HBV基因型在海南岛黎族和汉族之间分布及临床意义的研究

目的 了解乙型肝炎病毒(HBV)基因型在海南省黎族和汉族之间的流行病学分布情况,探讨HBV基因型与临床表型之间的关系.方法 采用实时荧光聚合酶链反应检测技术对血清HBV阳性的83例汉族和67例黎族慢性乙型肝炎患者,进行HBV DNA定量分析和基因分型.结果 在67例黎族患者中,B型22例(32.83%),C型36例(53.74%),D型8例(11.94%),C/D混合感染1例(1.49%),未发现其他基因型.在83例汉族患者中,B型38例(45.78%),c型34例(40.96%),D型7例(8.44%),B/C混合感染4例(4.82%),未发现其它基因型.在HBeAg阴性的人群中,基因型C型在黎族患者中出现的更为频繁(P<0.05).在67例黎族受检者中,基因型C型患者血清中的HBV DNA平均水平(10g值)(5.63±1.07),显著高于B型患者.在83例汉族受检者中,基因型C型患者的HBV DNA平均水平(10g值)(5.61±1.20),显著高于B型患者.结论 海南地区HBV基因型主要为B型和C型;存在D型及C+D型HBV混合感染.C型感染者HBV复制的活跃程度可能较B型感染者更高(P<0.05).     

荧光定量聚合酶链反应分型法检测乙型肝炎病毒B、C基因型的研究

目的探讨用荧光定量聚合酶链反应(PCR)分型法检测乙型肝炎病毒(HBV)B、C基因型,了解不同类型HBV感染者中HBV基因型的分布特点。方法选取2010年9月至2012年10月在成都市第五人民医院就治的乙型肝炎患者135例作为研究对象,用荧光定量PCR分型法检测135例HBV感染者的HBV基因型。结果荧光定量PCR分型法成功分型131例(97.04%)样本,4例(2.96%)未检出,其中,B/C混合型28例(20.74%);C型17例(12.60%);B型86例(63.70%)。B基因型的病毒载量显著高于C基因型、B/C混合型(P<0.05)。B基因型在慢性乙型肝炎、慢性重型乙型肝炎和急性乙型肝炎患者中所占百分比显著高于C基因型与B/C混合型(P<0.05)。结论本地区的HBV基因型以B基因型为主,其次是C基因型、B/C混合型。     

HBV基因型对慢性乙型肝炎临床的影响

目的了解HBV基因型对乙型肝炎病毒慢性感染者临床影响。方法采用限制性片段长度多态性(RFLP)及序列测定法检测广东地区27例HBV携带者和173例慢性乙肝患者的HBV基因型。结果B基因型105例(52.5%),C型94例(47%),D型1例,未发现其它基因型。B型中乙型肝炎表面抗原携带者(ASC)所占比例(18.1%)显著高于C型中ASC所占比例(8.5%)。C型中肝硬化所占比例(23.4%)显著高于B型中肝硬化所占比例(7.6%)。C型在ASC、慢性乙肝轻度、中度、重度及重型肝炎、肝硬化的比例依次增高。C型较B型年龄大,但二者间性别差异无统计学意义。结论广州地区HBV基因型由B、C、D型构成,以B型为主。C型较B型年龄大。C型与较重肝病有关。B、C型间性别差异无统计学意义。     

型特异引物PCR法分析238株乙肝病毒基因型

目的:研究乙肝病毒(HBV)感染者HBV基因型分布状况,并建立一套HBV病毒株分型的简便可靠的分析法.方法:设计型特异引物,采用基因型特异引物聚合酶链反应(PCR)法分型.结果:238株HBV中218株得到分型.其中B型149例(男115例、女34例);C型63例(男47例、女16例);B C混合型6例(男4例、女2例).B型、C型和B C混合型检出率分别为68.3%(男69.3%、女65.3%)、28.9%(男28.3%、女30.8%)和2.8%(男2.4%、女3.8%).未检出A、D、E、F、G、H基因型.结论:HBV感染者以B基因型为主.基因型B检出率显著高于其它基因型,其差异具有统计学意义(P<0.0).HBV各基因型分布与性别无关(P>0.01).     

实时荧光聚合酶链反应检测HBV基因型B～D方法的建立

目的建立实时荧光聚合酶链反应检测乙型肝炎病毒(HBV)基因型B～D方法并验证其准确性。方法比较GenBank中已发表的明确分型的143株HBV全序列，设计特异的组合引物探针，应用实时荧光聚合酶链反应HBV基因分型法对兰州地区128例慢性乙型肝炎患血清标本进行基因型B、C、D检测，并随机对检测的基因型各3株标本进行S基因测序验证。结果128例标本中B型检出率为20.3％(26／128)，C型71．9％(92／128)，D型7．8％(10／128)：18株HBV克隆标本S基因测序结果与本分型法完全一致。结论实时荧光聚合酶链反应HBV基因分型法能够简便、灵敏、快速、准确地鉴定HBV基因型，适宜用于HBV基因型的大规模临床和流行病学调查。     

