FQ-PCR法对孕前及孕中进行HCMV检测的临床意义

目的 运用荧光定量PCR(FQ-PCR)技术对孕前及孕中进行人巨细胞病毒(HCMV)检测,探讨受检者孕前及孕时感染HCMV的临床意义.方法 对302例孕前妇女和620例产前孕妇均做HCMV检测,取宫颈分泌物标本用FQ-PCR法做HCMV-DNA检测,取血清标本用ELISA法做HCMV-IgM检测.结果 302例孕前妇女宫颈分泌物标本HCMV-DNA阳性96例,血清标本HCMV-DNA阳性5例;620例产前孕妇宫颈分泌物标本HCMV-DNA阳性94例,血清标本HCMV-DNA阳性7例.可见用FQ-PCR法检测HCMV-DNA的阳性率远高于用ELISA法检测HCMV-IgM,ELISA法检测HCMV感染阳性率明显偏低,说明FQ-PCR法敏感性显著高于ELISA法.结论 宫颈分泌物组和血清组有明显差异,运用FQ-PCR技术对孕前及孕时进行HCMV检测具有重要的临床意义.     

某城镇地区孕妇TORCH感染血清抗体筛查结果分析

目的分析某城镇地区孕妇TORCH感染血清抗体筛查结果,为优生优育提供参考依据。方法分析2017年8月-2018年12月于阳江市人民医院进行孕检的3 866例孕妇临床资料,通过化学发光法定性检测孕妇血清中TORCH特异性IgM与IgG,对其筛查结果进行分析。结果 3 866例孕妇中巨细胞病毒(CMV)感染IgM阳性率1.71%,高于弓形体(TOX)感染IgM阳性率0.16%,高于风疹病毒(RUV)感染IgM阳性率0.26%,高于单纯疱疹病毒(HSVⅡ)感染IgM阳性率0.10%,差异均有统计学意义(P0.05);RUV与CMV感染IgG阳性率分别为89.83%、89.24%,高于TOX感染IgG阳性率2.48%,高于HSVⅡ感染IgG阳性率6.83%,差异均有统计学意义(P0.05)。年龄35岁孕妇RUV、CMV、HSVⅡ感染IgM阳性率,TOX、RUV、HSVⅡ感染IgG阳性率与年龄≥35岁孕妇比较,差异均无统计学意义(P0.05);年龄35岁孕妇TOX感染IgM阳性率(0.07%)低于年龄≥35岁孕妇(0.40%),年龄35岁孕妇CMV感染IgG阳性率(87.16%)低于年龄≥35岁孕妇(95.26%),差异均有统计学意义(P0.05)。不同季节孕妇TORCH感染IgG以及IgM阳性率比较差异无统计学意义(P0.05)。结论孕前或孕期进行TORCH感染血清抗体筛查,并实施早期干预,对预防胎儿不良结局具有积极意义。     

实时荧光定量PCR检测HBV DNA与ELISA检测HBV M结果的关系

目的:探讨实时荧光定量PCR(FQ-PCR)检测HBV DNA与ELISA检测HBV M结果的关系.方法:采用实时FQ-PCR和ELISA方法分别对240例乙肝患者进行HBV DNA定量测定和HBV M检测.结果:240例HBsAg阳性血清中HBV DNA阳性率为74.58%.HbsAg、HbeAg、HBcAb和HbsAg、HbeAg阳性组的HBVDNA含量及HBV DNA阳性率均明显高于HbsAg、HbeAb、HBcAb和HbsAg、HBcAb组(P＜0.05,P＜0.01).122例HBeAg阳性的血清中97.54%的HBV DNA阳性;118例HBBeAg阴性的血清中有50.85%HBV DNA阳性.结论:实时FQ-PCR检测HBV DNA准确灵敏,是HBV感染及复制的直接证据.HBV M和HBV DNA的检测各有其独特的临床检测意义,在乙型肝炎的诊断治疗中均具有重要的临床价值.     

