Long-term follow up of patients with common variable immunodeficiency treated with intravenous immunoglobulin: Reevaluation of intravenous immunoglobulin replacement therapy

Five patients with common variable immunodeficiency treated in our hospital between December 1979 and December 1990 were given six kinds of intravenous immunoglobulin preparations (pepsin treated, S-sulfonated, polyethylene glycol treated, pH4 treated, alkylated, and pH4.25 formulation preparation) for replacement therapy. Duration of the therapy ranged from 7.6 to 11 years. Incidences of fever and acute infections were variable among patients, but no significant differences were seen in the incidences among periods given each preparation. Three cases revealed abnormal pulmonary functions in tests. Adverse reactions were rarely seen in our study periods, and no severe reactions were observed. No significant differences were seen in incidences of adverse reactions. Postinfusion levels of serum complement slightly decreased from preinfusion levels. However, the decrease in complement was not related to any adverse reaction. No long-term complications such as transmission of hepatitis have been observed. Our data suggest that no obvious differences exist between the efficacy and safety of each IVIG preparation. Differences of efficacy of IVIG replacement therapy may be due to the variable pathophysiology of each patient.Abbreviations CVID common variable immunodeficiency - IVIG intravenous immunoglobulin     

酶类药物现状、问题及展望

随着生物制药的迅速发展,许多酶类药物应运而生,在治疗代谢疾病、心血管疾病、癌症等诸多疾病上发挥着越来越重要的作用。但是酶类药物也存在一些不足,如潜在的免疫原性、较短的体内半衰期,以及较差的组织靶向性,影响了酶类药物的疗效和应用。为克服这些缺点,人们已开发出多种技术,如通过糖基化、聚乙二醇修饰等分子工程技术提升酶蛋白药效,另一方面酶基因疗法也已成功用于多种酶缺陷疾病的治疗。基于酶类药物的迅速发展和广泛的应用前景,本文对酶类药物的现状进行较详细的阐述,并对酶类药物的优势、所存在的问题及未来发展趋势进行分析和评述。     

5个番石榴品种果实食用品质和香气特征分析

为比较番石榴(Psidium guajava)不同品种果实的外观、营养价值和香气特征,采用国家标准方法,对5个番石榴品种(‘红宝石’、‘粉红蜜’、‘西瓜’、‘水蜜’、本地种)果实的外观和营养成分进行测定,采用顶空气质联用(HS-GC-MS)技术对5个品种果实的香气成分进行测定。结果表明,不同品种果实外观及营养成分差异明显。‘水蜜’的果形指数最低,果实扁圆形,种籽最少;大多数糖类物质(总糖、还原糖、蔗糖等)、糖酸比、总酚含量最高;果糖、VC和总黄酮含量位居第2;总酸、脂肪、粗纤维、灰分含量最低。主成分分析表明,‘水蜜’作为鲜食水果的食用品质最高。己醛和石竹烯是红肉型品种的特征风味物质,3-羟基-2-丁酮是白肉型品种的特征香气成分。     

超声引导下神经阻滞麻醉联合全身麻醉对股骨头置换老年患者麻醉效果及术后认知功能的影响

摘要 目的：研究超声引导神经阻滞麻醉联合全身麻醉对股骨头置换老年患者的麻醉效果及对术后认知功能的影响。方法：选取2019年1月至2021年12月期间我院收治的150例拟行股骨头置换术的老年患者,随机分为对照组和观察组,各75例。对照组患者行常规全身麻醉,观察组在对照组的基础上行超声引导下神经阻滞麻醉,比较两组患者的血流动力学指标,拔管时间、苏醒时间和复苏室停留时间,苏醒后疼痛,术后认知功能及不良反应的发生率。结果：观察组患者各时间点的心率（HR）和平均动脉压（MAP）均较对照组低（P＜0.05）。观察组拔管时间、苏醒时间和复苏室停留时间均较对照组短（P＜0.05）。观察组患者术后视觉模拟评分（VAS）均低于同一时间点的对照组（P＜0.05）。与对照组相比,观察组患者术后1 h、12 h和24 h的简易智力状态检查（MMSE）评分均较高（P＜0.05）,观察组术后1 h、12 h和24 h术后认知功能障碍（POCD）发生率较对照组低（P＜0.05）。两组患者不良反应发生率无差异（P＞0.05）。结论：超声引导神经阻滞麻醉可稳定血流动力学,缩短拔管、苏醒及复苏室停留时间,减轻术后疼痛,改善术后认知功能,减少POCD的发生,值得临床推广。     

