淤积型婴儿肝病综合征的病毒病原检测分析(附78例报告)

目的探讨病毒感染与淤积型婴儿肝病综合征的关系。方法收集2007年3～12月在我院住院的78例淤积型婴儿肝病综合征患儿急性期和恢复期血清,进行病原学检测。采用间接ELISA法定量检测血清中巨细胞病毒（CMV）、EB病毒、单纯疱疹病毒和肠道病毒特异性IgM,荧光定量PCR法检测患者血清中CMV-DNA拷贝数,微粒子免疫发光法检测血清中乙肝病毒和丙肝病毒抗原和抗体,间接免疫荧光法检测血清中人类疱疹病毒6型（HHV-6）特异性IgM。结果78例中50例病毒病原检测阳性,阳性率为64.1%,其中人巨细胞病毒42例,阳性率为53.8%;人类疱疹病毒6型8例,阳性率为10.3%。血清中特异性EB病毒、单纯疱疹病毒、肠道病毒IgM抗体检测均阴性,乙肝病毒表面抗原和E抗原均阴性。有17例患儿进行了丙肝病毒检测,均阴性。结论CMV可能是淤积型婴儿肝病综合征的主要感染病原,HHV-6也可能与部分淤积型婴儿肝病综合征的发生相关。病毒感染诊断的确立要充分考虑血清学和分子生物学方法的意义和临床应用。     

传染性单核细胞增多症合并多种病原体感染患儿临床特征和预后研究

目的:研究传染性单核细胞增多症(IM)合并多种病原体感染患儿的临床特征和预后。方法:纳入IM患儿60例,根据病原体感染情况分为单纯EBV感染组和多重感染组,各30例。分析多重感染组病原体分布特征,比较两组的临床特征、实验室指标、并发症发生率、治疗方法以及预后。结果:IM患儿合并感染病原体主要为肺炎支原体(MP)(33.33%)和巨细胞病毒(CMV)(23.33%)。多重感染组发热、脾脏肿大、肝肿大、淋巴结肿大、咽峡炎、眼睑水肿的发生率明显高于单纯EBV感染组(P<0.05),多重感染组的发热持续时间明显高于单纯EBV感染组(P<0.05)。多重感染组白细胞计数(WBC)、异型淋巴细胞(AL)比例、磷酸肌酶同工酶(CK-MB)、丙氨酸氨基转移酶(ALT)和CD₃⁺水平均明显高于单纯EBV感染组(P<0.05)。多重感染组肺炎、贫血、心肌损害、肝损伤和消化道出血的发生率均明显高于单纯EBV感染组(P<0.05)。两组患儿出院时体温均恢复正常,临床体征均得以明显缓解,心肌功能和肝功能均于治疗2～4周后恢复正常,预后良好。结论...     

儿童传染性单核细胞增多症EB病毒载量及外周血T淋巴细胞亚群分布与肝损伤的相关性

目的 探讨传染性单核细胞增多症(IM)患儿EB病毒(EBV)载量及外周血T淋巴细胞亚群分布与肝功能损伤的相关性。方法 选取2021年1月至2022年12月新乡医学院第一附属医院收治的IM患儿40例为IM组，并选取同期40例健康体检儿为对照组。检测并比较两组儿童EBV DNA载量、CD3⁺、CD3⁺CD4⁺、CD3⁺CD8⁺、CD4⁺/CD8⁺、白细胞计数(WBC)、中性粒细胞百分比(Net%)、淋巴细胞百分比(LYM%)、单核细胞百分比(Mon%)及肝功能指标谷丙转氨酶(ALT)及谷草转氨酶(AST)。分析IM组患儿EBV DNA载量、T淋巴细胞亚群分布与ALT、AST的相关性。结果 IM组WBC、LYM%高于对照组，Net%低于对照组(P<0.05);两组Mon%差异无统计学意义(P>0.05)。IM组CD3⁺、CD3⁺ CD8⁺比率均高于对照组，CD3<...     

