N-乙酰基转移酶基因多态性与老年大肠癌易感性研究

目的探讨N-乙酰基转移酶(N-acetyltransferase,NAT)基因多态性与老年大肠癌易感性的关系。方法采用PCR-RFLP技术对105例年龄>60岁大肠癌患者(大肠癌组)和121例体检健康者(对照组)NAT基因多态性进行检测,分析NAT基因型分布特征。结果大肠癌组基因型Wt/M2频率(58.44%)明显高于对照组(23.41%)(P<0.01);2组慢速乙酰化基因型频率差异无统计学意义(P>0.05);吸烟组NAT快速乙酰化型个体患大肠癌风险(OR=1.959,95%CI:0.870～4.410)高于不吸烟组(OR=1.674,95%CI:0.830～3.378)。结论快速乙酰化基因型Wt/M2可能是老年大肠癌发病危险因素,NAT快速乙酰化基因型与吸烟有协同作用。     

中国南方汉族人群MICA-TM基因座等位基因分布

目的调查中国南方汉族人群MICA基因穿膜区(TM)基因座多态性分布。方法应用聚合酶链反应和荧光(6-FAM)自动化技术，对中国南方地区106例无亲缘关系汉族人群样本检测MICA—TM，计算基因频率、基因型频率、个体鉴别力、期望杂合性、多态性信息含量和非父排除率。结果MICA—TM基因型分布符合Hardy—Weinberg平衡，共检出MI—CA—TM 5个等位基因，即A4、A5、A5．1、A6和A9；MICA—TM A5基因频率(O．2877)最高，A4基因频率(0．1321)最低；A5—5．1和A5—5基因型分布频率分别为14．15％和10．38％。结论MICA—TM基因座适合作为中国人群的遗传标志，可用于人类学、遗传病的基因连锁分析、法医学亲子鉴定和个体识别等研究领域。     

徐州汉族人ABO血型及HAB分泌型基因分型研究

目的　研究徐州汉族人群ABO血型及HAB分泌型基因多态性分布特征并用于解决临床输血中血型血清学鉴定难题。方法　用快速盐析法提取外周血标本中的DNA ,用PCR SSP扩增ABO血型、HAB分泌型等位基因。结果　 1 0 4名健康、无血源关系的徐州汉族人ABO血型基因频率分别为A1:0 .1 53 8,A2 :0 .0 962 ,B :0 .2 4 52 ,O1:0 .50 4 8,O2 :未检测到 ( χ2 =6.73 2 3 ,P >0 .2 5,符合Hardy Weinberg公式 ) ;HAB分泌型基因频率分别为分泌基因Se:0 .980 8,非分泌基因se:0 .0 1 92 ( χ2 =0 .0 4 2 1 ,P >0 .75,符合Hardy Weinberg公式 )。 1份用血清学方法不能确定ABO血型的标本 ,用基因分型定为BO1型。结论　PCR SSP是一种方便、可靠的血型基因定型技术 ,与血型血清学方法相比本文非分泌基因se的频率显著偏低 ,4例血清学定为非分泌型个体用该方法鉴定基因型为Se/Se,间接提示G4 4 7A和G757A突变不能完全覆盖我国汉族人群的非分泌基因se。     

肺癌患者乙酰化代谢基因型探讨

目的 探讨N-乙酰基转移酶2(NAT2)基因多态性与肺癌易感性的关系.方法 应用自动实时荧光Light-Cycler技术,分析138例肺癌患者和112例健康人NAT2 4个位点的基因多态性,比较肺癌患者与对照组间频率差异.结果 肺癌组(吸烟者)NAT2慢乙酰化基因型频率与对照组比较差异有统计学意义(x2=7.97,P＜0.05),并使患肺癌的危险度提高了3.12倍(P＜0.05);肺癌组(非吸烟者)NAT2慢乙酰化基因型频率与对照组比较差异无统计学意义(x2=2.88,P＞0.05).结论 携带NAT2慢乙酰化基因型的吸烟者可能是肺癌的高危人群.     

