肝炎疾病中巨细胞病毒激活性感染的观察

巨细胞病毒（CMV）广泛感染于人类，多隐伏于组织和细胞内，一旦机体免疫功能改变，病毒即可复制，呈激活性感染，常导致条件致病。对CMV在肝炎疾病中的感染性及病理机制，目前尚不清楚，实验室用聚合酶链反应（PCR）技术，对不同型、不同病理反应的CMV激活性感染作了观察，初步探索了CMV在肝炎疾病中的分布。研究对象与方法1对象1995年～1996年采集西宁地区4所医院急性肝炎、慢性肝炎病例血清356例，一20C贮存，分期于l～5天内完成实验，样本中男性238例，女性118例，年龄7～72岁，肝炎分型由临床医院按肝炎标准诊断。2样本血清提取…     

巨细胞病毒在乙型肝炎患者中感染状况的探讨

目的：了解巨细胞病毒在乙型肝炎中感染状况。方法：在病例组及对照组中应用酶联免疫法(ELISA)法及CMV-IgM及CMV-DNA(PCR)法检测巨细胞病毒(CMV)。结果与结论：提示PCR技术敏感性高于ELISA法，用PCR技术检测乙肝患者血清中CMV-DNA是一种早期、快速、准确诊断CMV活动性感染的有效方法之一。     

巨细胞病毒宫内感染的临床分析(附3例报告)

目的 重视巨细胞病毒宫内感染的诊断。方法 巨细胞病毒宫内感染的孕妇均在尿沉渣、宫颈分泌物及羊水中找到CMV包涵体。结果 3例巨细胞病毒宫内感染,其中2例胎儿畸形死亡,1例存活。结论 巨细胞病毒宫内感染危害最重的的是胎儿,重在预防和诊断。     

PP65抗原检测在脑性瘫痪患儿巨细胞病毒感染诊断中的价值

人巨细胞病毒（CMV）感染是引起人类先天性中枢神经系统畸形的主要病原之一。CMV感染常常引起胎儿或新生儿脑性瘫痪（cerebral palsy，CP）或认知障碍，是造成出生缺陷和小儿残疾的重要原因。在感染早期进行特异性的抗病毒治疗能够有效地改善预后，提高治愈率，减少并发症及降低死亡率。因此，早期准确诊断活动性CMV感染，是早期抗病毒治疗的关键。PP65抗原是巨细胞病毒早期产生的一种结构蛋白，是巨细胞病毒活动性感染的标志。本研究通过流式细胞技术对CP患儿进行血PP65抗原测定，并同时测定尿定量CMV DNA及血CMV IgM作为对照，以探讨PP65抗原检测在CMV感染诊断中的意义。     

肝移植受者术后巨细胞病毒抗原血症的发生及其影响因素分析

巨细胞病毒（cytomegalvirus，CMV）感染正常人群后通常呈潜伏状态，当机体处于免疫功能受损或受抑制状态时，潜伏的CMV可能被激活。肝移植受体术后免疫系统功能大大低于正常人群，CMV易被激活而导致严重的CMV病，并与移植后急慢性排斥反应有关。监测移植术后CMV活动性感染的主要方法是测定外周血白细胞中是否出现CMVpp65抗原——即CMV抗原血症。借鉴骨髓移植、肾移植经验，肝移植受者术后定期、定量检测CMVpp65，并常规给予抗病毒药物预防而控制CMV感染。     

婴儿先天性CMV感染危险与母亲获得性免疫有关

据美国研究人员报道,与最初血清巨细胞病毒(CMV)阴性妇女相比,具有天然获得性CMV免疫的妇女分娩的婴儿先天性感染CMV的危险性较小。来自于美国伯明翰阿拉巴马     

孕妇巨细胞病毒、风疹病毒及弓形体感染的监测

对465例孕妇进行巨细胞病毒(CMV)、风疹病毒(RuV)、弓形体(Tox)感染的监测。孕妇 CMV 感染率为3.58%,新生儿先天性 CMV 感染率为3.01%。孕妇 RuV 感染率为3.6%,胎儿先天性 RuV 感染率为2.8%。未发现母婴有Tox 感染。4—14月龄时随访:6例先性 CMV 感染儿中患先心病1例,7例先天性 RuV感染中死胎1例,早产2例,存活6例中均有不同程度的生长发育障碍。提示孕妇感染对婴儿的危害是一个严重的问题。     

巨细胞病毒感染实验室检测结果的比较

巨细胞病毒(cytomegalovirus,CMV)是一类在自然界普遍存在,但又具有严格种属特异性的病毒。人类CMV感染非常普遍,并且是人巨细胞病毒(human cytomegalovirus,HCMV)的唯一宿主[1,2]。     

贫困山区孕期CMV感染与IL—6的关系

目的 研究贫困山区孕期巨细胞病毒（Cytomegalovirus,CMV)感染状况，探讨孕期CMV感染与白细胞介素6（Inter leukin-6,IL-6)的关系。方法 用ELISA和PCR方法检测贫困山区305例正常孕妇外周血特异性CMV IgM抗体及CMV DNA，对其中48例孕期CMV感染者及68例孕期未感染CMV者进行随访，检测产后两周内乳汁及新生儿尿液CMV DNA；并采用双抗体夹心ELISA法检测孕妇及乳母外周血中IL－6水平。结果 孕妇CMV活动性感染率19．02％，孕期CMV活动性感染及乳汁排泄CMV者其外周血IL－6水平显著高于未感染者（P＜0．05）。结论 贫困山区孕期CMV感染率较国内外报道的高；IL－6在孕期活动性CMV感染中可能起着重要作用。     

婴儿巨细胞病毒感染诊治进展

自1956年从组织培养中成功分离巨细胞病毒(CMV)以来，世界各地对巨细胞病毒感染进行了广泛而全面的研究。巨细胞病毒属疱疹病毒科，为DNA病毒。巨细胞病毒感染是人巨细胞病毒(HCMV)引起的人类感染性疾病。人巨细胞病毒在自然人群中感染非常普遍，大多为不显性和潜伏感染。在我国妇女，人巨细胞病毒感染率极高，潜伏在孕妇体内的人巨细胞病毒在妊娠期被激活，     

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.