;最后一次免疫后2周,在免疫小鼠的背部皮下注射106个SP2/0-NS3细胞,考察联合免疫对小鼠的保护作用;另取BALB/c小鼠,先在背部皮下注射106个SP2/0-NS3细胞,7 d后开始联合免疫,免疫3次,考察免疫治疗作用.结果 用HCV-T+HCV-E1联合免疫诱导了高滴度的HCV-E1特异性的IgG、IgG1和IgG2a抗体以及高水平的CTL活性;与单独免疫相比,联合免疫产生的分泌IFN-γ和IL-4的细胞数量有协同作用;而且联合免疫能有效预防和治疗SP2/0-NS3对小鼠的攻击.结论 HCV-T+HCV-E1联合免疫诱导了保护性的体液免疫和细胞免疫应答,有望进一步开发为一种有效的重组HCV疫苗.     

依达拉奉对Alzheimer病模型大鼠认知功能及海马内乙酰胆碱含量的影响

目的 探讨依达拉奉(EDA)对Alzheimer病(AD)模型大鼠认知功能及海马内乙酰胆碱(Ach)含量的影响.方法 30只大鼠随机分为假手术组、AD组及EDA组.向AD组及EDA组大鼠海马内立体定向注射β淀粉样蛋白(Aβ)1-40建立AD模型;EDA组术后给予EDA腹腔注射共2周.术后第5周进行Morris水迷宫试验评价各组大鼠的认知功能,高效液相色谱法测定各组大鼠海马区Ach含量.结果 与假手术组比较,EDA组及AD组水迷宫试验中的逃避潜伏期明显延长,目的象限停留时间明显缩短,穿环次数明显减少(P＜0.05～0.01);与AD组比较,EDA组逃避潜伏期明显缩短,目的象限停留时间明显增加,穿环次数明显增多(P＜0.05～0.01).与假手术组比较,EDA组及AD组海马区Ach含量明显减少(均P＜0.01);EDA组海马区Ach含量明显较AD组明显增加(P＜0.01).结论 EDA通过增加AD模型大鼠海马Ach含量,改善其认知功能.     

特发性黄斑裂孔的黄斑裂孔直径、被破坏的光感受器细胞内外节直径及其与视力的相关性研究

Objective To observe the diameters of macular hole and destroyed boundary line between inner and outer segment (IS/OS) of the photoreceptors and the correlation with the visual acuity in patients with idiopathic macular hole(IMH). Methods The clinical data of 39 eyes (37 patients) with IMH were retrospective analyzed. All the patients had undergone the examinations of visual acuity (Snellen chart), intra-acular pressure, ocular fundus (indirect ophthalmoscope), and Fourier-domain optical coherence tomography (FD-OCT) whose speed was 27 000 A scan/s, area was 6.0 mm×6.0 mm, and the mode was 512×128. The diametres of macular hole and destroyed IS/OS, and the correlations with visual acuity were detected. Results The mean IogMAR was 0.99±0. 44 (ranged from 0. 15 to 2.00), the mean diameter of macular holes was (942.0± 348. 4)μm(ranged from 171 to 1491 μm), and the mean diameter of IS/OS disruption was (1870. 35±673.2) μm(range from 463 to 3176 μm). There was a significant correlation among the diameter of the macular hole, the diameter of the IS/OS disruption, and IogMAR in IMH (P= 0. 038, 0. 002, 0. 000). In eyes with closed macular hole after surgery, the IogMAR and the diameter of the IS/OS disruption had a significant decrease. Conclusion Using FD-OCT the photoreceptor changes can be visualized in vivo. The abnormality in the IS-OS boundary line appears to be involved for a much larger area beyond the macular hole itself, and persists there with small size even after the maeular hole closure surgery.     

特发性黄斑裂孔的黄斑裂孔直径、被破坏的光感受器细胞内外节直径及其与视力的相关性研究

Objective To observe the diameters of macular hole and destroyed boundary line between inner and outer segment (IS/OS) of the photoreceptors and the correlation with the visual acuity in patients with idiopathic macular hole(IMH). Methods The clinical data of 39 eyes (37 patients) with IMH were retrospective analyzed. All the patients had undergone the examinations of visual acuity (Snellen chart), intra-acular pressure, ocular fundus (indirect ophthalmoscope), and Fourier-domain optical coherence tomography (FD-OCT) whose speed was 27 000 A scan/s, area was 6.0 mm×6.0 mm, and the mode was 512×128. The diametres of macular hole and destroyed IS/OS, and the correlations with visual acuity were detected. Results The mean IogMAR was 0.99±0. 44 (ranged from 0. 15 to 2.00), the mean diameter of macular holes was (942.0± 348. 4)μm(ranged from 171 to 1491 μm), and the mean diameter of IS/OS disruption was (1870. 35±673.2) μm(range from 463 to 3176 μm). There was a significant correlation among the diameter of the macular hole, the diameter of the IS/OS disruption, and IogMAR in IMH (P= 0. 038, 0. 002, 0. 000). In eyes with closed macular hole after surgery, the IogMAR and the diameter of the IS/OS disruption had a significant decrease. Conclusion Using FD-OCT the photoreceptor changes can be visualized in vivo. The abnormality in the IS-OS boundary line appears to be involved for a much larger area beyond the macular hole itself, and persists there with small size even after the maeular hole closure surgery.     

