丙型肝炎病毒基因NS5区酶切分型研究

目的：了解丙型肝炎病毒（HCV）感染的基因型及其与临床的关系。方法：用逆转录套式聚合酶链反应（RT－PCR）和限制性片断长度多态性（RFLP）分析的方法,对78例HCV感染患进行HCV NS5区基因分型。结果：HCV1b型感染71例（91％）,HCV2a型7例（9％）,未发现其它基因型;丙型肝炎患有无输血史,是否重叠HBV感染,其基因分型构成比均无显性差异（P＞0．05）;1b型HCV血清ALT异常（63．4％）明显多于2a型（14．3％）（P＜0．05）。结论：本组HCV感染的基因型多数为1b型,少数为2a型,1b型更易致肝细胞损伤,并可能与活动性肝病有关。     

广西地区丙型肝炎病毒的基因分型及其临床意义

目的：探索广西地区丙型肝炎病毒（HCV）基因型的分布特征。方法：收集广西地区137例HCV—RNA阳性患者的血清样本,采用逆转录巢式PCR法扩增HCVNS5B区段,对PCR终产物纯化测序,测序结果与Genbank中的标准株全基因序列比对,并构建HCVNSSB区段系统进化树。结果：广西地区137例样本中,主要基因型为1b型（58．4％）,其次是6a型（12．4％）,3b型（10．2％）,la型（7．3％）,2a型（7．3％）,3a型（4．4％）。进一步分析表明,HCV基因型分布与性别无关（P〉0．05）,而与年龄有关（P〈0.05）,3型及6a型主要见于年轻患者。结论：构建HCVNSSB区段系统进化树能得到准确的HCV基因型;广西地区HCV基因型呈多样化,以1b型为主,6a型和3b型次之,且新发现6例3a型;基因分型为不同基因型的HCV感染者的治疗和疗效预测提供了理论依据。     

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。     

湖北省部分地区经血途径感染艾滋病人群中丙型肝炎病毒基因型分布

目的了解湖北省经血途径感染HIV-1人群中合并HCV感染情况及HCV基因型分布。方法2004年7月至2010年12月间在本院诊治或会诊的597例抗HIV阳性者进行HCV筛查,并行HCV病毒载量检测,对HCVRNA阳性者进行逆转录巢式聚合酶链反应扩增HCV核心基因区,并对扩增产物进行测序,采用Mega软件对所得序列进行基因树分析。结果既往有偿供血和受血的HIV感染者中HCV的感染率分别为76．5％（205／268）,57．4％（189／329）。97例HIV、HCV合并感染者行HCV基因分型检测,发现1b型90例（92．8％）和2a型7例（7．2％）,两型的HCV病毒载量（HCV—VL）差别无统计学意义[对数值分别为（6．0±1．0）拷贝／ml、（5．8±1．4）拷贝／ml,t=0．40,P=0．69]。结论血液途径为HIV、HCV合并感染的主要途径。受血感染者合并HCV感染率低于献血人群,感染者中HCV的基因型主要为1b型和2a型。     

丙型肝炎病毒酶切分型与干扰素治疗临床研究

目的：探讨丙型肝炎病毒（HCV）感染的基因型及其与干扰素应答效果的关系。方法：应用逆转录－聚合酶链反应（RT－PCR）技术对269例肝炎病人血清进行HCV NS5b区基因片段扩增,并对56例阳性PCR产物进行酶切分型,同时观察干扰素α-2b对其中48例慢性丙型肝炎的疗效。结果：HCV单纯1b型感染、1b与1b混合感染及2a型感染对干扰素的应答率分别为14／20、2／21、5／7;其中完全应答分别为9／20、1／21、4／7;部分应答分别为5／20、1／21、1／7。1b与1b混合感染组同单纯1b型及2a型感染组比较有显著性差异（P＜0．01及P＜0．05）,而单纯1b型感染组与2a型感染组比较无明显差异（P＞0．05）。结论：HCV单纯1b型感染或2a型感染者对干扰素敏感,而1b与1b混合感染者干扰素治疗效果极差,可作为预测干扰素疗效的一项新的重要指标。     

