人巨细胞病毒糖蛋白B基因的分型

目的建立人巨细胞病毒(HCMV)糖蛋白B(gB)基因的套式聚合酶链反应(nPCR)加限制性长度多态性分析(RFLP)的分型方法。方法34例HCMV感染患儿的11份全血标本和23份尿标本，用nPCR扩增gB基因片段，RFLP对gB基因进行分型，并通过测序进行验证。结果34例HCMV感染患儿中，检出gBⅠ型13例，gBⅡ型12例，gBⅢ型9例，未发现gBⅣ型。测序结果与基因库中相应的标准株序列进行比较，Ⅰ、Ⅱ和Ⅲ型的同源性分别为98．1％～99．6％、98．9％～100％、97．3％～98．9％。结论nPCR检测HCMV感染敏感特异，RFLP对HCMV的gB基因分型明确可靠。     

巨细胞病毒活动感染与冠心病

目的：探讨人类巨细胞病毒（HCMV）近期感染与冠心病（CAD）的关系。方法：用ELISA法检测正常人群（365例）和CAD（急性心肌梗死41例、心绞痛79例和隐匿型CAD111例）人群血清HCMV—IgM抗体,并通过检测血清肌酸肌酶同工酶（CK—MB）将CAD人群分为急性组和慢性组,比较两组HCMV—IgM抗体水平的差异。结果：在231例病人血清标本中,HCMV—IgM抗体阳性95例（41．1％）;在对照组中,365例健康查体者HCMV—IgM抗体阳性84例（23．0％）。两组相比较有极显著性差异（X^2=22．08,P〈0．0001）。急性心肌梗死组阳性24例（58．5％）同心绞痛组31例（39．2％）和隐匿型CAD组40例（36％）相比,HCMV—IgM抗体阳性率有显著性差异（X^2=4．04,P〈0．05和6．21,P〈0．025）。CK—MB阳性组43例（51．2％）和CK—MB阴性组55例（37．4％）相比,HCMV—IgM抗体阳性率有显著性差异（X^2=4．15,P〈0．05）。结论：CAD人群有较高的HCMV—IgM抗体阳性率,急性CAD人群的HCMV—IgM抗体阳性率要显著高于慢性CAD。     

尿液HCMV-DNA和血清HCMV-IgM抗体诊断人巨细胞病毒感染的价值

目的提高人巨细胞病毒（HCMV）感染的诊断水平。方法对960例临床疑诊HCMV感染患儿分别应用FQ—PCR、CLIA法检测尿液HCMV—DNA及血清HCMV-IgM抗体水平。结果尿液HCMV-DNA阳性478例,HCMV-IgM抗体阳性206例;二者均阳性191例。478例尿液HCMV—DNA阳性者中,血清IgM抗体阳性HCMV-DNA拷贝数对数均值高于阴性者（P〈0．01）。结论尿液HCMV-DNA定量和血清HCMV-IgM抗体联合检测有助于HCMV感染的诊断。     

231例冠心病患者病毒感染临床分析

用酶联免疫吸附试验法检测冠心病（CAD）患者和健康人巨细胞病毒（HCMV）、流感病毒（IV）、呼吸道合胞病毒（RSV）、单纯疱疹病毒（HSV）、柯萨奇病毒（CoxV）的血清抗-IgM抗体。结果CAD患者的HCMV—IgM及IV—IgM阳性率明显高于健康者（P〈0．01）。CAD患者中,急性心肌梗死患者的HCMV—IgM阳性率显著高于心绞痛、隐匿性CAD患者（P〈0．05）。88．4％的HCMV—IgM阳性患者合并两种以上病毒感染。提示CAD患者HCMV—IgM及IV—IgM检出率较高;急性CAD患者的。HCMV-IgM检出率显著高于慢性者;CAD患者的病毒感染绝大多数是混合感染。且以HCMV感染为主。     

黄疸婴儿人巨细胞病毒的检测

目的: 探讨黄疸婴儿HCMV感染的诊断.方法:FQ-PCR检测248例黄疸婴儿和50例对照组患儿尿液中HCMV DNA, 化学发光免疫分析法(CLIA)检测黄疸婴儿血清HCMV IgM抗体, 在尿液HCMV DNA阳性黄疸婴儿中, 比较血清HCMV IgM抗体阳性与阴性组HCMV DNA拷贝数的差异.结果: 黄疸婴儿尿液HCMV DNA的阳性率为41.5%, 对照组患儿阳性率为2.0%, 两者有统计学意义(P<0.01). CLIA检测黄疸婴儿血清HCMV IgM抗体的阳性率为19.8%. 在尿液HCMV DNA检测阳性的黄疸患婴儿中, IgM抗体阳性组的尿液HCMV DNA拷贝数显著高于阴性组(t = 5.51, P<0.01).结论:FQ-PCR检测尿液HCMV DNA是早期诊断婴儿HCMV感染的敏感有效的方法.     

