A serosurvey of hepatitis B virus,hepatitis C virus,human T lymphotropic virus type-1 and syphilis in HIV-1-infected patients in Jamaica

The seroprevalences of hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotropic virus type-1 (HTLV-1) and syphyilis were determined in 129 HIV-1-infected patients using commercially prepared reagents. The seroprevalences were HCV, 0% (0/129); HBV, 37% (48/129); HTLV-1, 5% (6/129) and syphilis, 20% (26/129). Fifteen per cent (19/129) of the patients had active/chronic HBV infection. The seroprevalence of HBV was statistically significantly higher in HIV-1 infected men (24/49, 50% versus 17/80, 21%; p = 0.005), while the seroprevalence of syphilis was statistically significantly increased in HIV-1 infected patients in the over-40 age group (10/31, 32% versus 6/53, 11%; p = 0.05). These findings throw the spotlight on HBV infection and syphilis and suggest that these two sexually transmitted infections should be carefully surveyed in patients with HIV/AIDS in Jamaica. It is essential for management protocols in Jamaica to include screening for evidence of these co-infections.     

恒定型自然杀伤T细胞在1型糖尿病的免疫调节作用

1型糖尿病(type 1 diabete mellitus,T1DM)可能是免疫系统自我平衡破坏所导致的疾病,被认为是针对胰岛β细胞的致病性T细胞所介导。恒定型自然杀伤T(invariant nature killer T,iNKT)细胞是一种独特的调节性T细胞,在免疫调节中发挥关键作用,对T1DM有保护作用。在脾和胰岛中iNKT细胞通过与糖脂配体、相应细胞表面CD1d复合物结合后,iNKT细胞释放出大量IL-4和IL-10分子,这是一种与辅助性T淋巴细胞2(T-helper lymphocyte 2,Th 2)有关的保护作用。同时,iNKT细胞能够与其他多种细胞,包括CD4+CD25+调节性T细胞、树突状细胞、产生TGF-β的T细胞和部分B细胞协同作用,抑制糖尿病的发生发展。这些研究结果表明,iNKT对T1DM有预防和缓解功能。     

Prevalence of antibody to human T lymphotropic virus type III by risk group and area, United Kingdom 1978-84

Antibody to human T lymphotropic virus type III (anti-HTLV-III) was sought in 2150 patients in three groups at risk with a radioimmunoassay and an immunofluorescence test. Results by the two methods were closely concordant. Anti-HTLV-III was already present in some British homosexuals in 1980 and in some British haemophiliacs in 1981, and since then its prevalence has increased. Of homosexual patients needing laboratory tests for hepatitis B virus infection in 1984, 34% of 282 in London and 5% of 955 in five centres outside London were positive for anti-HTLV-III. Of haemophiliacs sampled in 1984, 38% of 81 were anti-HTLV-III positive. Most of the seropositive haemophiliacs were regular recipients of commercial factor VIII concentrates. Few British intravenous drug abusers sampled in 1984 (2.5% of 203) were positive for anti-HTLV-III. These results show that infection with HTLV-III has rapidly become widespread among homosexuals attending sexually transmitted disease clinics and among haemophiliacs receiving pooled blood products. Thus, while many anti-HTLV-III positive individuals may remain asymptomatic, there may soon be a considerable increase in the incidence of the acquired immune deficiency syndrome and related disease in Britain.     

1型糖尿病与HLA-DRB1?DQB1基因相关性研究

目的: 研究中国江苏地区汉族人群1型糖尿病(T1DM)与人类白细胞抗原(HLA)-DRB1?DQB1基因及单倍型频率的相关性?方法:选取江苏地区汉族人群T1DM患者(112例)与对照组(69例),运用聚合酶链反应-寡核苷酸探针序列特异性引物(PCR-SSO)技术,进行HLA-DRB1?DQB1基因分型,两组间等位基因频率比较采用χ2检验,通过Arlequin软件进行单倍型频率的分析?结果:112名T1DM患者中检测到DRB1位点等位基因17个(对照组19个),DQB1位点等位基因7个(对照组7个)?与对照组相比,T1DM组DRB1*0901?DRB1*0405和DRB1*0301频率明显增高,DQB1位点的DQB1*0201与DQB1*0303频率明显高于对照组;与对照组相比,T1DM患者明显升高的单倍型频率为:DRB1*0901-DQB1*0303?DRB1*0301-DQB1*0201?DRB1*0405-DQB1*0401和DRB1*0405-DQB1*0302?结论:中国江苏地区汉族T1DM患者HLA基因DR位点的DRB1*0901?DRB1*0405?DRB1*0301及DQ位点的DQB1*0201?DQB1*0303对T1DM易感?发现了4个新的具有易感作用的单倍型:DRB1*0901-DQB1*0303?DRB1*0301-DQB1*0201?DRB1*0405-DQB1*0401和DRB1*0405 -DQB1*0302?     