免疫酶染色法检测传染性单核细胞增多症血清 EB 病毒特异性 IgM 抗体

本文用免疫酶染色法检测217例,疑似传染性单核细胞增多症(IM)患儿血清EB 病毒特异性VCA—IgM 抗体。126例阳性、阳性率58.1%。并与正常儿血清作了比较,检测39例,2例阳性,阳性率±5.12%。提示在诊断IM 时,免疫酶染色法测定体血清EB 病毒特异性VCA—IgM 抗体、方法敏感、特异。     

广州地区儿童病毒性脑炎病原构成和流行特点

目的 研究引起广州地区儿童病毒性脑炎的病原流行病学特征.方法 用荧光PCR方法检测198例病毒性脑炎患儿核酸和酶联免疫吸附法检测脑脊液病原抗体IgM,100例其他脑病患儿脑脊液作为对照.结果 198份脑脊液病毒和(或)抗体检出病原体的66例,阳性率33.6％.其中肠道病毒(EV) 25例占阳性病例的37.9％,单纯疱疹Ⅰ型病毒(HSV1) 19例占28.8％,单纯疱疹Ⅱ型病毒(HSV2)1例占1.5％,巨细胞病毒(CMV)3例占4.6％,EB病毒(EBV)3例占4.6％,流感病毒(IFV)1例占3.0％,腺病毒(ADV)5例占7.5％,乙脑病毒(JEV)6例占9.1％,呼吸道合胞病毒(RSV)2例占3.O％,所有标本均检测不到麻疹病毒.对照组的其他脑病患儿标本均检测不到病原体.患儿全年均可发生病毒性脑炎,但5月～10月发病率最高.疱疹性病毒脑炎没有明显季节性,年龄较大患儿的居多,乙型脑炎和肠道病毒引起的脑炎以夏秋季较多,而且年龄较小的患儿更容易受感染.结论 引起广州地区病毒性脑炎的主要病原体是疱疹病毒和肠道病毒,肠道病毒主要发生在夏秋季,以年龄较小的儿童多见;单纯疱疹病毒性脑炎全年散发,以年龄较大的儿童较多见.     

孕产妇4种病原体感染血清学筛查的临床意义

目的　探讨正常孕产妇弓形虫 (Toxoplasma)、风疹病毒 (Rubellavirus ,RV )巨细胞病毒 (Cytomegalovirus ,CMV)及单纯疱疹病毒 (herpessimplexvirus ,HSV )感染情况及其血清学筛查的临床意义。 方法　采用酶联免疫吸附 (ELISA)法检测 80 0份孕产妇血清 4种病原体IgG抗体和IgM抗体。 结果　血清弓形虫IgG/IgM抗体阳性率分别为 1.98%、0 .13 %;风疹病毒IgG/IgM抗体阳性率分别为 82 .75 %、0 .3 7%;巨细胞病毒IgG/IgM抗体阳性率为 70 .5 %、0 .75 %;单纯疱疹病毒IgG/IgM抗体阳性率分别为 0 .4%、0。 结论　对孕产妇进行 4种病原体感染血清学筛查 ,了解孕产妇对这 4种病原体的免疫状态 ,在优生优育方面有着重要的临床意义。尤其妊娠前确定风疹的免疫状态对孕妇风疹筛查意义重大。     

先天性心脏病合并社区获得性肺炎患儿呼吸道病毒及特殊病原体相关分析

【摘要】目的 探讨先天性心脏病（CHD）合并社区获得性肺炎患儿与单纯社区获得性肺炎患儿呼吸道病毒和特殊病原体抗体分布特点。方法 选取2014年1月～2019年8月于我院儿科住院的721例社区获得性肺炎患儿进行回顾性分析, 根据患儿有无合并先天性心脏病分为先天性心脏病组（CHD组）208例和单纯社区获得性肺炎组（LRI组）513例。采用间接免疫荧光法检测血清嗜肺军团菌IgM抗体（LP1A）、肺炎支原体IgM抗体(MPA)、Q热立克次体IgM抗体（QR-FA）、肺炎衣原体IgM抗体（CPnA）、腺病毒IgM抗体（ADVA）、呼吸道合胞病毒IgM抗体(RSVA)、甲型流感病毒IgM抗体（IAVA）、乙型流感病毒IgM抗体（IBVA）、副流感病毒IgM抗体(PIVsA)等9种呼吸道病原体抗体及特殊病原体IgM抗体。比较两组9种呼吸道病原体及特殊病原体检出阳性率、不同年龄阶段、不同季节分布情况。结果 CHD组纳入研究的呼吸道病原体抗体九项检测,阳性共136例,LRI组纳入研究的呼吸道病毒及特殊病原体九项,阳性共305例,CHD组病原体IgM总阳性率(65.4%)高于LRI组阳性率(59.4%),但两组比较差异无统计学意义（P＞0.05）。CHD组与LRI组均以肺炎支原体（MP）最常见,其次为乙型流感病毒（IBV）,其余病毒及呼吸道特殊病原体检出阳性率较低。CHD组和LRI组相比较,在婴幼儿时期,CHD组较易感染MP,但在1～3岁时,则是易感染IBV（均P＜0.05）;冬春季,CHD组较易感染MP及IBV,而LRI组较易感染LP1及ADV,但两组LP1阳性率均低,无临床指导意义。结论 合并社区获得性肺炎患儿特殊病原体抗体谱与单纯社区获得性肺炎患儿相似,以MP最常见;在婴幼儿期及冬春季,CHD合并社区获得性肺炎患儿较单纯社区获得性肺炎患儿易于感染MP;在1～3岁年龄段及冬春季,易于感染IBV。     

