巨细胞包涵体病20例临床分析

报告20例巨细胞包涵体病,年龄最小3天,最大5岁。其中90％病例有黄疸(18例),85％病例肝脾肿大(17例),55％伴有呼吸道症状(11例)。尿沉渣细胞检查包涵体全部阳性,其中有10例患儿之母亲尿沉渣包涵体检查阳性,2例患儿母亲的乳汁中检到包涵体。     

人巨细胞病毒DNA检测在小儿人巨细胞病毒感染诊断中的应用

目的 探讨小儿血液、尿液及其母亲母乳的人巨细胞病毒DNA检测结果在人巨细胞病毒感染的诊断价值。 方法 选取2017年—2018年期间在浙江大学丽水医院就诊的疑似人巨细胞病毒感染的患儿328例为研究对象。收集患儿血液、尿液和对应母乳标本,进行实时荧光定量PCR,检测人巨细胞病毒DNA载量;再将患儿血清用化学发光法检测HCMV-IgM,比较不同标本不同检测方法的阳性率。针对阳性患儿,对不同临床症状分布构成进行分析。 结果 328例患儿检测总阳性率为71.04%,男性患儿和女性患儿阳性率分别为71.02%和69.74%,差异无统计学意义(χ2=0.065,P=0.799)。血液、尿液和乳汁的人巨细胞病毒阳性率分别为49.09%、70.43%和58.23%,尿液阳性率最高,差异有统计学意义(χ2=31.147,P<0.001)。新生儿组的乳汁阳性率最高,为72.41%,28 d到1岁之间和1岁以上患儿尿液阳性率最高,各年龄组之间阳性率差异有统计学意义(P<0.05);血人巨细胞病毒DNA和血清HCMV-IgM阳性率检出率分别为49.09%(161/328)和16.16%(53/328),2种方法联合检测的阳性检出率为49.69%,对比单一血DNA检测方法,两者差异无统计学意义(P>0.05)。临床症状小于1岁患儿主要以黄疸,腹泻为主,大于1岁的患儿主要以肝损害和肺炎为主。 结论 在小儿血液、尿液及其母亲母乳HCMV-DNA的检测中,尿液HCMV-DNA对诊断患儿人巨细胞病毒有更好的临床应用价值。且尿标本留取方便、无创,易为家长和小儿接受,所以采用FQ-PCR方法对小儿尿标本进行检测能起到快速、简洁、灵敏的作用,对提高HCMV感染的诊断率有实际的临床意义,对于小月龄患儿临床应推广尿液HCMV-DNA检测。      

新生儿巨细胞病毒感染临床分析及干预对策

目的 分析新生儿巨细胞病毒感染的危险因素、干预对策与护理.方法 选择来我院就诊的巨细胞病毒感染患儿及健康新生儿,采用PCR、ELISA分别检测标本的CMV-DNA、CMV-IgG、CMV-IgM的水平.结果 95例新生儿尿液中50例CMV-DNA为阳性（52.63％）,且其母亲乳汁CMV-DNA大多为阳性（90.00％）;随着产妇年龄的增加,产妇CMV-IgM、CMV-IgG的阳性率均逐渐增加,其中产妇CMV-IgM差异有统计学意义,新生儿CMV-IgG均低于产妇CMV-IgG.结论 加强对孕妇产前的产检是预防新生儿CMV感染的重要措施.     

新生儿巨细胞病毒感染与迟发型母乳性黄疸

探讨巨细胞病毒感染与新生儿母乳性黄疸间的关系。在34例迟发型母乳性黄疸患儿新鲜尿液沉渣中,11例找到典型巨细胞包涵体细胞,阳性率32.3%。因而认为巨细胞病毒感染可能是迟发型母乳性黄疸的一个重要原因,其机制可能是巨细胞病毒感染抑制了新生儿肝脏二磷酸尿甙葡萄糖醛酸脱氢酶的活性,从而引起的高未结合胆红素血症。     

2403份不同类型标本中人巨细胞病毒DNA的检出情况及临床分析

目的 探讨孕妇和婴儿不同类型标本中人巨细胞病毒（HCMV）DNA的检出情况,并进行临床分析。方法 2021年5月至2021年10月收集到在昆明市妇幼保健院检验科采用荧光定量PCR法进行HCMV-DNA检测的临床标本共2 403份,对不同标本来源人群、不同类型标本的HCMV-DNA检出率进行回顾性分析。结果 2 403份不同类型的标本中,乳汁的HCMV-DNA检出率为31.70%,尿液为0.85%,血清为0%。2个年龄段（0～28 d和28 d至6个月）母亲乳汁、尿液标本的检出率随婴儿年龄增加而增高,且差异均有统计学意义（P <0.001）。同时进行了尿液及其母亲乳汁HCMV-DNA检测的221例婴儿中,检出率：乳汁22.62%,尿液0.45%,乳汁的检出率高于尿液。当母亲乳汁标本HCMV-DNA阴性,患儿自身尿液标本为阳性的占0.58%,阴性占99.42%;母亲乳汁标本HCMV-DNA阳性时,患儿自身尿液标本全为阴性。结论 孕妇及其婴儿的各类标本中,乳汁标本的HCMV-DNA检出率明显高于其他类型标本,对于疑似HCMV感染的孕妇或婴儿,建议首先采集母亲乳汁标本进行检测。然而母亲乳...     

