Human leukocyte antigen associations with humoral and cellular immunity following a second dose of measles-containing vaccine: persistence, dampening, and extinction of associations found after a first dose

Previously we found human leukocyte antigen (HLA) associations with humoral immunity following a single dose of measles-containing vaccine. In this study, we sought to determine if HLA associations exist with humoral and cellular immunity following a second dose of measles-containing vaccine and if the associations we found with humoral immunity after the first dose persist following a second dose.We recruited a population-based sample of 346 schoolchildren, all who previously received two doses of a measles-containing vaccine. Molecular HLA classes I and II typing as well as humoral and cellular immune assays (measles-specific IgG antibody levels and lymphoproliferative response) were performed in these subjects.We found significant associations with class I HLA-B (p = 0.05) as well as class II HLA-DPB1 (p = 0.01) and -DPA1 (p = 0.03) genes for measles vaccine-induced antibody levels after the second dose. Similarly, we found significant associations with class II HLA-DQB1 (p = 0.05) and -DRB1 (p = 0.01) genes for measles-specific lymphoproliferation after the second dose.While we found HLA associations after the second dose that we previously found after the first dose of measles containing vaccine, fewer alleles had statistically significant associations, suggesting that the second dose had a dampening or extinguishing effect on the HLA associations. It appears that the second dose overcomes HLA restriction through an as yet unknown mechanism. Future studies of HLA associations should consider both the effect of dose and the role that subsequent doses might play on genetic associations found with the response to a first dose.     

朱砂莲提取物(A_(1015))对D-氨基半乳糖胺肝损伤模型小鼠DNA合成作用的影响

目的　研究朱砂莲提取物 (A10 15)对D 氨基半乳糖胺(D Gl)肝损伤模型小鼠DNA合成作用的影响。方法　采用D Gl造模 ,3 H TdR参入法测定小鼠肝细胞DNA合成 ,并与肝细胞再生因子进行比较。观察了A10 15的剂量曲线和时间曲线。结果和结论　朱砂莲提取物 (A10 15)抵抗D Gl造成的肝组织坏死和促进肝脏细胞DNA合成作用的最适剂量为 2 5mg·kg-1体重。试验还提示A10 15的抗肝中毒作用2 0 0 1-12 -2 6收稿 ,2 0 0 2 -0 3 -0 6修回1 华西医科大学基础部药理学教研室 ,成都　 610 0 41作者简介 :刘碧崇 ,女 ,3 7岁 ,副研究员 ,博士。研究方向 :微生物药物与中药研究。Tel:0 2 8 43 780 40 ,Fax :0 2 8 43 3 3 2 18,E mail:huanggen @mail sc cninfo net;王浴生 ,男 ,81岁 ,教授 ,博士生导师。研究方向 :抗生素与中药药理不强于肝细胞再生因子     

疤痕电疗仪配合持续被动活动机治疗烧伤后期膝关节疤痕挛缩的效果观察

目的探讨疤痕电疗仪配合持续被动活动（continuous passive motion，CPM）治疗烧伤后期膝关节疤痕挛缩的效果。方法将96例烧伤后期膝关节疤痕挛缩患者按抽签法随机分为3组，CPM组30例，采用CPM治疗；疤痕电疗仪组30例，采用疤痕电疗仪进行治疗；疤痕电疗仪配合CPM组36例，采用疤痕电疗仪配合CPM进行治疗。比较3组在膝关节活动度和整体疗效方面的差异。结果3组治疗后4周膝关节活动度均较治疗前改善，差异具有统计学意义（P〈0．01）；疤痕电疗仪配合CPM组膝关节活动度较单纯CPM组和疤痕电疗仪组增大，差异具有统计学意义（P〈0．01）；3组整体疗效比较，差异具有统计学意义（P〈0．01），根据平均秩次推断，疤痕电疗仪配合CPM组疗效最好。结论疤痕电疗仪配合CPM对烧伤后期膝关节挛缩具有良好的治疗效果，恰当的护理方法有助于患者的康复。     

Immediate continuous passive motion after internal fixation of an ankle fracture

Background  Surgical treatment is usually mandatory in displaced bimalleolar and trimalleolar fractures. Some authors have recommended early mobilization of the ankle joint after surgical treatment of these lesions. In this study, we evaluate the effect of immediate postoperative continuous passive motion in the management of displaced bimalleolar and trimalleolar fractures treated surgically. Materials and methods  Two series of 22 patients each, who had had a Weber type A, B or C ankle fracture treated surgically, were followed up at least 10 years after the injury. In the first series, immediately after surgery, a continuous passive motion machine was applied to the operated ankle for 3 weeks, whereas in the second series, after surgery a plaster splint or a plaster cast was applied for 3 weeks. Results  At follow-up, all patients were evaluated clinically and radiographically using the AOFAS Ankle Hindfoot Score System (Kitaoka, Foot Ankle 15:349–353, 1994). The average final score for the first series of patients was 95.7 points (range 87–100 points, standard deviation 3.42 points). Of this series, at radiographic examination, in two patients we observed minor signs of osteoarthritis of the ankle joint. The average final score for the second series was 88 points (range 68–100 points, standard deviation 10.60 points). At radiographic examination, in six patients we observed minor signs of osteoarthritis of the ankle joint, whereas in another one the osteoarthritis was severe. Conclusions  Continuous passive motion started immediately after surgery seems to be an effective method both for allowing complete and quick recovery of the range of motion of the ankle and for reducing the risk of early degenerative joint disease. Immediate passive ankle motion can be applied only after adequate reduction and stable internal fixation.     

