结节性肺淀粉样变PET/CT显像二例

病例1 患者男,66岁,汉族,因“胸闷、气短、乏力伴双下肢肿1周”入院.血清蛋白电泳提示:IgG伴游离轻链型M蛋白血症.血清免疫固定电泳:γ区出现M条带,血β2-微球蛋白760[正常参考值(以下括号中同)3.2～6.5] mg/L,尿κ轻链8.8(0 ～7.1) mg/L,尿L轻链394 (0～ 3.9) mg/L,尿本周蛋白(+).肝功能、肾功能及肿瘤标志物出现异常.肝功能:总胆红素53.1(5.0 ～28.0)μmoL/L,直接胆红素40.6(0 ～7.0) μmol/L;肾功能:血尿素8.81(1.8 ～7.1) μmol/L,SCr 145(53～106) μmol/L,尿酸430.4( 150～420) μmol/L;肿瘤标志物:铁蛋白1952(16.4～323.0) g/L、CA-125 261.7(＜35) kU/L,CEA 18.75(＜5) g/L,CA19-9 41(0～35) kU/L.     

高原地区汉族和藏族健康女性性激素水平调查

目的:了解高原地区健康汉族和藏族女性性激素水平.方法:在青海省果洛州大武镇(海拔3 680m)抽取受试者的血液,采用化学发光法测定血清睾丸酮(T)和雌二醇(E2)的含量,比较不同年龄段汉族和藏族女性间T和E2的差异.结果:汉族和藏族不同年龄段比较,T含量无显著性差异,E2在(40～)岁、(50～)岁年龄段汉族明显低于藏...     

维吾尔族与汉族上消化道出血327例胃镜分析

1993～ 1 999年 ,我们对 3 2 7例维汉族的上消化道出血病人进行病因分析 ,发现维汉民族之间出血原因及部位不尽相同 ,现报告如下。1　资料与方法本组男 2 0 7例 ,女 1 2 0例 ,维吾尔族 1 1 8例 ,汉族 2 0 9例 ;年龄 1 3～ 74岁 ,平均 4 1 .5岁。按年龄分为四组 :儿童组 <1 4岁 ,4例 ( 1 .2 % ) ;青年组 1 4～ 3 9岁 ,1 2 5例 ( 3 8.2 % ) ;中年组4 0～ 59岁 ,1 3 7例 ( 41 .9% ) ;老年组 >59岁 ,61例 ( 1 8.7% )。其中呕血伴黑便 1 45例 ,单纯黑便 1 82例 ,均伴有不同程度的头晕、心悸、口渴等周围循环不良的表现。出血 1 2ｈ内受检者 4 4例…     

茶多酚和维生素C对FeSO4-半胱氨酸诱发离体人血浆脂质过氧化及CCl4诱发肝自由基损伤的抑制作用

目的观察不同剂量的茶多酚 (TP)、维生素C(VitC)对FeSO4 半胱氨酸诱发离体人血浆脂质过氧化及CCl4诱发肝自由基损伤的抑制作用。方法 ( 1 )在FeSO4 半胱氨酸诱发离体人血浆脂质过氧化损伤体系中 ,分别检测 0 .3、0 .9、2 .7、8.1mg/L(C～F组 )的TP及 3、9、2 7、81mg/L(G～J组 )的VitC对该体系过氧化脂质 (MDA)生成的影响 ;( 2 )雄性昆明种小鼠 36只 ,随机分为 4组 (n =9) ,分别为空白对照组 (A)、单纯损伤组 (B)、茶多酚 1 0 0mg/kg组 (C) ,以及VitC 1 0 0mg/kg组 (D)。除空白对照外 ,用药组以相应剂量的防护药物灌胃 1次 /日 ,共 3次。末次灌胃 1 2h后 ,除空白对照外 ,其他 3组均用 2 30mg/kg的CCl4灌胃 ,36h后 ,各组小鼠均断头处死 ,分别检测肝匀浆中MDA的含量。结果TP、VitC均可剂量相关地抑制FeSO4 半胱氨酸诱发的离体人血浆脂质过氧化损伤 ,其中TP抑制率分别为30 .7% ,32 .0 %、46.9%、59.7% ;VitC的抑制率分别为 8.3%、41 .4%、47.7%、52 .7%。在CCl4诱发肝自由基损伤体系中 ,同等剂量的TP、VitC对MDA的抑制率分别为 45.2 %、42 .8%。结论在FeSO4 半胱氨酸诱发的人离体血浆过氧化损伤体系中 ,TP( 0 .3～ 8.1mg/L)及VitC( 9～ 81mg/L)对脂质过氧化均有明显的抑制作用 (P <0 .0 1 ) ;同等剂量下 ,T     

