Compromised kidney graft rejection response in Vervet monkeys after withdrawal of immunosuppressants tacrolimus and sirolimus

BACKGROUND: In nonprimates, organ allografts are often not rejected after withdrawal of immunosuppression. In this study, we examined whether such a phenomenon also occurs in primates. METHODS: Vervet monkeys were transplanted with renal allografts and treated for 60 days with tacrolimus, or tacrolimus plus sirolimus. The drugs were totally withdrawn on day 61. The survival of the monkeys was monitored, and their response to donor- or third party-derived alloantigens was examined in vivo and in vitro. RESULTS: The majority (80-100%) of the grafts survived for at least additional 30 days with no signs of acute rejection. The compromised rejection is donor-specific, because recipient monkeys failed to reject a donor-derived skin graft, but a third-party skin graft was rejected. In vitro mixed lymphocyte reaction and interleukin-2 production in the mixed lymphocyte reaction between the recipients and their donors or between the recipients and a third party had no discernable patterns, and thus did not reflect the in vivo status of the immune system. Although the recipients could not reject the graft acutely after drug withdrawal, the kidney grafts and the donor-derived skin grafts had pathological findings of chronic rejection. CONCLUSIONS: The rejection response of the monkeys to an established graft after withdrawal of immunosuppression is compromised. The compromised rejection is specific and is not due to a permanent alteration of the immune system by the initial drug treatment. The allografts are not inert but have low levels of interaction with the recipient immune system.     

美国间谍小说的起源、发展与现状

美国间谍小说的起源可以追溯到詹姆斯·库珀的《间谍》 ,但发展缓慢。其原因在于美国人崇尚明斗的西部硬汉精神 ,而美国政府历来对间谍工作也未予重视 ,直到20世纪30年代美国的间谍小说还不很成熟 ,40年代才出现了较有影响的间谍小说女作家海伦·麦克英纳斯。至70年代却大有后来居上之势 ,并在题材上形成业余间谍、硬派间谍和反间谍三足鼎立的格局     

经IFN-γ诱导的人IL-2基因修饰的人原代成纤维细胞体外细胞因子表达及某些免疫学特性的研究

成纤维细胞作为基因治疗载体细胞是肿瘤基因治疗的一项重要途径,但以往的研究仅仅将成纤维细胞作为载体而忽略了其自身的免疫学功能的发挥。本文采用本室构建的逆转录病毒载体将IL-2基因转入人原代成纤维细胞,再用IFN-7诱导。结果表明,IFN-7诱导后,IL-2基因修饰的成纤维细胞MHC-Ⅰ、MHC-Ⅱ、CD40等分子表达具有一定程度的增高,并且表达IL-2、IL-1、IL-6等,由于这些免疫分子及细胞因子的表达与肿瘤抗原的递呈、效应细胞的激活密切相关,提示这种经IFN-7诱导后的IL-2基因修饰的成纤维细胞可能作为抗原递呈细胞而参与肿瘤抗原的递呈及效应细胞的激活。     

鼻窦黏液囊肿造袋术的组织病理学基础

目的探讨鼻窦黏液囊肿造袋术的组织病理学基础，为鼻窦黏液囊肿造袋术提供理论依据，并观察造袋术的临床疗效。方法21例鼻窦黏液囊肿病人均行经鼻内镜囊肿造袋术，手术后标本作常规病理检查和电镜超微结构检查。随访6～12个月。结果常规病理检查21例均为黏液囊肿，电镜检查除1例为立方状上皮外，其余内衬上皮为假复层纤毛柱状上皮。上皮纤毛发达，线粒体丰富，内质网、高尔基氏体发达，黏液性腺细胞和杯状细胞浆中有大量黏液分泌颗粒，基底膜下有大量淋巴细胞、中性粒细胞及少量嗜酸性粒细胞浸润。术后无1例复发。结论囊肿造袋术是治疗鼻窦黏液囊肿的有效术式。鼻窦黏液囊肿内衬上皮与鼻腔大部分黏膜一样均为假复层纤毛柱状上皮，纤毛发达，术后纤毛功能可以恢复，这是鼻窦黏液囊肿造袋术的组织病理学基础。     

对护理人员"处理错误方式"的调查和思考

提高护理人员防范风险的意识和能力,树立时刻把病人的安全摆在第一位的服务理念,是降低护理差错发生率,提高整体护理质量的关键所在。为此,作者于2005年6月对某三级乙等医院的233名临床护士进行了有关护理人员“处理错误方式”的调查。结果表明,护理人员防范风险的意识和能力有待进一步加强;仍有部分护士在处理“错误”时没有将病人的利益摆在首位,故转变护理人员服务理念,强调以改善系统和程序作为减少风险之策略,建立一种非惩罚性的病人安全的文化环境已迫在眉睫。     

米非司酮在子宫黏膜下肌瘤宫腔镜术前的应用价值

目的：研究米非司酮（Ru486）在子宫黏膜下肌瘤宫腔镜术前的应用价值。方法：67例患者分两组。Ⅰ组31例服用Ru4863个月后实施经宫颈子宫肌瘤切除术（TCRM）．Ⅱ组36例直接行TCRM治疗。观察Ⅰ组Ru486治疗后不同时间肌瘤大小及血红蛋白变化；两组手术时间及术中出血量比较；子宫肌瘤大小与手术时间、术中出血量的相关性。结果：Ⅰ组治疗后1个月肌瘤较治疗前无明显缩小．治疗后两个月及3个月与治疗前比较肌瘤明显缩小，差异显著，P〈0．01；治疗后血红蛋白增高明显．P〈0．01；两组间手术时间、术中出血量比较差异显著．P〈0．05；子宫肌瘤大小与手术时间覆术中出血量均呈正相关。结论：Ru486作为TCRM术前的药物治疗可有效地缩小子宫肌瘤，相时扩大手术适应证，减少术中出血量，缩短手术时间；Ru486导致药物性闭经，有利于术前纠正岔血。     

