5例布鲁氏菌急性菌血症的分析

目的 探讨布鲁氏菌病的流行、诊断及血培养布鲁氏菌的微生物检验特性,提高对该病的认识.方法 对经血培养阳性确诊的5例布鲁氏菌病患者的流行病学、临床资料、实验室资料进行系统分析.结果 3例患者为广州市人,1例为中山市人,1例为顺德市人;2例与猪、牛有接触史,1例疑为实验室感染,2例无明显的接触史.5例患者均以急性布鲁氏菌菌血症引起的布氏病中毒症状为主,临床症状及体征各有不同,但均有长期不规则低热.结论 广州地区存在分散的点状流行.布氏病急性期临床表现变化多样性,临床医生对其认识不足易误诊,因此对发热病人应重视血培养的检查,对散发的布鲁氏菌病的早期诊断、治疗有重要意义,增强高危人群防护意识,防止暴发流行.     

A reduced segment II/III graft for neonatal liver failure with absence of detectable hepatocytes. A case report and literature review

Alawi K, Mitros FA, Bishop WP, Rayhill S, Wu Y. A reduced segment II/III graft for neonatal liver failure with absence of detectable hepatocytes. A case report and literature review.
Pediatr Transplantation 2011: 15:e60–e63. © 2010 John Wiley & Sons A/S. Abstract: When hepatic failure occurs in newborns, most cases are because of viral hepatitis, metabolic diseases, and neonatal hemochromatosis. It is rare to have liver failure presenting in the first day after birth. We report a unique case of a newborn baby with liver failure in the first day of life who received a reduced segment II and III graft when she was 19 days old and became the youngest survivor of LDLT. Common and rare causes of liver failure in this age group were excluded by appropriate testing. She underwent a liver biopsy that showed a liver devoid of hepatocytes. Similar pathological findings were found in the explanted liver. She was discharged from the hospital with normal graft function three months after the transplant.     

受控凋亡素基因逆转录病毒载体诱导人肝癌细胞凋亡

目的:构建受控重组凋亡素基因逆转录病毒载体,观察受四环素调控的凋亡素基因的表达对人肝癌细胞的影响。方法:构建重组逆转录病毒表达载体pRevTRE—VP3。调节载体pRevTet-Off和表达载体pRevTRE—VP3分别转染PT67包装细胞后,取其病毒上清液依次感染人肝癌细胞系HepG2,以四环素调控凋亡素基因在HepG2/Off-VP3细胞中的表达,以流式细胞仪检测细胞凋亡率。结果:重组逆转录病毒载体pRevTRE—VP3构建成功;经PCR和RT—PCR证实凋亡素基因在HepG2细胞中得到了表达;HepG2/Off-VP3—8细胞在无四环素培养环境中凋亡率明显高于在1μg/ml四环素环境中的细胞凋亡率(P＜0．05)。结论:凋亡素基因经RevTet系统导入人肝癌细胞HepG2后,可在四环素调控下表达凋亡素并诱导HepG2细胞凋亡。     

某院2016 年儿外科门诊超说明书用药现状分析

目的:回顾性调查宁夏医科大学总医院儿外科门诊超说明书用药情况,分析超说明书用药发生原因,为了解我国儿科超说明书用药现状和制订相关政策提供基线数据。方法:抽取该院儿外科2016年门诊处方,按照说明书从适应证、禁忌证、用法、用量、用药人群5个方面6个指标综合判断超说明书用药情况,分析超说明书用药发生原因。结果:共分析762 张处方,涉及用药医嘱810 条,按用药医嘱计超说明书用药发生率为30.12%;超说明书用药各类型中“ 未提及儿童用药信息”比例最高(36.07%);各年龄段中婴幼儿的超说明书用药发生率较高(50.47%);超说明书用药前3位分别是抗肿瘤药和免疫调节药(75.24%)、神经系统用药(63.41%)、消化道及代谢用药(7.14%)。结论:我院小儿外科门诊存在着超说明书用药现象,临床药师应对儿童用药进行密切关注及合理干预。急需国家出台相关法律法规或指南,规范超说明书用药行为,促进儿童药物临床试验提供更多用药数据,保障儿童用药安全和规避医师职业风险。     

Enhancement of humoral and cellular responses to HBsAg DNA vaccination by immunization with praziquantel through inhibition TGF-β/Smad2,3 signaling

Praziquantel (PZQ), which is used to treat all forms of schistosomiasis, has been shown to induce strong T cell activities and decrease T regulatory cell levels. In our study, we investigated whether PZQ may be used as an adjuvant for a hepatitis B surface antigen (HBsAg) DNA vaccine (pcD-S2) in eliciting strong humoral and cellular responses. Our data demonstrate that PZQ as an adjuvant increased T cell proliferation and an HBsAg-specific antibody response that was characterized by a higher ratio of IgG2a/IgG1. Moreover, a higher level of IFN-γ in CD4⁺ and CD8⁺ T cells were elicited. In addition, a significantly antigen-specific cytotoxic T lymphocyte response was also observed. The expression of TGF-β can be induced by HBsAg, while PZQ as an adjuvant can inhibit the expression of TGF-β and TGF-β/Smad2,3 signaling. The frequency of CD4⁺CD25⁺Foxp3⁺ Treg cells was reduced. Importantly, the regulatory function of CD4⁺CD25⁺ Treg cells was correspondingly impaired. Together, these results suggest that PZQ can enhance humoral and cellular responses to HBsAg DNA vaccination through inhibition TGF-β/Smad2,3 signaling.     

