随机扩增DNA多态性技术在A组链球菌分型上的应用

目的 了解A组乙型溶血性链球菌的基因分型状况。方法 采用随机扩增多态性DNA技术(Random amplified polymorphic DNA，RAPD)，对1988～1994年度．从广东城市和农村，1993～1994年度，从湖北、吉林9～11岁学龄儿童分离的179株GAS进行RAPD分析。结果 ①同一T型的菌株有特征性条带，但有些亚型带型间差异较大：②不同T型间可有相同的带型；③分型率比T分型高，达到96．6％；④有主导RAPD型菌株流行的情况存在。结论 RAPD方法对GAS分型及流行病学中有一定的应用价值，可以区别同一血清型不同地区来源的GAS。     

北京市猩红热患者A组链球菌M蛋白基因型别与超抗原基因特征的相关性研究北大核心CSCD

目的分析2012年5月至2013年7月北京市猩红热患者A组链球菌（GAS）超抗原基因特征及其与M蛋白基因（emm基因）型别的相关性。方法采集猩红热患者标本进行GAS分离鉴定,并应用PCR方法检测Pmm基因和超抗原基因（speA、speB、speC、speF、speG、spell、speI、speJ、speL、speK、speM、SSa和smeZ）。应用卡方检验比较率和构成比。结果2012年5月至2013年7月分离到的423株GAS菌株进行超抗原基因检测,结果显示speB、speC、speF、speG、smeZ和ssa的检出率较高,分别达97．6％、99．8％、98．3％、99．8％、94．1％和88．4％,其次为speH（54．6％）、speI（53．4％）、speA（45．2％）和speJ（43．5％）,而speK（2．4％）．speL（1．4％）和speM（1．7％）的检出率较低。GAS菌株主要emm型别为emm12型（59．5％）和emm1型（37．4％）。emm12型携带spell和speI基因的比例高达84．8％和84．0％,而emm1型仅为4．0％和3．4％;emm12型携带speA和speJ基因的比例仅为17．3％和14．8％,而Pmml型为95．3％和94．6％。emm12型与emm1型菌株之间携带基因谱的差异有统计学意义（P〈0．05）。结论2012年至2013年,北京市GAS菌株流行型别以emm1和emm12型为主,且emm型别与超抗原基因谱之间存在相关关系。     

AF固定器治疗胸腰椎爆裂性骨折及并发症防治

1994年 6月至 1 999年 7月 ,我们采用 AF固定器治疗胸腰椎爆裂性骨折 (TL BI)患者 72例 ,取得较好效果。现结合资料对其并发症的防治进行探讨。1　临床资料1 .1　一般资料　全组男 6 2例 ,女 1 0例 ;年龄1 4～ 6 7岁 ,平均 32岁。致伤原因为砸伤 30例 ,坠落伤 2 3例 ,交通事故伤 1 6例 ,其它伤 3例。按 Denis爆裂性骨折分类标准 ,A型 2 6例 ,B型 38例 ,C型 2例 ,D型 4例 ,E型 2例。骨折部位为 T10 、T11各 1例 ,T11、T12 1例 ,T12 、L12例 ,T12 2 5例 ,L12 9例 ,L2 6例 ,L32例 ,L4 2例 ,L53例。有合并伤 43例。1 .2　手术方法　伤…     

老年妇女T型节育器穿入膀胱形成结石一例

患者女性 ,6 4岁 ,孕 5产 3。因尿频、尿痛伴下腹部隐痛 13年于 2 0 0 1年 6月 2 1日入院。患者于 1977年 6月放置T型节育器。 1980年 1月孕 4 0余天行人工流产术。术中宫腔探查未发现节育器 ,故再次放置O型金属节育器。此后至绝经期 (末次月经 1990年 2月 )出现痛经 ,经期延长4～ 6d ,未予重视。 1988年起出现尿频、尿痛伴下腹隐痛 ,以劳累及性交后加重 ,无肉眼血尿。既往患糖尿病 2 0年 ,曾服降糖、抗感染药。血糖控制在 5 4～ 7 9mmol/L之间 ,但膀胱刺激症状反复出现并逐渐加重。查体 :慢性病容 ,心肺未见异常。腹平软 ,膀胱区轻压痛 …     

