甲型肝炎减毒活疫苗免疫效果的进一步观察

目的 进一步观察我国研制的规范化甲型病毒性肝炎（简称甲肝）减毒活疫苗流行病学和血清学效果。方法 在河北省阜城县以群体随机分组法接种Ｈ２株甲肝减毒活疫苗，疫苗组５５５１人，对照组６４８５人。观察全人群和上述两组人群甲肝发病率，出现流行时采集两组人群血液，检测抗－ＨＶＡ ＩｇＧ和ＩｇＭ，分析疫苗保护效果。结果 １９９７年５月完全疫苗接种，疫苗接种后７个月内为甲肝散发，发病率为０．５５／１０万；疫苗组未     

甲型肝炎减毒活疫苗免疫原性与保护效果的研究

目的 观察国产甲型肝炎（甲肝）减毒活疫苗（H2株与LA－1株）的免疫原性及预防效果。方法 在广西、河北、上海等地457251例观察对象中进行随机对照试验,比较接种疫苗组与对照组甲肝发病率,观察轩保护效果;并筛选易感者,观察疫苗接种后发生甲肝感染的转归及免疫后甲肝抗体阳性率与持久性。结果 H2株（10^7.0TCID50）与LA－1株（10^6.75TCID50)疫苗保护效果均达95％,抗体阳转率峰值分别出现在疫苗接种后2个月与6个月,为94.9%与86.0%,3年后抗体阳性率下降至75％－80％,但保护效果不变。结论 国产甲肝减毒活疫苗（H2株与LA－1株）具有很好免疫原性与保护效果,可与国外灭活疫苗相媲美。接种者可通过隐性感染获得加强免疫。     

甲型肝炎灭活疫苗与减毒活疫苗的免疫效果分析

目的 观察甲型肝炎灭活疫苗（灭活疫苗）和甲型肝炎减毒活疫苗（减毒活疫苗）基础免疫、加强免疫的效果。方法2004年对湛江市赤坎区寸金管区156名2～10岁儿童进行调查，检测抗-HAV水平。结果减毒活疫苗基础免疫后1个月抗-HAV阳性率为76．17％，灭活疫苗基础免疫后1个月抗-HAV阴性的儿童，加强接种减毒活疫苗1个月后抗-HAV全部阳性，几何平均浓度为508mlu／ml；加强接种灭活疫苗1个月后抗-HAV全部阳性，抗体几何平均浓度为3013mlu／ml。结论用减毒活疫苗进行基础免疫者需要加强接种,用灭活疫苗加强接种比用减毒活疫苗产生的甲肝抗体更高。     

甲型肝炎灭活疫苗和冻干减毒活疫苗接种后1年的免疫原性研究

目的评价甲型肝炎灭活疫苗和冻干减毒活疫苗接种1剂1年后的免疫原性。方法采用单一中心随机双盲试验设计,对18月龄~4岁健康幼儿受试者随机接种1剂设盲的甲肝灭活疫苗或甲肝减毒活疫苗。接种前及接种后12个月,采用微粒子酶免法（MEIA）定量检测受试者甲型肝炎抗体（抗-HAV）。结果免疫后1年,甲肝灭活疫苗组和甲肝减毒疫苗组分别有124人和135人完成试验,抗-HAV阳转率分别为95.2%和91.1%,抗-HAV的几何平均浓度（GMC）分别为101.7 IU/L和65.5 IU/L,甲肝灭活疫苗免疫的抗体水平明显高于甲肝减毒活疫苗（P〈0.001）。结论接种1剂甲肝灭活疫苗或甲肝减毒活疫苗后12个月,均可产生良好的免疫效应,甲肝灭活疫苗免疫的抗体水平明显高于甲肝减毒活疫苗。     

对恒河猴作为鉴定甲肝减毒活疫苗的动物模型评估

1995～1997年期间,采用10批甲肝减毒活疫苗(H_2株)对50只恒河猴进行甲肝减毒活疫苗接种观察,接种后8周内检测ALT、抗-HAV抗体及肝穿病理检查,其结果表明恒河猴可作为鉴定甲肝减毒活疫苗的较好动物模型。     

