Stanford A型主动脉夹层孙氏手术患者术后血流感染的影响因素及术前PCT、IL-6、D-D的预测价值研究

摘要 目的：分析Stanford A型主动脉夹层（AD）孙氏手术患者术后血流感染（BSI）的影响因素,并探讨术前血清降钙素原（PCT）、白细胞介素-6（IL-6）、D-二聚体（D-D）对术后发生BSI的预测价值。方法：选取2019年1月～2022年1月贵州医科大学附属医院收治的236例接受孙氏手术的Stanford A型AD患者,根据术后是否BSI分为BSI组和非BSI组。收集患者基础资料和实验室指标,采用多因素Logistic回归分析Stanford A型AD孙氏手术患者术后发生BSI的影响因素,采用受试者工作特征（ROC）曲线分析血清PCT、IL-6、D-D水平对Stanford A型AD孙氏手术患者术后发生BSI的预测价值。结果：BSI组年龄≥60岁、糖尿病史、机械通气、气管切开、人工瓣膜植入比例和术后24 h引流量、血清C反应蛋白、PCT、IL-6、D-D水平高于非BSI组,手术时间、心包纵隔管保留时间长于非BSI组（P＜0.05）。多因素Logistic回归分析显示,年龄≥60岁、糖尿病史、机械通气、气管切开、术后24 h引流量上升,血清PCT、IL-6、D-D水平上升为Stanford A型AD孙氏手术患者术后发生BSI的危险因素（P＜0.05）。ROC曲线分析显示,血清PCT、IL-6、D-D三项联合预测的Stanford A型AD孙氏手术患者术后发生BSI的曲线下面积大于单独预测。结论：年龄、糖尿病史、机械通气、气管切开、术后24 h引流量、血清PCT、IL-6、D-D水平是Stanford A型AD孙氏手术患者术后发生BSI的影响因素,术前血清PCT、IL-6、D-D水平可作为Stanford A型AD孙氏手术患者术后发生BSI的辅助预测指标。     

Effects of changes in the shape of the intracellular action potential on the peak-to-peak ratio of single muscle fibre potentials

In situ recording of the intracellular action potential (IAP) of human muscle fibres is not yet feasible, and consequently, knowledge about certain IAP characteristics of these IAPs is still limited. The ratio between the amplitudes of the second and first phases (the so-called peak-to-peak ratio, PPR) of a single fibre action potential (SFAP) is known to be closely related to the IAP profile. The PPR of experimentally recorded SFAPs has been found to be largely independent of changes in the fibre-to-electrode (radial) distance. The main goal of this paper is to analyze the effect of changes in different aspects of the IAP spike on the relationship between PPR and radial distance. Based on this analysis, we hypothesize about the characteristics of IAPs obtained experimentally. It was found that the sensitivity of the SFAP PPR to changes in radial distance is essentially governed by the duration of the IAP spike. Assuming that, for mammals, the duration of the IAP rising phase lies within the range 0.2-0.4 ms, we tentatively suggest that the duration of the IAP spike should be over approximately 0.75 ms, with the shape of the spike strongly asymmetric. These IAP characteristics broadly coincide with those observed in mammal IAPs.     

Molecular Interactions between HIV-1 Integrase and the Two Viral DNA Ends within the Synaptic Complex that Mediates Concerted Integration