Co-infection by the human T-cell lymphotropic virus type II in patients infected by the human immunodeficiency virus in Yucatan, Mexico

BACKGROUND: The HTLV-II infection has been reported in patients with HIV infection as often in asymptomatic as those with acquired immunodeficiency syndrome (AIDS). The aim of this study was to determine the prevalence of HTLV-II infection in a group of patients infected by HIV in our region, as well as determining the risk factors associated with HTLV-II transmission in this group of patients and its impact on the clinical course of HIV infection. METHODS: A cross-sectional study was carried out to determine the prevalence of co-infection of HIV-1 and HTLV-II among 192 patients from Yucatán, México. Serum specimens were tested for HTLV antibodies by an enzyme-linked immunosorbent assay (ELISA) test. Positive results were confirmed and typed by Western blot. Twenty four (12.5%) patients were confirmed with antibodies for HTLV-II, but none had antibodies for HTLV-I. Specific risk factors for HTLV-II transmission were not identified. RESULTS: Candidiasis (42 vs. 12%, p = 0.0004) and more than two defining entities of AIDS (37 vs. 18%, p = 0.02) was observed with greater prevalence in the group co-infected. CONCLUSIONS: In our study, a higher frequency of candidiasis and a larger number of AIDS-defining pathologies were observed in the co-infected patients, suggesting that co-infection is associated with greater immunodeficiency.     

ABCA1基因13148C/T多态性与2型糖尿病的相关性分析

目的：探讨ABCA1基因13148C/T单核苷酸多态性与中国甘肃地区汉族人群2型糖尿病及脂质代谢的关系.方法：采用巢式多聚酶链反应-限制性片段长度多态性（nested-PCR-RFLP）技术检测148例2型糖尿病患者和114例健康对照组ABCA1基因13148C/T单核苷酸多态性.结果：①2型糖尿病组CC型频率低于对照组（P〈0.05）,而TT型频率高于对照组（P〈0.05）,等位基因频率在两组间的差异有统计学意义（P〈0.05）.②2型糖尿病组的体质量指数、空腹血糖、收缩压、总胆固醇、三酰甘油、低密度脂蛋白胆固醇、空腹胰岛素、HOMA胰岛素抵抗指数、糖化血红蛋白高于对照组,而高密度脂蛋白胆固醇低于对照组,差异有统计学意义（P〈0.05）.③2型糖尿病组三酰甘油、HOMA胰岛素抵抗指数在CC型、CT型、TT型之间依次递增,差异无统计学意义,高密度脂蛋白胆固醇（HDL-C）水平在CC型、CT型、TT型之间依次递减,TT型的HDL-C水平明显低于CC型,差异有统计学意义（P〈0.05）.结论：2型糖尿病患者脂质代谢发生紊乱且与胰岛素抵抗、肥胖、高血压密切相关;ABCA1基因13148C/T多态性与2型糖尿病相关,并与其血脂代谢相关;T等位基因可能是2型糖尿病的易感等位基因,TT基因型可能是2型糖尿病的易感基因型.     

1型糖尿病诊疗技术新进展

1型糖尿病(type 1 diabetes mellitus,T1DM)是一种由于胰岛β细胞损伤,导致胰岛素绝对缺乏的自身免疫性疾病.良好的血糖控制可以降低T1DM患者并发症的发生风险,技术进步是T1DM患者实现良好血糖管理的重要前提.随着连续血糖监测系统(continue glucose monitoring sys...     

Myopia in young patients with type 1 diabetes mellitus

INTRODUCTION

This study aimed to evaluate the proportion of young patients with type 1 diabetes mellitus (T1DM) who have myopia, as well as the risk factors associated with myopia in this group.

METHODS

In this cross-sectional study, patients aged < 21 years with T1DM for ≥ 1 year underwent a comprehensive eye examination. Presence of parental myopia, and average hours of near-work and outdoor activity were estimated using a questionnaire. Annualised glycosylated haemoglobin (HbA1c), defined as the mean of the last three HbA1c readings taken over the last year, was calculated. Multivariate analysis using genetic, environmental and diabetes-related factors was done to evaluate risk factors associated with myopia.

