乙型肝炎病毒S/C基因位点反义锁核酸在小鼠体内抗病毒疗效研究

目的 探讨针对HBV S/C双基因位点反义锁核酸对乙型肝炎转基因小鼠HBV复制和表达的影响.方法 将30只HBV转基因小鼠随机分为5组,每组6只.分别为5%葡萄糖液对照组、空脂质体对照组、单靶区S组,单靶区C组、双靶区SC组.反义锁核酸片段经尾静脉注入小鼠体内,采用时间分辨免疫荧光技术定量检测血清HBsAg;实时荧光聚合酶链反应定量检测血清HBV DNA含量;逆转录聚合酶链反应检测肝组织HBV C-mRNA的表达;免疫组织化学法检测肝细胞HBsAg、HBcAg的表达,自动牛物化学分析仪检测血清白蛋白、ALT、尿素氮、肌酐;小鼠肝,肾脏做常规病理切片,观察反义锁核酸对小鼠脏器的影响.应用SPSS12.0统计学软件分析.各组问比较采用重复测量方差分析的SNK检验和Kruskal Wallis H检验. 结果注射锁核酸后,对HBsAg的表达均显示有较强的抑制作用,单靶区S组,单靶区C组和双靶区SC组的平均抑制率分别为36.6%、31.5%和54.9%;对HBV DNA的复制也有抑制作用,平均抑制率分别为24.0%,21.1%和35.8%.注射后1、3、5 d,HBsAg的平均抑制率分别为14.4%、25.6%和31.3%;HBVDNA的平均抑制率分别为11.0%、19.2%和24.1%;血清中白蛋白、ALT、尿素氮、肌酐等指标,各组结果与对照组比较,差异均无统计学意义;小鼠肝细胞的HBsAg、HBcAg阳性细胞数均较对照组明显减少.小鼠肝,肾脏组织学表现未见异常. 结论 HBV S/C基因位点反义锁核酸对乙型肝炎病毒转基冈鼠HBV复制和表达有显著抑制作用,且双基因靶位优于单基因靶位.     

逆转录病毒载体介导双靶区乙型肝炎病毒反义RNA模型的构建

构建在真核细胞内转录表达乙型肝炎病毒(HBV)双靶区反义核酸重组载体用以抗HBV基因治疗的研究。方法为合成互补于HBV(ayw亚型)X区核苷酸X片段以及互补于HBV P区的P片段,利用基因重组技术将X、P片段分别正向、反向插入逆转录病毒载体pLXSN的相应酶切位点构建成单靶区重组载体质粒。在构建单靶区载体质粒的基础上,类似方法再构建双靶区重组载体质粒。经酶切电泳、PCR扩增和DNA测序鉴定成功构建了HBV双靶区反义核酸重组载体。为探索在真核细胞内转录表达HBV反义RNA的方法及研究多基因区抗病毒治疗和抗变异病毒打下基础。     

RNA干扰对乙型肝炎病毒复制的体外影响

目的:通过一种能够在细胞内表达短发卡RNA的逆转录病毒载体来研究RNA干扰对乙型肝炎病毒复制的影响.方法:首先针对HBV基因组Pol基因RT区寻找RNAi的靶位,并设计相对应的寡核苷酸链.然后再将一对碱基配对寡核苷酸链退火后连接入载体形成重组的质粒,并进行鉴定.在Huh-7细胞中,将通过鉴定的干扰质粒与HBV复制型质粒pHBV3.8共转染,分别应用ELISA方法来检测HBV相关的抗原,应用Northern印迹检测HBV RNA,以及应用实时荧光定量PCR和Southern印迹检测HBV核心颗粒DNA.结果:研究通过计算机方法协助寻找了3条RNAi靶位,并且构建了相应的基于逆转录病毒载体的RNA干扰质粒154i、312i和734i.结果发现312i对pHBV3.8表达有明显的抑制,HBsAg和HBeAg分别为阴性对照组的39%和41%,差异均有显著性(P=0.001,P=0.000).定量荧光PCR结果显示312i组核心颗粒DNA水平显著低于阴性对照组(21.3%±1.1%vs 100.0%±10.6%,P=0.0046).Southern blot和Northern blot结果均显示,312i组病毒复制及mRNA转录水平最低(10.5%,12.0%).结论:在HBV基因组RT区找到了一个可用于RNAi的靶位,并且构建了相对应的干扰质粒,此质粒可成功地抑制HBV复制型质粒在细胞中的复制和表达.     

