乙型肝炎病毒前S1抗原检测的应用与评价

目的评价乙型肝炎病毒(HBV)前S1抗原(PreS1)检测的临床应用价值.方法用双抗体夹心ELISA一步法对280例HBV感染者进行PreS1检测,其结果与HBV-DNA聚合酶链反应(PCR)和HBV血清标志物的检测结果相比较.结果 PreS1在乙型肝炎病毒e抗原(HBeAg)阳性组的检出率为83.0%,显著高于HBeAg阴性组的检出率36.7%(P＜0.05).PreS1在HBV-DNA阳性组的检出率为80.9%,显著高于HBV-DNA阴性组的检出率29.1%(P＜0.05).PreS1与HBV-DNA检测结果的符合率为77.9%,两者检出率的相关系数r=0.983 0(P＜0.01).结论 PreS1是反映HBV复制与传染性的一个可靠指标,可作为HBV血清标志物检测的重要补充.     

HBV感染者血清HBV PreS1抗原检测与病毒复制的关系

目的探讨乙型肝炎病毒(HBV)PreS1抗原与HBV复制的关系.方法采用ELISA法检测HBV血清标志物和HBV PreS1抗原;采用荧光定量PCR方法检测HBV-DNA,对检测结果作分析.结果HBVPreS1抗原和HBV-DNA在HBeAg阳性标本组中的检出率明显高于其在HBeAg阴性标本组中的检出率(P＜0.01);HBV PreS1抗原和HBV-DNA有较高相关性(P＜0.01).结论HBV PreS1抗原与具有病毒活动性复制意义的指标(HBeAg和HBV-DNA)有良好的相关性,HBV PreS1抗原的检测结果可以较好地反映HBV的复制情况.     

乙型病毒性肝炎患者前S1抗原检测的意义

目的:探讨乙型肝炎病毒前S1抗原在临床上的应用价值。方法:采用酶联免疫吸附试验(ELISA)和聚合酶链反应(PCR)方法,对306例乙型病毒性肝炎(以下简称乙肝)患者和50例健康人分别检测HBV标志、preS1抗原和乙肝病毒-脱氧核糖核酸(HBV-DNA)。结果:306例乙型肝炎患者preS1抗原和HBV-DNA的检出率分别为53.6%和58.8%;preS1-Ag在HBeAg阳性组和HBeAg阴性组中的阳性率分别为90.9%、29.2%,HBV-DNA在HBeAg阳性组和HBeAg阴性组中的阳性率分别为95.9%、34.6%,以HBV-DNA测定结果为判断标准,则preS1-Ag的敏感性、特异性、阳性和阴性预测值及符合率分别为87.8%、95.2%、96.3%、84.5%和90.8%;HBV-DNA检出率稍高于PreS1-Ag的检出率,但两者的检出率差异无统计学意义(P>0.05)。结论:乙肝病毒PreS1抗原与HBeAg阳性、HBV-DNA阳性呈高度相关,PreS1-Ag可与HBeAg、HBV-DNA同时作为HBV存在复制和传染性的重要检测指标,值得临床实验室推广应用。     

检测乙型肝炎病毒前S1抗原的临床意义

目的 探讨乙型肝炎病毒前S1抗原(Pre-S1Ag)的检测及在临床的应用价值. 方法 采用酶联免疫吸附实验(ELISA)和荧光定量PCR测定100例乙型肝炎患者和30例健康体检者血清中Pre-S1Ag、HBeAg和HBV-DNA. 结果 以HBV-DNA≥103拷贝/ml为判断乙肝病毒复制的标准,Pre-S1Ag在HBV-DNA阳性组的检出率为84.71%,明显高于阴性组的56.47%;HBeAg阳性组Pre-S1Ag的阳性率81. 25%明显高于阴性组Pre-S1Ag的阳性率27.03%.结论 Pre-S1Ag是参与HBV感染与复制的重要指标,Pre-S1Ag作为乙型肝炎病毒复制的标志物优于HBeAg.     

乙型肝炎病毒前S1蛋白的检测和临床应用价值

目的:探讨乙型肝炎病毒前S1蛋白(Presl)的检测及在临床的应用价值。方法:对210例乙型肝炎患者和67例健康体检者进行Presl、HBeAg和HBV-DNA测定,采用酶联免疫吸附实验(ELISA)对Presl和HBeAg进行检测;采用荧光定量PCR法对HBV-DNA进行测定。比较各组Presl、HBeAg、HBV-DNA三者之间的关系。结果:Presl在HBeAg阳性组中的检出率为81.8%(72/88),明显高于HBeAg阴性组的40.4%(36/89)。以HBV-DNA≥10~3拷贝/ml为判断乙肝病毒复制的标准,Presl在HBV-DNA阳性组的检出率为76.3%(135/177),明显高于阴性组的33.3%(11/33)。结论:Presl是参与HBV感染与复制的重要指标,Presl作为乙型肝炎病毒复制的标志物优于HBeAg。     