右美托咪定联合芬太尼对心脏瓣膜置换术患者细胞免疫功能的影响及心脑保护作用研究

摘要 目的：观察右美托咪定联合芬太尼对心脏瓣膜置换术患者细胞免疫功能的影响及在心脑保护中的作用。方法：纳入海南医学院第二附属医院2019年4月~2021年6月间接收的体外循环（CPB）下心脏瓣膜置换术患者97例,根据信封抽签法将患者分为对照组（芬太尼,48例）和观察组（右美托咪定联合芬太尼,49例）。对比两组血流动力学指标[平均动脉压（MAP）、心率（HR）]、心肌损伤指标[肌钙蛋白（cTnI）、肌酸激酶同工酶（CK-MB）、心型脂肪酸结合蛋白（HFABP）]、脑损伤指标[神经元特异性烯醇化酶（NSE）、S-100β]、细胞免疫功能、镇痛情况及不良反应发生率。结果：观察组CPB开始后10 min（T2）时间点HR、MAP低于对照组,CPB结束（T3）、术毕（T4）时间点HR、MAP高于对照组（P<0.05）。两组术前（T1）、术后24 h、术后48 h视觉模拟评分法（VAS）评分升高后降低（P<0.05）,观察组术后24 h、术后48 h VAS评分低于对照组（P<0.05）。观察组术后48 h CD4⁺、CD4⁺/CD8⁺高于对照组,CD8⁺低于对照组（P<0.05）。观察组术后48 h cTnI、CK-MB、HFABP低于对照组（P<0.05）。观察组术后48 h NSE、S100B低于对照组（P<0.05）。观察组的不良反应发生率低于对照组（P<0.05）。结论：心脏瓣膜置换术患者选用右美托咪定联合芬太尼麻醉方案,有助于减轻疼痛,稳定血流动力学,减轻免疫抑制,同时还可发挥心脑保护效果,降低不良反应发生率,是一种可靠的麻醉方案。     

电针疗法联合全麻诱导对老年下肢关节置换手术患者血流动力学和术后恢复的影响

摘要 目的：评估电针预处理对行下肢关节置换术的老年患者术中血流动力学、术后心血管不良事件、恢复质量的影响。方法：选择择期行下肢关节置换术（膝关节置换或髋关节置换）的老年患者70例,采用随机数字表法分为试验组和对照组。试验组在全麻诱导前30 min于手术准备间予双侧内关、列缺、足三里电针治疗,对照组单纯行全身麻醉。两组全麻诱导后均采用静吸复合麻醉。记录气管插管时（T1）、手术开始后10 min（T2）、拔管后10 min（T3）时的血流动力学参数（HR、MAP、RPP）,术后24 h的心血管不良事件、VAS评分、恢复质量（QoR40）的情况。结果：与对照组相比,试验组T1、T2、T3三个时间点的HR、MAP、RPP均明显降低（P＜0.05）;试验组术后24 h心血管不良事件发生率高于对照组（P＜0.05）,VAS评分以及术后QoR40比较无差异（P>0.05）。结论：麻醉前电针预处理内关、列缺、足三里可以有效的降低患者心率、血压和心肌氧耗量,降低机体对围术期应激的反应,从而降低围术期不良心血管事件的发生率,提高麻醉的安全和质量。     

Crystal structure determination of basic phospholipase A2 from venom of Agkistrodon halys pallas by molecular replacement method