Lack of endogenous modulation and reduced decay of prolonged heat pain in older adults

This study supports the hypothesis that healthy older adults exhibit decreased endogenous pain inhibition compared to younger healthy controls. Twenty-two older adults (56–77 years of age) and 27 controls aged 20–49 participated in five experimental sessions following a training session. Each experimental session consisted of five 60-s trials in which the experimental heat stimulus was presented to the thenar eminence of the left palm with or without a conditioning stimulus (cold-water immersion of the foot). The temperature for the palm (44–49 °C) and foot (8–16 °C) was customized for each subject. The intensity of experimental pain produced by the contact thermode was continuously measured during the 60-s trial with an electronic visual analogue scale. No significant associations were found between subjects rating of concentration and the overall inhibitory effect. Older subjects failed to demonstrate conditioned pain modulation (CPM) and showed facilitation in the trials using painful concurrent immersion of the foot. A novel aspect of the study was that we recorded “pain offset” (i.e., after-sensations) and found that ratings for the older sample decreased at a slower rate than observed for the group of younger adults suggesting increased central sensitization among the older sample. Decrements in CPM could contribute to the greater prevalence of pain in older age. Since a number of neurotransmitter systems are involved in pain modulation, it is possible age-related differences in CPM are due to functional changes in these systems in a number of areas within the neuroaxis.     

Release of endogenous 5-hydroxytryptamine from resting and stimulated enteric neurons

Physiological and biochemical evidence has indicated that there may be serotoninergic neurons in the enteric nervous system. A critical step in the identification of a neurotransmitter is the demonstration of the release of the substance upon nerve stimulation. We now report the release of endogenous 5-hydroxytryptamine from enteric neurons. Segments of guinea-pig small intestine were everted and perfused in vitro through the newly created serosal lumen. Tests with [³H]5-hydroxytryptamine revealed the existence of a tissue barrier preventing diffusion of mucosal (enteroendocrine cell) 5-hydroxytryptamine into the perfusate; thus, all 5-hydroxytryptamine in the perfusate was of neural origin. The gut was stimulated electrically. 5-Hydroxytryptamine in the perfusate and in the myenteric plexus was assayed by a specific radioenzymatic method. 5-Hydroxytryptamine was present in the myenteric plexus; it was released into the perfusate spontaneously and the release was enhanced by electrical stimulation. The stimulated, but not the spontaneous, release of the amine was Ca²⁺-dependent. Comparison with the release of newly taken up [³H]5-hydroxytryptamine showed that the specific radioactivity of electrically released 5-hydroxytryptamine was higher than that of either the spontaneously released or tissue amine. Stimulation also increased the release of 5-hydroxytryptamine more than that of its metabolites in the perfusate.These results indicate that 5-hydroxytryptamine is an endogeneous constituent of the enteric nervous system, that it is released by electrical field stimulation of enteric nerves, and that newly taken up 5-hydroxytryptamine is released preferentially by these neurons.     

患处热敷对膝关节置换患者术后CPM锻炼效果影响的分析

目的探讨患处热敷对膝关节置换患者术后CPM功能锻炼效果的影响。方法将选取的符合条件的70例病例随机分为热敷组和对照组各35例,两组患者在遵医嘱拔除引流管的第2天开始使用CPM进行功能锻炼。热敷组在使用CPM功能锻炼前先热敷患处20min,对照组不做热敷处理直接行CPM功能锻炼。结果两组患者锻炼的最初2d关节活动度相同,热敷组第3～7天关节活动度的度数均较对照组有所增加（P〈0．01）。结论在CPM锻炼前先于患处热敷20min,能更有效地提高功能锻炼效果,值得推广应用。     

立体动态干扰电疗对膝关节骨关节炎的疗效

目的：观察立体动态干扰电疗机辅以CPM机对膝关节骨性关节炎（OA）患者疼痛和膝关节ROM的作用。方法：68例膝OA患者分为2组,均给予非甾体抗炎药治疗,并辅以CPM机锻炼,干扰电组36例同时增加立体动态干扰电治疗,超短波组32例配合超短波治疗。结果：治疗12次后,与治疗前比较,2组VAS疼痛评分均明显降低,膝关节（屈曲）ROM测量明显提高（P〈0.01或0.05）;与超短波组比较,干扰电组改善更明显（P〈0.05）。结论：膝关节OA患者治疗中配合立体动态干扰电疗可以显著缓解疼痛症状,提高膝关节ROM。     

CPM对预防下肢骨折术后患者深静脉血栓形成的影响

目的探讨CPM下肢功能训练对预防下肢骨折患者深静脉血栓形成的影响。方法将268例下肢骨折患者随机分为CPM实验组（134例）和对照组（134例）两组进行对比，CPM实验组应用CPM装置进行训练，对照组不使用CPM，只由专业医务人员指导，鼓励患者主动、被动功能训练，观察两组预防深静脉血栓形成的效果。结果CPM实验组在预防患者下肢深静脉血栓形成明显优于对着组（P〈0．05）。结论下肢骨折术后患者患者应用CPM装置有利于预防深静脉血栓形成。     

消肿汤联合CPM治疗膝关节内骨折术后早期30例

自2001年1月至2005年2月笔者采用消肿汤联合CPM机治疗膝关节内骨折术后早期30例,疗效较好,现介绍如下。1临床资料膝关节内骨折术后早期运用消肿汤及CPM机