基于颜色判定的环介导恒温扩增技术快速检测铜绿假单胞菌的研究

目的建立了一种基于颜色判定的,能够快速准确地检测铜绿假单胞菌的LAMP方法。方法针对铜绿假单胞菌OprL基因设计3对LAMP引物,通过引物特异性识别OprL的8个独立区域来快速检测铜绿假单胞菌。如果在反应前添加荧光染料羟基萘酚蓝(HNB)或钙黄绿素(Calcein),其结果可以通过肉眼观察反应前后颜色变化来判定并经琼脂糖凝胶电泳验证。对该技术进行特异性、灵敏度分析,利用LAMP和PCR同时检测临床标本。结果设计出针对铜绿假单胞菌OprL基因的恒温扩增检测方法。本恒温扩增检测法只扩增铜绿假单胞菌DNA,对其他菌不扩增,显示出良好的特异性。其最低检测限为17.414 pg/μl,PCR方法最低检出限为174.414 pg/μl,LAMP方法检测灵敏度是PCR方法检测灵敏度的10倍,灵敏度高。LAMP法对临床阳性标本检出率与PCR法相当(27/27)。结论 LAMP方法用于快速检测铜绿假单胞菌具有检测过程简单、实验装置简便、反应结果肉眼可辨别、灵敏度高和特异性强的特点,适合用于现场和基层检疫及医疗单位的快速诊断。     

环介导等温扩增技术检测铜绿假单胞菌的研究

用环介导等温扩增技术(LAMP)快速、灵敏地检测铜绿假单胞菌.利用铜绿假单胞菌gbca基因,特异性设计3对LAMP引物,在反应体系中添加羟基萘酚蓝(HNB)荧光染料,通过反应前后颜色的变化肉眼观察结果,并用琼脂糖凝胶电泳加以验证.对临床标本利用LAMP和PCR法平行检测,验证该法灵敏度、特异性.针对铜绿假单胞菌DNA特异性引物的LAMP法可以扩增,其他无扩增产物.本实验建立的LAMP法具备简便、快速、特异性强和灵敏度高的特点,适于实际应用.     

环介导等温扩增法直接检测阳性血培养瓶中大肠埃希菌

目的：应用环介导等温扩增技术（LAMP）建立一种快速敏感的直接检测阳性血培养瓶中大肠埃希菌的方法。方法根据美国国立卫生研究院基因序列数据库（GenBank）上大肠埃希菌的lacZ（登录号：M74750）基因序列,设计4条特异引物（2条内引物、2条外引物）,对lacZ基因进行扩增,对扩增反应进行优化。分别验证该方法的特异性及敏感性,并与传统培养法进行比较。结果在300份阳性血培养瓶中,采用LAMP法检测到68株大肠埃希菌,所设计引物对大肠埃希菌扩增的特异性及敏感性均较好,与传统培养法比较,灵敏度和特异性均达100％,但传统培养法的检出时间为3d,而LAMP法的检出时间只需1h。结论LAMP检测大肠埃希菌是快速、低成本、特异性强、灵敏度高的方法,适合临床开展。     

LAMP结合核酸试纸条技术快速检测粪便中艰难梭菌的方法研究

目的 研究利用环介导等温扩增（loop–mediated isothermal amplification,LAMP）结合核酸试纸条技术建立艰难梭菌（Clostridium difficile,CD）的快速检测方法,为艰难梭菌检测提供一种快速检测的方法。方法 收集2016年1月至2017年12月杭州市临安区第一人民医院临床感染性腹泻患者的粪便标本201份。根据艰难梭菌毒素A基因特异序列设计引物,选择6条最佳引物,用LAMP环介导等温扩增曲线、钙黄绿素目视法和核酸试纸条测试实验结果,再优选反应体系,最后检测粪便中的艰难梭菌。结果 LAMP法能在60℃条件下扩增1h检出艰难梭菌,对1株艰难梭菌和7株非艰难梭菌检测,只有艰难梭菌能检出阳性扩增,设计的引物具有良好的特异性。脱氧核糖核酸（deoxyribo nucleic acid,DNA）检出限为0.8pg/μl。结论 LAMP结合核酸试纸条技术快速检测粪便艰难梭菌具有敏感度高、操作简便、特异性强、可视化、方便快捷的特点,适用于艰难梭菌的快速检测。     

LAMP和PCR法检测痢疾志贺菌的特异性和灵敏性比较

目的建立环介导等温扩增技术(LAMP)快速检测痢疾志贺菌,并对其特异性、灵敏度与传统PCR进行比较。方法以痢疾志贺菌侵袭性质粒抗原H基因(ipaH)为靶序列,设计6条特异性引物(内引物、外引物和环引物各2条),优化LAMP反应体系及反应条件,检测LAMP反应的灵敏度、特异性及模拟样品,同步与PCR进行比较。结果 LAMP法和PCR均能特异性地扩增出志贺菌靶DNA,而其他非志贺菌均未扩增出特有条带。检测细菌纯培养物和模拟食品的灵敏度LAMP法分别为5.3×101cfu/ml、6.8×101cfu/ml,PCR法分别为5.3×102cfu/ml和6.8×102cfu/ml。结论利用LAMP技术,可快速、灵敏、简便地检测痢疾志贺菌,与PCR方法比较,特异性强、操作简便、检测成本低、耗时短,有望发展成为快速检测痢疾志贺菌的有效手段。     

