肾小球滤过率活体实时监测荧光示踪剂的研究进展

急性肾损伤是一种临床常见的急性疾病. 通过外源性的荧光示踪剂对肾小球滤过率进行非侵入性的实时监测, 对于及时了解易患病人的肾脏功能具有重要的临床价值和应用前景. 本文综合评述了用于活体检测肾小球滤过率的外源性荧光示踪剂的近期研究进展, 重点介绍了荧光示踪剂的设计策略及其活体成像应用效果, 并对相应检测装置的发展进行了阐述, 同时对该领域的挑战与发展前景进行了展望.     

细菌溶解产物对预防 COPD急性发作的临床价值--基于多项随机对照试验的荟萃分析

目的评价细菌溶解产物减少慢性阻塞性肺疾病（COPD）的急性发作及其应用的临床价值。方法检索Cochrane、MEDLINE、EMBASE、CNKI、CBM,纳入细菌溶解产物用于预防COPD急性发作的随机对照研究。评价对照试验的方法学,提取试验的相关指标,对临床数据进行荟萃分析。结果纳入16个研究,共1746例稳定期COPD患者,结果显示细菌溶解产物相较于安慰剂组,可明显减少患者的年平均急性感染次数[SMD=-0.93,95%CI （-1.26~-0.60）,P＜0.01],急性感染的持续时间[SMD=-1.38,95%CI （-1.6~-1.11）,P＜0.01],平均住院时间[SMD=-9.01,95%CI （-10.24~-7.78）,P＜0.01],抗生素应用时间[SMD=-1.07,95%CI （-1.32~-0.82）,P＜0.01],提高患者的 T淋巴细胞水平[SMD=1.38,95%CI （0.64~2.13）,P＜0.01]、IgG [SMD=1.46,95%CI （1.18~1.59）,P=0.02]、IgM [SMD=0.26,95%CI （0.18~0.41）,P=0.01]及6min步行距离[SMD=58.7,95%CI （33.5~84.1）,P＜0.01]。然而,细菌溶解产物对肺功能指标并无影响。结论细菌溶解产物对COPD的急性发作的临床价值在于减少感染次数,其对COPD的肺功能并无改善。     

血清C 反应蛋白在预测非创伤性急腹症的CT表现的价值

目的 探讨C 反应蛋白（CRP）急性期快速上升能否可靠预测非创伤性急腹症的CT 检查阳性表现。方法 收集CRP 检测后24h内行腹盆、腔CT扫描的非创伤性急腹症患者121 例,其中男57例,女64例,平均年龄57岁。近期手术、已知恶性肿瘤、炎症性肠病除外。CT表现由2 位放射科医师阅片并一致后进行分类。结果 CRP 正常CT 检查阳性16 人,阴性15 人,随着CRP 升高,CT 检查阳性率也随着升高,灵敏度下降,特异度增高,似然比也随之增高,当CRP 在130mg/L 水平以上时,其灵敏度与特异度分别为31.4%、90.9%,阳性似然比为3.14。结论 CRP阴性的非创伤性急腹症患者,不能除外CT 检查,随着血清CRP 水平升高,CT检查阳性率及阳性似然比也随之升高。     

On a proper acute triangulation of a polyhedral surface

Let Σ be a polyhedral surface in R³ with n edges. Let L be the length of the longest edge in Σ, δ be the minimum value of the geodesic distance from a vertex to an edge that is not incident to the vertex, and θ be the measure of the smallest face angle in Σ. We prove that Σ can be triangulated into at most CLn/(δθ) planar and rectilinear acute triangles, where C is an absolute constant.     

快速造P(n,k)大表的左肩法则和斜线法则

设Ｐ（ｎ,ｋ）为整数ｎ分为ｋ部的无序分拆的个数,每个分部≥１,它为大师欧拉所建立（１７０７－１７８３）．它是组合图论和数论里最重要的数据之一．然而,它却十分难于计数和造表．本文,由公式Ｐ（ｎ,ｋ）＝Ｐ（ｎ－１,ｋ－１）＋Ｐ（ｎ－ｋ,ｋ）定义了Ｐ（ｎ,ｋ）的左肩数和锐角数,并由此得到求Ｐ（ｎ,ｋ）的左肩法则（第一法则）．还根据本文作者［５］的一些重要定理得到求 Ｐ（ｎ,ｋ）的斜线法则（第二法则）．使用这些法则得到造Ｐ（ｎ,ｋ）大表的有趣原理．为方便计,我们仅用第一法则设计了计算机程序,用此程序即可快速造出任意大的Ｐ（ｎ,ｋ）表．     

Localized in vivo proton spectroscopy of the bone marrow in patients with leukemia

Volume selective magnetic resonance (MR) proton spectroscopy was used to investigate the haemopoietic (iliac bone) and fatty bone marrow (tibia) in patients with leukemia and polycythaemia vera. Selective measurements of the relaxation times T₁ and T₂ for the “water” and “fat” resonances in the bone marrow spectra were performed. Nine patients with acute leukemia and three patients with chronic leukemia were examined at diagnosis. Three patients with acute leukemia in remission were also examined. Five of the leukemic patients had follow-up examinations performed in relation to chemotherapeutic treatment. Nine patients with polycythaemia vera and 21 normal control subjects were examined with identical methods for comparison. All patients had bone marrow biopsies performed prior to every MR examination. Significant differences could be detected in the spectral patterns from iliac bone marrow in patients with leukemia at diagnosis compared to the healthy normal controls. The “relative water content” was increased in the iliac bone marrow spectra of the leukemic patients compared to the normal subjects, which indicates an increase in the amount of haemopoietic tissue and a corresponding decrease in marrow fat content. The T₁ relaxation times of the “water” resonance in the spectra from the iliac bone marrow of the leukemic patients were significantly prolonged at diagnosis, compared to the normal controls and the patients with polycythaemia vera. After chemotherapeutic induction of remission, the spectra from the iliac bone marrow in the patients with leukemia resembled normal spectra. Four leukemic patients had abnormal spectra from the tibial bone marrow and one patients showed early changes in tibial marrow during chemotherapeutic treatment, before any major changes could be detected in the iliac bone marrow.     