雌激素受体基因多态性与高血压关系的研究

目的　了解雌激素受体 (ER)基因多态性在中国汉族人群中的分布及其与原发性高血压 (EH)是否相关。方法　应用聚合酶链反应 (PCR)和限制性片段长度多态性 (RFLP)方法检测 97例EH患者和 118例正常对照者ER基因型 ,结合血脂水平探讨两者间的关系。结果　ER等位基因X、x和P、p频率在高血压组和对照组分别为 0 .2 4 7、0 .75 3、0 .16 9、0 .831;0 .4 0 2、0 .5 98、0 .339、0 .6 6 1。基因型频率分布符合Hardy Weinberg平衡定律。XbaⅠ和PvuⅡsg酶切多态性基因型频率 ,等位基因频率及结合XbaⅠ和PvuⅡ两个酶切多态性分析在组内、组间比较均无显著性差异 (P >0 0 5 ) ,且ER基因型间血脂水平在组内比较无统计学意义 (P >0 0 5 )。结论　在EH人群中存在着ERXbaⅠ和PvuⅡ基因多态性 ,但它们与EH无相关性 (P >0 0 5 ) ,不是EH的遗传易感因子。     

早发性帕金森病与细胞色素P4501A1和N-乙酰基转移酶2基因多态性及个体易感危险性

目的：探讨细胞色素P4501Al(CYP1A1)和N-乙酰基转移酶2(NAT2)基因多态性及其交互作用与早发性帕金森病的关系。方法：用病例对照研究方法及聚合酶链式反应-限制性片段长度多态性(PCR—RFLP)技术分析了126例散发的早发性帕金森病患者(发病年龄&;lt;50岁)与122例正常健康成人对照组CYP1A1基因Msp1位点3种多态(A，B，C)及NAT2基因常见的3个突变所导致的慢乙酰化基因型在早发性帕金森病患者与正常人之间的分布差异及其交互作用。结果：CPY1A1基因各基因型在两组中分布差异无显著性意义；NAT2基因慢乙酰化基因型在帕金森病组中的分布频率(23．0％)明显高于对照组(10.7％)，OR值为2．507；协同分析发现在帕金森病组中携带NAT2慢乙酰化基因型兼CYP1A1基因杂合型B的频率(62．1％)明显高于对照组(23.1％)，OR值达5．455，显著提高了患帕金森病的危险度。结论：CYP1A1基因杂合型B与NAT2慢乙酰化基因型之间有协同作用，共存时可能增加个体患帕金森病的危险性。     

汉族人群Tap1和Tap2基因座等位基因频率和基因型频率分布

本研究分析汉族人群tap1和tap2基因座等位基因和基因型频率的分布及意义。运用TaqManPCR分型技术调查339例中国健康汉族人群随机样本tap1（transporterassociatedwithantigenprocessing）和tap2基因座等位基因频率和基因型频率分布,并计算个体鉴别力、累积鉴别力、多态性信息含量、无偏倚期望杂舍性、观察杂合性等遗传参数。结果表明：共有5种tap1等位基因（tap1＊0101、020101、020102、0301和0401）和4种tap2等位基因（tap2$0101、0102、0103和0201）被检出,tapl实际检出基因型8种,占理论基因型的53．3％,tap2实际检出基因型6种,占理论基因型60％。Tap1和tap2基因型分型结果符合Hardy—Weinberg定律（P〉0．05）。Tap1＊0101（79．79％）和tap2女0101（82．74％）在中国汉族人群中分布最广。结论：Tap1＊0101和tap2$0101在汉族人群中分布最广。Tap1和tap2基因座具有一定的信息量和个体鉴别能力,可用于人类遗传学、遗传疾病基因连锁分析、法医学亲子鉴定和个体识别等研究领域。     

急性冠脉综合征患者MMP-3基因启动子5A/6A的多态性分析

目的　建立MMP 3基因启动子 5A/6A多态性的快速基因型分析方法 ,并且探讨此多态性对湖北武汉地区汉族人群急性冠脉综合征危险性的可能影响。方法　通过设计错配引物以及多聚酶链反应 限制性片段长度多态性 (PCR RFLP)分析方法 ,同时结合单链构象长度多态性 (SSCP)分析 ,检测了湖北地区10 3例汉族急性冠脉综合征患者及 10 0例健康成人的MMP 3基因 16 12 (5A/6A)的基因型。结果　急性冠脉综合征组与健康对照组MMP 3基因的 5A/6A +5A/5A基因型频率分别为 4 1 7%、 2 4 % ,5A等位基因频率分别为 2 1 8%、 13% ,两两比较均有显著性差异 (P <0 0 5 )。 5A/6A +5A/5A基因型的OR值为 2 2 6 9(95 %CI :1 2 4 1～ 4 14 9,P =0 0 0 7)。结论　MMP 3基因 5A/6A多态性与急性冠脉综合征危险性有关 ,并可能在冠心病的发生发展中起重要作用     