RESULTS

Of the 146 patients (mean age 12.5 ± 3.6 years) recruited, 66.4% were Chinese and 57.5% were female. Myopia (i.e. spherical equivalent [SE] of –0.50 D or worse) was present in 96 (65.8%) patients. The proportion of patients with myopia increased from 25.0% and 53.6% in those aged < 7.0 years and 7.0–9.9 years, respectively, to 59.2% and 78.4% in those aged 10.0–11.9 years and ≥ 12.0 years, respectively. Higher levels of SE were associated with lower parental myopia (p = 0.024) and higher annualised HbA1c (p = 0.011).

CONCLUSION

Compared to the background population, the proportion of myopia in young patients with T1DM was higher in those aged < 10 years but similar in the older age group. Myopia was associated with a history of parental myopia. Environmental risk factors and poor glycaemic control were not related to higher myopia risk.     

微生物疫苗在1型糖尿病中的应用

1型糖尿病(T1DM)是由抗原特异性T淋巴细胞对β细胞靶向破坏,引起胰岛素绝对缺乏而导致的自身免疫性疾病,患者需终身进行胰岛素治疗,其发病机制尚不完全清楚,但多项数据显示感染性疾病发病率的下降伴随着过敏和自身免疫疾病发病率的上升,因而推测环境因素在T1DM的发生中起到重要作用。现已有多种细菌、寄生虫、病毒及其成分在动物模型中被证明可以预防T1DM,因此,通过微生物疫苗进行早期免疫刺激,进而诱导自身免疫耐受,有望成为预防T1DM安全有效的新方法。本文对临床和动物研究中的1型糖尿病微生物疫苗进行综述,主要从微生物的灭活疫苗、减毒活疫苗、亚单位疫苗、核酸疫苗和活载体疫苗进行概述,并讨论了各类疫苗可能的作用机制。     

人ZnT-8作为1型糖尿病新型免疫调节剂的研究

目的：构建人锌转运体8（Zinc transporter 8,ZnT-8）羧基端原核表达载体,表达和纯化人ZnT-8羧基端（ZnT-8-COOH）重组蛋白,为寻找1型糖尿病新型免疫调节剂创造条件。方法：人ZnT-8-COOH cDNA克隆入pET-32a载体,在大肠杆菌BL21中利用异丙基-硫代-β-D-半乳糖苷（isopropyl-thio-β-D-galactoside,IPTG）诱导表达,经十二烷基硫酸钠-聚丙烯酰胺凝胶电泳和Western blot鉴定表达产物,镍离子亲和层析纯化重组蛋白。40只4周龄的雌性非肥胖型糖尿病（non obese diabetic,NOD）小鼠随机分为ZnT-8重组蛋白预处理组及生理盐水对照组,分别腹腔注射ZnT-8重组蛋白和生理盐水,每周测量各组NOD小鼠体质量,检测血糖、血清C肽水平。结果：经PCR扩增后得到306 bp的DNA片段,成功构建到pET-32a表达载体上,经测序分析序列正确;ZnT-8重组蛋白在大肠杆BL21中获得成功表达,并得以有效纯化。ZnT-8重组蛋白预处理组NOD小鼠与生理盐水对照组相比,28周龄时ZnT-8重组蛋白预处理组的体质量高于生理盐水对照组（P<0.05）。28周龄时ZnT-8重组蛋白预处理组的血糖低于生理盐水对照组（P<0.05）;28周龄时ZnT-8重组蛋白预处理组的血清C肽水平高于生理盐水对照组（P<0.05）。结论：成功制备人ZnT-8-COOH重组蛋白,并初步证实了其对1型糖尿病的免疫调节作用。     

柯萨奇病毒感染及T淋巴细胞亚群的改变与1型糖尿病的关系研究

目的 探讨柯萨奇病毒感染与1型糖尿病的关系,及T淋巴细胞亚群改变在病情发生发展中的作用.方法 选取新发糖尿病患者(Ⅰ组)22例,发病一段时间后的患者(Ⅱ组)30例,正常对照组(Ⅲ组)30例,RT-PCR法检测血中柯萨奇病毒RNA,流式细胞术检测T淋巴细胞亚群的变化.结果 柯萨奇病毒RNA的阳性率Ⅰ组患者为55.55%,Ⅱ组患者为23.33%,Ⅲ组为6.67%,x2检验显示P<0.01,差异具有显著统计学意义;Ⅰ组患者中有上呼吸道感染者较无上呼吸道感染者,CVB-RNA的阳性率明显升高,x2检验显示P<0.05,差异具有显著性.Ⅰ,Ⅱ组患者T淋巴细胞亚群与对照组相比,CD3和CD4的百分率下降,CD4/CD8的比值也降低,差异有统计学意义(P<0.01或P<0.05);但Ⅱ组CD3,CD4及CD4/CD8均较Ⅰ组有上升趋势,其中CD3和CD4的百分率两组差异有统计学意义(P<0.01或P<0.05) ;CVBRNA阳性组与对照组相比,CD3,CD4,CD8及CD4/CD8均降低,且差异有统计学意义(P<0.01或P<0.05),CVBRNA阳性组与阴性组相比,CD3,CD4,CD8及CD4/CD8也均降低,有显著差异性(P<0.05或P<0.01).结论 1型搪尿病的发生发展与柯萨奇病毒感染有关,T淋巴细胞亚群的改变可能是其致病机制之一.     

