异源性Th表位修饰的CTLA4-Ig—msBlys构建及融合蛋白表达

目的构建异源性Th表位修饰的CTLA4-Ig-msBlys的原核表达质粒,并在EcoliBL21中诱导融合蛋白表达,初步检测蛋白特性。方法采用PCR法从质粒pCMV-sBlys扩增sBlys片段,将与卵清蛋白（ovalbumin,OVA）Th表位重组后的msBlys连接CTLA4-Ig片段,克隆入pGEX-KG原核表达载体,用LB固体培养基抗生素筛选、酶切并经琼脂糖凝胶电泳鉴定;将质粒pGEX—KG-CTI。A4-Ig—msBlys转入E．coliBL21菌株中,实现插入基因的融合表达,用SDS-PAGE和Western-blot检测表达产物。结果pGEX—KG—GTLA4-Ig—msBlys构建正确且最终转人E．coliBL21,得到融合蛋白的表达;CTLA4-Ig-msBlys融合蛋白在E．coli中获得表达,表达产物的相对分子质量同预期值一致。结论成功构建原核表达质粒pGEX-KG-CTLA4-Ig-msBlys,并在E．coliBL21表达CTLA4-Ig-msBlys融合蛋白,为下一步探讨Blys在自身免疫性疾病患者的治疗作用奠定了基础。     

Building confidence into communication of bad news: The role of the patient advocate

The need for a patient advocate is greater than ever as medical errors continue to occur. News media quickly capture the egregious errors, but more errors are experienced by patients who suffer quietly. These patients know something wrong occurred during their hospitalization, but they choose to refrain from pursuing litigation against the providers. There also are thousands of individuals who never realize that a medical error occurred. In a patient‐ and family‐centered care environment, patient advocates can bridge these issues by participating on the healthcare team that is involved with the initial disclosure of the event and by providing a caring relationship to assure the patient's voice is heard and understood.     

Complications during pregnancy in women with epilepsy: population-based cohort study

Objective  To investigate whether women with epilepsy have an increased risk of complications during pregnancy and to explore the impact of antiepileptic drug (AED) use.
Design  Population-based cohort study.
Setting  Data from Medical Birth Registry of Norway based on all births in Norway 1999–2005.
Population  All births ( n  = 372 128) delivered in Norway, ensured through linkage with the National Population Registry run by Statistics Norway. All singleton births and the first child in multiple pregnancies were included, leaving 365 107 pregnancies for analyses.
Main outcome measures  Pre-eclampsia (mild and severe), gestational hypertension, eclampsia, vaginal bleeding (early and late) and preterm birth.
Results  We compared 2805 pregnancies in women with a current or past history of epilepsy (0.8%) and 362 302 pregnancies in women without a history of epilepsy. Women with epilepsy had an increased risk of mild pre-eclampsia, [odds ratio 1.3: 95% confidence interval (1.1–1.5)] and delivery before week 34 [1.2: (1.0–1.5)].
Antiepileptic drugs were used in 33.6% ( n  = 942) of the pregnant women with epilepsy. Compared to women without epilepsy, women with epilepsy and AED use had an increased risk of mild pre-eclampsia [1.8: (1.3–2.4)], gestational hypertension [1.5: (1.0–2.2)], vaginal bleeding late in pregnancy [1.9: (1.1–3.2)], and delivery before 34 weeks of gestation [1.5: (1.1–2.0)]. No significant increase in the risk of these complications was observed in women with epilepsy not using AED. These results remained unchanged after exclusion of multiple pregnancies.
Conclusion  Women with epilepsy have a low complication rate, but special attention should be paid to those using AED during pregnancy.     

