聚合酶链反应检测血清及肝脏中丙型肝炎病毒核糖核酸的研究

本文报道了简便快速检测血清及肝脏中丙型肝炎病毒核糖核酸(HCV RNA)的聚合酶链反应(PCR)方法。检测单浆献血员61例,其中抗-HCV阳性30例,检出血清HCV RNA阳性者17例;抗-HCV阴性31例,检出血清HCV RNA阳性者9例。检测6例血清HCV RNA阴性、抗-HCV阳性丙型肝炎患者的肝穿标本,发现4例HCV RNA阳性。说明本文所建立的PCR方法是诊断HCV感染的特异性强、敏感度高的一种新方法。检测肝组织内的HCV RNA可提高HCV RNA的检出率。本文还对标本的处理及如何避免假阳性等问题进行了讨论。     

丙型肝炎病毒核心抗原检测的临床应用探讨

[目的]探讨HCV核心抗原在HCV感染诊断和治疗中的作用。[方法]对173例HCV感染患者血清和82例健康对照者血清,使用ELISA法分别检测抗-HCV、总的HCV核心抗原,使用荧光定量RT-PCR检测HCV RNA。[结果]173例HCV感染者抗-HCV均为阳性。HCV RNA阳性率为49.7%(86/173);HCV核心抗原阳性率为36.4%(63/173)。二者差异有统计学意义(P<0.05)。86例HCV RNA阳性标本中,HCV核心抗原阳性60例(69.8%);HCV核心抗原阴性26例(30.2%)。82例健康对照者抗-HCV、HCV核心抗原、HCV RNA均为阴性。[结论]在没有HCV RNA检测资格的实验室,HCV核心抗原检测可作为病毒存在和复制的一个指标,作为抗-HCV检测的补充试验。     

广西部分地区人类免疫缺陷病毒感染者合并丙型肝炎病毒感染情况分析

目的 了解广西人类免疫缺陷病毒(HIV)感染者中HIV/丙型肝炎病毒(HCV)的混合感染率及其HCV RNA的阳性率,为今后HIV患者丙肝筛查及预防提供参考.方法 采用ELISA法检测HIV感染者血清中的丙肝病毒抗体,按结果分成抗-HCV(+)组和抗-HCV(-)组,再用巢式PCR法检测血清的HCV RNA,分析比较HCV RNA阳性率.结果 在300例HIV感染者中,有146例抗-HCV阳性,154例抗-HCV阴性;在抗-HCV阳性组中,HCV RNA的阳性率为78.08％(114/146);在抗-HCV阴性组中,HCV RNA阳性率为26.62％(41/154);ELISA法和巢式PCR法检测HCV感染的符合率为75.67％[(113+114)/300].结论 在广西的HIV感染者中HCV感染状况较严重.对HIV感染者进行丙肝筛查时,为减少漏诊率,建议采用PCR方法检测抗-HCV阴性血清中的HCV RNA.     

丙型肝炎病毒抗体与丙型肝炎病毒核糖核酸的关系

目的:研究丙型肝炎病毒抗体(抗-HCV)与丙型肝炎病毒核糖核酸(HCV RNA)的关系。方法:对38例抗-HCV阳性的丙型肝炎(HC)病人,用酶标仪测血清抗-HCVOD值,同时用逆转录-套式-聚合酶链反应(RT-nesled-PCR)检测血清HCVRNA。结果:38例抗-HCV阳性的HC病人中23例HCV RNA阳性,即60％的HC病人存在病毒血症;在不同的抗-HCV OD值范围内HCV RNA检出率不等。HCV RNA检出率随抗-HCV OD值增高而增加(P<0.01)。结论:①血清抗-HCV与血清HCV RNA之间有较好的一致性;②抗-HCV OD检测对HC的诊断及判断HC病人是否存在病毒血症有一定价值。     

PCR-BHEL技术的建立及对血清中丙肝病毒的检测

目的:探讨聚合酶链反应偶联印迹杂交和酶联放大技术(PCR-BHEL)在检测血液传染性病毒中的优越性。方法:采用PCR-BHEL检测129例抗-HCV阳性和45例抗-HCV阴性的血清标本,并将该项技术与逆转录聚合酶链反应(RT-PCR)的检测结果进行比较。结果:PCR-BHEL检测129例抗-HCV阳性标本的HCV RNA检出率为78.29%,45例阴性标本的HCV RNA检出率为6.67%;采用RT-PCR检测的HCV RNA检出率分别为62.02%和2.22%。PCR-BHEL技术对HCVRNA的检出率高于RT-PCR,差别有统计学意义(P<0.001)。结论:PCR-BHEL较RT-PCR技术的灵敏度高,能够有效地提高HCV RNA的检出率,可推广应用于其他传染性病毒的检测。     

