甲型H1N1流感95例临床分析

目的分析甲型H1N1流感的临床特征。方法对我院2009年7月—2009年9月收治的95例确诊为甲型H1N1流感患者的病例资料进行回顾性分析。结果昆明地区甲型H1N1流感患者常见临床表现为发热、咽痛、咳嗽、咯痰,咽部充血,白细胞数减少、中性粒细胞比例下降、淋巴细胞及单核细胞比例升高,咽拭子甲型H1N1病毒核酸阳性(100%)。未发现重症病例及严重并发症。采取口服磷酸奥司他韦、双黄连口服液、莲花清瘟胶囊等中西医结合治疗,效果较好,无死亡病例。结论昆明地区甲型H1N1流感临床表现典型,并发症少,但其传染性强,防控重点地区应放在人口密集的学校。     

妊娠并发甲型H1N1流感15例诊治分析

目的研究妊娠并发甲型H1N1流感的临床特点、治疗方法及妊娠结局。方法对2015年12月至2016年2月苏州市立医院收治15例妊娠期感染H1N1流感的孕妇临床表现、实验室检查、治疗情况进行回顾性分析。结果 15例患者中发热15例,咳嗽14例,咽痛8例,胸痛2例,7例重症及危重症患者出现呼吸困难。15例患者按病情严重程度,轻症8例,重症4例,危重症3例。轻型甲型H1N1流感患者外周血白细胞、淋巴细胞百分比均正常,转氨酶、乳酸脱氢酶、肌酸激酶、白蛋白无明显变化;重症及危重症患者外周血白细胞降低,以T淋巴细胞计数降低明显,转氨酶、乳酸脱氢酶、肌酸激酶增高,白蛋白下降。重症及危重症患者胸部影像显示弥漫性外周为主的渗出性病变。8例轻症患者均治疗后痊愈并足月自然分娩正常新生儿,4例重症患者好转后2例早产2例足月分娩,3例危重患者均行急诊剖宫产术终止妊娠,其中1例胎死宫内,2例足月存活,但有1例孕产妇术后死亡。随访至目前,所有婴儿未有发育异常。结论妊娠并发甲型H1N1流感,轻症患者及时诊断和治疗多可痊愈;对重症及危重症H1N1妊娠患者,死亡率高,及时有效地救治,适时终止妊娠或可改善孕妇病情。     

甲型H1N1流行性感冒患者疾病严重程度预测指标的初探

目的分析轻症和重症甲型H1N1流行性感冒(以下简称流感)患者外周血转录组的差异,评估影响患者疾病严重程度的指标。方法纳入2018年1月至5月上海复旦大学附属华山医院确诊的10例甲型H1N1流感患者(轻症组与重症组各5例),以健康人群(5名)作为对照。采集研究对象的外周血进行RNA转录组测序并分析其结果。计量资料比较采用t检验和Mann-Whitney U检验,计数资料比较采用Fisher确切概率法。转录组测序结果的数据分析采用生物信息学方法。结果重症组患者血小板计数为(163.4±21.5)×109/L,低于轻症组患者的(255.6±52.5)×109/L,差异有统计学意义(t=3.636,P=0.007)。两组患者的性别、年龄、白细胞计数、中性粒细胞比例、淋巴细胞比例和血红蛋白值的差异均无统计学意义(均P>0.05)。外周血转录组研究结果显示,重症组患者的外周血基质金属蛋白酶8(matrix metalloproteinase 8,MMP8)测序结果的平均值为18.41,高于轻症组的2.33及健康对照组的1.43,差异均有统计学意义(均P<0.01)。基质金属蛋白酶9(matrix metalloproteinase 9,MMP9)的平均值在重症组为174.00,高于轻症组的22.91和健康对照组的34.65,差异均有统计学意义(均P<0.01)。结论MMP8及MMP9有望作为判断甲型H1N1流感患者疾病严重程度的分子生物学标志物。     

甲型H1N1流感患者血清心肌酶学的临床研究

目的 探讨甲型H1N1流感患者血清心肌酶学水平与其疾病严重程度的关系.方法 对2009年9月至12月承德市集中收治的206例甲型H1N1流感患者的心肌酶水平进行对比分析.结果 危、重症组血清肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、门冬氨酸氨基转移酶(AST)、乳酸脱氢酶(LDH)高于轻症组(P＜0.05或P＜0.01),甲型H1N1流感的严重程度与血清CK、CK-MB、AST、LDH均呈正相关(r=0.160、0.396、0.181、0.392,P=0.021、0.001、0.009、0.001).结论 监测血清CK、CK-MB、AST、LDH等酶学水平,对判断甲型H1N1流感患者病情的危重程度及预后具有实际意义.     