辐射诱导大鼠大脑皮质中转录因子的激活

目的 :检测电离辐射对大鼠脑损伤中相关转录因子 AP-1、Sp- 1、p5 3和 NF- κB的 DNA结合活性的作用。方法 :选择约 2 5 0 g雄性 Sprague- Dawley大鼠和对照大鼠 ,肌注 6 .36 mg/ m L氯胺酮、3.6 mg/ m L xylazine和 0 .6 7mg/ m L阿托品 (0 .15 m L / 10 0 g体重 )溶液进行麻醉 ,然后 ,实验大鼠接受 1 37　 Cs射线 5～ 30 Gy全身照射 (3.8Gy/ min)。另选择一组实验大鼠 ,照射但不麻醉。大鼠在照后 2～ 2 4h断头 ,分离大脑皮质提取核蛋白。用电泳迁移率分析 AP- 1、Sp- 1、p5 3和 NF- кB的 DNA结合活性 ;提取大脑皮质的总 RNA,…     

诺氟沙星致药物性肝炎1例

1　病例报告患者男 ,71岁。自述于入院前 3天因“泌尿系感染” ,自服诺氟沙星 0 2g ,4次 /天。 2天后停服 ,因出现皮肤及黏膜黄染 1天而就诊。患者无发热及厌油腻等症状 ,既往无肝病史及输血史。查体 :皮肤黏膜轻度黄染 ,未见肝掌及蜘蛛痣 ,巩膜黄染 ,肝脾肋下均未触及 ,莫氏征 (- ) ,肝区无叩痛。辅助检查 :血清丙氨酸转氨酶 (ALT) 6 6 1U/L(正常值 5～ 4 0U/L) ;总胆红素 (TBIL) 10 7 9mmol/L(正常值 0～ 2 0mmol/L) ;直接胆红素 (DBIL) 39 5mmol/L(正常值 0～ 8mmol/L) ;碱性磷酸酶 (ALP) 2 0 0U/L(正常值 2 5～ 90U/L) ;转…     

C-反应蛋白在急性冠状动脉综合征中的应用价值

目的　探讨C 反应蛋白在急性冠状动脉综合征中的应用价值。方法　分别检测稳定型心绞痛 3 6例 ,不稳定型心绞痛 2 4例 ,急性心肌梗死急性期 (1个月内 ) 5 7例 ,急性心肌梗死恢复期 (1年内 ) 44例及 5 9名健康人的C 反应蛋白。结果　急性心肌梗死急性期与不稳定型心绞痛分别为 (19 2 2± 13 0 3 )mg/L和 (15 47± 12 61)mg/L ,与对照组 (3 63± 2 5 9)mg/L相比 ,差异非常显著 (P <0 0 1)而稳定型心绞痛 [(4 .2 4± 5 .3 0 )mg/L]与急性心肌梗死恢复期 [(6 0 3± 8 43 )mg/L]与对照组比较 ,无显著差异 (P均 >0 0 5 )。结论　C 反应蛋白作为急性心肌梗死和不稳定型心绞痛的预报因子是敏感和可靠的。     

单剂量口服奥美拉唑在中国蒙古族和汉族健康人体的药代动力学

目的研究蒙古族和汉族健康受试者单剂量口服奥美拉唑肠溶片的药代动力学。方法健康蒙古族和汉族受试者各10名,男、女各半,单剂量口服奥美拉唑肠溶片40mg后,于不同时间点采集静脉血,经血浆样品处理后用反相高效液相色谱法测定人血浆中奥美拉唑的浓度。用DAS2．0药动学软件进行数据处理,SPSS11．5软件进行统计分析。结果蒙古族受试者的主要药动学参数分别为Cmax为（942．54±297．46）mg·L^-1。;Tmax为（3．05±1．21）h;t1/2（1．8±1．01）h;AUC0-12为（2325．08±1322．42）mg·h·L^-1;AUC0-∞为（2381．40±1355．00）mg·h·L^-1。汉族受试者的主要药动学参数分别为Cmax为（760．49±581．23）mg·L^-1;Tmax为（2．70±0．82）h;t1／2（1．60±1．28）h;AUC0-12为（1437．61±798．05）mg·h·L^-1;AUC0-∞为（1470．09±769．48）mg·h·L^-1。结论蒙古族受试者、汉族受试者的Cmax,AUC（0-12）,AUC（0-∞）个体间差异较大,但统计学分析结果显示两民族主要药动学参数无统计学意义。     