A macromolecular nucleoprotein complex in retrovirus-infected cells, termed the preintegration complex, is responsible for the concerted integration of linear viral DNA genome into host chromosomes. Isolation of sufficient quantities of the cytoplasmic preintegration complexes for biochemical and biophysical analysis is difficult. We investigated the architecture of HIV-1 nucleoprotein complexes involved in the concerted integration pathway in vitro. HIV-1 integrase (IN) non-covalently juxtaposes two viral DNA termini forming the synaptic complex, a transient intermediate in the integration pathway, and shares properties associated with the preintegration complex. IN slowly processes two nucleotides from the 3′ OH ends and performs the concerted insertion of two viral DNA ends into target DNA. IN remains associated with the concerted integration product, termed the strand transfer complex. The synaptic complex and strand transfer complex can be isolated by native agarose gel electrophoresis. In-gel fluorescence resonance energy transfer measurements demonstrated that the energy transfer efficiencies between the juxtaposed Cy3 and Cy5 5′-end labeled viral DNA ends in the synaptic complex (0.68 ± 0.09) was significantly different from that observed in the strand transfer complex (0.07 ± 0.02). The calculated distances were 46 ± 3 Å and 83 ± 5 Å, respectively. DNaseI footprint analysis of the complexes revealed that IN protects U5 and U3 DNA sequences up to ∼ 32 bp from the end, suggesting two IN dimers were bound per terminus. Enhanced DNaseI cleavages were observed at nucleotide positions 6 and 9 from the terminus on U3 but not on U5, suggesting independent assembly events. Protein-protein cross-linking of IN within these complexes revealed the presence of dimers, tetramers, and a larger multimer (> 120 kDa). Our results suggest a new model where two IN dimers individually assemble on U3 and U5 ends before the non-covalent juxtaposition of two viral DNA ends, producing the synaptic complex.     

老年腰椎间盘突出症患者术后下肢深静脉血栓形成的影响因素及术前D-D、TM、Leptin联合应用的预测价值

摘要 目的：分析老年腰椎间盘突出症（LDH）患者术后下肢深静脉血栓形成（LDVT）的影响因素并探讨术前D-二聚体（D-D）、血栓调节蛋白（TM）、瘦素（Leptin）联合应用的预测价值。方法：选取2020年1月～2021年12月广州医科大学附属第三医院收治的412例接受腰椎椎间融合术（LIF）老年LDH患者,根据术后是否发生LDVT将其分为LDVT组和非LDVT组。收集老年LDH患者临床资料,采用酶联免疫吸附法检测术前血清D-D、TM、Leptin水平。采用多因素Logistic回归分析老年LDH患者LIF术后LDVT的影响因素,采用受试者工作特征（ROC）曲线分析术前血清D-D、TM、Leptin水平对老年LDH患者LIF术后LDVT的预测价值。结果：412例老年LDH患者LIF术后LDVT发生率为21.12%（87/412）。多因素Logistic回归分析显示,年龄增加、体质指数≥24 kg/m²、卧床时间≥7 d、D-D升高、TM升高、Leptin升高为老年LDH患者LIF术后LDVT的独立危险因素（P＜0.05）。ROC曲线分析显示,术前血清D-D、TM、Leptin水平单独与联合预测老年LDH患者LIF术后LDVT的曲线下面积分别为0.766、0.760、0.767、0.894,联合预测的曲线下面积大于D-D、TM、Leptin单独预测。结论：老年LDH患者LIF术后LDVT发生与年龄、体质指数、卧床时间和D-D、TM、Leptin有关,术前血清D-D、TM、Leptin水平联合预测老年LDH患者LIF术后LDVT的价值较高。     

整细胞酶促合成抗HIV新药 D-D4FC

D-D4FC(β-D-2′,3′-双脱氢双脱氧-5-氟胞嘧啶核苷)是一种新型抗HIV病毒的核苷类药物,目前正在美国、法国和德国进行Ⅱ期临床。利用乳酸杆菌提取的粗制N-脱氧核糖转移酶实现了由D4T(β-D-2′,3′-双脱氢双脱氧-胸苷,司他夫定)和5-FC(5-氟胞嘧啶)合成D-D4FC,转化率达到25%。现在,发现利用乳酸杆菌整细胞也可实现此反应,其转化率经过12.5h可达到50%,更有利于可能的工业化连续生产。研究了整细胞催化合成D-D4FC反应中,pH值、缓冲液类型、底物浓度、加菌量、反应时间等条件的影响并进行了优化,探讨了反应中乳酸杆菌整细胞催化的可能机理。     

