益气养阴化瘀方治疗肺癌术后复发和转移临床研究

目的:观察益气养阴化瘀方治疗对肺癌术后患者复发和转移的影响。方法:将接受手术治疗的非小细胞肺癌患者88例随机分为2组,对照组44例术后行常规GP方案治疗,观察组44例在对照组的基础上加服益气养阴化瘀方治疗8周,观察患者治疗后复发转移情况,血清肿瘤标志物[血管内皮生长因子(VEGF)、癌胚抗原(CEA)、糖链抗原CA199、CA125、CA50]含量及免疫功能[T淋巴细胞(CD8^+、CD4^+、CD3^+、CD4^+/CD8^+)和自然杀伤细胞(NK)]改变情况。结果:随访12个月,观察组患者复复发2例(4.55%),转移10例(22.73%);对照组复发3例(6.82%),转移12例(27.27%);观察组复发率、转移率均低于对照组,但差异无统计学意义(P>0.05)。治疗后及随访12个月,观察组血清VEGF、CEA、CA199、CA50含量均较治疗前显著降低(P<0.05)。治疗后,对照组血清VEGF、CEA、CA199、CA50含量均较治疗前显著降低(P<0.05);随访12个月,对照组血清VEGF含量降低,CA125、CA50含量升高(P<0.05)。随访12个月,观察组患者血清VEGF、CEA、CA199、CA125及CA50含量均明显低于对照组(P<0.05)。随访12个月,观察组患者CD8^+、CD4^+、CD3^+含量均较治疗前及对照组同时间点显著升高(P<0.05)。治疗后,对照组患者CD3^+、CD4^+/CD8^+比值均较治疗前显著降低(P<0.05)。治疗后,观察组CD3^+、CD4^+/CD8^+比值均较对照组升高(P<0.05)。2组治疗前后NK值变化不显著(P>0.05)。结论:在肺癌术后GP方案治疗的基础上,加用益气养阴化瘀方可降低患者复发转移率、血清肿瘤标志物含量,提高患者机体免疫功能。     

Isolation and characterization of monoclonal antibodies elicited by trimeric HIV-1 Env gp140 protein immunogens

Eleven anti-HIV Env monoclonal antibodies (MAbs) were isolated from mice immunized with soluble Env proteins derived from the clade B Env, SF162, or DeltaV2 (a derivative of SF162 lacking the V2 loop). All six anti-gp120 MAbs studied, neutralized SF162 and their activities were dependent by the glycosylation patterns of the V1, V2 or V3 loops. Only one anti-gp120 MAb (an anti-V3 MAb) displayed cross-neutralizing activity, which was influenced by the type of V1 loop present on the target heterologous viruses. None of the five anti-gp41 MAbs studied displayed anti-SF162 neutralizing activity. Our studies indicate that the current limitation of soluble HIV Env gp140 immunogens to elicit robust cross-reactive neutralizing antibody responses is not only due to the elicitation of high titers of homologous antibodies but also due to the elicitation of antibodies whose epitopes are naturally occluded, or not present, on the virion-associated Env.     

New strategy of platelet substitutes for enhancing platelet aggregation at high shear rates: cooperative effects of a mixed system of fibrinogen γ-chain dodecapeptide- or glycoprotein Ibα-conjugated latex beads under flow conditions

To construct platelet substitutes that have hemostatic properties over a wide range of shear rates, we used fibrinogen γ-chain carboxy-terminal sequence HHLGGAKQAGDV (H12), which recognizes activated platelets at low shear rates, and a recombinant water-soluble moiety of the platelet glycoprotein (rGPIbα), which recognizes von Willebrand factor at high shear rates. Three kinds of samples were prepared for this purpose: H12-conjugated latex beads (H12-latex beads), rGPIbα-latex beads, and H12/rGPIbα-latex beads. These samples were evaluated in thrombocytopenia-imitation blood at various flow conditions. Based on ADP-induced platelet aggregation studies, the H12-latex beads significantly enhanced platelet aggregation via H12 binding with GPIIb/IIIa activated on the surface of activated platelets, whereas the rGPIbα-latex beads did not support platelet aggregation. In the case of the H12/rGPIbα-latex beads, the function of H12 was suppressed by steric hindrance from the larger rGPIbα bound to the latex bead. A mixture of the H12-latex beads and the rGPIbα-latex beads adhered to a collagen surface over a wide range of shear rates. In particular, at high shear rates, a cooperative effect was observed in the enhancement of platelet thrombus formation compared with H12-latex beads or rGPIbα-latex beads alone. We propose that a mixed system of H12- and rGPIbα-conjugated nanoparticles is a more effective platelet substitute than each of the beads used alone and has enhanced platelet aggregation properties.     

