恙虫病东方体Ot56蛋白序列生物信息学分析

目的分析恙虫病东方体Ot56蛋白序列中的变异区和保守区,为恙虫病的蛋白与核酸诊断提供参考。方法从Gen Bank获取目标序列,用Lasergene、MEGA、Vector NTI suite、Athe Port和NCBI Blast等工具进行分析。结果120条Ot56氨基酸序列的相似性为61.4％-100.0％,变异度为0.0～57．1;氨基酸的105-171、179～215、248～285、375～428和447～503区域为高变异区：膜外区200～400具有变异度高、抗原性强的特性。113条Ot56cDNA序列的相似性为41.8％～100.0％,变异度为0.0～116．1;其中303～481、562～667、756～842、1136～1243和1386～1568等5个区域属高变异区,而0～54、97～171、265～303、439～482、1015～1047和1477～1542为6个保守片段。结论恙虫病东方体Ot56蛋白具有5个高变异区,第200～400位氨基酸附近可能是株（型）特异性表位所在区域,其重组蛋白具有潜在的株（型）鉴定价值。根据cDNA6个保守片段设计引物,进行Ot56核酸检测可能在不同株（型）恙虫病东方体检测中具有较高的敏感性。     

佛山市南海区鼠类自然感染恙虫病东方体基因型分析

目的 调查佛山市南海区鼠类自然感染恙虫病东方体(Orientia tsutsugamushi, Ot)的情况，了解当地Ot基因型的分布及特点，为防控恙虫病提供科学依据。方法 2017年7月利用鼠夹和鼠笼，在佛山市南海区恙虫病高发镇街采集鼠类动物样本，应用巢式聚合酶链反应(nested polymearse chain reaction, nPCR)扩增技术检测Ot 56kDa型特异性抗原(type-specific antigen, TSA)基因核酸片段，通过核酸序列比对确定Ot基因分型。用MEGA 10.0.5、DNAStar 7.1、MegAlign等生物信息学软件进行同源性与遗传进化分析。结果 共捕获鼠类200只，褐家鼠检出56kDa TSA基因片段6份，黄胸鼠检出1份，阳性率为3.5%(7/200)。南海序列(L65、L68、L118、L119、L122、L150和L153)在核苷酸水平与Kawasaki、Gilliam、TA763、Kato、Kuroki、Karp基因型相似性为71.8%～100.0%,氨基酸水平相似性为54.9%～100.0%。同源性和系统进化分析表明，南海...     

恙虫病合并慢性血吸虫病发病特点及恙虫病的分型

目的了解恙虫病合并血吸虫病的发病特点以及恙虫病的分型情况。方法收集病例资料并对其进行分析,采用外斐反应和间接免疫荧光方法（IFA）检测患者血清中的恙虫病东方体（Ot）IgG抗体,用巢式PCR法扩增患者血液中的Ot 56kD蛋白基因,并进行核酸序列测定和分析。结果患者有血吸虫肝改变、肝功能受损、脾肿大、焦痂。外斐氏反应检测OXk 1：40,IFA检测Ot IgG抗体Kato型1：160、Karp型1：40,PCR检测Ot 56kD蛋白基因片断阳性,其序列分析结果与PG9、P25、CM438等一些泰国Ot株同源性最高（98%）,与Ot Karp、Gilliam、Kawasaki、TA678、Kato株同源性均在95%以下。结论证实了该患者为恙虫病合并慢性血吸虫病,其Ot血清型可能为Kato＋Karp,遗传进化关系与一些泰国Ot株关系较为密切。     

恙虫病东方体Karp株核酸疫苗的构建及其免疫功能初步研究

目的构建恙虫病东方体Karp株Sta56抗原候选核酸疫苗并初步探讨其可能诱导的免疫功能。方法从连有恙虫病东方体Karp株编码56000u表膜蛋白基因开放读码框全长的T载体质粒pMD18/Sta56中双酶切出目的基因,定向亚克隆构建核酸疫苗质粒载体pVAX1-Sta56,转染Hela细胞,WesternBlot分析Sta56蛋白的表达及其免疫原性,转染L929细胞,接种恙虫病东方体,Giemsa染色细胞内恙虫病东方体数目比较,初步探讨pVAX1-Sta56可能诱导的细胞免疫现象。结果pVAX1-Sta56连有正确读码框架的Sta56全长基因。转染有pVAX1-Sta56的Hela细胞培养上清可检测到被兔抗恙虫病东方体Karp株抗血清识别的特异条带。转染有pVAX1-Sta56的L929细胞内恙虫病东方体数目显著少于转染pVAX1的L929细胞(P<0.01)。结论成功构建能够表达Sta56表膜蛋白抗原的核酸疫苗载体pVAX1-Sta56,并能诱导产生细胞免疫功能。     

