油茶皂甙对实验动物造血机能的影响

目的：研究油茶皂甙对豚鼠和罗非鱼造血功能的影响。方法：比较油茶皂甙（1mg/kg）处理前和处理后豚鼠红细胞和血红蛋白量计数变化。罗非鱼分对照组和油茶皂甙处理组，分别在清水和含1ppm油茶皂甙水饲养6天后，再同时置入清水中净养，观察其存活20％的最高温度。结果：豚鼠用药前后红细胞计数和血红蛋白含量改变轻微，无明显统计学差异（P＞0．05），对照组和油茶皂甙处理组罗非鱼在清水中饲养的耐受最高温度为41．5℃，但在含油茶皂甙水中能耐受的最主温度为36℃。结论：油茶皂甙可短暂，轻微地降低红细胞和血红蛋白，但并不影响造血功能。     

Corpectomy for multi-level cervical spondylosis and ossification of the posterior longitudinal ligament

The choice of a surgical approach for multi-level cervical spondylotic myelopathy (CSM) and ossification of the posterior longitudinal ligament (OPLL) is still a controversial issue. While most of the surgeons are still performing decompression by laminectomy some are doing multi-level anterior decompression. Few neurosurgeons are performing decompression by corpectomy. We have treated 26 patients by median cervical corpectomy during the last 4 years. These patients were followed up for a mean period of 25 months. Twenty one (80%) patients had a good outcome, 2 patients remained unchanged and 3 expired. Review of the literature and our experience indicates that patients with CSM and OPLL should be operated by median cervical corpectomy (anterior approach).     

乳腺浸润性小叶癌超声特征与腋窝淋巴结转移的相关性研究

[目的]本研究旨在探讨乳腺浸润性小叶癌(Invasive lobular carcinoma,ILC)患者腋窝淋巴结转移(axillary lymph node metastasis, ALNM)的超声特征及其他参数影响因素。[方法]收集病理已证实为ILC且术前行超声检查的病例91例,根据有无腋窝淋巴结转移分为ALNM组和无ALNM组,采用回顾性研究,收集患者的超声图像特征、术前CA153以及免疫指标等。[结果] 91例ILC患者中,45例发生ALNM,46例未发生ALNM。单因素x_²分析显示,病灶>23.5mm、纵横比≧1、周边高回声晕等超声特征,以及术前CA153>6.5U/ml与ALNM有关(P<0.05)。多因素logistic回归分析显示,周边高回声晕和术前CA153>6.5U/ml是影响ILC患者ALNM的独立危险因素(P<0.05)。[结论]周边高回声晕和术前CA153>6.5U/ml是影响ILC患者发生ALNM的独立危险因素,可作为临床实践参考指标。     

CIK细胞临床应用技术规范探讨

 细胞因子诱导的杀伤细胞（cytokin induced killer cells，CIK细胞）因具有体外增殖倍数高、抗瘤谱广、杀瘤活性强、副作用极小等特点而受到关注。研究表明，CIK细胞对肿瘤细胞的杀伤作用是LAK细胞的100倍[1]。CIK细胞过继性免疫治疗是肿瘤治疗中的一项新技术，目前已逐步在临床上应用，因此，制订科学、严格的技术规范对该技术的正确使用及推广意义重大。但迄今国内还没有关于CIK细胞培养和临床应用的统一技术规范。无锡旺庄医院生物治疗中心参考国家食品药品监督管理局1999年制订的《新生物制品审批办法》和美国FDA 1998年制订的《人体细胞治疗和基因治疗指导原则》，结合数年的CIK细胞临床应用经验，制订出我们的CIK细胞临床应用技术规范，现介绍如下，供同行切磋和讨论，以期促成全国性统一技术规范的早日制定。     

Enhanced molecular volume of conservatively pegylated Hb: (SP-PEG5K)6-HbA is non-hypertensive