妊娠期甲型H1N1流感患者T淋巴细胞亚群变化

目的分析妊娠期重症甲型H1N1流感患者T淋巴细胞亚群变化,探讨患者的免疫病理机制及T淋巴细胞亚群检测在妊娠期合并重症甲型H1N1流感诊断中的临床意义。方法选择沧州地区2009年11月10日－12月31日确诊重症／危重症甲型H1N1流感56例。选取其中妊娠期患者32例（A组）,并设置正常妊娠组（B组）及对照组。取外周血检测T淋巴细胞亚群和NK细胞。结果白细胞总数A组低于B组（P〈0．05）,B组高于对照组（P〈0．05）;淋巴细胞绝对值及百分比A组低于B组及对照组（P〈0．05）。A组外周血总T细胞、CD4^＋T细胞、CD8^＋T细胞、CD15＋56NK细胞绝对值及CD4／CD8比值均低于B组、对照组（P〈0．05）;B组较对照组上述指标均降低（P〈0．05）。结论妊娠期免疫耐受所致细胞免疫功能抑制可能参与重症H1N1流感的疾病发生发展过程,应用细胞免疫增强剂可能对疾病过程有积极影响。     

重症甲型H1N1流感研究进展

甲型H1N1流感最新疫情的突出特点是重症和死亡病例数显著增加,有关我国重症甲型H1N1流感患者的临床特征、预后、危险因素等方面的研究尚未见相关报道.本文拟对国外有关这方面的研究进行总结,为我国重症甲型H1N1流感的诊断及治疗提供借鉴.     

重症甲型H1N1流感14例临床分析

目的探讨重症甲型H1N1流感的临床特点。方法对我院确诊的14例重症甲型H1N1流感临床特点和治疗进行回顾性分析。结果所有确诊重症甲型H1N1流感病例均有发热等流感样症状,易继发肺部感染等,白细胞(WBC)和淋巴细胞(L)减低,早期给予抗病毒等综合治疗,效果良好。结论重症甲型H lN1流感发病以年轻群体为主,传染性高于季节性流感。早期给予奥司他韦等抗病毒治疗,辅以中药施治,疗效肯定。     

新型甲型H1N1流感重症和危重病例75例临床分析

目的分析新型甲型H1N1流感重症和危重病例的临床特点,并对其诊治方法进行探讨。方法对2009年10月24日至12月12日中国医科大学附属第一医院收治的75例新型甲型H1N1流感重症和危重病例的临床症状、实验室检查及影像学资料进行回顾性分析。结果75例患者中男54例,女21例。年龄18～66岁,平均42.4岁。重症患者29例,危重症患者46例。16例患者有明确的接触史,平均潜伏期3.5d;56.0%的患者以发热为首发症状,10.7%的患者病程中没有出现发热,20.0%的患者出现血性痰;90.7%的患者肺部可闻及啰音笛槭壹觳?78.7%的患者中性粒细胞比率升高,74.7%的患者淋巴细胞比率降低;56.7%的患者白蛋白降低,乳酸脱氢酶(LDH)明显升高(58.2%);外周血T细胞亚群CD4明显降低(57.1%)。肺CT主要表现为双肺多发的斑片影和磨玻璃影。出现急性呼吸窘迫综合征(ARDS)23例,其中10例死亡。结论新型甲型H1N1流感诊治的关键是早期识别重症和危重病例,并及时给予奥司他韦治疗,综合支持治疗可取得较好的疗效。     

老年重症甲型 H1N1流感的临床特征分析

目的：分析老年重症甲型 H1N1流感病例的临床特征和疾病转归,以提高临床救治水平。方法收集2009年9月至12月中国426家医院确诊的重症甲型 H1N1流感住院患者中≥65岁的217例作为研究对象。确诊病例定义为甲型 H1N1流感病毒核酸检测阳性,并符合甲型 H1N1流感重症诊断标准。基于各变量有完整记录的病例数来计算各变量数据百分比。结果入选患者平均年龄(72.9±6.2)岁。82.0%的患者合并1种或以上基础疾病。患者发病到首次就诊的中位时间是24 h,到实验室确诊中位时间是102 h。发热(87.6%)和咳嗽(91.7%)是突出的临床表现,91.6%的患者影像学检查存在肺炎,56.4%的患者氧合指数≤300。入组患者中,死亡34例(15.7%),其中15例死于呼吸衰竭。死亡患者与存活者相比,在合并重要基础疾病、入院时的呼吸频率、心率、血小板计数、谷丙转氨酶、胆红素、氧合指数等方面存在显著性差异。结论老年甲型 H1N1流感患者多合并基础疾病,出现呼吸、心率增快、肝功能异常、血小板下降等情况提示患者预后不良。     

