交叉反应在I型变态反应诊断中的意义

IgE介导的I型变态反应的诊断需结合临床病史、体内检测和体外血清学检测结果进行特异性病因诊断。由于过敏原间交叉反应的影响,为其病因诊断带来困扰。阐述交叉反应的常见原因,包括结构类似的蛋白家族和交叉反应性糖类决定簇,并提出临床工作中的应对策略。在出现过敏原特异性IgE阳性并排除交叉反应性糖类决定簇一IgE干扰后,应进一步考虑进行过敏原组分检测,为患者提供个体特异性过敏原谱。     

中国北方人群血脂异常患病率及其影响因素分析的关系

目的调查中国北方人群血脂异常的患病率,并分析其影响因素。方法以参加2012年1月-2012年12月冀东油田社区健康体检的居民为调查人群,采用横断面调查的方法,分析人群中血脂异常的患病率及其影响因素。结果研究人群的一般情况:男性的年龄、体质指数、收缩压、舒张压、血总胆固醇、甘油三酯、低密度脂蛋白、空腹血糖高于女性,高密度脂蛋白胆固醇低于女性,不同性别组间比较差异有统计学意义(P<0.05);血脂异常患病率:研究对象血脂异常的总患病率为57.79%,其中男性患病率为66.34%。女性患病率为48.16%。血脂异常的logistic回归分析显示:男性、年龄增加、BMI升高、腹围增加、舒张压增加、血糖升高与血脂异常相关。结论中国北方人群血脂异常患病率逐渐增高且存在性别和年龄的差异,50岁以前男性高于女性,50以后女性明显增高甚至超过男性。男性、年龄增加、BMI升高、腹围增加、舒张压增加、血糖升高是血脂异常的独立危险因素。     

Inpatient Proton Pump Inhibitor Administration and Hospital-Acquired Clostridium difficile Infection: Evidence and Possible Mechanism

The incidence of Clostridium difficile infection continues to increase globally. Particularly concerning are hospital-acquired cases that attribute significant morbidity, mortality, and expenditures to the health care system. Proton pump inhibitors, which are widely prescribed and generally considered to have minimal adverse effects, have recently come under scrutiny for positive associations with C. difficile infection development. This article will specifically review the current state of evidence demonstrating a positive association between nosocomial proton pump inhibitor administration and the incidence of hospital-acquired C. difficile infection. In addition, the article delivers state-of-the-art knowledge relative to mechanisms by which proton pump inhibitor exposure may propagate the manifestation of C. difficile infection.     

医护人员下肢静脉曲张患病率断面调查研究

目的：调查我市医护人员下肢静脉曲张的发生、防护和治疗情况,为进一步干预和提高防护水平提供依据。方法：采用自设问卷进行凋查,被调查人员按CEAP分级方法自评,调查我市一、二、三级医院的医护人员150人。结采：被调查的医护人员150人中,下肢静脉曲张31人,患病率20．67％。其中单纯下肢静脉曲张17人,下肢静脉功能不全14人。全组医护人员采取弹力袜防护者11人,占7．33％。不同教育程度间比较尤明显差异（P=0．133,Fisher确切概率）,同样在不同级别医院比较也．无统计学差异（P=0．943）。采取治疗者8人,占25．81％,不同教育程度及不同级别医院间比较无统计学差异。经多因素条件Logistic回归分析结果显示,站立工作每13大于8h、遗传因素、护理工种可能足下肢静脉曲张的危险因素。结论：医护人员下肢静脉曲张发生几牢较高,防护和治疗均处于较低水平,需要采取合理的措施来改善目前状况。     

承德市双桥区居民甲型H1N1流感认知、行为和态度调查

目的 了解承德市双桥区居民对甲型H1N1流感的基本认知、行为和态度,为制定适宜的健康教育策略提供科学依据.方法 采用多阶段整群随机抽样方法,选择承德市双桥区城镇1个社区和农村1个村,共211人进行入户问卷调查.结果 96.7%的居民听说过甲型H1N1流感;知识总知晓率达58.5%,且有随文化程度的增加有上升趋势,不同职业间总知晓率也存在统计学差异;48.2%的居民认为自己日常生活受到了甲型H1N1流感的影响,9%的人认为将会出现甲型H1N1流感的大流行,但仍然有7%的人不将采取任何预防措施;78%的人愿意接种甲型H1N1流感疫苗,但有11.0%的人明确表示不会接种;对于政府和相关卫生机构应对甲型H1N1流感所采取的措施,93%的居民表示满意.结论 居民对甲型H1N1流感知识掌握不全面,倾向于采取健康行为,相应的健康教育还应进一步加强.     