乙型肝炎病毒DNA与血清免疫标志物的关系分析

目的 探讨乙型肝炎病毒DNA(HBV DNA)与血清免疫标志物的关系.方法 荧光定量聚合酶链反应法 (FQ-PCR) 检测血清样本中HBV DNA含量;酶联免疫吸附法(ELISA)检测HBV血清标志物.结果 A组(HBsAg和HBeAg阳性)、B组(大三阳)、C组(HBsAg 、HBcAb阳性)和D组(小三阳)的HBV DNA阳性率分别为96.7%、87.6%、52.2%和38.2%,各组之间均有显著性差异(P＜0.05); A组中阳性样本的HBV DNA量显著高于其它组别(P＜0.05); 315份HBV DNA阳性标本全部携带有HBsAg;HBsAg( )HBeAg( )和HBsAg( )HBeAg(-)中HBV DNA阳性率分别为89.1%和44.0%,有显著性差异(P＜0.05).结论 HBsAg是HBV感染灵敏的血清标志物;FQ-PCR定量检测HBV DNA作为血清学方法的补充对乙肝的临床诊断具有重要意义.     

单纯疱疹病毒的感染对孕妇及胎儿的影响

目的 了解单纯疱疹病毒(HSV)感染后对孕妇及其胎儿的影响。方法 用酶联免疫吸附法(ELISA)和聚合酶链反应(PCR)检测有不良妊娠史的孕妇及其胎儿的HSV感染情况,同期选取无不良妊娠史孕妇作为对照组。结果 有不良妊娠史孕妇IgM阳性率为23．33％,IgG阳性率为68．33％,IgM和IgG双阳性率为13．33％,而无不良妊娠史孕妇的感染率分别为10．0％、41．67％和1、67％,远远低于有不良妊娠史的孕妇。进一步进行HSV-ⅡDNA检测,结果 IgM或／和IgG阳性的孕妇其胎儿DNA阳性率也高于IgM和IgG阴性孕妇,而且其妊娠结局多为流产、早产、死胎及新生儿畸形。结论 HSV感染的孕妇可以通过胎盘或者由血液将HSv传播给胎儿,导致流产、早产等不良妊娠。     

临床关于HSV-Ⅱ四种实验室检测方法的比较

目的评价四种实验室检测Ⅱ型单纯疱疹病毒(HSV-Ⅱ)感染方法的灵敏度和特异度,寻找一种实验室检测HSV-Ⅱ快而准的方法.方法采用直接免疫荧光法(DIFA)检测生殖器疱疹(GH)患者患处分泌物中的HSV-Ⅱ抗原,用酶免疫法(EIA)检测GH患者患处分泌物中的HSV-Ⅱ抗原和血清中的HSV-Ⅱ IgM抗体,并将以上检验结果与细胞培养法比较.结果 DIFA法、EIA法检测HSV-Ⅱ抗原,EIA法测HSV-Ⅱ IgM抗体,细胞培养法分离HSV-Ⅱ,4种检测方法的灵敏度分别为75.8%,83.9%,17.7%和71.8%;特异度分别为95%,97%,85%和100%.与细胞培养法相比较,DIFA法灵敏度、特异度均无显著性差异(均P＞0.05);EIA法检测HSV-Ⅱ抗原灵敏度高于细胞培养法(P＜0.05),而特异度相比较,无显著性差异(P＞0.05);EIA法检测HSV-Ⅱ IgM抗体灵敏度和特异度均显著低于细胞培养法(P＜0.01,P＜0.05).结论EIA法检测HSV-Ⅱ抗原灵敏度和特异度均较高,是目前临床实验室检测HSV-Ⅱ感染较为理想的方法.     

