肾移植受者BK病毒感染的临床诊断

目的 探讨肾移植受者BK病毒感染的诊断方法、监测指标.方法 采集234例肾移植受者的血、尿样本,行BKV尿沉渣细胞学计数与实时荧光定量PCR检测方法.结果 234例受者的尿Decoy细胞、BK病毒尿症与病毒血症的阳性率分别为33.3%、33.3%和16.2%.尿Decoy细胞阳性者Decoy细胞中位数水平为6个/10HPF,BKV DNA阳性者尿液和外周血BKV中位数水平分别为7.62×103 copy/ml和7.61×103 copy/ml.尿液BKV阳性率较外周血明显升高(P=0.000).尿液Decoy细胞计数与尿液BKV含量相关(γ=0.59,P=0.000),但尿液和外周血中BKV含量无明显相关性(P=0.14).结论 肾移植受者易发生BKV再活化,定量尿沉渣细胞学检测简单、易行、敏感,可以做为BKV活化的指标,间接反映肾脏病理情况,也可检测血、尿BKV DNA了解病毒活化情况、筛查BKV相关的移植肾肾病.     

肾移植患者术后BK病毒感染的检测及危险因素分析

目的:检测肾移植患者术后BK病毒(BKV)感染率,分析BKV感染的危险因素.方法:收集63例肾移植患者术后第1、 2、3、4、6 和8个月的尿液和血液标本,实时荧光定量PCR方法检测标本中BKV DNA含量,并根据检测结果进行分组:尿液、血液BKV DNA均阳性者为UV PV 组,尿液阳性而血液阴性者为UV PV-组,尿液、血液均阴性者为UV-PV-组.尿沉渣涂片寻找含有病毒包涵体的脱落尿路上皮细胞(Decoy细胞),并对Decoy细胞进行细胞免疫学检测;对临床高度怀疑为BK病毒相关性肾病患者(BKVAN)行移植肾活检.比较3组患者的年龄、术前冷缺血时间、术前血透时间、免疫抑制方案、群体反应性抗体(PRA)致敏程度、术后是否合并其他病毒感染等临床指标的差异,应用Logistic回归法分析筛选BKV感染和BKVAN发生的危险因素.结果:UV PV-组19例(30.1%), UV PV 组患者9例(14.3%),UV-PV-组患者35例;前两组首次发现BKV的中位时间分别为术后4个月和3个月.63例患者Decoy细胞检出率为39.7%,Decoy细胞免疫染色阳性率为54.3%.1例移植肾活检未见BKVAN表现.Logistic回归法发现BKV DNA感染与冷缺血时间有显著联系(P=0.048;OR=1.151),与其他指标无显著相关(P=0.069).结论:实时荧光定量PCR能较好地监测术后BKV感染,术后3～4个月是BKV排泄高峰,术前冷缺血时间可能是BKV感染的危险因素之一,而术后免疫抑制方案对BKV感染可能无明显影响.     

多瘤病毒BK DNA监测在肾移植中的临床应用

[目的]探索建立一个简单便捷的血浆多瘤病毒Polyomavirus BK(BKV)感染的筛选方法并探讨其在肾移植中的临床应用.[方法]用PCR方法对40例行肾移植术的患者和15个正常人血浆中BKV DNA进行扩增检测和序列分析.[结果]扩增出的目的基因片段长度为18l bp,扩增结果与预期的片段大小一致.BKV的基因序列与GenBank中病毒的保守序列98%同源.15例正常人中BKV检测结果全部阴性;40例肾移植患者中有6例检测结果阳性,阳性率为15.0%,其中临床确诊为多瘤病毒相关性肾病(PAN)1例,发生率为2.5%.[结果]PCR方法检测血浆BKV DNA是反映肾移植患者术后感染多瘤病毒或体内多瘤病毒被激活并复制及评价肾病高危性的一个良好指标.     

