西安和郑州地区丙型肝炎患者的HCV基因分型

目的 了解西安和郑州地区丙型肝炎病毒（HCV）感染的基因型，比较了两地基因型分布的差异。方法 采用限制性长度多态性分析（RFLP）法对采自西安地区的46份和郑州地区的40份HCVRNA阳性标本进行HCV基因型分型研究。结果 西安地区46份标本中，25份（54．3％）为1b型病毒，17份（37．0％）为2a型病毒，4份（8．7％）为1b/2a混合型病毒；郑州地区40份标本中，19份（47．5％）为1b型，13份（32．5％）为2a型，3份（7．5％）为1a型，4份（10．0％）为1b/2a混合型病毒，1份（2．5％）为1a/1b混合型病毒。结论 两地的优势株均为HCV1b型，其次为2a型，郑州地区有1a型菌株的发现。     

出入境人员HCV基因型与血清HCV载量及ALT相关性研究

目的 探讨出入境人群HCV的基因分型，并分析HCV不同基因型与病毒载量、ALT活性水平的相互关系。方法 对72542名出入境人员进行HCV抗体检测，对抗-HCV阳性标本进行HCV基因分型。以荧光定量PCR测定HCVRNA载量，同时检测ALT活性。结果 共发现197份标本呈抗-HCV阳性，阳性率为0．27％，其中出境人员阳性率为0．24％。入境人员阳性率为0．31％。抗-HCV阳性标本经PCR检测基因分型后发现110份标本含有HCVRNA，共发现5种基因型，其中1b占40．0％、6a占30．0％、2a占14．5％、1a占8．2％、2b占7．3％。中国大陆人群与中国香港及其他国家人群的各基因型分布无明显差异。各基因型群间与HCVRNA载量差异具有统计学意义（P〈0．05），2a型人群HCVRNA载量明显高于其他各型人群（P〈0．05）。不同基因型人群间ALT水平差异无统计学意义。HCV RNA拷贝量与ALT活性无相关性。结论 HCV-1b为优势基因型。对HCV基因分型以厦PCR病毒载量和LAT活性检测。实行HCV实时监测具有重要的意义。     

BamH Ⅰ酶切位点变异区域性分布在HCV 1b型5＇非编码区的研究

目的研究丙型肝炎病毒（HCV）1b型5’非编码区BamH Ⅰ酶切位点变异的区域性分布。方法对来自中国4个不同地区的64例HCV 1b基因型血清样品进行5’-NCR扩增后，分别用MboⅠ、BamHⅠ限制性内切酶酶切分析，比较不同地区变异株分布的差异。结果测序证实中国HCV 1b基因型在117位有BamH Ⅰ酶切位点。64例血清样品中，BamHⅠ单切点变异株，华南7例（28％），东北1例（10％）。华北1例（11．1％），西南0例；MboⅠ及BamHⅠ切点均无的变异株，西南8例（40％），华南2例（4％），东北1例（10％），华北0例。结论证实HCV1b型BamHⅠ变异具有区域性分布特点，华南地区和西南地区变异较多，华北和东北变异较少。而这一变异是否与干扰素治疗耐药有关，尚有待于进一步研究。     

新疆汉族、维吾尔族丙型肝炎感染者 HCV 基因型研究

目的：了解新疆不同地区汉族和维吾尔族（以下简称维族）丙型肝炎感染者丙型肝炎病毒（HCV）基因分型的特征,为新疆丙型肝炎的诊断和治疗提供依据。方法对380份汉族和维族丙型肝炎感染者血清样本先进行荧光定量 PCR 检测病毒载量,载量大于1×103 copies／mL 的再采用 PCR-反向点杂交法进行 HCV 基因分型。结果基因分型确定355份样本,成功分型率为93．4％,汉族和维族基因型检出率1b 型分别为59．91％、69．92％,2a 型分别为30．17％、12．20％,3a 型分别为5．60％、8．13％,3b 型分别为3．88％、8．94％。新疆乌鲁木齐和其他地区丙型肝炎感染者中,维族、汉族病例分布差异有统计学意义（P＜0．05）,且乌鲁木齐和其他地区男性、女性病例分布差异有统计学意义（P＜0．05）。乌鲁木齐地区病例中,维族、汉族男性感染者2a 型和女性感染者1b 、3b 型差异均有统计学意义（P＜0．05）。新疆其他地区,仅2a 型男性维族、汉族感染者发病有差异有统计学意义（P＜0．05）,其他基因型差异无统计学意义（P＞0．05）。结论新疆地区汉族和维族丙型肝炎感染者 HCV 基因型分布与国内大多数地区不同,汉族以1b 、2a 型为主,而维族以1b 型为主,其次是2a 、3a 、3b 型。     

武威地区慢性丙型肝炎患者基因型分型与抗病毒治疗疗效分析

目的:了解武威地区丙型肝炎基因型与干扰素抗病毒治疗关系。方法:63例慢性丙型肝炎(CHC)患者,HCV-RNA采用荧光定量RT-PCR试剂盒,并对血清标本PCR扩增基因片段,测定核苷酸序列进行基因分型。采用IFN-α2b联合利巴韦林抗病毒治疗,疗程48周。全自动生化分析仪检测血清ALT。结果:63例患者基因型分型如下:HCV1b型36例,占57%;HCV2a型18例,占28%;HCV1b/2a混合型6例,占10%;HCV2b型3例,占5%。干扰素治疗中HCV1b型的SVR、RVR、EVR、ETVR的应答率分别是44.4%、55.6%、66.7%、61.1%,非HCV1b型的SVR、RVR、EVR、ETVR的应答率分别是74.1%、81.5%、92.6%、88.9%,两者分别进行χ2检验,有显著性差异(P<0.05)。结论:武威地区HCV基因型主要为1b型,其次为2a型,同时存在1b/2a混合型和2b型,干扰素对非1b型感染的疗效优于1b型,HCV基因分型有预测干扰素疗效的意义。     

