去白细胞输血对恶性血液病患者免疫活性细胞的影响

目的：观察应用输血治疗的恶性血液病化疗患者外周血T细胞亚群及NK细胞活性，探讨去白细胞输血对恶性血液病患者免疫活性细胞的影响。方法：将120例化疗期间需要接受输血治疗的恶性血液病患者分为2组：A组59例接受去白细胞输血；B组61例接受常规输血。2组每次的输血量、输血次数及化疗方案基本相同。对2组治疗前后的T细胞及NK细胞活性进行检测，并与对照组进行比较。结果：①恶性血液病患者各项免疫活性细胞表达均低于对照组（P〈0．01）；②治疗前A、B2组免疫活性细胞表达差异无统计学意义，治疗后A组的NK细胞活性明显高于B组（P〈0．01）；A组治疗后CD^3-、CD4^＋、CD4^＋／CD8^＋、NK细胞活性明显高于治疗前（P〈0．05）；③B组发生非溶血性发热反应（NHFTR）率明显高于A组（P〈0．01）。结论：T细胞亚群、NK细胞活性在恶性血液病患者中受到明显抑制；与常规的输血治疗方法相比，去白细胞输血能明显改善恶性血液病患者的细胞免疫功能，尤其是对NK细胞，并能有效预防NHFTR。     

根除幽门螺杆菌对胃黏膜炎症变化的人群随访研究

目的 观察胃癌高发区中幽门螺杆菌(Hp)阳性者根除Hp5年后胃黏膜组织的炎症变化,以探讨。Hp感染与胃黏膜组织炎症及胃癌的关系。方法 对胃癌高发区山东省烟台市成年人群随机抽样1006例,做内镜、快速尿素酶试验及胃窦、胃体部黏膜组织学检查,将Hp阳性者随机分为治疗组(奥美拉唑20mg、克拉霉素500mg、阿莫西林1000mg)及对照组,2组入选者分别于1年后、5年后进行内镜复检,本研究是将5年后复查胃镜及相同部位胃黏膜组织病理检查与5年前结果进行比较并做χ^2检验。结果 552例Hp阳性者随机分为治疗组及对照组各276例,5年后Hp持续阴性者161例,持续阳性者198例。2组结果统计显示：(1)入选前2组胃窦部炎症及活动度发生率与体部相比差异无显著性,P值分别为0．105及0．084,但萎缩及肠化生发生率明显高于体部,P值均为0．000;(2)根除Hp 5年后胃窦、胃体部炎症及活动度均明显减轻,P值均为0．000;(3)根除Hp5年后胃窦部肠化生减轻或未进展,而Hp持续阳性组肠化生发生率明显增加,P=0．032;(4)根除Hp 5年后窦、体部萎缩改善差异无显著性,两组比较P值分别为0．223及0．402。结论 根除Hp可使胃慢性炎症及活动度明显减轻,窦部肠化生得到显著控制,溃疡病发病明显减少;持续Hp感染可使萎缩及肠化生呈进行性加重。     

Synergistic action of famotidine and chlorpheniramine on acetic acid-induced chronic gastric ulcer in rats

AIM: To assess the synergistic action of famotidine (FMD) and chlorpheniramine (CPA) on acetic acid-induced chronic gastric ulcer in rats. METHODS: Chronic gastric lesions were induced in male Sprague-Dawley (SD) rats by serosal application of the acetic acid. Forty SD rats were randomly divided into blank group (n=8), control group (n=8), FMD group (n = 8), CPA group (n=8), and FMD+CPA group (n=8). Each group was given intraperitoneally (i.p.) 0.5 mL/100 g distilled water, 9 g/L NaCl saline, 4 mg/kg FMD, 10 mg/kg CPA, 4 mg/kg FMD+10 mg/kg CPA, respectively, daily for 10 d. On d 10, ulcer area was determined by planimetry. The level of myeloperoxidase (MPO) in the liver homogenation was determined by biochemical methods and the plasma levels of 6-ketoprostaglandin F1 alpha (6-keto-PGFia) and IL-8 were determined by radioimmunoassay. RESULTS: The synergistic effects of FMD+CPA group on the lesion, IL-8, 6-keto-PGFia and MPO were confirmed. The effect of FMD+CPA group was significantly different as compared to the control and FMD groups. The lesion (mm2) was reduced from 40.18±2.6 in control group to 6.83±2.97 in PMD+CPA group, P<0.01, and from 32.9±3.27 in FMD group to 6.83±2.97 in PMD+CPA group, P<0.01. The plasma levels of IL-8 decreased from 0.69±0.11 ng/L in control group to 0.4±0.04 ng/L in PMD+CPA group, P<0.01, and from 0.51±0.08 ng/L in FMD group to 0.4±0.04 ng/L in PMD+CPA group, P<0.05. The level of 6-keto-PGFia increased from 7.55±1.65 ng/L in control group to 16.62±0.97 ng/L in PMD+CPA group, P<0.01, and from 13.15±1.48 ng/L in FMD group to 16.62±0.97 ng/L in PMD+CPA group, P<0.05. The levels of MPO in the liver homogenate decreased from 9.12±2.05 u/L in control group to 4.33±0.95 u/L in PMD+CPA group, P<0.01, and from 8.3±1.29 u/L in FMD group to 4.33±0.95 u/L, P<0.01. CONCLUSION: The synergistic action of FMD and CPA on acetic acid-induced chronic gastric ulcer in rats decreases the incidence of ulcer and also enhances the healing of ulcer.     

