Difference of T cell and B cell activation in two homologous proteins with similar antigenicity but great distinct immunogenicity

The candidate particulate hepatitis E vaccine, HEV 239, has been shown to be an efficacious vaccine in primates, and clinical study to date shows it to be safe and immunogenic for humans. The antigenicity of HEV 239 is virtually identical to its N-terminal 26 amino acids truncated protein, E2, which is not particulate but soluble. However, HEV 239 is over 200 times more immunogenic than E2. In present study, several events underlying this dramatic immunogenicity difference have been addressed. (1) HEV 239 can efficiently evoke a vigorous and predominant T cell response while E2 cannot induce detectable T cell response; (2) the dominant T cell epitopes in HEV 239 are identified, and both are also contained integrally in E2; (3) priming mice with Th epitope peptide can partially rescue the weak immunogenicity of E2 in alum adjuvant and (4) HEV 239 but not E2 can induce significant antibody response in athymic mice, which indicates that HEV 239 can directly activate B cell more efficiently. These results contribute to a better understanding of the mechanisms involved in the significant high immunogenicity of particulate antigen and may provide knowledge for the rational design and development of future vaccines.     

福建口岸出入境人员心理健康状况与人格特征综合分析简

目的了解福建口岸出入境人员心理健康状况与人格特征。方法应用《出入境人员心理精神卫生测评系统》可操作性软件平台中的症状自评量表（SCL-90）和简化版艾森克个性问卷（EPQ-48）两量表对出入境人员进行测评。结果SCL-90量表9项因子得分结果显示：6项因子均分〉全国常模;除了人际关系因子外,其他因子与常模标准的差异均具有统计学意义（P〈0.05）;在EPQ-48量表中,精神质P和性格内外向E两项分值男、女间差异有统计学意义（P〈0.01）;同时,交通员工和劳务人员性格内外向E分值低于常模,则性格偏内向;出入境人员SCL-90量表各因子分与EPQ-48量表中精神质P、神经质N呈显著正相关,与性格内外向E、掩饰性L呈显著的负相关。结论出入境人员心理健康状况不容乐观,要加强心理健康保健咨询,使出入境人员保持身心健康以适应国际旅行环境。     

Ciliated muconodular papillary tumor of the lung: A newly defined peripheral pulmonary tumor with conspicuous mucin pool mimicking colloid adenocarcinoma: A case report and review of literature

We report the case of a 68‐year‐old man with a newly defined rare entity of a peripheral pulmonary tumor, consisting of a nodular papillary lesion with papillary structures containing ciliated columnar and goblet cells, as well as floating tumor cells in the mucin pool. The conspicuous mucin pool was observed to be mimicking colloid adenocarcinoma in a low‐power view, particularly in a frozen section slide. We originally reported it as an adenocarcinoma during intraoperative consultation. Immunohistochemically, the tumor cells exhibited a similar immunophenotype to pulmonary adenocarcinoma, except for the presence of focal ciliated and basaloid cells, which we found using CK5/6 and P63 immunostaining. No KRAS or EGFR mutation was found. We revised the diagnosis to that of a ciliated muconodular papillary tumor (CMPT). Four years after a wedge resection, the patient remained free of tumors. Although the malignant potential of CMPT cannot be ignored, a wedge resection with a safe margin might be a treatment option for CMPT patients.     

A pulmonary source of infection in patients with sepsis-associated acute kidney injury leads to a worse outcome and poor recovery of kidney function

BACKGROUND:Hospital mortality rates are higher among patients with sepsis-associated acute kidney injury(SA-AKI)than among patients with sepsis.However,the pathogenesis underlying SA-AKI remains unclear.We hypothesized that the source of infection affects development of SA-AKI.We aim to explore the relationship between the anatomical source of infection and outcome in patients with SA-AKI.METHODS:Between January 2013 and January 2018,113 patients with SA-AKI admitted to our Emergency Center were identifi ed and divided into two groups:those with pulmonary infections and those with other sources of infection.For each patient,we collected data from admission until either discharge or death.We also recorded the clinical outcome after 90 days for the discharged patients.RESULTS:The most common source of infection was the lung(52/113 cases,46%),followed by gastrointestinal(GI)(25/113 cases,22.1%)and urinary(22/113,19.5%)sources.Our analysis showed that patients with SA-AKI had a significantly worse outcome(30/52 cases,P<0.001)and poorer kidney recovery(P=0.015)with pulmonary sources of infection than those infected by another source.Data also showed that patients not infected by a pulmonary source more likely experienced shock(28/61 cases,P=0.037).CONCLUSION:This study demonstrated that the source of infection infl uenced the outcome of SA-AKI patients in an independent manner.Lung injury may influence renal function in an asyet undetermined manner as the recovery of kidney function was poorer in SA-AKI patients with a pulmonary source of infection.     

