琼脂凝胶球载体吸附剂清除免疫球蛋白E的性能特征

目的:观察以琼脂凝胶球为载体的吸附剂对血浆中多余免疫球蛋白E的清除效果。方法:实验于2002-04/2004-09在南开大学完成。①高免疫球蛋白E患者血清由天津市长征医院免疫室提供。琼脂粉(北京益利精细化学品有限公司,批号20000810)。环氧氯丙烷(天津津达精细化学品厂,批号20010502)。②以20～40目的琼脂凝胶微球为载体,经环氧氯丙烷活化,键联配基色氨酸及手臂制得免疫球蛋白E免疫吸附剂,进行体外静态吸附测试。吸附结果采用酶标法免疫球蛋白E试剂盒检测。③连接手臂的琼脂-色氨酸吸附剂进行血液相容性测试,检测吸附前后血清中免疫球蛋白G、免疫球蛋白M、免疫球蛋白A以及C3,C4含量的变化。全自动血球计数分析仪检测白细胞、红细胞、血小板数目的变化。结果:①不同配基对吸附剂吸附效果的影响:琼脂凝胶载体连接色氨酸配基后对免疫球蛋白E的吸附性能最好,对其吸附主要是一种非极性作用力。②不同缓冲体系及pH值对吸附效果的影响:pH=5～6的范围内色氨酸的饱和溶解度最低,键联量也很低。pH=6～8的磷酸盐缓冲体系,磷酸根离子参与环氧基的开环反应,降低载体的活化效率,同时可键联的活性氨基酸配基的量也相应减少。Tris-HCl和碳酸钠-碳酸氢钠缓冲体系,对色氨酸的饱和溶解度也不是很高。相对来说,pH=7～8的硼酸-硼砂缓冲体系效果较好。③不同手臂对吸附剂吸附效果的影响:与连接前比较,连接丁二酸酐、邻苯二甲酸酐手臂后的吸附剂对免疫球蛋白E的吸附能力均有所提高(56.02%,68.00%,60.87%)。④以色氨酸为配基、丁二酸酐为手臂的琼脂凝胶吸附剂吸附动力学实验:吸附剂在37℃对免疫球蛋白E的吸附率为70.73%。⑤吸附剂的血液相容性实验结果:经过2h的体外全血静态吸附后,吸附剂对5种组分的吸附率为免疫球蛋白A>免疫球蛋白G>C4>C3>免疫球蛋白M,而对最大的免疫球蛋白A的吸附率也仅为26.17%,远低于对免疫球蛋白E的吸附率70.73%。吸附剂对全血细胞有一定的破坏性,静态吸附2h后,白细胞下降27.3%,红细胞下降2.4%,血小板下降6.9%。结论:以琼脂凝胶微球载体,通过交联、活化和固定配基色氨酸成功制备免疫球蛋白E免疫吸附剂。此吸附剂对免疫球蛋白E有较高的清除率,同时具备较好的血液相容性,适用于临床血液灌流治疗支气管哮喘疾病。UniveReceiAccep     

脉压水平与经皮冠状动脉介入术患者的危险分层及预后评价

目的:通过对接受经皮冠状动脉介入治疗患者的临床特征,围手术期并发症和远期的疗效分析,了解脉压水平与经皮冠状动脉介入术患者的危险分层和预后关系。方法:选择2003-10/2005-10就诊于解放军第三○五医院心脏介入中心符合冠心病诊断标准并接受经皮冠状动脉介入治疗的631例患者。外周肱动脉压力测定收缩压、舒张压,脉压水平通过收缩压与舒张压差表示,冠状动脉病变的严重程度用冠脉病变积分表示。采用横断面前瞻性多变量观察研究,根据脉压>65mm Hg(1mm Hg=0.133kPa)和≤65mm Hg进行分组,其中脉压>65mm Hg组154例,男110例,女44例;脉压≤65mm Hg组477例,男288例,女189例。观察患者临床特征,随访[随访时间(18.6±4.3)个月]主要心血管事件发生率。结果:631例患者均进入结果分析。①与脉压≤65mm Hg组比较,脉压>65mmHg组年龄偏大,男性多见,高血压病史和糖尿病史多,C型病变和三支病变常见,冠脉病变积分高。②脉压>65mmHg组围手术期并发症发生率、住院期非致死性心肌梗死发生率和远期心源性死亡发生率显著高于脉压≤65mmHg组(16.8%,8.8%;5.2%,2.3%;1.3%,0.8%,P均<0.05)。③多因素logistic分析冠脉病变严重程度与脉压、年龄、糖尿病有正相关,OR分别为1.181(95%CI1.120～1.321),1.012(95%CI1.009～1.213),1.273(95%CI1.042～1.359)。结论:脉压与冠状动脉病变的严重程度密切相关,与经皮冠状动脉介入术围手术期及远期不良心血管事件发生率增加密切相关,可作为全身心血管疾病的一个危险信号,指导早期干预。     

Salivary glands – `an unisex organ’?

