HIV-1蛋白诱导T细胞产生IFN-γ反应特征及对HIV-1感染者病情进展的影响

目的 探讨HIV-1特异性T细胞反应特征及对HIV-1感染者病情进展的影响.方法 通过合成重叠肽技术及ELISPOT技术,采用队列研究方法对37名HIV-1感染者的病毒特异性T细胞免疫反应进行分析.结果 83.78%(31/37)的HIV-1感染者对1个或多个合成肽反应(反应强度大于50 SFU/106 PBMCs).HIV-1B型病毒不同蛋白均可激发HIV-1感染者的特异性T细胞反应,其中HIV-1 Gag蛋白被识别的频率最高,81%的HIV-1感染者识别HIV-1 Gag而且HIV-1 Gag蛋白诱导的T细胞反应强度最高,相对强度达到28.25%,明显高于其他蛋白,差异具有统计学意义(F=17.969,P<0.001);重叠肽诱导T细胞分泌IFN-γ反应频率、反应强度在HIV-1感染无症状期和艾滋病期无明显区别,但是HIV-1 Gag蛋白诱导的T细胞反应强度在无症状期明显高于艾滋病期.结论 HIV-1B型病毒不同基因编码蛋白激发T细胞分泌IFN-γ反应小同,其中HIV-1 Gag蛋白特异性T细胞在控制病情进展方面发挥了重要作用.     

单腔双扩张器重叠扩张术修复皮肤缺损

目的采用单腔双扩张器重叠扩张术提高皮肤软组织扩张效率,修复皮肤缺损。方法2003年6月~2005年3月,采用重叠扩张术,将传统的单腔单囊扩张变为在同一个皮肤软组织腔隙内重叠埋置2个扩张器进行皮肤软组织扩张,治疗5例皮肤缺损患者。其中男3例,女2例。年龄11~28岁。前臂瘢痕2例,黑毛痣1例;瘢痕性秃发2例。病程1.5~24年。皮肤缺损范围12cm×5cm~13cm×12cm。重叠置入均采用椭圆形上200ml、下250ml的扩张器。重叠扩张区域实际注水量480~685ml。患者均采用扩张皮肤一次修复皮肤缺损区域。结果5例患者均顺利完成预定的皮肤软组织扩张且一次修复皮肤缺损区域,扩张器扩张时间为27~50d,重叠扩张区域扩张皮肤13.0cm×6.0cm~14.5cm×9.0cm。术后供、受区创面均期愈合,经3~15个月随访,扩张皮肤无收缩与色素沉着,未见瘢痕复发,外观修复均满意。结论重叠扩张术可明显提高皮肤软组织扩张效率,适用于皮肤缺损边缘可扩张皮肤有限、或不便于过多剥离而又需足够多的扩张皮肤修复的区域。     

有和无重叠症状的肠易激综合征患者生活质量及精神心理状况比较研究

目的 调查有和无重叠症状的肠易激综合征(IBS)患者的生活质量、精神心理状况,分析有重叠症状IBS患者生活质量特点,探讨影响其生活质量的主要凶素及重叠症状产生的可能原因.方法 对2007年10月至2008年4月在我院消化科门诊就诊的、符合罗马Ⅲ诊断标准的76例IBS患者建立健康档案,采用消化道症状调查表、汉化版简明健康调查量表(SF-36)、焦虑自评量表(SAS)和抑郁自评量表(SDS)进行问卷调查.根据问卷调查结果将其分为有重叠症状组(食管、胃、十二指肠和肛门直肠症状)和无重叠症状组,分析比较两组患者生活质量和精神心理状况,并对结果进行统计学分析.结果 有重叠症状组IBS患者生活质量较无重叠症状组降低,合并焦虑抑郁状态的比例高于无重叠症状组(P＜0.05).结论 伴随重叠症状的IBS患者生活质量受到影响,不良精神心理因素可能是其生活质量主要影响因素及重叠症状产生的原因.     

