固相化细胞吸附浓集法分离污水中脊髓灰质炎病毒的实验研究

〔目的〕建立一个适用于污水中脊髓灰质炎病毒分离培养的方法。〔方法〕采用固相化的L2 0B细胞吸附法 ,浓集污水中的脊髓灰质炎病毒 ,将浓集物再用活的L2 0B细胞培养。〔结果〕能够检出 10 0 0ml水中的 0 .1～ 10TCID50 量的脊髓灰质炎病毒 ,在10 0 0ml预处理后的污水中加入 10TCID50 量的病毒 ,亦可以检出。〔结论〕本方法的有效检出限为 10TCID50 / 10 0 0ml,可用于污水中的脊髓灰质炎病毒的浓集和分离培养。     

20世纪中国农村初级卫生保健评价的成绩与不足

目的：回顾4次评估所采用的评价方法与评价指标，找出评价方法和指标的优势与不足，为制定《中国农村初级卫生保健发展纲要（2001—2010）》进度评价指标体系提供依据。方法：采用文献研究的方法．通过Medline光盘检索、Internet检索、灰色文献知情人线索查找和手工检索查找自1992年至2004年发表、与初级卫生保健评价有关的所有中文文献。结果：总体上肯定了这个指标体系。认为其简便易行，符合国情，能反映各试点县初级卫生保健工作的现状，能促进初级卫生保健事业的发展。但它存在一些问题需要改进，如标准设置不合理（卫生厕所普及率、卫生事业经费占财政支出比例）；评价策略考虑到地区差异、计分方法科学性、指标定义科学性和资料的可得性。建议：多部门联合评价、建立信息系统、评价要尽量减轻基层负担。     

细胞角蛋白-20mRNA在子宫内膜癌淋巴结中的表达及意义

目的 探讨巢式RT-PCR法检测子宫内膜癌区域淋巴结中细胞角蛋白-20信使RNA（CK20 mRNA）的表达,以了解肿瘤细胞的微转移.方法 取2003年3月至2004年2月间在北京大学人民医院手术治疗的18例子宫内膜癌患者的100枚盆腔淋巴结,巢式RT-PCR法检测其CK20mRNA的表达,同时取5例子宫肌瘤患者的子宫组织及淋巴结20枚作为阴性对照.取子宫内膜癌细胞系Ishikawa及子宫内膜癌组织作为阳性对照.结果 CK20 mRNA在Ishikawa细胞及全部18例子宫内膜癌组织中均呈阳性表达,阳性率100%（敏感性100%）.而在对照的5例正常子宫组织及20枚正常淋巴结中均未表达（特异性100%）.18例子宫内膜癌中有16例经手术病理分期为Ⅰ、Ⅱ期,临床病理检查淋巴结均为阴性;而用巢式RT-PCR方法检测,有5例CK20 mRNA呈阳性表达,证实有肿瘤细胞的微转移,阳性率为31%.结论 CK20可以作为检测子宫内膜癌细胞微转移的标志物.Ⅰ、Ⅱ期子宫内膜癌中有约31%的病例存在有区域淋巴结的肿瘤细胞微转移,其术后复发可能与此有关.     

CD20‐positive plasmablastic lymphoma with excellent response to bortezomib combined with rituximab

As a distinct type of aggressive mature large B‐cell lymphoma, plasmablastic lymphoma (PBL) poses diagnostic and treatment challenges. PBL is distinguished from other B‐cell lymphomas by the presence of plasmacytic differentiation markers such as CD38, CD138, and MUM1. Clinically, PBLs from oral and extra‐oral sites are rapidly progressive tumors with frequent relapse after treatment with standard diffuse large B‐cell lymphoma regimens. Here, we report a near‐complete response of one patient with relapsed PBL following treatment with a non‐cytotoxic regimen containing bortezomib, rituximab, and dexamethasone.     

Prenatal diagnosis of complex phenotype in a 13-week-old fetus with an interstitial multigene deletion 20q13.13.-q13.2 by chromosomal microarray

We report the first trimester three-dimensional ultrasonographic findings in a 13-week-old fetus with complex phenotype and a de novo 4.7 Mb multigene deletion encompassing chromosome region 20q13.13-q13.2 detected by chromosomal microarray. Fetal sonography detected radial-ray anomalies in the form of bilateral absence of thumbs and the left club hand deformity. The presence of single atrioventricular canal instead of the atrial septal defect typical for Holt-Oram syndrome pointed us to rather suspect the SALL4 related diseases. Central nervous system anomaly in the form of enlarged lateral brain ventricles with choroid plexus shifted backwards was not previously reported as a part of SALL4 related disorders. The pregnancy was terminated at 14 + 3 weeks of pregnancy and the autopsy confirmed ultrasonographic findings. Deleted region included 38 genes, where only SALL4, ADNP and KCNB1 heterozygote pathogenic variants were described to be cause of syndromic forms. Radial ray anomalies are common part of clinical picture of SALL4 related disorders. Despite the lack of prenatally described cases, we hypothesized that maldevelopment of lateral brain ventriculomegaly could be very early sonographic sign of disturbed ADNP expression causing Helsmoortel-Van der Aa syndrome, but in some extent also of KCNB1 related early-onset epileptic encephalopathy. Furthermore, the possible dosage-dependent influence of recessive genes located in this region cannot be also excluded. The use of genome-wide technologies enables the detection of subtle chromosomal imbalances and more precise familial genetic counseling regarding actual and future pregnancies.     

Relationship between cryoglobulinemia-associated nephritis and HCV infection

The pathogenetic mechanisms in hepatitis C virus (HCV)-related cryoglobulinemia are sustained by the chronic lymphocyte stimulation of HCV infection, and include the synthesis of IgM rheumatoid factor and tissue deposition of immunocomplexes, characterized by abnormal kinetics and an underlying lymphoproliferative disorder. Based on postulated pathogenetic mechanisms, therapeutic strategies include antiviral, immunosuppressive and immunomodulatory treatments. Combined interferon and ribavirin has shown a better response rate than interferon alone. Pegylated interferons are currently recommended in association with ribavirin. Advances in tolerance might be achieved by tailoring doses and treatment duration according to genotype and individual factors. Conventional immunosuppressive therapy has been widely used in patients with progressive renal involvement or relapsing disease. Rituximab is a promising alternative treatment option for severe cryoglobulinemic vasculitis and nephritis. Although the optimal treatment strategy in HCV-related cryoglobulinemia has not been determined yet, an algorithm based on the clinical severity of disease could be proposed, in which rituximab might be a first-line option in severe cases.