免疫球蛋白联合去乙酰毛花苷注射液治疗老年扩张型心肌病的临床研究

目的探讨免疫球蛋白联合去乙酰毛花苷注射液治疗老年扩张型心肌病的临床疗效。方法选取2010年1月—2014年12月榆林市第一医院心血管内科收治的老年扩张型心肌病患者200例,随机分为对照组和治疗组,每组各100例。两组患者均接受利尿剂等常规基础治疗。对照组患者静脉滴注去乙酰毛花苷注射液,0.5 mg/次,2次/d;治疗组在对照组基础上静脉滴注静注人免疫球蛋白,400 mg/d。两组均连续治疗4周。观察两组的临床疗效,同时比较两组治疗前后左心室射血分数(LVEF)、舒张早期血流峰值速度(EPFV)、充盈早期速率/晚期速率(E/A)、舒张晚期血流峰值速度(APFV)、左心室收缩末期容积(LVESV)、左心室质量(LV)、左心室舒张末期容积(LVEDV)、心胸比(CTR)、Ig G抗体的变化情况。结果治疗后,对照组和治疗组的总有效率分别为69.00%、85.00%,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者LVEF、E/A、EPFV显著升高,APFV、LVESV、LVEDV、LV、CTR、Ig G抗体均显著降低,同组治疗前后差异具有统计学意义(P0.05);且治疗组这些观察指标的改善程度优于对照组,两组比较差异具有统计学意义(P0.05)。结论免疫球蛋白联合去乙酰毛花苷注射液治疗老年扩张型心肌病具有较好的临床疗效,可显著改善患者的心功能,降低Ig G抗体水平,具有一定的临床推广应用价值。     

陕西某中医院校学生对中医药传统知识保护的态度研究

目的调查分析陕西某中医院校学生对中医药传统知识保护的态度及影响因素,为改进中医院校中医药传统知识保护教育提供科学依据。方法采用分层整群抽样法,对陕西某中医院校1162名在校学生进行问卷调查,运用秩和检验和多元线性回归模型探讨影响学生保护态度的因素。结果该校学生对中医药传统知识保护的态度得分为（43.09±6.50）,专业、父母最高学历、家人对中医药的态度、学生对本科阶段中医药课程设置的评价、学习过中医药传统知识保护相关课程与否、中医临床见习或实习经历以及对中医药传统知识保护相关知识的掌握程度是学生对中医药传统知识保护态度的影响因素（P<0.05）。结论该校学生对中医药传统知识的保护态度比较积极,建议国家和学校加强中医药传统文化类课程和教材体系建设,从而进一步提高学生对保护中医药传统知识及建立专门制度的积极性,为国家培养发展未来中医药事业的生力军。     

突发传染病相关临床研究伦理审查突出问题的总结与反思——基于文献综述的分析

突发传染病应急情境下,传染性疾病的不确定性、防控紧迫性、临床和研究资源有限性等问题对此阶段临床研究伦理审查带来诸多挑战。通过梳理突发传染病相关临床研究伦理审查文献,分析显示:临床研究的安全性、知情同意及隐私保护、临床研究设计的合理合法性、临床研究重要资源的分配、伦理审查的方式和效率是突发传染病相关临床伦理审查中的突出问题,亟待建立针对突发传染病临床研究的伦理审查特殊规范。以伦理审查实际工作需求为着力点,结合文献梳理,提示需健全临床研究机构管理、临床研究项目管理、伦理委员会管理、突发传染病情况伦理审查要点、多中心临床研究伦理审查等方面的特殊规范,降低突发传染病相关临床研究风险,创新伦理审查方式,提高伦理审查效率,保障特殊时期受试者的安全与权益。     

深圳人群弓形虫感染的血清流行病学调查研究

为了调查目前深圳地区人群弓形虫感染情况 ,本文自 1997年至 1999年采用酶联免疫吸附试验( ELISA)对深圳地区不同人群 12 2 0份血清进行检查 ,结果总人群 Ig G阳性率为 11.15% ,Ig M阳性率为0 .2 5%。其中 ,幼儿组、青少年组、成年组、老年组 Ig G阳性率分别为 2 .33%、 5.68%、 8.90 %、 10 .2 3% ;动物饲养员、屠宰工人的阳性率为 2 3.57%、 2 5.0 0 % ,与阳性率分别为 14 .66%、 7.14 %、 6.32 %、 5.68%的饮食业人员、目前没有与动物接触职业者、医务工作者、中学生之间有显著性差异 ( P<0 .0 0 5) ;男性 Ig G阳性率为 11.73% ,与 Ig G阳性率为 10 .66%的女性比较无差异 ( P>0 .5)。结果显示深圳地区人群感染率有随年龄递增而升高趋势 ,且不同职业之间亦有显著差异性 ,但性别差异无显著性。     

老年急性阑尾炎病情严重程度的超声评估及其临床应用

目的 探讨高龄急性阑尾炎患者的超声声像图特征与炎症病变严重程度的关系,为临床治疗提供影像学参考.方法 回顾性分析2011年1月至2021年1月中国人民解放军空军特色医学中心经临床及辅助检查诊断为急性阑尾炎、年龄>70岁的患者78例.剔除仅行保守、抗炎治疗患者21例,最终入组患者57例.按超声表现初步分为炎症反应轻、重2...     

