STAg和霍乱毒素滴鼻免疫小鼠诱导的鼻相关淋巴组织细胞免疫应答

目的研究可溶性速殖子抗原(solubletachyzoiteantigen,STAg)和霍乱毒素(choleratoxin,CT)佐剂滴鼻免疫BALB/c小鼠后鼻相关淋巴组织(nasal-associatedlymphoidtissue,NALT)的免疫效应及持续时间。方法BALB/c小鼠96只随机分为实验组和对照组,实验组以免疫原性好的STAg(20μg/只)为抗原,CT(1μg/只)为佐剂滴鼻免疫,对照组以PBS滴鼻。滴鼻2次(间隔2周)后分别于第1、2、3、4、6、8、10、12周处死6只小鼠。分离NALT的淋巴细胞,计数并涂片,用免疫细胞化学法(immunocytochemistry,ICC)检测其CD4 、CD8 T细胞亚群水平。结果小鼠免疫后,NALT淋巴细胞第1、2、6、8、12(P<0.05)周显著增生,可持续至免疫后第12周;CD4 T细胞第1周至第6周(P<0.05)持续显著增高,CD8 T细胞在第1周至第4周持续增高(P<0.01),CD4 /CD8 比值第2、3周显著降低(P<0.05)。结论STAg和CT佐剂滴鼻免疫BALB/c小鼠能够有效诱导NALT的免疫效应,并可持续较长时间。     

弓形虫复合黏膜疫苗滴鼻免疫小鼠诱导的肠IEL持续性免疫应答

目的采用可溶性速殖子抗原(solubletachyzoiteantigen,STAg)和霍乱毒素(choleratoxin,CT)佐剂制备弓形虫复合黏膜疫苗,观察经滴鼻免疫BALB/c小鼠后诱导的肠上皮内淋巴细胞(intraepitheliallymphocytes,IEL)免疫应答及持续时间,探讨其抗弓形虫感染的作用机制。方法BALB/c小鼠96只随机分为实验组和对照组,实验组以免疫原性好的STAg(20μg/只)为抗原和CT(1μg/只)为佐剂滴鼻免疫,对照组以PBS滴鼻。滴鼻2次(间隔2周)后分别于第1、2、3、4、6、8、10、12周处死小鼠。制备肠IEL细胞悬液,计数并涂片;免疫细胞化学法(immunocytochemistry,ICC)检测CD4 T、CD8 T细胞亚群水平。结果免疫后肠IEL显著增生,第2周达高峰,第1周至第4周(P<0.01)高于对照组。其中以CD8 T细胞增生为主,CD8 T细胞水平第2周达高峰,第1周至第6周增高显著(P<0.01),CD4 T细胞也略有增生,第2、3周(P<0.05)有显著性,CD4 /CD8 比值倒置,第1、2周明显低于对照组(P<0.05)。结论弓形虫复合黏膜疫苗滴鼻免疫BALB/c小鼠可有效诱导肠IEL免疫应答,且可持续较长时间,在预防弓形虫感染中起重要作用。     

弓形虫复合黏膜疫苗滴鼻免疫小鼠诱导的脾淋巴细胞持续性免疫应答

目的观察弓形虫复合黏膜疫苗滴鼻免疫BALB/c小鼠后诱导的脾淋巴细胞的免疫应答及持续时间。方法96只BALB/c小鼠随机分为免疫组和对照组,免疫组以弓形虫复合黏膜疫苗20μl/只(20μg可溶性速殖子抗原 1μg霍乱毒素)滴鼻免疫2次(间隔2周),对照组以PBS滴鼻。分别于末次滴鼻后第1,2,3,4,6,8,10,12周处死小鼠,脾淋巴细胞计数,免疫细胞化学法检测CD4 、CD8 T细胞亚群水平。结果免疫组小鼠于第1,2周脾淋巴细胞明显高于对照组(P<0.01),其中以CD4 T细胞增生为主,第1,2,3,4,6周增生显著(P<0.01),CD8 T细胞水平在第2,3周也有增生(P<0.05),CD4 /CD8 比值第6周高于对照组(P<0.01)。结论弓形虫复合黏膜疫苗滴鼻免疫BALB/c小鼠可有效诱导脾淋巴细胞增殖性免疫应答,且可持续较长时间。     

STAg和霍乱毒素不同程序滴鼻免疫小鼠诱导抗弓形虫作用

目的观察弓形虫可溶性速殖子抗原(soluble tachyzoite antigen,STAg)和霍乱毒素(cholera toxin,CT)佐剂不同程序滴鼻免疫小鼠诱导的抗弓形虫感染能力,确定STAg和CT滴鼻免疫的最佳程序。方法BALB/c小鼠随机分为3组:1次、2次和3次免疫组,用20 μg STAg 1 μg CT/只分别滴鼻免疫1次,2次或3次,前2次间隔2周,末次间隔1周。末次免疫后第14天,用4×104个速殖子/只灌胃攻击所有小鼠,观察小鼠健康及死亡情况,攻击后第30天处死,ELISA法检测血清IgG和粪便IgA,计数肝、脑组织内弓形虫速殖子,分离并计数派伊尔结(Peyer′spatches,PP)和脾淋巴细胞数。结果2次和3次免疫组小鼠存活率明显高于1次免疫组(P<0.05),肝、脑组织内虫荷显著低于1次免疫组(P<0.001),血清IgG和粪便IgA高于1次免疫组,PP和脾淋巴细胞数无显著性变化。结论STAg和CT佐剂滴鼻免疫2次或3次能有效诱导小鼠抗弓形虫感染。     