序列特异性引物PCR法检测MN血型基因型

目的　建立MN血型系统基因分型的方法 ,检测人群中MN基因的频率。方法　用快速盐析法抽提样本DNA ,序列特异性引物PCR法检测MN基因。结果　 115例汉族人群中MM基因型为 2 5例 ,MN基因型为 6 0例 ,NN基因型为 30例。M基因频率为 0 .4 78,N基因频率为 0 .5 2 2。结论　该方法可以检测MN血型基因型。浙江汉族中N基因频率大于M基因频率     

血管紧张素转换酶与肺源性心脏病的相关性分析

目的　探讨血管紧张素转换酶(ACE)与肺源性心脏病(肺心病)的关系。方法　选取肺心病病人6 0例,正常对照组4 0例。采用多聚酶链反应(PCR)检测两组人群ACE基因的I/D多态性,同时检测血清ACE水平(SACE)。结果　两组人群检测到ACE基因的DD ,ID及Ⅱ3种基因型,两组比较3种基因型的频率差异无显著性(X2 =2 .191,P >0 .0 5 ) ;两组I/D等位基因频率分别为0 .5 8,0 .4 2和0 .6 9,0 .31,差异无显著性(X2 =2 .2 15 ,P >0 .0 5 )。女性组ACE基因型中DD型占2 5 .9% ,ID型2 5 .9% ,Ⅱ型4 8.2 % ;男性组分别为15 .1%、2 7.3%和5 7.6 % ,统计学分析表明两组间基因型构成有明显差异,I/D等位基因频率无明显差别,DD型与非DD型基因型构成无明显差别。肺心病病人血清ACE水平明显低于正常人群。结论　ACE基因I/D多态性与肺心病发生无明显相关性,血清ACE活性降低可能参与肺心病进程     

用实时荧光定量PCR检测NAT2基因型及其意义

目的 探讨深圳地区汉族人中NAT2基因分布特征,为开展NAT2基因与肿瘤相关性研究和药物代谢性疾病诊治提供依据。方法将DNA浓度为40 ng/μl的标本进行1×100、1×101、1×102、1 ×103、1 ×104倍比梯度稀释,以验证实时荧光定量PCR检测NAT2基因的灵敏度。采用实时荧光定量PCR结合TaqMan探针技术检测554名深圳汉族健康人NAT2基因282、341、481、590和857突变位点,并进行基因分型。同时用直接测序法对47名健康人标本进行平行检测,以验证和评价荧光定量PCR检测NAT2基因的敏感度、特异度和准确性。结果 经倍比梯度稀释试验验证实时荧光定量PCR检测NAT2基因的灵敏度可精确至10-4ng/μl。采用实时荧光定量PCR从554名深圳汉族人中检出NAT2*4、*5、*6、*7、*11等位基因频率分别为64.6％( 358/554)、6.3％( 35/554)、25.3％ (140/554)、30.0％( 166/554)、0.6％( 3/554)。主要基因型NAT2* 4/*6、*6/*7、*13/*13或*12/*12或*4/*4、*4/*7、*7/*13、*12、*6/*13(*12)频率依次为12.3％(68/554)、8.3％ (46/554)、7.6％(42/554)、40.5％(224/554)、8.1％ (45/554)、7.2％ (40/554)、5.6％(31/554),7种基因型约占总基因型的89.6％ (496/554)。深圳地区汉族人中NAT2基因主要等位基因为*4、*6、*7、*13,表型以快乙酰化型和中间型为主,分别占40.5％( 224/554)、46.7％(259/554),慢乙酰化型仅占12.8％(71/554)。用荧光定量PCR和直接测序法平行检测47名健康人NAT2基因,与直接测序法比较,检测282、341、481、590、857位点的敏感度分别为88.2％ (30/34)、87.5％( 7/8)、80.0％ (4/5)、100.0％ (22/22)、93.8％ (15/16),特异度分别为100.0％ (13/13)、94.9％ (37/39)、100.0％ (42/42)、96.0％( 24/25)、96.8％( 30/31),准确性分别为91.5％(43/47)、93.6％( 44/47)、97.6％( 46/47)、97.9％ (46/47)、95.7％ (45/47)。结论实时荧光定量PCR检测NAT2基因的灵敏度、敏感度、特异度高,适用于临床及科学研究,深圳地区汉族人主要NAT2等位基因是*4、*6、*7,最常见慢乙酰化表型为*6/*7,这为与NAT2基因相关的代谢性疾病及肿瘤研究提供了数据。     