广州市孕妇碘营养状况研究

目的　了解广州市孕妇 (孕中、晚期 )碘营养状况。方法　用砷 -铈接触法测定尿碘 ,用放射免疫分析法 (RIA )测定血清甲状腺素 (T4 )、促甲状腺激素 (TSH )。结果　孕妇孕中期尿碘中位数为 2 4 9.3μg/ L ,<10 0μg/ L者占 4 .5 % ;孕晚期尿碘中位数为 2 4 1.2μg/ L ,<10 0μg/ L者占 12 .5 % ,两期尿碘值差异无显著意义 (P >0 .0 5 )。孕中期血清 T4 (15 7.0± 6 6 .4 ) nmol/ L ,在正常范围 (5 4～ 174 nm ol/ L )者占 5 8.2 % ,超过 174 nmol/ L者占38.8% ;孕晚期血清 T4 (12 4 .4± 5 9.4 ) nm ol/ L ,在正常范围者占 78.3% ,超过 174 nmol/ L者占 13.0 %。孕中期血清 TSH (中位数 3.9m U / L ) <5 m U / L者占 6 5 .7% ,>5 m U / L者占 34.3% ;孕晚期血清 TSH (中位数 6 .9m U / L ) <5 m U/ L者占 18.2 % ,>5 m U / L者占 81.8%。两期自身对照 TSH>5 m U / L与 <5 m U / L人数构成差异有非常显著意义 (P <0 .0 1)。结论　广州市孕妇碘营养状况良好 ;孕晚期血清 TSH>5 m U / L者 (81.8% )较多 ,与尿碘、T4 水平不一致 ,有待进一步研究     

耐甲氧西林金黄色葡萄球菌对万古霉素敏感性的变迁

目的　通过对近年来耐甲氧西林金黄色葡萄球菌 (MRSA)临床分离株对万古霉素抑菌圈直径的分析 ,研究MRSA对万古霉素敏感性的变化。方法　药敏试验采用纸片扩散法 (K B法 ) ,抑菌圈直径的比较采用t检验。结果　 1994～ 2 0 0 0年每年收集的临床分离的MRSA菌株数分别为 2 18、187、2 92、2 37、35 1、886和 6 5 2 ,各年菌株对万古霉素抑菌圈的平均直径 (mm)分别为 19 9、19 1、18 6、17 4、18 4、18 2和 17 8。 2 0 0 0年的 6 5 2株MRSA对万古霉素抑菌圈的平均直径 (17 8mm)明显小于1994年 2 18株MRSA的平均直径 (19 9mm) ,差异有显著性 (P <0 0 0 1)。 2 0 0 0年分离的MRSA对氯霉素、环丙沙星、红霉素、庆大霉素、四环素和复方新诺明等常用抗生素的耐药率均很高 ,其耐药百分率分别为 44 0 %、73 7%、89 1%、6 5 7%、6 1 0 %和 6 7 0 %。结论　 1994年到 2 0 0 0年MRSA对万古霉素的敏感性在逐年降低 ,加强金黄色葡萄球菌对万古霉素敏感性的监测非常必要。     

