外周血白细胞与AIS的相关性研究

<正>脑梗死是指因脑部血液循环障碍导致局部脑组织缺血、低氧,出现相应部位的神经功能障碍。急性脑梗死(acute ischemic stroke,AIS)患者存在外周免疫异常,常伴有白细胞水平升高和炎症因子高表达,增加脑梗死后的脑损伤,有多种细胞类型影响AIS患者预后^[1]。AIS后感染是导致患者预后不良的危险因素,据报道,23%～65%的患者发生AIS后感染,     

空肠弯曲菌Lulei株WaaF基因克隆与序列分析

目的克隆空肠弯曲菌Lulei株WaaF基因,并分析其遗传进化关系。方法聚合酶链反应扩增空肠弯曲菌Lulei株WaaF基因,构建pGEM-T-WaaF质粒,选择正确克隆质粒测序。自美国国家生物技术信息中心Nucleotide数据库下载5株吉兰-巴雷综合征相关菌株WaaF序列,1株非吉兰-巴雷综合征相关菌株WaaF序列,利用DNAstar v7.1软件建立进化树,分析不同菌株间WaaF基因遗传关系。结果完成了空肠弯曲菌Lulei株WaaF基因的克隆,发现WaaF基因在吉兰-巴雷综合征相关菌株间存在聚类现象。结论空肠弯曲菌Lulei株WaaF基因是807bp的片段,与Lichang株遗传进化关系最近。     

H2H健康教育模式在脑梗死患者二级预防中的作用

目的通过跟踪随访观察研究H2H健康教育模式对脑梗死康复期患者二级预防的作用。方法根据ACC(American College of Cardiology)提出的H2H(Hospital to Home)健康教育模式,对62例脑梗死患者在规范用药及改变不良生活方式等方面进行健康教育跟踪随访一年。配比分为健康教育组和对照组,每组各31例。结果 H2H健康教育模式提高了医院、家庭及社会对脑梗死患者健康教育的重视程度,改善了脑梗死患者的心理状态及身体健康,(1)规范了脑梗死患者二级预防用药,健康教育组患者规范用药率(67.7%)较对照组(29%)明显提高(P=0.002);(2)改善了不良的生活方式,健康教育组患者生活评分(18.26±3.48)高于对照组患者(16.10±3.53)(P=0.018)。(3)减少了患者可能的危险因素,降低了脑梗死发生率,健康教育组患者脑梗死复发率(0)较对照组(22.6%)明显减少(P=0.011)。结论 H2H健康教育模式对脑梗死患者二级预防起着重要的积极作用。     

空肠弯曲菌Penner O:19 galE基因真核表达质粒的构建

目的构建空肠弯曲菌Penner O:19 galE基因真核表达质粒。方法 PCR扩增空肠弯曲菌Penner O:19 galE基因,构建pGEM-T-galE克隆质粒及构建pEGFP-N1-galE真核表达质粒,并检测真核表达质粒在293T细胞中的表达。结果构建了真核表达质粒pEGFP-N1-galE,检测到其在293T细胞表达。结论 pEGFP-N1可作为Penner O:19 galE基因的真核表达载体。     

434名医学新生心理健康与生活事件的关系

目的 以石家庄市某医科大学为例,探讨医学新生的心理健康情况,以及生活事件对医学新生心理健康情况的影响。方法 从石市某医科大学临床医学专业新生中随机抽取472人,使用自编一般情况调查表、90项症状校核量表、青少年生活事件量表对被试进行调查。结果 (1)抽样调查显示,医学新生中54.8%存在心理问题,9.4%存在中度以上心理问题,SCL-90各项因子分除焦虑、恐怖两因子外,均显著低于全国青年常模;各因子得分均显著低于3个大学生常模。(2)负性生活事件对医学新生产生中度影响率为66.8%,医学新生最常遇到的负性生活事件因子类型为学习压力因子,各负性事件因子刺激量和SCL-90各分量表因子分间存在相关关系,pearson系数为0.206~0.539。(3)通过多元线性回归分析预测SCL-90总均分,进入回归方程的因子有:人际关系因子,特殊因子,学习压力因子,健康适应因子,回归方程的调整R2为0.349。结论 医学新生的心理健康情况良好,负性生活事件可较好的预测本人群心理健康水平。     

2011年神经病学临床方面的主要进展

2011年国内外神经病学领域有诸多新的进展,但对临床有直接指导作用的论点有如下几个方面:美国心脏学会/美国卒中学会(American Heart Association/American Stroke Association,AHA/ASA)发布了血管因素可导致认知障碍和痴呆的一项声明,并发布了首个关于脑静脉血栓形成诊断和管理指南.其他学会分别推出糖尿病周围神经痛治疗指南、2011年美国阿尔茨海默病最新诊断标准等重要临床工作相关的指导性文章.这些指南、数据的公布及相关的建议和推荐都会对临床工作有较大的影响.     

