Inter-clade cross-reactivity of HIV-1-specific T cell responses in human immunodeficiency virus type 1 infection in China

To determine the degree of HIV-1-specific cytotoxic-T-lymphocyte (CTL) cross-responses to the clade B and C consensus sequences at the single peptide level. We assessed CTL responses in 46 HIV-1 clade B chronically infected individuals using an interferon-gamma Elispot assay with a total of 826 overlapping peptides spanning HIV-1 clade B and C consensus sequences. In general, 583 peptides were recognized by HIV-1-specific T cells in the study subjects (292 clade B, 291 clade C respectively), of which 204 peptides in both clades were recognized simultaneously. The HIV-1-specific CTL responses to both clade peptides contributed 54.23% (954/1759) to the total responses. No significant difference was observed between the overall magnitude or frequency of CTL responses to clade B proteins and those to clade C proteins. According to the profiles of CTL magnitude and CTL frequency, the top 44 and 35 synthetic peptides were identified as immunodominant regions in the clade B and C consensus sequences respectively and 27 corresponding peptides in two immunodominant regions were cross-reactive. These peptides with cross-reactivity had a significantly higher ability to elicit CTL responses (P< 0.01) and preferentially had a trend of lower entropy and higher inter-clade homology. A wide degree of cross-clade reactivity of HIV-1-specific T cells exist in clade B and clade C variants. Most of immunodominant peptides with cross-reactivity are vigorous to elicit CTL responses and preferentially be conservative. This result may make future HIV-1 vaccines including multiple copies of CTL epitopes in these immunodominant peptides effective for this population.     

NSCLC患者血清中HSP90α的表达及其临床意义

目的:探讨热休克蛋白90α（HSP90α）在非小细胞肺癌（NSCLC）患者血清中的表达水平及其临床意义。方法:选取2015年10月至2016年10月期间，在第四军医大学唐都医院胸外科确诊为NSCLC的患者100例为肺癌组。选取同期在我院进行体检的健康成年人40例为对照组。检测并比较两组血清HSP90α表达水平差异；比较不同肿瘤分期(TNM分期)患者的血清HSP90α水平差异；探讨不同TNM分期与血清HSP90α表达水平之间的关系。培养NSCLC A549细胞，检测其分泌至胞外的HSP90α蛋白；使用HSP90α抑制剂处理A549细胞，MTT法检测细胞增殖能力的变化。结果:肺癌组与对照组患者血清HSP90α表达水平比较，差异有统计学意义（P＜0.001）；不同TNM分期患者血清HSP90α表达水平比较，差异有统计学意义（P<0.001）；Spearman秩相关分析显示，TNM分期与血清HSP90α水平呈正相关(r=0.95，P＜0.05)。体外细胞实验证实A549细胞能分泌HSP90α至细胞外，使用HSP90α抑制剂处理后细胞增殖能力明显下降。结论:NSCLC患者血清中HSP90α表达水平较正常人升高，并且与TNM分期呈正相关。血清HSP90α由肺癌细胞分泌入血，检测其水平对肺癌的诊断与治疗有一定的临床参考价值。     

体外诱导C2C12细胞向成骨细胞的分化

目的成骨细胞特异性转录因子a1(core binding factor a1,Cbfa1)通过调节生长因子和骨特异性细胞外基质蛋白的基因表达而参与成骨细胞的分化和骨发育过程。文中构建成Cbfa1,以腺病毒载体转染成肌细胞C2C12,为种子细胞构建组织工程化骨。方法体外培养小鼠成肌细胞C2C12,用重组腺病毒质粒pAd-IL-31介导Cbfa1/Osf2基因瞬时转染小鼠成肌C2C12细胞,Western blot检测Cbfa1蛋白表达。结果 Cbfa1蛋白表达、碱性磷酸酶(alkaline phosphatase,ALP)活性测定、骨钙素(osteocalcin,OCN)分泌量以及茜素红染色感染组明显高于对照组。结论成肌细胞C2C12可以作为种子细胞构建组织工程化骨。     

一项基于内镜治疗儿童消化道异物的回顾性分析

目的 总结儿童消化道异物的临床特点及内镜治疗方法和效果,为临床诊治工作提供参考。方法 选取2016年12月－2018年5月在空军军医大学唐都医院儿科诊治的103例儿童消化道异物患儿作为研究对象,对其一般资料、异物类型、临床表现、并发症、异物停留部位及干预治疗等进行回顾性分析。结果 消化道异物患儿男(75.73%)多于女(24.27%),农村(59.22%)多于城镇(20.78%),幼儿期最高发(69.90%),事发时普遍不在家长的监护下(65.05%)。异物类型硬币最为常见(50.49%),异物停留部位食管最多(43.69%),其次为胃底(36.89%)。经电子胃镜取出83例,住院观察自行排出19例,1例经外科手术取出。88例出现不同程度食管或胃黏膜损害,3例合并食管穿孔及食管气管瘘,经抑酸护膜等治疗后复查胃镜及气管镜均痊愈,1例合并肠梗阻经普外科手术治疗痊愈。结论 儿童消化道异物多种多样,多会造成胃黏膜损伤,预防首要提高家长监护,电子胃镜治疗简便、安全、成功率高,可作为首选。     