重症甲型H1N1流感的临床特点研究

目的探讨重症甲型H1N1流感的临床特点,以期了解新发疾病的发展及转归,尽早采取有效治疗措施。方法对我院2009年09-15—11-19收治的11例重症甲型H1N1流感患者临床表现、实验室检查、影像学特征、治疗及其预后等方面资料进行回顾性分析。结果重症甲型H1N1流感患者年龄中位数为39.9岁;均有发热、咳嗽和咳痰症状;8例(72.72%)入院时血常规白细胞计数减少,7例(63.63%)中性粒细胞比例>75%;8例患者血气分析氧合指数<200;胸片以斑片状双侧浸润阴影改变为主;重症甲型H1N1流感患者均给予抗病毒、抗生素和激素治疗,呼吸衰竭及ARDS时给予机械通气治疗。2例死亡,1例需行ECMO治疗,8例好转出院。结论重症甲型H1N1流感患者青壮年易感,临床表现与季节性流感相似,易并发病毒性肺炎,出现呼吸衰竭及发展为ARDS,病死率高。     

Inhibition of procarcinogen-bioactivating human CYP1A1, CYP1A2 and CYP1B1 enzymes by melatonin

Abstract:  Administration of melatonin to rodents decreases the incidence of tumorigenesis initiated by benzo[ a ]pyrene or 7,12-dimethylbenz[ a ]anthracene, which requires bioactivation by cytochrome P450 enzymes, such as CYP1A1, CYP1A2 and CYP1B1, to produce carcinogenic metabolites. The present study tested the hypothesis that melatonin is a modulator of human CYP1 catalytic activity and gene expression. As a comparison, we also investigated the effect of melatonin on the catalytic activity of CYP2A6, which is also a procarcinogen-bioactivating enzyme. Melatonin (3–300 μ m ) decreased 7-ethoxyresorufin O -dealkylation catalyzed by human hepatic microsomes and recombinant CYP1A1, CYP1A2 and CYP1B1, whereas it did not affect coumarin 7-hydroxylation catalyzed by hepatic microsomes or recombinant CYP2A6. Melatonin inhibited CYP1 enzymes by mixed inhibition, with apparent K _i values (mean ± S.E.M.) of 59 ± 1 (CYP1A1), 12 ± 1 (CYP1A2), 14 ± 2 (CYP1B1) and 46 ± 8 μ m (hepatic microsomes). Additional experiments indicated that melatonin decreased benzo[ a ]pyrene hydroxylation catalyzed by hepatic microsomes and CYP1A2 but not by CYP1A1 or CYP1B1. Treatment of MCF-10A human mammary epithelial cells with melatonin (up to 300 μ m ) did not affect basal or benzo[ a ]pyrene-inducible CYP1A1 or CYP1B1 gene expression. Consistent with this finding, melatonin did not influence reporter activity in aryl hydrocarbon receptor-dependent pGudluc6.1-transfected MCF-10A cells treated with or without benzo[ a ]pyrene, as assessed in an in vitro cell-based luciferase reporter gene assay. Overall, melatonin is an in vitro inhibitor of human CYP1 catalytic activity, and it may be useful to develop potent analogues of melatonin as potential cancer chemopreventive agents that block CYP1-mediated chemical carcinogenesis.     

甲型H1N1流行性感冒33例确诊病例临床分析

目的 总结甲型H1N1流行性感冒(流感)确诊患者的临床特征,以期为今后的甲型H1N1流感防治工作积累经验.方法 将2009年5月15日-6月22日在北京地坛医院隔离治疗并达到出院标准的33例甲型H1N1流感确诊患者纳入研究,采用SPSS11.0软件进行统计学分析.结果 33例患者中有25例在发病前1周曾前往美国、加拿大、日本等甲型H1N1流感流行国家旅行.12例有明确密切接触史患者的潜伏期为1-6 d.患者的主要临床症状有发热(66.7%)、咳嗽(60.6%)、咳痰(42.4%)、咽痛(36.4%).24例(72.7%)患者实验室检查结果均正常,仅少数患者出现轻度异常.33例患者均达到出院标准,病毒核酸检测连续2次阴性距出现首发症状的时间为2～16 d,住院时间为3～16 d.结论 新型甲型H1N1流感具有症状轻微、病程较短、预后良好等临床特征,如无严重基础疾病,患者均能治愈.     