临朐县儿童接种甲肝疫苗后人群抗体水平检测

目的了解儿童接种甲肝疫苗后人群甲肝总抗体水平。方法按不同年龄分成7组,分别于1996年疫苗接种前及2005年儿童接种疫苗后9年,检测正常人群720名和803名甲肝总抗体。血清检测法ELISA。结果疫苗接种后人群总抗体阳性率有显著的提高。青少年及儿童(18岁以下)抗体阳性率有接种前的29.84%提高到接种后的64.15%(P<0.01)。成人组(25~35)抗体阳性率从78.9%到84.5%,没有显著差别(P>0.05),但未见有下降趋势。结论儿童接种甲肝疫苗显著地提高了人群抗体水平,同时没有发现疫苗接种后易感人群的后移。     

潍坊高新区儿童接种甲肝疫苗后人群抗体水平检测

目的了解儿童接种甲肝疫苗后人群甲肝总抗体水平。方法按不同年龄分成7组,分别于1996年疫苗接种前及2005年儿童接种疫苗后9年,检测正常人群720名和803名甲肝总抗体。血清检测法ELISA。结果疫苗接种后人群总抗体阳性率有显著的提高。青少年及儿童(18岁以下)抗体阳性率有接种前的29.84%提高到接种后的64.15%(P<0.01)。成人组(25～35)抗体阳性率从78.9%到84.5%,没有显著差别(P>0.05),但未见有下降趋势。结论儿童接种甲肝疫苗显著地提高了人群抗体水平,同时没有发现疫苗接种后易感人群的后移。     

HFRS疫苗、HAV疫苗联合接种后免疫效果研究

[目的]观察吉林省某部新兵肾综合症出血热(HFRS)灭活疫苗I型及甲肝(HAV)减毒活疫苗联合接种的反应性及免疫效果,为部队防疫工作提供可靠依据。[方法]将1380名新兵随机分为联合接种组(HFRS HAV)、单甲组和单出组,12个月后加强一次。于接种前、后45 d、6个月、12个月、18个月分别采取晨起空腹血清,观察接种后反应性。HFRS灭活疫苗接种后采用间接免疫荧光法测特异性IgG荧光抗体,计算阳转率;HAV减毒活疫苗接种后采用竞争抑制法检测血清中抗-HAV(IgG)。[结果]联合组及单甲组、单出组疫苗接种后均无明显不良反应,无人发病,疫苗保护率达100%;接种后45 d、6个月、12个月联合接种组抗-HFRS的阳转率及抗-HAV(IgG)的阳转率均明显高于单出组及单甲组;18个月后联合组抗-HFRS阳转率与单出组比较,抗-HFRS阳转率无显著性差异;联合组抗-HAV(IgG)阳转率与单甲组阳转率仍有显著性差异。[结论]HFRS灭活疫苗I型及HAV减毒活疫苗联合接种安全有效,其免疫效果优于单独接种组。     

甲型肝炎病毒H2株减毒活疫苗与乙型肝炎血源疫苗同时接…

本文报道了对学龄前儿童进行甲肝减毒活疫苗（Ｈ２株）和乙肝血源疫苗同时接种的免疫效果观察。投苗前１周通过血清学检测筛检出３００名地ＨＡＶ，ＨＢＶ易感的健康儿童，分为三组观察，即单独接种甲肝疫苗的Ｉ组，单独接种乙肝疫苗的Ⅱ组和同时接种甲，乙肝疫苗的Ⅲ组。甲肝疫苗接种后１个月，Ⅰ组和Ⅲ组的血清抗体阳转率分别为８７．３９％和９０．１４％；而７个月后分别为９８．３１％和１００％，抗－ＨＡＶ滴度在１：１－１：     

广西灵山县狂犬病疫苗人体免疫效果分析

目的了解狂犬病疫苗的免疫效果。方法对2 085名狂犬病暴露人群按规定接种狂犬病疫苗,全程接种疫苗后10天取静脉血用ELISA法检测狂犬病抗体IgM。结果全程免疫后10天,狂犬病抗体IgM阳转率为96.83%,20~30岁年龄组阳性率最低,10~20岁年龄组阳性率最高。不同性别的血清抗体阳性率差异无显著性。结论全程接种狂犬病疫苗后10天阳性率能达96.83%,但以接种狂犬病疫苗后狂犬病抗体IgM阳转率达100%为工作目标,故应对所有狂犬病暴露者全程接种疫苗并检测抗体,对阴性结果者进行及时加强疫苗接种。接种疫苗期间注意饮食禁忌。     

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.     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.