EMA-PCR方法快速检测铜绿假单胞菌活菌研究

目的 探讨将叠氮溴乙锭(ethidium monoazide bromide,EMA)选择渗透性与PCR技术相结合（EMA-PCR）,建立有效快速检测铜绿假单胞菌活菌的方法。方法 以铜绿假单胞菌oprI基因为PCR检测靶基因,纯培养物提取模板进行PCR,检测PCR灵敏度、EMA使用浓度和曝光时间优化试验。结果 PCR检测灵敏度为3×103 CFU/mL;曝光处理时间为10 min;EMA浓度≤5 μg/mL对活菌DNA扩增没有明显抑制,终浓度为1 μg/mL EMA能有效抑制3×106 CFU/mL死菌扩增;1%活菌混合体系检测结果阳性。结论 EMA-PCR方法能有效快速检测铜绿假单胞菌活菌,能避免PCR检测可能造成的假阳性结果。     

建立环介导等温扩增方法检测腹泻患者中小肠结肠炎耶尔森菌

目的建立快速的检测方法对腹泻患者中的小肠结肠炎耶尔森菌进行快速检测。方法利用析因设计试验方法建立并优化检测小肠结肠炎耶尔森菌的环介导等温扩增技术（LAMP）,并与普通PCR法对临床腹泻标本进行检测比较。结果析因设计试验确定LAMP最佳反应体系：Mg2＋＋为2．0mmol,内引物FIP／BIP为1．6umol,dNTPs为1．6mmol,时间为60rain,反应温度为63℃。对12种细菌进行LAMP扩增,仅小肠结肠炎耶尔森菌获得阳性扩增结果,小肠结肠炎耶尔森菌基因组DNA和纯培养物的检测灵敏度分别为38．05fg和15CFU／ml。对腹泻样本进行直接检测,检测限为150CFU／g。539例腹泻患者粪便标本中,LAMP成功检出13例样本中含有小肠结肠炎耶尔森菌,普通PCR检出11例,灵敏度为100％,特异度为99．62％。结论本方法检测小肠结肠炎耶尔森菌特异性强、灵敏度高．且操作简单、快速、检测成本低．适合基层单位及现场廊用．     

LAMP快速检测沙门菌invA基因的方法建立与应用

目的：建立一种环介导等温扩增（loop-mediated isothermal amplification, LAMP）,反应快速检测沙门茵的方法。方法：根据美国国立卫生研究院基因序列数据库（GenBank）上的鼠伤寒沙门菌的特异invA和fimA（登录号：M90846和M18283）基因序列,设计特异引物,提取标本DNA,然后以LAMP技术扩增invA基因,PCR方法扩增厅棚基因,采用琼脂糖电泳观察结果。结果：91份血培养阳性报警瓶,LAMP和PCR法检测出阳性18份,与最终培养结果一致;30份粪便标本,LAMP和PCR法检测出阳性5份,培养阳性3份,LAMP测限达到10^2CFU／mL。结论：LAMP是一种简便、快速、特异和敏感的检测临床和环境标本中沙门菌的有效方法。     

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。     

应用PCR法检测小鼠沙门氏菌

本文根据沙门氏菌保守基因序列合成一对寡桩苷酸引物,建立一种聚合酶链反应检测小鼠沙门氏菌的方法。通过对14株沙门氏苗和8株非沙门氏菌的检测,发现只有沙门氏菌才能扩增出495bp的特异性条带,检测灵敏度可达50条沙门氏菌水平。该法检测小鼠粪便中沙门氏菌的阳性率高于培养法,且整个实验过程仅需6～8h。可见,该法是一种特异、敏感、简便、快速的沙门氏菌检测方法,对实验动物质量控制将发挥积极的作用。     