Sulfotransferase 1A1 (SULT1A1) polymorphism and susceptibility to primary brain tumors

Purpose Sulfotransferase 1A1 is a member of sulfotransferase family that plays an important role in the biotransformation of numerous carcinogenic and mutagenic compounds through sulfation. The present study has investigated the association between SULT1A1 polymorphism and primary brain tumor incidence. Methods SULT1A1 genotypes were successfully detected using the PCR-RFLP assay in 60 primary brain tumor patients and 156 hospital-based healthy control individuals with no history of cancer or precancerous disorder. Results There was a significant difference in genotypes distribution (GG vs. GA + AA) between brain tumor patients (GG genotype frequency = 48.3%) and control population (GG genotype frequency = 65.4%; OR = 2.019, 95% CI = 1.103–3.695; P = 0.022). In order to determine the association between SULT1A1 polymorphism and specific types of brain tumors, the patients were classified according to the type of brain tumors they suffer from: glial and non-glial. Results of the statistical analyses of each group of patients in comparison with the control individuals showed a significant difference only between SULT1A1 polymorphism and non-glial brain tumors (OR = 2.615; 95% CI = 1.192–5.739; P = 0.014) but glial tumors (OR = 1.535; 95% CI = 0.688–3.425; P = 0.293). When non-glial tumors were classified as meningiomal and others (pituitary adenoma, craniopharyngioma, acoustic neuroma and hemangioblastoma), statistical analysis showed that this significance is only due to the meningiomal tumors (OR = 3.238; CI = 1.205–8.704; P = 0.015). We also estimated a reduced risk of brain tumor in non-smokers (OR = 1.700; CI = 0.800–3.615) in comparison to smokers (OR = 2.773; CI = 0.993–7.749), but this was not statistically significant. Conclusion Our findings have suggested that there was a significant association between brain tumor and SULT1A1*2 allele (A allele that is also known as His allele) and this allele is an important risk factor in the development of meningiomal brain tumors.     

COL1A1-shRNA表达质粒构建及抑制COL1A1表达的有效序列的筛选

目的: 构建和筛选对大鼠肝星状细胞前Ⅰ型胶原α1链(COL1A1)mRNA有抑制作用的COL1A1短发夹RNA (shRNA)的表达质粒.方法:从NCBI网站获得大鼠的COL1A1 cDNA序列, 根据Whitehead研究所的siRNA设计软件设计3条理论上最佳的siRNA序列, 相应的双链DNA被插入pGPU6/GFP/Neo质粒中, 即pGPU6/GFP/Neo-shRNA-A、pGPU6/GFP/Neo-shRNA-B和pGPU6/GFP/Neo-shRNA-C. 为得到高效沉默COL1A1-siRNA, 以脂质体LipofectAMINE2000, 将1、2、3、4 μg DNA质粒转染至HSC-T6细胞中, 并观察转染效果. 将最佳沉默siRNA导入HSC-T6细胞, RT-PCR分析各组的COL1A1 mRNA表达水平.结果: 靶向COL1A1 mRNA的3个shRNA重组质粒载体pGPU6/GFP/Neo-shRNA-A、pGPU6/GFP/Neo-shRNA-B和pGPU6/GFP/Neo-shRNA-C经测序分析, shRNA编码序列与设计的片段完全一致, 经酶切凝胶电泳证实载体构建成功. 1、2、3、4 μg组转染效率分别为16.7%、20.3%、23.5%和22.3%, 以2 μg siRNA为最佳剂量, pGPU6/GFP/Neo-shRNA-A、pGPU6/GFP/Neo-shRNA-B和pGPU6/GFP/Neo-shRNA-C对COL1A1 mRNA的抑制率分别为16.6%, 63.3%和80.3%. 结论:筛选出的pGPU6/GFP/Neo-shRNA-C表达质粒能高效地抑制转染细胞COL1A1 mRNA的表达, 从而为肝纤维治疗提供新的方法和材料.     