钳夹加压固定器治疗尺骨鹰嘴骨折130例临床观察

应用钳夹加压固定器治疗尺骨鹰嘴骨折130例,经3个月～8年随访,解剖及近解剖复位率达96.9％;关节功能恢复优良率达98.0 4％。观察认为:该器械可用于各类型尺骨鹰嘴骨折,大型号者还可用于膑骨骨折。关键在于根据不同骨折类型,选取适当固定点。     

基于体素观察慢性阻塞性肺疾病肺叶损伤程度及空间分布

目的 探讨基于体素定量CT分析慢性阻塞性肺疾病（COPD）患者肺叶损伤程度及空间分布的价值。方法 在"数字肺"多研究中心连续性纳入接受双气相扫描COPD患者，测定小气道病变（fSAD）和肺气肿（Emph）的定量值；分析患者各肺叶之间Emph、fSAD肺叶损伤程度及肺叶分布的差异，以及各肺叶定量CT分布与肺功能的相关性。结果 最终纳入50例COPD患者。Emph和fSAD均以右肺中叶最重，两肺上叶次之，两肺下叶程度最轻；Emph和fSAD均主要分布于左肺上叶，其次为右肺上叶，右肺中叶分布最少。两肺下叶Emph和fSAD与FEV₁%的相关性较好。结论 COPD患者肺叶损伤程度以右肺中叶及两肺上叶为重，尤其是右肺中叶；Emph和fSAD主要分布于左肺上叶，其次是右肺上叶；两肺下叶损伤对COPD患者肺功能的影响更著。     

Object Recognition Under Distorted Prosthetic Vision

Psychophysical studies have reported the efficacy of phosphene‐based prosthetic vision in partly recovering the visual function of blind individuals. However, results by far have been based on evenly aligned phosphene arrays, which neglected the complicated visuotopy in the visual prosthesis system. In this study, we investigated how the objects were recognized under the stimuli with distorted phosphene arrays simulated by transformations of barrel distortion, rotation, or translation. The results revealed that distortions significantly decreased the accuracy of categorization (CA) and showed distinct interactive effects with the factors of object category and phosphene array density. Moreover, the CA changed differently with the increase of distortion levels. Regression analysis suggested a phosphene array of at least 10 × 10 be the essential for achieving a CA over the threshold value (CA_t = 62.5%) under distorted prosthetic vision. It is recommended that discriminative features be extracted to improve the performance of prosthetic vision.     

皮层下缺血性脑血管病患者弥散张量成像中脑微结构变化与整体认知功能及执行功能的独立相关性研究

目的探讨皮层下缺血性脑血管病(sIVD)患者弥散张量成像(DTI)皮层下灰白质微结构变化与整体认知功能和执行功能的独立相关性。方法 66例SIVD患者(其中认知障碍非痴呆组30例,认知功能正常组36例)行常规核磁共振成像(MRI)和DTI检查,采用简易精神状态量表(mini-mental state examination,MMSE)和画钟试验(cDT)分别评价其整体认知功能和执行功能。比较两组患者常规MRI上脑形态学指标及皮层下灰白质的DTI参数,分析与SIVD患者认知功能相关的影像学独立相关因素。结果与认知功能正常(NCI)组相比较,认知障碍非痴呆(VCIND)组侧脑室周围白质病变(PVLs)分级显著增加(P<0.01),半卵圆中心看似正常白质(NAWM)区和白质病变(WMLs)区、壳核及丘脑的表观弥散系数(ADC,值显著增加(P<0.01),侧脑室前角NAWM、尾状核、壳核及丘脑的部分各向异性(FA)值显著降低(P<0.05)。控制年龄和受教育程度后,PVLs、半卵圆中心NAWM区和WMLs区ADC值、壳核ADC值与MMSE呈显著负相关(P<0.01);壳核及侧脑室前角NAWM区FA值与MMSE呈显著正相关。脑腔梗数目、侧脑室后角NAWM区及尾状核头部ADC值与CDT呈显著负相关;侧脑室前角NAWM区和丘脑FA值与CDT呈显著正相关。多元逐步回归分析显示半卵圆中心NAWM和WMLs区ADC值与MMSE呈独立负相关;尾状核头ADC值和腔梗数目与CDT呈独立负相关。结论在非痴呆SIVD患者中,半卵圆中心白质结构的完整性是影响SIVD患者整体认知功能的主要因素,且独立于常规MRI上的脑结构改变;尾状核微结构的改变和腔梗的数目是影响SIVD患者执行功能主要因素。     

Generation and characterization of a large panel of murine monoclonal antibodies against vaccinia virus

Vaccinia virus (VACV), the vaccine for smallpox, induces an antibody response that is largely responsible for conferring protection. Here, we studied the antibody response to VACV by generating and characterizing B cell hybridomas from a mouse immunized with VACV. Antibodies from 66 hybridomas were found to recognize 11 VACV antigens (D8, A14, WR148, D13, H3, A56, A33, C3, B5, A10 and F13), 10 of which were previously recognized as major antigens in smallpox vaccine by a microarray of VACV proteins produced with a prokaryotic expression system. VACV C3 protein, which was not detected as a target of antibody response by the proteome array, was recognized by two hybridomas, suggesting that selection of hybridomas based on immune recognition of infected cells has the advantage of detecting additional antibody response to native VACV antigens. In addition, these monoclonal antibodies are valuable reagents for studying poxvirus biology and protective mechanism of smallpox vaccine.