野菊花中刺槐甙的库伦滴定法

野菊花Chrysanthemum indicum L.是一种常用中草药,对防治流行性脑脊髓膜炎、流感、高血压、肝炎、痢疾、痈疖疗疮有一定作用。最近还报道野菊花栓剂可用于治疗前列腺炎等症。野菊花的化学成分,据报道含有黄酮类化合物,已知的有刺槐甙(acaciin),水解后得刺槐素(acacetin),分子结构式为     

高PRA介导肾移植后延迟性超急排斥反应

目的：了解HLA-A、B、DR、DQ表现型为纯合子的终末期肾脏疾病患者的PRA水平,并研究其与肾移植预后的关系。方法：对2006年8月至2007年8月间在我院登记等待首次肾移植的438例终末期肾脏疾病患者HLA、PRA情况以及其中1例PRA65的HLA纯合子患者肾移植效果进行分析。HLA基因分型采用PCR-SSP技术,PRA、抗体强度及抗体特异性分析采用ELISA技术,数据统计采用SPSS11.5统计软件。结果：438例患者中有HLA纯合子12例,杂合子426例;12例纯合子中PRA阳性者6例,阳性率50,平均HLA抗体强度为55,广泛致敏率达100;426例杂合子中PRA阳性者65例,阳性率15.26,平均HLA抗体强度为28,广泛致敏率为40;纯合子与杂合子之间的PRA阳性率、平均HLA抗体强度和广泛致敏率相比差异均有统计学意义（P〈0.05）,纯合子高PRA的风险大（OR=5.29,95CI：1.67～16.70）;1例PRA65的纯合子患者术前经血浆置换、蛋白免疫吸附、静滴丙种球蛋白治疗使PRA降低至阴性,在舒莱免疫诱导下行尸体肾移植术,供受者HLA抗原2个错配,术后移植肾功能逐渐恢复,第3天开始PRA呈阳性并逐渐升高,伴随临床逐渐出现尿少、血压升高、移植肾区疼痛等排斥反应征象,血清肌酐逐渐升高,移植肾B超见动脉阻力指数逐渐升高,提示急性排斥反应,采用术前有效清除HLA抗体的所有方法再次治疗无效,于术后第36天因移植物失功行移植肾切除。结论：HLA纯合子产生高PRA的风险大;文中1例PRA阳性的HLA纯合子早期移植肾功能恢复随后出现不可逆排斥反应致移植肾失功的情况,提示近年来随着各种有效清除HLA抗体的治疗方法不断用于临床导致了抗体介导的延迟性超急排斥反应（AMDR）的出现从而使移植肾失功;高PRA患者行肾移植术需高度慎重,应尽可能避开受者PRA峰值时的全部抗体谱来选择供体。     

活动期SLE患者外周血淋巴细胞、单核细胞HLA-DR的表达

目的：探讨活动期SLE患者外周血淋巴细胞、单核细胞HLA-DR表达的变化。方法：应用双色荧光抗体标记流式细胞术检测活动期SLE患者外周血淋巴细胞、单核细胞HLA-DR表达的阳性百分率及荧光强度。结果：与正常对照组比较,活动期SLE患者外周血淋巴细胞HLA-DR表达的阳性率和荧光强度均显著升高（t=9.769,P〈0.001;t=11.184,P〈0.001）;而单核细胞HLA-DR表达的阳性率和荧光强度均显著降低（t=27.528,P〈0.001;t=67.522,P〈0.001）。结论：淋巴细胞HLA-DR表达的增高、单核细胞HLA-DR表达的降低与SLE的发病、发展有着非常密切的关系。     

5—氨基水杨酸与乙基纤维素溶混性的计算机模拟

使用计算机辅助分子建模（ＣＡＭＭ）、分子力学和蒙特卡罗方法,模拟了５－氨基水杨酸（５－ＡＳＡ,Ｃ７Ｈ７ＮＯ３,美沙拉灵（ｓｐ－５７－６））与乙基纤维素（ＥＣ）的溶混性。模拟结果显示,在２７３Ｋ至３１６Ｋ的温度范围内,５－氨基水杨酸与乙基纤维素能以任何比例混溶。得出Ｅｍｉｘ（Ｔ）＝Ａ＋ＢＴ＋Ｃ／Ｔ模型,Ａ＝０．３６９４Ｅ＋０４,Ｂ＝－０．２６１０Ｅ－０２,ａｎｄＣ＝０．１８１８Ｅ＋０４,以及Ｅｍｉｘ（Ｔ）模型标准方差,Ｓ＝０．２６５４Ｅ－０３ｋｃａｌ／ｍｏｌ。对乙基纤维素及５－氨基水杨酸与乙基纤维素混溶过程的能量和构象分析表明,混溶过程中有乙基纤维素分子内和乙基纤维素与乙基纤维素分子间氢键形成。对两相混溶体系进行了热力学分析。     