献血员和非甲非乙型肝炎病人的抗—HCV

用抗-HCV EIA法检测献血员和非甲非乙型肝炎病人的抗-HCV。ALT异常献血员抗-HCV阳性率(37.5%)明显高于ALT正常献血员(2.9%),抗-HCV与ALT异常密切相关,提示用ALT加上抗-HCV筛选献血员将大大减少输血后NANBH的危险性。HCV是输血后和慢性NANBH的主要原因,是散发性NANBH的重要原因。抗-HCV检出率随着病程的延长而升高,但抗-HCV出现时间较迟。     

河北赵县献血村丙肝感染情况调查

目的了解1985年左右参与非法献血人数较多的赵县前大章乡城郎村村民受HCV感染的现状,为当地丙肝防治提供依据。方法采用横断面调查方法 ,将户每位成员基本情况录入数据库。采集每位村民4mL血清,现场分离血清,并检测血清ALT、抗-HCV抗体。结果河北赵县献血村人群抗-HCV阳性率为26.72%;感染人群主要集中在40~60岁之间;献血员抗-HCV阳性率高于非献血员;不同献血类型HCV感染情况不同,混合献血感染几率最大。抗-HCV阳性率随混合献血次数的增加而升高。结论河北赵县献血村HCV感染情况较严重,人群抗HCV感染率远高于全国水平。     

丙肝病毒感染者外周血抗-HCV与HCVRNA测定结果比较

多年来,抗-HCV检查已成为筛选献血员的常规项目之一,但输血后丙肝仍屡见不鲜.我们对78例非甲非乙型肝炎患者 进行了检查,发现抗-HCV阴性40例中,HCV RNA阳性11例,现报道如下. 1 材料和方法①病例选择:根据1995年在北京修订的<病毒性肝炎防治方案>诊断标准,选择非甲非乙型肝炎病毒感 染患者78例,皆为1996年7月～1999年12月在我院住院的患者,其中肝硬化12例,肝癌5例,肝炎61例.②方法:78例 患者皆行外周血HCV RNA检测及抗-HCV检则.HCV RNA采用反转录-聚合酶链反应(RT-PCR).抗-HCV采用第二代酶 联免疫吸附试验诊断盒. 2 结果 78例患者中,抗-HCV阳性38例,占48.7%,HCV RNA阳性32例,占41.0%.抗-HCV阳性38例中HCV RNA阳性21例,占26.9%,抗-HCV阴性40例中,HCV RNA阳性11例.占14.1%. 3 讨论丙型肝炎患者外周血中抗-HCV、HCV RNA可单项存在,亦可重叠存在.Sakamoto等报道抗-HCV阳性的 血液透析患者有25.0%HCV RNA阳性,这是因为丙肝一部分可自愈,但抗原消失后一段时间抗体才转阴,因此丙型肝炎 抗-HCV阳性患者不能确定何时感染上丙型肝炎及目前是否有传染性.丙肝病毒感染后,HCV RNA检出时间早于抗-HCV阳 转时间,而且敏感性高于后者,是一种早期、灵敏及特异的HCV感染诊断方法. 丙型肝炎存在输血及非输血感染途径.输血与血制品是感染丙肝的重要途径.同时进行抗-HCV及HCV RNA检测,可     

定量PCR与EIA法检测血液透析患者HCV比较

目的 探讨血液透析患丙型肝炎病毒（HCV）的检测方法。方法 对79例尿毒症长期血液透析患,采用荧光定量PCR法测定血清HCV-RNA水平,及第二代酶免疫试验（EIA）检测丙型肝炎病毒抗体（抗-HCV）。结果 血液透析患抗-HCV阳性率22.8%(18/79),荧光定量PCR法HCV-RNA检出率39.2%(31/79）。在抗HCV阴性的患中,HCV-RNA的检出率为42.6%(26/61)。两种方法检测结果的符合率为50.6%(40/79)。结论 荧光定量PCR技术可弥补EIA检测的不足,在抗-HCV阴性的血液透析患中检测HCVRNA具有重要意义。     

丙型肝炎病毒检测与抗体检测的比较

应用ELISA法检测抗-HCV抗体的阳性检出率不及PCR法检测HCV RNA。据文献报道HCV的感染率高于抗-HCV抗体检测的结果,而PCR法可检出携带者血内少量的丙型肝炎病毒,因此被视为较有效的检测手段。我们对本院各科送检丙型肝炎的部分标本及少量献血员标本进行抗-HCV抗体和HCVRNA的检测,以比较两种方法在临床检验中的意义。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.