巨细胞病毒DNA检测在筛查巨细胞病毒感染中的应用

目的 探讨荧光定量聚合酶链反应(FQ-PCR)方法检测婴儿尿液人巨细胞病毒(CMV)DNA在儿科CMV感染诊断中的价值.方法 对565例临床疑诊CMV感染患儿分别应用荧光定量聚合酶链反应(FQ-PCR)、酶联免疫法(ELISA)检测尿液CMV-DNA及血清CMV-IgM抗体.结果 FQ-PCR检测尿CMV-DNA的阳性率为42 83%,ELISA检测婴儿血清CMV-IgM抗体阳性率为20 18%.两种方法对CMV感染诊断符合率为76 46%,前者诊断阳性率显著高于后者(χ2=33 59,P<0 01).结论 FQ-PCR检测尿液CMV-DNA是早期诊断婴儿CMV感染的敏感有效的方法.     

支气管肺泡灌洗液荧光定量PCR检测大叶性肺炎患儿肺炎支原体的效果

目的探讨大叶性肺炎患儿肺炎支原体感染的早期诊断方法。方法选择2013年1月~2014年5月于石河子大学医学院第一附属医院儿科诊治的60例大叶性肺炎患儿,采用荧光定量PCR(FQ-PCR)法检测患儿支气管肺泡灌洗液(BALF)中支原体DNA(MP-DNA),并与酶联免疫吸附法(ELISA)血清MP特异性抗体(MP-Ig M)检测结果比较。结果 FQ-PCR检测BALF MP-DNA阳性55例(91.6%),血清MP-Ig M阳性29例(48.3%),BALF MP-DNA阳性率明显高于血清MP-Ig M阳性率,其差异有统计学意义(P<0.05);随着病程增加,ELISA法检测血清MP-Ig M检测的阳性率增加(P<0.05);BALF荧光定量PCR检测MP-DNA的阳性率不随病程变化(P>0.05)。结论 FQ-PCR检测BALF中MP-DNA是诊断早期支原体肺炎的可靠方法,优于血清MP抗体检测。     

应用FQ-PCR方法检测单纯疱疹病毒-Ⅱ型DNA的研究

目的:了解广东省深圳市某区人群单纯疱疹病毒Ⅱ型(HSV-Ⅱ)的感染状况。方法:采用荧光定量聚合酶链反应(FQ-PCR)技术测定HSV-ⅡDNA。结果:性传播疾病(性病)患者的HSV-ⅡDNA阳性检出率:35.34%( 464/1 313);正常对照组的HSV-ⅡDNA检出率:12.20%(15/123)两组的HSV-ⅡDNA检出率,患者组明显高于对照组(P<0.01)。结论:不同人群HSV的感染状况不同,正常人群中存在HSV-Ⅱ感染,HSV-Ⅱ是性病的重要病原体之一。     

单纯疱疹病毒抗体检测在生殖器疱疹断中的应用

目的讨论单纯孢疹病毒(HSV)抗体检测在生殖器疱疹中的价值,并了解生殖器疱疹患者的疱疹原由。方法采用酶联免疫吸附试验(ELISA)的方式,对我院2015年3月至2016年2月期间的182例疱疹病患进行HSV抗体检测(观察组)。之后使用91例健康人员的血清进行对比(对照组)。结果 182例疱疹患者的HSV-ⅠIgM、HSV-ⅠIgG的检测分别得出8.23%,38.56%,HSV-ⅠIgM、HSV-ⅠIgG的检测分别得出16.19%,37.02%,对照组HSV-ⅠIgM、HSV-ⅡIgG的检测结果是3.00%、21.00%,HSV-ⅡIgM、HSV-ⅡIgM、HSV-ⅡIgG检测结果为8.00%、19.00%。通过检测可以得出两组差异具有统计学意义(P0.05),对照组与观察组的IgG阳性要高于IgM(P0.05);男性HSV-ⅠIgM、HSV-ⅠIgG、HSV-ⅡIgM、HSV-ⅡIgG检测结果是9.78%,33.51%11.47%,31.81%。而女性的检测结果为9.17%,46.21%,21.52%,63.49%。可以看出性别不同的HSV-ⅡIgG阳性差异具有统计学意义(P0.05)。结论生殖器疱疹患者的疱疹抗体检测率较高,并主要以HSV-Ⅱ为主要感染方式,且女性HSV-ⅡIgG感染率明显高于男性。     

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.