电针推拿治疗膝关节骨性关节炎合并膝关节滑膜炎临床观察

目的:观察针灸推拿治疗孟加拉人膝关节骨性关节炎合并滑膜炎的疗效.方法:采用针刺配合电针刺激鹤顶、内外膝眼等穴,并在膝关节周围行推拿按摩,治疗孟加拉人膝关节炎合并滑膜炎51例,观察1个疗程(10次).结果:显效17例,有效25例,无效9例,总有效率为82.4%.结论:中国传统针灸推拿疗法对孟加拉人膝关节炎合并滑膜炎疗效满意.     

The genotype analysis of the hepatitis C virus in Heilongjiang Province,China

Introduction: Hepatitis C virus (HCV) infection is a major public health issue. HCV genotype identification is clinically important to tailor the dosage and duration of treatment, and recombination in intra-patient populations of HCV may lead to the generation of escape mutants, as previously observed for other RNA viruses. Up to now, there is no study assessing HCV genotypes and subtypes in Heilongjiang Province, China.Methods: To determine genotype and phylogenetic analysis of HCV in Heilongjiang Province is crucial. In this study, we amplified 3 genome regions (5’UTR, E1, and NS5B) of 30 HCV patients in Heilongjiang Province, amplified products were analyzed by bioinformatics.Results: We found that 23 specimens had concordant subtypes in the 3 gene regions (2a and 1b), 7 HCV patients were considered the recombinants, the recombination pattern of the 7 HCV patients in the 5’UTR, E1, and NS5B region as followed: 1b/2a/1b, 2a/2a/1b, 1b/2a/2a, 1b/2a/1b, 1b/2a/1b, 1b/2a/1b, 2a/2a/1b.Conclusions: The findings in the present study showed that a higher recombination rate (23%) than other researches, and the recombination of 2a/1b in the 5’UTR, E1, and NS5B region was only found in the present study up to now.     

影响胰十二指肠切除术死亡的危险因素分析

目的探讨影响胰十二指肠切除术治疗胰头和壶腹周围癌死亡的危险因素。方法对1995年1月至2004年6月期间行胰十二指肠切除术的196例胰头和壶腹周围癌患者的10项临床观察指标进行分析。结果术后并发症发生率为31．1％,病死率为5．6%。术前低蛋白血症(<35g／L)、高血糖(>10mmol／L)、术中出血量>1000ml、围手术期的APACHE Ⅱ评分>12和POSSUM评分>38时手术危险度较大,与手术死亡率呈正相关(P<0．05)。而年龄>65岁、手术时间超过6h、术前血清胆红素>170μmol／L、黄疸持续时间>30d、肿瘤>3cm并不增加手术的病死率(P>0．05)。结论术前低蛋白血症,高血糖,出血量多及高APACHE Ⅱ和POSSUM分值是影响胰头十二指肠切除术死亡的高危因素。     

非超声乳化小切口白内障术中后囊膜破裂的临床分析

目的：探讨非超声乳化小切口白内障术中晶状体后囊膜破裂的临床原因及处理方法。
　　方法：回顾分析108例121眼非超声乳化小切口白内障人工晶状体植入术,对术中6例6眼后囊破裂患者原因及处理方法进行分析和总结。
　　结果：术中发生晶状体后囊破裂6例6眼(4.96%),其中术中植入后房型人工晶状体2例2眼,术后1 wk行Ⅱ期睫状沟人工晶状体植入2例2眼,前房型人工晶状体植入2例2眼。术后1~3mo门诊复诊,矫正视力<0.1者1例1眼,为黄斑病变眼底;0.3者1例1眼为糖尿病视网膜病变眼底;0.4~0.6者2例2眼;>0.6者2例2眼,均无严重并发症。
　　结论：晶状体后囊破裂为非超声乳化小切口白内障联合人工晶状体植入术中最常见并发症之一,可发生于术中任何步骤。术者提高手术操作技巧,并不断积累经验,可有效地减少后囊破裂的发生率;即使术中出现后囊破裂,及时发现并妥善处理,患者术后仍可获得良好的手术效果。     

