依达拉奉联合低分子肝素钙治疗短暂性脑缺血疗效分析

目的:观察依达拉奉联合低分子肝素钙治疗短暂性脑缺血的疗效.方法:选择短暂性脑缺血住院患者60例,治疗组30例应用依达拉奉联合低分子肝素钙,对照组30例给予低分子肝素钙,两组其他治疗相同.结果:治疗组脑梗死发生率3.3%,对照组脑梗死发生率16.7%;治疗组明显优于对照组(P<0.01).结论:依达拉奉联合低分子肝素钙治疗短暂性脑缺血能有效降低脑梗死发生率,值得临床推广.     

应用PCR检测恶性淋巴瘤骨髓浸润及其临床意义

目的：检测恶性淋巴瘤（ＭＬ）的骨髓浸润（ＩＢＭ）并探讨其与临床分期、疗效和预后的关系。方法：以克隆性ＩｇＨ和ＴＣＲγ基因重排分别作为Ｂ和Ｔ细胞淋巴瘤克隆基因标志，应用ＰＣＲ基因扩增技术检测ＭＬ患者ＩＢＭ。结果：（１）３４份ＭＬ患者骨髓标本ＩＢＭ检出率为７０．６％（２４／３４），明显高于形态学检测方法（３８．６％，Ｐ＜０．０５）。（２）１９例形态学检测正常的非霍奇金淋巴瘤（ＮＨＬ）骨髓标本，ＩＢＭ阳性率５７．９％（１１／１９），其中８例Ｂ－ＮＨＬ（８／１４）检测到克隆性ＩｇＨ基因重排；５例同时还检测到克隆性ＴＣＲγ基因重排，２例Ｔ－ＮＨＬ（２／３）检测到克隆性ＴＣＲγ基因重排，无克隆性ＩｇＨ基因重排；２例免疫分型不明确ＮＨＬ患老中１例（１／２）检测到克隆性ＩｇＨ基因重排，无克隆性ＴＣＲ，基因重排。２例霍奇金病（ＨＤ）和１０例非淋巴系肿瘤骨髓ＩＢＭ均阴性。（３）Ⅲ，Ⅳ期ＮＨＬ患者ＩＢＭ检出率显著高于ＩＩ期（ｐ＜０．０１），初诊未治及复发患者也显著高于部分或完全缓解患者（Ｐ＜０．０１）。（４）ＩＢＭ阳性组ＮＨＬ２年死亡率５４．５％（６／１１），明显高于ＩＢＭ阴性（ｐ＜０．０５）。结论：ＰＣＲ方法检测ＩＢＭ有助于估     

靶向EGFR隐蔽表位的免疫毒素的制备及其对肿瘤细胞的特异性杀伤

目的： 制备靶向表皮生长因子受体（epithelial growth factor receptor,EGFR）隐蔽表位（287-302）的免疫毒素,并鉴定其生物学功能。 方法： 通过基因工程方法将抗EGFR（287-302）的806单链抗体（806 single-chain antibody fragment, 806scFv ）基因经柔性肽与铜绿假单胞菌外毒素A（Pseudomonas exotoxin A, PEA）的截短形式PE38KDEL连接,构建原核表达载体pET-22b-806scFv-PE38KDEL并转化至大肠杆菌BL21（DE3）中,经纯化获得该免疫毒素融合蛋白806scFv-PE38KDEL,ELISA和流式细胞术检测其与EGFR的结合活性,间接免疫荧光检测重组免疫毒素的内化作用,CCK-8法检测806scFv-PE38KDEL对人脑胶质瘤细胞U87MG和U87MG-EGFRvⅢ、表皮癌细胞A431、乳腺癌细胞MDA-MB-468、舌癌细胞CAL-27的细胞毒性。 结果： 成功构建重组免疫毒素806scFv-PE38KDEL,诱导表达的蛋白806scFv-PE38KDEL以包涵体形式存在,经纯化后的纯度>95%,经SDS-PAGE和Western blotting 鉴定为目的蛋白。806scFv-PE38KDEL 能EGFRvⅢ胞外段蛋白结合,还能与外源性表达EGFRvⅢ的肿瘤细胞和高表达EGFR的肿瘤细胞相结合,而与表达低水平EGFR的肿瘤细胞不结合。806scFv介导了重组免疫毒素的内化。806scFv-PE38KDEL对靶细胞有明显的杀伤作用,对过表达EGFRvⅢ的U87MG-EGFRvⅢ细胞IC50值为（5.85±0.03） ng/ml,对EGFR高表达细胞MDA-MB-468、A431、CAL-27的IC50值分别为（162.80±0.06）、（75.72±0.04）、（123.70±0.03） ng/ml。在1 μg/ml的质量浓度下,相比PBS对照组,806scFv-PE38KDEL对U87MG-EGFRvⅢ 、MDA-MB-468、A431和CAL-27细胞增殖的抑制率均显著增高\[（98.67±0.07）% vs （2.45±2.85）%、（86.26±101）% vs （0.48±1.76）%、（96.72±016）% vs （1.33±1.31）%、（96.29±0.30）% vs （2.00±0.60）%,均P<0.01\],而对U87MG细胞几乎没有抑制作用\[（359±2.09）% vs （0.19±0.95）,P>0.05\]。 结论： 本研究所制备的靶向EGFR（287-302）表位的重组免疫毒素806scFv-PE38KDEL能特异地结合并杀伤EGFRvⅢ或EGFR高表达的肿瘤细胞。     

