不同稀释液配制的结合疫苗免疫持久性研究

目的 了解分别用Al(OH)3佐剂、生理盐水配制Hib结合疫苗和A、C群脑膜炎球菌结合疫苗的免疫持久性.方法 分别用两种稀释液配制Hib结合疫苗和A、C群脑膜炎球菌结合疫苗,各自免疫小鼠,采集分离血清用ELISA测定血清IgG抗体滴度,计算血清抗体GMT和阳转率及不同免疫针次的免疫持久性.结果 两种稀释液配制的Hib结合疫苗和A、C群脑膜炎球菌结合疫苗均可产生明显的抗体应答和免疫记忆反应,但在刺激机体快速产生免疫应答,加强免疫后的回忆反应,抗体滴度及免疫持久性方面有明显差异.生理盐水配制的结合疫苗较Al(OH)3盐水配制的结合疫苗可刺激机体快速产生抗体应答,但Al(OH)3盐水配制的结合疫苗具有更好的抗体GMT和免疫持久性.结论 Al(OH)3盐水配制的结合疫苗具有较好的免疫原性.     

Management of preterm prematurely ruptured membranes: a retrospective comparison of observation versus use of steroids and timed delivery

A retrospective study of 38 women with preterm prematurely ruptured membranes was performed. Twenty were treated with intravenous hydrocortisone followed by timed delivery between 48 and 72 hours after initiation of steroid therapy. Eighteen were managed expectantly, with observation for labor and infection. There were no significant differences between steroid-treated patients and observed patients in the incidence of neonatal respiratory distress syndrome, perinatal mortality, or maternal or neonatal infections.     

Cultures of thoracotomy specimens confirm usefulness of sputum cultures in cystic fibrosis

Bacteriologic cultures of sputum and specimens obtained at thoracotomy from 17 patients with cystic fibrosis were compared. All organisms found in the surgical specimens were found in the sputum. Only two surgical specimens failed to yield any organisms. The most frequently isolated organisms were Pseudomonas aeruginosa (41%) and Pseudomonas cepacia (35%). Serotypes of P. aeruginosa and antibiogram results on both P. aeruginosa and P. cepacia further supported the concordance of the isolates from the two sources. In addition, anaerobic cultures were obtained in specimens from 10 patients with CF and revealed two patients with anaerobic colonization of the lower respiratory tract. These findings also correlated well with the sputum cultures. The correlation of sputum and lung specimen culture results supports the value of sputum culture in the management of lung disease in CF.     

Medicinal therapy for hearing loss resulting from noise exposure

A large-scale review of the literature concerning the effects of noise on hearing, published primarily during the 1970s, was initiated by the National Institute of Neurological and Communicative Disorders and Stroke in 1981. This review demonstrated a continuing search for medicinal treatment for the adverse effects of noise on hearing. The present article focuses on the results of investigations of human subjects. The literature in this area is primarily European and deals principally with treatment of acoustic trauma, although a few reports have described attempts to render the ear less susceptible to the hazards of chronic noise exposure. Much of the published information is of questionable value because of inadequate experimental design and control. To date, the search for effective medicinal treatment for hearing loss caused by noise has been unsuccessful. Results reported from studies of the effects of carbogen are encouraging and suggest that continued rigorous investigation of this agent is warranted.     

Broviac catheter-related Malassezia furfur sepsis in five infants receiving intravenous fat emulsions

Malassezia furfur, a lipophilic fungus commonly found on the skin of healthy adult, was isolated from Broviac catheter blood cultures in five sick infants who were receiving fat emulsions intravenously. The most common manifestations of sepsis included apnea and bradycardia, low-grade fever, interstitial pneumonia, elevated neutrophil band counts, and thrombocytopenia. All infants recovered without antifungal therapy after removal of the Broviac catheters. Early onset of fungemia after catheter placement in these five infants and the recovery of M. furfur from the skin of nearly 33% of hospitalized premature neonates indicate that contamination of the Broviac catheter at time of placement may be the most likely origin of infection.     

The diurnal variations of serum prolactin levels before and during pregnancy in normal and hyperprolactinemic patients

Although it seems likely that some patients with unexplained repeated abortions have early or subclinical autoimmune disease, there are no reports on the incidence of autoimmune serologic abnormalities in such patients by use of a series of tests. This diagnosis would suggest a treatable etiology for reproductive loss. We performed 11 serologic autoimmune tests in sera from 14 patients with three or more unexplained abortions (group II) and compared these results to those of 16 control patients with an established diagnosis for repeated abortions (group I). The groups were similar in age, gravidity, number of spontaneous abortions and live births, and in the interval from last abortion to serum sampling. A positive antinuclear antibody test plus at least one other positive test was found in four of 14 (29%) patients in group II (p less than 0.05). The tests that identified all these patients included levels of antinuclear antibody, antibodies to DNA or extractable nuclear antigen, and low levels of complement 3.     

