丙型肝炎病毒感染成年树Qu的实验研究

探讨成年树Ｑｕ感染ＨＣＶ的可能性。方法用ＨＣＶＲＮＡ阳性人血清接种１０只健康成年Ｔｕｐａｉａ。观察临床表现；定期检测血清ＡＬＴ和ＨＣＶＲＮＡ正，负链；检测肝组织中ＨＣＶ３种抗原和负链ＨＣＶＲＮＡ；行肝组织病理检查。     

肝癌及癌旁组织中丙型肝炎病毒基因负链的研究

运用巢式聚合酶链反应（ＰＣＲ）等方法检测了５例丙型肝炎病毒核糖核酸（ＨＣＶ—ＲＮＡ）阳性患者的肝癌、癌旁组织和周围血清中ＨＣＶ—ＲＮＡ正链和负链，其中男４例，女１例。结果，正链检测：血清及癌旁组织全部阳性，癌组织中３例阳性。负链检测：血清中均阴性，癌组织３例阳性，癌旁组织５例均阳性。本组５例患者肝脏ＨＣＶ—ＲＮＡ负链阳性，推测ＨＣＶ以ＨＣＶ—ＲＮＡ负链作为模板在感染的肝脏组织中复制，ＨＣＶ持续存在于肝脏组织中对肝癌的发生起了一定的作用。     

肝细胞癌和癌旁肝组织中HCVRNA正,负链的检测

用逆转录－聚合酶链反应（ＲＴ－ＰＣＲ）检测了４２例肝细胞癌（ＨＣＣ）患者肝癌及癌旁肝组织中丙型肝炎病毒（ＨＣＶ）ＲＮＡ的正，负链，结果显示，肝组织中ＨＣＶＲＮＡ正，负链的检出率分别为５４．８％和３５．７％，ＨＣＶＲＮＡ的正链和负链在肝癌和癌旁肝组织中，同时阳性的患者分别占４５．２％和３１．０％，血清ＨＣＶＲＮＡ和抗ＨＣＶ阴性埂肝组织中ＨＣＶＲＮＡ的检出率仍有５１．３％，肝组织ＨＣＶＲＮＡ与乙型肝炎     

肝炎病人血清、外周血单核细胞及肝脏中GBV-C/HGV负链RNA的检测

目的：研究２７例肝炎病人血清、外周血单核细胞（ＰＢＭＣ）及肝脏中ＧＢＶ－Ｃ／ＨＧＶ正链及负链ＲＮＡ（复制中间体）的存在状况。方法：应用逆转录－巢式多聚酶链反应技术检测ＧＢＶ－Ｃ／ＨＧＶ正、负链ＲＮＡ。结果：２７例病人中２１例病人血清、７例ＰＢＭＣ、１０例肝组织中检测到ＧＢＶ－Ｃ／ＨＧＶ正链ＲＮＡ,其中２例单一ＧＢＶ－Ｃ／ＨＧＶ感染者肝组织中检测到负链ＲＮＡ,在２７例病人血清及ＰＢＭＣ中均未检测到负     

精细胞及血单个核细胞中丙型肝炎病毒RNA及其负链检测

用聚合酶链反应（ＰＣＲ）方法对８例慢性丙型肝炎患者的血浆、外周血单个核细胞（ＰＢＭＣ）、精液和精细胞中的正链和负链丙型肝炎病毒（ＨＣＶ）ＲＮＡ进行检测，以了解ＨＣＶ在肝外细胞中是否存在，有否复制。结果血浆中正链ＨＣＶＲＮＡ均阳性，而负链ＨＣＶＲＮＡ全部阴性；ＰＢＭＣ中正链ＨＣＶＲＮＡ阳性者５例，其中２例检出负链ＨＣＶＲＮＡ。在３例留取精液的患者中１例精液和精细胞中检出正链ＨＣＶＲＮＡ。精细胞未次洗液ＨＣＶＲＡＮ阴性，精细胞负链ＨＣＶＲＮＡ阴性。上述结果提示：（１）血浆中可能仅有正链ＨＣＶＲＮＡ存在；（２）ＨＣＶ可在ＰＢＭＣ中存在，并可能在其中复制；（３）精液中有ＨＣＶ存在，因此通过性交传播丙型肝炎的可能性确实存在，但ＨＣＶ可能不在精细胞中复制     

原发性肝癌患者肝组织中HCVRNA和HCV抗原的定位

分别用原位杂交过氧化物酶与抗氧化物酶复合物法检测了７３例肝细胞癌患者肝组织切片中的丙型肝炎病毒ＲＮＡ和ＨＣＶ抗原以及乙型肝炎病毒的表面抗原和核心抗原。结果显示：ＨＣＶＲＮＡ，ＨＣＶＡｇ，ＨＢｓＡｇ和ＨＢｃＡｇ的检测出率分别为２６．０％，２８．８％，７５．３％和２６．０％；ＨＣＶ阳性的肝细胞多呈散在型分布，可见有ＲＮＡ，ＨＣＶＡｇ，ＨＢｓＡｇ和ＨＢｃＡｇ的检测率分别为２６．０％     

