小儿流行性乙型脑炎的临床观察及救治体会

流行性乙型脑炎（简称乙脑）是以脑实质炎症损害为主要病变的中枢神经系统急性传染病，临床经过凶险，病死率高达10％以上，存活者亦常留有不同程度的后遗症，严重地威胁着小儿的生命与健康。现将我院2001～2005年间收治的94例乙脑患儿的临床观察及救治体会报道如下。     

Pseudotype hepatitis C virus enters immature myeloid dendritic cells through the interaction with lectin

Dendritic cells (DC) are the most potent antigen-presenting cells that regulate immune responses. One of the mechanisms for hepatitis C virus (HCV) persistence is the ability of HCV to suppress DC function. Direct HCV infection to blood DC has been implicated for DC dysfunction. To clarify the susceptibility of each DC subset to HCV, we used pseudotype vesicular stomatitis virus (VSV) coated with chimeric HCV envelope glycoproteins (E1 and E2). We demonstrate that pseudotype VSV enters myeloid DC (MDC) but not plasmacytoid DC (PDC). The highest efficiency of pseudotype VSV entry to MDC was observed when MDC were cultured with GM-CSF. Such efficiency decreased when MDC are matured with the treatment of IL-4, CpG oligodeoxynucleotide, or CD40 ligand. Mannan inhibited pseudotype VSV entry to MDC, but Ca(2+) chelators failed to do so. These results show that pseudotype VSV possessing HCV-E1 and E2 enters immature MDC through the interaction with lectins in a Ca(2+)-independent manner.     

A case of hyperlipoproteinemia caused by corticosteroid therapy in a child with subacute necrotizing lymphadenitis

A 10-year-old child was diagnosed as subacute necrotizing lymphadenitis. After a steroid hormone (predonine) administration for 17 days, he showed total cholesterol(TC) 420 mg/dl, triglyceride(TG) 839 mg/dl, and LDL-cholesterol 241 mg/dl. The hyperlipidemia seemed to be a side effect of the steroid at the onset. However, the lipoprotein fraction by the agarose gel and polyacrylamide gel (PAG) electrophoresis showed type III of the WHO classification, that is, presence of broad band as well as appearance of mid band, small dense-LDL and the disrupted type of LDL band. In addition, there were hyperlipidemia (high levels of the TC, TG, LDL-cholesterol) in 4 persons out of 6 family members, and LDL pattern of the PAG electrophoresis, 4 persons showed the nodular type. They have higher possibility of combined-type familial hyperlipiemia from the above results, and it seemed to be the case in which the hyperlipidemia was exacerbated by the steroid administration.     

血清总胆汁酸、胆碱酯酶在婴儿肝病诊治中的意义

目的探讨血清总胆汁酸(TBA)、胆碱酯酶(CHE)在婴儿肝病中的意义。方法婴儿肝病60例分别为母乳性黄疸、巨细胞病毒(CMV)性肝炎及先天性胆道畸形患儿,选择20例正常婴儿作为对照组;检测血清TBA、CHE水平。并对CMV性肝炎患儿急性期和恢复期进行自身对照比较。结果正常对照组、母乳性黄疸、巨细胞病毒性肝炎及先天性胆道畸形各组TBA分别为(6.47±3.25)、(8.71±1.79)、(45.86±40.85)(、119.50±31.73)μmol/L;CHE分别为(11295.50±1731.91)、(10762.89±1237.30)、(9771.32±860.27)(、7967.304±31.58)U/L。其中CMV性肝炎及先天性胆道畸形两组TBA、CHE在与各组两两比较中均有显著性差异(P均<0.01),先天性胆道畸形组改变最明显;CMV性肝炎急性期和恢复期TBA比较有明显差异(P<0.05,P<0.01),淤胆型患儿CHE恢复期明显升高(P<0.05)。结论在婴儿肝病诊治中,检测TBA、CHE有助于及早对病因、病情、预后作出判断和估计。     

远程护理教育的发展现状

远程教育是以学习者为主体,以教师为主导,以先进的教育技术为手段,以终身教育理念为宗旨的现代教育形式.通过对国内外远程护理教育的现状的描述,以发现我国远程护理教育的不足,借鉴他国先进的远程教育管理模式,为我国远程护理教育管理体制和运行机制的完善提供依据.     

Hsp27表达上调与宫颈癌细胞化疗耐药的相关性研究

目的本研究旨在探讨亚坤酸钠作用下宫颈癌细胞Siha及Hela中Hsp27的表达水平变化及与宫颈癌细胞对紫杉醇化疗耐药的相关性。方法将细胞分成实验组与对照组,分别用含有不同浓度(0、0.1、0.5、1、5及10μM)的诱导剂亚坤酸钠处理6 h。采用免疫荧光细胞化学及Western blot方法检测各组细胞中Hsp27在蛋白水平的表达;应用MTT法测定细胞在化疗药物紫杉醇作用下的生存率,并分析Hsp27的表达在两种宫颈癌细胞对紫杉醇耐药中的作用。结果 Siha及Hela实验组细胞中Hsp27的表达水平均明显高于相应的对照组细胞,且与亚坤酸钠具有一定的浓度依赖性。MTT显示两种实验组细胞对紫杉醇的生存率均明显高于相应的对照组细胞,亦呈一定的亚坤酸钠浓度依赖性。结论亚坤酸钠可以诱导宫颈癌细胞Siha及Hela中的Hsp27的表达上调,且其表达水平都与亚坤酸钠具有一定的浓度依赖性。Hsp27高表达的细胞对紫杉醇的生存率明显高于低表达的细胞,表明Hsp27的表达上调与宫颈癌细胞对紫杉醇的耐药有一定的相关性。     