弓形体、风疹病毒、巨细胞病毒、单纯疱疹病毒病原体检测与自然流产的相关性研究

目的探讨弓形体、风疹病毒、巨细胞病毒、单纯疱疹病毒病原体检测及与自然流产的相关性。方法选取108例自然流产妇女为观察组,104例正常妊娠妇女为对照组,对两组TORCH病原体检测结果进行分析。结果观察组TORCH检测总感染率(55.56%)明显高于对照组(P<0.05);自然流产组妇女既往感染、活动性感染以及复发性感染均高于正常妊娠组,差异有统计学意义(P<0.05)。结论弓形体、风疹病毒、巨细胞病毒、单纯疱疹病毒病原体感染与自然流产有密切关系,加强孕妇孕期TORCH各项IgG、IgM抗体检测,是达到优生优育的重要措施。     

儿童EBV和CMV不同模式感染相关单核细胞增多症的临床和实验室检查特征分析

目的 探讨儿童感染EB病毒（EBV）或（和）巨细胞病毒（CMV）后所致的传染性单核细胞增多症（IM）的临床特征和实验室指标的差异。方法 回顾性分析2018年1月—2023年1月入本院治疗的109例IM患儿资料,根据感染病原体的不同分为EBV感染组（38例）、CMV感染组（25例）、混合感染组（46例）。分析不同感染组IM患儿的一般特点、临床表现和实验室检查结果。结果 共计收集109例IM患儿,男61例,女48例,男女比例为1.27〖DK〗∶1,平均年龄为（4.66±2.68）岁,2~6岁儿童发病较多,约占73.4%。IM患儿一年四季均有患病,其中冬春季患病人数相对较多,占总人数的58.7%。患儿临床表现多样,其中以发热（86.2%）、淋巴结肿大（78.0%）、咽峡炎（75.2%）、肝脏肿大（48.6%）、咳嗽（47.7%）最常见。其中CMV感染组淋巴结肿大、咽峡炎的发生率显著低于其他两组（P＜0.05)。混合感染组WBC计数、LY%、AL%异常率高于其他两组,LDH、ALT、AST结果异常的发生率在混合感染组更为显著（P＜0.05）。结论 IM儿童CMV和EBV混合感染较为常见,其临床表现更像EBV感染,而实验室检查结果则比单一感染EBV、CMV更为严重,需更加重视     

肺结核病人疱疹病毒感染的检测和临床意义

目的 探讨肺结核病人疱疹病毒活动性感染情况.方法 采用酶联免疫吸附试验(ELISA),检测62例肺结核病人和43例正常对照者血清中人巨细胞病毒(HCMV)和单纯疱疹病毒(HSV)特异性IgM抗体以及EB病毒(EBV)衣壳抗原(VCA)IgM抗体. 同时,采用PCR-Southern检测肺结核病人和正常人外周血单个核细胞中EBV DNA表达.结果 肺结核组血清HCMV-IgM和HSV-IgM阳性率分别为19.4%和12.9%,正常对照组分别为4.7% 和0,肺结核组HCMV-IgM和HSV-IgM阳性率均高于正常对照组(χ2=4.75、4.31,P＜0.01).肺结核组和正常对照组均未检测到EB病毒VCA-IgM,肺结核组EBV DNA阳性率(48.4%)高于正常对照组(4.7%),差异有显著性(χ2=22.92,P＜0.01).继发性肺结核疱疹病毒感染率(39.6%)高于原发性肺结核(7.1%),差异有显著性 (χ2=3.84,P＜0.05).结论 部分肺结核病人存在HCMV、HSV以及EBV的活动性感染,人疱疹病毒感染可能影响肺结核病情发生发展.     

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.