乙型病毒前S1抗原与乙肝病毒血清标志物的相关性探讨

目的探讨乙型肝炎患者前S1抗原(PreS1-Ag)与乙型肝炎病毒血清标志物的关系及临床应用价值。方法采用酶联免疫吸附试验(ELISA)测定乙肝肝炎血清标志物和PreS1,并对检测结果进行比较分析。结果 PreS1在HBeAg阳性组检出率和HBeAg阴性组中检出率差异有统计学意义(P<0.001),部分HBeAg阴性患者仍存在病毒复制。结论 PreS1可作为乙型肝炎病毒(HBV)感染和复制的良好指标,较HBeAg更稳定地反应了HBV复制的情况,其简便、可靠、廉价的测定可作为乙肝临床诊断和治疗的常规检测。     

267例乙型肝炎病毒前S1抗原检测的临床意义

目的:传统乙肝血清标志物是目前我国用于乙肝检测与筛查的普及指标,但其在检测病毒复制等方面尚有不足。本研究分析了前S1抗原(PreS1)和乙型肝炎病毒(HBV)血清标志物之间的关系,探讨了乙型肝炎病毒前S1蛋白在临床上的应用价值。方法:对267例乙型肝炎表面抗原(HBsAg)阳性患者血清标本用酶联免疫吸附试验(ELISA)检测HBV血清标志物和PreS1抗原,同时采用聚合酶链反应(PCR)检测HBV-DNA。结果:267例乙型肝炎患者PreS1抗原和HBV-DNA的检出率分别为67.0%和76.0%;其中HBeAg(+)165例中,PreS1抗原阳性147例,HBVDNA阳性155例,阳性检出率分别为89.1%和93.9%。HBeAg(-)102例,PreS1抗原阳性32例,HBV-DNA阳性48例,阳性检出率分别为31.4%和47.1%。HBV-DNA检出率稍高于PreS1Ag的检出率,但两者的检出率差异无统计学意义(P>0.05)。结论:前S1蛋白与HBV-DNA的一致性较好,在反映乙型肝炎病毒复制情况方面比很敏感,可作为临床上乙型肝炎病毒感染的诊断的一项理想的检测指标。     

乙肝病毒前S1蛋白的临床诊断意义

目的 研究前S1蛋白(PreS1)与乙型肝炎病毒(HBV)复制的关系,及其诊断乙型肝炎的价值和判断预后的作用.方法 采用酶联免疫吸附法对232例慢性乙型肝炎患者血清标本和40例确诊为急性乙型肝炎患者发病后一段时间的血清标本进行PreS1测定,并与HBV-DNA、ALT间关系做对比分析.结果 HBsAg、HBeAg、HBcAb阳性组HBV-DNA和PreS1阳性检出率分别为87.4%和82.5%,HBsAg、HBeAb、HBcAb阳性组分别为32.6%和30.3%,两组患者血清PreS1与HBV-DNA检出率高度符合(P>0.05).急性乙肝患者ALT异常与PreS1阳性相关性高(P＞0.05),而与HBV-DNA阳性检出率之间有显著差异(P＜0.05).结论 PreS1蛋白能够敏感地反映乙型肝炎病毒复制的情况,在一些设备比较落后的地方可以采用PreS1法代替HBV-DNA.急性乙肝患者PreS1先于HBV-DNA转阴,提示疾病预后良好,并且可以有效监测ALT的动态变化.     

乙型肝炎PreS1抗原检测的临床意义

目的:分析PreS1抗原与HBV-DNA、HBeAg的关系.方法:用ELESA法检测376例HBsAg阳性患者血清中HBV-M和PreS1抗原,用荧光定量PCR法同时检测HBV-DNA.结果:164例HBeAg阳性患者血清中PreS1抗原和HBV-DNA的阳性率分别是87.20%和90.85%;二者无显著性差异(P＞0.05).212例HBeAg阴性患者血清中PreS1抗原和HBV-DNA的阳性率分别是40.57%和39.62%,说明HBeAg阴性患者仍存在病毒复制;229例PreS1抗原阳性患者血清中HBeAg和HBV-DNA的阳性率分别是62.45%和81.66%,说明PreS1抗原与HBV-DNA的符合率较HBeAg高,在判断乙肝病毒复制方面PreS1抗原更有意义.结论:PreS1抗原与HBV-DNA有较高的一致性,PreS1抗原可作为诊断乙肝病毒复制及活跃程度的重要指标,但不能完全替代HBV-DNA检测.     

乙型肝炎病毒前S1抗原与HBV-DNA和HBV之间的关系

目的探讨乙型肝炎病毒(HBV)前S1抗原与HBV-DNA和血清标志物之间的关系及其临床意义。方法用ELISA法对418例HBV感染者血清进行前S1抗原检测,其结果与HBV-DNA及"乙肝五项"进行统计学分析。结果在HBeAg阳性组,前S1抗原阳性率(89.4%)与HBV-DNA阳性率(96.2%)两者比较无显著性差异(P>0.05)。组1前S1抗原阳性率及浓度和HBV-DNA阳性率及病毒含量与2组、3组比较,差异具有显著性(P<0.01)。前S1抗原在HBV-DNA阳性组的检出率为81.1%,显著高于HBV-DNA阴性组的检出率53.9%(P<0.01)。前S1抗原灵敏度为81.1%,明显高于HBeAg的灵敏度53.1%(P<0.01)。结论前S1抗原检测比HBeAg更敏感地反映了HBV的复制程度,对乙肝五项血清标志物和HBV-DNA起重要的补充作用。     

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.