Exploration of nucleos(t)ide analogs cessation in chronic hepatitis B patients with hepatitis B e antigen loss

BACKGROUNDNucleos(t)ide analogs (NAs) cessation in chronic hepatitis B (CHB) patients remains a matter of debate in clinical practice. Current guidelines recommend that patients with hepatitis B e antigen (HBeAg) seroconversion discontinue NAs after relatively long-term consolidation therapy. However, many patients fail to achieve HBeAg seroconversion after the long-term loss of HBeAg, even if hepatitis B surface antigen (HBsAg) loss occurs. It remains unclear whether NAs can be discontinued in this subset of patients.AIMTo investigate the outcomes and factors associated with HBeAg-positive CHB patients with HBeAg loss (without hepatitis B e antibody) after cessation of NAs.METHODSWe studied patients who discontinued NAs after achieving HBeAg loss. The Cox proportional hazards model was used to identify predictors for virological relapse after cessation of NAs. The cut-off value of the consolidation period was confirmed using receiver operating characteristic curves; we confirmed the cut-off value of HBsAg according to a previous study. The log-rank test was used to compare cumulative relapse rates among groups. We also studied patients with CHB who achieved HBeAg seroconversion and compared their cumulative relapse rates. Propensity score matching analysis (PSM) was used to balance baseline characteristics between the groups.RESULTSWe included 83 patients with HBeAg loss. The mean age of these patients was 32.1 ± 9.5 years, and the majority was male (67.5%). Thirty-eight patients relapsed, and the cumulative relapse rate at months 3, 6, 12, 24, 36, 60, 120, and 180 were 22.9%, 36.1%, 41.0%, 43.5%, 45.0%, 45.0%, 45.0%, and 52.8%, respectively. Twenty-six (68.4%) patients relapsed in the first 3 mo after NAs cessation, and 35 patients (92.1%) relapsed in the first year after NAs cessation. Consolidation period (≥ 24 mo vs < 24 mo) (HR 0.506, P = 0.043) and HBsAg at cessation (≥ 100 IU/mL vs < 100 IU/mL) (HR 14.869, P = 0.008) were significant predictors in multivariate Cox regression. In the PSM cohort, which included 144 patients, there were lower cumulative relapse rates in patients with HBeAg seroconversion (P = 0.036).CONCLUSIONHBeAg-positive CHB patients with HBeAg loss may be able to discontinue NAs therapy after long-term consolidation, especially in patients with HBsAg at cessation < 100 IU/mL. Careful monitoring, especially in the early stages after cessation, may ensure a favorable outcome.     

A candidate DNA vaccine elicits HCV specific humoral and cellular immune responses

AIM: TO investigate the immunogenicity of candidate DNA vaccine against hepatitis C virus (HCV) delivered by two plasmids expressing HCV envelope protein 1 (El) and envelope protein 2 (E2) antigens respectively and to study the effect of CpG adjuvant on this candidate vaccine.METHODS: Recombinant plasmJds expressing HCV EI and E2 antigens respectively were used to simultaneously inoculate mice with or without CpG adjuvant. Antisera were then collected and tJters of antJ-HCV antibodies were analyzed by ELISA. One month after the last injection, animals were sacrificed to prepare single-cell suspension of splenocytes.These cells were subjected to HCV antigen specific proliferaion assays and cytokine secretion assays to evaluate the cellular immune responses of the vaccinated animals.RESULTS: Antibody responses to HCV EI and E2 antigens were detected in vaccinated animals. Animals receiving CpG adjuvant had slightly lower titers of anti-HCV antibodies in the sera, while the splenocytes from these animals showed higher HCV-antigen specific proliferation. Analysis of cytokine secretion from the splenocytes was consistent with the above results. While no antigen-specific IL-4 secretion was detected for all vaccinated animals, HCV antigen-specific INF-γ, secretion was detected for the splenocytes of vaccinated animals. CpG adjuvant enhanced the secretion of INF-γ, but did not change the profile of IL-4 secretion.CONCLUSION: Vaccination of mice with plasmids encoding HCV E1 and E2 antigens induces humoral and cellular immune responses. CpG adjuvant significantly enhances the cellular immune response.