PTD-HBcAg融合蛋白诱导特异性CTL抑制转基因小鼠HBV复制

目的:探讨经PTD-HBcAg融合蛋白体内诱导的特异性细胞毒T淋巴细胞(CTL)对HBV转基因小鼠病毒的抑制作用.方法:20只HBV转基因小鼠随机分组, 融合蛋白PTD-HBcAg及对照蛋白HBcAg经皮下免疫小鼠, 每周1次, 共3次. 流式细胞仪检测脾细胞中胞内细胞因子水平; 微粒子酶免疫分析法(MEIA)检测血清中乙型肝炎表面抗原(HBsAg)水平; 荧光定量聚合酶链反应(PCR)检测HBV DNA水平; 肝脏HE染色及免疫组织化学方法检测HBsAg表达.结果:PTD-HBcAg融合蛋白免疫转基因小鼠后, 能有效上调特异性CTL数量, 肝组织中炎性细胞的数量明显增多, 同时对小鼠血清中HBsAg及HBV DNA水平有明显的抑制作用.肝组织HBsAg免疫组织化学蛋白平均吸光度分析显示, 50 μg和100 μg PTD-HBcAg融合蛋白组中平均吸光度值与空白组和50 μg HBcAg组相比明显降低(127.77±4.92, 117.71±5.18vs 156.84±4.94, 138.70±5.92, 均P<0.05), 且组间比较差异有统计学意义.结论:PTD-HBcAg融合蛋白免疫HBV转基因小鼠后能增加特异性CTL数量, 显著降低血清中HBsAg及HBV DNA水平, 同时抑制肝脏中HBsAg的表达, 在HBV免疫治疗中具有抗病毒作用.     

HBV/HCV重叠感染患者HBV DNA、HCV RNA的复制及肝脏损害情况分析

目的探讨HBV/HCV重叠感染患者HBV DNA、HCV RNA的复制及肝脏损害情况,加深对HBV/HCV重叠感染患者的认识。方法选取2000～2013年在深圳市第三人民医院住院治疗的HBV/HCV重叠感染患者116例为研究对象。根据患者HBV DNA、HCV RNA实时荧光定量PCR定量检测结果,将患者分为4组,即HBV单阳性组(27例)、HCV单阳性组(49例)、双阳性组(17例)和双阴性组(23例)。比较4组患者年龄、性别、可能传播途径的差异;检测比较4组患者的谷丙转氨酶(ALT)水平及肝纤维化情况;对双阳性组患者的HBV DNA水平与其HCV RNA水平的关系进行Pearson相关性分析;比较4组患者的HBV DNA及HCV RNA复制水平。结果双阴性组患者的年龄显著小于其他3组患者,差异有统计学意义(P0.05);4组患者的ALT水平表现为HBV单阳性组双阴性组双阳性组HCV单阳性组,差异有统计学意义(P0.05),中重度肝纤维化表现为HBV单阳性组(25.9%)双阳性组(23.5%)HCV单阳性组(18.4%)双阴性组(17.4%),但差异无统计学意义(P0.05)。Pearson相关性分析结果显示,双阳性组患者的HBV DNA水平与其HCV RNA水平呈负相关(r=-0.519)。双阳性组患者的HBV DNA复制水平明显低于HBV单阳性组,差异有统计学意义(P0.05)。结论 HBV/HCV重叠感染患者体内HBV DNA与HCV RNA复制存在相互抑制和消耗情况,重叠感染患者体内HCV RNA复制占主导地位可能会促使其HBV自发阴性率有所增高。     

