目的:探索更有效的肺炎链球菌DNA疫苗和疫苗免疫策略,并探究其中的保护机制.方法:构建重组质粒pcDNA3-dnaJ并表达DnaJ蛋白,实验分别设置重组质粒pcDNA3-dnaJ/蛋白DnaJ免疫小鼠组及单独质粒pcDNA3-dnaJ免疫小鼠组,分别比较肺炎链球菌菌株攻毒后小鼠鼻腔灌洗液细菌载量及生存率,采用ELISA检测免疫小鼠血清抗体效价及炎症因子,流式细胞术分析体外BMDCs激活情况及Th1和Th17细胞免疫应答.结果:质粒pcDNA3-dnaJ免疫3次可诱导血清中抗原特异性抗体的产生,并减少肺炎链球菌攻毒后鼻咽部的细菌载量,但在防止致死性感染方面效果较差.然而,与重复质粒DNA接种三次相比,pcDNA3-dnaJ1次/DnaJ蛋白加强1次的免疫策略可以显著减少鼻咽中的肺炎链球菌定植,并能够更好的预防致死性感染.此外,与DNA质粒加强免疫相比,DnaJ蛋白加强免疫后可产生更高水平的IFN-γ和IL-17A.结论:重组质粒pcDNA3-dnaJ/蛋白DnaJ异源免疫可能通过活化树突状细胞,进而诱导Th1和Th17细胞免疫应答,抵抗肺炎链球菌感染.

背景现普遍认为支气管哮喘(简称哮喘)是基因和环境交互作用的结果,由于基因改变的缓慢性,越来越多的证据表明哮喘的发病率和病死率是暴露于现代室内环境中的过敏原和刺激物所致,WHO报道,44％的哮喘疾病由室内燃料、二手烟等环境因素引起.目前研究表明家族哮喘史、过敏原等是哮喘众所周知的危险因素.除此之外,诱发哮喘发病的因素还有很多:如室内环境潮湿、室内空气污染、被褥、枕芯材质及清洁程度、吸油烟机及防尘罩等的使用情况却少有研究.目的 探讨重庆市室内环境与儿童哮喘发病的相关性,为哮喘儿童家庭护理的干预措施提供依据.方法 选取2017年5—7月重庆医科大学附属儿童医院呼吸中心诊治的哮喘患儿作为病例组,根据性别、年龄按1:1匹配选取2017年8—9月于本院呼吸中心诊治的非哮喘儿童作为对照组.在瑞典Dampness in Buildings and Health(DBH)问卷的基础上结合实际住宅特征进行调整补充,拟定"儿童支气管哮喘相关因素调查问卷",问卷内容包含一般资料、室内环境(枕芯、被褥材质,枕芯、床单清洗频率,防尘罩清洗,鲜花接触频率,霉菌生长、漏水、冷凝水,加湿器使用频率,母孕期或儿童被动吸烟,地面材料,墙壁类型,开窗通风频率,厨房燃料、吸油烟机、空调过滤器清洗,宠物饲养,毛绒玩具接触频率,蟑螂/老鼠接触频率).采用Logistic回归分析分析室内环境与儿童哮喘的相关性.结果 共发放问卷750份,收回730份,剔除不合格问卷18份,有效问卷712份,有效回收率为94.9％.最终病例组入选356例,对照组入选356例.多因素Logistic回归分析结果显示,枕芯材质、被褥材质、枕芯清洗频率、床单清洗频率、鲜花接触频率、霉菌生长、漏水、冷凝水,母孕期被动吸烟、儿童被动吸烟、蟑螂/老鼠接触频率与儿童哮喘有相关性(P<0.05).结论 不良室内环境对儿童哮喘有一定的影响,枕芯材质、被褥材质、枕芯清洗频率、床单清洗频率、鲜花接触频率、霉菌生长、漏水、冷凝水、母孕期被动吸烟、儿童被动吸烟、蟑螂/老鼠接触与儿童哮喘相关,积极采取干预措施改善存在的危险因素,减少室内环境污染,可降低儿童哮喘的发病率.

目的 观察贝母瓜蒌散对慢性阻塞性肺疾病(COPD)模型大鼠肺组织中p38MAPK信号通路和肿瘤相关因子受体因子MIP-T3的影响.方法 将40只SD雄性大鼠随机分为正常组、模型组、地塞米松组及贝母瓜蒌散组,每组10只;采用脂多糖(LPS)气管滴入加烟熏法制造COPD大鼠模型,为期30 d.从造模第8天开始,地塞米松组给予地塞米松注射液腹腔注射(2 mg/kg),贝母瓜蒌散组给予贝母瓜蒌散灌胃(20 ml/kg),1次/d,连续22 d,模型组予0.9% 生理盐水灌胃(20 ml/kg).Western印迹检测p38MAPK蛋白和MIP-T3蛋白的表达水平.结果 与正常组比较,模型组大鼠肺组织p38MAPK和MIP-T3的表达明显升高(P<0.05);与模型组比较,地塞米松组和贝母瓜蒌散组可降低大鼠肺组织中p38MAPK和MIP-T3的表达(P<0.05);而地塞米松组和贝母瓜萎散组p38MAPK和MIP-T3的表达无明显差异(P>0.05).结论 贝母瓜蒌散有抑制p38MAPK和MIP-T3表达的作用.

Objective:To assess the guiding role of preoperative visual analog scale(VAS) symptom scores in patients with chronic rhinosinusitis(CRS) during perioperative period.Method:The patients with CRS undergoing endoscopic sinus surgery were divided into experimental group and control group according to doctor group.Preoperative VAS symptom scores which including the overall symptom score and every single symptom scores were assessed. Patients with symptom(nasal congestion, nasal discharge, dizziness or headache, hypoamia or anosmia, rhinocnesmus, sneeze) scores more than 5 points were taken corresponding appropriate strategies in experimental group, but conventional empirical measures in control group during perioperative period.Nasal endoscopic surgeries were performed under local or general anesthesia after preoperative preparation. Postoperative followup were performed in six months and one year for the overall symptom and each symptom scores in both groups. SPSS17.0 was used for statistical analysis.Result:There was no statistical difference in general condition, overall symptom score and every symptom scores before operation between experimental group(120 cases) and control group(82 cases) (P >0.05). At the three time points (preoperative, six months, one year after operation), significant differences were found in the two groups about VAS overall symptom score (P <0.05). Except hypoamia, VAS for the other symptoms in different postoperative time showed statistical significance (P <0.05).Conclusion:Preoperative VAS symptom score can be used not only in the evaluation of severity and treatment effect,but also in the guiding of perioperative treatment for CRS, which is worthy of using widely in clinic.

Objective To investigate the therapeutic effect of aztreonam in the treatment of low respiratory tract infections.Methods The clinical records of 120 patients with low respiratory tract infections were analyzed.120 patients were randomly divided into 2 groups,the therapy group(60 cases) and the control group (60 cases).The control group was given cefoperazone sodium and sulbactam sodium for injection as routine therapy.The therapy group was given aztreonam for injection.The treatment course was 7-14 d for two groups.The therapeutic effects were investigated and compared after treatment.Results The total effective rate was 83.33%for therapy cases and 66.67%for control cases with siginificant difference(P < 0.05).Mild adverse reactions were occurred in the two groups,but spontaneously disappeared after ceasing drugs.Conclusion Using aztreonam in treating low respiratory tract infections is well effective and worthy of application to clinical practice.