类风湿性关节炎活动性病变MRI征象及其与FIB、FDP、D-D的相关性研究

摘要 目的：探讨类风湿性关节炎（RA）活动性病变磁共振成像（MRI）征象及其与纤维蛋白原（FIB）、纤维蛋白(原)降解产物（FDP）、D-二聚体（D-D）的相关性研究。方法：选取2020年1月-2021年2月期间我院诊治的61例RA患者,根据28个关节疾病活动指数（DAS28）评分将其分为活动组（35例）和稳定组（26例）。对比两组MRI征象,血清FIB、FDP、D-D水平。采用Spearman相关性分析RA活动期患者MRI各征象间的相关性及MRI各征象与血清FIB、FDP、D-D水平间的相关性。结果：活动组滑膜增厚或滑膜炎、骨髓水肿、软骨及骨侵蚀、腱鞘炎或周围软组织受累、关节腔积液征象人数占比均高于稳定组（P＜0.05）。活动组患者血清FIB、FDP、D-D水平均高于稳定组（P＜0.05）。Spearman相关性分析结果显示,RA活动期患者滑膜增厚或滑膜炎征象与骨髓水肿、软骨及骨侵蚀、关节腔积液征象均呈正相关（P＜0.05）,骨髓水肿征象与软骨及骨侵蚀征象呈正相关（P＜0.05）;RA活动期患者滑膜增厚或滑膜炎、骨髓水肿、关节腔积液征象与血清FIB、FDP、D-D水平均呈正相关（P＜0.05）,软骨及骨侵蚀征象与FIB呈正相关（P＜0.05）。结论：MRI征象可清晰显示RA患者的滑膜、骨质、关节腔及周围肌腱、软组织等异常改变,且MRI征象之间具有相关性,可在一定程度上反映RA的病理改变;血清FIB、FDP、D-D的检测有助于反映RA活动情况;MRI征象与血清FIB、FDP、D-D水平间具有相关性,二者联合应用有助于进一步评估RA活动情况。     

Characterization of human αβTCR repertoire and discovery of D-D fusion in TCRβ chains

The characterization of the human T-cell receptor (TCR) repertoire has made remarkable progress, with most of the work focusing on the TCRβ chains. Here, we analyzed the diversity and complexity of both the TCRα and TCRβ repertoires of three healthy donors. We found that the diversity of the TCRα repertoire is higher than that of the TCRβ repertoire, whereas the usages of the V and J genes tended to be preferential with similar TRAV and TRAJ patterns in all three donors. The V-J pairings, like the V and J gene usages, were slightly preferential. We also found that the TRDV1 gene rearranges with the majority of TRAJ genes, suggesting that TRDV1 is a shared TRAV/DV gene (TRAV42/DV1). Moreover, we uncovered the presence of tandem TRBD (TRB D gene) usage in ～2% of the productive human TCRβ CDR3 sequences.     

Enzymatic synthesis of β-D-2', 3'-unsaturated-5-fluorocytidine from β-D-2',3'-unsaturated thymidine

We have used crude preparations of N-deoxyribosyl transferases (NdRT-II) from Lactobacillus helveticus to catalyze the transfer of a glycosyl moiety from a donor nucleoside to an acceptor base. Optimal conditions for the transglycosylation reaction to make D-D4FC starting from D-D4T and 5-FC were determined after the analysis of several experimental parameters including reaction time, concentration of substrate, pH and the type of buffer. For the first time, a practical procedure for enzymatic synthesis of β-D-2',3'-unsaturated-5-fluorocytidine (β-D-2',3'-didehydro-2',3'-dideoxy-5-fluorocytidine, D-D4FC) from β-D-2',3'-unsaturated thymidine (D-D4T) has been established. This method will be useful in the manufacture of important nucleoside analogues for anti-viral therapy.