乙型肝炎病毒多聚酶末端蛋白重链可变区抗体体外抑制病毒的复制

目的用蛋白片段互补法(PCA)选择HBV多聚酶末端蛋白(TP)重链可变区(VH)抗体,研究特异性VH抗体体外抑制HBV的复制与分泌。方法以HBV多聚酶TP区为抗原,用PCA法进行特异性VH抗体筛选。特异性VH抗体基因定向亚克隆人真核表达载体pZeoSV2( ),构建pZeoSV2( )-VH重组质粒,用脂质体介导的转染技术,将其导入HepG 2.2.15细胞,观察特异性抗体的生物学活性。结果用PCA法从抗体库中选择出3个特异性抗体:VH1、VH2和VH3,其中与抗原亲和力最高的是VH1。转染pZeoSV2( )-VH1的HepG 2.2.15细胞比未转染pZeoSV2 ( )-VH1或只转染空载体pZeoSV2( )的HepG 2.2.15细胞病毒颗粒分泌明显减少,上清液内为2.978 7±0.276 1比5.150 4±0.276 1和5.295 1±0.241 0(P<0.05);细胞内为5.283 9±0.162 9比8.300 4±0.323 2和8.532 1±0.138 3(P<0.05)。结论用PCA法可从抗体库中选择出HBV多聚酶TP区特异性VH抗体,该抗体在体外可抑制HBV的复制与分泌。     

Signal‐Averaged P Wave Duration and the Dimensions of the Atria

Background: Delay of atrial electrical conduction measured as prolonged signal‐averaged P wave duration (SAPWD) could be due to atrial enlargement. Here, we aimed to compare different atrial size parameters obtained from echocardiography with the SAPWD measured with a signal‐averaged electrocardiogram (SAECG). Methods: In 74 patients scheduled for elective echocardiography, an SAECG was recorded directly after the echocardiogram. We measured the SAPWD and registered clinical characteristics. The correlation between the SAPWD and the left atrial diameter (LAD), left atrial volume (LAV), right atrial volume (RAV), and total atrial volume (TAV) was analyzed by linear regression analyses. The effect of concomitant risk factors on TAV and the SAPWD was examined. Results: Linear regression analysis showed that the correlation between the SAPWD and the LAD was significant (R²= 0.11, P = 0.03). However, LAV (R²= 0.15, P = 0.009), RAV (R²= 0.27, P = 0.0003), and TAV (R²= 0.37, P < 0.0001) were more strongly correlated to the SAPWD. The TAV and the SAPWD were not significantly associated with coexisting risk factors. Conclusions: The SAPWD is significantly correlated to the atrial size; most strongly to the TAV. The size of the right atrium, with the sinus node area, appears to affect the SAPWD.     

Costs of COPD in Sweden according to disease severity

OBJECTIVES: COPD is a common and disabling disease that entails high costs for society. The objectives of this study were to measure the societal costs of COPD in Sweden, and to examine the relationship between severity of illness and costs. METHODS: The costs of COPD were examined using a well-defined and representative cohort of subjects with mild, moderate, and severe COPD. Regular telephone interviews regarding resource utilization were made to a cohort of 212 subjects with COPD derived from studies of the general population in Northern Sweden. RESULTS: The annual per capita cost for COPD in Swedish crowns (SEK) was estimated at SEK 13,418 (1,284 US dollars (USD); 1,448 euros (EUR). The direct and indirect costs were SEK 5,592 (42%) and SEK 7,828 (58%), respectively. A highly significant relationship was found between severity of disease and costs. Costs for severe disease were 3 times as high as costs for moderate disease and > 10 times as high as for mild disease. Large individual variations in the level of costs were found. CONCLUSION: Assuming that the prevalence and treatment patterns are representative of Sweden as a whole, the total costs of COPD to society in 1999 were estimated at SEK 9.1 billion (USD 871 million; EUR 982 million). Subjects with mild disease (83%) accounted for 29%, while subjects with moderate disease (13%) accounted for 41% of the total costs. The subjects with severe disease (4%) accounted for the remainder (30%). Prevention, early diagnosis, and postponement of disease progression should have large monetary and policy implications.     

MR淋巴造影显影兔VX2乳腺癌模型内乳前哨淋巴结

目的 探讨MR淋巴造影（MR-LG）显影兔VX2乳腺癌内乳前哨淋巴结（SLN）的可行性。方法 将75只新西兰大白兔分别建立兔VX2乳腺癌（肿瘤组）及炎性（炎症组）实验动物模型,并对其行MR-LG检查,检查后进行淋巴结清扫术。记录内乳SLN及淋巴管的显示情况,分析影响其显像的因素。结果 实验兔建模成功率为97.33%（73/75）;MR-LG对内乳SLN及淋巴管的显示率分别为15.94%（11/69）和75.36%（52/69）,其在肿瘤组与炎症组差异均无统计学意义（P均>0.05）。肿瘤组内乳SLN显示与未显示实验兔间体质量,肿瘤生长时间,肿瘤长径,腋窝SLN数目、大小及阳性数目,内乳淋巴管显影情况差异均无统计学意义（P均>0.05）;内乳淋巴管显示与未显示实验兔间肿瘤大小及腋窝SLN数目差异有统计学意义（P均<0.05）。MR-LG检出内乳SLN的准确率、敏感度、特异度、假阴性率及假阳性率分别为76.81%（53/69）、39.13%（9/23）、95.65%（44/46）、60.86%（14/23）和4.35%（2/46）。结论 MR-LG可有效显像兔VX2乳腺癌模型内乳SLN及淋巴管。     

