端粒重复序列扩增聚合酶链反应检测肺刷落细胞端粒酶活性

用端粒酶聚合酶链反应（ＰＣＲ）酶联免疫吸附测定（ＥＬＩＳＡ）法，联合聚丙烯酰胺凝胶电泳（ＰＡＧＥ）和银染色法，检测肺刷落细胞中端粒酶活性，并探讨了其在肺癌诊断中的价值。一、方法ＴＲＡＰＰＣＲＥＬＩＳＡ测定具体操作如下：将肺刷落细胞加裂解液１０～５...     

鼻咽癌中端粒酶活性的相对定量检测

为了探讨端粒酶在鼻咽癌中的表达规律及相对含量,我们用端粒酶聚合酶链反应（ＰＣＲ）酶联免疫吸附测定（ＥＬＩＳＡ）试剂盒,测定了鼻咽癌组织的端粒酶活性。从ＨＮＥ１细胞株提取物中显示,酶活性与细胞数呈线性关系,灵敏度可达１０２个ＨＮＥ１细胞,并从热灭活测...     

尿液脱落细胞中端粒酶活性及临床意义

为了研究端粒酶活性的变化与泌尿系肿瘤之间的关系,我们用端粒酶聚合酶链反应（ＰＣＲ）酶联免疫吸附测定（ＥＬＩＳＡ）技术测定癌组织及其尿中脱落细胞的端粒酶活性,并与正常组织及非癌患者的尿脱落细胞进行了比较。用膀胱癌和肾癌细胞株细胞验证,此试剂盒的灵敏度...     

巨细胞病毒即刻早期基因mRNA检测方法的建立

目的建立快速简便的逆转录聚合酶链反应（ＲＴＰＣＲ）方法检测人巨细胞病毒（ＨＣＭＶ）即刻早期（ＩＥ）基因ｍＲＮＡ。方法设计合成跨越ＨＣＭＶＩＥ基因内含子区的一对引物，分别用ＲＴＰＣＲ和ＰＣＲ技术扩增ＨＣＭＶｍＲＮＡ和ＤＮＡ，用Ｓｏｕｔｈｅｒｎ杂交鉴定阳性产物。结果ＨＣＭＶＩＥ基因ｍＲＮＡ表达在感染后６小时即可出现，并持续到感染后至少９６小时，ＲＴＰＣＲ检测的最低敏感性为１００ｆｇ总ＲＮＡ，其他病毒和细胞ＲＮＡ不能被扩增。结论ＲＴＰＣＲ技术检测ＨＣＭＶｍＲＮＡ敏感、特异，有望应用于临床作为ＨＣＭＶ活动性感染的早期诊断方法     

乳头溢液脱落细胞端粒酶活检测

目的 探讨乳头溢液脱落细胞端粒酶活性检测在临床诊断中的应用。方法 采用ＴＲＡＰ－ＰＣＲ银染定性法及ＴＲＡＰ－ＰＣＲ－ＥＬＩＳＡ定量法对５０例溢乳进行脱落细胞端粒酶活性分析。结果 ５０例溢乳脱落细胞端粒酶阳性率高达７８％（３９／５０）,随着年龄的增大,端粒酶阳性率呈逐步下降趋势,而同期送检的细胞病理诊断则无１例找到癌细胞。结论 溢乳脱落细胞端粒酶阳性检出率明显增高。随着疾病的发展,端粒酶阳性患者易发     

乳头溢液脱落细胞端粒酶活性检测

目的探讨乳头溢液脱落细胞端粒酶活性检测在临床诊断中的应用。方法采用ＴＲＡＰ－ＰＣＲ银染定性法及ＴＲＡＰ－ＰＣＲ－ＥＬＩＳＡ定量法对５０例溢乳进行脱落细胞端粒酶活性分析。结果５０例溢乳脱落细胞端粒酶阳性率高达７８％（３９／５０）,随着年龄的增大,端粒酶阳性率呈逐步下降趋势,而同期送检的细胞病理诊断则无１例找到癌细胞。结论溢乳脱落细胞端粒酶阳性检出率明显增高。随着疾病的发展,端粒酶阳性患者易发生恶变的可能性是否大于端粒酶阴性患者需进一步研究。     