A COMPARISON OF NSP-RETICULONS WITH CONVENTIONAL NEUROENDOCRINE MARKERS IN IMMUNOPHENOTYPING OF LUNG CANCERS

Neuroendocrine-specific protein (NSP)-reticulons are endoplasmic reticulum-associated protein complexes, which have been identified as markers for neuroendocrine differentiation. In this study, the expression of two members of the family of NSP-reticulons, NSP-A and NSP-C, have been investigated in different types of lung cancer and compared with the expression patterns of five conventional neuroendocrine markers, the neural cell adhesion molecule (NCAM), synaptophysin, chromogranin A, Leu-7, and neurofilament proteins. NSP-A and NSP-C antibodies were reactive with most carcinoid tumour and small cell lung carcinoma (SCLC) cases, while atypical carcinoid tumours showed a variable expression. In the total group of neuroendocrine tumours, a high concordance of expression was found between NSP-A and NSP-C, while their expression correlated well with NCAM and synaptophysin positivity. Chromogranin A, Leu-7, and neurofilament proteins were shown to be expressed to a limited extent in these neuroendocrine tumours. In a selected group of non-SCLCs known to exhibit neuroendocrine features, NSP-A expression was detected at much higher frequency than NSP-C. In virtually all NSP-A positive cases, this expression was associated with one or more of the other neuroendocine markers. NSP-A expression showed a stronger correlation with conventional neuroendocrine markers than NCAM. In detecting neuroendocrine differentiation in non-SCLC, NSP-A is more sensitive than synaptophysin, chromogranin A, Leu-7, and neurofilament proteins. It is concluded that NSP-reticulons are valuable markers in the diagnosis of neuroendocrine differentiation in non-SCLC and should be used in conjunction with NCAM. © 1997 John Wiley & Sons, Ltd.     

Toxoplasmosis of the stomach: a cause of antral narrowing

Radiographs of the stomach showed narrowing of the antrum, caused by toxoplasmosis, in a patient with acquired immunodeficiency syndrome (AIDS). A biopsy specimen demonstrated numerous cysts containing Toxoplasma gondii and many free trophozoites. A subsequent brain scan, obtained with computed tomography, showed multiple enhancing lesions throughout the cerebrum, cerebellum, and basal ganglia that were characteristic of toxoplasmosis. Radiographic abnormalities of the stomach are not uncommon in patients with AIDS. They are associated with infections such as cryptosporidiosis and cytomegalovirus and neoplasms such as Kaposi sarcoma and malignant lymphoma. To the authors' knowledge, this is the first reported case of toxoplasmosis involving the stomach.     

BRAIN GROWTH IN CHILDREN WITH KWASHIORKOR A Study using Head Circumference Measurement, Transillumination und Ultrasonic Echo Ventriculography

ABSTRACT. Engsner, G., Habte, D., Sjögren, 1. and Vahlquist, B. (Ethiopian Nutrition Institute and the Ethio-Swedish Pediatric Clinic, Addis Ababa, Ethiopia, and the Department of Paediatrics, University Hospital, Uppsala, Sweden). Brain growth in children with kwashiorkor. A study using head circumference measurement, transillumination and ultrasonic echo ventriculography. Acta Paediatr Scand, 63, 1974.—Brain growth was studied in 53 children with kwashiorkor and marasmic kwashiorkor by the simultaneous use of head circumference measurement, transillumination and ultrasonic echo ventriculography. The results of examinations on admission showed that the head circumference was reduced but probably slightly less so than in marasmic children. The transillumination findings were distinctly abnormal: bearing the age difference in mind, the abnormality was more pronounced than in the cases of marasmus. The lateral ventricle index, calculated from echo ventriculograms, was increased, which was not the case in marasmus. A systematic follow-up study for 6 months of 10 patients showed a gradual and complete normalization of the transillumination and echo ventriculographic findings. The interpretation of the results, taking into consideration also the possible sources of error, is discussed.     

Localization of motor-related proteins and associated complexes to active, but not inactive, centromeres

Multicentric chromosomes are often found in tumor cells and certain cell lines. How they are generated is not fully understood, though their stability suggests that they are non-functional during chromosome segregation. Growing evidence has implicated microtubule motor proteins in attachment of chromosomes to the mitotic spindle and in chromosome movement. To better understand the molecular basis for the inactivity of centromeres associated with secondary constrictions, we have tested these structures by immunofluorescence microscopy for the presence of motor complexes and associated proteins. We find strong immunoreactivity at the active, but not inactive, centromeres of prometaphase multicentric chromosomes using antibodies to the cytoplasmic dynein intermediate chains, three components of the dynactin complex (dynamitin, Arp1 and p150 Glued ), the kinesin-related proteins CENP-E and MCAK and the proposed structural and checkpoint proteins HZW10, CENP-F and Mad2p. These results offer new insight into the assembly and composition of both primary and secondary constrictions and provide a molecular basis for the apparent inactivity of the latter during chromosome segregation.      

Neonatal aortic arch thrombosis

An infant presented shortly after birth with signs suggestive of aortic coarctation. Echocardiography revealed an extensive aortic arch thrombus, not amenable to surgery. Thrombolytic agents reduced thrombus size, enabling survival, but failed to prevent neurological damage secondary to cerebral embolisation.