弓形虫复合黏膜疫苗滴鼻免疫小鼠诱导NALT和GALT黏膜部位的免疫应答

目的观察弓形虫复合黏膜疫苗滴鼻免疫小鼠诱导的鼻相关淋巴组织（NALT）和肠相关淋巴组第（GALT）黏膜部位的免疫应答。探讨弓形虫黏膜疫苗能否在感染起始阶段有效诱导免疫应答。方法将BALB／小鼠随机分为免疫和对照组，免疫组小鼠以弓形虫复合黏膜疫苗20μl／只（20μg STAg＋1μg CT）滴鼻免疫2移（间隔2周），对照组PBS滴鼻。于末次滴鼻后14d颈椎脱臼处死小鼠，ELISA测定粪便和鼻咽冲洗液IgA抗型水平；计数NALT、NC及PP、IEL淋巴细胞数，免疫细胞化学法检测CD4^＋、CD8^＋T细胞亚群水平。结果免疫匀小鼠粪便IgA和鼻咽冲洗液IgA抗体显著高于对照组（P〈0．05）。NALT内淋巴细胞明显增生（P〈0．05），其中CD4^＋、CD8^＋T细胞均有增生（P〈0．01），CD4^＋／CD8^＋比值降低（P〈0．05）。NC中淋巴细胞数明显升高（P〈0．01），以CD4^＋T细胞水平为主（P〈0．01）。GALT部位PP淋巴细胞增生显著（P〈0．01），主要以CD4^＋T细胞为主；而IEL以CD8^＋T细胞增生为主（P〈0．01），CD4^＋／CD8^＋比值降低（P〈0．05）。结论弓形虫复合黏膜疫苗滴鼻免疫BALB／c小鼠可有效诱导NALT和GALT黏膜部位免疫应答。     

不同佐剂的弓形虫复合黏膜疫苗鼻内免疫小鼠诱导的黏膜免疫应答

目的比较IFN-γ、蜂胶佐剂以及两种佐剂混合鼻内免疫辅助可溶性速殖子抗原(STAg)增强机体黏膜免疫应答的水平,探讨两种佐剂联合应用的免疫效果。方法将5～6周龄雌性BALB/c小鼠60只随机分为4组(各15只):20μgSTAg,20μgSTAg 40μg蜂胶,20μgSTAg 1000UIFN-γ或20μgSTAg 40μg蜂胶 1000UIFN-,γ均溶于总体积为20lμ的PBS中,滴鼻免疫(10lμ/鼻孔),免疫2次,间隔14d。末次免疫后第10天用RH株弓形虫速殖子4×104个/只灌胃攻击。攻击后第43天处死全部存活小鼠,比较各组小鼠肠黏膜小肠上皮内淋巴细胞(IEL)、PP结T淋巴细胞数;检测小鼠粪便、鼻咽冲洗液、肺冲洗液、阴道冲洗液中弓形虫特异性sIgA含量。结果各佐剂组小鼠IEL、PP结T淋巴细胞数显著高于STAg组,黏膜sIgA含量显著高于STAg组;蜂胶 IFN-γ联合组小鼠黏膜免疫应答水平高于单独佐剂组,其中显著高于蜂胶组(P<0.05)。结论IFN-γ作为弓形虫黏膜疫苗佐剂的效应优于蜂胶,IFN-γ 蜂胶作为复合黏膜佐剂鼻内免疫效果优于两者单独应用。     

霍乱毒素佐剂联合弓形虫ESA鼻内免疫小鼠抗弓形虫感染作用

目的 观察霍乱毒素(cholera toxin,CT)佐剂和弓形虫排泄-分泌抗原(ESA)鼻内免疫小鼠诱导的抗弓形虫感染作用。方法 6周龄BALB/c小鼠60只,随机分为3组,每组20只。分别用PBS 20μl、ESA 20μg或CT 1.0μg+ESA 20μg每只滴鼻免疫2次,间隔2周。末次免疫后14 d,用4×104个弓形虫速殖子每只灌胃攻击所有小鼠,观察小鼠健康及死亡情况。速殖子攻击后30 d,计数肝、脑组织内弓形虫速殖子。结果 CT作为佐剂联合弓形虫ESA滴鼻免疫小鼠的健康状况明显好于PBS组和ESA组,存活率(95%)也显著高于PBS组(55%)。与PBS组相比,CT+ESA组肝和脑组织内速殖子数分别减少了80.19%(P0.001)和78.24%(P0.005)。CT作为佐剂联合ESA滴鼻免疫小鼠诱导了高水平的黏膜免疫应答和系统免疫应答。结论 CT作为佐剂联合弓形虫ESA滴鼻免疫小鼠诱导的免疫应答可有效抵抗弓形虫速殖子攻击。     

