红细胞免疫印迹法检测抗SSA抗体

本文以人红细胞（ＲＢＣ）胞浆提取物为ＳＳＡ抗原来源，探讨了免疫印迹法（ＩＢＴ）检测抗ＳＳＡ抗体的可能性及特点。结果显示，在ＲＢＣ－ＩＢＴ中有两条抗ＳＳＡ（干燥综合征抗原）抗体特异性酶染色带，分子量分别为５２ＫＤ和６０ＫＤ。非特异性染色带极少或无。也未见其它几种常一自身抗体（抗ＳＭ、ＲＮＰ、ＳＳＢ等）的显色带。这说明ＲＢＣ－ＩＢＴ对抗ＳＳＡ抗体的检测有高度的专一性和特异性，值得推荐。文中还就ＲＢＣ－ＩＢＴ法中主要的实验影响因素进行了探讨。     

Isolation and characterization of an acquired antithrombin antibody

A 68-year-old man, following mitral valve replacement, presented with a low-grade chronic consumptive coagulopathy. Laboratory analysis showed mild fibrinolysis, minimal effect of coumadin therapy, and a prolonged thrombin time (greater than 150 seconds using bovine IIa). When purified human IIa was used the thrombin time normalized to within 17 seconds of controls, suggesting a possible inhibitor of bovine IIa. An anti-IIa antibody was isolated by protein A-Sepharose (Sigma, St Louis, MO) chromatography followed by affinity chromatography using a bovine IIa-Sepharose column. The effects of this purified anti-IIa antibody on both bovine and human IIa procoagulant and anticoagulant functions were studied. The isolated immunoglobulin G (IgG) was observed to inhibit bovine IIa in all assays tested. This IgG was also able to slightly prolong fibrinogen clotting by human IIa. Using an enzyme-linked immunosorbent assay it was observed that the IgG bound to bovine IIa, bovine II, human IIa, but not to human II. Further, binding was detectable at approximately 50-fold lower concentrations to bovine IIa (1 nmol/L IgG concentration) than to human IIa (50 nmol/L IgG concentration). The effect of the antibody on the reaction between IIa and AT III/heparin was investigated. Human IIa was found to be protected from AT III/heparin neutralization in the presence of this antibody. These results suggest that this patient developed an antibody that strongly binds to and inhibits the bovine IIa in all assays tested. However, the antibody only significantly affects human IIa neutralization by AT III/heparin, and has little effect on the human IIa procoagulant activity. These data suggest that the decreased effect of AT III/heparin on this patient's IIa may have been a contributing factor in his coagulopathy. The exact cause of this antibody development is unclear, but the role of bovine topical thrombin used during cardiac valve replacement surgery is suspect.     

Cholesterol crystal embolization: an atherosclerotic disease with frequent and varied cutaneous manifestations

In this paper the basic pathogenesis of cholesterol crystal embolization (CCE) is described, its clinical characteristics are presented and diagnosis and therapy are discussed. The main focus will be on the cutaneous manifestations; however, considering that CCE is a systemic illness, findings in other organs will also be highlighted, particularly the commonly involved renal and gastrointestinal systems.     

仰卧和俯卧位心脏对煤尘肺患者肺组织体积与功能的影响

目的:观察仰卧位和俯卧位心脏对煤尘肺患者肺组织体积和肺功能的影响,为临床应用俯卧位治疗成人呼吸窘迫综合征等肺部疾病提供依据。方法:2006-08/2007-01河南鹤煤集团公司总医院放射科对10例煤尘肺患者行仰、俯卧位高分辨螺旋CT扫描,分别测量位于心脏下方肺组织的体积,测量仰、俯卧位状态下肺功能,用配对t检验进行统计学分析。结果:10例患者均进入结果分析。①CT扫描心脏压迫下的肺组织体积:俯卧位时均小于仰卧位[左肺:(7.74±9.55),(242.60±72.11)mm3;右肺:(12.21±11.41),(156.49±76.54)mm3,P均<0.01]。②肺功能测量结果:仰卧位时,患者的用力肺活量、第1秒用力呼气容积、第1秒用力呼气容积预计值百分率、最大呼气量,分别为(2.14±0.58)L、(1.62±0.79)L、(89.80±29.26)、(3.42±1.98)L/s;俯卧位时,患者的用力肺活量、第1秒用力呼气容积、第1秒用力呼气容积预计值百分率、最大呼气量,分别为(2.36±20.79)L、(1.80±0.77)L、(100.10±22.46)、(4.30±2.37)L/s。俯卧位时肺功能明显优于仰卧位(P<0.05)。结论:俯卧位时位于心脏下方的肺组织明显减少,可显著改善人体的肺换气功能。     

术前肌电图和脑干听觉诱发电位与面肌痉挛微血管减压术后迟发性面瘫发生的关系(英文)

Background Delayed facial palsy ( DFP) after microvascular decompression ( MVD) in patients with hemifacial spasm ( HFS) is not uncommon,but the cause remains unknown. Objectives To assess whether intraoperative electromyography ( EMG) and brainstem auditory evoked potential ( BAEP) can predict DFP after MVD. Methods Between September 2009 and February 2011 we examined 86 patients,9 of whom ( 10. 4% ) developed DFP after MVD on the same side. All patients underwent MVD and were followed - up for a median period of 13 months ( range 6-22) . We retrospectively examined intraoperative facial EMG and BAEP findings using our MVD patients’ registry. We excluded secondary HFS and immediate postoperative facial palsy after MVD in this study. We assessed the prevalence and clinical characteristics of DFP and compared EMG and BAEP findings between DFP and non-DFP groups. Results: All pa- tients recovered completely,with a mean time to recovery of 37. 8 days ( range 22-57) . There were no significant differences between DFP and non - DFP patients in terms of the amplitude and latency of intraoperative EMG and BAEP. Conclusion The usefulness of intraoperative facial EMG and BAEP is limited and cannot predict DFP after MVD for HFS. We speculate that DFP after MVD is not associated with permanent nerve damage according to the EMG findings.