肝脏血管平滑肌脂肪瘤的CT及MRI表现

目的 分析肝脏血管平滑肌脂肪瘤的CT及MRI征象特点。方法 回顾性分析经手术病理证实的7例肝脏血管平滑肌脂肪瘤患者的CT和/或MRI表现,并与病理结果进行对照。结果 CT及MRI平扫共8个病灶,CT显示6个病灶中,5个呈稍低密度,1个病灶大部分呈低密度,其内可见小片状等密度。MR显示的4个病灶中,2个脂肪抑制T2WI呈低信号,T1WI呈较均匀低信号,1病灶未显示脂肪信号特点,病灶内未见囊变、血肿、坏死等信号。增强扫描动脉期7个病灶表现为明显不均匀强化,1个病灶呈均匀强化;3个病灶呈"快进快出"强化改变,5个病灶呈持续强化改变;3个病灶内部见粗大畸形血管,5个病灶可见引流静脉。结论 肝脏血管平滑肌脂肪瘤的影像学表现有一定特征性,影像学检查有助于诊断和鉴别诊断。     

踝臂指数和颈动脉斑块积分预测冠脉病变的价值

目的 探讨踝臂指数(ABI)和颈动脉斑块积分(Crouse积分)预测冠状动脉病变的价值.方法 选择2013年12月～2014年5月在解放军总医院心内科住院并首次行冠状动脉造影的194例患者,根据冠状动脉造影结果按病变狭窄程度(Gensini积分)分为严重病变组(64例)和非严重病变组(130例),分析ABI及颈动脉Crouse积分与冠脉病变的关系.结果 严重病变组和非严重病变组的ABI和颈动脉Crouse积分差异均有统计学意义(P＜ 0.05或P＜ 0.01);相关性分析结果,ABI与冠脉病变情况呈负相关(r=-0.518,P＜0.01),颈动脉Crouse积分与冠脉病变情况呈正相关(r=0.616,P＜0.01).ABI诊断严重冠脉病变的受试者工作特征曲线(ROC曲线)下面积为0.278,以ABI≤0.9为截断值,其预测冠脉严重病变的敏感性为23.4％,特异性为95.4％;颈动脉Crouse积分诊断严重冠脉病变的ROC曲线下面积为0.627,以颈动脉Crouse积分≥1.9为截断值,其预测冠脉严重病变的敏感性为70.3％,特异性为41.5％.结论 ABI和颈动脉Crouse积分与冠状动脉的病变程度密切相关,对于预测严重病变的冠状动脉,二者具有很高的应用价值.     

天津蓟县山区药用植物根际及自然土壤无机元素含量测定

[目的] 通过对天津蓟县山区8个代表区域的土壤以及常用重点药材根际土壤中无机元素[铁、锰、铜、锌、钾、钙、镁、铅、镉(Fe、Mn、Cu、Zn、K、Ca、Mg、Pb、Cd)]的含量测定,分析与评价土壤背景质量,为天津野生中药扩大种植奠定基础。[方法] 电热板湿法消解,火焰原子吸收光谱法测定Fe、Mn、Cu、Zn、K、Ca、Mg的含量,石墨炉原子吸收光谱法测定Pb、Cd的含量。[结果] 8个区域自然土壤样品中大量元素Fe、K、Ca、Mg的含量较多,Cu、Zn、Pb的含量水平相当。重金属元素Cu、Zn、Pb的含量均未超出标准,1个区域中Cd的含量稍有超标,但尚未对生态环境造成影响。药用植物根际土壤无机元素水平与蓟县山区自然土壤相当。[结论] 天津蓟县土壤无机元素含量适中,均达到自然背景水平,土壤整体质量较优。     

运动神经元病的临床及神经电生理分析

目的：探讨神经电生理分析对运动神经元病(MND)诊断的临床价值。方法应用肌电图检测对23例MND患者神经电生理数据资料进行研究,并与对照组健康人40例进行比较分析。结果该院23例患者中,静息时出现纤颤电位19例(82.61%),正锐波17例(73.91%),肌肉轻收缩时运动电位的时限延长18例(78.26%),多相波波幅增高11例(47.83%),大力收缩时的电压增高22例(95.65%)。四肢肌肉的异常情况为71.33%,拇短展肌的异常情况为71.43%,胸锁乳突肌的异常情况为92.11%,MND组与对照组四肢MEP中枢运动传导时间,差异有统计学意义(P<0.05),MND组MEP值显著高于对照组。结论神经电生理技术的应用和推广,对诊断运动神经元病(MND)具有重要的临床价值,其中肌电图检测是诊断MND的重要手段。     

停用免疫抑制药对肾移植肺部感染患者人肾长期存活的影响

目的：探讨停用免疫抑制药对肾移植受体及移植肾长期生存的影响。方法：选取2005年12月至2014年8月 在中南大学湘雅医院器官移植中心接受肾移植手术后出现肺部感染的患者共104例,其中50例患者在肺部感染治疗期 间停用免疫抑制药,作为停药组,余54例作为对照组。比较两组间受者以及肾5年累积生存率及感染期间生化指标的 变化情况。结果：停药组的受体5年累积生存率明显低于对照组[(69.8±7.0)%对比(94.2±3.2)%,P=0.001],但移植肾生 存率两组间差异无统计学意义[(81.7±6.6)%对比(90.9±4.3)%,P=0.113]。肺部感染康复后,停药组受体的长期生存率与 对照组相比差异无统计学意义(P=0.979)。结论：肺部感染严重危害肾移植受体的生存;停用免疫抑制药对于肾移植 术后严重肺部感染患者而言并不影响患者和移植肾的长期存活。