Association of CYP1A1 and GSTM1 Polymorphisms With Oral Cancer Susceptibility: A Meta-Analysis

Our meta-analysis was aimed to evaluate the association of CYP1A1 and glutathione-S-transferase M1 (GSTM1) polymorphisms with oral cancer susceptibility.The related articles were searched in PubMed, Embase, and CNKI databases. Fifty eligible studies were included in our meta-analysis. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to evaluate the relationship of CYP1A1 (rs4646903 and rs1048943) and GSTM1 polymorphisms with oral cancer risk. A random-effects model or fixed-effects model was employed depending on the heterogeneity.In overall analysis, CYP1A1 rs4646903 polymorphism was associated with the risk of oral cancer (CC vs TT: OR 1.65, 95% CI 1.33–2.05; CC vs TC+TT: OR 1.77, 95% CI 1.48–2.11; C vs T: OR 1.17, 95% CI 1.07–1.28), whereas rs1048943 showed no obvious association with oral cancer susceptibility. Moreover, subgroup analysis by ethnicity demonstrated that rs4646903 and rs1048943 both related with increased risk of oral cancer in Asians. Moreover, the analysis based on source of control suggested that rs4646903 could increase the risk for oral cancer in both population- and hospital-based populations, whereas no remarkable relationship of rs1048943 with oral cancer susceptibility was observed. For GSTM1 gene, null genotype appeared to be a risk factor for oral cancer (null vs present: OR 1.23, 95% CI 1.12–1.34), which was also proved in the subgroup analysis.The results demonstrated that CYP1A1 rs4646903 and null genotype of GSTM1 polymorphisms might serve as risk factors for oral cancer.     

A Simple Microchromatographic Column for Determination of Hemoglobins A1a+b and A1c

A simple microchromatographic homemade column was devised for the measurement of glycosylated minor hemoglobin fractions. the mean and one standard deviation of hemoglobins A_1a+b,A_1c and A_1a+b+c determined by the homemade column in 150 non-diabetic controls and 56 juvenile onset insulin-dependent diabetics were 2.6 + 0.5%, 6.0 + 1.0%, 8.6 + 1.1%, 3.3 + 0.9%, 13.7 + 2.2% and 16.9 + 2.8% respectively. A twofold increase in hemoglobins A_1c and A_1a+b+c levels was observed in the diabetics as compared to the non-diabetic controls suggesting that the homemade column is valid for the measurement of all three glycosylated hemoglobin fractions and assessment of blood glucose control in diabetic patients. the homemade column procedure yields accurate and reproducible results, is simple to perform, inexpensive, relatively rapid and may be used in the routine clinical laboratory. Hemoglobin A_1a+b+c levels measured by a commercial column in 35 non-diabetic controls and in 56 diabetics showed good correlation (R=0.91) with hemoglobin A_1a+b+c levels determined by the homemade column. the commercial column is valid for the measurement of the combined glycosylated hemoglobin A_1a+b+c fraction and may be used in the routine clinical laboratory to assess diabetic control.     

A simple microchromatographic column for determination of hemoglobins A1a + b and A1c

A simple microchromatographic homemade column was devised for the measurement of glycosylated minor hemoglobin fractions. The mean and one standard deviation of hemoglobins A1a + b, A1c and A1a + b + c determined by the homemade column in 150 nondiabetic controls and 56 juvenile onset insulin-dependent diabetics were 2.6 +/- 0.5%, 6.0 +/- 1.0%, 8.6 +/- 1.1%, 3.3 +/- 0.9%, 13.7 +/- 2.2% and 16.9 +/- 2.8% respectively. A twofold increase in hemoglobins A1c and A1a + b + c levels was observed in the diabetics as compared to the non-diabetic controls suggesting that the homemade column is valid for the measurement of all three glycosylated hemoglobin fractions and assessment of blood glucose control in diabetic patients. The homemade column procedure yields accurate and reproducible results, is simple to perform, inexpensive, relatively rapid and may be used in the routine clinical laboratory. Hemoglobin A1a + b + c levels measured by a commercial column in 35 non-diabetic controls and in 56 diabetics showed good correlation (R = 0.91) with hemoglobin A1a + b + c levels determined by the homemade column. The commercial column is valid for the measurement of the combined glycosylated hemoglobin A1a + b + c fraction and may be used in the routine clinical laboratory to assess diabetic control.     

某中学甲型H1N1流感暴发疫情调查

目的 描述洪雅县某中学甲型H1N1流感暴发疫情的流行病学特征,为学校甲型H1N1流感暴发防控提供参考.方法 应用现场流行病学方法开展调查,用RT - PCR检测病例标本,用Epidata录入数据,用Excel、Epiinfo软件进行结果分析.结果 该校共发现流感病例151例,罹患率6.31％,学生病例149例,首发病例为高一学生,高一年级罹患率最高(11.19％),住校生罹患率9.1％,走读生为2.83％.病原学检测,采集25例病例的咽拭子标本,甲型H1N1流感病毒阳性率20％.结论 此次疫情是为甲型H1N1流感暴发疫情,住校学生罹患率较高,住宿条件较差和学生接触密切是此次疫情的危险因素.