吉兰-巴雷综合征相关空肠弯曲菌cstⅡ基因序列对比研究

目的 研究华北地区3株吉兰-巴雷综合征(Guillain-Barré syndrome,GBS)相关空肠弯曲菌(Campylobacter jejuni,C.jejuni)的cstⅡ基因序列并寻找GBS相关及GBS无关的两类空肠弯曲菌菌株间可能与GBS致病性相关的基因突变位点和蛋白高级结构变化,分析菌株间遗传进化关系.方法 选取分离自GBS患者粪便并经动物模型证实为致GBS的3株空肠弯曲菌菌株进行培养并提取基因组DNA测序,与GenBank中GBS无关空肠弯曲菌基因序列进行配对对比,寻找两类菌株间可能导致空肠弯曲菌致病能力差异的cstⅡ基因碱基突变位点及蛋白高级结构改变,观察这种变化是否为GBS相关菌株的共性,并构建遗传进化树.结果 与GBS无关菌株相比,3株致GBS菌株cstⅡ基因的氨基酸序列二级结构的第7个α螺旋的165～180区段均被打开形成了折叠或转角,该变化在其他GBS相关菌株的二级结构变化中同样得到体现.实验中75%的GBS相关菌株cstⅡ基因为双功能,25%GBS相关菌株及所有GBS无关菌株cstⅡ基因为单功能.LL株与实验中涉及的GBS相关菌株在进化上高度类聚.结论 双功能cstⅡ可能与空肠弯曲菌的致GBS特性相关.LL株cstⅡ基因在一定程度上反映了亚洲地区的GBS相关菌株cstⅡ基因的序列特征,为进一步探索GBS发病的地域性特点并对GBS菌株进行监测提供了资料.

Abstract：

Objective To investigate the pathogenic mechanism of Campylobacter jejuni(C.jejuni) associated with Guillain-Barré syndrome(GBS) and provide strategy for gene modification, the cstⅡ gene from 8 GBS-associated C.jejuni strains were compared with that from 3 GBS-unrelated C.jejuni strains, getting the base and amino acid mutations, the changes of secondary structures and finding the region which may be responsible for the pathogenicity of C.jejuni inducing GBS. Methods Three GBS-associated C.jejuni strains isolated from stools of GBS patients in north China were selected and cultured, which has been confirmed as GBS-associated by animal model. After sequencing the genome of them, the nucleotide sequences of cstⅡ gene were got through sequence alignment. The nucleotide sequences and deduced amini acid sequences of 3 GBS-associated cstⅡ genes were compared with that from 3 GBS-unrelated C.jejuni strains through bioinformatics software, getting the base and amino acid mutations, the changes of secondary structures. Other 5 GBS-associated cstⅡ genes were also aligned to know whether the differences we got above makes sense. In this way the genetic differences between two kinds of C.jejuni strains may be found and speculating the gene region related to the pathogenicity of GBS became possible. Results The cstⅡgene of 3 GBS-associated C.jejuni strains were all composed of 876 base pairs. Compared with GBS-unrelated C.jejuni strains, there were 9 consistent mutation sites in cstⅡ gene of LL and QYT stains, leading to 3 consistent amino acid mutation. The amino acid mutation of 114 and 182 sites in LL and QYT stains existed in other 5 GBS-associated C.jejuni strains. The sole amino acid mutation of ZHX strain -169 site, located near the 182 site. The seventh α-helix(165-180 region)of the secondary structure of the amino acid sequence from GBS-associated strains were shorter than that from GBS-unrelated strains, and the shorter regions were opened to form β-sheet or coli, which also existed in other GBS-related strains in this study.75% of the GBS-associated cstⅡ genes were Asn-51, while 25% of the GBS-associated and all of the GBS-unrelated cstⅡ genes were Thr-51.LL strain showed highly identity to other GBS-unrelated strains in this study. Conclusion The 165-180 segment of secondary structures in cstⅡ gene from local 3 GBS-associated C.jejuni strains are probably the responsible region involved in inducing GBS. The senior structure changes in this region may affect the activity of sialyltransferase and the structures of ganglioside epitope, so that the C.jejuni can acquire the pathogenicity of GBS. This finding may give a clue to genetic modified site. The bi-functional cstⅡ of C.jejuni may be related to the pathogenicity of GBS. The cstⅡ of LL strain to some extent represents the characteristics of Asian strains, which may directs strains monitoring.