高原与低浓度一氧化碳联合作用对汽车驾驶员神经行为功能的影响

本文采用自身对照方法,对低浓度一氧化碳驾驶环境中汽车驾驶员分别在海拔2800m、3650m、和4600m地区进行了神经行为功能测试,在三个海拔高度,当驾驶室内气温和风速无明显变化,一氧化碳浓度分别为21.8mg/m~3、23.3mg/m~3、24.7mg/m~3时,驾驶员的神经行为功能随海拔增高而明显变化,消极情绪得分不断增加、积极情绪得分逐渐减少;反映驾驶灵敏度、注意力和精确性的指标得分显著下降;反应时间延长、记忆力减退。三个海拔之间相比较,其差异多数有显著性意义。提示高原低氧环境与低浓度一氧化碳联合作用可使汽车驾驶员的驾驶能力下降,影响行车安全。     

大黄煎剂对多发伤并严重感染患者血中内毒素、白细胞介素-6和一氧化氮的影响

目的　观察多发伤并严重感染患者血中内毒素 (LPS)、一氧化氮 (NO)、白细胞介素 -6 (IL - 6 )变化及探讨大黄煎剂的治疗作用。　方法　 75例多发伤并严重感染患者随机分为治疗组和对照组 :对照组 (38例 )应用常规治疗 ;治疗组 (37例 )在常规治疗的基础上 ,自第 4天起应用大黄煎剂 (10 0ml,口服 ,2次 d)治疗。观察两种方法治疗后LPS、NO、IL - 6的变化。　结果　 (1)两组患者血中 3项指标均明显升高 ,对照组LPS为 (15 .2 6± 4 .0 1)～ (40 .2 4± 4 .4 7)ng L、NO为 (5 5 5 .91± 12 4 .70 )～ (72 1.5 9± 2 5 5 .33)mg L、IL - 6为 (0 .10± 0 .0 2 )～ (5 4 3.2 3± 319.75 )ng L ;治疗组LPS为(15 .74± 3.81)～ (41.35± 4 .16 )ng L、NO为 (5 4 2 .70± 139.2 1)～ (74 9.37± 2 91.80 )mg L、IL - 6为(0 .11± 0 .0 2 )～ (5 79.18± 4 0 5 .4 3)ng L ,两组间比较差异无显著性意义 (P >0 .0 5 )。 (2 )治疗组应用大黄煎剂后 ,3项指标均逐渐下降 ,LPS为 (2 1.0 7± 3.6 5 )～ (17.0 4± 5 .91)ng L、NO为 (6 0 4 .35±2 13.72 )～ (5 91.15± 136 .31)mg L、IL - 6为 (2 15 .5 4± 110 .6 5 )～ (10 0 .6 8± 95 .4 4 )ng L ,而对照组 3项指标有继续增高趋势 ,两组比较差异有非常显著性意义或显著     

Driving under the influence of alcohol. A 5-year overview in Piedmont,Italy

Alcohol consumption represents a major health issue worldwide and a crucial factor in road accidences. This study provides information on the prevalence of alcohol in blood testing performed on 2752 subjects involved in vehicle accidents, which occurred in Piedmont (northern Italy) between 2008 and 2013. Blood alcohol concentration (BAC) was determined by an ISO 17025 accredited GC/MS procedure. Fifty-one % of positive samples showed BAC concentrations above 1.5 g/L, with a legal cut-off fixed at 0.5 g/L (and 0 g/L for specified categories such as novice and professional drivers). BAC values proved statistically different regarding the day of sampling (week or weekend days), age and gender, with a prevalence of positive results that reflects different drinking habits of a multifaceted population of alcohol consumers.     

Top ten defence challenges among drinking drivers in Sweden.