空肠弯曲菌套式PCR快速检测方法的建立与初步应用

目的建立套式PCR快速检测实验动物空肠弯曲菌的方法。方法根据GenBank数据库的空肠弯曲菌flaA基因设计2对引物，对空肠弯曲菌抽提DNA作PCR扩增及克隆测序。同时，对其他病原菌抽提核酸扩增，并对120份临床样品进行检测。结果空肠弯曲菌经2对引物分别扩增出1719bp和640bp片段，与预期大小一致。套式PCR检测的最低限度为10CFU。整个检测过程可在8h内完成。而其他病原菌未出现特异性扩增条带。采用套式PCR对121份临床样品进行检测，检出31份阳性，与传统的细菌分离方法完全一致。结论本研究建立的套式PCR方法具有很好的特异性和敏感性，可用于实验动物空肠弯曲菌的快速检测。     

环介导等温扩增技术检测福氏志贺菌的实验研究

目的：了解并建立福氏志贺菌的快速、特异的环介导等温扩增技术（loop-mediated isothermal amplification,LAMP）检测方法,探讨快速、简便、有效的消化道传播性病原体的临床诊断、饮水检测和环境卫生监测等检测手段。方法对福氏志贺菌进行细菌培养,然后使用聚合酶链反应（polymerase chain reaction,PCR）和LAMP技术设计4条特异性引物,以及使用克隆等分子生物学方法进行DNA提取,然后对PCR方法与LAMP方法进行对比分析。结果LAMP扩增具有非常高的特异性,几乎不会产生非特异性扩增;与PCR方法相比,LAMP检测限更低,仅为5个拷贝;LAMP在等温条件下扩增,不会因温度改变而造成时间的损失,在1h内可将靶序列扩增至109～1010倍,并且不需要模板的热变性。结论 LAMP技术具有特异敏感简单的特点,不需要特殊的仪器,在65℃时1 h即可完成反应,同时检测结果可直接通过肉眼或加入荧光染料即可判断。     

环介导恒温扩增技术快速检测大肠杆菌O157特异基因的建立

目的 建立环介导的恒温扩增快速检测大肠杆菌O157的方法。方法 采用环介导的恒温扩增反应（LAMP）技术扩增大肠杆菌O157特异性基因,并与传统PCR比较。结果与传统的PCR技术相比,LAMP法更加简便快速、且在等温条件下进行,具有更高的灵敏性;特异性100%。结论 该方法具有灵敏度高,特异性强,操作简便快速,不需要复杂仪器设备、为临床检测大肠杆菌O157提供了一个快速简便的新方法。     

实验树鼩空肠弯曲菌、沙门氏菌和志贺菌多重荧光定量PCR方法的建立

目的为实验树鼩微生物检测提供一种快速、简便、灵敏,并且特异性强的空肠弯曲菌、沙门氏菌和志贺菌多重荧光定量PCR检测方法。方法根据空肠弯曲菌的Hip O区域、沙门菌的in V区域和志贺菌的ipa H区域设计特异性引物和探针,并进行单病原定量PCR检测验证;后分析多重PCR的灵敏度和特异性,并使用该多重PCR方法检测实验树鼩样品。结果本研究的PCR要素可用于空肠弯曲菌、沙门氏菌及志贺菌等单种菌的实时荧光定量PCR扩增。多重定量PCR扩增出了空肠弯曲菌、沙门氏菌和志贺氏菌标准扩增曲线;该方法的灵敏度为1×103ng/μL;特异性检测未从其他参考菌株中检出阳性。结论该多重定量PCR方法在实验树鼩微生物检测中具有很好的应用和推广前景。     

淋病奈瑟菌porA基因实时荧光环介导等温扩增方法的建立

目的 运用实时荧光环介导等温扩增技术(LAMP)建立一种快速准确检测淋球菌的方法,以期用于淋病的早期临床诊断.方法 以淋球菌porA为靶基因,设计保守性和特异性良好的引物,以淋球菌标准菌株基因组DNA为模板,进行LAMP扩增,用23种其他在生殖系统中存在的微生物验证其灵敏度和特异性.结果 实时荧光LAMP法可检测到1 pg/μl(103CFU/ml)淋球菌基因组DNA,稳定性良好,其针对23种其他在生殖系统中存在的微生物均不能扩增,porA引物对淋球菌高度特异,阳性结果15 min可快速检出.结论 成功建立了检测淋球菌porA的LAMP技术,为淋球菌的快速检测提供了新的手段,有望成为淋球菌常规检测的简便方法.     

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.