社区医生糖尿病防治知识“专家传授与互动式”优化教育方案的效果评价

目的通过“专家传授与互动式”的糖尿病优化教育方案对社区医生实施专题系列教育,了解该方案后对社区医生糖尿病综合防治知识与技能水平的影响。方法对实验组医生进行DM（糖尿病）诊治与预防知识基线测试;经过2个月的知识优化后对实验与对照组实施DM综合防治知识与技能水平进行测试。结果实验组社区医生干预后,基础、并发症和营养方面知识成绩平均上升了7.63分、5.83分和35.66分,实施前后测试的成绩差别具有统计学差异（P〈0.05）。实验组知识优化后的得分与对照组比较,总均分高出23.49,经t检验,两组成绩差别具有统计学意义（P〈0.05）。结论本研究说明对社区医生实施专家式的DM专题知识优化效果明显,提高了社区医生对DM患者实施综合防治知识与行为指导的能力。     

Anti-β2 glycoprotein I antibodies in complex with β2 glycoprotein I induce platelet activation via two receptors: apolipoprotein E receptor 2' and glycoprotein I bα

Anti-β₂ glycoprotein I (anti-β₂GP I ) antibodies are important contributors to thrombosis, especially in patients with antiphospholipid syndrome (APS). However, the mechanism by which anti-β₂GP I antibodies are involved in the pathogenesis of thrombosis is not fully understood. In this report, we investigated the role of anti-β₂GP I antibodies in complexes with β₂GP I as mediators of platelet activation, which can serve as a potential source contributing to thrombosis. We examined the involvement of the apolipoprotein E receptor 2' (apoER2') and glycoprotein I ba (GP I bα) in platelet activation induced by the anti-β₂GP I /β₂GP I complex. The interaction between the anti-β₂GP I /β₂GP I complex and platelets was examined using in vitro methods, in which the Fc portion of the antibody was immobilized using protein A coated onto a microtiter plate. Platelet activation was assessed by measuring GP II b/ III a activation and P-selectin expression and thromboxane B₂ production as well as p38 mitogen-activated protein kinase phosphorylation. Our results revealed that the anti-β₂GP I /β₂GP I complex was able to activate platelets, and this activation was inhibited by either the anti-GP I bα antibody or the apoER2' inhibitor. Results showed that the anti-β₂GP I /β₂GP I complex induced platelet activation via GP I bα and apoER2', which may then contribute to the prothrombotic tendency in APS patients.     

高尔基蛋白73（GP73）在原发性肝癌中的诊断价值

目的评价高尔基蛋白（GP73）在原发性肝癌诊断中的价值。方法选择肝癌患者93例,对照人群共71例（包括健康人,肝硬化,及慢性肝炎患者）,用电化学发光法检测AFP;采用WesternBlot方法和ELISA方法检测高尔基蛋（q73（GP73）。结果GP73的ROC曲线下面积为0．873,当35．76ng／ml为GP73诊断肝细胞癌的cut．off值时,GP73检测肝细胞癌的敏感性和特异性分别为79．6％和85．9％。AFP阳性的肝癌组23．4％（11／47）GP73阴性,如果单用GP73检测,会漏诊23．4％。AFP阴性同时GP73阴性占（6／93）6．4％,联合检测AFP、GP73,肝癌漏诊率降低至6．4％。肝硬化组GP73浓度均值大于慢性肝炎及正常人群,但差异无统计学意义。丙型肝炎肝癌组GP73浓度均值高于乙型肝炎及非病毒性肝炎肝癌,差异有统计学意义。结论GP73诊断肝细胞癌的敏感性优于AFP。GP73、AFP联合应用有较好的互补性,可以有效避免可能发生的AFP阴性病例的漏检。GP73可成为鉴别肝硬化、肝癌患者的血清标志物,有一定的早期诊断价值。