不同人群抗SARS冠状病毒特异性抗体血清学检测与分析

目的 :探索不同人群中抗SARS冠状病毒特异性抗体的发生、发展及分布规律 ;评价间接ELISA方法检测SARS冠状病毒IgG、IgM特异性抗体试剂盒及改进方法。 方法 :分别获取SARS流行前无偿献血者标本 3990份 ,一线抗SARS医务人员标本 397份和临床确诊的SARS患者标本 15 7份 ,采用ELISA方法进行SARS冠状病毒特异性抗体检测。结果 :SARS流行前无偿献血者标本 3990份共检出IgG抗体阳性标本 16份 ,阳性率为 0 .4 0 % ;IgM抗体阳性标本 0份 ,阳性率为 0 %。一线抗SARS医务人员标本 397份 ,共检出IgG抗体阳性标本 2份 ,阳性率为 0 .5 0 % ;IgM抗体均为阴性。临床确诊的SARS患者标本 15 7份 ,共检出IgG抗体阳性标本 119份 ,阳性率为 75 .79% ;IgM阳性标本 6 8份 ,阳性率为 4 3.31%。结论 :一线抗SARS医务人员与SARS流行前无偿献血者IgG、IgM抗体阳性率无显著差异 (P =0 .76 >0 .0 5 ) ;采用该SARS冠状病毒 (变异株 )IgG抗体试剂盒检测SARS流行前无偿献血者人群存在一定的阳性率 ,说明该试剂盒包被的抗原与其它免疫球蛋白 (IgG)有交叉反应 ,有待进一步改进     

SARS临床排除病例血清学诊断结果分析

1材料和方法1　血清标本按常规留取临床上已排除SARS的患者静脉血 ,2h内离心分离血清 ,- 2 0℃保存 ,1周内检测抗SARS病毒特异性抗体1 .2　试剂使用北京华大吉比爱生物技术有限公司提供的SARS冠状病毒抗体 (IgG、IgM )诊断试剂盒 ,批号为2 0 0 30 4 2 6 ,该试剂盒是使用纯化SARS冠状病毒全病毒裂解液作包被抗原 ,采用间接ELISA法 ;本实验还使用军事医学科学院生物工程技术研究所提供的非典型肺炎 (SARS)病毒抗体酶联免疫诊断试剂盒 ,批号 2 0 0 30 5 0 1,该试剂盒采用双抗原夹心ELISA法来检测抗SARS病毒核心蛋白抗体。1.3　…     

SARS患者血清冠状病毒抗体检测

目的探讨SARS患者血清冠状病毒抗体产生情况.方法采用ELISA方法,对42例临床诊断SARS患者、47例普通肺炎患者和30例正常人进行血清冠状病毒抗体(IgG,IgM)检测.结果42例临床诊断为SARS患者,36例可在10 d左右检测到IgM抗体,阳性率为85.7%,IgG抗体阳性33例,阳性率为78.6%.47例临床诊断为普通肺炎的患者,IgM阳性2例,阳性率为4.26%,IgG阳性4例,阳性率为8.51%.30例正常人体检者没有出现IgM或IgG阳性.结论SARS冠状病毒抗体检测对临床早期诊断有一定的帮助.     

特异性抗体阳性SARS患者治疗前后血清生化指标的比较

1　材料和方法1.1特异性抗体检测　使用北京华大吉比爱生物技术有限公司提供的SARS冠状病毒抗体 (IgGIgM )诊断试剂 ,批号为 2 0 0 30 4 2 6。该试剂盒使用纯化SARS冠状病毒全病毒裂解液作包被抗原。采用ELISA技术按说明书检测SARS患者血清中的特异性IgG和IgM ,并同时作生化检验1 .2生化检测　按常规抽取 30例抗体阳性的SARS患者治疗前后静脉血 ,其中男性 2 0例、女性 10例 ,年龄 18～ 72岁。抽取静脉血后 15min内离心分离血清 ,立即上机测定。各项生化指标用OLYMPUS定标液定标 ,用质控血清进行监测 ,室内质控在控。1.3　仪…     

严重急性呼吸综合征患者康复后8个月内IgG抗体变化

目的　了解严重急性呼吸综合征 (SARS)患者康复后短期内血清中冠状病毒特异性抗体IgG的产生水平及其动态变化 ,为该病的下一步预防、监测及疫苗的保护效力等提供线索。方法　自 2 0 0 3年 5～ 12月 ,每隔 2～ 4周抽取IgG抗体阳性的SARS康复者的血液 ,经病毒灭活后分离血清 ,用酶联免疫吸附法对SARS病毒特异性抗体IgG进行检测。结果用Stata 7 0软件进行分析。结果　康复期SARS患者以出院后约 35d时抗体平均水平最高。 8个月内 ,IgG抗体平均水平呈逐渐下降趋势 ,降幅约为 2 7 3% (8个月间的抗体水平经统计学检验差异有显著意义 :F =5 76 5 2 ,P =0 0 0 4 6 )。结论　全部SARS康复者皆产生了冠状病毒特异的IgG类抗体 ,但随着康复时间的推移 ,该抗体呈逐渐下降趋势。应对该抗体进行长期的监测     