应用Protein G纯化细胞培养上清中的大鼠单抗

用ｍｉｎｉＰｅｒｍ系统旋转连续培养大鼠杂交瘤细胞株,获得大量含抗鼠ＩＬ－４（ＩｇＧ１）和ＩＬ－５（ＩｇＧ１和ＩｇＧ２ａ）抗体的培养上清;经ＰＭ１０膜超滤,５０％饱和硫酸铵沉淀及链球菌Ｃ蛋白－琼脂糖亲和层析纯化ＩｇＧ单抗。结果每升杂交瘤细胞２上清得到大鼠,ＩｇＧ２２－３６ｍｇ;１次可纯化抗体２０ｍｇ;经过ＳＤＳ－ＰＡＧＥ及ＥＬＩＳＡ鉴定,所得到的抗体纯度高,活性保持良好。     

IgG4相关性疾病临床病理学特征分析

目的：探讨IgG4相关性疾病的病理学形态、免疫表型特征。方法观察12例IgG4相关性疾病的镜下特点,结合免疫组化EnVision两步法染色检测IgG、IgG4、CD138、CD34的表达,分析IgG4相关性疾病的病理学形态特征。结果 IgG4相关性疾病主要表现为组织弥漫性纤维化;伴大量淋巴细胞、浆细胞浸润,围绕血管神经分布;闭塞性静脉炎形成,免疫组化EnVision两步法染色IgG4阳性浆细胞与IgG阳性浆细胞比例>40%。结论 IgG4相关性疾病临床特点和影像学无特异性,易误诊为肿瘤,术前血清IgG4检测可作为疑似病例的首选方法。     

Forces acting on particle-enhanced immunoassays

The aim of the present work is to study the role of the different forces involved in the agglutination of immune γ-globulin (IgG) covered latex particles due to antigen-antibody reaction. An experimental investigation on the adsorption of IgG molecules on three latexes with different surface charge densities is described. Photon correlation spectroscopy was used to determine the hydrodynamic layer thickness of the IgG molecules adsorbed on the latexes. In order to get an insight into the forces acting between two antibody-covered particles approaching each other, the colloidal stability and immunoreactivity of these biocomplexes were studied. They can be stabilized by electrostatic or hydration forces. The immunological agglutination of IgGimmobilized latex particles due to the addition of the antigen was quantified through scattered light intensity measurements. The immunoresponse increases with ionic strength of the medium until a maximum value is achieved. Above this maximum, the immunoreactivity decreases.     

Efficiency of immunoglobulin G replacement therapy in common variable immunodeficiency: correlations with clinical phenotype and polymorphism of the neonatal Fc receptor

Treatment of common variable immunodeficiency disorders (CVID) is based on replacement therapy using intravenous (i.v.) or subcutaneous (s.c.) immunoglobulin (Ig)G. Interindividual variation of IgG dose is common. A total of 380 CVID patients on stable IgG replacement from two prospective cohorts were analysed. An ‘efficiency’ index was defined as the ratio of serum IgG trough level minus IgG residual to the average weekly dose of IgG infusion. A reduced efficiency of IgG was associated independently with the i.v. route (P < 0·001) and with the presence of at least one CVID disease‐related phenotype (lymphoproliferation, autoimmune cytopenia or enteropathy) (P < 0·001). High IgG efficiency was noted in patients homozygotes for the variable number tandem repeat (VNTR) 3/3 polymorphism of the neonatal Fc receptor gene [IgG Fc fragment receptor transporter alpha chain (FCGRT)] promoter, and this was particularly significant in patients treated with IVIG (P < 0.01). In a multivariate analysis, FCGRT VNTR 3/3 genotype (P = 0·008) and high serum albumin (P < 0·001) were associated independently with increased efficiency of i.v. Ig.     

IgG subclasses of anti-FVIII antibodies during immune tolerance induction in patients with hemophilia A

The eradication of inhibitory antibodies in patients with haemophilia A can be accomplished by frequent administration of high or intermediate doses of factor VIII (FVIII), so-called immune tolerance induction (ITI). This study monitored the distribution of IgG subclasses of anti-FVIII antibodies during ITI. FVIII-specific antibodies of subclass IgG1 were detected in all inhibitor patients tested, anti-FVIII IgG4 in 16, IgG2 in 10 and IgG3 in one of 20 patients analysed. Levels of anti-FVIII IgG1 and IgG4 correlated well with inhibitor titres as measured by Bethesda assay. In low-titre inhibitor patients, anti-FVIII antibodies consisted primarily of subclass IgG1 whereas, anti-FVIII antibodies of subclass IgG4 were more prominent in patients with high titre inhibitors who needed prolonged treatment or who failed ITI. Longitudinal analysis of 14 patients undergoing ITI revealed that the relative contribution of IgG subclasses was constant for most of the patients analysed. In two patients, the relative contribution of IgG4 increased during ITI. Overall, our findings document the distribution and dynamics of anti-FVIII IgG subclasses during ITI. Future studies will need to address whether monitoring the relative contribution of anti-FVIII subclasses IgG1 and IgG4 may be useful for the identification of patients who are at risk of failing ITI.