原发性胆汁性肝硬化患者外周血APRIL基因表达水平初探

目的 建立检测人增殖诱导配体（APRIL）mRNA的实时荧光定量PCR方法,探讨外周血单个核细胞APRIL mRNA表达水平与原发性胆汁性肝硬化（PBC）的相关性。方法 采用实时荧光定量PCR法检测30例正常人和40例PBC患者外周血单个核细胞（PBMC）APRIL基因的相对表达量,以Ct值比较法计算APRIL基因相对表达水平。结果 PBC患者外周血单个核细胞APRIL mRNA的△Ct值为9．3±2.0,与正常对照组比较．差异显著（P〈0．05）。采用2^-△△Ct法进行数据分析后,PBC组APRIL mRNA相对表达量比正常对照组高3．5倍。PBC患者中抗核抗体（ANA）阳性占80％,其中荧光模式为核膜型19例。其他型13例（着丝点型10例,混合型3例）,其APRIL基因相对表达量比正常对照组高6.5和1．7倍。结论 PBC患者外周血单个核细胞APRIL mRNA表达水平显著升高,且与ANA荧光模式相关。     

Delayed haemolytic transfusion reaction due to anti-Jkb in a patient with non-Hodgkin's lymphoma-transient nature of anti-Jkb and the importance of early serological diagnosis

Delayed haemolytic transfusion reactions (DHTRs) are relatively common following blood transfusions. In the UK, DHTRs were responsible for 10.2% of all serious transfusion-related hazards between 1996 and 2003. In most cases, there is minor or no morbidity, and the reaction may go unnoticed. However, in some cases, a large fall in haemoglobin level and major morbidity may occur. Even in such serious cases, the true cause of the patient's clinical deterioration may be unrecognized if serological investigation is not carried out immediately because of the often transient nature of the antibodies involved. Failure to make the correct diagnosis will lead to inappropriate treatment and expose the patient to risk of further serious transfusion reactions. We describe a case of DHTR caused by anti-Jk(b) antibodies, which illustrates the difficulty in diagnosing this common but under-recognized reaction and shows the transient nature of the antibody involved, which became undetectable within 4 weeks.     

放松性音乐对不同焦虑病人手术应激反应的影响研究

目的 :探讨放松性音乐对不同焦虑病人手术应激反应的影响。方法 :选择择期外科手术病人 60例 ,根据焦虑程度分为低焦虑组、中焦虑组和高焦虑组 ,每组再按分层随机分为实验组和对照组 ,分别观察病人术前 3d、术前 1d、术日、术后 1d和术后 3d各时点收缩压 (SBP)、心率 (HR)和血皮质醇的变化。结果 :低焦虑、高焦虑组中对照组SBP、HR于术前 3d、术前 1d均高于实验组(P <0 .0 5 ) ;低焦虑组血皮质醇术前实验组与对照组无差异 ,术日对照组升高幅度明显高于实验组 (P <0 .0 5 ) ;而高焦虑组血皮质醇术前对照组高于实验组 (P <0 .0 5 ) ,术日对照组的升高幅度明显高于实验组 (P <0 .0 5 ) ;手术后实验组焦虑程度均为中等水平 ,而对照组低焦虑病人明显升高(P <0 .0 5 ) ,高焦虑组仍处于较高水平 (P >0 .0 5 )。结论 :放松性音乐能够调整病人的焦虑程度 ,维持正常的应激能力     

随机引物PCR法基因分型肺炎克雷伯菌

目的：对肺炎克雷伯菌进行随机引物PCR(AP-PCR)法基因分型。方法：以单一随机引物及优化的反应体系对临床分离的199株肺炎克雷伯菌(K．pneumoniae)进行AP-PCR分析并按指纹图上DNA条带数及片段大小绘制基因分型图谱。结果：199株临床分离K．pneumoniae共得158种AP-PCR型。结论：AP-PCR法可将K.pneumoniae分型158种。     

自注胰岛素糖尿病患者注射技能认知与不良反应调查分析

目的 探讨家庭自注胰岛素的2型糖尿病患者注射技能认知状况与不良反应的发生关系,为健康教育提供依据.方法 采用自行设计的问卷调查表,对120名患者的注射技能和认知水平进行评价,按其评分结果分为注射知识掌握良好组(A组)和注射知识掌握较差组(B组),比较两组患者不良反应发生情况.结果 两组患者年龄、文化程度、职业、经济收入有明显差异(P<0.01).两组患者血糖控制状况有明显差异(P<0.05).两组患者自注史≤3年者与大于3年者比较,皮肤青紫、红肿、皮下硬结发生有明显差异(P<0.05);自注史>3年者与≤3年者比较,皮下硬结、萎缩或增厚的发生有明显差异(P<0.05).结论 提高患者胰岛素自注技能的认知水平,能有效控制血糖、减少不良反应发生.     