Influence of NAT2 polymorphisms on sulfamethoxazole pharmacokinetics in renal transplant recipients

The sulfamethoxazole (SMX)-trimethoprim drug combination is routinely used as prophylaxis against Pneumocystis pneumonia during the first 3 to 6 months after renal transplantation. The objective of this study was to examine the impact of N-acetyltransferase 2 (NAT2) and CYP2C9 polymorphisms on the pharmacokinetics of SMX in 118 renal transplant recipients. Starting on day 14 after renal transplantation, patients were administered 400 mg/day-80 mg/day of SMX-trimethoprim orally once daily. On day 14 after the beginning of SMX therapy, plasma SMX concentrations were determined by a high-performance liquid chromatography method. The SMX area under the concentration-time curve from 0 to 24 h (AUC(0-24)) for 15 recipients with the NAT2 slow acetylator genotype (NAT2 5/ 6, - 6/ 6, - 6/ 7, and - 7/ 7) was significantly greater than that for 56 recipients with the NAT2 rapid acetylator genotype (homozygous for NAT2 4) (766.4 ± 432.3 versus 537.2 ± 257.5 μg-h/ml, respectively; P = 0.0430), whereas there were no significant differences in the SMX AUC(0-24) between the CYP2C9 1/ 1 and - 1/ 3 groups. In a multiple regression analysis, the SMX AUC(0-24) was associated with NAT2 slow acetylator polymorphisms (P = 0.0095) and with creatinine clearance (P = 0.0499). Hepatic dysfunction in NAT2 slow acetylator recipient patients during the 6-month period after SMX administration was not observed. SMX plasma concentrations were affected by NAT2 polymorphisms and renal dysfunction. Although standard SMX administration to patients with NAT2 slow acetylator polymorphisms should be accompanied by monitoring for side effects and drug interaction effects from the inhibition of CYP2C9, SMX administration at a low dose (400 mg) as prophylaxis may not provide drug concentrations that reach the level necessary for the expression of side effects. Further studies with a larger sample size should be able to clarify the relationship between SMX plasma concentration and side effects.     

Association of CYP2E1 and NAT2 gene polymorphisms with chronic obstructive pulmonary disease

BACKGROUND: Detoxification genes are potential candidates in the susceptibility of patients with chronic obstructive pulmonary disease. Polymorphisms in these genes alter the metabolism of xenobiotics such as present in cigarette smoke. METHODS: We conducted a case-control study to investigate total 9 polymorphisms of CYP2E1, CYP2D6 and NAT2 genes by PCR-RFLP. RESULTS: The -1053C/T and -1293G/C promoter polymorphisms of CYP2E1 were found to be in complete linkage disequilibrium (LD) (D'=1.00, r(2)=1.0, p<0.0001), whereas -1293G/C and 7632T/A polymorphisms of the same gene were also in significant LD (D'=0.5183, r(2)=1.0, p=0.01) in patients. The patients over-represented the -1293GC+CC genotypes of -1293G/C polymorphism of CYP2E1 (p=0.03) and NAT2*4/7, NAT2()5/6, NAT2*5/7, NAT2*6/6 and NAT2*6/7 genotypes of NAT2 (p=0.01, p=0.039, p=0.01, p=0.032, p=0.006, respectively), resulting in to higher frequency of -1293C (OR=7.02, 95% CI=1.63-30.15, p=0.002), NAT2*6 (OR=1.90, 95% CI=1.27-2.83, p=0.001) and NAT2*7 (OR=2.91, 95% CI=1.65-5.12, p=0.0001) alleles. The 7632T/A and 9893C/G polymorphisms of CYP2E1 and 1934G/A polymorphism of CYP2D6 did not associate with the disease (p>0.05). The haplotypes -1293G:9893C and -1293G:7632T:9893C were under-represented (p<0.001), whereas haplotypes -1293C:7632T, -1293C:9893C, -1293C:9893G and -1293C:7632T:9893C of the 4 CYP2E1 polymorphisms were over-represented in patients (p<0.05). CONCLUSION: The CYP2E1 and NAT2 variants associated with COPD.     

