Dependence of macrophage phagocytic efficacy on antibody concentration

Macrophages ingest the fungus Cryptococcus neoformans only in the presence of opsonins, and this provides a remarkably clean system for the detailed analysis of phagocytosis. This system is also unusual in that antibody-mediated phagocytosis involves ingestion through both Fc and complement receptors in the absence of complement. Mathematical modeling was used to analyze and explain the experimental data that the macrophage phagocytic index increased with increasing doses of antibody despite saturating concentrations and declined at high concentrations. A model was developed that explains the increase in phagocytic index with increasing antibody doses, differentiates among the contributions from Fc and complement receptors, and provides a tool for estimating antibody concentrations that optimize efficacy of phagocytosis. Experimental results and model calculations revealed that blocking of Fc receptors by excess antibody caused a reduction in phagocytic index but increased phagocytosis through complement receptors rapidly compensated for this effect. At high antibody concentrations, a further reduction in phagocytic index was caused by interference with complement receptor ingestion as a consequence of saturation of the fungal capsule. The ability of our model to predict the antibody dose dependence of the macrophage phagocytic efficacy for C. neoformans strongly suggest that the major variables that determine the efficacy of this process have been identified. The model predicts that the affinity constant of the opsonic antibody for the Fc receptor and the association-dissociation constant of antibody from the microbial antigen are critical parameters determining the efficacy of phagocytosis.     

LIS、HIS无缝连接及检验样本条码化应用体会——以海河医院为例

通过HIS系统升级增加医生工作站、LIS系统建设、LIS与HIS无缝连接、条码技术在LIS中的应用,实现病人基本信息及检验结果信息全医院联网.实践证明,该方案切实可行,可大大优化和规范医院工作流程,降低出错率,医患共同受益.     

Chemolithoautotrophic oxidation of thiosulfate and phylogenetic distribution of sulfur oxidation gene (soxB) in rhizobacteria isolated from crop plants

Twenty-one thiosulfate-oxidizing bacteria were isolated from rhizosphere soils and 16S rRNA analysis revealed that the isolates were affiliated with seven different phylogenetic groups within the Beta and Gamma subclasses of Proteobacteria and Actinobacteria. Among these, five genera, including Dyella, Burkholderia, Alcaligenes, Microbacterium and Leifsonia sp., represented new sulfur oxidizers in rhizosphere soils. The thiosulfate-oxidizing Dyella, Burkholderia, Alcaligenes, Microbacterium, Leifsonia and Pandoraea were able to grow chemolithotrophically with a medium containing thiosulfate and exhibited growth coupled with thiosulfate oxidation. They accumulated intermediate products such as sulfur, sulfite and trithionate in the spent medium during the time course of thiosulfate oxidation, and these products were finally oxidized into sulfate. Furthermore, they possessed thiosulfate-metabolizing enzymes such as rhodanese, thiosulfate oxidase, sulfite oxidase and trithionate hydrolase, suggesting that these bacteria use the 'S4 intermediate' (S4I) pathway for thiosulfate oxidation. Phylogenetic analysis of the soxB gene revealed that Pandoraea sp. and Pandoraea pnomenusa strains formed a separate lineage within Betaproteobacteria.     

连续性肾脏替代治疗在12例大面积严重烧伤患者中的应用

目的探讨连续性肾脏替代治疗（CRRT）在挽救严重烧伤患者生命中的作用。方法收集2003年7月至2007年1月12例采取CRRT治疗的大面积严重烧伤患者，进行病例分析。结果12例患者中2例放弃治疗，10例痊愈，随访时间6个月-2年，1人时有周身浮肿，尿蛋白（＋），其余11例患者均无不适感。结论CRRT可提供稳定的血流动力学，为烧伤常规治疗以及衰竭脏器功能的恢复创造重要保障，有效改善患者的预后。     

荧光定量PCR以及培养法检测男性不育症患者液解脲支原体结果的比较分析

目的 研究解脲支原体(UU)感染在男性不育症患者中的意义以及对其培养法和荧光定量PCR两种方法检测结果进行比较分析.方法对342例男性不育症患者和198例对照组同时进行UU培养和荧光定量PCR检测,培养法同步伴有药物敏感试验的结果.结果在不育症患者中培养法和荧光定量PCR检测UU的阳性率分别为43.0%和55.8%,在对照组中则分别为25.3%和29.8%,经x<'2>检验在男性不育症患者中两种方法检测UU的阳性率均显著高于对照组,P<0.005;荧光定量PCR的阳性率显著高于培养法,P<0.005;药物敏感试验结果显示UU培养法阳性者对克拉霉素敏感性最高,敏感率为97.4%,对环丙沙星耐药性最高,耐药率为62.1%.结论UU检测可对男性不育症患者的病因诊断和临库治疗提供实验依据.荧光定量PCR检测UU的敏感性要高于培养法,但是培养法的药敏试验可及时准确的指导临床选择用药.     