RNA干扰在动物体内抗乙型肝炎病毒的效果

目的以乙型肝炎病毒(HBV)C区为靶位,动物实验体内观察RNA干扰抗HBV的效果。方法以流体动力学法建立HBV感染的动物模型,将pcDNA 3．1-HBV和体外细胞实验证明有效的小干扰 RNA(siRNA)尾静脉共注射BALB／c小鼠;用时间分辨免疫荧光分析法检测小鼠血清中乙型肝炎表面抗原(HBsAg)水平,用荧光定量聚合酶链反应法检测血清HBV DNA水平,用逆转录聚合酶链反应法检测 HBV C-mRNA,用免疫组织化学法检测肝组织HBsAg和乙型肝炎核心抗原。结果在小鼠体内,siRNA 能有效抑制HBV的复制和表达,干扰效果至少持续3 d。结论靶向HBV C区的siRNA在动物体内能有效抗HBV。     

基因重组HBV的构建及其表达反义RNA抗-HBV作用的研究

目的　探索利用乙型肝炎病毒 (HBV)作为基因治疗载体的可能性及检验其表达反义RNA抗HBV的作用。方法　在表达完整HBV颗粒的质粒上 ,经基因修饰后分别表达S或S启动子区的反义RNA ,整合于具有HBV复制的 2 .2 .15细胞 ,形成细胞克隆 ,酶联免疫吸附 (ELISA)法检测细胞培养上清液中HBsAg和HBeAg ,斑点杂交法检测细胞内HBV核壳中HBVDNA ,聚合酶链反应(PCR)法检测上清液中重组HBV颗粒。结果　 2 .2 .15 pMEP4组、2 .2 .15 SAS组和 2 .2 .15 PAS组对HBsAg平均抑制率分别为 (2 .74± 3.83) %、(6 6 .5 4± 4 .4 5 ) % (P <0 .0 1)和 (5 5 .18± 3.2 7) % (P <0 .0 1) ;对HBeAg平均抑制率分别为 (4 .4 6± 4 .2 5 ) %、(2 6 .36± 1.6 9) % (P <0 .0 1)和 (6 5 .5 4± 3.2 2 ) % (P <0 .0 1) ;对HBV复制的抑制率分别为 17.0 %、5 9.9%和 72 .8%。 2 .2 .15 SAS组及 2 .2 .15 PAS组培养上清液中能检测出突变型HBV颗粒。结论　经过对HBV基因组的两处改造 ,分别在细胞内表达S区及S启动子区反义RNA具有干扰HBV复制及抑制HBV抗原表达的作用 ;在 2 .2 .15细胞中野生型HBV辅助下 ,仍能包装并分泌完整的HBV样颗粒     

RNA干扰抑制乙型肝炎病毒复制的实验研究

目的 以乙型肝炎病毒(HBV)核心区为靶位，构建表达小干扰RNA(siRNA)的质粒载体pSilencer3．1-Hlhygro，体外观察siRNA抗HBV的效果。方法 以HepG2 2．2．15细胞为靶细胞，利用脂质体Metafectene与表达siRNA的质粒载体pSilencer3．1-Hlhygro共转染，用定量聚合酶链反应检测细胞上清液中DNA，用逆转录聚合酶链反应检测HBV C-mRNA。结果 成功构建了表达siRNA的转录质粒载体，两条siRNA均可抑制HBV的复制，而且与siRNA浓度成正相关。结论 靶向HBV核心区的siRNA能抑制HBV的复制。     

甲胎蛋白启动子介导反义乙型肝炎病毒X基因在肝癌细胞中的表达及其作用

目的 构建含甲胎蛋白(AFP)启动子和增强子的反义乙型肝炎病毒X基因(HBX)真核表达载体，研究其特异性和有效性，为开发肝癌细胞特异性HBX反义RNA基因治疗乙型肝炎病毒(HBV)奠定基础。方法 聚合酶链反应(PCR)扩增HBX(1370—1872nt)基因，克隆至EB病毒表达载体，双轮PCR筛选、鉴定基因插入方向。脂质体转染肝癌细胞和ECV304细胞，Northernblot检测HBX mRNA的表达，酶联免疫试验(ELISA)检测HBV抗原，荧光定量PCR检测HBV DNA。结果 成功构建正、反义RNA表达载体pEBAF—s—HBX、pEBAF—as—HBX。Northernblot证实反义RNA仅在AFP阳性的肝癌细胞中表达。pEBAF—as—HBX转染3d后，可显著抑制2．2．15细胞HBV复制和抗原表达，其HBsAg、HBeAg抗原表达较正义对照分别下降37．9％和36．8％，HBV DNA降低25％。结论 反义RNA表达载体pEBAF—as—HBX仅在肝癌细胞中特异表达、并可有效抑制HBV，有良好的开发应用前景。     