固相萃取结合高效液相色谱法测定人血浆中多索茶碱浓度

目的:建立固相萃取结合高效液相色谱法测定人血浆中的多索茶碱浓度,为多索茶碱的体内血药浓度监测和人体药物动力学研究提供测定方法.方法:血样经固相萃取法处理,276 nm紫外检测法测定,内标法定量.结果:平均回收率为82.5%,回归方程为Y=7.68×103X-2.00×103,r=0.999 3.日内与日间RSD均低于10%.结论:该法重复性好、干扰小,是一种较为理想的测量方法.     

Epidemiologic Correlation and Drug Resistance Analysis of Pathogenic Bacteria in Different Open Limb Injury External Conditions

ObjectiveTo study the epidemiological correlation and drug resistance of external factors of infection caused by open injury of limbs to pathogens.MethodsThis experiment is a retrospective study. We took the geographical location and climate of Nanchang, Jiangxi Province, China as the background, analyzed 2017 strains of pathogens from 1589 patients with limb trauma infection in a University Affiliated Hospital from 2012 to 2017. Patients were divided into three groups according to the type of incision: I, In‐hospital infection of clean limb incision, II, In‐hospital infection with open injury, III, Community infection with open injury of the limb. Groups II and Groups III were divided into six subgroups according to the causes of trauma, including: accidents from non‐motor vehicles, machinery, cutting/piercing, pedestrian injuries, struck by/against, pedal cycles, and other injuries. We found eight common pathogens of orthopedic infection, which were mainly divided into Gram‐positive bacteria (G+, mainly including Staphylococcus) and Gram‐negative bacteria (G‐, mainly Enterobacteriaceae). The relationship between main pathogens and damage mechanism, apparent temperature and relative humidity was discussed in this study. SPSS v22.0 was used for statistical analysis of the data. Friedman''s two‐way ANOVA was used to analyze the difference between the injury mechanism and incidence of pathogenic bacteria. Linear regression was used to determine the trend between the incidence of major pathogens and seasonal temperature and humidity. The level of significance was set as P < 0.05.ResultsThere was no significant difference in the distribution of pathogens between Groups II and Groups III (P>0.05). The drug resistance of Groups III was significantly higher than that of Groups II and Groups I. G+ bacteria were resistant to cephalosporin, ceftriaxone and other cephalosporins and erythromycin and other macrolides. They were sensitive to vancomycin and linezolid. G‐ were resistant to the first‐ and the second‐generation cephalosporins, including cefotetan and cefazolin, and ampicillin and other penicillins, while they were sensitive to third‐generation cephalosporins, such as ceftazidime, as well as to levofloxacin and other quinolones, meropenem, and other beta‐lactamases. The correlation between the injury mechanism and infection of pathogenic bacteria was not significant. The monthly average apparent temperature and relative humidity were correlated with the infection rate of pathogenic bacteria.ConclusionIn open injury of extremities, apparent temperature and relative humidity is an important risk factor for infection by pathogenic bacteria and the drug resistance of pathogenic bacteria in out‐of‐hospital infection was lower than that of hospital infection.     

The novel infra‐pectineal buttress plates used for internal fixation of elderly quadrilateral surface involved acetabular fractures

ObjectivesIn geriatric acetabular fractures, the quadrilateral surface (QLS) was frequently involved in acetabular fracture patterns and accompanied by medial displacement. It was important to buttress the medial displaced QLS and reconstruct the congruity of the affected acetabulum. To evaluate the clinical effectiveness of the novel infra‐pectineal quadrilateral surface buttress plates for the treatment of geriatric acetabular fractures.MethodsTwenty‐three geriatric patients who were treated for acetabular fractures involving QLS with the novel infra‐pectineal buttress plates (NIBP) through a single supra‐ilioinguinal approach between January 2015 and June 2019 were retrospectively analyzed; all patients received at least 1 year''s follow‐up. All patients were aged ≥60 years old and including 18 males and five females. Radiologic and clinical outcomes of patients involved in the study were collated and analyzed according to the Matta scoring system and the Merle D''Aubigné–Postel scoring system. The functional recovery scoring was compared using q‐test.ResultsAll 23 consecutive patients had relatively satisfactory clinical treatment effectiveness. Average ages, length of incision, operation time, and intraoperative blood loss were 69.8 ± 6.1 years, 12.1 ± 2.6 cm, 166.5 ± 43.5 min, and 500 (500,700) ml, respectively. According to the Matta scoring system, 14 cases of reduction were graded as excellent, five as good, and four as fair. At the last follow‐up, the clinical outcome evaluation was excellent in 13 cases, good in seven cases, and poor in three cases with the use of the Merle D''Aubigné–Postel scoring system. The difference of modified Merle D''Aubigne‐Postel score at 3 months, 6 months and last follow up was statistically significant (F = 21.56, p < 0.05). Postoperative lateral femoral cutaneous nerve injury occurred in three patients and heterotopic ossification occurred in one patient.ConclusionsFor the treatment of geriatric acetabular fractures, the NIBP could provide stable and effective fixation to the QLS involved acetabular fractures, and related satisfactory clinical results with few complications were noted.