母体巨细胞病毒感染致幼儿听力异常的研究

随机检查322例孕妇,取其宫颈分泌物、产后乳汁及新生儿尿液培养分离巨细胞病毒(CMV),阳性率为12/322例(3.72%).对其中CMV感染母亲的8例幼儿进行脑干听觉诱发电位(BAEP)测定,与8例母亲未感染之幼儿对比,结果表明,感染组中5例出现听功能损害,P<0.01,同时检查两组婴幼儿尿液,各出现4例CMV阳性,母亲阳性组4例幼儿均发生听力异常,母亲阴性组4例中仅1例异常,提示先天性巨细胞病毒感染对婴幼儿的危害性比后天感染对婴儿的损害大。     

应用聚合酶链技术快速诊断病毒性心肌炎

应用聚合酶链反应（ＰＣＲ）技术对６１例临床诊断为心肌炎，５例扩张型心肌病，３例心内膜弹力纤维增生症患儿血标本进行检测。结果显示：６１例临床诊断为心肌炎患儿血标本中３０例阳性，阳性率４９．１％，５例扩张型心肌病２例阳性，阳性率４０％，３例心内膜弹力纤维增生症均为阴性，证明阳性患儿为柯萨基Ｂ组病毒感染所致。春季发病率及阳性率均高于冬夏季（Ｐ〈０．０５），扩张型心肌病与病毒感染有密切关系，柯萨基Ｂ组病毒     

献血者巨细胞病毒感染筛查的初步研究

目的：探讨检测人巨细胞病毒(HCMV)的低基质磷酸化蛋白(pp65)抗原对健康献血巨细胞病毒感染情况的筛查。方法：对2003年2～7月收集的103份EDTA抗凝外周血标本，用免疫组化方法进行pp65抗原血症检测，同时以ELISA法检测其中的86份血清中的IgM和IgG抗体。结果：103份标本中共有10份pp65抗原阳性，阳性率为9．71％；ELISA法检测86份标本CMV—IgM抗体全部阴性，CMV—IgG抗体56例阳性，阳性率为62％(56／86)，10份pp65抗原阳性的标本中，CMV—IgG阳性9例。结论：pp65抗原是检测CMV感染的一种敏感、特异的方法，而检测CMV—IgM、CMV—IgG不能预测CMV的活动性感染，因此对需要输注全血、成分血的免疫力低下或各种移植病人，应进行CMVpp65抗原的检测。     

荧光定量PCR技术在诊断婴儿人巨细胞病毒感染中的应用

目的探讨荧光定量PCR技术（FQ-PCR）检测人巨细胞病毒（HCMV）-DNA在诊断婴儿HCMV感染中的临床价值。方法选取322例疑诊HCMV感染的婴儿,收集血液、新鲜尿液及母亲母乳,应用FQ-PCR检测HCMV-DNA。结果 322例疑诊HCMV感染的婴儿血液标本、尿液标本以及母乳标本的阳性率分别为15.2%,44.37%,57.15%。对母乳喂养的87例疑诊感染患儿进行尿液及对应母乳的FQ-PCR联合检测,其中40例尿液阳性的患儿母乳标本33例阳性,阳性率为82.5%;47例尿液阴性的患儿母乳标本24例阳性,阳性率为51.06%。结论 HCMV感染母乳是婴儿获得感染的主要途径之一。FQ-PCR是早期诊断婴幼儿HCMV感染的有效方法,对临床诊断及治疗有着重要的指导意义。     

班氏丝虫宿主循环抗原的检测

应用兔抗牛丝虫抗体ＥＬＩＳＡ双抗体夹心法和Ｄｏｔ－ＥＬＩＳＡ法检测安徽流行区人体班氏丝虫循环抗原。微丝蚴血症者血清总阳性率９６％（２４／２５），尿液总阳性率为６０％（１５／２５），４份乳汁阳性率均为１００％。１５份尿液阳性和４份乳汁阳性者与血清阳性结果的符合率分别为１００％（１５／１５）和７５％（３／４）。检测江苏非流行区正常人血清、尿液、乳汁共４３份，全部阴性。１１份肠道线虫感染者尿液全为阴性，血清Ｄｏｔ－ＥＬＩＳＡ阴性。１０份肺吸虫感染者血清Ｄｏｔ－ＥＬＩＳＡ阴性。结果表明，班氏丝虫循环抗原不仅存在于血清而且存在于尿液和乳汁中。     

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.