深低温储皮后其抗原性改变的免疫学研究

以人皮和豚鼠皮新鲜及－１９６℃冷冻皮片匀浆做为抗原，研制出兔抗人和豚鼠的新鲜及－１９６℃冷冻皮片匀浆的可溶性蛋白高效价的免疫血清，并通过免疫电泳、火箭免疫电泳、免疫火箭扩散电泳及单相免疫扩散电泳等不同免疫学电泳的检测，分别对新鲜皮片及－１９６℃冷冻皮片抗原性改变的这一现象进行探讨与研究。结果表明：人皮、豚鼠皮其新鲜皮片的抗原成份、抗原决定簇及抗原量均显著高于相应的－１９６℃冷冻组皮片，因而证实了通过深低温冷冻的皮片其抗原性低于新鲜皮片的论断。     

Challenges in the Diagnosis of the Right Patient for Testosterone Replacement Therapy

Diagnosis of testosterone deficiency is important to identify patients who might benefit from testosterone replacement therapy. Unfortunately, the diagnosis of hypogonadism may be a challenge for many practicing physicians, including endocrinologists and urologists. Signs and symptoms, such as sexual dysfunction, change in body composition, lethargy, and mood changes, are nonspecific and the available questionnaires are generally not useful in clinical practice. The diagnosis of testosterone deficiency is ultimately based on measurement of serum testosterone levels. However, marked variations in the reference ranges of serum testosterone levels among laboratories pose a challenge for physicians when interpreting the results. In addition, initial laboratory assessments usually determine total testosterone levels. About 1–2% of total testosterone is free and a further 30–50% is bound with low affinity to albumin; only these two components are bioavailable to the target tissues. In general, assuming the normal reference range for serum total testosterone in adult men is 300–1000 ng/dl (10–35 nmol/l), levels of < 250 ng/dl (8.7 nmol/l) suggest the patient is likely to be hypogonadal, whereas levels of > 350 ng/dl (12.7 nmol/l) suggest the symptoms may not be due to androgen deficiency. Values between 250 to 350 ng/dl warrant a repeat morning serum testosterone determination with assessment of free or bioavailable testosterone. In men with symptoms suggestive of androgen deficiency and borderline serum testosterone levels, where there are no contraindications to androgen therapy, a short therapeutic trial of testosterone may be justified.     

高血胆固醇症病人体内铁贮水平与心肌灌注 左心室功能的相关研究

目的评价血清铁参数与高血胆固醇症(HCL)病人心肌灌注、室壁运动异常及血管造影显示的冠状动脉疾病(CAD)程度的相互关系.方法选择38名具有高血胆固醇症(LDL-C＞3.38mmol/L)从未治疗过的男性病人(平均年龄59±6岁)作为HCL组和32名年龄匹配而胆固醇水平正常(NCL)的男性为NCL组,进行冠状动脉造影并在10d内行SPECT检查,应用99mTc-甲氧基异丙基异氰(MIBI)进行静息/负荷门控断层心肌灌注显像、室壁运动功能图像分析;同时测定血清铁参数、血脂及常规血液学参数.结果在HCL组发现血清铁蛋白(SF)与心肌灌注系数(r=0.70,P＜0.01),可逆系数(r=0.66,P＜0.01)和室壁运动系数(r=0.53,P＜0.05)之间呈显著性相关;而总铁结合力与灌注系数之间呈一弱(负)相关(r=-0.52,P＜0.05).在NCL组铁参数与灌注系数及室壁运动系数之间无显著性相关.多元回归分析证实血清铁蛋白水平是决定HCL病人中心肌灌注的独立因素(β=0.55,P＞0.05).铁参数与两组通过冠状动脉造影(CAG)进行评分所定义的CAD程度无关.结论体内铁贮水平升高与HCL病人心肌灌注和功能异常的严重性和程度有着密切的关系,但与CAD的造影显示的病变范围无关.血清铁蛋白水平增高,可增加铁介导的氧化应力和LDL过氧化作用,导致HCL相关的血管内皮功能紊乱并进一步损伤心肌灌注和室壁运动功能.     