Overlapping sphincteroplasty for acquired anal incontinence

When defects of the anal sphincter are caused by trauma, surgical correction can be successful even in long-standing cases. At the University of Minnesota, we used overlapping sphincteroplasty in 79 patients with fecal incontinence from 1952 to 1982. There were 62 women and 17 men. Ages ranged from 17 to 68 years. Incontinence had been present from three weeks to 40 years and had been caused by childbirth, previous anorectal surgery, trauma or rectal prolapse. Following overlapping sphincteroplasty, there was one postoperative death and 13 complications. Complications included temporary difficulty in voiding, excessive bleeding, abscess formation, fecal impaction, and hematoma. Seventy-six of the 78 surviving patients were followed for an average of 35 months. Results ranged from excellent to poor with only one failure. From our experience it was concluded that several factors were important for good surgical results. 1) The patient must have intact neuromuscular bundle with detectable voluntary sphincter contraction. 2) If a primary repair has failed, a minimum duration of three months should elapse before overlapping sphincteroplasty is attempted. 3) Scar tissue from the severed muscles should not be excised. 4) The internal and external sphincter muscles should not be separated. 5) A temporary concomitant colostomy is not necessary. Read at the meeting of the American Society of Colon and Rectal Surgeons, Boston, Massachusetts, June 5–9, 1983. The work for this paper was performed at the Division of Colon and Rectal Surgery. Department of Surgery, University of Minnesota Medical School, Minneapolis, Minnesota.     

Identification of Two Potential Suppressor Gene Regions on Chromosome Arm 14q That Are Commonly Lost in Advanced Colorectal Carcinomas

Background: Remarkably little is known about the molecular alterations contributing to the establishment of a distant metastasis from a primary colorectal carcinoma. Previous studies on primary colorectal carcinomas have suggested an association between loss of chromosome 14 sequences and cancer progression. Methods: In the present study, we analyzed 20 distant metastases and peripheral blood samples from 18 patients using 24 microsatellite markers spanning chromosome arm 14q. In addition, DNA from microdissected corresponding primary tumors (formalin-fixed and paraffinembedded) was analyzed at selected 14q loci. Results: Sixty-five percent (13/20) of the metastases, from 11/18 patients, showed loss of one or more markers at 14q, and the majority (94%) of the primary carcinomas showed identical 14q genotypes to those found in the metastasis. Two minimal common deleted regions were delineated in the metastases, one between markers D14S288-D14S52 at 14q13-21 and the other between D14S284-D14S81 at 14q24-31, pinpointing two previously unrecognized map positions for potential target genes. The genotype pattern of five tumors was consistent with monosomy or large chromosomal deletions spanning both potential suppressor regions. The reasons for monosomy in cancer remain unknown, but our data support the hypothesis that deletions of several tumor suppressor genes are more readily obtained by one chromosome loss than by several molecular events, and through this unison loss a growth advantage may be provided. Conclusion: Our data suggest that 14q loss is not a rate-limiting event in colorectal metastasis formation, but the high frequency of this alteration in primary tumors with metastatic ability, as well as in the metastases themselves, suggests it is part of the tumor clone with selective growth capacity.     

Effects of halogen light irradiation variables (tip diameter, irradiance, irradiation protocol) on flexural strength properties of resin-based composites

OBJECTIVE: Investigation of halogen light irradiation variables (tip diameter, irradiance, irradiation protocol) on flexural strength and modulus of four methacrylate resin-based composites (RBCs). METHODS: Rectangular bar-shaped specimens (25 mm x 2 mm x 2 mm; n=20 per group) of four RBCs were irradiated at varying irradiances (640 and 790 mW/cm2; standard and boosted mode) with different tip diameters (8, 11, 13 and 25 mm) and for the 8mm Turbo light tip diameter at irradiances of 880 and 1040 mW/cm2 (standard and boosted mode). Following irradiation the specimens were stored in a light-proof container for 24h at 37+/-1 degrees C and tested in three-point flexure. One-way analyses of variance were made at P=0.05, guided as necessary by Tukey's correction in multiple partial analyses, in addition to a Weibull analysis. RESULTS: The mean three-point flexure strengths, Weibull moduli and flexure moduli of the four RBC materials, irradiated with varying irradiances, tip diameters and irradiation protocols highlighted no significant differences although the values were material specific. Similarly the 8mm conventional and Turbo tip diameter resulted in no significant differences for varying irradiances and irradiation protocols. CONCLUSION: Within the limitations of the experiment halogen tip diameter, irradiance and irradiation protocol have no influence on three-point flexural strength and modulus data. The efficacy of the overlapping irradiation regime was upheld for the conditions tested.     

Prospective study of a noninvasive treatment for two common congenital toe abnormalities (curly/varus/underlapping toes and overlapping toes)

OBJECTIVE

To assess, in the newborn, the efficacy of a standard taping treatment used in children for two selected congenital toe abnormalities (curly/varus/underlapping toes and overlapping toes), and compare the outcome with the available world literature.

