FA方案巩固强化治疗急性髓系白血病的临床观察

目的探讨氟达拉滨联合中剂量阿糖胞苷即FA方案巩固强化治疗急性髓系白血病（acute myeloidleukemia,AML）的临床疗效及副作用。方法观察组28例AML患者采用FA方案进行巩固强化治疗,氟达拉滨30 mg/m2（1～3 d）,静脉滴注,阿糖胞苷2 g/m2,（1～3 d）,静脉滴注,阿糖胞苷在氟达拉滨结束后4 h应用。同期对照组10例AML患者采用大剂量阿糖胞苷进行巩固强化治疗,即Ara-C 3 g/m2,q12 h×3 d。结果 FA组28例AML患者CR时间为109～1 735 d,14例患者持续完全缓解（continuous complete remission,CCR）2年以上,（3年）生存率为21.4%,1 300 d（〉3年）的生存率为14.3%,与大剂量阿糖胞苷组没有统计学差异。7例患者于CCR后3～47个月复发,复发患者均存在各种不良预后因素,至少处于中高危分级。不良反应主要为骨髓抑制和继发感染,但总体而言骨髓抑制时间较短,非血液毒性较轻,住院时间在3周左右。结论氟达拉滨能提升胞内Ara-CTP浓度,增强抗白血病作用。FA方案多疗程巩固治疗低中危AML,能减少AML复发,提高总体生存率和无病生存率,临床疗效肯定,不良反应较少,值得进一步深入研究。     

脊柱推拿对腰椎间盘突出症患者脑功能活动的影响

目的观察脊柱推拿治疗对腰椎间盘突出症患者脑功能活动的影响。方法招募11例腰椎间盘突出症患者，8例受试者完成了研究。所有患者接受6次腰部脊柱推拿治疗，并在脊柱推拿治疗前、后对患者进行颅脑功能核磁共振成像检测，评估患者脑功能活动的改变及与疗效关系。结果4例腰椎间盘突出症患者脊柱推拿治疗有效，4例无效。脊柱推拿有效患者治疗前、后产生视觉模拟评分（VAS）为50分时的疼痛压力值分别为（7.43±1.47）kg和（10.53±0.55）kg（ P < 0.05），而无效患者的则无明显差异（ P＞0.05）。颅脑功能核磁共振成像检测结果提示，脊柱推拿治疗有效患者的脑功能活动以抑制为主，抑制区域主要位于右侧前额叶及小脑区域；而脊柱推拿治疗无效患者的脑功能活动以增强为主。 结论脊柱推拿能够影响腰椎间盘突出症患者的脑功能活动，其治疗有效患者的抑制区域主要在额叶及小脑。     

Role of DTI in cases of cervical spondylosis presented with compression myelopathy: Could it explain the clinical radiological mismatch?!

Introduction and aim of work

The work aimed to assess if Diffusion Tensor Imaging and Fiber Tractography (DTI) can explain the contradiction between the side of brachialgia in patients with cervical spondylosis and the side of cord compression by the cervical disc-osteophytes complex.

伪狂犬病病毒单克隆抗体的研究

本文采用杂交瘤技术得到能分泌伪狂犬病病毒(PrV,Pseudorabies Virus)特异抗体的杂交瘤细胞。细胞融合率为98％,分泌特异抗体的杂交瘤细胞达65％,得到不同类和亚类的杂交瘤细胞系,克隆出的杂交瘤细胞系染色体数在82～109条之间。微量血清中和试验表明这些细胞系分泌的抗体为非中和性抗体。利用单抗IgG1与荧光素结合,制备出伪狂犬病病毒特异的荧光抗体,建立了伪狂犬病免疫荧光诊断法。同时,利用放射自显影和SDS-PAGE对病毒结构多肽进行了分析,表明伪狂犬病病毒主要有13种多肽成分,能被高免血清识别的有5种。     

Selection of monoclonal antibodies detecting serodiagnostic human tumor markers

Monoclonal antibodies (MAbs) were selected for specific binding to spent media of cultured tumor cells. Out of more than 12,000 hybridomas screened, 19 were selected in preliminary inhibition assays for secretion of MAbs which detected antigens in cancer patients' sera. Antibody CO 29.11, which was studied in detail, bound to an antigen shed and expressed by adenocarcinoma cells of colon, stomach, pancreas and urinary bladder. CO 29.11 bound to purified sialylated Lewis a (Lea) antigen but to a different epitope and with a higher binding affinity than the MAb CA 19-9. CO 29.11 but not CA 19-9 bound weakly to unsialylated Lea antigen. In double-determinant radioimmunoassay with sera of patients with colorectal carcinoma, CO 29.11 was found to be a more sensitive marker than CA 19-9 for the detection in serum of sialylated Lea antigen.     

Study on the Influencing Factors of Hypoglycemic Effect of Folate Targeted Polymersomes Encapsulating Insulin

PurposeTo study the effects of the density of folic acid (FA) on the hypoglycemic ability of FA-targeted polymersomes as oral insulin carriers. Also to study the change of the hypoglycemic effect of FA-targeted mixed polymersomes added with various mass ratio of d-α-tocopherol polyethylene glycol 1000 succinate (TPGS).MethodsThe FA-targeted polymersomes with different FA molar contents were prepared. The in vitro insulin release experiments in different media for FA-targeted polymersomes with various FA contents were studied. Their quantitative cellular uptake in Caco-2 cells was examined. The in vivo hypoglycemic activity of FA-targeted polymersomes was also studied with diabetic rats. The polymersomes with the optimal FA molar content was chosen to prepare mixed polymersomes with various TPGS contents.ResultsAmong insulin-loaded FA-targeted polymersomes with four different FA molar contents, insulin-loaded polymersomes with 10% FA molar content (insulin-loaded 10%FA-Ps) showed the hightest cellular uptake and the best hypoglycemic response. In addition, the insulin-loaded FA-Ps/TPGS5:1 mixed polymersomes exhibited higher cellular uptake and better hypoglycemic response than the other two insulin-loaded mixed polymersomes adding TPGS did.ConclusionsFA-Ps/TPGS5:1 could be a promising formulation for the oral administration of insulin.     

Liver-associated immune abnormalities

In recent years, the cross talk between the liver and the immune system is being uncovered, in part by studying liver involvement in primary immune deficiencies (PID) and in part by investigating the alterations of the immune system following orthotopic liver transplantation (OLT). Here we review some of the reciprocal interactions between the liver and the immune system. Patients with PID, particularly those involving inherited defects in T and B cells or innate immunity are prone to infections and inflammatory responses that often involve the liver. Omenn's syndrome, familial hemophagocytic lymphohistiocytosis, AIRE, FOXP3 and CD25 deficiencies, common variable immunodeficiency, CD40 ligand deficiency, chronic granulomatous disease and autoimmune lymphoproliferative syndrome are some of the notable PID associated with typical hepatobiliary abnormalities. Knowledge gained from studying these PID together with laboratory and histological evaluations can assist in managing PID-associated liver dysfunction. The liver itself also has important effects on the immune system, as evident from the growing experience with patients surviving OLT. Up to 40% of pediatric patients who receive OLT suffer from post transplantation allergy, autoimmunity, and immune-mediated disorders (PTAA). PTAA is more common after liver and heart transplantations than kidney transplantations. Potential contributing factors for the increased frequency of PTAA after OLT include the age of the patients, the prolonged use of tacrolimus and the reduced regulatory immune function with a shift towards a TH2 immune response. Better understanding of the mechanisms leading to the development of PTAA after OLT will also improve the management of these conditions.