慢性乙型肝炎患者196例病毒基因分型与临床的关系

目的探讨西安市中心医院感染科诊治的慢性乙肝患者血清中HBV基因型的分布状况及HBV基因型与临床特征的关系。方法采用巢式PCR法对196例慢性HBV患者的血清进行病毒基因型检测,并分析HBV基因型与患者临床特征的关系。结果 196例慢性HBV患者的基因分型结果为C型138例(70.4%)、B型40例(20.4%)、B/C混合型18例(9.2%),基因型的分布在性别上无统计学差异;各基因型在无症状携带者、慢性乙肝、肝硬化、肝癌中的分布差异也无统计学意义(P>0.05);C型感染者血清HBeAg阳性率(75.2%)高于B型感染者(14.2%),差异有统计学意义(P<0.05)。各基因型患者在HBV-DNA载量和ALT水平上无统计学差异(P>0.05)。结论西安市中心医院感染科诊治的HBV患者的基因型以C型和B型为主;基因C型患者血清HBeAg阳性率高于B型;基因C型患者与B型相比在肝脏炎症程度、HBV-DNA载量方面无显著差异;基因B型和C型患者临床特点相似。     

成都市HBV基因型分布特点及其临床意义

目的 了解成都市乙型肝炎病毒(HBV)基因型分布特点,探讨HBV基因型与疾病临床表现的相关性.方法 随机选择成都市HBV感染者422例,采用聚合酶链反应-限制性片段长度多态性法(PCR-RFLP)鉴定HBV基因型.结果 HBV/B基因型366例占86.7%(366/422),HBV/C基因型53例占12.6%(53/422),HBV/D基因型3例占0.7%(3/422).B、C基因型感染者相比,HBeAg、抗-HBeAg阳性率及HBV DNA水平的差异均无统计学意义(P＞0.05),C基因型感染者更易发生肝硬化(P=0.004)及肝细胞癌(P=0.029).结论 成都市HBV感染者所携带的HBV存在B、C、D 3种基因型,以B型为主,其次c型,D型最少;C基因型感染者更易发生较严重的肝脏疾病,如肝硬化及肝细胞癌.     

广西北部乙型肝炎病毒基因型流行分布的研究

目的了解广西北部桂林乙型肝炎病毒(HBV)基因型的流行分布情况.方法用套式PCR扩增检测41例桂林慢性无症状HBV携带者血清HBV DNA,阳性者用直接测序法进行HBV基因分型.结果19例HBV DNA阳性,阳性率为46.34%(19/41),其中15例为基因型B,占78.9%(15/19),4例为基因型C,占21.1%(4/19),未见到其它目前已知的HBV基因型A、D、E、F、G和H;另外,还发现HBV基因型C组HBeAg阳性率显著高于基因型B组(P＜0.05),提示HBV基因型C比HBV基因型B危害更大.结论广西北部桂林流行的HBV基因型有基因型B和C两种,以基因型B为主要流行的优势基因型.     

江苏地区不同类型乙型肝炎患者HBV基因分型研究

目的:了解江苏地区乙型肝炎病毒基因型分布特征,探讨HBV各基因型与血清HBV DNA水平的关系.方法:采用荧光定量PCR结合Taqman MGB探针技术,对江苏地区176份乙型肝炎患者血清中的HBV DNA进行基因分型和定量检测.结果:176例血清中,C型117人(66.5%),B, C型40人(22.7%),B型9人(5.1%),D型1人(0.6%),A型1人(0.6%).C型与B, C混合型在HBV DNA水平上存在统计学差异(P＜0.05),B, C混合型的HBV DNA水平明显高于C型.C基因型在慢性乙型肝炎患者中的所占比例(71.4%)比在急性乙型肝炎、肝硬化和肝癌患者中所占的比例较高,但差异无统计学意义.结论:江苏地区HBV基因型以C型为主, B, C混合型次之,B型较少,D型,A型极少;B, C混合型患者的HBV DNA数量水平高于C型.     

实时荧光聚合酶链反应检测HBV基因型B～D方法的建立

目的 建立实时荧光聚合酶链反应检测乙型肝炎病毒(HBV)基因型B~D方法并验证其准确性。方法 比较GenBank中已发表的明确分型的143株HBV全序列,设计特异的组合引物探针,应用实时荧光聚合酶链反应HBV基因分型法对兰州地区128例慢性乙型肝炎患者血清标本进行基因型B、C、D检测,并随机对检测的基因型各3株标本进行S基因测序验证。结果 128例标本中B型检出率为20.3%(26/128),C型71.9%(92/128),D型7.8%(10/128);18株HBV克隆标本S基因测序结果与本分型法完全一致。结论 实时荧光聚合酶链反应HBV基因分型法能够简便、灵敏、快速、准确地鉴定HBV基因型,适宜用于HBV基因型的大规模临床和流行病学调查。     

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.