缺铁性贫血并发脑血栓形成4例临床分析

目的 探讨脑血栓形成与缺铁性贫血之间的关系,临床表现及治疗.方法:回顾性分析4例缺铁性贫血并发脑梗死患者的临床资料.结果:4例患者均为中重度贫血,血小板增多,血压偏低,2例存在慢性感染病灶.所有患者均为颈内动脉系统脑梗死,其中2例为分水岭梗死,2例为基底节梗死.吸氧、纠正贫血、调整血压在适当水平以及其他常规治疗有效.结论:对于中重度缺铁性贫血患者,如伴有血小板增多和血压偏低等情况,易导致脑血栓形成.在常规治疗脑血栓形成的同时应注意寻找贫血原因并且纠正贫血.     

Distinct architecture and composition of mouse axonemal radial spoke head revealed by cryo-EM

The radial spoke (RS) heads of motile cilia and flagella contact projections of the central pair (CP) apparatus to coordinate motility, but the morphology is distinct for protozoa and metazoa. Here we show the murine RS head is compositionally distinct from that of Chlamydomonas. Our reconstituted murine RS head core complex consists of Rsph1, Rsph3b, Rsph4a, and Rsph9, lacking Rsph6a and Rsph10b, whose orthologs exist in the protozoan RS head. We resolve its cryo-electron microscopy (cryo-EM) structure at 3.2-Å resolution. Our atomic model further reveals a twofold symmetric brake pad-shaped structure, in which Rsph4a and Rsph9 form a compact body extended laterally with two long arms of twisted Rsph1 β-sheets and potentially connected dorsally via Rsph3b to the RS stalk. Furthermore, our modeling suggests that the core complex contacts the periodic CP projections either rigidly through its tooth-shaped Rsph4a regions or elastically through both arms for optimized RS–CP interactions and mechanosignal transduction.

