Selective IgG subclass deficiency: quantification and clinical relevance

Each of the four human IgG subclasses exhibits a unique profile of effector functions relevant to the clearance and elimination of infecting microorganisms. The quantitative response within each IgG subclass varies with the nature of the antigen, its route of entry and, presumably, the form in which it is presented to the immune system. This results in antibody responses to certain antigens being predominantly or exclusively of a single IgG subclass. An inability to produce antibody of the optimally protective isotype can result in a selective immunodeficiency state. This is particularly apparent for responses to certain bacterial carbohydrate antigens that are normally of IgG2 isotype. A failure to produce the appropriate specific antibody response may result in recurrent upper and/or lower respiratory tract infection. Careful patient investigation can identify such deficiencies and suggest appropriate clinical management. In this review we outline the biology and clinical relevance of the IgG subclasses and summarize current rational treatment approaches.     

云南省傣族G6PD一个家系的突变型研究

在调查云南少数民族Ｇ６ＰＤ缺乏症时，采用Ｇ６ＰＤ硝基四氮唑蓝纸片法筛查，按ＷＨＯ标准化方法进行生化变异型鉴定，再用错配碱基ＰＣＲ引入酶切位点法进行ＤＮＡ突变型研究，首次在傣族中发现Ｇ６ＰＤｃＤＮＡ突变型：１３８８Ｇ→Ａ。     

健脾补肾药对脾虚大鼠细胞因子水平的影响

目的 :观察健脾补肾方药对实验性脾虚证大鼠细胞因子的影响 ,探讨脾虚证与细胞因子的关系及脏腑相关的意义。方法 :选用SD雄性大鼠 ,随机分为 :正常对照组 ,脾虚模型组 ,健脾补肾方高、低剂量组 ,通过大黄复制脾虚证动物模型 ,并用健脾补肾方药进行防治。采用放射免疫分析观察各组动物血清肿瘤坏死因子(TNF)、白细胞介素 - 6 (IL - 6 )、白细胞介素 - 2 (IL - 2 )水平的变化。结果 :脾虚模型组大鼠血清TNF、IL - 6、IL - 2含量均比正常对照组显著降低 (p <0 0 1) ,而健脾补肾方药能明显升高TNF、IL - 6、IL - 2含量 ,使体重增加 ,脾脏和胸腺组织的重量增加。结论 :脾虚证的发生与细胞因子网络调节系统的失衡有关 ,而健脾补肾中药对实验性脾虚证有较好的防治作用 ,脾肾相关理论对实践有指导意义。     

两例补体第8成份β亚基缺陷家系患者的进一步分子遗传基础研究

目的　在白人群体中 ,导致人类补体第 8成份 β亚基缺陷的分子基础主要是在编码 β亚基基因的第 9外显子上发生碱基 C→ T的突变 ,从而形成终止密码 ,导致 C8β亚基不能完全合成。国外学者在两例 C8β亚基完全缺失的患者家系研究中 ,发现这两例β亚基缺失个体只是第 9外显子上碱基 C→ T突变的杂合子 ,现进一步寻找这两例 C8β亚基完全缺失的分子遗传学机理。方法　对两例 C8β亚基完全缺失患者的 C8β编码基因的全部 11个外显子的 PCR扩增产物进行 DNA测序分析并与正常人 DNA序列进行对比。结果　两例完全性 C8β亚基缺失患者的蛋白质编码基因中 ,分别在第 3外显子的 2 98和 388位置发现了 C→T突变 ,同时对这两个突变位点的家系分析也证实 ,位于第 3外显子上的这两个突变位点是独立于第 9外显子的突变而遗传。结论　所发现的两个突变位点均能形成终止密码而导致 C8β亚基合成提前终止 ,因此这两例患者 C8β亚基完全缺失的分子遗传学机理是由于编码 C8β亚基的基因在第 3和第 9外显子上同时发生了点突变 ,进而形成终止密码造成 C8β亚基合成终止所致。     

脑转移瘤同期加量混合调强放疗与调强放疗的剂量学比较

目的:探讨同时运用三维适形与调强的混合调强放疗（Hybrid-IMRT）与调强放疗（IMRT）用于脑转移瘤同期加量的剂量学差异。方法:选取20例进行头颅放疗的患者，分别设计Hybrid-IMRT计划和IMRT计划。Hybrid-IMRT计划包括全脑行三维适形（两野对穿）3 600 cGy/20 F、脑转移灶行IMRT同期加量至5 000 cGy/20 F；IMRT计划全程运用IMRT给予全脑照射3 600 cGy/20 F、脑转移灶5 000 cGy/20 F。在满足临床要求的前提下，比较两组计划靶区的均匀性指数、适形度指数、平均剂量和机器跳数，危及器官脑干、视神经、晶体、视交叉、眼球的最大剂量和平均剂量。结果:两种计划均能满足临床要求。Hybrid-IMRT计划的PGTV均匀性优于IMRT计划（P<0.001）；Hybrid-IMRT计划的脑干、视交叉、左右晶体的最大剂量与平均剂量，左右眼球的平均剂量以及左右视神经的最大剂量均低于IMRT计划（P<0.05）；Hybrid-IMRT计划的机器跳数比IMRT计划减少了约70%（P<0.001）。结论:两种计划均能满足临床要求，Hybrid-IMRT计划相较IMRT计划靶区剂量更加均匀，治疗时间缩短，也能更好地保护危及器官。     