昆明地区HIV和HCV共感染者丙型肝炎病毒基因型特征

目的分析昆明地区人类免疫缺陷病（HIV）和丙型肝炎病毒（HCV）共感染者丙型肝炎病毒基因型分布。方法对204例经逆转录聚合酶链反应检测HCV病毒栽量,核酸为阳性的样品,利用反向点杂交技术进行HCV基因分型检测,其中60例经免疫印迹试验（WB）确认的HIV感染者,对共感染和非共感染组的丙型肝炎病毒基因型分布进行分析。结果204例HCV患者中3b型85例（HCV感染率最高,为41．6％）;1b型HCV感染在HIV／HCV共感染组中的感染率（30．0％）明显高于单纯HCV感染组感染率（20．0％）（P〈0．05）。而3b型HCV感染在HIV／HCV共感染组中的感染率（35．0％）明显低于单纯HCV感染组感染率（44．2％）（P〈0．05）。1b型,3a型和3b型HCV合并HIV感染的发生率较高;2a型和6a型HCV合并HIV感染的发生率较低。不同丙肝基因型HIV／HCV共感染者间感染途径以静脉药隐为主,其次是性接触。结论昆明地区共感染纽中的HCV流行的基因亚型有1b,3a,3b,6a共4种,1h为流行的主要基因亚型3a,3b和6a型均占相当比例,初步说明昆明地区HCV流行的基因亚型呈现多样性．     

丙型肝炎病毒6a型感染的状态与分析

目的:初步探讨丙型肝炎病毒6a型感染的状态.方法:对经HCV 5'非编码区(5'NCR)复合酶切分型结果为6a的3例样本(95,126,150)进行5'NCR和NS5B区的扩增、测序,然后将5'NCR和NS5B区序列与24个HCV全基因参考序列(均来自GenBank)比对并构建遗传进化树.结果:对3例分型结果为6a型的样品进行5'NCR序列分析发现,这3例样品都具有6a型特征性的第-145位的CA碱基插入,且与6a型参考序列Y12083的同源性最高,分别为0.993,0.987,0.993;进化树分析表明,3例样本都属于6a型.然而NS5B区的序列分析结果表明,95,126,150在NS5B区与1b型参考序列HC-J4的同源性最高,分别为0.934,0.930,0.926;进化树分析结果也显示它们都属于1b型,两个区的分型结果完全不同.为排除引物扩增效率的问题,使用6a型特异的引物对3例样品进行NS5B区扩增,3例样本扩增结果均为阴性.结论:我们发现的HCV 6a型的感染中,存在3例样品5'NCR和NS5B区的分型结果不一致,尚无直接证据证明其是否发生了基因重组.但是,我们的结果提示,在两个或两个以上区域进行HCV分型是非常重要的,且HCV基因型之间的重组必须纳入到HCV分型的考虑中来.     

江苏淮阴地区单采浆献血员丙型肝炎病毒分型及发病情况

目的：了解江苏淮阴地区单采浆献血员丙型肝炎病毒（HCV）感染后发病情况和病毒基因分型,方法：应用ELISA法及RT－nested PCR法检测67例单采浆献血员感染HCV后抗－HCV和HCV RNA,并用限制性片段长度多态性分析法（RFLP）进行病毒基因分型,结果：67例单采浆献血员,在感染HCV后,急性丙型肝炎发病率为17．9％（12／67）,最终发展成慢性丙型肝炎者49．3％（33／67）,HCV慢性持续感染68．8％（46／67）,HCV基因分型：1b/ Ⅱ型占95．5％（64／67）,2a／Ⅲ型1．5％（1／67）,1b/2a混合型3．0％（2／67）。结论：淮阴地区单采浆献血员HCV感染以1b/Ⅱ型为优势株,慢性化比例高。     

丙型肝炎病毒（HCV）基因分型及序列动态变化研究

目的 研究HCV基因型别及序列动态变化。方法采用HCV型特异性引物PCR扩增检测及HCV5’-非编码区(NCR)和核心区测序确定不同时间、不同病人HCV感染者血清标本的HCV型别,并进行序列分析和比较。结果所测HCV基因型均为1b和2a型;HCV基因型随时间的推移发生1b和2a型的转换,且转换过程中有混合感染现象。同一型5’-NCR基因序列无变化,与时间和病人无关;核心区1b型序列均相同,与时间和病人无关,2a型序列因病人而异。结论HCV基因型的变化是多层次的,首先是型的变化,其次是准种,再次是不同的毒株。5’-NCR和核心区序列比较保守。     

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。     

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.