Retrospective analysis of Fusobacterium associated infections; experience at Aomori Prefectural Hospital with 108 cases from 1995 to 1999

We experienced 108 cases of Fusobacterium associated infections, including otolaryngeal, oral, pleuropulmonary, intraabdominal, skin and soft tissue infections, at Aomori Prefectural Hospital during The 5 year-period from 1995 to 1999. A total of 433 organisms, included 113 Fusobacterium spp. (80 Fusobacterium nucleatum, 18 Fusobaterium necrophorum, 5 Fusobacterium varium, 4 Fusobacterium mortiferum, 6 Fusobacterium spp.), were recovered with an average of 4.0 organisms per case of the 108 cases, 68% were mixed aerobic and anaerobic and yielded 185 anaerobic bacteria (2.5 per case) and 137 aerobic bacteria (1.9 per case) with an average of 4.4 per case. The remaining 32% were purely anaerobic and yielded 111 organisms with an average of 3.2 per case, Prevotella spp., Bacteroides fragilis group, Streptococcus milleri group, Enterobacteriaceae, Peptostreptococcus spp. Staphylococcus spp. were most frequently coisolated with Fusobacterium spp.     

The Jab1/COP9 signalosome subcomplex is a downstream mediator of Bcr-Abl kinase activity and facilitates cell-cycle progression

Jab1 is a multifunctional protein associated with the signaling pathway, cell-cycle regulation, and development, and acts as a key subunit of COP9 signalosome (CSN). Jab1 promotes degradation of the cyclin-dependent kinase inhibitor p27(Kip1) by transportation from the nucleus to the cytoplasm. However, there has been no clear evidence for whether and how Jab1 contributes to malignant transformation in human cancers. Here we show that Bcr-Abl tyrosine kinase facilitates the down-regulation of p27 by modulating complex formation of Jab1/CSN through the mitogen-activated protein (MAP) kinase and phosphatidylinositol 3 (PI3) kinase signaling pathways. Nearly half of the chronic myelogenous leukemia cell lines and the murine hematopoietic precursor cells expressing Bcr-Abl exhibited a marked increase in the small loose Jab1 complex located in the cytoplasm. Inhibition of Bcr-Abl kinase by STI571 induced G1 arrest and caused a recovery of the p27 level with reduction of the small Jab1 complex from the cytoplasm. Either blockade of the MAP kinase and PI3 kinase pathways by specific inhibitors or Jab1 knockdown by small interfering RNA (siRNA) prevented p27 down-regulation as well as formation of the small complex. Thus, regulation of p27 via modulation of the Jab1 subcomplex is a novel mechanism whereby Bcr-Abl oncogenic signals accelerate abnormal cell proliferation.     

抗结核分枝杆菌培养滤液蛋白10的新型单克隆抗体的制备及其临床应用

目的 制备抗结核分枝杆菌培养滤液蛋白10(CFP-10)特定抗原肽的单克隆抗体,为建立结核病临床早期诊断的免疫学方法奠定物质基础.方法 设计并合成结核分枝杆菌CFP-10第53 ～ 66位氨基酸(14肽AAVVRFQEAANKQK)作为特定的抗原肽序列,经免疫BALB/C小鼠,取其脾细胞和小鼠骨髓瘤细胞SP2/0融合,经酶联免疫吸附试验(ELISA)检测、多次有限稀释亚克隆建立能稳定分泌抗结核分枝杆菌特异抗原肽单克隆抗体的杂交瘤细胞系,纯化该单克隆抗体,进行免疫球蛋白亚型分析,并鉴定分析该单克隆抗体在蛋白质免疫印迹法(Western blotting)、免疫沉淀法和ELISA检测中的应用效果.共检测结核分枝杆菌培养上清样本38份,非结核分枝杆菌培养上清样本20份,结核性胸水样本32份,非结核性胸水样本24份以及健康对照血清样本20份.结果 单克隆抗体免疫球蛋白亚型分析显示该杂交瘤细胞系产生的抗体类型为IgG1和κ型.该抗结核分枝杆菌CFP-10特异性单克隆抗体可成功用于Western blotting和免疫沉淀法分析.ELISA定量检测显示,该特异性抗体检测结核分枝杆菌的敏感性为78.6％ (55/70),特异性为92.2％ (59/64).结论 CFP-10特定抗原肽单克隆抗体用于结核分枝杆菌检测有较高的敏感性和特异性,可用于结核病的早期诊断.