二恶英染毒诱导相同芳香烃受体小鼠肝脏基因的差异表达

 目的 用cDNA微阵列分析（microarray）探查具有相同芳香烃受体（AhR）的不同种系小鼠对二恶英（TCDD）反应的基因表达谱。 方法 用 TCDD染毒具有相同AhR受体表型的BALB, CBA 和C3H种系小鼠,染毒剂量为40 µg/kg。24 h后取肝脏样品,提取RNA,用cDNA微阵列法,分析肝脏基因表达的差异。结果 用测序法确认了BALB,CBA和C3H 3种系小鼠的芳香烃受体的基因型完全相同。cDNA微阵列分析结果显示了TCDD诱导3系小鼠基因变化总数、各系小鼠共同的诱导基因和独特的诱导基因。 结论 本文数据提供了在不同遗传背景下具有相同AhR受体种系小鼠的不同TCDD诱导基因表达谱,提示了TCDD染毒后3系小鼠的基因表达特异性,为探讨不同种系小鼠对化学物毒性作用的不同反应提供了基础数据。     

儿童1型糖尿病103例临床特点及疗效分析

目的 回顾分析儿童1型糖尿病(T1DM)的发病状况,探讨其临床特点及诊治方法.方法 对2002年2月至2010年8月成都市妇女儿童中心医院住院的T1DM患儿103例的临床资料进行回顾性分析,并将其中不同的胰岛素给药方法的31例学龄期糖尿病酮症酸中毒患儿分为基础-餐时胰岛素治疗组和胰岛素泵治疗组,进行疗效分析,比较其血糖达标所需时间、低血糖发生情况、血糖波动情况、治疗达标时空腹血糖、餐后2 h血糖水平、每日胰岛素用量、尿酮体消失时间、住院时间等.结果 103例T1DM患儿年龄38 d至15岁4个月,平均(8±3)岁;初发病例78例(75.7%),男孩多见(57例,55.3%),发病年龄以7～10岁最多(47例,占45.6%),冬春季发病51例(49.5%),合并感染67例(65.2%),以呼吸道感染(27例)和消化道感染(15例)多见.而62例(60.2%)以酮症酸中毒就诊,并发脑水肿者4例(3.9%).部分患儿合并桥甲炎、甲状腺功能亢进、系统性红斑狼疮等自身免疫性疾病.不同的胰岛素给药方法患儿治疗后空腹血糖及餐后血糖均明显下降,差异无统计学意义(P＞0.05).胰岛素泵治疗组酸中毒纠正时间短、尿酮体消失快(P＜0.01),血糖达标时间短(P＜0.01),血糖波动幅度小、持续时间短,胰岛素用量少,住院时间短,与基础-餐时胰岛素治疗组比较差异有统计学意义(P＜0.05).结论 儿童T1DM起病临床表现不典型,易合并酮症酸中毒,感染可能是患儿出现糖尿病酮症酸中毒的重要诱因之一.胰岛素泵治疗可较好控制血糖,使用方便,是目前儿童T1DM较佳治疗方法.     

PON1基因微卫星多态性与2型糖尿病的关联研究

目的:探讨南京地区汉族人群中对氧磷酶1基因(PON1)多态性与2型糖尿病是否存在相关性。方法:选择PON1基因附近高杂合度微卫星DNA多态标志,应用聚合酶链反应及变性聚丙烯酰胺凝胶电泳技术,探察这一微卫星多态在正常对照组与2型糖尿病组中的基因频率分布。结果:该多态位点存在4种等位基因,GT重复序列分别重复12、15、17、20次,病例与对照分析结果表示,两组间等位基因频率总体分布差异有显著性(χ2=14.10,P<0.01)。两组间基因型频率总体分布差异有显著性(χ2=12.72,P<0.01)。结论:南京地区汉族人群中对氧磷酶1基因多态性可能与2型糖尿病相关。