BK多瘤病毒在肾移植受者中的感染特征

目的探讨肾移植受者术后BK多瘤病毒的感染特征和干预时机。方法回顾性分析2013年1月~2018年1月在本中心检测尿液 BKV载量≥1.0×104 copy/mL的157例肾移植受者的临床资料,选择69例同期接受移植且尿液BKV载量始终<1.0×104 copy/mL 肾移植受者作为对照。结果157例BKV感染再激活受者中出现尿BKV阳性60例（38.2%）、BKV尿症66例（42.0%）、BKV血 症31例（19.7%）。BKV阳性患者与BKV阴性患者相比,尿隐血阳性率更高,差异有统计学意义（P<0.05）。受者尿液BKV载量 变化率与他克莫司谷值血药浓度变化率呈正相关（r2=0.351, P<0.05）。首次发现BKV再激活时,BKV阳性患者平均eGFR低于 基线水平（eGFR=60 mL/min·1.73 m-2）。干预后至末次随访,尿BKV阳性组平均eGFR可恢复至正常值,BKV尿症组和BKV血症 组肾功能有所改善但均未达到基线水平。结论肾移植术后部分受者尿隐血阳性与BKV再激活状态相关,BKV载量对免疫抑制 剂血药浓度的改变敏感。在BKV复制早期进行干预,适度减少免疫抑制剂剂量,能够有效控制BKV复制、维持移植肾功能。     

肾移植受者BK病毒感染的临床诊断及治疗

目的 探讨肾移植受者BK病毒(BKV)感染的诊断及治疗方法.方法 选取肾移植术后48个月内的患者共227例.采集其血、尿样本,行BKV尿沉渣细胞学计数与实时荧光定量PCR检测病毒拷贝.对部分肾移植受者进行移植肾活检.将尿或血中BKV DNA阳性患者80例分成干预组(51例)与对照组(29例).干预组进行调整免疫抑制剂:19例环孢素A(CsA)减量,22例他克莫司(FK506)减量,10例FK506转换成CsA;对照组不进行干预,并且密切监测急性排斥反应.干预3个月后再次检测,比较组内和组间干预前后BKV活化指标的差异.结果 227例受者的尿decoy细胞、BK病毒尿症与病毒血症的阳性率分别为33.O%、33.5%和15.4%.干预组干预后尿decoy细胞、尿和血BKV数量的中位水平均为O,明显低于干预前(5.0个/10HP,1.50 x 104拷贝/ml,0拷贝/ml,均P<0.01).对照组观察前后尿decoy细胞、血BKV数量的中位水平差异无统计学意义(6.0个/10HPvs 5.0个/10HP、0拷贝/ml vs 0拷贝/ml,均P>0.05),尿BKV数量观察结束时上升(观察前:0.79×104拷贝/ml,观察后:2.21 x104拷贝/ml,P<0.01).上述各项指标干预前后的差值在干预组与对照组间差异均有统计学意义(均P<0.05).干预过程中所有患者均未出现急性排斥反应.确诊BKV相关性肾病4例,其干预治疗后尿decoy细胞计数以及血、尿BKV DNA均明显降低,移植肾功能有所恢复.结论 定量尿沉渣细胞学检测简单、易行、敏感,可以作为BKV活化的指标,间接反映肾脏病理情况.也可检测血、尿BKV DNA了解病毒活化情况、筛查BKV相关的移植肾肾病.减少免疫抑制剂剂量或换FKS06为CsA治疗肾移植术后BKV感染效果良好.     

自动核酸提取实时荧光定量PCR检测全血及血浆中EBV DNA载量的性能评价

目的探讨自动核酸提取实时荧光定量PCR方法检测全血及血浆中EBV DNA载量的方法学性能。方法评价自动核酸提取实时荧光定量PCR方法的线性范围、灵敏度、精密度及抗干扰等方法学性能,比较自动核酸提取法和煮沸提取法的相关性。用该方法检测152例EB病毒感染儿童的全血及血浆中的EBVDNA载量,比较分析全血与血浆中的EBVDNA载量关系。结果本法的线性范围为5×102~5×108Copies/ml,检测灵敏度为500 Copies/ml。批内CV为3.78%~4.57%,批间CV为6.35%~7.56%,总CV为7.24%~8.62%。肝素、胆红素、溶血对本检测方法均无干扰。EBVDNA载量在5×103~5×108Copies/ml范围内,本法()与煮沸提取法()的相关性良好(=0.924+0.873,2=0.900,<0.01),结果相差在1.0 logCopies/ml以内。80例EB病毒活动性感染组儿童,全血EBV DNA阳性率60%,血浆EBV DNA阳性率25%,全血EBV DNA阳性率高于血浆(=0.016);72例EBV非活动性感染组全血EBV DNA阳性阳性率5.6%,血浆EBV DNA阳性率0。活动性感染组全血EBV DNA阳性率高于非活动性感染组(<0.01)。结论自动核酸提取实时荧光定量PCR方法检测全血及血浆中的EBV DNA载量,具有灵敏高、抗干扰能力强、定量准确、操作简便的优点,适合临床实验室常规开展。     