Protein array for assist diagnosis of acute myocardial infarction

A nanogold probe immunoassay for cardiac troponin I (cTnI) combining the concepts of the one-step dual monoclonal antibody “sandwich” principle, the low density protein array, and silver enhancement on the gold particle is described. Two main substrates, namely the capture antibody (IgG1) coated supporting nitrocellulose membrane and the colloidal gold-labeled detection antibody (cAu–IgG2), were prepared before the detection. The detection procedure involved two steps, i.e. immunoreaction and silver amplification. The assay needs only small amounts of serum samples of patients. The detection results could be easily imaged with a simple flatbed scanner or even the naked eye. The whole detection procedure of the assay could be fulfilled within 40 min (much faster than the routine enzyme-linked immunosorbent assay (ELISA) that takes usually at least 3 h for a turnaround test). The detection limit of cTnI was found to be 1 ng/ml. The detecting results of cTnI in serum samples were similar to those detected by ELISA.     

Towards a Precise NMR Quantification of Acute Phase Inflammation Proteins from Human Serum

Nuclear Magnetic Resonance (NMR) spectra of human serum and plasma show, besides metabolites and lipoproteins, two characteristic signals termed GlycA and B arising from the acetyl groups of glycoprotein glycans from acute phase proteins, which constitute good markers for inflammatory processes. Here, we report a comprehensive assignment of glycoprotein glycan NMR signals observed in human serum, showing that GlycA and GlycB signals originate from Neu5Ac and GlcNAc moieties from N-glycans, respectively. Diffusion-edited NMR experiments demonstrate that signal components can be associated with specific acute phase proteins. Conventionally determined concentrations of acute phase glycoproteins correlate well with distinct features in NMR spectra (R² up to 0.9422, p-value <0.001), allowing the simultaneous quantification of several acute phase inflammation proteins. Overall, a proteo-metabolomics NMR signature of significant diagnostic potential is obtained within 10–20 min acquisition time. This is exemplified in serum samples from COVID-19 and cardiogenic shock patients showing significant changes in several acute phase proteins compared to healthy controls.     

Isolation of Structurally Heterogeneous TCR-CD3 Extracellular Vesicle Subpopulations Using Caliper Strategy

Cells in different states can release diverse types of extracellular vesicles (EVs) that participate in intracellular communication or pathological processes. The identification and isolation of EV subpopulations are significant to explore their physiological functions and clinical value. In this study, structurally heterogeneous T-cell receptor (TCR)-CD3 EVs were proposed and verified for the first time using a caliper strategy. Two CD3-targeting aptamers were designed in the shape of a caliper with an optimized probe distance and were assembled on gold nanoparticles (Au-Caliper) to distinguish TCR-CD3 monomeric and dimeric EVs (m/dCD3 EVs) in skin-transplanted mouse plasma. Phenotyping and sequencing analysis revealed clear heterogeneity in the isolated m/dCD3 EVs, providing the potential for mCD3 EVs as a candidate biomarker of acute cellular rejection (ACR) and holding great prospects for distinguishing EV subpopulations based on protein oligomerization states.     

不同病原体引起的儿童化脓性扁桃体炎的临床特点

目的探究不同病原体引起的儿童化脓性扁桃体炎的临床特点。方法选择2014年住院确诊且有明确病原体的化脓性扁桃体炎患儿97例,比较不同病原体引起的化脓性扁桃体炎的流行病学特点、临床症状与体征、实验室检查结果等。结果A族β溶血性链球菌（GABHS）、EB病毒、腺病毒和肺炎支原体（MP）引起的化脓性扁桃体炎患儿发病年龄分别为（6.29±2.17）、（3.41±1.81）、（3.35±2.50）、（3.88±2.95）岁,差异有统计学意义（P＜0.05）,其中GABHS感染患儿年龄最大。GABHS感染患儿发病年龄多在5岁以下,冬春季为发病高峰季节。有咽部出血点表现的多为GABHS和腺病毒感染,EB病毒感染患儿易出现肝、脾和颈部淋巴结肿大,腺病毒感染患儿易出现结膜炎。不同病原体引起的急性化脓性扁桃体炎患儿血清中性粒细胞（NC）、C-反应蛋白（CRP）、血清降钙素原（PCT）水平比较,差异均有统计学意义（均P＜0.05）;与GABHS感染患儿相比,EB病毒、MP感染患儿CRP水平均较低（均P＜0.05）,EB病毒、腺病毒和MP感染患儿PCT水平均较低（均P＜0.05）。结论在化脓性扁桃体炎患儿中,除GABHS感染外,腺病毒、EB病毒和支原体感染也占相当一部分。对于年龄＜5岁,冬末春初发病,有明显咽痛、咽后壁出血样表现,CRP明显升高,PCT＞0.5ng/ml的患儿,应考虑GABHS感染的可能,并及早、足疗程使用抗生素。