重庆地区HCV基因亚型的分布状态

目的:探讨重庆地区丙型肝炎病毒(HCV)流行的基因亚型分布状态.方法:在77份抗HCV抗体和HCV RNA均阳性的血清标本中,分别提取HCV RNA,通过逆转录巢式PCR(RT nested-PCR)扩增C基因的羧基端至E1基因的氨基端长度为474 bp的片段,测定其核苷酸序列,与GenBank中已知的HCV序列进行系谱分析,确定HCV基因亚型.结果:77份HCV感染者血清标本通过RT-nested PCR检测均获得阳性条带,该方法特异性和敏感性均较好.序列与系谱分析显示1b 29例(38%),2a 10例(13%),3a 12例(16%),3b 11例(14%),6a 15例(19%),未见1a和2b型.结论:重庆地区HCV流行的基因亚型有1b,2a,3a,3b,6a共5种,1b为流行的主要基因亚型.2a,3a,3b和6 a型均占相当比例,初步说明重庆地区HCV流行的基因亚型呈现多样性.     

贵州地区丙型肝炎病毒基因分型的研究

目的：了解贵州地区丙型肝炎病毒（HCV ）基因型的分布特点及其与感染途径、性别、年龄因素的关系。方法在198份抗HCV抗体和HCV RNA均阳性的血清标本中,分别提取HCV RNA ,通过逆转录巢式PCR（RT nested-PCR）扩增C基因的羧基端至E1基因的氨基端长度为474 bp的片段,测定其核苷酸序列,与GenBank中已知的 HCV序列进行系谱分析,确定HCV基因亚型。结果198例患者中,HCV 1a型4例（2．0％）;1b型例71例（35．9％）;2a型9例（4．6％）;3a型29例（14．7％）,3b型47例（23．7％）,6a型37例（18．7％）,6d型1例（0．5％）。各基因型在男女性别分布比较,差异无统计学意义（χ2＝6．518, P＝0．885）;不同年龄人群 HCV基因型分布比较,差异有统计学意义（χ2＝49．056,P＝0．005）;不同感染途径人群 HCV基因型分布比较,差异有统计学意义（χ2＝99．245,P＝0．005）。结论贵州地区 HCV 基因型主要为1b型,其次为3b、6a、3a型,同时还存在1a、2a和6d等基因型。HCV基因型与其感染途径有关,基因亚型呈现多样性。     

南通地区慢性丙型肝炎患者的HCV基因分型

目的 :了解南通地区慢性丙型肝炎患者的HCV基因型分布情况。方法 :将 5 3例抗HCV阳性的血清标本用RT -PCR法检测HCV -RNA ,然后采用膜显色结果判读的基因芯片对 3 2例HCV -RNA阳性者进行基因分型研究。结果 :南通地区HCV感染检出 1b、1a、2a、1b + 1a、1b + 1a + 2a共 5种单一基因型和混合基因型 ,其中以 1b型为主 ,占 5 3 .1%。结论 :南通地区 1b型为优势株 ,2a和 1b + 1a型居次 ;1b + 1a型高于全国其他地区。     

武威地区丙型肝炎基因分型情况分析

目的:了解武威地区丙型肝炎基因分型特征,为HCV感染者的个体化治疗提供科学依据.方法:实时荧光定量RT-PCR检测70例抗-HCV阳性血清标本,并对血清标本PCR扩增基因片段,测定核苷酸序列进行基因分型.结果:70例标本中HCV1b型38例,占54%;HCV2a型21例,占30%;HCV1b/2a混合型9例,占13%;HCV2b型2例,占3%.结论:武威地区HCV基因型主要为1b型,其次为2a型,同时存在1b/2a混合型和2b型,与相邻城市HCV基因型分布比较有一致和差异.     

乌鲁木齐地区82例丙型肝炎患者基因型分布研究

目的 观察乌鲁木齐地区丙型肝炎患者的丙型肝炎病毒(HCV)基因型分布情况,了解HCV基因型与民族、年龄的关系.方法 在82份抗HCV抗体和HCV RNA均阳性的血清标本中,分别提取HCV RNA,通过PCR-反向点杂交法进行基因分型检测.结果 82例血清标本检测示,基因分型率95.12%,其中1型占60.26%(47/78),2型占20.51%(16/78),3型占16.67%(13/78), 6型占2.56%(2/78).≤40岁和＞40岁基因型总体分布上存在差异(P＜0.05),维吾尔族、汉族间基因型分布无统计学差异.结论 乌鲁木齐地区流行的HCV基因型为1(1b)、2(2a)、3(3a、3b)、6(6a)4型,1型为流行的主要基因型, 2、3、6型均占相当比例,初步说明乌鲁木齐地区HCV流行的基因型呈现多样性.     

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.     

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.