不同剂量CpG ODN联合STAg鼻内免疫BALB／c小鼠诱导的免疫应答

目的 观察弓形虫可溶性速殖子抗原（STAg）与不同剂量的CpG ODN联合滴鼻免疫小鼠的免疫效果，探索CpG ODN佐剂最佳剂量。方法 5-6周龄BALB／c小鼠50只随机分为5组，每组10只，实验组以20μg STAg联合不同剂量CpG ODN佐剂滴鼻免疫小鼠，佐剂剂量分别为0、1、5、10μg，对照组以PBS滴鼻，间隔2wk免疫2次。末次免疫后30d断颈处死全部小鼠，分离脾、Peyer＇s patch（PP结）、肠系膜淋巴结（MLN）和IEL淋巴细胞，观察淋巴细胞增殖情况。用ELISA的方法检测血清IgG和粪便IgA含量。结果 与PBS组和0剂量佐剂组相比，10μg CpG ODN联合STAg免疫后，小鼠肠粘膜淋巴组织和脾淋巴细胞增殖明显（P〈0．05）。10μg组血清IgG远高于对照组（P〈0．05），粪便IgA高于对照组（P〉0．05）。结论 CpG ODN可作为STAg的粘膜佐剂，10μg CpG ODN与STAg联合具有最佳的免疫效果。     

CD137L在HBsAg DNA疫苗诱导小鼠细胞免疫应答中的佐剂效应

目的:研究共刺激分子CD137L重组质粒对HBsAg DNA疫苗诱导小鼠细胞免疫应答和回忆反应的佐剂作用.方法:将小鼠CD137L真核表达载体(pcD137L)体外转染NIH3T3细胞,RT-PCR、流式细胞仪和免疫荧光法分别检测CD137L mRNA和蛋白的表达;pcD137L与HBsAg DNA疫苗(pcDS)通过肌肉注射联合免疫BALB/c小鼠,LDH释放法测定体外脾细胞特异性CTL杀伤活性;流式细胞仪分析小鼠脾脏CD8+记忆T细胞数量;流式细胞仪检测CD8+T细胞及淋巴细胞中IFN-γ和IL-4的表达水平.结果:重组质粒pcD137L在NIH3T3细胞中获得有效表达.与pcDS单独免疫组比较:免疫后1周,pcDS+pcD137L免疫组能诱导更强的HBsAg特异性CTL杀伤活性(P<0.05);免疫后1周和12周,pcDS+pcD137L免疫组CD8+T细胞CD44high和CD127表达水平均显著增高(P<0.05或P<0.01);免疫后1周、12周和13周(即再次给予pcDS刺激后1周),pcDS+pcD137L免疫组分别明显上调CD8+T细胞和淋巴细胞中IFN-γ产生细胞的百分比,差异有显著意义(均P<0.05).结论:共刺激分子CD137L能显著增强HBsAg DNA疫苗诱导的Tc1(I型)细胞免疫、特异性CTL应答及回忆反应,是诱导HBV特异性T细胞应答的有效佐剂.     

不同佐剂的复合黏膜疫苗鼻内免疫小鼠抗弓形虫感染的保护作用

目的比较IFN-γ和蜂胶作为佐剂鼻内免疫小鼠抗弓形虫攻击的能力,探索两种佐剂联合应用的效果。方法将5～6周龄雌性BALB/c小鼠60只随机分为4个组,每组15只,分别用20μg可溶性速殖子抗原(STAg)、20μgSTAg+40μg蜂胶、20μgSTAg+1000UIFN-γ或20μgSTAg+40μg蜂胶+1000UIFN-γ鼻内免疫小鼠2次,间隔14d。末次免疫后第10天,用RH株弓形虫速殖子4×104个/只灌胃攻击,逐日观察小鼠存活情况。攻击后第43天处死全部存活小鼠,计算胸腺、脾指数,计数脑、肝组织速殖子。结果STAg+IFN-γ组、STAg+蜂胶+IFN-γ组胸腺、脾指数显著高于STAg组(P<0.05);组织内速殖子虫荷显著降低(P<0.01),STAg+IFN-γ组小鼠脑、肝组织减虫率分别为57.00%和79.06%;STAg+蜂胶+IFN-γ组小鼠脑、肝减虫率分别为68.30%和79.06%。STAg+蜂胶组小鼠胸腺、脾指数有升高趋势,组织内速殖子虫荷降低,但与STAg组比较差异无统计学意义。结论在抗弓形虫感染中,IFN-γ、蜂胶+IFN-γ的佐剂效果优于蜂胶,IFN-γ、蜂胶+IFN-γ辅助...     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.