丁型肝炎的分布状况与分析

我们用ＥＬＩＳＡ法检测了６５５例不同类型乙肝病人，２９５例无症状ＨＢｓＳＡｇ携带者和３１７例献血员血清丁型肝炎病毒抗原（ＨＤＡｇ）和丁型肝炎病毒抗体（抗ＨＤ）。结果表明，９１例丁型肝炎病毒（ＨＤＶ）标志物阳性病人中，以慢活肝占比数最大，无症状ＨＢｓＡｇ携带者和献血员的感染率分别为５．４％和１．２６％，证实乙型肝炎病毒（ＨＢＶ）和ＨＤＶ同时或重叠感染与肝炎慢性化有密切关系。应注意对无症状ＨＢｓＡｇ携带者或献血员进行ＨＤＶ标志物的检测。     

前C区A83点突变在乙型肝炎病毒感染中的分布

乙型肝炎病毒（ＨＢＶ）前Ｃ区Ａ８３点突变相当常见。我们设计一种错配引物，通过聚合酶链反应（ＰＣＲ）在含Ａ８３的序列中引进Ｂｓｕ３６１限制酶位点，经酶切即可检出Ａ８３。用以分析急慢性ＨＢＶ感染７７例：在乙型肝炎ｅ抗体（抗－ＨＢｅ）（＋）４８例中检出Ａ８３优势感染６５％；乙型肝炎ｅ抗原（ＨＢｅＡｇ）（＋）２９例中检出Ａ８３非优势混合感染３８％。急性乙肝和慢性无症状ＨＢＶ携带者中均未见Ａ８３。提示变异须     

乙型肝炎患者和无症状HBVM携带者血清HBV-DNA与HBVM模式相关性研究

目的探讨乙型肝炎患者和无症状ＨＢＶＭ携带者血清ＨＢＶ－ＤＮＡ与ＨＢＶＭ模式的相关性。方法应用ＰＣＲＥＢ法对１７８３例乙型肝炎血清学标志（ＨＢＶＭ）模式不同的乙型肝炎患者（包括急性乙型肝炎８７例，慢性乙型肝炎８９１例，乙型肝炎后肝硬化１９３例）和无症状ＨＢＶＭ携带者（６１２例），做了血清乙型肝炎病毒ＤＮＡ（ＨＢＶ－ＤＮＡ）检测。结果①乙型肝炎患者和无症状ＨＢＶＭ携带者血清ＨＢＶ－ＤＮＡ与ＨＢＶＭ模式密切相关（Ｐ＜０．０１），不同ＨＢＶＭ模式患者和携带者血清ＨＢＶ－ＤＮＡ阳性率有较大差异（Ｐ＜０．０１）。②患者血清ＨＢＶ－ＤＮＡ阳性率（５６．８％）明显高于携带者（４５．６％）（Ｐ＜０．０１）。③相同ＨＢＶＭ模式患者和携带者血清ＨＢＶ－ＤＮＡ阳性率与性别差异无显著性（Ｐ＞０．０５），男性乙型肝炎患者血清ＨＢＶ－ＤＮＡ阳性率（６０．７％）明显高于女性（４８．８％）（Ｐ＜０．０１）。结论无论何种ＨＢＶＭ感染者均应检测血清ＨＢＶ－ＤＮＡ，以判断其病毒复制情况和传染性高低     

丙型肝炎患者外周血单个核细胞HCV和Fas抗原检测

目的：探讨丙型肝炎（丙型）患者外周血单个核细胞（ＰＢＭＣｓ）内丙型肝炎病毒抗原（ＨＣＶＡｇ）及Ｆａｓ抗原（ＦａｓＡｇ）表达状况及意义。方法：采用ＨＣＶ核心区及ＮＳ３区单克隆抗体,对２８例慢性丙肝患者ＰＢＭＣｓ进行免疫组化检测,并同步检测ＦａｓＡｇ。结果：ＨＣＶＡｇ及ＦａｓＡｇ阳性率分别为８５．７％（２４／２８）和８２．２（２３／２８）,经相关分析显示。两者表达呈显著正相关（ｒ＝０．５４６,Ｐ〈０．     

乙型肝炎患者和无症状HBVM携带者血清HBV—DNA与HBVM模式相？…

探讨乙型肘炎患者和无症状ＨＢＶＭ携带者血清ＨＢＶ－０ＤＮＡ与ＨＢＶＭ模式的相关性。方法应用ＰＣＲＥＢ法对１７８３例乙型肝炎血清学标志（ＨＢＶＭ）模式不同的乙型肝炎患者（包括急性乙型肝为８７例，慢性乙型肝炎８９１例，乙型肝炎后肝硬化１９３例）和无症状ＨＢＶＭ携带者（６１２）例，做了血清乙型肝炎病毒ＤＮＡ（ＨＢＶ－０ＤＮＡ）检测。结果（１）乙型炎患者和无症ＨＢＶＭ携带者血清ＨＢＶ－ＤＮＡ和ＨＢＶＭ模式     

