抗病毒治疗对乙型肝炎病毒感染者肾移植术后临床转归的影响

目的 探讨乙型肝炎病毒感染者肾移植术后临床转归及治疗对策.方法 将术前乙肝病毒标志物阳性(HBsAg阳性、HBeAg阳性或HBeAb阳性、HBV DNA阳性或阴性)的32例肾移植术后患者分为抗病毒治疗组和无抗病毒治疗组两组.观察两组(术前1周至术后9年)的肝功能(ALT、AST、TBIL、PT)变化、病毒复制(HBV DNA)及存活情况.结果 抗病毒治疗组23例患者肝功能损害复常率为82.60%,存活率为82.60%,HBV DNA(PCR法)下降(≥2 log10)或保持低复制率为86.95%;未抗病毒组9例患者肝功能损害复常率为22.22%,存活率为11.11%,HBV DNA(PeR法)下降(≥2log10)或保持低复制率为11.11%.抗病毒组肝功能复常率、存活率及HBV DNA下降或保持低复制率高于无抗病毒组,两组比较差异有统计学意义(P<0.05).19例拉米夫定治疗患者6例出现病毒学反弹31.58%,1例加用阿德福韦酯,2例换用恩替卡韦后好转,其余3例肝功能衰竭死亡.结论 持续有效的抗病毒治疗可以有效控制乙肝病毒复制,促进肝功能恢复,减少肝衰竭发生,提高乙肝病毒感染者肾移植术后患者存活率.在治疗过程中出现病毒学反弹应及时换用或加用有效药物减少肝衰竭发生.     

慢性乙肝患者血清趋化因子RANTES水平与肝功能生化指标等的相关性研究

Objective To investigate the level of the serum chemokine RANTES and its correlation with serum biochemical indices of liver function test, HBeAg and HBV DNA load in patients with chronic hepatitis B.Methods 144 patients with chronic hepatitis B (observed group) and 18 normal cases (control group) were enrolled in this study. The serum level of chemokine RANTES was detected with an ABC-ELISA assay. Statistical analysis was performed on the software of SPSS13.0. Results The serum chemokine RANTES level in the observed group (3930.12 ng/ml±2856.96) ng/ml was significantly higher than that in the control group (329.46 ng/ml±152.23) ng/ml. The results from the observed group indicated the positive correlation of serum RANTES level with indices of liver function test, including ALT (r=0. 197, P=0.018), AST(r=0.239, P=0.004) and TBil (r=0.316, P=0.001), but did not with PTA (r=-0.078, P=0.357). Neither difference of serum chemokine RANTES level between HBeAg-positive group and HBeAg-negative group nor that between high HBV DNA load group (≥105 copies/ml) and low HBV DNA load group (< 105 copies/ml) were statistically significant (P=0.407 and 0.185, respectively). Conclusions Serum chemokine RANTES level in patients with chronic hepatitis B elevates significantly and is not affected by HBeAg or HBV DNA load. Its positive correlation with indices of liver function test indicates that RANTES might play an important rule in the pathogenesis of chronic hepatitis B.     

抗病毒治疗对乙型肝炎病毒感染者肾移植术后临床转归的影响

目的 探讨乙型肝炎病毒感染者肾移植术后临床转归及治疗对策.方法 将术前乙肝病毒标志物阳性(HBsAg阳性、HBeAg阳性或HBeAb阳性、HBV DNA阳性或阴性)的32例肾移植术后患者分为抗病毒治疗组和无抗病毒治疗组两组.观察两组(术前1周至术后9年)的肝功能(ALT、AST、TBIL、PT)变化、病毒复制(HBV DNA)及存活情况.结果 抗病毒治疗组23例患者肝功能损害复常率为82.60%,存活率为82.60%,HBV DNA(PCR法)下降(≥2 log10)或保持低复制率为86.95%;未抗病毒组9例患者肝功能损害复常率为22.22%,存活率为11.11%,HBV DNA(PeR法)下降(≥2log10)或保持低复制率为11.11%.抗病毒组肝功能复常率、存活率及HBV DNA下降或保持低复制率高于无抗病毒组,两组比较差异有统计学意义(P<0.05).19例拉米夫定治疗患者6例出现病毒学反弹31.58%,1例加用阿德福韦酯,2例换用恩替卡韦后好转,其余3例肝功能衰竭死亡.结论 持续有效的抗病毒治疗可以有效控制乙肝病毒复制,促进肝功能恢复,减少肝衰竭发生,提高乙肝病毒感染者肾移植术后患者存活率.在治疗过程中出现病毒学反弹应及时换用或加用有效药物减少肝衰竭发生.     