胰岛素瘤的解剖分布特点分析

目的胰岛素瘤是最常见的胰腺神经内分泌肿瘤，因其临床表现多样，导致诊断困难。影像学诊断尤其是超声内镜(EUS)在胰岛素瘤的诊断中起着重要作用，拥有较高的敏感性和特异性。本研究拟通过明确胰岛素瘤的解剖分布特点，以期有助于提高影像学的诊断准确率和降低漏诊率，尤其是在教育和培训实践中对于EUS的学习者更具有指导价值。 方法回顾性分析解放军总医院第一医学中心病案资料数据库1993年1月至2019年11月经外科手术、病理确诊为胰岛素瘤的患者的临床资料，检索方法采取搜索术后病理诊断为"胰岛素瘤"的病例，通过查阅病例的方法，提取出胰岛素瘤的大小和解剖分布等数据，进一步分析其特点。 结果共检索到确诊为胰岛素瘤的患者116例，其中，男45例、女71例，年龄13～76岁，平均年龄(44.4±14.85)岁。胰岛素瘤单发110例(94.8%)、多发6例(5.2%)。位置分布：头颈部46例(39.7%)，单发45例、多发1例；体尾部68例(58.6%)，单发65例、多发3例；全胰腺多发2例(1.7%)。病变大小特点：最大径0.4～3.4 cm，平均大小(1.53±0.58)cm。≤1 cm 29例、>1 cm而≤1.5 cm41例、>1.5 cm而≤2.0 cm28例，≤3 cm 15例，>3 cm 3例。年龄与肿瘤的大小相关，≤44岁患者肿瘤平均大小为(1.36±0.51)cm、>44岁患者肿瘤平均大小为(1.70±0.60)cm，P<0.05。头颈部的肿瘤大于体尾部的肿瘤，头颈部肿瘤平均大小(1.66±0.63)cm，体尾部(1.42±0.52)cm，P<0.05。 结论胰岛素瘤在胰腺体尾部较头颈部更好发；绝大多数单发，但可以全胰腺多发；多数小于1.5 cm，肿瘤的大小与患者年龄和肿瘤的解剖分布相关。     

Pathogenesis of carcinoma of the papilla of Vater

Most adenomas and carcinomas of the small intestine and extrahepatic bile ducts arise in the region of the papilla of Vater. In familial adenomatous polyposis (FAP) it is the main location for carcinomas after proctocolectomy. In many cases symptoms due to stenosis lead to diagnosis at an early tumor stage. In about 80%, curative intended resection is possible. Operability is the most relevant prognostic factor. Most ampullary carcinomas resp. carcinomas of the papilla of Vater develop from adenomatous or flat dysplastic precursor lesions. They can be sited in the ampulloduodenal part of the papilla of Vater, which is lined by intestinal mucosa. They also can develop in deeper parts of the ampulla, which are lined by pancreaticobiliary duct mucosa. Intestinal-type adenocarcinoma and pancreaticobiliary-type adenocarcinoma represent the main histological types of ampullary carcinoma. Furthermore, there exist unusual types and undifferentiated carcinomas. Many carcinomas of intestinal type express the immunohistochemical marker profile of intestinal mucosa (keratin 7?, keratin 20+, MUC2+). Carcinomas of pancreaticobiliary type usually show the immunohistochemical profile of pancreaticobiliary duct mucosa (keratin 7+, keratin 20?, MUC2?). Even poorly differentiated carcinomas, as well as unusual histological types, may conserve the marker profile of the mucosa they developed from. These findings underline the concept of histogenetically different carcinomas of the papilla of Vater which develop either from intestinal- or from pancreaticobiliary-type mucosa of the papilla of Vater. Molecular alterations in ampullary carcinomas are similar to those of colorectal as well as pancreatic carcinomas, although they appear at different frequencies. In future studies, molecular alterations in ampullary carcinomas should be correlated closely with the different histologic tumor types. Consequently, the histologic classification should reflect the histogenesis of ampullary tumors from the two different types of papillary mucosa.     