树鼩感染丁型肝炎病毒的实验研究

作者以树为对象、建立丁型肝炎病毒（ＨＤＶ）／乙型肝炎病毒（ＨＢＶ）实验感染动物模型，为丁型肝炎发病机理和药物筛选提供研究基础。对人工饲养的２０只健康成年树　接种ＨＢＶＤＮＡ阳性血清后ＨＢｓＡｇ的转阳率为７５％（１５只）；分别以同时感染（１３只）和重叠感染（９只）两种方式接种ＨＢＶＤＮＡ和ＨＤＶＲＮＡ阳性血清后，各有８只和６只树　的血清乙肝表面抗原（ＨＢｓＡｇ）、丁肝抗原（ＨＤＡｇ）和丁肝抗体（抗ＨＤ）相继转阳，部分血清或肝内检出ＨＤＶＲＮＡ，以ＨＤＶ／ＨＢＶ阳性树　血清在树　间进行传代感染，可见第二代４只中３只、第三代５只中４只树　的血清ＨＢｓＡｇ、ＨＤＡｇ和抗ＨＤＶ相继转阳，２只第三代感染树　血清中检出ＨＤＶＲＮＡ，肝内检出ＨＢｓＡｇ和ＨＤＡｇ阳性；连续观察１６～１９个月，经重叠感染成功的４只树　血清ＨＢｓＡｇ持续阳性，２只ＨＤＡｇ和抗ＨＤ交替出现，１只抗ＨＤ持续阳性，提示可发展成慢性ＨＤＶ感染；感染ＨＤＶ的树　血清ＡＴＬ升高，肝组织有类似肝炎样病理变化，与ＨＤＶ在黑猩猩体内感染结果类似，提示树　可作为ＨＤＶ感染的动物模型。     

逆转录巢式聚合酶链反应检测重型肝炎患者血清HGVRNA及分析

采用逆转录巢式聚合酶链反应技术检测重型肝炎患者血清ＨＧＶＲＮＡ，并与临床病死率间关系进行了初步探讨。结果发现２２例重肝患者血清标本中检出６例ＨＧＶＲＮＡ阳性，阳性率２７．３％，其中亚急性重型肝炎１１例，ＨＧＶＲＮＡ阳性４例，阳性率３６．４％，慢性重型肝炎１０例，ＨＧＶＲＮＡ阳性２例，阳性率２０．０％，急性重型肝炎１例未检出。ＨＧＶＲＮＡ阳性６例中，死亡１例，死亡率１６．７％，ＨＧＶＲＮＡ阴性１６例中，死亡６例，死亡率３７．５％。表明川北地区亦存在ＨＧＶ感染，ＨＧＶ感染病例病死率较低，预后好     

重组干扰素治疗慢性丙型肝炎的临床及肝组织学疗效评价

报告８４例慢性丙型肝炎（ＣＨＣ）患者，通过临床、血清学、肝组织学、分子生物学和免疫组织化学等方法，观察应用重组α－干扰素加传统护肝治疗的效果，疗程２４周，并与单用传统护肝治疗的对照组治疗前后各项指标变化比较。疗程结束时结果显示：治疗组６４例中，血清ＡＬＴ复常率为７０．３％，ＨＣＶ－ＲＮＡ阴转率为６７．２％，肝组织学好转率为６５．６％，肝组织内ＨＣＶ－ＲＮＡ阴转率为５１．５％，肝组织内ＨＣＶ－Ａｇ抗原的免疫组化检出率从治疗前的１５．６％减至治疗后的６．３％，分别显著高于对照组（Ｐ＜０．０５）。疗程结束后随访３～６个月，测定ＨＣＶ－ＲＮＡ并动态观察血清ＡＬＴ的变化，部分病人有复发，但治疗组ＡＬＴ复常率及ＨＣＶ－ＲＮＡ阴转率仍达７０．０％。     

急慢性丙型肝炎患者ALT,抗—HCV与HCVRNA关系的分析

对４０例丙型肝炎患者的血清ＡＬＴ、抗－ＨＣＶ及ＨＣＶＲＮＡ进行了检测。结果显示，在急慢性丙型肝炎中，抗－ＨＣＶ阳性率分别为８３．３％，９３．８％，ＨＣＶＲＮＡ阳性率分别为５０％、６８．８％，有４例抗－ＨＣＶ阴性急性患者ＨＣＶＲＮＡ阳性。     

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.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.