双能量减影技术的临床应用

目的:通过对比双能量减影技术和普通X线摄影方法,总结出双能量减影技术的优势,推荐有条件时普及双能量减影技术。方法:通过对比双能量减影技术和普通X线摄影(包括CR、DR等数字化X线摄影技术)影像所能提供的信息量及准确程度,得出结论。结果:双能量减影技术较普通X线摄影技术,能为诊断医师提供更多更准确的诊断信息,对于普通检查时的一些重叠部位效果更明显。结论:双能量减影技术先进,有助于提高诊断准确率,射线量较低,建议有条件的单位进行普及。     

距骨骨折DR漏诊原因分析

目的分析DR（Digital Radiography,DR）对距骨骨折漏诊原因,探讨预防方法,提高距骨骨折诊断的准确率。方法回顾性分析2010年1月～2011年12月对25例距骨骨折的DR检查结果,并对漏诊原因进行分析。结果25例距骨骨折中,14例首次DR检查准确诊断,11例经复查或进一步CT检查才明确诊断。结论 DR检查足踝创伤时,应结合患者病史、投照条件、投照角度、短期的随访复查及结合CT检查,从而减少距骨骨折的漏诊。     

中国北方汉族人群HLA-DRB1单核苷酸多态性与脑血管病的关系

目的：研究北方汉族人群脑血管病与HLA-DRB1单核苷酸多态性的遗传关联性,为脑血管病的免疫遗传学研究奠定基础。方法：采用病例对照研究方法,收集160例脑血管病患者和139例健康对照。根据知情同意原则对每例受检者进行身高、体质量、腰围(WC)、腹围(AC)、体质量指数(BMI)等一般指标测量,采集空腹静脉血,检测血白蛋...     

槲皮素通过SIRT1/ROS/DR5途径发挥对TRAIL的协同抗前列腺癌活性

目的: 探讨中药活性成分槲皮素是否对TRAIL有协同抗前列腺癌效应并研究其机制。方法: MTT实验检测前列腺癌细胞系PC3的细胞活力;流式细胞术检测PC3细胞的凋亡和ROS的产生;western blot实验检测PC3细胞中SIRT1、DR5的表达水平及caspase-8、caspase-3的活化水平。结果: TRAIL联合槲皮素对PC3的细胞活力抑制率(64.7±5.2)和凋亡诱导率(34.7±2.6)显著高于TRAIL单治疗组的细胞活力抑制率(16.9±1.4,P<0.05)和凋亡诱导率(9.1±0.8,P<0.05)。TRAIL联合槲皮素治疗组的SIRT1表达水平显著低于TRAIL单治疗组,同时TRAIL联合槲皮素治疗组的DR5表达水平、ROS产生水平及caspase-8、caspase-3活化水平均显著高于TRAIL单治疗组。另外,TRAIL+槲皮素+SIRT1质粒组PC3的细胞活力抑制率(23.4±1.9)和凋亡诱导率(12.5±1.2)及TRAIL+槲皮素+NAC组PC3的细胞活力抑制率(21.5±1.8)和凋亡诱导率(11.3±1.1)均显著低于TRAIL联合槲皮素组PC3的细胞活力抑制率(64.7±5.2,P<0.05)和凋亡诱导率(34.7±2.6,P<0.05)。结论: 槲皮素通过SIRT1/ROS/DR5途径发挥对TRAIL的协同抗前列腺癌活性。     

我院DR摄影重复检查的原因分析

目的分析我院DR重复摄影的原因及预防措施。方法应用KODAK DR7500;PHILIPSDR2.0,对我院2008年10月至2010年12月,DR重复摄片413例（男254例、女159例）进行分析。结果所拍部位影像包括不全,影响诊断152例;患者不能很好配合132例;拍片位置不正确49例;技术操作人员操作失误18例;体外异物产生伪影27例;机器故障引起图像信息丢失3例;拍片部位与申请单不符15例。结论 DR摄影重复检查率相比CR及传统摄影已大幅下降,但重复检查还是无法避免。从对413例重复检查的原因分析可以看出,许多重复检查可以通过操作人员的努力、患者及其陪护人员的积极配合减到最低程度。     

Anti-tumor effect of the alphavirus-based virus-like particle vector expressing prostate-specific antigen in a HLA–DR transgenic mouse model of prostate cancer