Combined phenotypic assessment of cytochrome p450 1A2, 2C9, 2C19, 2D6, and 3A, N-acetyltransferase-2, and xanthine oxidase activities with the "Cooperstown 5+1 cocktail"

Previously, we have validated a 4-drug phenotyping cocktail, the "Cooperstown cocktail," using caffeine (cytochrome p450 [CYP] 1A2, N-acetyltransferase-2 [NAT2], and xanthine oxidase [XO]), dextromethorphan (CYP2D6), omeprazole (CYP2C19), and intravenous midazolam (hepatic CYP3A). Data suggest that warfarin can be used as a safe and accurate biomarker for CYP2C9, and if warfarin is administered with vitamin K, the pharmacodynamic effect is ablated. Twelve subjects received the Cooperstown cocktail, warfarin plus vitamin K, and both sets of biomarkers (Cooperstown 5+1 cocktail) in a randomized crossover fashion. On the basis of log-transformed data and a paired t test, no significant difference was seen for S-warfarin area under the serum concentration-time curve from time 0 to infinity (P =.09), omeprazole metabolic ratio (P =.374), caffeine metabolic ratio (P =.169 for CYP1A2 activity), midazolam plasma clearance (P =.573), or dextromethorphan metabolic ratio (P =.747) with the Cooperstown cocktail, warfarin plus vitamin K alone, or the Cooperstown 5+1 cocktail. During drug administration, the only side effect was mild and short-lived sedation after intravenous midazolam administration. Phenotypic measurements were in concordance with the subject's CYP2C9, CYP2C19, and CYP2D6 genotypes. The Cooperstown 5+1 cocktail may be used to simultaneously assess the activities of CYP1A2, CYP2C9, CYP2C19, CYP2D6, CYP3A, NAT2, and XO.     

Concordance between the deduced acetylation status generated by high-speed: real-time PCR based NAT2 genotyping of seven single nucleotide polymorphisms and human NAT2 phenotypes determined by a caffeine assay

BACKGROUND: The utility of typing single nucleotide polymorphisms (SNPs) for the determination of the N-acetyltransferase 2 (NAT2) acetylation status is a matter of debate. AIMS OF THE STUDY: Evaluation of the concordance between deduced genotype results of seven human NAT2 SNPs generated by Real-time PCR analysis and human NAT2 phenotypes. METHODS: NAT2 phenotypes of 38 Caucasian workers were determined using a suitable caffeine test method. Genomic DNA aliquots were used for the determination of seven human NAT2-specific SNPs (G191A, C282T, T341C, C481T, G590A, A803G, G857A). RESULTS AND CONCLUSIONS: Phenotypic results based on the molar ratio of 5-acetylamino-6-formylamino-3-methyluracil (AFMU)/(AFMU+1-methlyuric acid (1U)+1-methylxanthine (1X)) calculated from excreted caffeine metabolite levels in urine samples with 0.3 as a cut-off point between slow (<0.3) and rapid acetylators (>or=0.3). Twenty-seven samples belonged to the slow (mean 0.13; range: 0.03-0.25), 11 to the rapid (mean: 0.41; range: 0.34-0.48) acetylators. LightCycler analyses revealed 11 different NAT2 variant combinations, whereby *5B/*5B and *5B/*6A or *5A/*6C (each 21%), were the most frequent. The deduced acetylation status of the seven NAT2 SNPs matched perfectly with the 38 results determined by phenotyping. This study showed a 100% concordance between NAT2 phenotypes and the deduced NAT2 genotypes and the suitability of the high-speed NAT2-specific LightCycler analysis in a Caucasian population.     

