【Abstract】Objective To explore the feasibility that the recipient against donor antigen-specific T lymphocytes clones are formed,and the suicide genes are induced into the clone. In the end it may induce the transplanted-organ tolerance. Methods The recipient rats were immunized by the donor rats-splenocytes, then the recipient’s T cell were isolated, purified and diluted with limited-dilute methods into single cell.The T cells were cultured by adding raise cells,ConA or IL2 under the different concentration and at last the T cell clone were formed. Results A stable recipient against donor antigen-specific T cell clone was established. The difference among the different immune groups was very significant(tgt;t0.05). The T cell clone was not formed without raise cells or only with raise cells. The rare clone could be formed by ConA stimulation but without IL-2. The clone-forming rate was associated with concentration of IL-2. ConclusionThe mature T cell is able to proliferate to form clone when the condition is suitable. The recipient is immunized with donor rats spleen cellular antigen. The T cells clones selected in the end are donor antigen-specific.
目的：对鲍曼不动杆菌感染的临床特征和耐药性进行分析，为临床诊治提供参考。方法：对2005年1月～2006年6月我院临床分离的共107株鲍曼不动杆菌通过琼脂对倍稀释法进行MIC测定；同时对相应的临床病例进行回顾性分析。结果：107株鲍曼不动杆菌大多分离自痰液，主要来自于ICU病房；且91.59%的患者同时存在2种以上基础疾病。鲍曼不动杆菌对氨曲南耐药率最高，为89.72%，依次是头孢西丁(87.85%)，头孢哌酮(76.64%)、哌拉西林(69.16%)、头孢噻肟(65.42%)、环丙沙星(65.42%)、阿米卡星(56.07%)、头孢他定(5514%)等。结论：我院鲍曼不动杆菌耐药情况严重，治疗首选碳青霉烯类抗生素，其次可选用头孢吡肟、头孢哌酮/舒巴坦。
目的:旨在评价预注维库溴铵联合稀释依托咪酯减轻依托咪酯全麻诱导中肌阵挛的效果。方法:本研究为前瞻性、双盲、随机对照研究。80名ASA I-II级、年龄18～60岁、拟行胆囊切除术的全麻患者被随机分为4组:组1,预注维库溴铵0.01 mg/kg;组2,依托咪酯用生理盐水由2 mg/mL 稀释为1 mg/mL;组3,预注维库溴铵联合稀释依托咪酯;组4,生理盐水对照组+非稀释依托咪酯组。根据分组给予患者预注维库溴铵0.01 mg/kg或同等量的生理盐水,观察并询问患者有无呼吸困难,并记录呼吸频率和脉搏氧饱和度(SpO2)。3分钟后推注稀释或无稀释依托咪酯0.3 mg/kg,询问患者有无注射痛并做疼痛评分,观察有无肌阵挛并评估其程度。2分钟后给予维库溴铵0.1 mg/kg、芬太尼3 μg/kg和丙泊酚1 mg/kg行气管插管。实验期间同时记录无创动脉血压(BP)和心率(HR)。结果:组1和组4分别有2例(10%)和3例(15%)患者述轻度注射疼痛,而组2和组3无患者述注射疼痛。组1、组2和组3肌阵挛的发生率明显低于组4(30%、40%和15% vs 70%,Plt;0.05)。且组1、组2和组3肌阵挛的程度多为轻中度,而组4多为中重度。四组患者均未述任何呼吸困难,呼吸频率无明显降低,SpO2无明显变化。四组患者BP和HR变化一致,无明显差别。结论:预注小剂量维库溴铵或稀释依托咪酯可明显降低依托咪酯引起肌阵挛的发生率并减轻其程度。且这两种方法联合应用比单独应用效果更佳,具有一定程度的协同作用。
ObjectiveTo investigate the clinical significance of cardiac function index (CFI) and global ejection fraction (GEF), derived from single-indicator transpulmonary thermodilution technique, in assessment of cardiac function in critically ill patients. MethodsA prospective clinical observational study was conducted in the Intensive Care Unit of the First Affiliated Hospital of Guangzhou Medical University. Between January 2012 and December 2012, 39 patients who underwent PiCCO monitoring were recruited, including 18 cases with left ventricular systolic dysfunction and 21 cases without left ventricular systolic dysfunction. Both groups underwent transpulmonary thermodilution measurements and transthoracic cardiac ultrasonography. Pearson correlation analysis was conduced to assess the correlation between left ventricular ejection fraction (LVEF) and CFI and GEF. ROC curve was established to calculate the predicted threshold of CFI and GEF for diagnosing cardiac insufficiency. ResultsLVEF was significantly correlated with CFI and GEF (r=0.553, P < 0.005; r=0.468, P < 0.005). The area under ROC curve of CFI, GEF and LVEF for diagnosing cardiac insufficiency was 0.885, 0.862 and 0.903, respectively (P > 0.05 for comparison). The cut-off value of CFI for predicting cardiac insufficiency was 4.25/min, with a sensitivity of 77.8% and a specificity of 88.9%. The cut-off value of GEF for predicting cardiac dysfunction was 19.5/min, with a sensitivity of 88.9% and a specificity of 66.7%. ConclusionCFI and GEF measured by transpulmonary thermodilution correlate well with LVEF assessed by transthoracic echocardiography, both can be used for assessment of left ventricular systolic function.