胸部体表导纳变化与胸腔中血管导纳变化的关系

目的：探讨胸部体表导纳变化与胸腔中血管导纳变化的关系。方法：根据导纳与阻抗互为倒数的关系，导出胸部体表导纳变化公式，并用模型实验证明。结果：单根血管在胸部体表引起的导纳变化与血管本身的导纳变化和基础导纳的比值成正比，与血管的长度和胸部体表两检测电极之间的基础导纳成正比，与血管到两检测电极连线的距离成反比；多根血管在胸部体表共同引起的导纳变化等于各血管单独在胸部体表产生的导纳变化的代数和，即在电导纳图测量中导纳变化遵从标量迭加原理。结论：本文结果可为心导纳图的波形重建奠定理论基础。     

贵州白纹伊蚊对登革病毒易感性的研究

目的 用细胞、分子生物学技术进行贵州省白纹伊蚊不同地理株对登革病毒(DEN)易感性的研究。方法 采集贵州省9个地(州)市共计15个县(区)白纹伊蚊幼虫标本，饲养为成蚊；取羽化后3～5日龄期的贵州不同地理株白纹伊蚊，用不同型别的DEN分别经口连续感染3d，于首次感染后的4、7、10、14d收集感染成蚊标本；制备蚊悬液，碘化钠法提取RNA，用DENNS1基因区通用引物经逆转录．聚合酶链反应(RT-PCR)检测DEN核酸；蚊悬液接种C6／36细胞进行病毒分离，制作细胞抗原片，经间接免疫荧光法检测DEN抗原；同时感染白纹伊蚊海南株作为对照。结果 DEN1-4型国际参考株感染白纹伊蚊贵州省不同地方株，其感染比率分别为12／15、12／15、8／15和13／15。结论 白纹伊蚊贵州省不同地方株对DEN1-4型国际参考株普遍易感，表明贵州省具备引起登革热流行的条件。     

rIL-18对肺炎链球菌肺炎小鼠Th1/Th2免疫应答的影响

目的 研究重组白细胞介素18(rIL-18)对肺炎链球菌肺炎小鼠Th1/ Th2免疫应答的影响.方法 鼻腔接种肺炎链球菌建立小鼠肺炎链球菌肺炎模型,将Balb/c小鼠24只随机分为3组,分别为对照组,肺炎组和肺炎rIL-18干预组(n=8 ),RT-PCR法检测各组小鼠肺组织中IFN-γ、IL-4 mRNA 的表达,同时支气管肺泡灌洗液(BALB)进行活菌计数,有核细胞分类计数.结果 ①肺炎rIL-18干预组BA LF中性粒细胞和巨噬细胞计数显著高于肺炎组和对照组(P＜0.001);②肺炎rIL-18 干预组BALF活菌计数显著低于肺炎组(P＜0.001);③肺炎rIL-18干预组肺组织IFN- γ mRNA表达上调而IL-4 mRNA表达下调(P＜0.001).结论 在小鼠肺炎链球菌肺炎早期给予rIL-18可诱导IFN-γ的合成,促进Th1免疫应答,使Th1/ Th2免疫平衡向Th1免疫偏移、促进宿主对肺炎链球菌的防御.     

慢性乙肝患者血清趋化因子RANTES水平与肝功能生化指标等的相关性研究

Objective To investigate the level of the serum chemokine RANTES and its correlation with serum biochemical indices of liver function test, HBeAg and HBV DNA load in patients with chronic hepatitis B.Methods 144 patients with chronic hepatitis B (observed group) and 18 normal cases (control group) were enrolled in this study. The serum level of chemokine RANTES was detected with an ABC-ELISA assay. Statistical analysis was performed on the software of SPSS13.0. Results The serum chemokine RANTES level in the observed group (3930.12 ng/ml±2856.96) ng/ml was significantly higher than that in the control group (329.46 ng/ml±152.23) ng/ml. The results from the observed group indicated the positive correlation of serum RANTES level with indices of liver function test, including ALT (r=0. 197, P=0.018), AST(r=0.239, P=0.004) and TBil (r=0.316, P=0.001), but did not with PTA (r=-0.078, P=0.357). Neither difference of serum chemokine RANTES level between HBeAg-positive group and HBeAg-negative group nor that between high HBV DNA load group (≥105 copies/ml) and low HBV DNA load group (< 105 copies/ml) were statistically significant (P=0.407 and 0.185, respectively). Conclusions Serum chemokine RANTES level in patients with chronic hepatitis B elevates significantly and is not affected by HBeAg or HBV DNA load. Its positive correlation with indices of liver function test indicates that RANTES might play an important rule in the pathogenesis of chronic hepatitis B.     