Lack of correlation of degree of villous atrophy with severity of clinical presentation of coeliac disease

BACKGROUND AND AIM: Both the clinical presentation and the degree of mucosal damage in coeliac disease vary greatly. In view of conflicting information as to whether the mode of presentation correlates with the degree of villous atrophy, we reviewed a large cohort of patients with coeliac disease. PATIENTS AND METHODS: We correlated mode of presentation (classical, diarrhoea predominant or atypical/silent) with histology of duodenal biopsies and examined their trends over time. RESULTS: The cohort consisted of 499 adults, mean age 44.1 years, 68% females. The majority had silent coeliac disease (56%) and total villous atrophy (65%). There was no correlation of mode of presentation with the degree of villous atrophy (p=0.25). Sixty-eight percent of females and 58% of males had a severe villous atrophy (p=0.052). There was a significant trend over time for a greater proportion of patients presenting as atypical/silent coeliac disease and having partial villous atrophy, though the majority still had total villous atrophy. CONCLUSIONS: Among our patients the degree of villous atrophy in duodenal biopsies did not correlate with the mode of presentation, indicating that factors other than the degree of villous atrophy must account for diarrhoea in coeliac disease.     

Demonstration of the mechanism of action of biguanides

Summary Palmitic acid oxidation in rat diaphragm homogenate is depressed by biguanide concentrations that are still incapable of inhibiting oxidative phosphorylation. Glucose oxidation is not directly effected by the same biguanide concentrations: however, the inhibitory effect of palmitic acid on glucose oxidation is partly removed by biguanides. Inhibition of fatty acid oxidation, which accounts for most of the metabolic effects caused by these drugs, can be regarded as the fundamental mechanism of action of biguanides. There is some evidence suggesting that these drugs might interact with carnitine, thus preventing long-chain fatty acids from being transported across the mitochondrial membrane to the site of oxidation. Traduzione a cura degli AA.     

血吸虫童虫生长发育及其机制的研究进展

血吸虫童虫是宿主免疫系统攻击的重要靶标,包括皮肤型、肺型和肝门型童虫。宿主分子对童虫生长发育具有重要作用。童虫生长发育机制包括免疫调节、信号转导、性别发育及凋亡等。肌动蛋白、组织蛋白酶、烯醇化酶和葡萄糖基转移酶等分子为血吸虫童虫生长发育的重要分子。本文对血吸虫童虫生长发育及其机制的研究进展做一综述。     

124例耐多药结核分枝杆菌基因突变特征分析

目的对临床分离的耐多药结核分枝杆菌相关基因的突变特征进行分析。方法对124例耐多药结核分枝杆菌以及50株敏感株的耐药相关基因(包括异烟肼inh A、kat G、oxyR-ahp C间隔区以及利福平rpo B)进行序列测定,分析其基因突变情况。结果异烟肼耐药inh A基因突变率为14.5%;kat G基因突变率为70.2%(87/124),主要位于315位;oxyR-ahp C间隔区突变率为15.3%;inh A、kat G两种基因同时突变率75.0%,三种基因同时突变率为89.5%。利福平rpo B基因突变的检出率高达95.2%,突变主要发生在531、526、516位点。结论我省耐多药菌异烟肼耐药相关基因最常见突变为kat G 315、inh A C-T(-15)、axyR-ahp C间隔区(-10)C-T,利福平为rpo B531、526、516。结合MDR-TB耐药相关基因的特征分析,可以建立一种快速、准确、特异的适合于我省的检测结核菌耐多药性的新方法。     

Assessment of quality of life of parents of children with juvenile chronic arthritis