应用聚合酶链反应检测乙肝患者外周血单个核细胞HBV.DNA的研究

应用聚合酶链反应（ＰＣＲ）检测６０例乙型肝炎患者外周血单个核细胞（ＰＢＭＣ）及血清ＨＢＶ．ＤＮＡ阳性率分别为７６．７％和４５％，尤其在急性乙肝（ＡＨ）或抗ＨＢｅ阳性或抗ＨＢｓ阳性的患者中，ＨＢＶ．ＤＮＡ在ＰＢＭＣ中检出率显著高血清，提示ＨＢＶ．ＤＮＡ普遍存在乙肝患者甚至ＨＢｓＡｇ转阴的病人ＰＢＭＣ中，可能是肝脏病病变反复活动及病毒重复感染的来源。因此也导致既往有ＨＢＶ感染史的ＨＢｓＡｇ阴性献血员传     

乙肝病毒标志物阳性产妇母乳喂养的研究

目的：探讨乙型肝炎（ 乙肝） 病毒携带孕妇胎儿宫内感染率和乳汁中乙肝病毒（ Ｈ Ｂ Ｖ） 阳性率的相关性,分析研究乙肝血清学指标阳性产妇是否适于哺乳。方法：对５２ 例乙肝血清学指标阳性的产妇,应用酶联免疫吸附法和斑点杂交法分别检测脐血和初乳中的 Ｈ Ｂ Ｖ 标志物（ Ｈ Ｂ Ｖ Ｍ） 以及 Ｈ Ｂ Ｖ 脱氧核糖核酸（ Ｈ Ｂ Ｖ Ｄ Ｎ Ａ） ,并对比分析。结果：孕妇 Ｈ Ｂ Ｖ 阳性与相应的脐血和初乳中的 Ｈ Ｂ Ｖ Ｍ 阳性率以及 Ｈ Ｂ Ｖ Ｄ Ｎ Ａ 的检出率呈高度的一致性（ Ｐ ＞ ００５） 。５２ 例 Ｈ Ｂ Ｖ Ｍ 阳性的孕妇中,脐血和初乳中 Ｈ Ｂ Ｖ Ｄ Ｎ Ａ 的检出率均以乙肝表面抗原（ Ｈ Ｂｓ Ａｇ） 、乙肝ｅ 抗原（ Ｈ Ｂｅ Ａｇ） 及乙肝核心抗体（ Ａｎｔｉ Ｈ Ｂｃ）３ 项阳性者最高（８５７１ ％ 和９２８６ ％ ） , Ｈ Ｂｓ Ａｇ 、 Ｈ Ｂｅ Ａｇ 双项阳性者次之（８０ ％ ） , Ｈ Ｂｓ Ａｇ 单项阳性者最低（２０ ％ ） 。结论： Ｈ Ｂ Ｖ 宫内传播以及初乳排毒率与母亲的 Ｈ Ｂｓ Ａｇ 和 Ｈ Ｂｅ Ａｇ 状态密切相关。直接检测初乳中 Ｈ Ｂ Ｖ Ｄ Ｎ Ａ 为指导哺乳的最可靠方法。血中 Ｈ Ｂｓ Ａｇ 、 Ｈ Ｂｅ Ａｇ 和 Ａｎｔｉ Ｈ Ｂｃ３ 项阳性以及 Ｈ Ｂｓ     

不同类型干扰素对慢性乙型肝炎的疗效比较

对９６例用不同类型干扰素治疗的慢性乙型肝炎患者乙肝 母亲土改的（ＨＢＶＭ）ＨＢｅＡｇ、ＨＢＶＤＮＡ变化进行比较分析。４组中Ａ组ＨＢｅＡｇ、ＨＢＶＤＮＡ阳转率稍高于其它组中但无统计学差异（Ｐ〉０．０５）。提示：不同类型干扰素治疗方案、剂量、疗程相同、疗效基本相同。干扰素治疗慢性乙型肝炎疗效判断不是药品类型的选择,而是干扰素适应症的合理选择。     

无症状HBs Ag携带者外周血淋巴细胞SCE变化

①目的 探讨乙型肝炎病毒（ＨＢＶ）感染对无症状ＨＢｓＡｇ携带者遗传物质的损伤。②方法 用常规法培养外周血淋巴细胞,用５－溴脱氧尿嘧啶核苷诱导姐妹染色单体互换（ＳＣＥ）,用紫外线照射法制备ＳＣＥ标本,对２０例无症状ＨＢｓＡｇ携带者和３５例正常对照组的外周血淋巴细胞的ＳＣＥ频率进行了分析。③结果 无症状ＨＢｓＡｇ拘束３者外周血淋巴细胞ＳＣＥ频率明显高于正常对照组,差异有极显著性（ｔ＝３．１０１,Ｐ〈０     

ICAM-1蛋白和mRNA在慢性乙型肝炎肝组织中的表达

目的：探讨肝组织细胞间粘附分子－１（ＩＣＡＭ－１）表达在慢性乙型肝炎（ＣＨＢ）发病机制中的作用。方法：用原位杂交和免疫组织化学技术检测１１例正常人和５０例慢性ＨＢＶ感染者肝内ＩＣＡＭ－１ｍＲＮＡ和蛋白表达情况。结果：正常人和慢性无症状ＨＢｓＡｇ携带者肝细胞无ＩＣＡＭ－１ｍＲＮＡ和ＩＣＡＭ－１表达,ＣＨＢ患者肝细胞１－ＣＡＭ－１ｍＲＮＡ和ＩＣＡＭ－１表达增强,阳民生肝细胞多分布在汇管区周围和腺泡内炎     

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.