支气管狭窄性病变的临床与纤支镜检查特点

我院于 1994年 9月至 2 0 0 0年 8月纤维支气管镜 (纤支镜 )下观察到支气管腔内狭窄性病变 2 0 3例 ,对其临床、镜下表现、病理学特点分析如下。1　资料分析1.1　一般资料　本文 2 0 3例 ,男性 15 6例 ,女性 47例 ,年龄 2 8～ 79岁 ,平均 5 8.71岁。年龄分布 2 9岁以下 7例 (3.45 % ) ,30～ 39岁 9例 (4.43% ) ,40～ 49岁 2 4例 (11.82 % ) ,5 0～ 5 9岁 6 1例 (30 .0 5 % ) ,6 0～ 6 9岁 70例 (34.48% ) ,70～ 79岁 32例 (15 .76 % )。长期吸烟史 (>2 0 0支 /年 ) 91例 (44 .7% )。1.2　临床表现咳嗽 16 7例 (82 .2 7% ) ,咯血 79例 (38.92…     

纤维支气管镜检查对肺癌确定诊断的价值

我们从 1994年 4月至 1997年 9月 ,共进行纤维支气管镜 (简称纤支镜 )检查 2 193次 ,经纤支镜检查确诊为肺癌患者 2 86例 (13 0 % )。现将结果报告如下。2 86例患者中男 2 2 0例 ,女 6 6例 ,男女之比为 3 3∶1,平均年龄 5 4 5岁 (2 0～ 75岁 )。主要临床表现 :咳嗽为主要症状者 2 5 1例 (87 8% ) ,其中湿性咳嗽 2 12例 (84 5 % ) ,干性咳嗽 39例 (15 5 % )。不同程度咯血 118例 (4 1 3 % ) ,气喘 2 2例 (7 7% ) ,不同程度发热 13例 (4 5 % ) ,胸痛 7例(2 4% )。平均病程 3 6个月 (1周至 3年 ) ,1例慢性支气管炎 10年除外。主要Ｘ线表现 :…     

2型糖尿病患者血清生长停滞特异性基因产物6水平的变化及相关因素分析

目的 探讨血清生长停滞特异性基因产物6（GAS6）水平与T2DM、肥胖的相关性及临床意义。方法新诊断T2DM患者（T2DM组）46例和NGT者（NGT组）42名按BMI18．5kg／mz％BMI％24．9kg／m2或≥25k／m2又各自分为正常体重和超重／肥胖亚组。采用ELISA法测定空腹血清GAS6水平。结果T2DM组血清GAS6浓度低于NGT组[（10．63士1．95）VS（14．27±3．82）ng／m1]（P〈0．01）。偏相关分析显示,血清GAS6与BMI、WC、FPG、Hb＆c、C-RP、TNF-a、IL-6呈负相关（r分别为-0．235、-0．266、-0．362、-0．427、-0．268、-0．442、-0．380,Pd0．05或P〈0．01）,与HDL-C呈正相关（r-0．235,P〈0．05）。多元逐步回归分析显示,BMI、HbA1c、TNF-a（β分别为-0．190、-0．483、-0．580）为血清GAS6水平的独立影响因素。结论T2DM患者血清GAS6水平低于NGT者,BMI、HbA1c、TNF-a与GAS6呈独立负相关。     

广东省广州市2001—2004年分枝杆菌初步菌种鉴定与药物敏感性试验结果分析

目的了解广州市2001—2004年3年间分枝杆菌菌种的分布状态和抗结核药物的耐受性情况,为临床诊断和治疗结核病提供可靠的科学依据。方法对2001年9月—2004年3月从1 459例患者中共分离出的2 154株分枝杆菌进行菌种鉴定,并采用绝对浓度间接法对结核分枝杆菌和部分非结核分枝杆菌进行4种抗结核药物的敏感性试验。结果非结核分枝杆菌的分离率由1998年7月—2001年9月的16.5%上升至20.3%;对2 154株分枝杆菌中的1 703株结核分枝杆菌复合群菌株进行的药物敏感性试验结果显示:原始耐药率由1998年7月—2001年9月的14.4%上升至20.3%。继发耐药率则由原来的35.4%下降至32.3%;而非结核分枝杆菌对抗结核药物基本上呈现高度的原始耐受性。结论对临床分离出的阳性标本,有必要进行分枝杆菌的菌种鉴定和药物敏感性试验。     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.