老年人血浆维生素K和D水平的季节变化

目的了解老年人群血浆维生素K和维生素D水平的季节变化。方法对85名健康老年人用放射免疫分析法测定春秋两季血浆维生素D(25(OH)D)和甲状旁腺素(PTH)含量,用高压液相色谱法测定血浆维生素K含量。结果血浆维生素K水平女性在春秋两季均明显高于男性,而男性和女性各自无季节性差异。无论男女秋季血浆维生素(25(OH)D)水平明显高于春季,同一季节内男女间差异无统计学意义。维生素D缺乏率女性春季为63.4%,秋季为7.3%。男性春季为65.9%,秋季无缺乏者。春季维生素D缺乏率显著高于秋季(P<0.05)。男女秋季血浆PTH浓度明显低于春季。老年女性春季血浆25(OH)D浓度和血浆PTH浓度之间呈负相关(r=-0.426,P<0.001)。结论该人群血浆25(OH)D和PTH有明显的季节变化,春季血浆25(OH)D水平低。而血浆维生素K没有季节变化。     

Age, race and season predict vitamin D status in African American and white octogenarians and centenarians

Objective: Poor vitamin D status has been associated with osteoporosis, falls, cardiovascular diseases, cancer, autoimmune diseases, pain, nursing home placement, and other age-related conditions, but little is known about the prevalence and predictors of vitamin D status in those aged 80 and older. Thus, this study tested the hypothesis that vitamin D status would be 1) poorer in a population-based multi-ethnic sample of centenarians as compared with octogenarians and 2) predicted by specific dietary, demographic or environmental factors.Design: Cross-sectional population-based analyses.Setting: Northern Georgia in the United States.Participants: Men and women aged 80 to 89 (octogenarians, n=80) and 98 and older (centenarians, n=237).Measurements: Regression analyses were used to examine the associations of serum 25-hydroxyvitamin D [25(OH)D] with age, gender, race, living arrangements, dairy food intake, supplement intake, and season.Results: The prevalence of vitamin D insufficiency [25(OH)D<50 nmol/L] was higher in centenarians than in octogenarians (p<0.02). In logistic regression analyses, the risk of being vitamin D insufficient was significantly increased by being a centenarian vs. octogenarian (p<0.005) and by being African American vs. white (p<0.001) and decreased by taking a supplement with vitamin D (p<0.001) or by having vitamin D status measured in the summer or fall (each p<0.05), compared with spring.Conclusions: Centenarians and octogenarians are at high risk for vitamin D insufficiency for many of the same reasons identified in younger populations. Given the numerous potential adverse consequences of poor vitamin D status, efforts are needed to ensure vitamin D adequacy in these older adults.     

Techniques to maximize mammary artery length

The available length of the internal mammary artery has limited its versatility as a bypass conduit. Several techniques for increasing usable internal mammary artery length are described.     

Increase of bone volume in vitamin D-repleted rats by massive administration of 24R,25(OH)2D3

Summary A large dose of 24R,25(OH)₂D₃ was administered to the vitamin D-repleted rat to examine its effect on the bone. Male Wistar rats were fed a diet containing 0, 0.025, 1.25, 4.0, and 12.5 ppm 24R,25(OH)₂D₃ for 2 years starting at age 6 weeks. The estimated amounts of daily intake of 24R,25(OH)₂D₃ were 0, 93, 4640, 14680, and 49580 ng/100 g body weight, respectively. No notable difference was found in either the weight or the death rate of the animal. The long-term administration of massive doses of 24R,25(OH)₂D₃ did not lead to hypercalcemia nor did it affect the blood phosphorus, alkaline-phosphatase, or creatinine levels. Radiographs revealed a striking increase in the bone density on the bones from the animals treated with 1.25 ppm or more 24R,25(OH)₂D₃. Direct single photon absorptiometry revealed a dose-dependent increase in total bone minerals of both the femur and coccyx. Histological examination revealed a marked increase in the cortical thickness of the femur as well as in the cancellous bone volume of the coccyx. Polarizing microscopy demonstrated the lamellar structure of the bone, and undecalcified sections confirmed the increase of mineralized bone. Ash weight, calcium, phosphorus, and magnesium contents on the tibia and fibula also indicated the ascending dose-dependent increase up to 150% of the control. The parameters of bone size were not altered in any group. These results clearly suggest that 24R,25(OH)₂D₃ given in massive doses has the pharmacological action of increasing bone volume in the rat without causing remarkable hypercalcemia.