Psychological reactions in patients with early rheumatoid arthritis

We report the interaction of RA and psychological factors over 2 years in a group of 89 patients with newly established disease. Short-time outcome regarding physical features was fairly good. Disease activity decreased, and disability evaluated by HAQ remained at a low level. Psychological distress as measured by the depression and anxiety subscales of SCL 90 (Symptom Check List) was not very pronounced and not related to disease state factors. A slight decrease of anxiety was recorded after 2 years. A new adjustment test was applied. It contained 13 items focused mainly on negative illness effects such as loss of independence, feelings of guilt, and change of social and leisure time activities. Three factors (regret of lost life values, dysphoric mood, and acceptance) explained 48% of the variance of the 13 items. The validity of the test was acceptable. The patients' degree of adjustment changed slowly or not at all during the 2 years.     

利用纳米颗粒的光核反应实现原位活化治疗的可行性研究

目的:利用蒙特卡罗程序Geant4模拟13.5 MeV和6 MeV X射线照射细胞内的纳米颗粒，分析其光核反应的剂量贡献份额。方法:以纳米金颗粒（GNP）为例，分别模拟6 MeV和13.5 MeV照射细胞内的GNP，给出各自条件下由GNP造成的剂量贡献。创建水模体（0.426 mm×0.426 mm×0.426 mm），包含1 103个细胞，作为GNP的载体。在6 MeV和13.5 MeV下分别模拟细胞中包含和不包含GNP所造成的剂量沉积。结果:13.5 MeV X射线照射，其由GNP造成的剂量贡献为5.12 cGy，细胞总能量沉积为25.37 cGy，由GNP引起的剂量贡献占20.19%；6 MeV X射线照射，其由GNP造成的剂量贡献为2.87 cGy，细胞总能量沉积为23.05 cGy，由GNP造成剂量贡献约为12.46%。与6 MeV相比，13.5 MeV下由GNP光核反应造成的剂量贡献占7.7%。结论:对于细胞模型内纳米金的研究表明，GNP确实能引起额外的剂量贡献。由于GNP光核反应引起的剂量贡献很低，难以作为能够被原位激活的放射源使用。     

缺铁性贫血对学龄儿童某些认知能力影响的研究

本文采用双盲法对 IDA 和 NIDA学龄儿童各61名进行了认知能力测验及铁治疗前后的动态比较。结果表明:IDA 儿童识记再认、字母匹配反应时、数字扫描记忆和一般推理能力测验成绩较 NIDA 儿童差。经铁治疗的IDA 儿童,注意、短时记忆和心理动作反应速度均有明显提高。但对较高级认知能力的改善不明显。     

An epidemiologic approach to computerized medical diagnosis—AEDMI program

A program called “An Epidemiological Approach to Computerized Medical Diagnosis” (AEDMI) is presented. Using an interactive questionnaire, physician-patient interviews are conducted and a summary of the relevant clinical data is provided. Standard items, obained on a multi-centre basis, form a large-scale data base. Simultaneously, the reasoning of clinical experts in each real case is analyzed to obtain a knowledge-rules data base. The methodology of the program combines Bayesian systems, expert systems, and other new lines of researcg such as neural networks or case-based reasoning. The general concepts of clinical decision making aid systems are reviewed. This publication is aimed at obtaining international cooperation.     

儿童铁缺乏对血清IgG亚类及PnPs特异性IgG亚类抗体的影响

本文测定铁缺乏症患儿血清IgG亚类(47例)和PnPs特异性IgG_1、IgG_2抗体(18例)。发现47例缺铁儿童中28例伴IgG亚类缺陷,各亚类缺陷检出率依次为:IgG_4 27.66％(13/47)、IgG_1 21.28％(10/47)、IgG_2 14.89％(7/47)、IgG_2 2.13％(1/47)。与同龄正常儿童比较,缺铁组血清IgG_4和IgG_1均值以及PnPs特异性IgG_1、IgG_2抗体水平明显降低;缺铁患儿外周血CD~+_4细胞百分率及CD~+_4/CD~+_8细胞比值降低,IL-6活性、T淋巴细胞增殖反应减低。缺铁时反复呼吸道感染率(占63.83％)亦明显增高。提示缺铁不仅致T细胞功能受损,B细胞功能亦明显障碍。