Recent studies have suggested that the "pressor effect" of acellular Hb is a consequence of perturbation of the macro-and microcirculatory system in multiple ways, and that PEGylation is an effective approach for controlling the same. In an attempt to confirm this concept, a new and simple thiolation mediated, maleimide chemistry-based conservative PEGylation protocol has been developed to conjugate multiple copies of PEG-chains to Hb. This approach combines the high reactivity of maleimides towards thiols with the propensity of iminothiolane to derivatize the epsilon-amino groups of proteins into reactive thiol groups, with conservation of their positive charge. One of the PEGylated products, namely (SP-PEG5K)6-HbA, that carries on an average six copies of PEG5000 chains per Hb, is non-hypertensive in hamster top load and in rat 50% exchange transfusion models. This hexa-PEGylated-Hb has (i) a hydrodynamic volume corresponding to that of an oligomerized Hb of 256kDa, (ii) a molecular radius of approximately 6.8 nm, (iii) high oxygen affinity, (iv) lowered Bohr effect, and (v) increased viscosity and colloidal osmotic pressure. These properties of (SP-PEG5K)6-HbA are consistent with the emerging new paradigms for the design of Hb based oxygen carriers and confirm the concept that the "pressor effect" of Hb is a multifactorial event. The thiolation mediated maleimide chemistry-based PEGylation protocol described here for the generation of (SP-PEG5K)6-Hb is simple, highly efficient, and is carried out under oxy conditions. The results demonstrate that a non-hypertensive PEG-Hb can be generated by conjugation of a lower number of PEG chains than previously reported.     

Altered chromatin landscape in circulating T follicular helper and regulatory cells following grass pollen subcutaneous and sublingual immunotherapy

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采用永磁悬浮的永久性左心室辅助装置

研制出一台采用永磁轴承的左心室辅助装置（LVAD）。该装置包括一个定子和一个转子，采用径向驱动方式；转子包括驱动磁钢和叶轮，电机定子线圈和泵壳组成定子。装置设计采用了一种特殊结构的永磁轴承。转子的位置测量表明，转子稳定悬浮的前提条件是必须有较高的转速（大于3250r／min）且流量大于1L/min。用猪血为介质所做的液动力测试表明，当转速达到3500r／min～4000r／min时，血泵输出流量达到4L/min～6L/min，输出压力达到100mmHg。该装置重200g，最大处直径为40mm。     

Human MSH2 binds to trinucleotide repeat DNA structures associated with neurodegenerative diseases

The expansion of trinucleotide repeat sequences is associated with several neurodegenerative diseases. The mechanism of this expansion is unknown but may involve slipped-strand structures where adjacent rather than perfect complementary sequences of a trinucleotide repeat become paired. Here, we have studied the interaction of the human mismatch repair protein MSH2 with slipped-strand structures formed from a triplet repeat sequence in order to address the possible role of MSH2 in trinucleotide expansion. Genomic clones of the myotonic dystrophy locus containing disease-relevant lengths of (CTG)n x (CAG)n triplet repeats were examined. We have constructed two types of slipped-strand structures by annealing complementary strands of DNA containing: (i) equal numbers of trinucleotide repeats (homoduplex slipped structures or S-DNA) or (ii) different numbers of repeats (heteroduplex slipped intermediates or SI-DNA). SI-DNAs having an excess of either CTG or CAG repeats were structurally distinct and could be separated electrophoretically and studied individually. Using a band-shift assay, the MSH2 was shown to bind to both S-DNA and SI-DNA in a structure- specific manner. The affinity of MSH2 increased with the length of the repeat sequence. Furthermore, MSH2 bound preferentially to looped-out CAG repeat sequences, implicating a strand asymmetry in MSH2 recognition. Our results are consistent with the idea that MSH2 may participate in trinucleotide repeat expansion via its role in repair and/or recombination.      

Development of a composite indicator to prioritize districts for implementation of human immunodeficiency virus programmes in Maharashtra,India

A key recommendation of the National AIDS Control Programme‐IV of India was to develop new strategies for geo‐prioritization of the human immunodeficiency virus (HIV) epidemic. We conducted this study to categorize the districts in Maharashtra (India) based on a multidimensional framework for geo‐prioritization of services. Programmatic data on trends of HIV prevalence, coverage of marginalized populations and vulnerability factors were included. A composite indicator based on these was developed, and the cumulative score was calculated for each district. HIV prevalence among general population has declined steadily from 0.60% in 2007 to 0.33% in 2017. The programme coverage was stable but inadequate for men who have sex with men (MSM). The coverage for female sex workers (FSWs) was inadequate and reduced over time. Nine districts were categorized as high priority, 13 as moderate priority and 11 were classified as low‐priority districts based on burden and vulnerability for HIV. The high‐priority districts were Pune, Solapur and Yavatmal for FSW interventions and Pune, Thane and Latur for MSM interventions. This multidimensional indicator is based on existing programmatic data, dynamic and can be made state‐specific. It is useful to categorize and prioritize districts for allocation of resources and geo‐prioritization of services in resource limited settings.