恙虫病东方体Karp株Sta56基因的克隆及序列比较的研究

目的 扩增恙虫病东方体Karp株主要表膜抗原Sta56的开放读码框(ORF)全长，并进行序列比较研究。方法 小鼠接种传代和体外细胞扩增分离恙虫病东方体Karp株，用PCR方法扩增恙虫病东方体Karp株Sta56基因，并采用TA克隆技术构建测序载体，对测序结果进行同源性分析比较。结果 扩增出Sta56的ORF全长，并TA克隆到测序载体pMD18—T vector，测序结果与Karp标准株的同源性为99．4％。结论 Sta56全长ORF克隆扩增成功，为进一步构建表达载体，进行Sta56蛋白表达研究提供基础。     

恙虫病东方体56 kD表面抗原基因片段的克隆、表达及纯化抗原在恙虫病抗体检测中的应用

目的　构建恙虫病东方体 5 6 k D表面抗原基因 (sta5 6 )片段的重组表达质粒 ,在 E.coli中表达 Sta5 6重组抗原 ,重组抗原纯化后应用于间接法 EL ISA、金标快速免疫层析法检测恙虫病东方体特异性抗体。　方法　从恙虫病东方体Karp株基因组中扩增出 sta5 6基因的 ORF及其中长 10 5 3bp的大片段 ,用 TA克隆技术将此大片段克隆以该重组质粒为模板 ,扩增出不同长度的截短的 sta5 6片段 ,定向插入p PROEX HTb及 p ET30 a载体 ,转化大肠杆菌 DH 5α或BL2 1(DE3) ,IPTG诱导表达 ,应用 SDS- PAGE观察重组蛋白表达情况 ,应用 Western blot分析重组抗原的活性 ;采用电洗脱、亲和层析等方法纯化重组蛋白。纯化的重组蛋白直接包被聚乙烯 96孔板 ,用于间接法 EL ISA检测恙虫病东方体 Ig G,或以胶体金标记重组抗原 ,运用金标快速免疫层析法检测恙虫病东方体 Ig M和 Ig G抗体。　结果　 (1)从恙虫病东方体 Karp株基因组中扩增出含 sta5 6基因的 ORF,并成功构建含 sta5 6 ORF大片段的重组质粒 TOPO- sta5 6。(2 )以截短的 sta5 6基因片段构建重组表达质粒 p HTb Ot95 7、p HTb O4 98、 p HTb Ot342和 p ETOt95 7、 p ETOt4 98、p ETOt342 ,各重组子均可在 E.coli中以融合蛋白的形式有效表达 ,SDS- PAGE显示各表示重组子     

海南省发热患者血标本中恙虫病东方体groEL基因检测

目的了解海南省发热病人中感染恙虫病东方体的状况,并确定其基因分型。方法利用巢氏PCR方法,检测海南省各家医院2009~2010年送检的117份不明原因发热病人血标本的groEL基因的特异性片段,对所检测到的部分目的片段进行基因测序,从基因水平进一步证实阳性结果,并对序列同源性及进化分析。结果从117份发热病人血标本中发现有恙虫病东方体阳性15份,检出率为12.8%。取10份PCR阳性产物进行测序,核酸序列基本一致,彼此间仅存在3个核苷酸的差异,构建进化树进行聚类分析,结果示海南省恙虫病东方体序列与R.tsutsugamushi(M31887)恙虫病东方体在同一分支上,同源性高。结论海南省发热病人中存在恙虫病东方体感染的状况,应加强相关监测和防控措施,为给海南省制定恙虫病防治策略提供科学依据。     