上海地区AIDS初诊病人合并感染CMV的CMV-gB基因分型

目的了解上海市艾滋病（AIDS）初诊病人合并巨细胞病毒（CMV）感染的CMV-gB基因分型特征。方法采用随机入组的方式,收集2011年3月至2012年2月,在上海市公共卫生临床中心就诊的AIDS初诊病人的血液,用套式聚合酶链反应（nPCR）确诊其是否感染CMV,并对阳性病人用限制性长度多态性分析（RFLP）法进行CMV-gB基因分型。结果在264名AIDS病人中,CMV-gB1型24例（占9．09％）,gB2型0例,gB3型8例（3．03％）,gB4型1例（0．38％）。CMV-gB基因阴性者与阳性者的CD;T淋巴细胞计数差异有统计学意义（P〈0．0001）。结论上海地区AIDS初诊病人中,CMV感染以CMV-gB1型为主,在CD4＋T淋巴细胞计数〈（108．4±22．18）／μL时需加强CMV的筛查。     

人巨细胞病毒活动性感染患者颈动脉超声检查分析

目的：探讨人巨细胞病毒（HCMV）活动性感染患者的颈动脉超声特点。方法：应用免疫荧光法检测外周血白细胞HCMV-PP65作为HCMV活动性感染的指标，观察56例HCMV活动性感染相关性和171例非HCMV活动性感染相关性动脉粥样硬化患者的颈动脉超声结果，同时比较年龄、高血压、糖尿病、吸烟等血管危险因素。结果：HCMV活动性感染组年龄、高血压、高脂血症、糖尿病、吸烟等危险因素以及内膜增厚和斑块形成的发生率均与非HCMV活动性感染组无显著差异，HCMV活动性感染组颈内动脉同时存在≥2种不同类型斑块的发生率显著高于非HCMV活动性感染组（52．94％比12．5％，P〈0．01）。结论：颈内动脉同时存在≥2种不同类型斑块可能与HCMV活动性感染相关。     

催化信号扩增法检测人巨细胞病毒被膜磷蛋白65的实验分析

目的建立一种新型的快速诊断肾移植受者人巨细胞病毒（HCMV）活动性感染的方法。方法采用免疫组织化学催化信号扩增法，通过抗HCMV被膜磷蛋白65（pp65）单克隆抗体AAC10对外周血WBC中的HCMVpp65抗原进行标记识别，并与荧光定量PCR（FQ-PCR）方法进行比较。结果检测的102例肾移植受者中，血浆HCMVDNA阳性66例，HCMVpp65抗原阳性56例，血浆HCMVDNA阴性患者中无pp65阳性，两种方法检测的符合率为90．2％，相关性好（r=0．831）；HCMV病患者31例，两者均阳性；同时检测40名健康者，结果pp65抗原全为阴性。结论催化信号扩增法敏感、简便，能更准确地反映HCMV感染的活动状况，有助于肾移植术后HCMV病的早期诊断，并可指导抗病毒治疗。     

乙型肝炎病毒B与C基因型感染者临床和有关免疫细胞计数的比较

目的探讨乙型肝炎病毒B与C基因型感染者临床和有关免疫细胞计数的差别。方法在128例乙型肝炎患者,采用微板核酸杂交-ELISA技术进行HBV基因分型,采用流式细胞仪检测T细胞亚群、非特异性CTL、辅助性T（Th1）、Th2细胞、自然杀伤（NK）细胞,在64例人白细胞抗原（HLA）A2阳性的CHB患者检测HBV特异性CTL。结果在128例CHB患者中,B基因型感染者70例（54．69％）,C基因型57例（44．53％）,B／C混合型1例（0．78％）;C基因型感染者血清丙氨酸氨基转移酶和总胆红素水平高于B基因型感染者（P〈0．01和P〈0．05）;C基因型感染者HBVDNA水平（P＜0．01）、HBeAg阳性率（P〈0．01）、Th1细胞（P〈0．05）和非特异性CTL（P〈0．01）高于B基因型感染者,而HBV特异性CTL低于B基因型（P〈0．01）。结论C基因型感染者肝功能损害比B基因型重,可能与HBV特异性CTL低,导致HBV DNA水平和HBeAg阳性率高有关。     

支原体肺炎与毛细支气管炎的临床研究

目的探讨肺炎支原体（MP）感染与毛细支气管炎的相关性，分析其临床特点。方法对186例毛细支气管炎患儿血清采用酶联免疫法（ELISA）MP-IgM检测，MP-IgM阳性为MP感染（感染组），MP-IgM阴性为对照组，对两组进行比较分析。结果感染组64例（34．4％），其中年龄〈6个月13例（20．3％），～2岁51例（79．7％），冬春发病38例（59．4％），夏秋26例（40．6％）。对照组122例，其中年龄〈6个月78例（63．9％），～2岁44例（36．1％），冬春发病112例（91．8％），夏秋10例（9．2％）。两组发病年龄和发病季节均有显著性差异（P〈0．01）。两组患儿均有咳嗽、喘憋及呼吸困难，与对照组比较，MP感染组中高度发热62例（96．9％）、肺部x线片状阴影48例（75％），均高于对照组，有显著性差异（P〈0．01）。CRP、白细胞总数（WBC）两组无显著性差异。并发症发生率，MP感染组18例（28．1％），对照组19例（15．5％），P〈0．05。结论以中高度发热，且持续时间较长，肺部x线有片状阴影的毛细支气管炎患儿，应疑为MP感染及时进行MP抗体的检查，早期作出诊断与治疗。     

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.     

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.     

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.     

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.