实时荧光定量PCR检测乙型肝炎病毒DNA的临床应用价值

目的:探讨实时荧光定量PCR(FQ-PCR)检测乙型肝炎病毒DNA的临床应用价值.方法:采用FQ-PCR方法检测196例患者血清中HBV-DNA.结果:112例HBeAg( )/HBeAb(-)标本中FQ-PCR均阳性,HBV-DNA拷贝数1.08×107/ml;68例HBeAg(-)/HBeAb( )标本中,平均拷贝数6.12×105/ml,其阳性率为66.2%;16例HBeAg(-)/HBeAb(-)标本中,平均拷贝数为2.72×104/ml.结论:实时FQ-PCR可以实现准确定量,是了解HBV在体内复制和判断疗效的有利手段.     

定量PCR检测血清HBV-DNA与血清HBV标志物关系的研究

目的 :探讨定量PCR检测血清HBV -DNA与血清HBV标志物之间的关系及其临床意义。方法 :35 2例血清标本运用荧光定量PCR检测血清HBV -DNA及放射免疫法 (ELISA)检测血清HBV标志物。结果 :经荧光定量PCR检测 94例HBsAg、HBeAg、HBcAb均阳性的标本 ,其血清HBV -DNA全部阳性 ,DNA测值范围 4 .8× 10 5～ 2 .8× 10 8copy/ml;81例HBsAg、HBeAb、HBcAb均阳性的标本 ,其血清HBV -DNA4 3例阳性(阳性率为 5 3% ) ,DNA测值范围 1.0× 10 4～ 1.4× 10 7copy/ml;39例HBsAg、HBcAb阳性的标本 ,其血清HBV-DNA2 4例阳性 (阳性率为 6 1% ) ,DNA测值范围 3.5× 10 3 ～ 1.6× 10 7copy/ml;10 0例HBVM全阴性的标本 ,血清HBV -DNA全部阴性。结论 :荧光定量PCR检测血清HBV -DNA准确灵敏 ,可反映乙肝患者病程变化 ,对于乙肝临床诊断、治疗方案的选择、疗效观察及预后判断有极其重要的作用。     

实时荧光定量PCR法检测肾移植术后BK病毒感染及意义

目的检测肾移植患者术后BK病毒DNA并探讨其临床应用价值。方法应用实时荧光定量聚合酶链反应(PCR)对86例同种异体肾移植患者术后血液及尿液标本进行BK病毒DNA检测。结果 86例肾移植患者中,尿BK病毒DNA阳性12例(14.0%),血液BK病毒DNA阳性6例(7.0%)。BK病毒DNA血、尿均为阳性5例患者中有4例经肾脏穿刺病理活检确证为BK病毒相关性肾病(BKVAN)。结论尿液BK病毒检测能够早期发现BK病毒感染,结合血液BK病毒检测为早期诊断、治疗并预防肾移植术后BKVAN提供重要的依据。     

乙肝产妇乳汁HBV DNA定量检测的意义

目的 探讨乙肝产妇乳汁中乙肝病毒标志物(H B V-M)和H B V-D N A的关系,从而正确指导乙肝产妇产后母乳喂养.方法 采用时间分辨荧光免疫定量分析法(TRFIA)检测乙肝产妇血清中的HBV-M,采用荧光定量PCR 法(FQ-PCR)检测血清及乳汁中HBV-DNA含量情况.结果 100例乙肝阳性产妇大三阳的血清与乳汁HBVDNA阳性检出率为100%,二者HBVDNA含量为最高,小三阳组HBVDNA阳性率分别为87.2%和84.6%,HBsAg/HBcAb组的阳性率分别为88.9%和86.1%,后两组血清HBV DNA含量分别为4.57×105和5.84×106copy/ml,乳汁HBV DNA分别为4.40×105和5.98×106 copy/ml.结论 乙肝产妇产后能不能母乳喂养与产后产妇血清和初乳中HBV-DNA情况有关,根据检测结果 决定喂养方式,以保证分娩婴儿的安全哺乳环境.     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Analysis of CK-19,PDX-1,Nestin,Ngn3 in different donor islet purity in rats