无偿献血者与SARS康复者血清冠状病毒抗体检测

目的　比较未患过SARS的无偿献血者与SARS康复者血清冠状病毒抗体阳性率的差别。方法　应用酶联免疫吸附法 (ELISA)对 2 2 2 7例未患过SARS的无偿献血者和 3 1例SARS康复者血清进行SARS病毒抗体 (IgG)检测 ,阳性的SARS康复者血清作倍比稀释 ,各稀释血清再用ELISA法检测以测定其IgG抗体效价。结果　 2 2 2 7例无偿献血者有 11例抗体阳性 ,阳性率为 0 49% ,3 1例SARS康复者中有 3 0例阳性 ,阳性率为 96 8% ,两者差异有非常显著性(P <0 0 1)。结论　冠状病毒抗体检测对筛选近期感染冠状病毒的献血者有一定作用     

针对SARS患者的特异性抗体检测结果不容乐观

为了探讨SARS患者体内抗SARS冠状病毒抗体的产生和变化规律，北京佑安医院采用经国家食品药品监督管理局（SDA）审批的，由中国医学科学院，军事医学科学院和北京华大基因工程有限公司共同开发研制的抗SARS冠状病毒抗体检测试剂盒（ELISA试剂盒），对75例住院SARS患者的390份血清标本进行了IgM抗体和IgG抗体的检测。     

张家口市SARS患者、疑似病例、留观及密切接触医护人员血清中IgG、IgM抗体测定

目的：为临床诊断及排除严重急性呼吸综合征(SARS)提供依据和对留观及密切接触医护人员有无感染作初步调查。方法：用酶联免疫吸附测定(ELISA)53例临床诊断病例、29例疑似病例、63例留观及114例密切接触医护人员的血清中SARS冠状病毒IgG、IgM抗体。结果：SARS临床诊断病例IgG抗体阳性21例，IgM抗体阳性18例，其中有17例IgG、IgM抗体均为阳性，总阳性率为41．5％；留观人员IgG抗体阳性1例；其他均为阴性。结论：ELISA测定血清抗SARS冠状病毒抗体阳性病例可确诊感染病毒，对于观察期后(一般为21d)人员，阴性结果可以排除感染。     

三种特殊群体血清中SARS抗体检测分析

目的 了解新生儿、1～10岁儿童以及与SARS患者密切接触的医护人员血清中出现SARS病毒抗体的情况,并加以分析。方法 应用间接ELISA法,对15例新生儿、30例1～10岁儿童以及我院50例在SARS病房工作15天以上的医护人员的血清进行了SARS相关冠状病毒抗体IgM、IgG水平的检测。结果 15例新生儿以及50例医护人员中未检测到SARS抗体IgM、IgG,30例1～10岁儿童中,检测出3例SARS抗体IgG阳性,阳性率为10％,无一例SARS抗体IgM阳性。结论 我院一线医护人员中可能无SARS病者隐性感染者,儿童中SARS抗体IgG阳性率较高,这可能是此次SARS爆发中儿童感染率较低的原因之一。     

SARS病人SARS冠状病毒核壳抗原抗体的变化规律

目的通过监测SARS冠状病毒感染患者的抗体水平,阐明SARS冠状病毒感染机体免疫应答的机制并探讨血清学诊断的意义。方法采用基因重组SARS冠状病毒核壳抗原(N)建立间接ELISA法,检测健康人和SARS患者急性期和恢复期多点血清中特异性IgG和IgM抗体。以D450值=2.1×200例健康人血清中特异性IgG和IgM抗体均值作为抗体阳性判断的临界值。结果IgM和IgG的阳性临界值分别为0.233 和0.239。以此对13例SARS病人急性期和恢复期IgM和IgG抗体检测结果进行判断,结果发现:发病1周内,IgM和IgG抗体检测均为阴性;发病第2周,IgM和IgG检出阳性率分别为83.3%和66.7%;第3周均为100%;发病第2个月,IgM检出阳性率为61.5%,至第3个月,IgM检出阳性率为38.5%;IgG至第1个月时达到高峰,第3个月仍维持在高水平。结论机体产生针对SARS冠状病毒核壳抗原的抗体持续时间长,提示SARS冠状病毒核壳抗原具有强免疫原性,在SARS冠状病毒致病机制中可能起重要的作用、在SARS的血清学诊断方面具有重要的价值。     

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.