双甲五灵胶囊治疗肝纤维化的临床研究

目的 :观察中药双甲五灵胶囊治疗肝纤维化的疗效。方法 :将 96例患者随机分为双甲五灵胶囊治疗组(A组 )和基础保肝对症治疗对照组 (B组 ) ,观察两组治疗前后临床症状、体征、肝功能 [总胆红素 (TBi L)、丙氨酸转氨酶 (AL T)、白蛋白 (AL B) ]、血清透明质酸 (HA)、 型前胶原 (PC )、转化生长因子 β1 (TGF- β1 ) ,并进行统计学处理。结果 :双甲五灵胶囊对改善乏力、纳差、腹胀、肝区不适等症状及脾大回缩、恢复肝功能疗效明显 ,并能降低血清 HA、PC 、TGF- β1 浓度 (P <0 .0 5 )。结论 :双甲五灵胶囊治疗肝纤维化效果较好 ,未发现副作用。     

神经肿瘤专科医师职业精神的探讨

神经肿瘤,特别是脑胶质瘤的综合治疗有其复杂性、特殊性,使得神经肿瘤医师常需面对专业知识和职业精神的双重考验。加强职业精神持续培养、增加医患有效沟通、重视专业知识的更新提高、采取有效措施、体现对患者关爱等措施,有助于提升神经肿瘤专科医师的职业精神。     

Chinese clinical practice guidelines for acute infectious diarrhea in children

Background

The guidelines addressed the evidence-based indications for the management of children with acute infectious diarrhea in Chinese pediatric population.

Data sources

The experts group of evidence development put forward clinical problems, collects evidence, forms preliminary recommendations, and then uses open-ended discussions to form recommendations. The literature review was done for developing this guideline in databases including PubMed, Cochrane, EMBASE, China Biomedical Database, and Chinese Journal Full-text Database up to June 2013. Search the topic “acute diarrhea” or “enteritis” and “adolescent” or “child” or “Pediatric patient” or “Baby” or “Infant”.

Results

For the treatment of mild, moderate dehydration, hypotonic oral rehydration solutions (ORS) are strongly recommended. Intravenous (IV) rehydration is recommended for severe dehydration, with a mixture of alkali-containing dextrose sodium solution. Nasogastric feeding tube rehydration is used for children with severe dehydration without IV infusion conditions with ORS solution. Regular feeding should resume as soon as possible after oral rehydration or IV rehydration. The lactose-free diet can shorten the diarrhea duration. Zinc supplements are recommended in children with acute infectious diarrhea. Saccharomyces boulardii and Lactobacillus Rhamnus are recommended to be used in acute watery diarrhea. Saccharomyces boulardii is recommended in children with antibiotic-associated diarrhea as well. Montmorillonite and Racecadotril (acetorphan) can improve the symptoms of diarrhea or shorten the course of acute watery diarrhea. Antibiotics are recommended with dysenteric-like diarrhea, suspected cholera with severe dehydration, immunodeficiency, and premature delivery children with chronic underlying disease; otherwise, antibiotics are not recommended.

Conclusion

The principles of the most controversial treatments with of acute infectious disease are reaching to a consensus in China.

     

Pretreatment neutrophil count as an independent prognostic factor in advanced non-small-cell lung cancer: An analysis of Japan Multinational Trial Organisation LC00-03

We examined the impact of pretreatment neutrophil count on survival in patients with advanced non-small-cell lung cancer (NSCLC). A total of 388 chemo-naïve patients with stage IIIB or IV NSCLC from a randomised controlled trial were evaluated. The effects of pretreatment peripheral blood neutrophil, lymphocyte and monocyte counts and neutrophil–lymphocyte ratio on survival were examined using the proportional hazards regression model to estimate hazard ratios after adjustment for covariates. The optimal cut-off value was determined by proportional hazards regression analysis with the minimum P-value approach and shrinkage procedure. After adjustment for prognostic factors, the pretreatment elevated neutrophil count was statistically significantly associated with short overall (P = 0.0008) and progression-free survival (P = 0.024), whereas no association was found between prognosis and lymphocyte or monocyte count. The cut-off value selected for neutrophil count was 4500 mm^–3 (corrected hazard ratio, 1.67; 95% confidence interval (CI), 1.09–2.54). The median survival time was 19.3 months (95%CI, 16.5–21.4) for the low-neutrophil group (?4500 mm^–3, n = 204) and was 10.2 months (95%CI, 8.0–12.3) for the high-neutrophil group (?4500 mm^–3, n = 184). We confirmed that pretreatment elevated neutrophil count is an independent prognostic factor in patients with advanced NSCLC receiving modern chemotherapy. Neutrophil count is easily measured at low cost, and it may be a useful indicator of patient prognosis.     

基于RFID技术的伤员信息管理系统

本文介绍了RFID（射频识别）技术的技术原理和技术特点。野战医疗所伤员信息管理系统的开发采用了RFID技术、无线通讯技术,满足对于伤员远距离、快速识别的需求。能够保证战场伤员救治的及时性、有效性、准确性,对作战指挥、战斗力评估也有重要的指导意义。