凝胶材料制备方法及其反应动力学的研究进展

部分水凝胶材料具有良好的生物相容性、低细胞毒性和生物可降解性,广泛应用于组织工程和生物医药等领域,其中采用天然高分子明胶、壳聚糖和海藻酸钠制备复合凝胶材料,负载骨髓间充质干细胞用于修复和治疗骨缺损成为近年来的研究热点之一。因为水凝胶材料抗张强度低和化学稳定性差,所以研究凝胶反应机理和凝胶反应动力学对提高水凝胶的性能具有重要意义。本文总结了明胶、壳聚糖和海藻酸钠凝胶材料的制备方法和凝胶反应机理,比较了不同凝胶反应动力学研究方法,介绍凝胶复合材料在骨修复中的应用,为天然高分子凝胶材料的分子设计和临床应用提供思路。     

酶联免疫吸附测定法和血液学分析法筛查缺失型α-地中海贫血的比较研究

目的 评价并比较酶联免疫吸附测定（ELISA）法检测胎胚型ζ-珠蛋白链和传统的血液学分析法在诊断缺失型α-地中海贫血（地贫）中的临床诊断价值。方法 以双盲试验对287份珠海市妇幼保健院门诊需做血红蛋白（Hb）分析的血样同时采用ELISA法和血液学分析法分别检测--SEA携带者和α-地贫表型，并以基于聚合酶链反应（PCR）技术作为诊断标准，对两种方法筛查--SEA携带者的敏感度、特异度、准确性进行评估并比较其诊断--SEA携带者的临床应用价值。结果ELISA法诊断--SEA携带者总的敏感度、特异度、准确性、阴性预测值和阳性预测值分别为95．0％、100．0％、97．9％和96．5％及100．0％，显著高于血液学分析法的74．4％、96．4％、86．1％、83．5％和90．9％，P均〈0．01）。ELISA法不但能有效地检出--SEA携带者，而且还能鉴定出--SEA合并β-地贫特征或异常Hb的个体，且不受缺铁的干扰，但其对HbH病和α-地贫-2和α^T-地贫基因携带者的诊断价值不及血液学分析法（P均〈0．05）。结论ELISA法对--SEA携带者，特别是--SEA／αα的诊断价值优于传统的血液学分析法，加之该法简便快速、经济实用且易自动化，故非常适合于（--SEA）α-地贫的大样本人群遗传筛查和临床样品的常规检测。     

Rapid identification of Streptococcus pneumoniae serotypes by cpsB gene-based sequetyping combined with multiplex PCR

Background/purposeStreptococcus pneumoniae is an important human pathogen that causes invasive infections in adults and children. Accurate serotyping is important to study its epidemiological distribution and to assess vaccine efficacy.MethodsInvasive S. pneumoniae isolates (n = 300) from 27 teaching hospitals in China were studied. The Quellung reaction was used as the gold standard to identify the S. pneumoniae serotypes. Subsequently, multiplex PCR and cpsB gene-based sequetyping methods were used to identify the serotypes.ResultsBased on the Quellung reaction, 299 S. pneumoniae isolates were accurately identified to the serotype level and 40 different serotypes were detected. Only one strain was non-typeable, and five most common serotypes were identified: 23F (43, 14.3%), 19A (41, 13.7%), 19F (41, 13.7%), 3 (31, 10.3%), and 14 (27, 9.0%). Overall, the multiplex PCR method identified 73.3 and 20.7% of the isolates to the serotype and cluster levels, respectively, with 1.7% of the isolates misidentified. In contrast, the cpsB sequetyping method identified 59.0 and 30.3% of the isolates to the serotype and cluster levels, respectively, and 7% were misidentified.ConclusionsThe cpsB gene sequetyping method combined with multiplex PCR, can greatly improve the accuracy and efficiency of serotyping, besides reducing the associated costs.     

Structural effects of the slow/b-cardiac myosin heavy chain R453C mutation in cardiac and skeletal muscle

Objectives. Hypertrophic cardiomyopathy (HCM) represents an important cause of sudden cardiac death particularly in otherwise healthy young individuals. In some families, HCM is caused by distinct mutations of the cardiac beta myosin heavy chain gene (MYH7). Design. We have analyzed the expression of the malignant MYH7Arg453Cys mutation, in cardiac and skeletal muscle, and related it to morphological alterations. Results. Morphological investigation revealed hypertrophic cardiomyocytes but regularly arranged myofibrils. Skeletal muscle showed no sign of structural alterations. Conclusions. Our results indicate that cardiomyocyte hypertrophy is secondary, due to impaired function, and that the mutation causes no structural alteration in myofibrillar structure in cardiac or skeletal muscle.