单检及16份混样检测模式对献血者核酸检测效果的比较研究

目的 探讨单份及16份混合标本2种检测模式对献血者血液病毒核酸检测(nucleic acid test,NAT)效果的影响.方法 2009年2至6月顺序留取北京无偿献血者标本,用诺华Procleix ULTRIO Assay进行单份(ID)或16份混合标本(P16)乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)和人类免疫缺陷病毒-1( HIV-1)三项联合核酸检测.单份NAT反应性同时HBsAg、抗-HCV或抗-HIV血清学不合格的标本,血清学合格的单份NAT反应性经双孔NAT复检阳性的标本,以及混合NAT反应性/拆分NAT为阳性的标本,进一步用诺华Procleix HBV、HCV和HIV-1鉴别试剂进行鉴别试验.血清学合格、HBV NAT单独阳性标本进一步用Roche HBV定量实验加以验证和进行病毒含量测定、血清学分析、并进行稀释以模拟是否能被P16-NAT检出.阳性检出率进行四格表连续校正的x2检验.结果 (1)在7613份单份NAT (ID-NAT)标本中,检出NAT阳性26份,ID-NAT阳性率0.34％(26/7613);(2)在16 064份共1004份P16混合标本NAT(P16-NAT)中,检出NAT阳性27份,P16-NAT阳性率为0.17％ (27/16 064);(3)在血清学合格标本中,单份检测的NAT单独阳性检出率为0.12％ (9/7438),高于16份混样检测的NAT单独阳性检出率0.01％ (2/15 750)(x2=11.880,P＜0.05).9份ID-NAT及2份P16-NAT单独阳性标本经鉴别均为HBV NAT阳性,未检出 HCV NAT单独阳性或HIV NAT单独阳性;(4)9份ID-NAT HBV单独阳性血样模拟P16-NAT,仅有2份可被检出;(5)对8份ID-NAT及2份P16-NAT单独阳性标本进行Roche HBV定量测定,均可确证其核酸检测结果,但病毒含量很低.其中2份HBV病毒含量为472 IU/ml及15 IU/ml,6份含量＜12 IU/ml,另2份原倍不能定量经10倍浓缩处理后测得含量为＜ 12 IU/ml和14.3 IU/ml;(6)11份HBV NAT单独阳性标本中,3份(27.3％)为潜在的窗口期感染,其余8份(72.7％)抗-HBc阳性或抗-HBe阳性,但抗-HBc-IgM均为阴性,为隐匿性感染;(7) P16-NAT初检呈反应性需要进行拆分试验的混合样本比率为2.49％ (25/1004),其中由血清学合格标本所致初检反应性的混合样本比率为0.20％ (2/1004).结论 ID-NAT单独阳性检出率高于P16-NAT单独阳性检出率.为避免低病毒含量HBV的漏检,应选用灵敏度高的核酸检测试剂,并尽量采用小标本量混合检测,甚至采用单份检测方式.     

Two HBV DNA+/HBsAg− blood donors identified by HBV NAT in Shenzhen, China

Background

In order to further improve blood safety, mini-pool (MP) nucleic acid testing (NAT) was implemented to screen samples negative for hepatitis B surface antigen (HBsAg), anti-hepatitis C virus (anti-HCV), anti-human immunodeficiency virus (anti-HIV), syphilis (anti-Treponemal antibody) and with normal ALT.

Study design and methods

From August 2006 to February 2008, 41,301 donations were screened using commercial HIV/HCV RNA and HBV DNA Real-Time PCR NAT assays in pools of 8. Reactive pools were re-tested as individual samples using the appropriate screening test and confirmed using an alternate commercial NAT assay. Donors reactive on both NAT assays were considered ‘confirmed’ positive for the virus concerned and recalled for additional follow-up testing and counseling.

Results

Of the 41,301 samples screened, no HIV or HCV RNA-positive/seronegative donations were detected but two HBV DNA positive/HBsAg negative blood donors (Donors 1 and 2) were identified. Their respective hepatitis immunological markers were: Donor 1 - anti-HBc positive/anti-HBe positive/HBeAg negative/ALT normal and HBV DNA viral load of 112 IU/ml; Donor 2 - anti-HBc positive/anti-HBe negative/HBeAg negative/ALT normal and HBV DNA viral load 2750 IU/ml.

Conclusions

MP NAT identified two HBsAg negative donors with presumed occult infection but no HIV or HCV seronegative/NAT positive (yield) donors. The HBV yield rate of 1 in 20,650 (95%CI - 1 in 5663 to 1 in 75,303) is comparatively high, exceeds the predicted rate based on previous modeling for the population and demonstrates the incremental blood safety value of NAT in countries where HBV is highly epidemic. The low viral load of the two yield samples underscores the importance of optimizing the sensitivity of the HBV NAT assay selected for screening.     

Craniocervical Orientation Affects Muscle Activation When Exercising the Cervical Extensors in Healthy Subjects

Elliott JM, O'Leary SP, Cagnie B, Durbridge G, Danneels L, Jull G. Craniocervical orientation affects muscle activation when exercising the cervical extensors in healthy subjects.

Objective

To evaluate the activity of neck extensor muscles during different extension exercises with muscle functional magnetic resonance imaging (mfMRI).