Basic phospholipase A₂ (BPLA₂) from the venom of Agkistrodon halys pallas has a strong ability to hemolyze erythrocytes. The asymmetrical unit of P2₁2₁2₁ crystal of BPLA₂ contains two molecules. Self-rotation function was used to study the orientation relationship of these two molecules. Cross-rotation and translation functions were then used to determine the orientations and positions of the two molecules in the unit cell. The model building and preliminary structure refinement were carried out. The result shows that the two molecules in the asymmetrical unit of orthorhombic crystal are related by a non-crystallographic 2-fold symmetry axis.     

Detection of section-specific random amplified polymorphic DNA (RAPD) markers in Lilium

Random amplified polymorphic DNA (RAPD) markers were utilized for the identification of Lilium species and inter-specific hybrids. The optimum annealing temperature of the polymerase chain reaction (PCR) for the RAPD assay in Lilium was 54 °C, which is relatively higher than the temperature used for other genera reported by previous researchers. Among 76 primers used to amplify genomic DNA by PCR, 18 primers (24%) generated polymorphic DNA fragments in Lilium species and hybrids. Cultivars were also identified by RAPD markers. Some amplified fragments were unique to species of each section and to hybrids derived from these species; that is, they were the section-specific DNA markers. Sections, Sinomartagon, Leucolirion b, Leucolirion a and Archelirion could be identified by 6 section-specific markers amplified with five primers. Seven inter-section hybrids showed the section-specific bands of both parental sections, indicating that these markers would be useful for identifying the parental sections of inter-section hybrids.     

A hypervariable middle repetitive DNA sequence from citrus

The use of hypervariable sequences for DNA typing of plants is focussed on microsatellites and on amplification of regions defined by random (RAPD) or defined (AFLP) primers for PCR analysis of genomes. A hypervariable length of middle repetitive DNA has been isolated from citrus that contains no obvious hypervariable structures. The fingerprinting probe was shown to have an important commercial application in the separation of zygotic from nucellar progeny. A somatic variant of the sequence within one orange tree suggests that somatic variation in hypervariable markers may be a common event.     

The inhibition of infection thread development in the cultivar-specific interaction ofRhizobium and subterranean clover is not caused by a hypersensitive response

Summary The cultivar specific interaction ofTrifolium subterranean cv. Woogenellup andRhizobium leguminosarum bv.trifolii strain ANU 794 was examined to establish the basis for nodulation failure on this cultivar. Infections were initiated by strain ANU 794 on cv. Woogenellup. Root hair curling, the initiation of infection threads, and cortical cell divisions were evident on the tap root and appeared normal after microscopic observation. However, in most cases, the infection threads stayed confined to the root hairs. No evidence was found for a hypersensitive response by the plant. The progress of infections on the tap roots was different from that on the lateral roots. This was confirmed by the differential tap and lateral root nodulation patterns of the mutants derived from strain ANU 794, which show enhanced nodulation on cv. Woogenellup. On the lateral roots, cortical cell divisions progressed further than those on the tap root and formed macroscopically visible swellings, which could be divided into two morphological classes. In some cases infection threads developed into these primordia but successful nodules were not established. The inhibition of infection appeared to be manifested at two levels: first, on the tap roots in the root hairs, where many of the infection threads are contained and secondly, in the primordia induced on the lateral roots, where the infection threads sometimes penetrate further than the root hair cell but stop in the primordial cells. It appears that an essential factor or trigger in the communication between plant and bacteria is missing or altered, resulting in an array of primordia-structures, which cease to develop.Abbreviations bv biovar - cv cultivar - Fix⁺ nitrogen fixing - GUS -glucuronidase - Nod⁺ nodulating - HR hypersensitive response - Km kanamycin - LOSs lipo-oligosaccharides - Sm streptomycin - Sp spectinomycin - X-Gluc 5-bromo-4-chloro-3-indonyl--glucuronic acid