121例重症恶性疟疾的临床抢救

目的重症恶性疟疾病情重，变化快，并发症多，患者若抢救不及时常可导致死亡，为观察疗效，总结121例重症恶性疟患者的临床抢救情况。方法用国产青蒿琥酯、蒿甲醚和法国产Quinimax配合一系列综合治疗。结果抢救121例重症恶性疟疾患者，共治愈103例（85．1％），死亡18例（14．9％）。结论早期诊断，积极预防并发症是降低死亡率的主要环节。     

提高抗恶性疟独特型单抗克隆出现频率的方法学探讨

用Protein A-Sepharose亲和层析法提纯McAb-IgG,皮下多点和腹腔免疫雄性Wistar大鼠,间隔两周共3次,融合前3天采用腹腔、尾静脉和脾内注射等三种加强免疫方法,以间接ELISA法和抗体竞争ELISA法筛选Anti-Id阳性克隆。结果显示:融合前大鼠血清抗小鼠IgG或抗免疫原McAb-IgG滴度,静脉组和脾内组比腹腔组高一个滴度;Anti-Id阳性克隆出现频率,腹腔组为0.9％和0.3％,静脉组为11.0％和13.3％,脾内组为16.4％和12.9％,静脉组和脾内组明显高于腹腔组(P<0.01);上述三种加强免疫方法对抗小鼠IgG阳性克隆出现频率无明显影响(P>0.05);与腹腔加强免疫组相比,静脉和脾内加强免疫组也可提高细胞融合效果(P<0.01).本实验结果提示,腹腔和皮下多点多次长程基础免疫结合静脉或脾内加强免疫是制备Anti-Id McAb比较好的免疫方案。     

The Receptor Role of Glycophorin A during the Invasion of Erythrocytes by Plasmodium Falciparum

Under the condition of in vitro culture,the effects of glycophorin A(GPA)of human erythrocyte membrane,anti-GPA IgG,α_1-acid glycoprotein,ovomucoid,wheat germ agglutinin,etc.on the invasion of erythrocytes by P.falciparum were observed in this study.The results show that the combination ofGPA with P.falciparum merozoites has high specificity,high affinity and atendency to saturation,and produces specific biological effects.These confirm forthe first time from the characteristics of the ligand-receptor interaction that GPAis a receptor recognized and bound by P.falciparum merozoites.     

氯喹敏感与抗性株恶性疟原虫对青蒿琥酯、克林霉素及其联用的体外敏感性

目的 为了解氯喹敏感和抗性株恶性疟原虫对青蒿琥酯、克林霉素及其二联用的敏感性。方法 运用Rieckmann体外微量法测定原虫对药物的敏感性。结果 氯喹敏感株恶性疟原虫对青蒿琥酯、克林霉素及青／克联用的ID50分别为2.8、3784.7及6.4/2046.6nmol/L；抗性株原虫对上述药物的ID50分别为8.1、1652.1及2.35/1409.4nmol/L。结论 抗氯喹恶性疟原虫对克林霉素无交叉抗性。青蒿琥酯与克林霉素联用在体外测定中，其抗疟作用对抗性株明显优于敏感株。     

A Comparative Study of Dihydroartemisin in Compounds in Treatment of Uncomplicated Falciparum Malaria in Kampong of Cambodia

Objective: To compare the safety and efficacy of two compounds of dihydroartemisinin(DHA) -Artekin and Artekin (T) in the treatment of uncomplicated falciparum malaria. Methods:The regimen of 8-tablet for 2 days of Artekin and Artekin (T) were applied to 100 patients with uncomplicated falciparum malaria, who were randomly divided into two groups. Each group contained 50 cases. The cure rate, the mean parasites clearance time, the mean fever clearance and side-effects were observed to assess the safety and efficacy of the compounds used. Results: The mean parasites clearance time was 31. 7±9.0 hours in the Artekin group and 32. 8±8. 8 hours in Artekin (T) group respectively; the mean fever clearance time was 12. 7±7. 2 hours in Artekin group and 16. 5±7. 9 hours in Artekin (T) group; there were no recrudescence case in both groups within the 28 days of follow-up, the cure rates in Artekin group and Artekin (T) groups were 100%. It indicated that the tolerability of both compounds were very good, the     

青蒿琥酯和巴利捷克治疗塞内加尔恶性疟病儿的比较

目的：比较青蒿琥酯和巴利捷克治疗西非塞内加尔恶性疟的疗效。方法：西非恶性疟病儿１９０例，随机分为青蒿琥酯组７６例（男性４７例，女性２９例，年龄６±ｓ３ａ），用青蒿琥酯每次１５ｍｇ／ｋｇ，ｉｖ或１ｍ，于入院后即刻，ｈ４，ｈ２４，ｈ４８给药，２ｄ为一个疗程；巴利捷克组１１４例（男性６８例，女性４６例；年龄６±３ａ），用巴利捷克剂量２５ｍｇ奎宁基质／（ｋｇ·ｄ），ｉｖ或ｉｍ，ｂｉｄ，３ｄ为一个疗程。结果２组血检疟原虫转阴率，退热时间和住院时间各为９４．７％，７８．９％；１．３±０．５ｄ，２．７±１．１ｄ和３．２±１．１ｄ，４．５±１．５ｄ；差别皆有非常显著意义（Ｐ均＜０．０１）。结论：青蒿琥酯疗效优于巴利捷克。     

恶性疟P190抗原保守区Ⅰ、Ⅴ基因的亚克隆及在大肠杆菌中高效表达

作者采用PCR方法克隆了我国海南省FCC1/HN株P190抗原两个保守区基因,分别定名为P190CRI和P190CRV。基因片段经纯化后连接到pUC18载体中进行DNA序列分析,结果显示:除了P190CRV中有5个碱基变换外,其余序列均与MAD20型序列一致。经序列分析的两个基因片段分别与pGEX-2T载体连接,经双酶切鉴定后转化感受态JM109(DE_3)大肠杆菌进行高效融合表达,并且用Sepharose 4B-谷胱甘肽层析柱进行亲和纯化,结果为:两个插入基因片段均得到高效融合表达,经一步亲和纯化后就取得高纯度的重组蛋白。     

Macrophage activation in falciparum malaria as measured by neopterin and interferon-gamma.

Macrophage activation during acute falciparum malaria in 71 Thai adults was investigated by measuring urinary neopterin and serum interferon-gamma (IFN-gamma). Neopterin, a product of IFN-gamma-activated macrophages, was elevated in 94% of patients upon admission (day 0, prior to treatment) and in all at some time during the period of study. Neopterin levels tended to rise further (days 1-5) before falling back towards the normal range as patients recovered following effective chemotherapy (days 6-8). IFN-gamma was measured in 32 patients and found to be directly related to neopterin concentration. Both neopterin and IFN-gamma values were highest in patients experiencing a first malaria infection. Among those with histories of prior malaria, neopterin and IFN-gamma levels were inversely related to the number of previous infections. Morbidity, as assessed by degree and duration of fever, was directly related to neopterin concentration. This longitudinal study quantitatively describes the extent and duration of macrophage activation in falciparum malaria. The data also suggest that with repeated malaria infection and antigen exposure, there is a progressive decrease or possibly suppression of the T cell-macrophage interaction mediated by IFN-gamma.