胃底静脉曲张组织胶治疗并发脑动脉空气栓塞一例

胃底静脉曲张出血是肝硬化严重并发症,内镜下组织胶注射治疗已成为胃底静脉曲张的一线治疗,其异位栓塞等并发症也多次被报道。本篇报道了1例胃底静脉曲张急诊出血病例,行内镜下组织胶注射治疗后出现罕见的脑动脉空气栓塞。     

Enhanced catalytic degradation of amoxicillin with TiO2–Fe3O4 composites via a submerged magnetic separation membrane photocatalytic reactor (SMSMPR)

A novel photo-Fenton catalytic system for the removal of organic pollutants was presented, including the use of photo-Fenton process and a submerged magnetic separation membrane photocatalytic reactor (SMSMPR). We synthesized TiO₂–Fe₃O₄ composites as the photocatalyst and made full use of the magnetism of the photocatalyst to realize the recollection of the catalyst from the medium, which is critical to the commercialization of photocatalytic technology for wastewater treatment. The photo-Fenton performance of TiO₂–Fe₃O₄ is evaluated with amoxicillin trihydrate (AMX) as a target pollutant. The results indicate that the TiO₂–Fe₃O₄/H₂O₂ oxidation system shows efficient degradation of AMX. Fe₃O₄ could not only enhance the heterogeneous Fenton degradation of organic compounds but also allow the photocatalyst to be magnetically separated from treated water. After four reaction cycles, the TiO₂–Fe₃O₄ composites still exhibit 85.2% removal efficiency of AMX and show excellent recovery properties. Accordingly, the SMSMPR with the TiO₂–Fe₃O₄ composite is a promising way for removing organic pollutants.

With a TiO₂–Fe₃O₄ composite as the catalyst, amoxicillin was degraded via a photo-Fenton process using a submerged magnetic separation membrane photocatalytic reactor.     