子宫内膜异位症患者血清及腹腔液中血小板衍生生长因子、血管细胞粘附分子水平的变化及其意义

目的通过检测子宫内膜异位症(EMs)患者血清及腹腔液中血小板衍生生长因子(PDGF)、血管细胞粘附分子-(VCAM-1)浓度,探讨PDGF和VCAM-1在EMs发病中的作用。方法选取手术后病理证实为EMs的40例患者为EMs组,其中I~II期17例,III~IV23例;非EMs组20例作为对照组。应用酶联免疫吸附法(ELISA)检测血清及腹腔液中PDGF和VCAM-1水平。结果EMs组血清及腹腔液中PDGF、VCAM-1水平均明显高于对照组(P<0.01)。随EMs期别的增加,其血清和腹腔液中PDGF、VCAM-1含量呈上升趋势;EMsIII~IV期水平显著高于I~II期(P<0.05)。EMs患者PDGF与VCAM-1呈正相关性(P<0.05)。结论EMs患者PDGF、VCAM-1表达水平升高,在EMs的发生发展中具有重要作用。     

Endocrinology: Intravenous albumin does not prevent the development of severe ovarian hyperstimulation syndrome in an in-vitro fertilization programme

A cohort study was undertaken to compare the effect at the timeof oocyte retrieval of the i.v. administration of either 1000ml of lactated Ringer' solution or 1000 ml of a 5% solutionof human albumin on in-vitro fertilization patients at riskfor severe ovarian hyperstimulation syndrome (OHSS). A totalof 207 patients with an oestradiol concentration > 10 000pmol/l and/or > 15 follicles (>10 mm diameter) on theday of human chorionic gonadotrophin (HCG) injection were reviewed.Of these, 158 women received 500 ml of lactated Ringer’ssolution both before and after egg retrieval, and 49 women receivedtwo infusions of 500 ml of 5% human albumin in normal salineat the time of egg retrieval. Severe OHSS developed in two patientswho received human albumin and in 10 women who did not receivethe albumin. This difference was not statistically significant.There were no differences between the two groups in terms ofage, number of follicles punctured at transvaginal oocyte retrievalor oestradiol concentration at the time of HCG injection. Theadministration of a 5% human albumin solution does not preventthe development of severe OHSS in at risk patients. It doesappear to blunt the severity of the condition.     

Characteristics of antibody responses induced in mice by protein allergens

Whereas many foreign proteins are immunogenic, only a proportion is also allergenic, having the capacity to induce the quality of immune response necessary to support the production of IgE antibody. We have demonstrated previously that intraperitoneal administration to mice of proteins such as ovalbumin (OVA) or the industrial enzyme A. oryzae lipase, which possess significant allergenic potential, stimulates the production of both IgG and IgE antibody. Identical exposure to bovine serum albumin (BSA), a protein with limited potential to cause immediate respiratory or gastrointestinal hypersensitivity reactions, induced IgG responses only. In the current investigations, the quality of immune responses induced following exposure to these proteins via mucosal tissue (intranasal) has been compared with those provoked following administration via a non-mucosal (intraperitoneal) route of exposure. Intranasal or intraperitoneal administration of BSA, OVA or A. oryzae lipase elicited in each case vigorous IgG and IgG1 antibody responses. For all three proteins, at every concentration tested, and via both routes of exposure, IgG1 antibody titres paralleled closely IgG titres. However, the three materials displayed a differential potential to provoke IgE responses and this correlated with their known allergenic potential in humans. Thus, OVA and A. oryzae lipase stimulated strong IgE antibody responses, whereas BSA provoked low titre IgE only at the highest concentration tested (5% administered intraperitoneally). The quality of induced responses was not affected by the route of exposure. It would appear, therefore, that the stimulation of IgG and IgG1 antibody responses is a reflection of protein immunogenicity whereas protein allergenicity is associated with the induction of strong IgE responses.     

评价酶联免疫检测血清CYFRA21—1对非小细胞肺癌的诊断价值

目的评价检测ＣＹＦＲＡ２１┐１对非小细胞肺癌的诊断价值。方法用ＥＬＩＳＡ法测定７０例肺癌（ＬＣ）其中４７例非小细胞肺癌（ＮＳＣＬＣ），３例小细胞肺癌（ＳＣＬＣ）和２０例未分型肺癌、６４例肺部良性疾病患者及４０例健康人血清ＣＹＦＲＡ２１┐１浓度。试验的诊断性能用相对操作特征（ＲＯＣ）分析法估测之。结果测得全阈诊断准确率（ＯｖｅｒａｌＤｉａｇ┐ｎｏｓｔｉｃＡｃｃｕｒａｃｉｅｓ）ＬＣ为０．７５、ＮＳＣＬＣ为０．７６，ＳＱＣ为０．８３，ＡＤＥ为０．６７和ＳＣＬＣ为０．３８。在相应于特异性为０．９５的界定值３．４７μｇ／Ｌ处，各型的灵敏度分别为ＳＱＣ０．６２，ＬＣ０．５３，ＮＳＣＬＣ０．５１，ＡＤＥ０．４８和ＳＣＬＣ０．００。结论结果显示ＣＹＦＲＡ２１┐１是ＮＳＣＬＣ较灵敏和特异的一个标志物。未观察到ＴＮＭ各期间该标志物的平均水平有明显的差异；然而异常升高水平的患者的比例随病期的进展而显著增加，提示一系列检测ＣＹＦＲＡ２１┐１水平可能有助于监查ＮＳＣＬＣ患者的疗效。     