Food Allergy Overview in Children

Food allergies have increased significantly in the past decade. An accurate history is crucial in approaching the management. At the outset, food intolerance must be distinguished from food allergies and, furthermore, these allergies should be classified into either an IgE, Non-IgE, or a mixed response. The clinical features vary from life-threatening anaphylaxis to milder IgE-mediated responses, atopic dermatitis, and gastrointestinal symptoms. The severity of the reaction and the potential risk for anaphylaxis on reexposure should be assessed. Milk, soy, egg, wheat, and peanut allergies are common in children, whereas peanut, tree nut, fish, shell fish allergies, and allergies to fruits and vegetables are common in adults. Structural proteins are important determinants of the severity of the reactions and may often predict the natural history and cross reactivity. Diagnostic work up must be guided by the clinical history. Skin testing and food-specific IgE done by standard methods are very useful, whereas oral challenges may be indicated in some situations. Majority of the patients outgrow their allergies to milk, soy, egg, and wheat, and some to peanut also, therefore, patients should be periodically reassessed. Novel diagnostic techniques which detect specific allergenic epitopes have been developed. Several newer therapies are promising.     

Sustained cross‐presentation capacity of murine splenic dendritic cell subsets in vivo

An exclusive feature of dendritic cells (DCs) is their ability to cross‐present exogenous antigens in MHC class I molecules. We analyzed the fate of protein antigen in antigen presenting cell (APC) subsets after uptake of naturally formed antigen‐antibody complexes in vivo. We observed that murine splenic DC subsets were able to present antigen in vivo for at least a week. After ex vivo isolation of four APC subsets, the presence of antigen in the storage compartments was visualized by confocal microscopy. Although all APC subsets stored antigen for many days, their ability and kinetics in antigen presentation was remarkably different. CD8α⁺ DCs showed sustained MHC class I‐peptide specific CD8⁺ T‐cell activation for more than 4 days. CD8α^? DCs also presented antigenic peptides in MHC class I but presentation decreased after 48 h. In contrast, only the CD8α^? DCs were able to present antigen in MHC class II to specific CD4⁺ T cells. Plasmacytoid DCs and macrophages were unable to activate any of the two T‐cell types despite detectable antigen uptake. These results indicate that naturally occurring DC subsets have functional antigen storage capacity for prolonged T‐cell activation and have distinct roles in antigen presentation to specific T cells in vivo.     

Topical rather than intradermal application of the TLR7 ligand imiquimod leads to human dermal dendritic cell maturation and CD8+ T‐cell cross‐priming

Toll‐like receptor (TLR) ligands are attractive candidate adjuvants for therapeutic cancer vaccines, since TLR signaling stimulates and tunes both humoral and cellular immune responses induced by dendritic cells (DCs). Given that human skin contains a dense network of DCs, which are easily accessible via (intra‐)dermal delivery of vaccines, skin is actively explored as an antitumor vaccination site. Here we used a human skin explant model to explore the potential of TLR ligands as adjuvants for DC activation in their complex microenvironment. We show that topical application of Aldara skin cream, 5% of which comprises the TLR7 agonist imiquimod, significantly enhanced DC migration as compared with that resulting from intradermal injection of the TLR7/8 ligand R848 or the soluble form of imiquimod. Moreover, Aldara‐treated DCs showed highest levels of the costimulatory molecules CD86, CD83, CD40, and CD70. Topical Aldara induced the highest production of pro‐inflammatory cytokines in skin biopsies. When combined with intradermal peptide vaccination, Aldara‐stimulated DCs showed enhanced cross‐presentation of the melanoma antigen MART‐1, which resulted in increased priming and activation of MART‐1‐specific CD8⁺ T cells. These results point to advantageous effects of combining the topical application of Aldara with antitumor peptide vaccination.     

中德学龄儿童数学能力发展水平跨文化研究

目的：开展中德儿童基本数学能力跨文化比较,探讨我国数学基础教育的不足,为改善教育质量提供决策依据.方法：采用多阶段分层整群抽样,抽取普通小学1年级末至4年级末的学生为研究样本.中国在大陆31个省、自治区、直辖市取样,共抽取样本7827例,其中男生3985人,女生3842人.德国样本3354人,来自不同的州,其中男生1731人,女生1623人.结果：在数学运算领域的分测试,即加法、减法、乘法、除法、比较大小5个分测试,中国儿童的得分显著高于德国儿童（P＜0.01）;但在逻辑思维与空间-视觉功能领域的分测试,如续写数字、目测长度、方块计数、数字连接等分测试中,中国儿童无明显优势,有些分测试甚至低于德国儿童.结论：我国的数学基础教育应加强逻辑思维、空间概念等思维的培养.