治疗用A型肉毒毒素的制备及其质量控制

我国治疗用Ａ型肉毒毒素采用酸等电点沉淀,磷酸盐提取,核糖核酸酶处理,ＤＥＡＥ Ａ５０离子交换层析,硫酸铵浓缩及自然结晶等程序从Ａ型肉毒梭菌培养物中提取,并经稀释、冻干而成。它毒力强、纯度高、性能稳定,宜于长期保存。经生化、免疫学测定,毒素系神经毒素和血凝素的复合体,纯度为２５～３．０×１０７ＬＤ５０（小鼠,下同）／ｍｇｐｒ,ＯＤ２６０／ＯＤ２８０≤０．５５不仅达到了美国ＦＤＡ对注射用Ａ型肉毒毒素的质量要求,而且在冻干损失,稳定性方面还优于美国制品。     

Use of botulinum toxin

In an extensive survey of postgraduate physicians in two teaching hospitals (N = 141) for their humanistic attitudes, values and behavior, all ratings of physicians'' humanistic performance, including physicians'' own scores on self-report measures, supervising faculty, nurses and patient ratings, were modestly but significantly correlated with each other. Sex, ethnic or racial background, year of training, marital status, number of children, Alpha-Omega-Alpha membership or number of articles published were unrelated to physicians'' humanistic behavior. Several measures of humanism were positively correlated with having taken more courses in the social sciences and humanities, having had more early person-centered work experience and reporting that before medical school others had confided in them or sought their advice more frequently.     

Botulinum A toxin for the treatment of adult-onset spasmodic torticollis

Thirty-five patients with adult-onset idiopathic torticollis were treated by local injections of botulinum A toxin into dystonic cervical muscles. Substantial improvement with respect to reduction and elimination of pain was found in 81 percent, improvement in posture deformity and involuntary spasms in 70 percent, increased range of motion of the neck in 78 percent, reduction in visible sternocleidomastoid hypertrophy in 86 percent, and improvement in tremor in 65 percent. The syndrome was divided into four subtypes based on pattern of dystonic muscle groups involved in the dystonia, head and shoulder posture, and sternocleidomastoid muscle hypertrophy. Injection strategy based on this subdivision is described.     

Clostridium botulinum type C toxin

Summary The purification and crystallization of type C botulinum toxin along with its physical characteristics are described. The shape of Clostridium botulinum type C toxin molecule is globular like a pressed ball with a 7.4 nm diameter and a 4.3 urn thickness. The molecular volume is approximately 185 nl and the molecular weight is 141 000. The toxin molecule is composed of two parts, which are separable under appropriate conditions. These parts have some differences in the electrophoretic properties, amino acid distribution, immunological, and functional characteristics. The toxin molecule can be reconstituted by association of S-S bond between the two chains. The expression of the toxicity requires that the fragments of the polypeptide chain carrying the necessary information be functionally organized for the proper development of the specific tertiary structure for active conformation.     

A simplified method for smile enhancement: botulinum toxin injection for gummy smile

The authors studied and provided treatment to patients with the complaint of gummy smile. Between October of 2009 and January of 2011, 52 unaesthetic smiles were evaluated and treated with onabotulinum toxin A. Botulinum toxin injection was an effective treatment, with an average satisfaction level of 9.75 on a 10-point scale. The levator labii superioris alaeque nasi is the ideal muscle for injection, and lopsided smiles could be resolved also with onabotulinum toxin A asymmetric injection. Gummy smile treatment with onabotulinum toxin A into the levator labii superioris alaeque nasi muscle is an effective method, with minimum risk of complications and very high patient satisfaction.     

Integrated bioassays in microfluidic devices: botulinum toxin assays

A microfluidic assay was developed for screening botulinum neurotoxin serotype A (BoNT-A) by using a fluorescent resonance energy transfer (FRET) assay. Molded silicone microdevices with integral valves, pumps, and reagent reservoirs were designed and fabricated. Electrical and pneumatic control hardware were constructed, and software was written to automate the assay protocol and data acquisition. Detection was accomplished by fluorescence microscopy. The system was validated with a peptide inhibitor, running 2 parallel assays, as a feasibility demonstration. The small footprint of each bioreactor cell (0.5 cm2) and scalable fluidic architecture enabled many parallel assays on a single chip. The chip is programmable to run a dilution series in each lane, generating concentration-response data for multiple inhibitors. The assay results showed good agreement with the corresponding experiments done at a macroscale level. Although the system has been developed for BoNT-A screening, a wide variety of assays can be performed on the microfluidic chip with little or no modification.     

肉毒毒素作用机制的研究进展

肉毒毒素(botulinum toxin,BTX)是肉毒梭状芽胞杆菌在生长繁殖过程中产生的一种外毒素,其通过抑制神经递质的释放而引起肌肉松弛型麻痹。在世界范围内,肉毒中毒的案例时有发生,病情严重的患者最终因呼吸衰竭而死亡。肉毒毒素相关产品在临床痉挛性疾病、腺体分泌过度、神经性疼痛的治疗及美容除皱等领域展现出广阔的应用前景。因而,肉毒毒素作用机制的研究在肉毒中毒的治疗以及临床新适应症的开发等方面具有重要意义。就肉毒毒素跨越小肠上皮细胞屏障的吸收及神经毒性作用机制的研究现状作一概述。     

Simplified purification method for Clostridium botulinum type E toxin

Clostridium botulinum type E toxin was purified in three chromatography steps. Toxin extracted from cells was concentrated by precipitation and dissolving in a small volume of citrate buffer. When the extract was chromatographed on DEAE-Sephadex without RNase or protamine treatment, the first protein peak had most of the toxin but little nucleic acid. When the toxic pool was applied to a carboxymethyl Sepharose column, toxin was recovered in the first protein peak in its bimolecular complex form. The final chromatography step at 4 degrees C on a DEAE-Sephacel column at a slightly alkaline pH purified the toxin (Mr, 145,000) by separating the nontoxic protein from the complex. At least 1.5 mg of pure toxin was obtained from each liter of culture, and the toxicity was 6 X 10(7) 50% lethal doses per mg of protein. These values are significantly higher than those previously reported.     

Antagonism of botulinum toxin by theophylline

Theophylline increased the time required for botulinum toxin to cause neuromuscular blockade in an isolated phrenic nerve-diaphragm preparation. Theophylline also offered some protection against botulinum toxin in mice, $\text{in}\text{vivo}$.