PAS联合六胺银染色诊断局限性马尔尼菲青霉菌感染的应用

目的探讨建立快速诊断局限性马尔尼菲青霉菌感染的方法,以期早期诊断,降低死亡率。方法采用高碘酸一无色品红（PAS）染色联合六胺银染色对4例非AIDS马尔尼菲青霉菌感染者活检组织进行马尔尼菲青霉菌的特殊染色,分析感染者的临床表现和病理组织学诊断特点。结果患者均为广东本地居民,属局限性马尔尼菲青霉菌感染。除1例有发热外,临床上未见以发热、失重、贫血、白细胞增高为主的马尔尼菲青霉菌感染症状以及多器官损害症状。HE染色显示病理组织学类型为肉芽肿型和化脓型。病变组织经PAS染色与六胺银染色后,在油镜下增生的泡沫状巨噬细胞胞浆内,呈现大量红色或黑色的卵圆形及腊肠状酵母样青霉菌孢子。无荚膜,在腊肠状菌体中可见马尔尼菲青霉菌特有的裂殖时出现的横隔膜。结论PAS联合六胺银染色清晰显示组织中马尔尼菲青霉菌的特征性结构和形态,结合病理组织学特点、中国南方地区生活或旅游史,可以快速诊断局限性马尔尼菲青霉菌感染。     

中国大陆学习困难儿童韦氏智力测验对照研究的Meta分析

目的 评估中国学习困难和正常儿童韦氏儿童智力量表（WISC）测量的差异.方法 检索PubMed、MD Consult、中图公司免费外文期刊整合库（cnpLINKer）、中国知网和万方生物医学期刊数据库,检索时间均从建库至2012年5月.获得中国学习困难和正常儿童WISC测量的对照研究,WISC中文版本为北京师范大学版（WISC-CR）或湖南医科大学版（C-WISC）.提取总智商（FIQ）、言语智商（VIQ）和操作智商（PIQ）.应用RevMan 5.0软件进行Meta分析,根据异质性结果选择相应的效应模型分析,并进行亚组分析.结果 23篇文献进入Meta分析,研究实施地均为中国大陆;10篇文献采用WISC-CR,13篇文献采用C-WISC;12篇文献研究现场为医院门诊或儿童保健门诊,对照组基本为来院智力检测的正常儿童;13篇文献研究现场为学校,对照组来自同校或同班同学.①FIQ、VIQ和PIQ异质性检验提示具显著异质性,均采用随机效应模型分析.Meta分析结果显示,FIQ、VIQ和PIQ的WMD分别为-16.23（95%CI：-18.20～-14.25）、-18.90（95%CI：-21.04～-16.77）和-11.92（95%CI：-13.90～-9.94）;学习困难组均显著低于对照组（P均〈0.000 01）.②对纳入文献的依据诊断方法、研究现场、WISC版本行异质性原因分析,结果显示不能消除异质性.③对VIQ和PIQ各分项进行亚组分析,结果显示VIQ的6个分项（常识、类同、算数、词汇、理解、数字广度）和PIQ的5个分项（填图、排列、积木、拼图、译码）的文献间均具显著异质性,采用随机效应模型分析.Meta分析结果显示,学习困难组VIQ和PIQ各分项得分均显著低于对照组（P均〈0.001）.结论 中国大陆学习困难儿童FIQ、VIQ和PIQ低于正常儿童,VIQ的延迟发展更明显.VIQ和PIQ各分项中以常识、类同、积木和译码的延迟发展更明显.     

喉部动脉影像解剖学的应用研究

目的研究喉部动脉的影像解剖学为临床提供解剖学依据和资料。方法取36例喉部结构完整的尸体标本,8例尸体标本做动脉铸型,12例尸体标本用MR扫描仪进行水平面和矢状面的扫描,8例尸体标本进行1mm/片冰冻磨铣,8例尸体标本进行大体及显微解剖,并对5种不同的形态学研究方法关于喉部动脉的观测结果进行统计学分析和定性、定量研究。结果左、右甲状腺上动脉的长度分别为(42.30±0.20)mm和(40.50±0.20)mm,起点处的管径分别为(1.80±0.30)mm和(1.65±0.30)mm;左、右甲状腺下动脉的长度分别为(23.60±0.27)mm和(22.40±0.24)mm,起始点的管径为分别为(1.40±0.25)mm和(1.35±0.30)mm。喉上动脉起点处的管径(1.50±0.20)mm,入喉处管径为(1.32±0.15)mm,长度为(18.60±2.45)mm;其入喉处在甲状软骨的前下方,距甲状软骨上角尖的距离,左侧为(6.80～25.50)mm,平均(14.60±2.45)mm;右侧为(7.60～28.60)mm,平均(15.58±2.58)mm,两侧差异有统计学意义(<0.05)。喉下动脉起点处的管径(1.70±0.30)mm,长度为(15.50±1.80)mm。结论喉部动脉的影像解剖学研究,为耳鼻喉头颈科特别是喉部病变的临床诊断和治疗提供更为科学和全面的影像解剖学依据及血供形态学资料。