HBsAg阳性母亲的新生儿乙肝疫苗免疫结果调查

２６３例母亲ＨＢｓＡｇ阳性的１－１０岁儿童,分别于出生时,１个月、６个月乙肝疫苗１２０μｇ接种,结果各年龄段ＨＢｓＡｇ阳性率平均为４．１８,抗－ＨＢｓ阳性率平均为６３．４９％。说明予双倍剂量乙肝疫苗接地其儿童避免乙肝的保护作用是成功的,且免疫效果可达１０年以上。     

复种乙肝疫苗致荨麻疹和喉头水肿1例

复种乙肝疫苗致荨麻疹和喉头水肿１例陶清，谷梅患者女性，１９岁。查ＨＢｓＡｇ阴性，转氨酶正常后于１９９５年７月５日接种乙肝疫苗１０μｇ（卫生部上海生物制品研究所生产，批号：９５０３０１－６），无不良反应。１月后复种同盒疫苗１０μｇ，当时无不适。１．５ｈ...     

单项乙型肝炎病毒核心抗体阳性的意义

目的 为阐明乙肝病毒单项抗－ＨＢｃ阳性的意义。方法 对经放免严格筛选的５６名乙肝病毒单项抗－ＨＢｃ阳性者，１２１名乙肝ＨＢｓＡｇ、ＨＢｓＡｂ、ＨＢｃＡｂ三项指标全阴性者均按０、１、６月方案接种同样的乙肝疫苗。在表面抗体出现高峰期（即接种乙肝疫苗后第９个月时），比较二者抗－ＨＢｓ的应答率。结果 单项抗－ＨＢｃ阳性组明显低于后者，提示乙肝病毒单项抗－ＨＢｃ阳性者可能与ＨＢＶ感染有关。为了进一步证实这一     

新生儿乙肝疫苗肌肉,皮内联合注射新方案

目的 评价不经筛选的孕妇健康足月新生儿乙肝疫苗肌肉，皮内联合注射新方案的的免疫应答及经济效益。方法 实验组：第１针乙肝疫苗３０μｇ肌肉注射，第２，３，针各２μｇ皮内注射；对照组；３针乙肝疫苗均采用肌肉注射，第１针３０μｇ，第２，３，针各为１０μｇ。以０，６，１２月时的ＨＢｓＡｇ有抗－ＨＢｓ观察免疫应答。     

费县乙型肝炎感染标志的血清学调查

我们于１９９８年３月对费县正常人群进行了ＨＢｓＡｇ、ＨＢｓＡｂ和ＨＢｃＡｂ三项血清学调查，结果如下。１　材料和方法１．１　标本来源及研究方法　用整群系统抽样方法随机抽取８２１人进行体格检查，询问有关病史，剔除乙肝疫苗接种者，并填写调查表，同时采静脉血分离血清置－２０℃下保存待检。１．２　检测方法与判定　应用酶联免疫吸附试验（ＥＬＩＳＡ）检测ＨＢｓＡｇ、ＨＢｓＡｂ和ＨＢｃＡｂ，试剂盒由上海科华生物技术有限公司生产，结果用９６０酶标仪检测，三项指标中有一项阳性即判定为ＨＢＶ感染。２　结果见表１、表…     

不同剂量乙肝疫苗的保护效果

本文观察不同剂量乙肝疫苗对儿童５５个月后的免疫效果。小剂量组９８人，剂量５ｕｇ×３次；对照组１３６人，剂量３０ｕｇ、１０ｕｇ、１０ｕｇ。于０、１、６月三角肌部位注射。同时观察未接种乙肝疫苗儿童１７６人ＨＢＶ感染情况。结果；首剂接种８、１８、５５个月后，抗－ＨＢｓ≥１０ｍＩｕｕ／ｍｌ的人数，小剂量组和对照组分别为５０／５４对５７／５８（Ｐ＞０．０５）；５２／５３及５４／５５（Ｐ＞０．０５）；３６／４１对７３／７８ｐ＜０．０５）。两组抗－ＨＢｓ几何平均滴度（ＧＭＴ）分别为３４±０．２７对５５．４±０．４２（ｐ＜０．０１）；４２．０对５５．０（ｐ＜０．０５）；７６．１４对１３９．５（ｐ＞０．０５）。５５个月两组无显著性差异。所有接种儿童，不论抗－ＨＲｓ滴度是否达到有效保护水平，ＨＢ、Ａｇ均阴性。未按种儿童ＨＢｓＡｇ（＋）为１１／１７６（６．２５％）。结论：与正规剂量一样，小剂量乙肝疫苗同样产生有效的保护作平，接种后机－ＨＢｓ低滴度儿童仍可防止ＨＢＶ感染。     

成人接种乙肝疫苗40个月后的免疫状态（附1021例分析）

本文对１０２１例ＨＢｓＡｇ阴性者进行乙肝疫苗接种，于接种后４０个月进行了外周血ＨＢＶ标志检测，了解其免疫状态．结果抗－ＨＢｓ阳性５５２人占５４．５０％，ＨＢｓＡｇ阳性１０例，其中单项ＨＢｓＡｇ阳性４例，ＨＢｓＡｇ、抗－ＨＢｃ双阳性５例，ＨＢｓＡｇ、抗－ＨＢｓ、ＨＢｓＡｇ三项阳性１例，感染率０．９８％．我们认为，在有条件的单位或地区，成人ＨＢｓＡｇ阴性者也应推广乙肝疫苗免疫接种．     

不同方案HBIG联合乙肝疫苗阻断HBV母婴传播的长期观察

本文总结了母亲ＨＢｓＡｇ阳性的新生儿１８２名，将其分为３组。分别在其出生时注射乙肝高效价免疫球蛋白（ＨＢＩＧ）１支，２支以及在出生时和出生后２周时，各注射１支（ＨＢＩＧ），接着在１、２、７个月龄时，再接种乙肝疫苗２０μｇ。长期观察其抗－ＨＢｓ阳转率和ＨＢｓＡｇ的携带率。从而提出在出生时和出生后２周各注射１支（ＨＢＩＧ）的免疫效果较佳。     

献血员乙肝疫苗免疫模式及效果观察(附992例分析)

本文对８１７例接受乙肝疫苗免疫的献血员及１７５名未曾接种的献血者进行了抗－ＨＢｓ阳性率分析,结果两者均未发现其阳性率与受检区域,性别,ＡＢＯ血型等因素有关：用０,３,５,０,３,６,０,３,７,０,４,７的１０μｇ×３针及０,２～６的１０μｇ×１＋２０μｇ×１针等５种程序免疫,阳性率在７３．１７％～８０．００％之间无明显差异,１０μｇ×１针,１０μｇ×２针与１０μｇ×３针免疫后阳性率无显著差异,１     

1434名健康成人HBsAg携带状况调查分析

对１４３４名职工血清ＨＢｓＡｇ检测结果。１６０名ＨＢｓＡｇ为阳性，阳性率１１．１６％。与我国人群中ＨＢｓＡｇ携带率基本一致。对ＨＢｓＡｇ阳性者进一步检测两对半和肝功能，其中１４例（８．７５％）肝功能异常，分别为ＨＢｓＡｇ、ＨＢｅＡｇ、ＨＢｃＡｂ阳性组７例（２０．００％）；ＨＢｓＡｇ、ＨＢｅＡｂ阳性组４例（１０．５３％）；ＨＢｓＡｇ、ＨＢｅＡｂ、ＨＢｃＡｂ阳性组３例（３．５７％）。ＨＢｓＡｇ、ＨＢｅ     

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.     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.