Design

Cross-sectional.

Setting

University laboratory.

Participants

Healthy subjects (N=11; 7 men, mean age ± SD, 34±5.6y; 4 women, mean age ± SD, 23.3±5.2y; group mean age ± SD, 30.1±7.5y).

Intervention

Not applicable.

Main Outcome Measures

mfMRI measures of T2 relaxation were made for the multifidus (Mul), the semispinalis cervicis (SCe), the semispinalis capitis (SCa), and the splenius capitis (SpC) at C2-3, C5-6, and C7-T1 in response to 2 head/neck orientations: craniocervical neutral (CCN) and craniocervical extension (CCE). Subjects performed three 1-minute repetitions of each condition at 20% maximum voluntary contraction.

Results

Significant shifts were observed in all muscle groups at the C5-6 and C7-T1 levels after both conditions (P=.04) except the SpC muscle at C5-6 with CCN (P=.17). T2 shifts in the SCa were significantly greater in response to CCE than CCN at C2-3 (P=.03) and C5-6 (P=.02). Similarly, CCE resulted in larger shifts than CCN in the Mul/SCe at C7-T1 (P=.003). No segmental differences were observed between exercises for SpC (P=.25).

Conclusions

The results of this study provide some preliminary insight into the impact of craniocervical orientation on the differential response of the deep and superficial cervical extensor muscles during the performance of cervical extensor exercises.     

Work motivation of nurses: a literature review

Objectives

The aim of this review is to describe nurses’ work motivation from the perspective of staff nurses. This information would be useful for the development of motivation strategies and further research into nurses’ work motivation.

Design

A thorough review of the research literature.

Data sources

The literature search was performed using four databases: CINAHL, PubMed, PsychINFO, and SocINDEX. Only studies that met the following criteria were selected for review: (1) were published between 1990 and 2009, (2) were written in English, (3) dealt with work motivation, (4) concerned working staff nurses, (5) involved empirical research, (6) clearly and explicitly provided the research results about the factors affecting nurses’ work motivation. Altogether 24 studies met these criteria and were included in this review.

Review methods

Inductive content analysis was carried out to analyse and categorise the data.

Results

Nursing research has neither clear understanding nor consensus about the concept of work motivation; nor has a universal definition been adopted. Despite limited empirical evidence it may be concluded that staff nurses appear to be motivated. Five categories of factors affecting their work motivation were identified: (1) work-place characteristics, (2) working conditions, (3) personal characteristics, (4) individual priorities, and (5) internal psychological states.

Conclusions

Further research is needed to gain a more comprehensive insight into nurses’ work motivation and the factors affecting it. This can be achieved by defining the concept of work motivation as precisely as possible, working out a pertinent research methodology, and subsequently developing and testing a theoretical model of nurses’ work motivation.     

库珀引流管与中心静脉导管在恶性浆膜腔积液治疗中的应用效果比较

目的比较库珀引流管与中心静脉导管在恶性浆膜腔积液患者治疗中的应用效果。方法 2014年7月至2015年2月,便利抽样法选取在上海瑞金医院肿瘤科治疗的恶性浆膜腔积液患者50例为研究对象,通过抽签的方式将其分为观察组(n=26)和对照组(n=24)。所有患者均穿刺置管引流并腔内化疗药物注射治疗。观察组患者采用库珀引流管置管,而对照组采用传统的中心静脉导管置管。比较两组患者引流装置的使用情况、并发症的发生情况及治疗费用。结果观察组患者总引流量为(4234.38±2403.94)ml,对照组为(4584.61±2768.78)ml,差异无统计学意义(P0.05)。在引流积液的性状方面,两组的差异亦无统计学意义(P0.05)。两组患者在导管滑脱、导管感染以及导管引起局部疼痛等并发症等方面的差异均无统计学意义(均P0.05)。观察组和对照组患者的导管阻塞发生率为7.69%和29.17%,二次置管率为3.85%和29.17%,差异均有统计学意义(均P0.05)。观察组治疗费用为(621±126.1)元,而对照组的治疗费用为(399.5±152.5)元,差异有统计学意义(P0.01)。结论库珀引流管在治疗恶性浆膜腔积液中的应用,使积液引流更顺畅,重复置管率低,护理更便捷,并发症与中心静脉导管相似,尤其适用血性、蛋白含量高的浆膜腔积液的治疗,可以替代传统的中心静脉导管。