The majority of motile cilia and flagella are composed of nine dynein arm-containing peripheral doublet microtubules (DMTs) surrounding a central pair (CP) of MTs (the “9+2” axoneme). The radial spoke (RS) is a T-shaped protein complex with an orthogonal head pointing toward the CP and a stalk anchored on each A-tubule of the DMTs (1–5). It acts as the mechanochemical transducer between the CP and axonemal dynein arms to regulate flagellar/ciliary motility (6–11). The flagella of Chlamydomonas reinhardtii, a widely used model organism, contain two full-size RSs (RS1 and RS2) in each 96-nm repeat unit of the axoneme. In contrast, motile cilia/flagella of Tetrahymena thermophila and metazoa possess triplet RSs (RS1 to RS3) (2–4, 11). The Chlamydomonas RS is composed of at least 23 subunit proteins (RSP1 to RSP23) (2, 12, 13). Seventeen of them have mammalian homologs (14). Mutations leading to the loss of the entire RS or RS head result in immotile flagella in Chlamydomonas (6–8) but in rotatory ciliary beat in mammals, causing primary ciliary dyskinesia (PCD), a genetic syndrome characterized by recurrent respiratory infections, situs inversus, infertility, and hydrocephalus (4, 15–21).The most striking morphological differences in the RS lie in the RS head, the key structural domain that mediates the mechanosignaling by directly contacting projections of the CP (9–11). The heads of RS1 and RS2 consist of two structurally identical, rotationally symmetric halves that differ largely from that of RS3 (3, 4). Furthermore, their morphologies differ dramatically between protozoa and metazoa. In Chlamydomonas and Tetrahymena, for instance, the heads of RS1 and RS2 are rich in lateral branches that also form a connection between the two heads (2, 4). In contrast, in sea urchin (Strongylocentrotus purpuratus) and human, the heads of RS1 and RS2 resemble a pair of ice skate blades with many fewer interfaces toward the CP (3, 4). Despite the importance of the RS and RS head in cilia/flagella motility, the structural details of the RS and the RS–CP interactions remain poorly understood, especially in mammals.The RS heads have probably been remodeled to comply with both structural and functional alterations of the axoneme during evolution. How the morphological changes occurred, however, remains unclear. The Chlamydomonas RS head is composed of RSP1, -4, -6, -9, and -10 and part (the C terminus) of the stalk component, RSP3. Each of the symmetrical halves of the head contains one copy of these components (2, 10, 22). All the head components have mammalian orthologs (Rsph1, -4a, -6a, -9, -10b, and -3b) (11, 14). In sharp contrast to the markedly reduced surface area of metazoan RS heads, the peptides of human RSPH4A, -6A, and -10B are longer than their Chlamydomonas orthologs by 1.5-, 1.3-, and 4-fold, respectively (11). Only RSPH1 (309 amino acids [aa]) is shorter than RSP1 (814 aa) (11). The lengths of mouse RS head proteins are also similarly changed as their human counterparts (SI Appendix, Fig. S1A). Furthermore, while murine Rsph4a is essential for the head formation of RS1 to RS3 in motile multicilia of the trachea, ependyma, and oviduct (15), Rsph6a is specifically expressed in sperm for their normal flagellar formation (23). RSP4/Rsph4a and RSP6/Rsph6a are paralogs: RSP4 and RSP6 share 48% sequence identity (24), whereas murine Rsph4a is 63% identical to Rsph6a (SI Appendix, Fig. S1B). Sea urchin and Ciona, however, have only one ortholog (11, 25). These results suggest that, unlike the protozoan RS heads, the metazoan ones may not simultaneously contain Rsph4a and Rsph6a. The general shapes of the RS structure in axonemes have been determined by conventional electron microscopy (EM) (26–28) and cryo-electron tomography (cryo-ET) (2–5). Recently, a 15-Å-resolution RS structure of Chlamydomonas was resolved by cryo-EM single-particle analysis (29). The resolutions, however, do not suffice for the delineation of the locations of individual RS subunits.In the present study, by biochemical and structural analyses, we show the murine RS head is both compositionally and morphologically distinct from that of Chlamydomonas. Our study suggests that the RS head has experienced profound remodeling to probably comply with both structural and functional alterations of the axoneme during evolution for coordinated ciliary or flagellar motility.     

安徽省移民建镇试区血吸虫病流行因素调查

目的　调查移民建镇地区血吸虫病流行因素 ,为制订该类地区血吸虫病控制对策提供依据。　方法　选择退人不退耕的单退点和退人又退耕的双退点各 2个 ,采用常规方法调查各试点钉螺分布、人畜感染以及滩地野粪污染情况。　结果　移民建镇试区钉螺分布广 ,单退点感染螺密度较双退点高 ,两个单退点钉螺感染率分别为 0 .69%、1.88% ,两个双退点钉螺感染率分别为 0 .3 9%、0 .2 9% ;滩地野粪污染仍较严重 ,尤其以单退点为甚 ;人、畜血吸虫感染在单退点相当严重 ,居民血吸虫抗体阳性率 (IHA)高达 2 0 %以上 ,耕牛粪检阳性率最高达 3 4.48%。　结论　移民建镇地区依然存在血吸虫病流行因素 ,单退点血吸虫病流行更为严重     

现代药物分析中快速检测技术的应用进展

现代药物分析技术具有简便快捷、灵敏度高、特异性强的特点,能够满足样品检测的快速性、稳定性等要求。快速检测的应用范围涉及药物残留、体内药物代谢、药物疗效评价、临床诊断及疾病发生发展过程的综合评价和动态分析。本文通过简述现代药物分析中快速检测技术的特点及应用进展,为药物分析实验研究中检测方法的选择提供参考。     

