加强乙型肝炎防治

乙型肝炎病毒(HBV)感染是一个严重的公共卫生问题.据世界卫生组织报道,全球60亿人口中,约20亿人曾感染过HBV,其中3．5亿人为慢性HBV感染,每年约有100万人死于HBV感染所致的肝衰竭、肝硬化和原发性肝细胞癌(肝癌)[1].     

正确认识和处理慢性乙型肝炎病毒感染恢复期

正目前,全球超过20亿人已经被乙型肝炎病毒(HBV)感染,其中慢性HBV感染者约3.5亿。而中国大陆人群约70%已经被HBV感染过,约1.2亿人为慢性HBV感染者。每年约数10万人死于HBV病毒相关性肝病。因此,国际国内学者对HBV感染相关性肝病的诊断与治疗的研究如火如荼、方兴未艾。然而,其中一个特殊的临床阶段——慢性HBV感染恢复期,人们知之甚少。     

轻型慢性乙型肝炎患者肝组织病理相关因素分析

<正>乙型肝炎病毒(HBV)感染是导致慢性肝脏疾病的最常见病因。据世界卫生组织报道~[1],全球约20亿人曾感染过HBV,其中3.5亿人为慢性HBV感染者,每年约有100万人死于HBV感染所致的肝衰竭、肝硬化和肝细胞癌(HCC)。文献~[2]报道,在谷丙转氨酶(ALT)持续正常的慢性HBV感染者中有相当一部分患者存在着肝组织学的病变。本文对308例轻型慢性乙型肝炎肝组织病理相关因素分析如下。     

治疗性乙型肝炎疫苗实验和临床应用进展

乙型肝炎病毒(HBV)感染呈全球性分布,估计全世界有20亿人受到感染,HBV携带者约为3.5亿。我国人群中HBsAg阳性率达9.75%,约1.3亿人,其中慢性乙型肝炎(CHB)患者约2 000万人,10%~30%可发展为肝硬化,肝硬化中1%~5%可发展为肝细胞性肝癌[1-2]。因此,防治HBV感染及预防该类人群发展成     

HBeAg阴性慢性乙型肝炎抗病毒治疗研究进展

乙型肝炎病毒(HBV)感染是一个严重的公共卫生问题。全球60亿人口中,约20亿人披证明有HBV感染,3-4亿人为HBV慢性感染,其中25％-40％最终将死于HBV感染引起的肝硬化和肝癌。近年来由于HBV疫苗免疫、各种抗病毒药物的应用等,导致HBV变异株出现、HBeAg阴性慢性乙型病毒性肝炎(CHB)增多。辛绍杰对解放军302医院近期745例CHB进行了分析,结果表明,HBeAg阴性患者322例,占43.2％。HBeAg阴性CHB的增多对CHB的治疗提出了新的挑战。     

乙型肝炎的预防和治疗研究进展

乙型肝炎病毒(hepatitis B virus,HBV)感染是一个全球性的卫生问题,全世界慢性感染者约有3.5亿人,每年约100万人死于HBV感染所致的肝衰竭、肝硬化和原发性肝细胞癌。我国是HBV的高感染区,总的感染人数约1.3亿,每年有近30万人死于各类末期肝病及重症肝炎[1]。国内外研究结果一致认     

乙型肝炎病毒表面抗原定量检测的临床研究进展

目前,全球约20亿人曾感染过乙型肝炎病毒(HBV),其中3.5亿为慢性HBV感染者,每年约有100万人死于HBV感染所致的肝衰竭、肝硬化和原发性肝细胞癌.HBV感染,尤其是慢性化感染是一个十分严重的问题.     

应用抗病毒治疗阻断HBV垂直传播的现状和进展

<正>慢性乙型肝炎是我国常见的慢性传染病之一,全球约20亿人曾感染过HBV,其中3.5亿人为慢性HBV感染者,每年约有100万人死于HBV感染所致的肝衰竭、肝硬化和原发性肝细胞癌(HCC)。我国属HBV感染高流行区,一般人群的HBsAg阳性率为9.09%,接种与未接种乙型肝炎疫苗人群的HBsAg阳性率分别为4.51%和9.51%;围生(产)期传播是母婴传播的主要方式,多为在分娩时接触HBV阳性母亲的血液和体液传播,在围生(产)期和婴幼儿时期感染HBV者中,分别有90%和25%～30%将发展成慢性感染,在青少年和成人期感染HBV者中,仅5%～10%发展成慢性。HBV难根     

中医药抗乙肝病毒的研究进展

乙型肝炎病毒(Hepatitis B Virus,HBV)感染至今仍是世界性的医学难题,它是嗜肝HBV引起的一种高发病率、高病死率的传染病.据统计,目前全世界大约有20亿人感染过HBV,其中约有3.5亿人是HBV携带者[1].在我国约有1.2亿HBV携带者,每年有30～50万人死于HBV引起的肝硬化或肝癌.因此,抗HBV药物研究一直是防治乙型病毒性肝炎(乙肝)的重点[2].中国传统医药博大精深,一些单味中药和中药复方治疗HBV感染疗效肯定,且毒副作用轻,是亟待开发的理想药物.笔者就近年来中医药抗HBV的研究进展作一综述.     

十堰地区医院门诊人群HBsAg携带率抽样调查

<正>乙型肝炎病毒(Hepatitis B virus,HBV)感染可导致慢性肝脏损伤,是肝硬化和肝细胞肝癌最重要的病因~([1-2])。慢性乙型肝炎(chronic hepatitis B,CHB)是严重危害人类健康的一种常见病,全球60亿人口中,约1/2的人生活在HBV高流行区,约20亿人被证明有HBV感染,3~4亿人为HBV慢性感染,其中25%~40%最终将死于肝硬化和肝癌~([2-3])。根据世界卫生组织估计,全球约有2.4亿人慢性感染HBV(http://www.who.int/hiv/pub/hepatitis/hepatitis-b-guidelines/en/)。我国是病毒性肝炎的高发     

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.