This paper gives a review and opinion about defence challenges arising during the prosecution of drinking drivers in Sweden. The statutory limit of blood-alcohol concentration (BAC) is two-tiered; 0.2 mg/g (21 mg/100 ml) and 1.5 mg/g (159 mg/100 ml). In rank order of occurrence, the top ten defence challenges are shown in Table I. The hip-flask defence occurs in more than 90% of all challenges. Because the burden of proof in Swedish law rests on the prosecution, the charge of driving under the influence of alcohol is often dropped when alleged drinking after the offence is an issue.     

Stellungnahme zur Studie „Cannabis im Straßenverkehr”

In his recent study “Cannabis im Straßenverkehr” Prof. Dr. Th. Daldrup was searching for reliable criteria assessment of drivers’ incapacity after Cannabis use. He proposed the “Cannabis influence factor” (CIF) as a measure of impairment of driving performance. The CIF is calculated from the formula: $$CIF = \frac{{\left( {THC + 11 - OH - THC} \right)}}{{THC - COOH \times 0.01}}$$ after determination of all analytes in blood (in molar concentration). A CIF value above 10 was said to be equivalent to an absolute incapacity to drive (like BAC of 1.1 g/l). The conclusions of the study, especially the immediate forensic use of CIF as a “cut-off value” for impaired driving, are not supported by the data presented and are questionable from the pharmacokinetical and methodological points of view. The forensic application of various combinations of analytical data as a measure of drivers’ performance after cannabis use obviously needs further, intensive study.     

Ultra-rapid rate of ethanol elimination from blood in drunken drivers with extremely high blood-alcohol concentrations

The rate of alcohol elimination from blood was determined in drunken drivers by taking two blood samples about 1 h apart. These cases were selected because the individuals concerned had reached an extremely high blood-alcohol concentration (BAC) when they were apprehended. This suggests a period of continuous heavy drinking leading to the development of metabolic tolerance. Use of double blood samples to calculate the elimination rate of alcohol from blood is valid provided that drunken drivers are in the post-absorptive phase of the BAC curve, the time between sampling is not too short, and that zero-order elimination kinetics operates. Evidence in support of this came from other drunken drivers in which three consecutive blood samples were obtained at hourly intervals. The mean BAC (N = 21) was 4.05 g/l (range, 2.71–5.18 g/l), and the average rate of alcohol elimination from blood was 0.33 g l⁻¹ h⁻¹ with a range of 0.20–0.62 g l⁻¹ h⁻¹. The possibility of ultra-rapid rates of ethanol elimination from blood in drunken drivers having extremely high BAC deserves to be considered in forensic casework, e.g., when retrograde extrapolations and other blood-alcohol calculations are made. The mechanism accounting for more rapid metabolism is probably related to induction of the microsomal enzyme (CYP2E1) pathway for ethanol oxidation, as one consequence of continuous heavy drinking. However, the dose of alcohol and the duration of drinking necessary to boost the activity of CYP2E1 enzymes in humans have not been established.     

上海地区汉族优秀游泳运动员ACE基因I/D多态性研究

目的:探讨上海地区汉族不同水平优秀游泳运动员ACE(血管紧张素转化酶)基因I/D多态性的分布特点。方法:采用PCR方法,对上海地区85名汉族优秀游泳运动员和90名汉族普通人的ACE基因I/D多态性进行检测。结果显示,上海地区汉族优秀游泳运动员的ACE基因的基因型和等位基因频率与上海和成都地区汉族普通人无明显差异(P>0.05);上海地区汉族游泳运动员和普通人以及成都地区汉族普通人的基因型和等位基因频率均与高加索人群存在高度显著性差异(P<0.0001),表现出明显的种族差异性。7名上海地区汉族国际健将ACE基因均为II型,运动水平越高的组别,II基因型和I等位基因频率越高,提示具有II基因型或I等位基因频率高的运动员经过多年运动训练,具有成为优秀运动员的可能,特别是II基因型的运动员可能性更大。     