Oral Diseases (2010) 16 , 577–585 Usually no distinction is made between female and male salivary glands although cyclic changes of and/or differences in serum and salivary sex steroid concentrations characterize women and men. Moreover, sexual dimorphism is well recognized in salivary glands of rodents. Salivary glands contain estrogen and androgen receptors and are, according to modern high throughput technologies, subjected to gender differences not explainable by gene dose effects by the X chromosome alone. Because sex steroids are lipophilic, it is often thought that approximately 10% of them passively diffuse from plasma to saliva. Indeed, saliva can find use as sample material in sports medicine, pediatrics, veterinary medicine and behavioral sciences. Last but not least, humans and other primates are unique in that they have a reticular zone in their adrenal cortex, which produces dehydroepiandrosterone and androstendione pro‐hormones. These are processed in peripheral tissues, not only in female breast and uterus and male prostate, but also in salivary glands by an intracrine enzymatic machinery to active 17β‐estradiol, dihydrotestosterone and others, to satisfy and buffer against a constantly changing needs caused by circadian, menstrual, pregnancy and chronobiological hormonal changes in the systemic circulation. Female dominance of Sjögren’s syndrome and certain forms of salivary gland cancer probably reflect these gender‐based differences.     

New thrombopoietin receptor agonists for platelet disorders

Since thrombopoietin (TPO) was cloned in 1994, TPO receptor (TPO-R) agonists have been developed which have shown significant clinical activity in various conditions characterized by thrombocytopenia. First-generation TPO-R agonists were recombinant forms of human TPO. The clinical development of these molecules was discontinued after one of them, pegylated recombinant human megakaryocyte growth and development factor, was associated with the development of neutralizing autoantibodies cross-reacting with endogenous TPO. Second-generation TPO-R agonists are now available, which present no sequence homology to endogenous TPO. Two of these new agents, romiplostim and eltrombopag, have been granted marketing authorization for use in patients with primary immune thrombocytopenia unresponsive to conventional treatments. Clinical trials with TPO-R agonists are also ongoing in other thrombocytopenias, such as hepatitis C virus-related thrombocytopenia and the myelodysplastic syndromes.     

Orthopoxvirus Infections in Rodents,Nigeria, 2018–2019

To investigate animal reservoirs of monkeypox virus in Nigeria, we sampled 240 rodents during 2018–2019. Molecular (real-time PCR) and serologic (IgM) evidence indicated orthopoxvirus infections, but presence of monkeypox virus was not confirmed. These results can be used to develop public health interventions to reduce human infection with orthopoxviruses.     

应用MAS PCR技术诊断β地中海贫血

本文应用多重等位基因特异ＰＣＲ技术，对４种常见的β地贫进行基因诊断，成功地对２例β患者进行基因诊断和１例β地贫高危胎儿进行产前诊断。结果表明多重等位基因特异ＰＣＲ人有简便、快速、准确和经济等优点，利于推广应用。     

Impact of medical therapy on patients with Crohn’s disease requiring surgical resection