老年患者下肢手术43例椎管内麻醉探讨

老年患者由于生理功能减退以及并发症较多,尤其呼吸、循环系统的病变。而呼吸循环疾病与椎管内麻醉相互影响较大。所以麻醉医生在选择麻醉方式时考虑,既要满足手术要求,更重要的是减少对患者生理的干扰,特别是高危老人。我院从2005-2008年对43例老年下肢手术患者,分别采用腰硬联合麻醉、连续腰麻进行麻醉,现就其综合麻醉效果分析报告如下。     

右佐匹克隆治疗41例失眠症患者的疗效观察

将84例失眠症患者随机均分为治疗组和对照组,连续服药3周.采用睡眠障碍量表评定药物的临床疗效,以症状量表评定其不良反应.两组临床疗效的比较无统计学差异.     

1例甲泼尼龙琥珀酸钠致精神兴奋、失眠的病例分析

甲泼尼龙为中效糖皮质激素,具有较强的抗炎、抗休克、抗毒素及免疫抑制作用,是临床广泛使用的药物之一。但与此同时,激素相关的药物不良反应越来越多,越来越受到关注,国外有报道称[1],精神异常是糖皮质激素较为常见的不良反应,有近20%的患者出现躁狂、抑郁、精神异常、兴奋、失眠等。国内张雪玲等[2]对甲泼尼龙琥珀酸钠不良反应文献分析发现,约有16.56%（23/151）的患者出现精神异常（其中失眠1例）。     

特发性黄斑裂孔的黄斑裂孔直径、被破坏的光感受器细胞内外节直径及其与视力的相关性研究

Objective To observe the diameters of macular hole and destroyed boundary line between inner and outer segment (IS/OS) of the photoreceptors and the correlation with the visual acuity in patients with idiopathic macular hole(IMH). Methods The clinical data of 39 eyes (37 patients) with IMH were retrospective analyzed. All the patients had undergone the examinations of visual acuity (Snellen chart), intra-acular pressure, ocular fundus (indirect ophthalmoscope), and Fourier-domain optical coherence tomography (FD-OCT) whose speed was 27 000 A scan/s, area was 6.0 mm×6.0 mm, and the mode was 512×128. The diametres of macular hole and destroyed IS/OS, and the correlations with visual acuity were detected. Results The mean IogMAR was 0.99±0. 44 (ranged from 0. 15 to 2.00), the mean diameter of macular holes was (942.0± 348. 4)μm(ranged from 171 to 1491 μm), and the mean diameter of IS/OS disruption was (1870. 35±673.2) μm(range from 463 to 3176 μm). There was a significant correlation among the diameter of the macular hole, the diameter of the IS/OS disruption, and IogMAR in IMH (P= 0. 038, 0. 002, 0. 000). In eyes with closed macular hole after surgery, the IogMAR and the diameter of the IS/OS disruption had a significant decrease. Conclusion Using FD-OCT the photoreceptor changes can be visualized in vivo. The abnormality in the IS-OS boundary line appears to be involved for a much larger area beyond the macular hole itself, and persists there with small size even after the maeular hole closure surgery.     

TrkA基因修饰、诱导神经干细胞分化为胆碱能神经元

目的研究外源性TrkaA基因修饰C17．2神经干细胞，对神经干细胞定向分化的影响。方法采用脂质体法将携带有TrkA基因的真核表达载体pcDNA3．1（＋）/TrkA转染C17．2神经干细胞，Western blot观察转染后基因表达情况；将正常生长的C17．2神经干细胞随机分成两组（A组和C组），将重组质粒转染阳性的C17．2神经干细胞随机分成两组（B组和D组），并用100ng／mg神经生长因子（NCF）分别作用于C组及D组，应用间接免疫荧光染色方法，观察各组细胞胆碱乙酰转移酶（CHAT）的表达。结果Western blot结果显示转染组TrkA蛋白表达明显高于非转染组，说明外源性TrkA基因导入靶细胞，并实现蛋白表达；间接免疫荧光染色显示，经NGF孵育的转染组细胞（D组）约有26％呈ChAT阳性，而非转染组（C组）约为9％，未经NGF孵育的A、B组未观察到CHAT阳性细胞。结论应用外源性TrkA基因修饰神经干细胞，造成TrkA基因过度表达，在NGF作用下，可以诱导更多的神经干细胞向胆碱能神经元分化。