急性冠状动脉综合征患者ALDH2基因型和红细胞体积分布宽度变化的关系

 目的 分析我国急性冠状动脉综合征(acute coronary syndrome, ACS)患者乙醛脱氢酶2(ALDH2)基因多态性与红细胞体积分布宽度(RDW)变化的关系。方法 收集128例ACS患者临床基线数据,按不同RDW区间进行分类,对患者相关的临床数据及ALDH2基因型分布频率,以及等位基因分布频率进行比较,并分析ALDH2基因多态性及冠状动脉病变严重程度与RDW水平的相关性。结果 将RDW按四分位数分为4组,不同RDW组间ACS患者其超敏C反应蛋白Q1~Q4组分别为:(4.12±0.77)、(5.89±0.89)、(5.01±0.76)、(7.66±0.95)mg/L和血肌酐Q1~Q4组分别为:(70.3±19)、(76.8±21)、(74.1±23)、(86.5±24)μmol/L,差异均有统计学意义(P<0.05)。4组间ALDH基因型分布差异有统计学意义(P<0.05),G和A等位基因分布的频率差异也有统计学意义(P<0.05)。ALDH基因型与Gensini积分呈显著相关(r=-0.154, P<0.05),ALDH2基因型多态性对RDW大小存在显著性影响(r=-0.386,P<0.05)。结论 我国ACS患者中ALDH2基因多态性与RDW存在密切的相关性。     

The effect of blood in the oral cavity on breath alcohol analysis

The theory that blood (containing alcohol) present in the oral cavity may falsely increase breath analysis recently led to a successful appeal against a drink driving conviction. Subjects who had previously consumed vodka (37.2% alc/vol), at 30 ml/10 kg and reached a BAC (blood alcohol concentration) of between 0.05 and 0.10% were then given four oral solutions consisting of a control (distilled water), and 0.05, 0.10 and 0.15% aqueous alcohol (ethanol) solutions, administered in coded form. A four-way cross-over, blind, randomized assay was conducted with the solutions, with breath analyses conducted in the presence or absence of solution in the mouth. The first trial group (n = 18) received 2 ml of solution, and we found that the simulated 0.15, 0.10 and 0.05% alcohol solutions in the mouth produced BAC reading increases of 0.0088 +/- 0.0014, 0.0062 +/- 0.0008 and 0.0055 +/- 0.0010% respectively (p < 0.001). The second trial group (n = 20) received 1 ml of solution and produced BAC reading increases of 0.0047 +/- 0.0011 (p < 0.001), 0.0023 +/- 0.0008 (p < 0.01) and 0.0020 +/- 0.0006% (p < 0.05) respectively. In conclusion, these studies indicate that small volumes of blood (containing alcohol) in the mouth would not have a practical effect on breath analysis readings.     