聚合酶链反应-微孔板杂交技术用于结核分枝杆菌的检测

目的建立结核分枝杆菌的ＰＣＲ酶联免疫吸附测定（ＥＬＩＳＡ）方法，使ＰＣＲ结果判定更加客观。方法我们使用玻璃粉吸附提纯模板ＤＮＡ，将ＰＣＲ引物５′端标记生物素，用ＰＣＲ产物与微孔板中预先包被的克隆靶基因杂交，然后用酶标链霉亲和素与杂交体中的生物素结合，最后用酶底物与所标记酶进行显色反应，通过测定其吸光度来判断结果。结果所建立的ＰＣＲＥＬＩＳＡ检测法可提高检测的灵敏度和特异性。对５０份来自结核病人高度怀疑有结核分枝杆菌的标本检测表明，ＰＣＲＥＬＩＳＡ检出２２份阳性，比抗酸染色法（７／５０）、培养法（１３／５０）和ＰＣＲ电泳法（１８／５０）检出率高，而２０份证实无结核分枝杆菌的标本，几种方法检查均为阴性。结论该法可敏感、特异和客观地检测临床标本中的结核分枝杆菌。     

儿童B系急性淋巴细胞白血病TEL-AML1融合基因的研究

目的了解ＴＥＬＡＭＬ１融合基因在儿童Ｂ系急性淋巴细胞白血病（急淋）中的发生率及其与临床诊断和预后的关系,并比较巢式逆转录聚合酶链反应（ＲＴＰＣＲ）和双标记荧光原位杂交（ＦＩＳＨ）两种方法。方法采用巢式ＲＴＰＣＲ和双标记ＦＩＳＨ技术检测ＴＥＬＡＭＬ１融合基因。结果和结论ＲＴＰＣＲ检测发现儿童Ｂ系急淋中２２．５％（４０例中９例）的患者有ＴＥＬＡＭＬ１融合基因转录本,这类患者预后较好,完全缓解率达１００％。ＲＴＰＣＲ和ＦＩＳＨ技术是检测ＴＥＬＡＭＬ１的有效方法,并为临床诊断和预后估计提供了有一定价值的手段。     

急性白血病细胞端粒酶表达及其临床意义初探

近年来端粒 端粒酶假说 (ｔｅｌｏｍｅｒｅ ｔｅｌｏｍｅｒａｓｅｈｙｐｏｔｈｅｓｉｓ)已成为恶性肿瘤分子生物学发病机制研究的热点。国外学者研究指出 ,急性白血病细胞有较高的端粒酶活性 ,其临床意义结论不一[1,2 ] 。我们用端粒重复序列聚合酶链反应扩增法(ＰＣＲ ＴＲＡＰ) [3 ] 半定量测定了急性白血病 (ＡＬ)患者的白血病细胞端粒酶活性 ,同时用免疫组化ＡＢＣ法测定ＡＬ细胞Ｐ170表达 ,并观察这些患者对治疗的反应。病例和方法1　临床资料　 2 4例均为我院 1997年 12月～ 1998年 2月的住院或门诊成人ＡＬ患者 ,按 1987年苏州全国…     

葡萄糖-6-磷酸脱氢酶基因G487A突变型研究

目的　鉴定中国白族和傣族人群中的葡萄糖６磷酸脱氢酶（Ｇ６ＰＤ）Ｇ４８７Ａ 基因突变型,为少数民族Ｇ６ＰＤ缺乏症的防治提供理论指导;为研究分子进化、民族起源及迁移提供遗传学资料。方法　对云南白族、傣族、汉族及广西汉族的Ｇ６ＰＤ缺乏症患者进行聚合酶链反应限制性内切酶分析（ＰＣＲＲＥ） ,聚合酶链反应单链构象多态性（ＰＣＲＳＳＣＰ） 及ＤＮＡ序列分析。结果　首次在白族及傣族人群中发现Ｇ６ＰＤＧ４８７Ａ基因突变型。６６ 例白族患者中发现６ 例,５２ 例傣族患者中发现１ 例Ｇ４８７Ａ 突变;检查４６ 例广西汉族患者未发现该突变。Ｇ６ＰＤＧ４８７Ａ基因突变型的个体在无诱因作用时,其血红蛋白含量、红细胞计数及网织红细胞计数基本正常。结论　Ｇ６ＰＤＧ４８７Ａ 基因突变型多属Ｇ６ＰＤ 缺乏症临床Ⅲ型;该突变型是汉族、白族和傣族共同具有的基因突变型。提示：中华民族可能同源     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

俯卧位通气对高海拔地区肺复张治疗无效急性呼吸窘迫综合征患者氧合的影响

目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高＜20％视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P＜0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P＜0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P＜0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.     

Digital imaging among medical facilities

The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.     

Myocardial elastography at both high temporal and spatial resolution for the detection of infarcts

Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNR(e)) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (>/=0.125 ms) and spatial ( approximately 55 microm) resolution as well as high precision ( approximately 0.05 microm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo.     

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.