Objective: To investigate if there are the CK-19, PDX-1, Nestin, Ngn3 positive cells in the donor islets of different purity in rats. Methods: Thirty male adult SD rats were randomly divided into 3 groups. Islets were isolated using digestion by ductal injection of collagenase. Group Ⅰ (n=10): Separating cell preparations were not purified, Group Ⅱ(n=10): Islet sediment was purified with 25% Ficoll400 ,Group Ⅲ (n=10): Islet sediment was purified with 25% and 11% Ficoll-400. The levels of protein of CK-19, PDX-1, Nestin and Ngn3 were detected by immunohistochemistry and the mRNA of CK-19, PDX-1, Nestin, Ngn3 was amplified by RT-PCR. Results: After two different purification methods applied, three islet preparations of different purities were obtained. The difference of islet purity was significant among various groups (P＜0.05). Compared with group Ⅱ and group Ⅲ,the protein and mRNA of CK-19, PDX-1, Nestin,Ngn3 were both higher in group Ⅰ; group Ⅲ was poorly expressed. Conclusions: The three different islet purity donor islet have different CK-19, PDX-1, Nestin, Ngn3 positive cells within them, indicating that there are some islet stem cells in the purified donor islet.     

A preliminary screening study on the associated proteins in human psoriasis vulgaris by serum proteomics technologies

Objective：To investigate the optimum screening conditions of associated proteins in human psoriasis vulgaris by serum proteomics technique, and to screen the different expression proteins related with psoriasis vulgaris. Methods：Serum samples of peripheral blood were collected from newly diagnosed psoriasis vulgaris patients in the clinic, and 20 matched healthy persons. Serum albumin IgG was removed by filtering with ProteoExtract Albumin/IgG. After comparative proteomics analysis the different protein spots were identified using 2-DE and MS. Results ：Electrophoresis figures with high resolution and reproducibility were obtained. Three different expression proteins were found only in the serum from psoriasis vulgaris patients, while nine other different proteins expressing from healthy volunteers. Conclusion：The protein expression was different in the serum between the psoriasis vulgaris patients and healthy volunteers. It was hoped that we could find the biomarkers related to psoriasis vulgaris by using proteomics.     

A CASE OF HUGE GASTRIC DISOPYROBEZOAR

PYTOBEZOARS are common bezoars in gastrontestinal tract, commonly seen in stomach and mall intestine,1but huge disopyrobezoars are     

Acupuncture Treatment of Chest Bi Syndrome

CASE HISTORY A male,a retired officer of 61 years old,paid his first visit on May 12,2006.The patient stated that 2 weeks before he suddenly got paroxysmal precordial choking pain,with irregular attacks.Each attack would last several seconds to several minutes.The attack was accompanied with heavy oppressed sensation in the precordial region,palpitation,lassitude,and in severe cases,sweating,which was once diagnosed by a hospital as'coronary heart disease'.Recalling the case history,the patient said that several days before he got angry with others because of some affairs in work,and he was not so used to the life pattern since he had just retired from his busy working post.At usual times,he was quick tempered and peevish.In recent days,he had poor appetite,and loose stool.     

Instructions to Contributors

The English edition of Chinese Journal of Integrative Medicine is edited and published by the Chinese Journal of Integrated Traditional and Western Medicine Press.Original scientific papers of advanced clinical and experimental medicine in the field of complementary/alternative medicine or integrative medicine are expected.     

Development Is A High Level Inheritance for China Time-honored Brand Products

<正>As culture is the soul of a nation,the three books,"History of Chinese Philosophy,""History of Chinese Culture"and"History of Chinese Science and Technology"have demonstrated the superiority of our great Chinese culture,and its significant impact in the field of international culture.Both core value and practical value of the Chinese culture are very clear,reflected in the views of universe,nature,life,health,disease,and therapy and related considerations,concepts,and technical methods.