METHODS

All children referred by their family physician between January 2004 and January 2006 were included. The newborns were reviewed by one author (WGS) within 10 days of birth, assessed for severity, and the toes were taped in a standard manner if the abnormalities met the study criteria. After one and two months, the same author reviewed the children, and retaped the toes. The children’s toes were photographed before the taping and then after three months when the tape was removed permanently. After six months, the children, with their pictures, were sent to a second author (JTS), and were scored for the grade of severity and improvement using standard criteria.

RESULTS

The world literature and standard textbooks indicate a 25% spontaneous improvement of these abnormalities. The recommendation is for surgical correction at a later date because intervention with taping has not shown success after the newborn period. No prior studies have been undertaken in the newborn. In the present study of 84 toes, the abnormality occurred in 2.8% of newborns, and 94% of the toes were improved or cured with no complications related to the technique.

CONCLUSION

A simple, office-friendly technique of taping underlapping and overlapping toes in the newborn proved successful in 94% of the toes.     

79例慢性乙型肝炎患者重叠HCMV感染T细胞亚群结果分析

目的研究慢性乙型肝炎重叠人巨细胞病毒感染情况下T细胞表面抗原CD3、CD4、CD8变化。方法检测HBV重叠HCMV感染组与单纯HBV感染组的T细胞亚群。结果慢性乙型肝炎重叠感染HCMV与慢性乙型肝炎无重叠感染HCMV的T细胞亚群。结果重叠感染组的CD3、CD4明显低于无重叠感染组,CD8高于无重叠感染组。结论HCMV的重叠感染会加剧抑制慢性乙型肝炎患者的T淋巴细胞免疫功能,致T淋巴细胞表面抗原表达更加紊乱。     

Overlapping section coverage in multisection imaging

A method is proposed in which the section position for two-dimensional Fourier transform multisection imaging is advanced from one phase-encoding step to the next, so that information is sampled continuously over the total volume under observation. This “ramp scan”technique allows reconstruction of images from any arbitrary position within the sampled volume. The imaging properties depend strongly on the order of distribution of phase-encoding steps to the different section positions. In practice, images are reconstructed at each nominal position of a multisection experiment, plus at each position halfway between sections. The volume under study is thus represented by overlapping sections. The gaps between sections that arise in conventional multisection imaging-even with optimized pulse shapes-are thus avoided. This approach is applicable not only to conventional spin-echo imaging but to other techniques such as RARE (rapid acquisition with relaxation enhancement) and gradient-echo and echo-planar imaging.     

NREM sleep arousal-related disorders reflect cognitive impairment in Parkinson's disease

BackgroundSleep disorders and cognitive impairment are frequently reported in Parkinson's disease (PD) as non-motor disabling symptoms. While it is known that REM sleep Behaviour Disorder (RBD) in PD is associated with motor and cognitive decline, little is known about the neurobiological significance of NREM sleep arousal-related disorders.Objectives: to evaluate the cognitive and clinical correlates of arousal-related disorders in PD.MethodsClinical data and video-polysomnography were analysed from one hundred-seventy consecutive subjects with PD. Based on the neuropsychological assessment, the subjects were divided into three groups: no cognitive impairment (PD; n = 58), mild cognitive impairment (PD-MCI; n = 58) and overt dementia (PDD; n = 54).ResultsArousal-related disorders by history were reported in 32.9% of the subjects: 10.3% PD, 31.6% PD-MCI and 59.3% PDD (p = 0.001). Video-PSG captured arousal-related disorders in 1.7% PD, 21.2% MCI-PD and 35.6% PDD (p = 0.001). Arousal-related disorders and RBD were recorded in the same night in 7.7% PD, 9.8% MCI-PD and 15.6% PDD (p = 0.04). Patients with arousal-related disorders captured at V-PSG have a longer disease duration (p = 0.003), higher UPDRS score (p = 0.039), longer duration of treatment with levodopa (p = 0.017) and dopamine agonists (p = 0.018), worse H&Y staging (p = 0.001), lower MMSE score (p = 0.019) and more frequently hallucinations (p = 0.004). In multivariate analysis, cognitive impairment significantly increases the risk of arousal-related disorders (OR 3.387–95% CI 1.395–8.220, p = 0.007).ConclusionArousal-related disorders appear to be a marker of cognitive decline in PD. Recognizing arousal-related disorders should make clinicians aware of a possible cognitive decline in PD and eventually modify the therapeutic approach.