Assessment of 188Re marked anti MHC class II antibody by Peripheral Blood Mononuclear Cells Stimulated by Donor Alloantigen

Background  Previous studies showed that anti MHC-II monoclone antibody (MAb) only had partial inhibiting effect of alloreactive mixed lymphocyte reaction (MLR) in vitro and it was unsteady and non-persistent. The aim of this research was to determine whether radioactive isotope ¹⁸⁸Re marked MHC-II antibody could benefit the allograft acceptance in transplantation as compared to normal MHC-II antibody.

Methods  ¹⁸⁸Re was incorporated to 2E9/13F(ab’)₂ which is against swine MHC class II antigen (MAb-¹⁸⁸Re). Porcine peripheral blood mononuclear (PBMC) cells were examined for proliferation and cytokine mRNA expression after stimulation with MHC-II MAb or MAb-¹⁸⁸Re.

Results  The proliferative response of recipient PBMCs in mixed lymphocyte reaction (MLR) to donor alloantigen showed that the stimulation index of MAb-¹⁸⁸Re group was significantly lower than the MHC-II MAb group and control (P <0.05). mRNA expression of interleukin 2, interferon γ and tumor necrosis factor α (type 1 cytokines) was lower in MAb-¹⁸⁸Re group than the MHC-II MAb group, while interleukin 10 (type 2 cytokines) was higher in MAb-¹⁸⁸Re group in the first 24 hours.

Conclusion  MAb-¹⁸⁸Re could help the graft acceptance by inhibiting T cell proliferation, lowering the expression of type 1 cytokines and elevating the type 2 cytokines produced by PBMC.

     

剖宫产疤痕妊娠70例临床分析

目的:探讨子宫动脉栓塞后清宫术在剖宫产子宫疤痕妊娠(CSP)治疗中的价值。方法:回顾性分析首诊治疗的CSP患者的临床资料,对70例行子宫动脉栓塞联合超声引导下清宫术的患者进行分析。结果:70例CSP患者中65.7%(46/70)有阴道出血,其中10%(7/70)伴下腹痛,15.7%(11/70)有下腹痛,18.6%(13/70)无临床症状。70例均行子宫动脉栓塞术(Uterine arteryembolization,UAE)后超声监视下清宫,94.3%(66/77)清宫术中出血<200 ml,69例患者成功地保留了生育功能,1例因清宫术中持续性大出血予急诊行子宫全切术。所有患者均痊愈出院,随访65例患者血HCG均在术后9～40 d恢复正常,25～90 d后均恢复正常月经。结论:利用UAE治疗CSP具有降低大出血风险,但对大孕周患者应做好输血及子宫切除准备。     

腹腔镜手术肿瘤切口转移的机制与预防

腹腔镜手术后肿瘤切口转移被报道以来,人们对肿瘤细胞切口转移的病因和机制进行了大量探索,本文将对目前影响腹腔镜肿瘤切口转移的可能因素及预防治疗措施作一总结,使读者了解在腹腔镜肿瘤切除术中发生肿瘤切口转移的潜在危险,并在日常工作中选择合适的预防措施。     

替比夫定阻断乙肝病毒母婴传播的疗效和安全性研究

 目的 观察HBsAg和HBeAg双阳性孕妇妊娠晚期应用替比夫定阻断乙型肝炎病毒（HBV）母婴传播的疗效和安全性。方法 选择HBsAg和HBeAg双阳性且乙型肝炎病毒 DNA≥1×10⁶拷贝·mL^-1的孕妇80例,分为治疗组和对照组各40例。治疗组自孕28周开始口服替比夫定600 mg,1次·d^-1,至分娩时停药,对照组不服用替比夫定及其他抗病毒药。观察治疗组服药后出现的不良反应,并检测两组孕妇在孕28周、分娩时和产后6个月时血清乙型肝炎病毒 DNA水平;两组孕妇所产婴儿在出生时和1个月时肌注乙肝免疫球蛋白各200 IU,同时在出生时、1个月和6个月时肌注乙肝疫苗各10 μg,检测两组婴儿在出生时、6个月和12个月时血清HBsAg及乙型肝炎病毒 DNA的阳性率。结果 ①孕28周时治疗组与对照组孕妇血清乙型肝炎病毒 DNA水平比较,差异无统计学意义;分娩时治疗组孕妇血清乙型肝炎病毒 DNA（3.48±0.90）×10²拷贝·mL^-1较对照组血清乙型肝炎病毒 DNA（6.96±0.94）×10⁶拷贝·mL^-1明显降低,差异有统计学意义（P＜0.05）;产后6个月治疗组与对照组孕妇血清乙型肝炎病毒 DNA水平比较,差异无统计学意义。②治疗组与对照组孕妇所产婴儿12个月时乙型肝炎病毒母婴传播阻断率分别为97.5％和75％,差异有统计学意义（P＜0.05）。③治疗组服药期间未见明显不良反应;两组婴儿出生时Apgar评分及发育指标差异均无统计学意义。结论 HBsAg和HBeAg双阳性孕妇在妊娠晚期服用替比夫定可有效阻断乙肝病毒母婴传播,安全性好。