唾液抗－HAVIgM检测及其意义

唾液抗－ＨＡＶＩｇＭ检测及其意义张涛，曹丽，王占英（第二临床学院传染科）关键词酶联免疫吸附试验，唾液，抗－ＨＡＶＩｇＭＥＬＩＳＡ法检测血清抗－ＨＡＶＩｇＭ其灵敏度高，特异性强￣［１］，对甲型肝炎（甲肝）的诊断和流行病学调查均有重要意义。然而检测血清抗...     

成人甲型肝炎患者20例粪便排出HAV持续时间的临床分析

ＨＡＶ主要是通过粪－口途径传播，弄清甲型肝炎（甲肝）患者粪便排出ＨＡＶ的持续时间，对控制甲型肝炎的流行十分重要。据文献报道，甲肝患者粪便排出ＨＡＶ的时间长达７周，但目前尚有争议。作者对本院收治的２０例甲肝住院病人的粪便排出ＨＡＶ的持续时间采用ＲＴ－Ｐ...     

甲型肝炎与胃幽门螺杆菌传播途径关系的探讨

把甲肝抗体用作粪－口传播的标示物，用ＥＬＩＳＡ法检测３２５例人群血清ＨＰ及ＨＡＶ感染率以探讨ＨＰ是否经粪－口途径传播结果：在３２５例人群中抗ＨＰ及抗ＨＡＶ抗体阳性率分别是５１１％和５６０％ＨＰ与ＨＡＶ的感染率均是农村高于城镇，饮用非自来水、生水高于饮用自来水和开水结果表明：ＨＰ感染与经济、卫生状况有关，与甲肝感染呈平行关系，为粪－口传播性疾病     

甲型肝炎患者PBMC中HAV-Ag的APAAP检测法及HAV-Ag检出的意义

目的 建立检测甲肝患外周血单个核细胞（ＰＢＭＣ）中甲肝病毒抗原（ＨＡＶ－ＡＧ）的ＡＰＡＡＰ方法,并对５２例甲肝患ＰＢＭＣ中ＨＡＶ－Ａｇ进行动态。方法 应用抗ＨＡＶ－ＭｃＡｂ,着抗鼠ＩｇＧ及ＡＰＡＡＰ建立了三层重叠的ＡＰＡＡＰ法,对５２例甲肝患急性期及恢复期ＰＢＭＣ进行动态检测,对ＨＡＶ－Ａｇ阳性率及平均阳性细胞百分率及其与甲肝病程的相关关系进行了分析。结果 替代试验及阴断试验证明本方法特异性     

甲型肝炎患者血清抗独特型抗体的动态观察及临床意义

目的：对甲型肝炎（甲肝）患血清ＩｇＭ及ＩｇＧ型抗ＨＡＶ－抗独特型抗体（抗ＨＡＶ－抗Ｉｄ）进行动态观察，探讨其在甲肝发病机理中的可能作用。方法：在Ｉｒｓｈａｄ等方法的基础上建立了抗ＨＡＶ－抗Ｉｄ的ＥＬＩＳＡ法。结果：抗ＨＡＶ－抗Ｉｄ在甲肝急性期以ＩｇＭ型为主（３０．１２％），ＩｇＧ型仅少量出现（８．４３％）；恢复期以ＩｇＧ型为主（３１．３３％，Ｐ＜０．０１），ＩｇＭ型则明显减少（１５．６６％，Ｐ＜     

广西肝癌高发区人群多种肝炎病染的流行病学研究

目的：对广西肝癌高发区健康人群及肝癌患者ＨＢＶ、ＨＣＶ、ＨＥＶ、ＨＧＶ感染状况及其与肝癌的关系进行血清流行病学研究。方法：采用ＥＬＩＳＡ方法检测调查对象血清中ＨＢｓＡｇ、抗－ＨＣＶ、抗－ＨＥＶ、抗－ＨＧＶ,用ＲＴ－ＰＣＲ方法检测肝癌患者血清中ＨＧＶ－ＲＮＡ;用成组病例－对照研究方法分析ＨＢＶ、ＨＣＶ、ＨＥＶ及ＨＧＶ感染与肝癌的关系。结果：ＨＢＶ、ＨＣＶ、ＨＥＶ、ＨＧＶ相应的肝炎病毒感染率,健康人群     

甲型肝炎减毒活疫苗免疫效果的进一步观察

目的 进一步观察我国研制的规范化甲型病毒性肝炎（简称甲肝）减毒活疫苗流行病学和血清学效果。方法 在河北省阜城县以群体随机分组法接种Ｈ２株甲肝减毒活疫苗，疫苗组５５５１人，对照组６４８５人。观察全人群和上述两组人群甲肝发病率，出现流行时采集两组人群血液，检测抗－ＨＶＡ ＩｇＧ和ＩｇＭ，分析疫苗保护效果。结果 １９９７年５月完全疫苗接种，疫苗接种后７个月内为甲肝散发，发病率为０．５５／１０万；疫苗组未     

柳州地区不同人群庚型肝炎病毒感染流行病学调查

目的：了解柳州地区不同人群中庚型肝炎病毒感染情况。方法：对柳州地区１０２０例不同人群血清用ＥＬＩＳＡ法进行庚型肝炎病毒抗体（抗－ＨＧＶ）检测。结果：抗－ＨＧＶ总阳性率为３．２４％。其中丙型肝炎患者、血透者、静脉吸毒者三组人群中抗－ＨＧＶ阳性率较高，分别为２０．０％，１８．１８％，６．０％，与自然人群组对比，ＨＧＶ感染率有显著差异。而非甲－戊型肝炎患者中ＨＧＶ感染率仅３．７０％，与自然人群对比无显著     

柳州市静脉吸毒人群肝炎病毒感染的调查与分析

目的：调查柳州市静脉吸毒者中肝炎病毒的感染情况。方法：应用酶联免疫吸附法（ＥＬＩＳＡ）对２０８名静脉吸毒者进行ＨＢｓＡｇ、抗－ＨＤＶ、抗－ＨＤＶ、抗－ＨＧＶ的血清学检测。结果：ＨＢｓＡｇ、抗－ＨＣＶ、抗－ＨＤＶ、抗－ＨＧＶ的阳性率分别为２７．４％、８９．４％、４９．１％、８．７％,均显著高于自然人群的感染率,并存在不同的重叠感染模式。结论：静脉吸毒者中ＨＢＶ、ＨＣＶ、ＨＤＶ和ＨＧＶ的感染率和重叠感     

乙肝标记物检测甲肝病人的临床意义

对１３６例甲型病毒性肝炎（以下称甲肝）患者进行了乙型病毒性肝炎（以下称乙肝）标记物（ＨＢＶＭ）检测。检出ＨＢＶＭ阳性者２４例（１７．６５％），其中抗－ＨＢｃ阳性２１例（１５．４％），抗－ＨＢｓ阳性８例（５．８８％），ＨＢｓＡｇ阳性８例（５．８８％），抗－ＨＢｅ阳性６例（４．４１％），ＨＢｃＡｇ和ＨＢｅＡｇ阳性的各一例（０．７４％）。动态观察恢复期ＨＢＶＭ阴转８例（３３．３３％）；２例ＨＢｓＡｇ阴转病例中，一例产生抗－ＨＢｓ。病毒复制指标：ＨＢｅＡｇ和ＨＢｃＡｇ各一例阳性均全部阴转，说明在甲肝病毒（ＨＡＶ）感染时，乙肝病毒（ＨＢＶ）复制受抑制。此外，不论ＨＢＶＭ阴性或阳性，对肝功能恢复均无明显影响     

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.