恙虫病东方体56kD表达抗原基因片段的、表达及纯化抗原在恙虫抗体检测中的应用

目的：构建恙虫病东方体56kD表面抗原基因（sta56)片段的重组表达质粒，在E.coli中表达Sta56重组抗原，重组抗原纯化后应用于间接法ELISA，金标快速免疫导析法检测恙虫病东方体特异性抗体，方法：从恙虫病东方体Karp株基因组中扩增出sta56基因的ORF及其中长1053bp的大片段，用TA克隆技术将此大片段克隆以该重组质粒为模板，扩增出不同长度的截短的sta56片段，定向插入pPROEX HTb及pET30a载体，化大肠杆菌DH5a或BL21（DE3），IPTG诱导表达，应用SDS－PAGE观察重组蛋白表达情况，应用Western blot分析重组抗原的活性；采用电洗脱，亲和层析等方法纯化重组蛋白。纯化的重组蛋白直接包被聚乙烯96孔板，用于间接法ELISA检测恙虫病东方体IgG，或以胶体金标记重组抗原，运用金标快速免疫层析法检测恙虫病东方体IgM和IgG抗体，结果：（1）从恙虫病东方体Karp株基因组中扩增出含sta56基因的ORF，并成功构建含sta56 ORF大片段的重组质粒TOPO－sta56.(2)以截短的sta56基因片段构建重组表达质粒pHTbOt957,pHTbO498,pHtbOt342和pETOt957,pETOt498,pETOt342，各重组子均可在E.coli中以融合蛋白的形式有效表达，SDS－PAGE显示各表示重组子表达不同分子量的重组蛋白，Western blot证实各重组蛋白均能被恙虫病患者阳性血清所识别。（3）电洗脱、Ni-NTA并和层析均可用于重组蛋白的纯化，并获得高纯度的重组蛋白。（4）纯化的重组蛋白应用于间接法ELISA检测恙虫病东方体特异性IgG，与间接免疫荧光法IFAT比较，其敏感性和特异性分别91．7％和76．5％。（5）纯化的重组蛋白应用于金标免疫层析法，可直接快速检测恙虫病东方体特异性IgM和IgG。与间接免疫荧光法IFAT比较，其检测IgG的敏感性和特异性分别为94．2％和84．2％，结论：恙虫病东方体Karp株sta56基因可在大肠杆菌获得高效表达。重组蛋白具有免疫反应性，纯化后可用作免疫诊断抗原；以重组抗原建立的间接法ELISA检测IgG，适用于大规模的流行病学调查，以胶体金标记重组抗原建立的免疫层析法用于同时检测IgM和IgG抗体，具有简便，快速的特点，适于在缺乏实验条件的基层医院，农村对门诊病人进行诊断。     

105例恙虫病疑似患者巢式PCR检测结果分析

目的对泰州市靖江105例恙虫病疑似患者全血进行恙虫病东方体(Ot)检测,分析该地区恙虫病感染情况,为恙虫病预防控制提供科学依据。方法采集靖江市2013年10~11月的105例恙虫病疑似患者全血样品进行巢式PCR检测,并进行个案调查,记录结果,用描述性分析方法对检测结果及个案资料进行分析。结果 105例疑似患者中62例检出恙虫病东方体核酸阳性(阳性率59.0%)。发病人群年龄以50~80岁为主,占69.4%,实验室诊断病例中农民占82.3%,男女性别之比1:1.7。结论靖江市恙虫病发病率较高,应针对流行特征采取综合防制措施。     

Genotype identification of Orientia tsutsugamushi isolated from Nan Peng Lie Islands in China

目的：为确定我国南澎列岛是否为恙虫病疫源地,对来自该地的８个恙虫病东方体分离株进行基因鉴定。方法;应用套式聚合酶链反应（NPCR）和限制片段长度多态性分析（RFLP）,NPCR的引物来自恙虫病东方体５６kDa蛋白基因,NPCR阳性产物由HincII和PstI消化并产生特异性酶切图谱予以分析。结果;南澎列岛的8个恙虫病东方体分离株属三个型,即Karp,Kato和一新型恙虫病东方体。结论：南澎列岛是恙虫病疫源地。     

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.