上颌窦提升术同期或延期牙种植的早期临床评价

目的对上颌窦提升术同期或延期牙种植进行早期临床评价。方法37例患者38侧上颌窦进行上颌窦提升同期或延期牙种植,种植体上部结构修复完成后6～36个月定期复查。结果观察期内同期牙种植27侧上颌窦共59颗种植体,松动、脱落1颗,成功率为98.3%。延期牙种植上颌窦11侧共23颗种植体,全部成功。除1颗失败种植体外,其余同期或延期植入的种植体均无松动或脱落,经X线片检查显示植入骨材料改建良好,种植体周围未见明显骨吸收阴影。结论上颌窦提升术同期或延期牙种植的早期临床效果无明显差异。     

结缔组织生长因子诱导大鼠心肌细胞肥大的作用及其与细胞外信号调节激酶1/2的关系

目的 观察结缔组织生长因子(CTGF)诱导大鼠心肌细胞肥大的作用,探讨其作用与细胞外信号调节激酶1/2(ERK1/2)的关系.方法 以培养的新生Sprague-Dawley(SD)大鼠心肌细胞为实验模型,用图象分析法测定心肌细胞表面积,用[3H]-亮氨酸掺入法测定心肌细胞蛋白合成速率,用考马斯亮兰法测定心肌细胞蛋白含量,用蛋白免疫印迹法(Western blot)测定心肌细胞总ERK1/2(t-ERK1/2)与磷酸化ERK1/2(p-ERK1/2)的蛋白表达水平.结果 (1)随着CTGF浓度的增加,心肌细胞表面积呈剂量依赖性增加,其中10、25、50、100 μg/L的CTGF组心肌细胞表面积分别为(929.9±132.2)、(1411.3±129.2)、(1732.0±153.0)、(2040.6±205.4)μm2,均明显高于对照组心肌细胞表面积[(606.3±72.7)μm2,P均＜0.01];100 μmol/L的PD98059明显减少CTGF诱导的心肌肥大(P＜0.01).(2)随着CTGF浓度的增加,心肌细胞蛋白合成速率与蛋白含量呈剂量依赖性增加,CTGF组心肌细胞[3H]-亮氨酸掺入率明显高于对照组(P＜0.01);ERK1/2抑制剂PD98059明显减少CTGF诱导的心肌细胞[3H]-亮氨酸掺入率及蛋白含量(P＜0.01).(3)随着CTGF浓度的增加,心肌细胞p-ERK1/2表达呈剂量依赖性增高,5、10、25、50、100 μg/L的CTGF组的心肌细胞p-ERK1/2表达明显高于对照组,而t-ERK1/2在各组表达差异不明显.结论 CTGF可诱导心肌细胞肥大,该作用可能是通过ERK1/2的磷酸化来实现的.     

快速滴定法加量美托洛尔治疗急性心肌梗死的疗效

目的：观察常规加量法及快速滴定法加量美托洛尔治疗急性心肌梗死（AMI）的疗效。方法：将发病24h 内诊断为 AMI 且无美托洛尔禁忌证的住院患者60例随机分成两组,在常规治疗的基础上采用不同方法给予美托洛尔,常规加量组采用7d 加量法,快速滴定组采用3d 加量法,两组均在达目标剂量190mg/d 后,以此量维持之,观察两组的疗效。结果：①在随访期间,两组均无患者再发心肌梗死、心衰而再次住院治疗,没有出现猝死等现象;②3月后门诊行心脏超声检查,与常规加量组比较,快速滴定组左室舒张末内径[LVEDd,（55.00±7.56） mm 比（50.00±5.81） mm]显著降低（P ＜0.01）,左室射血分数[LVEF,（49.13±10.18）％比（57.84±10.34）％]显著升高（P ＜0.01）。结论：快速滴定法可以更早达到患者美托洛尔的目标量,更早抑制肾素释放,阻断肾素-血管紧张素系统,改善心肌重构和心功能。     

上皮细胞钙黏附素在鼻咽癌中的表达

目的 探讨上皮细胞钙黏附素（E—CD）在鼻咽癌中的表达关系。方法 采用免疫组织化学方法对56例鼻咽癌活检病理标本的E—CD表达进行研究。结果 56例鼻咽癌中E—CD阳性表达15例,弱阳性表达16例,阴性表达25例：而20例正常鼻咽黏膜E—CD阳性表达18例,弱阳性表达2倒（P＜0．01）。中分化鳞状细胞癌阳性表达3／4,低分化鳞状细胞癌阳性表达12／47,未分化细胞癌均为阴性表达（P＜0．025）。结论鼻咽癌细胞E—CD表达改变与鼻咽癌细胞分化程度有关,失去E—CD阳性表达的肿瘤细胞,细胞问的黏附能力减低或丧失,是鼻咽癌易发生颈淋巴结转移的因素之一．