Drug-Biomacromolecule Interaction XII: Comparative binding study of sulfaethidole to bovine serum albumin by equilibrium dialysis,fluorescence probe technique,uv difference spectrophotometry and circular dichroism

Binding of sulfaethidole to bovine serum albumin was studied by equilibrium dialysis, fluorescence probe technique, uv difference spectrophotometry and circular dichroism. Equilibrium dialysis method enabled us to estimate the total number of drug binding sites of albumin molecule. For sulfaethidole, albumin had 6 primary and 40 secondary binding sites. The primary and secondary binding constants were 0.9×10⁵ M⁻¹ and 0.2×10⁶ M⁻¹, respectively. 1-Anilino-8-naphthalenesulfonate (ANS) and 2-(4′-hydroxylbenzeneazo)-benzoic acid (HBAB) were used as the fluorescence probe and the uv spectrophotometric probe, respectively. In fluorescence probe technique, results indicated that the number of higher affinity drug binding site of albumin was 1 and the number of lower affinity drug binding sites of albumin was 3, and the primary and secondary drug binding constants for bovine serum albumin were 2.15×10⁵ M⁻¹ and 1.04×10⁵ M⁻¹, respectively. In uv difference spectrophotometry, binding sites were 3 and binding constant was 1.88×10⁵ M⁻¹. The above results suggest that several different methods should be used in ompensation for insufficient information about drug binding to albumin molecule given by only one method.     

Protein-loading test, urinary albumin excretion and renal morphology in diagnosis of subclinical diabetic nephropathy.

The acute effects of protein loading (1.5 g kg-1) on glomerular filtration rate (GFR) and urinary albumin excretion (UAE) were investigated in 23 type-I diabetic patients with no clinical nephropathy, and in 7 healthy subjects (controls). The results were compared with renal morphology data. In controls and in 14 diabetic patients (group 1) GFR increased by 27 and 37%, respectively, corresponding to normal renal reserve, but in 9 patients (group 2) GFR decreased by 20%, indicating the absence of a renal reserve. Microalbuminuria was found in none of the patients in group 1 and in 50% of patients in group 2. Two hours after the load UAE increased in all groups, but the increase was most marked in group 2, despite the fall in GFR. The two groups of patients did not differ with regard to the duration and control of diabetes, but differed markedly in terms of baseline GFR (131 vs. 195 ml min-1, P less than 0.01, in groups 1 and 2, respectively). Renal morphology showed minimal non-specific glomerular injury in group 1, and signs of glomerulosclerosis in group 2. We conclude that the impaired renal response to protein load precedes other subclinical manifestations of diabetic renal injury, and may be useful in the diagnosis of latent diabetic nephropathy.     

血清亚硝酸盐的快速测定

目的：建立一种无需去蛋白的血清亚硝酸盐的快速测定方法。方法：加入蛋白活化剂后，直接用Ｇｒｉｅｓ试剂显色分光光度测定。结果：方法的检测下限为０．２μｍｏｌ／Ｌ，相对标准差为５．１３％～８．８６％，回收率为９４．５％～９９．８％（平均为９７．８％）。血清ＮＯ－２浓度为１４．３８±０．２５μｍｏｌ／Ｌ时，批内变异系数为１．７５％，ＮＯ－２浓度为５．６９±０．２５μｍｏｌ／Ｌ时，批间变异系数为４．４６％。测定５５例正常人血清，得到血清中ＮＯ－２浓度的平均值分别为５．３６±２．１６ｕｍｏｌ／Ｌ；对糖尿病病人血清测定结果表明，亚硝酸盐浓度明显高于正常人。与去蛋白的Ｇｒｉｅｓ试剂分光光度法比较，结果无统计学差异。结论：用蛋白活化剂替代蛋白沉淀剂，减少操作步骤和干扰，测定准确、简便、快速，适用于血清中ＮＯ－２的测定。