The goal of this study was to determine if an alphavirus-based vaccine encoding human Prostate-Specific Antigen (PSA) could generate an effective anti-tumor immune response in a stringent mouse model of prostate cancer. DR2bxPSA F₁ male mice expressing human PSA and HLA-DRB1^*1501 transgenes were vaccinated with virus-like particle vector encoding PSA (VLPV–PSA) followed by the challenge with Transgenic Adenocarcinoma of Mouse Prostate cells engineered to express PSA (TRAMP–PSA). PSA-specific cellular and humoral immune responses were measured before and after tumor challenge. PSA and CD8 reactivity in the tumors was detected by immunohistochemistry. Tumor growth was compared in vaccinated and control groups. We found that VLPV–PSA could infect mouse dendritic cells in vitro and induce a robust PSA-specific immune response in vivo. A substantial proportion of splenic CD8 T cells (19.6 ± 7.4%) produced IFNγ in response to the immunodominant peptide PSA_65–73. In the blood of vaccinated mice, 18.4 ± 4.1% of CD8 T cells were PSA-specific as determined by the staining with H-2D^b/PSA_65–73 dextramers. VLPV–PSA vaccination also strongly stimulated production of IgG2a/b anti-PSA antibodies. Tumors in vaccinated mice showed low levels of PSA expression and significant CD8+ T cell infiltration. Tumor growth in VLPV–PSA vaccinated mice was significantly delayed at early time points (p = 0.002, Gehan–Breslow test). Our data suggest that TC-83-based VLPV–PSA vaccine can efficiently overcome immune tolerance to PSA, mediate rapid clearance of PSA-expressing tumor cells and delay tumor growth. The VLPV–PSA vaccine will undergo further testing for the immunotherapy of prostate cancer.     

Safety of reassessment-and-release practice for mental health patients boarded in the emergency department

Objectives

Among emergency department (ED) mental health and substance abuse (MHSA) patients, we sought to compare mortality and healthcare utilization by ED discharge disposition and inpatient bed request status.

Myocardial perfusion imaging in humans by contrast echocardiography using polygelin colloid solution

This study evaluated the myocardial contrast effect and safety of polygelin colloid solution selectively injected into the coronary arteries in 25 patients during two-dimensional echocardiography. Six patients (group I) had selective intracoronary injections of nonagitated and 19 (group II) of hand-agitated polygelin colloid solution. Myocardial contrast was seen on two-dimensional echocardiographic cross sections in three patients of group I and in all patients of group II; in 16 patients it was also seen on M-mode echocardiograms. The contrast effect lasted for 15 to 60 seconds. The intensity of myocardial opacification was not significantly influenced by the amount of polygelin colloid solution injected, heart rate or cardiac size. The total number of contrast-enhanced segments after right and left coronary artery injections delineated the entire cross-sectional area in any given view. None of the patients developed symptoms during or immediately after the injections. One patient had transient second degree atrioventricular block after a right coronary wedge injection, one patient showed a QRS axis shift and two others had transient T wave changes. There were no aortic blood pressure changes and no significant serum enzyme (creatine kinase [CK], CK-MB fraction, glutamic oxaloacetic transaminase) elevation or alterations of left ventricular function assessed echocardiographically. It is concluded that hand-agitated polygelin colloid solution is a useful and safe intracoronary contrast agent for delineating myocardial perfusion areas on two-dimensional echocardiography in humans.     

HLA-DRB1和肿瘤坏死因子α基因多态性与肝硬化的遗传易感性

目的探讨HLA-DRB1和肿瘤坏死因子(TNF)α基因多态性与肝硬化遗传易感性之间的关系.方法应用聚合酶链反应-序列特异性引物法、限制性片段长度多态性等技术检测106例乙型肝炎后肝硬化患者和108例健康对照者的HLA-DRB1和TNFα基因多态性.结果肝硬化组HLA-DRB1*120X等位基因频率比对照组显著升高(35.9%比11.1%,P＜0.001),TNFα中TNF2/1基因型频率比对照组明显升高(19.8%比10.2%, P＜0.05),DRB1*150X等位基因频率明显低于对照组 (13.2%比30.6% ,P＜0.05),分层分析表明,DRB1*120X等位基因与肝硬化的关联大于TNF2等位基因.结论 HLA-DRB1*120X和TNF2等位基因与乙型肝炎后肝硬化的遗传易感性相关,携带这2个等位基因的个体发生肝硬化的危险性增加.HLA-DRB1*120X等位基因可能是肝硬化的易感基因,HLA-DRB1*150X等位基因为抗性基因.     

Composition of the HLA‐DR‐associated human thymus peptidome

Major histocompatibility complex class II (MHC‐II) molecules bind to and display antigenic peptides on the surface of antigen‐presenting cells (APCs). In the absence of infection, MHC‐II molecules on APCs present self‐peptides and interact with CD4⁺ T cells to maintain tolerance and homeostasis. In the thymus, self‐peptides bind to MHC‐II molecules expressed by defined populations of APCs specialised for the different steps of T‐cell selection. Cortical epithelial cells present peptides for positive selection, whereas medullary epithelial cells and dendritic cells are responsible for peptide presentation for negative selection. However, few data are available on the peptides presented by MHC molecules in the thymus. Here, we apply mass spectrometry to analyse and identify MHC‐II‐associated peptides from five fresh human thymus samples. The data show a diverse self‐peptide repertoire, mostly consisting of predicted MHC‐II high binders. Despite technical limitations preventing single cell population analyses of peptides, these data constitute the first direct assessment of the HLA‐II‐bound peptidome and provide insight into how this peptidome is generated and how it drives T‐cell repertoire formation.