AIM: To evaluate the impact of medical therapy on Crohn’s disease patients undergoing their first surgical resection.METHODS: We retrospectively evaluated all patients with Crohn’s disease undergoing their first surgical resection between years 1995 to 2000 and 2005 to 2010 at a tertiary academic hospital (St. Paul’s Hospital, Vancouver, Canada). Patients were identified from hospital administrative database using the International Classification of Diseases 9 codes. Patients’ hospital and available outpatient clinic records were independently reviewed and pertinent data were extracted. We explored relationships among time from disease diagnosis to surgery, patient phenotypes, medication usage, length of small bowel resected, surgical complications, and duration of hospital stay.RESULTS: Total of 199 patients were included; 85 from years 1995 to 2000 (cohort A) and 114 from years 2005 to 2010 (cohort B). Compared to cohort A, cohort B had more patients on immunomodulators (cohort A vs cohort B: 21.4% vs 56.1%, P < 0.0001) and less patients on 5-aminosalysilic acid (53.6% vs 29.8%, P = 0.001). There was a shift from inflammatory to stricturing and penetrating phenotypes (B1/B2/B3 38.8% vs 12.3%, 31.8% vs 45.6%, 29.4% vs 42.1%, P < 0.0001). Both groups had similar median time to surgery. Within cohort B, 38 patients (33.3%) received anti-tumor necrosis factor (TNF) agent. No patient in cohort A was exposed to anti-TNF agent. Compared to patients not on anti-TNF agent, ones exposed were younger at diagnosis (anti-TNF vs without anti-TNF: A1/A2/A3 39.5% vs 11.8%, 50% vs 73.7%, 10.5% vs 14.5%, P = 0.003) and had longer median time to surgery (90 mo vs 48 mo, P = 0.02). Combination therapy further extended median time to surgery. Using time-dependent multivariate Cox proportional hazard model, patients who were treated with anti-TNF agents had a significantly higher risk to surgery (adjusted hazard ratio 3.57, 95%CI: 1.98-6.44, P < 0.0001) compared to those without while controlling for gender, disease phenotype, smoking status, and immunomodulator use.CONCLUSION: Significant changes in patient phenotypes and medication exposures were observed between the two surgical cohorts separated by a decade.     

冠状动脉内支架植入术后患者冠状窦内血浆内皮素水平的变化：药物洗脱与普通支架的比较

目的:观察冠状静脉窦血浆内皮素1水平在冠状动脉粥样硬化性心脏病患者冠状动脉内支架植入术后的动态变化,探讨药物洗脱支架对术后再狭窄防治的作用机制。方法:选择2005-05/10在新疆医科大学第一附属医院心血管病专科医院住院行冠脉支架植入术的冠心病患者42例,随机分为药物洗脱支架组26例置入雷帕霉素洗脱支架,普通支架组16例置入普通支架,分别于冠状动脉球囊扩张术前、支架术后即刻、1,3和6h自冠状静脉窦采血,非平衡法检测血浆内皮素1的质量浓度。结果:42例患者进入结果分析。两组血浆内皮素1水平在术后即刻均降至最低点后即开始回升,到术后1h已超过术前水平,以后普通支架组继续升高出现内皮素1释放的第2峰,术后6h时与术前比升高了69.5%(P<0.01);但药物洗脱支架组内皮素1释放程度较为缓和,未出现明显的第2峰,术后6h时与3h时比下降了12.4%(P<0.05)。普通支架组在术后6h内皮素1水平是药物洗脱支架组的2.24倍(P<0.01)。结论:药物洗脱支架可有效抑制冠状静脉窦血浆内皮素1水平的升高,从而产生防治再狭窄的作用。     

Matrix metalloproteinases-I, -3 and -8 and myeloperoxidase in saliva of patients with human immunodeficiency virus infection

OBJECTIVE: Human immunodeficiency virus (HIV)-sero-positive patients have frequently severe gingival inflammation andlor attachment loss. In addition many infectious diseases affect their periodontium with varying clinical manifestations. Matrix metalloproteinases seem to play a key role in physiological periodontal remodelling and pathological tissue destruction, The aim of the present study was to characterize the presence, molecular forms, cellular sources, activities, and relative amounts of fibroblast-type (matrix metalloproteinase [MMPJ-I) and neutrophil (MMP-8) collagenases, as well as their potential activator stromelysin-I (MMP-3) and myeloperoxidase in saliva of HIV-seropositive patients at different phases of HIV-infection. HIV-seronegative, healthy, age-matched patients served as controls.
PATIENTS AND METHODS: Saliva samples were characterized by Western blotting using antibodies specific for MMP-I, MMP-3 and MMP-8. Interstitial collagenase activities were measured using quantitative sodium dodecyl sulfate (SDS)-polyacrylamide gel electrophoresis/laser densitometry assay. Myeloperoxidase was analysed using quantitative dot blotting. RESULTS: Clinical and microbiological evaluation of HIV-seropositive patients' periodontium showed the presence of putative periodontopathogens ie Actinobacillus actinomycetemcomitans (Ao), Porphyromonos gingivalis (Pg), Prevotella intermedia (Pi), Peptostreptococcus micros (Psm) and Campylobacter rectus (Cr) in their periodontal pockets. The amount of Candida increased with the severity of HIV-infection. Clinical and microbiological findings of HIV-seropositive patients suggested that they have a tendency to develop periodontal disease. Interstitial collagenase activities were found to be increased in saliva of different phases of HIV-infected patients compared to the controls. Independent of the phase of HIV-