基于深度学习的像素闪烁算法对高体质量指数患者低剂量腹部CT平扫图像质量的影响

目的 探讨基于深度学习的像素闪烁（PS）算法对体质量指数（BMI）≥ 25 kg/m²患者低剂量腹部CT平扫图像质量的影响。方法 选取59例接受腹部CT检查、BMI ≥ 25 kg/m²的患者,根据管电压分为A组（100 kVp,n=30）和B组（120 kVp,n=29）。根据不同重建算法和处理方式,将A组分为A1亚组（FBP）、A2亚组（FBP+PS）、A3亚组（50% ASiR-V）和A4亚组（50% ASiR-V+PS）;将B组分为B1亚组（FBP）和B2亚组（50% ASiR-V）。测量2组肝右叶、右侧竖脊肌CT值及SD值,计算肝脏SNR、CNR及容积CT剂量指数（CTDI_vol）,评价2名观察者间所测数值的一致性。结果 2名观察者所测数据的一致性良好（ICC值均> 0.80）。A组各亚组间肝脏及竖脊肌CT值差异无统计学意义（P > 0.05）;肝脏及竖脊肌SD值、肝脏SNR值差异有统计学意义（P均< 0.001）;两两比较SD_A4 < SD_A2 < SD_A3 < SD_A1,SNR_A4 > SNR_A2 > SNR_A3 > SNR_A1;A1与A3亚组间CNR值差异无统计学意义（P=0.078）,其余亚组间两两比较CNR_A4 > CNR_A2 > CNR_A3或CNR_A1（P均< 0.001）。A2亚组肝脏SD值较B1亚组、A4亚组较B2亚组明显降低,SNR及CNR值明显增高（P均< 0.001）。A组CTDI_vol明显低于B组（P均< 0.001）。结论 采用基于深度学习的PS算法可改善高BMI患者低剂量腹部CT平扫图像质量。     

快速评估心脏MR左心室长轴应变及其与左心室整体纵向应变的相关性

目的 探讨快速评估左心室长轴应变（LAS）的方法及其与左心室整体纵向应变（GLS）的相关性。方法 对77名健康志愿者行心脏MR检查,于收缩末期和舒张末期分别测量二尖瓣瓣环插入点连线中点与左心室心尖的心外膜边缘的距离（方法1）、二尖瓣室间隔侧插入点与左心室心尖的心外膜边缘的距离（方法2）以及二尖瓣瓣环游离壁插入点与左心室心尖的心外膜边缘的距离（方法3）,计算3种方法的LAS值,并测量左心室心功能参数及GLS,比较3种LAS测值的差异,并分析其与GLS的相关性。取3种LAS值的均值,观察LAS及GLS与左心室射血分数（LVEF）的相关性。分析观察者间及观察者内测量上述参数的一致性。结果 3种方法所测LAS值差异无统计学意义（F=0.97,P=0.41）。方法1的LAS值与GLS呈显著正相关（r=0.86,P<0.001）,方法2的LAS值与GLS呈中度正相关（r=0.57,P<0.001）,方法3的LAS值与GLS呈较好正相关（r=0.64,P<0.001）。LAS及GLS与LVEF均呈中度负相关（r=-0.38、-0.42,P=0.04、0.02）。观察者内和观察者间一致性均好（ICC均>0.75）。结论 通过计算不同位点在心脏舒张和收缩末期相对位移的百分比可快速、简便评估LAS,且后者与GLS呈正相关。     

卵巢甲状腺肿MRI和CT表现

目的 分析卵巢甲状腺肿的MRI、CT表现。方法 回顾性分析14例经手术病理证实的单发卵巢甲状腺肿患者的MRI及CT表现,观察其形态、大小、密度/信号、强化特点等。结果 14例病变均表现为包膜完整的囊实性肿块,其中分叶状11例,类圆形3例;多囊状13例,单囊1例;11例实性成分为明显厚壁或分隔,3例呈结节状。肿瘤最大径为3~34 cm,平均（11.34±2.24） cm。7例MR T2WI囊性部分均可见极低信号区,增强后无强化,实性成分明显强化。7例CT囊性部分均可见高密度区,CT值57~90 HU,增强扫描未见强化;实性成分明显强化,CT值为145~270 HU;4例囊壁或实性结节中见斑片状钙化。结论 卵巢甲状腺肿的MRI、CT表现具有一定特征性,有助于诊断及鉴别诊断。