Thoracic ossification of ligamentum flavum caused by skeletal fluorosis

Thoracic ossification of ligamentum flavum (OLF) caused by skeletal fluorosis is rare. Only six patients had been reported in the English literature. This study reports findings from the first clinical series of this disease. This was a retrospective study of patients with thoracic OLF due to skeletal fluorosis who underwent surgical management at the authors' hospital between 1993 and 2003. Diagnosis of skeletal fluorosis was made based on the epidemic history, clinical symptoms, radiographic findings, and urinalysis. En bloc laminectomy decompression of the involved thoracic levels was performed in all cases. Cervical open door decompression or lumbar laminectomy decompression was performed if relevant stenosis was present. Neurological status was evaluated preoperatively, at the third day postoperatively, and at the end point of follow-up using the Japanese Orthopaedic Association (JOA) scoring system of motor function of the lower extremities. A total of 23 cases were enrolled, 16 (69.6%) males and 7 (30.4%) females, age ranging from 42 to 72 years (mean 54.8 years). All patients came from a high-fluoride area, and 22 (95.7%) had dental fluorosis. Medical imaging showed OLF together with ossification of many ligaments and interosseous membranes, including interosseous membranes of the forearm (18/23 patients 78.3%), leg (14/23 patients 60.9%), and ribs (11/23 patients 47.8%). OLF was classified into five types based on MRI findings: localized (4/23 patients 17.4%), continued (12/23 patients 52.2%), skip (3/23 patients 13.0%), combining with anterior pressure (2/23 patients 8.7%), and combining with cervical and/or lumbar stenosis (2/23 patients, 8.7%). Urinalysis showed a markedly high urinary fluoride level in 14 of 23 patients (60.9%). Patients were followed up for an average duration of 4 years, 5 months. Paired t-test showed that the JOA score was slightly but nonsignificantly increased relative to preoperative measurement 3 days after surgery (P = 0.0829) and significantly increased at the end of follow-up (P = 0.0001). In conclusion, Fluorosis can cause ossification of thoracic ligamentum flavum, as well as other ligaments. Comparing with other OLF series, a larger number of spinal segments were involved. The diagnosis of skeletal fluorosis was made by the epidemic history, clinical symptom, imaging study findings, and urinalysis. En bloc laminectomy decompression was an effective method.     

精索脂肪肉瘤（附6例报告）

目的探讨精索脂肪肉瘤的临床特点和诊治方法。方法回顾6例精索脂肪肉瘤临床资料，并复习有关文献。结果6例患者均行手术治疗，2例行肿瘤切除术，其余4例行根治术，术后随访19个月-11年，1例保留精索的年轻患者于术后3年出现局部复发，其余5例无复发及远处转移。结论精索脂肪肉瘤是一种低度恶性肿瘤，治疗方法主要以根治性手术为主，对于肿瘤高分化且年轻未育者，可行保留精索手术。     

护生手卫生知识、态度、行为调查分析

目的 通过调查了解实习护生手卫生知识情况,分析手卫生依从性的影响因素.方法 采用自行设计的问卷对101名护生进行手卫生知识、行为进行调查.结果 手卫生知识掌握程度不够理想,手卫生态度行为处于较好水平,经过临床带教培训,护生操作后的态度和行为得分高于操作前(P＜0.01),有创操作态度和行为得分高于无创操作和不接触患者的操作(P＜0.01);护生自身学历和带教老师是影响其手卫生的重要因素.结论 实习护生的手卫生知识了解欠全面,应促进护生完善相关手卫生知识的补充与培训,手卫生态度和行为方面总体较好,但对于干燥双手和不同环境时的手卫生态度和行为欠佳,应加强临床带教中手卫生知识培训.     

A candidate DNA vaccine elicits HCV specific humoral and cellular immune responses

AIM: TO investigate the immunogenicity of candidate DNA vaccine against hepatitis C virus (HCV) delivered by two plasmids expressing HCV envelope protein 1 (El) and envelope protein 2 (E2) antigens respectively and to study the effect of CpG adjuvant on this candidate vaccine.METHODS: Recombinant plasmJds expressing HCV EI and E2 antigens respectively were used to simultaneously inoculate mice with or without CpG adjuvant. Antisera were then collected and tJters of antJ-HCV antibodies were analyzed by ELISA. One month after the last injection, animals were sacrificed to prepare single-cell suspension of splenocytes.These cells were subjected to HCV antigen specific proliferaion assays and cytokine secretion assays to evaluate the cellular immune responses of the vaccinated animals.RESULTS: Antibody responses to HCV EI and E2 antigens were detected in vaccinated animals. Animals receiving CpG adjuvant had slightly lower titers of anti-HCV antibodies in the sera, while the splenocytes from these animals showed higher HCV-antigen specific proliferation. Analysis of cytokine secretion from the splenocytes was consistent with the above results. While no antigen-specific IL-4 secretion was detected for all vaccinated animals, HCV antigen-specific INF-γ, secretion was detected for the splenocytes of vaccinated animals. CpG adjuvant enhanced the secretion of INF-γ, but did not change the profile of IL-4 secretion.CONCLUSION: Vaccination of mice with plasmids encoding HCV E1 and E2 antigens induces humoral and cellular immune responses. CpG adjuvant significantly enhances the cellular immune response.