中国汉族正常成人视束的高分辨率MRI测量

目的 研究中国汉族正常成人视束MRI形态特征,为建立中国标准脑提供视束形态学测量数据.方法 采用全国多中心临床研究形式,选取18～70岁健康中国成年志愿者共1000名,按照年龄18～30、31～40、41～50、51～60、61～70岁分为A、B、C、D、E组,每组男、女各100例.所有受试者均行3D磁化强度预备梯度回波序列T1WI采集容积数据,再采用多基线技术最佳化显示视束结构及形态,测量视束各径线:视束脑池段横径(TD1)、视束大脑脚周段横径(TD2)、视束起点池段到大脑脚周段长度(L)、视束夹角(AOT),以及视束从前到后5个断面上下径(H):视束起始点层面上下径(H1)、视束池-前联合层面上下径(H2)、视束乳头体层面上下径(H3)、视束室间孔层面上下径(H4)、视束近外侧膝状体节段上下径(H5).不同性别及年龄分组的视束测量值比较采用协方差分析,左、右视束侧别的比较采用配对样本t检验分析.结果 (1)男、女性别间视束径线比较:男性左、右侧L分别为(11.69±1.45)、(11.56±1.44)mm,女性左、右侧L分别为(10.58±1.29)、(10.40±1.34)mm,男性左、右侧H1分别为(2.56±0.28)、(2.60±0.29)mm,女性左、右侧H1分别为(2.57±0.31)、(2.63±0.32)mm,以上测量指标在性别间差异有统计学意义(F值分别为22.236、29.703、11.130、7.805,P值分别为0.000、0.000、0.000、0.005),男性L大于女性,男性H1小于女性;余测量径线性别差异无统计学意义(P值均>0.05);(2)年龄分组比较:左、右侧TD1、右侧TD2在5个年龄分组的值分别为:左TD1为(4.64±0.51)、(4.64±0.57)、(4.55±0.58)、(4.39±0.53)、(4.36±0.58)mm;右TD1为(4.84±0.53)、(4.80±0.60)、(4.77±0.65)、(4.60±0.59)、(4.57±0.59)mm;右TD2为(3.33±0.45)、(3.34±0.41)、(3.33±0.36)、(3.23±0.38)、(3.23±0.39)mm,在年龄分组间差异有统计学意义(F值分别为3.458、2.735、4.711,P值分别为0.008、0.028、0.001),且两两比较结果为50岁前后差异有统计学意义(P值均<0.05);左、右侧L在5个年龄分组的值分别为:左L为(11.09±1.37)、(10.99±1.58)、(10.96±1.43)、(11.15±1.53)、(11.50±1.40)mm;右L为(10.88±1.35)、(10.79±1.62)、(10.83±1.45)、(11.04±1.52)、(11.34±1.51)mm,在年龄分组间差异有统计学意义(F值分别为14.510、14.532,P值均为0.000),两两比较结果为60岁前后差异有统计学意义(P值均<0.05);左TD2及双侧H1～H5年龄分组差异无统计学意义(P值均>0.05);(3)视束测量径线的左、右侧别比较:左、右侧TD1分别为(4.52±0.57)、(4.72±0.60)mm,左、右侧H1分别为(2.56±0.30)、(2.61±0.30)mm,左、右侧H2分别为(2.66±0.30)、(2.70±0.30)mm,左、右侧L分别为(11.14±1.47)、(10.98±1.50)mm,以上测量指标侧别差异均有统计学意义(t值分别为12.460、-6.013、5.595、4.784,P值均为0.000),双侧TD2、H3、H4及H5侧别差异无统计学意义(P值均>0.05).结论 高分辨率MRI 3D数据重组能清晰显示视束形态,能准确测量视束各段径线.     

Problems in blood alcohol testing of severely injured drivers brought to emergency departments in Japan

Breath alcohol tests are widely used to control DUI (driving under the influence) in Japan. However, this test is not applied to injured drivers transported to emergency hospitals. In such cases, BAC (blood alcohol concentration) testing should be done to prove DUI. In this paper, we tried to clarify two important issues on the BAC testing in Japan using a questionnaire survey and experiments about contamination of antiseptic ethanol. First, we have described the doctor's dilemma with DUI cases; our present questionnaire survey showed that the police often request the doctor to volunteer blood samples of the suspected drunk drivers brought to emergency hospitals since they have not been granted the right to order blood sampling in Japan. Then, doctors face a serious dilemma whether comply with the police request or not, resulting in widely different responses. Secondly, we have estimated the effects of antiseptic ethanol routinely used as a dermal antiseptic on the BAC tests. Our present experiments showed that uptake of ethanol can occur under certain conditions. Given the actual conditions outlined in the questionnaire, there seem to be a definite risk of ethanol contamination in BAC testing. Obviously, the time has come to discuss problems in BAC testing of injured drivers brought to emergency hospitals in Japan.     

中国北方汉族男子FECH基因IVS3-48T/C多态与有氧运动能力表型指标的关联性研究

目的:探讨亚铁螯合酶(FECH)基因IVS3-48T/C多态在中国汉族男性中的分布特征及其与耐力训练前后有氧耐力表型指标的关联,为提高耐力训练效果提供分子标记。方法:选取102名中国北方汉族男性健康受试者,以95%～105%个体无氧阈强度进行5000米跑训练,每周3次,共18周。训练前后测定VO2max、通气阈(VT)、跑节省化(RE)等指标。使用PCR-RFLP和测序方法解析该基因多态性的分布特征,并对该多态与上述生理指标进行关联性分析。结果:(1)3种基因型在中国北方汉族男性中的分布频率依次为CC基因型8%、TC基因型45%、TT基因型为47%;(2)耐力训练前,TT基因型RE/HR、RE/rVO2初始值均显著性低于CC基因型(P<0.05);(3)耐力训练后,TT基因型受试者在RE时的通气量(△RE/VE)的下降幅度显著高于CT基因型(P<0.05)。结论:FECH基因IVS3-48T/C多态性中,TT基因型具有较高的有氧运动能力起始水平,还有较高的训练敏感性,可作为预测有氧耐力训练敏感性的分子标记。