常见呼吸道病毒分子鉴别诊断技术的建立

目的 建立一种常见呼吸道感染病毒的快速检测方法,为尽早诊断、减少疾病的传播以及为临床提供良好的治疗依据.方法 采用液体芯片检测技术结合靶向多重RT-PCR技术建立可以同时检测13种呼吸道病原的检测技术.结果 该方法特异性方面检测13种常见呼吸道病毒没有交叉,标本的检出率为100%;灵敏度方面达到10e2-10e1（pfu/ml）.结论 该分子鉴别诊断可应用常见呼吸道病毒的检测,协助诊断病毒引起的病毒性呼吸道感染.     

双价痢疾菌苗滴鼻免疫小鼠后不同部位淋巴细胞表型的变化

目的:观测双价痢疾工程菌苗滴鼻免疫小鼠后,不同时间、不同部位淋巴组织细胞表型的变化,探讨痢疾菌苗滴鼻免疫对黏膜和系统免疫应答的影响。方法:BALB/c小鼠随机分为3组,每组30只,分别以FSM-2117和FS-5416痢疾菌苗经滴鼻途径免疫小鼠4次,菌量依次为5×106、1×107、4×107和4×107CFU/只,对照组给予PBS,间隔2 wk。4次免疫后7、30和90 d活杀,分离NALT、鼻通道、脾、小肠PP结淋巴细胞,采用流式细胞术检测其淋巴细胞表型的变化。结果:4次免疫后7 d,小鼠鼻相关淋巴组织(NALT)、鼻通道(NP)和Peyer’s结(PP)淋巴细胞中,CD3 T细胞数均显著增加,其中以CD4 T细胞增加为主。FSM-2117免疫组的脾细胞中B220 细胞显著增加;而FS 5416免疫组的脾细胞中CD3 T细胞显著增加。4次免疫后30 d,NALT、NP和脾淋巴细胞仍出现上述变化;而90 d,仅NALT和NP淋巴细胞出现上述同样变化。结论:两株双价痢疾菌苗滴鼻免疫小鼠后,能有效地诱导黏膜和系统免疫应答,且持续时间较长,但该免疫应答的减弱是从距免疫部位较远的部位而开始的。     

慢性乙肝患者血清趋化因子RANTES水平与肝功能生化指标等的相关性研究

Objective To investigate the level of the serum chemokine RANTES and its correlation with serum biochemical indices of liver function test, HBeAg and HBV DNA load in patients with chronic hepatitis B.Methods 144 patients with chronic hepatitis B (observed group) and 18 normal cases (control group) were enrolled in this study. The serum level of chemokine RANTES was detected with an ABC-ELISA assay. Statistical analysis was performed on the software of SPSS13.0. Results The serum chemokine RANTES level in the observed group (3930.12 ng/ml±2856.96) ng/ml was significantly higher than that in the control group (329.46 ng/ml±152.23) ng/ml. The results from the observed group indicated the positive correlation of serum RANTES level with indices of liver function test, including ALT (r=0. 197, P=0.018), AST(r=0.239, P=0.004) and TBil (r=0.316, P=0.001), but did not with PTA (r=-0.078, P=0.357). Neither difference of serum chemokine RANTES level between HBeAg-positive group and HBeAg-negative group nor that between high HBV DNA load group (≥105 copies/ml) and low HBV DNA load group (< 105 copies/ml) were statistically significant (P=0.407 and 0.185, respectively). Conclusions Serum chemokine RANTES level in patients with chronic hepatitis B elevates significantly and is not affected by HBeAg or HBV DNA load. Its positive correlation with indices of liver function test indicates that RANTES might play an important rule in the pathogenesis of chronic hepatitis B.