The aim of the study was to assess the quality of life (QOL) and the psychological status of parents of children with juvenile chronic arthritis (JCA). The QOL, anxiety and depression of the parents of 28 children with JCA were evaluated and compared to those of the parents of 28 healthy children. Mothers of JCA children and mothers of healthy children reported similar QOL. The reported anxiety and depression levels were similar for mothers and fathers in both groups. The parents of children with pauciarticular-type JCA reported lower QOL and higher levels of anxiety and depression than the parents of children with other types, namely polyarticular and systemic JCA. These findings may be explained by the fact that the pauciarticular patients had shorter disease duration and were less frequently seen in the outpatient clinic. The QOL of mothers of children with JCA was found to be slightly impaired in the group of children with pauciarticular JCA. Future larger studies are needed to confirm these results, as the number of subjects in the three groups was rather low. Received: 26 September 2001 / Accepted: 8 February 2002     

Numerical Simulation of the Effect of Rate of Change of Glucose on Measurement Error of Continuous Glucose Monitors

Background

A 5-day in-patient study designed to assess the accuracy of the FreeStyle Navigator® Continuous Glucose Monitoring System revealed that the level of accuracy of the continuous sensor measurements was dependent on the rate of glucose change. When the absolute rate of change was less than 1 mg•dl⁻¹•min⁻¹ (75% of the time), the median absolute relative difference (ARD) was 8.5%, with 85% of all points falling within the A zone of the Clarke error grid. When the absolute rate of change was greater than 2 mg•dl⁻¹•min⁻¹ (8% of the time), the median ARD was 17.5%, with 59% of all points falling within the Clarke A zone.

Method

Numerical simulations were performed to investigate effects of the rate of change of glucose on sensor measurement error. This approach enabled physiologically relevant distributions of glucose values to be reordered to explore the effect of different glucose rate-of-change distributions on apparent sensor accuracy.

Results

The physiological lag between blood and interstitial fluid glucose levels is sufficient to account for the observed difference in sensor accuracy between periods of stable glucose and periods of rapidly changing glucose.

Conclusions

The role of physiological lag on the apparent decrease in sensor accuracy at high glucose rates of change has implications for clinical study design, regulatory review of continuous glucose sensors, and development of performance standards for this new technology. This work demonstrates the difficulty in comparing accuracy measures between different clinical studies and highlights the need for studies to include both relevant glucose distributions and relevant glucose rate-of-change distributions.     

氯硝柳胺悬浮剂的毒性评价

目的评价氯硝柳胺悬浮剂的毒性，为现场大规模应用灭螺提供依据。方法按照中华人民共和国国家标准GB 15670-1995《农药登记毒理学试验方法》和鱼类毒性试验方法进行。结果经口、经皮肤的LDso雌、雄性大鼠均>5 000 mg/kg，经呼吸道的LCso雌、雄性大鼠均>5 000mg/m3，该药经口、经皮肤、经呼吸道毒性均属微毒类药物；兔眼用药后，观察期内无不良反应，对眼无刺激性；皮肤用药后对皮肤无刺激性。与氯硝柳胺原药、氯硝柳胺乙醇胺盐原药和氯硝柳胺乙醇胺盐可湿性粉剂相比，氯硝柳胺悬浮剂对鱼急性毒性最低。结论氯硝柳胺悬浮剂属微毒类药物，对鱼的毒性低于其乙醇胺盐可湿性粉剂，适合于现场应用。     

Study of constancy of hydrogen-consuming flora of human colon

The constancy of the hydrogen consuming flora of the human colon was studied in 15 healthy subjects via two measurements obtained 18 to 36 months apart. Hydrogen disappearance rate and the major products of H₂-consuming bacteria, methane and sulfide, were measured during incubation of fecal homogenates with excess hydrogen and sulfate. In 11/15, the hydrogen consumption rate and the predominant hydrogen-consuming pathway (methanogenesis, sulfate reduction, or neither) remained constant. However, major shifts in these pathways were observed in four subjects, with two losing and two gaining the ability to produce methane. Methanogenesis was associated with the highest hydrogen consumption rate. This study demonstrates that clinically unrecognizable, major alterations of the colonic flora occur in healthy subjects. Understanding of the factors responsible for these alterations might allow for therapeutic manipulation of the colonic flora.Supported in part by the Department of Veterans Affairs and NIDDKD RO1 DK 13309-25.