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。     

树鼩粪便中沙门氏菌LAMP检测方法建立及应用

目的建立树鼩粪便沙门氏菌的环介导等温扩增(loop-mediated isothermal amplification,LAMP)检测方法,并对此方法进行初步应用。方法根据沙门氏菌种属特异性基因inv A(侵袭蛋白基因A)的保守序列,设计合成特异性LAMP引物。分别设定十个反应温度即57℃~66℃和十个反应时间即24~42 min进行优化,并测定本方法的特异性和灵敏度;同时进行普通PCR实验,作为本方法的验证和比较。用建立的LAMP法对91份野生来源的树鼩稀便样品进行检测。结果优化反应条件选出反应温度为62℃,反应时间34 min;该方法对沙门氏菌的灵敏度可达3.36×101CFU/m L,比普通PCR方法高10~100倍;对10种树鼩来源的肠道细菌进行LAMP检测,只有沙门氏菌属的肠炎沙门氏菌和乙型副伤寒沙门氏菌检测为阳性,其余为阴性;对91份野生树鼩粪便样品进行LAMP检测,阳性检出率为20.88%;LAMP法的所有反应可在40 min内完成。结果可通过肉眼观察颜色变化直接判定。结论所建立的LAMP方法具有便捷、快速、灵敏、特异等特点,可用于树鼩粪便中沙门氏菌的大规模快速检测。     

实时定量聚合酶链反应检测腹泻粪便中小肠结肠炎耶尔森菌的研究与评价

目的 建立一种快速准确的分子生物学方法检测腹泻粪便中小肠结肠炎耶尔森菌,以替代繁琐费时的培养鉴定方法.方法 应用针对致病性小肠结肠炎耶尔森菌染色体上yst基因而设计的特异引物和探针进行实时定量聚合酶链反应（PCR,探针法）,检测致病性（7种血清型）和非致病性（5种）小肠结肠炎耶尔森菌、耶尔森菌属内的其他菌种（8种）及其他肠道细菌（8种）.此外,实时定量PCR检测经过培养方法鉴定的腹泻粪便200例,并比较两种方法的吻合度.结果 引物和探针对致病性小肠结肠炎耶尔森菌100%特异,与其他细菌无交叉反应.在纯培养物和粪便中,最低检测浓度分别为102菌落形成单位（CFU）/ml和103 CFU/g.在200例样本中,培养鉴定方法和实时定量PCR检出同样18例阳性样本,吻合度为100%.结论 实时定量PCR反应对致病性小肠结肠炎耶尔森菌高度特异且与培养鉴定方法有很好的吻合性又方便快捷,可应用于临床检测.     

副溶血性弧菌两种增菌方法的比较

目的 比较普通增菌法和摇床培养增菌法对副溶血性弧菌(Vibrio parahaemolyticus,Vp)的增菌效果.方法 采用测量吸光度值和菌落计数检测Vp数量,直接分离法和PCR法测定方法灵敏度.结果 普通培养增菌法可使菌量在3h增加200倍,摇床培养法可增加2000倍.1.3×102cfu/ml的Vp在普通增菌3h后可直接分离培养,3.8×101cfu/ml培养3h后可用PCR法检出;5×101cfu/ ml的Vp在摇床增菌3h后可直接分离培养,2.5×100cfu/ml增菌3h后可用PCR法检出.结论 摇床培养在短时间内快速增菌效果比普通增菌法好.     

实时荧光PCR技术在肠道沙门氏菌快速检测中的应用研究

目的探讨实时荧光PCR技术应用于肠道沙门氏菌快速检测中的可行性。方法随机采集从业人员健康体检肛拭子标本,用实时荧光PCR法进行检测,并以传统分离培养方法作为"金标准"进行对照实验,比较两者间的差异。结果在1 346份标本中,实时荧光PCR法检出沙门氏菌阳性13份,阳性率为9.66‰;培养法检出5份,阳性率为3.71‰。经统计学分析,两者对沙门氏菌检测的阳性数的差异有统计学意义(χ~2=6.125,P0.05);荧光PCR检测法灵敏度为100.00%,特异性为99.40%。结论实时荧光PCR法灵敏度高、操作简便,可降低工作强度,缩短检测时间,可作为快速检测肠道沙门氏菌的方法在从业人员健康检查中广泛推广应用。     

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.