中国南方四省区流行的HIV-1 CRF01_AE病毒株基因特征研究

Objective To analyze the genetic characteristics of HIV-1 CRF01_AE strains prevailing in. the four provinces of southern China. Methods Plasma samples were collected from the newly diagnosed HIV-1 individuals reported in 2006 in Guangdong, Guangxi, Jiangxi and Hunan province. The gag and env gene fragments were amplified from RNA template extracted from plasma using RT and nested PCR methods. CRF01_AE sequences were analyzed by phylogcnetie methods and characterized by calculating the genetic distance and Entropy analysis. Results Two main epidemic clusters were found to exist in the CRF01 AE strains from 210 HIV-1 CRF01 AE infected individuals collected in the 4 provinces, southern China. It was found that no international reference strain was closely correlated with cluster Ⅰ , which including 123 samples. The strains in cluster Ⅱ, consisting 57 cases of samples, were closely related with the strains identified in Vietnam. Genetic distance analysis of gag and env genes showed that the diversity of cluster Ⅰ was obviously less than that of cluster Ⅱ. Data on nucleotide polymorphism showed that nucleotides compositions of 42 sites in gag and 40 sites in env wer esignificantly different between the two clusters. When compared with cluster Ⅱ , the polymorphism decreased at 61 nucleotide sites but increased at 21 sites in cluster Ⅰ. Conclusion This was the first report describing that two main epidemic clusters were existed in CRF01_AE strains prevailing in the 4 provinces, Southern China. The vires in cluster Ⅰ was the dominant strain in this region, with shorter period of circulation and higher proportion seen in the HIV-infected population, which might belong to CRF01_AE strain with certain features facilitating the spread of the virus. The virus in cluster Ⅱ was highly homology with the CRF01_AE strains from Vietnam, and seemed to have had several events of epidemics in populations in border regions of China and Vietnam.     

B超定位经皮肾盂穿刺造影与引流术

我院自1986年以来，在B超定位下行经皮肾孟穿刺造影与置管引流30例，取得满意结果，报告如下．临床资料本组30例，男21例，女9例．年龄7～70岁．临床表现以肾区胀府14例，血尿7例，尿失禁2例，肾绞痛2例，尿毒症3例，无症状2例．ZS例行kUB＋lh，忠骨不显影20例，肾积水原因不明5例．均七BM检查，提示肾积水．14例行逆行油管，因忙尿管安阳失败．方法用者取侧卧位或俯卧位，由B超探查积水是明显处为穿刺目标．并测得穿刺深度，皮肤距目标最短距离为穿刺点，一般常位于肋脊角处。常现消毒皮肤，铺巾，局麻后尖刀片切开皮肤少许（约如，4mm…     

国外职业卫生法律法规介绍

把国外有关职业卫生方面的法规介绍到国内, 供从事职业卫生立法的专家、职业卫生管理人员及卫生法律界的学者参考。     

CCL21/CCR7对T24细胞生物学行为的影响

目的研究CCL21/CCR7对T24细胞迁移、侵袭、增殖以及抗凋亡能力的影响。方法采用不同浓度的CCL21(0、50、100、200ng/ml)作用T24细胞,用Transwell实验研究CCL21对T24细胞的迁移与侵袭能力;用MTT法研究了CCL21对T24细胞的增殖能力的影响,用FCM研究了CCL21对T24细胞抵抗ADM诱导的细胞凋亡,同时用Western blot检测了侵袭相关蛋白MMP-2与MMP-9表达及凋亡相关蛋白Bcl-2与Bax的表达。结果 CCL21作用于T24细胞能增强其迁移和侵袭能力,增强效果依赖于CCL21的浓度,CCL21能增加MMP-2与MMP-9的表达;CCL21还能促进T24细胞的增殖与抗凋亡能力,并能上调Bcl-2蛋白的表达,而抑制Bax蛋白的表达。结论 CCL21/CCR7增强了T24细胞的迁移与侵袭能力,促进了T24细胞的增殖与抗凋亡。     

食物过敏的致敏途径及发生机制的研究进展

由IgE抗体引起的食物过敏反应性皮肤病较为常见。探讨食物过敏的致敏途径及发生机制对临床有着重要意义。食物致敏的途径除消化道之外,还有经鼻腔黏膜的途径,如花粉-食物过敏反应综合征(Pollen-food allergy syndrome)等。此外食物抗原也可以经皮肤致敏,如橡胶-水果综合征(Latex-fruit syndrome)等。当患者皮肤屏障功能损害时,食物抗原也可以经皮肤吸收,引发过敏反应。食物过敏原有Ⅰ类和Ⅱ类之分,要根据蛋白性质,致敏途径采取不同的防治对策。     

2011-2013年上海市杨浦区卫生监督投诉举报情况分析

目的了解上海市杨浦区卫生监督投诉举报的现状和变化,提出进一步做好区域卫生监督工作的对策和建议。方法对上海市杨浦区2011-2013年卫生监督投诉举报数据进行统计和描述性分析。结果投诉举报总量有上升趋势,医疗执业类占总数的60.71%;电话举报占总数的70.84%,网络和媒体监测数量开始上升;无证行医类举报最多,生活饮用水和公共场所卫生逐渐成为热点;案件查实率只占总数的40.77%,立案比例在下降。结论继续保持对医疗执业类的重点监管,提高对新动向新问题的关注;加强对案件的查办能力,同时引导市民合理举报;畅通投诉举报主渠道,并积极拓展新的举报方式。     

胃癌手术后胆囊结石的原因及诊治体会

目的对胃癌手术后胆囊结石发生原因与诊治方法进行分析。方法选取2011年4月-2013年9月在我院接受胃癌手术的患者113例,对患者胆囊结石发生情况进行分析,回顾性分析患者的临床资料,分析胃癌手术后胆囊结石形成的原因及诊治方法。结果胆囊结石发病率为17.7%。经分析,合并胆囊结石组患者全胃切除术占比、非生理行重建术式占比、合并脏器切除占比显著高于无胆囊结石组。结论胃癌手术后胆囊结石的形成和胃癌手术方式,特别是和重建方法密切相关,应加以预防,发生后应根据患者具体情况展开保守治疗或胆囊切除术治疗。     

输尿管软镜下钬激光切开内引流术治疗肾盂旁囊肿的临床研究

目的 探讨经尿道输尿管软镜下钬激光切开内引流术治疗肾盂旁囊肿的安全性和可行性. 方法 回顾性分析2010年1月至2012年10月收治的11例肾盂旁囊肿患者的临床资料,男6例,女5例.年龄36～67岁,平均54岁.单发肾盂旁囊肿4例,双侧肾盂旁囊肿2例,一侧肾盂旁囊肿伴对侧单纯肾囊肿1例,肾盂旁囊肿伴同侧肾结石4例.囊肿直径平均4.8cm.全麻下行经尿道输尿管软镜下钬激光切开内引流术,逆行经尿道置入8.5～9.9 F电子输尿管软镜,观察集合系统与囊肿的解剖位置.直视下用200μm钬激光光纤将向集合系统凸起的囊壁开窗引流,开窗直径1～2cm,使囊腔与集合系相通,留置双J管引流. 结果 11例手术均成功.每侧囊肿处理时间13～27min,平均20min.术中、术后无严重并发症发生.术后随访3～24个月,8例囊肿消失,3例囊肿明显缩小,未见囊肿复发. 结论经尿道输尿管软镜下钬激光切开内引流术治疗肾盂旁囊肿具有创伤小、恢复快、近期疗效确切等优点,理论上更符合经自然腔道手术的优点,远期疗效有待进一步观察随访.