荧光定量PCR和ELISA检测乙肝病毒的应用比较

目的　探讨荧光定量PCR检测HBV—DNA的应用价值。　方法　从 2 92 0份用ELISA检测乙肝 5项的体检血清标本中 ,抽取 2 88份HBsAg阳性标本及 10 0份全阴标本 ,进行荧光定量聚合酶链式反应 (FQ—PCR)HBV—DNA定量分析。　结果　经FQ—PCR检测 ,80份HBsAg、HBeAg、HBcAb都阳性的标本 ,HBV—DNA阳性率为 10 0 % ( 80 /80 ) ,平均HBV—DNA拷贝数为 2 2× 10 8cp/ml ;164份HBsAg、HbeAb、HBcAb都阳性的标本 ,HBV—DNA阳性率为79 3 % ( 13 0 /164 ) ,平均HBV—DNA拷贝数为 1 5× 10 6cp/ml;12份HBsAg单项阳性的标本 ,HBV—DNA的阳性率为83 3 % ( 10 /12 ) ,平均HBV—DNA拷贝数为 1 6× 10 5cp/ml;10 0份HBsAg、HBsAb、HBeAg、HBeAb、HBcAb都阴性的标本 ,HBV—DNA的阳性率为 2 % ( 2 /10 0 ) ,平均HBV—DNA拷贝数为 4 5× 10 5cp/ml。　结论　FQ—PCR可以检测HBV的感染和复制情况 ,对准确报告HBV感染 ,指导其选择治疗方案和观察疗效具有重要的临床意义     

荧光定量—聚合酶链反应检测性传播性疾病病原体结果分析

用荧光定量—聚合酶链反应 (FQ -PCR)检测 2 2 0 2份泌尿生殖道分泌物中的UU、CT、NG。了解性传播性疾病中解脲脲原体 (UU)、沙眼衣原体 (CT)以及淋病奈瑟菌 (NG)的感染情况。三种病原体中 ,UU的阳性率居于首位 ,明显高于NG的阳性率 ,而CT与NG的阳性率差异无显著性。混合感染阳性率不高 ,由UU或CT引起的混合感染率与由NG引起的混合感染率差异无显著性。     

4种性病病原体感染16450例流行病学调查报告

目的：调查沙眼衣原体(CT)、解脲脲原体(UU)、淋球菌(NG)、人乳头瘤病毒(HPV)等性病病原体感染的流行病学状况。方法：对江西省12家市级医院性病门诊就诊的16450例泌尿生殖道感染患者留取的分泌物采用荧光定量PCR方法检测CT-DNA、UU-DNA、NG-DNA、HPV-DNA。结果：标本中CT、UU、NG、HPV 12733例男性阳性率分别为16．4％、9．1％、7．1％、6．5％,3717例女性阳性率分别为22．0％、21．1％、10．5％、2．1％;CT UU混合阳性检出率6．3％,CT NG混合阳性检出率为0．6％,CT HPV混合阳性检出率为1．4％,UU NG混合阳性检出率为3．4％,UU HPV混合阳性检出率为3．7％,NG HPV混合阳性检出率为0．7％,两种以上混合感染例数的阳性检出率为1．0％;2002年、2003年阳性检出率分别为37．1％、48．5％。结论：江西省CT、UU、NG、HPV4种性病病原体的流行较为严重,且呈逐年增长的趋势。     

荧光定量PCR检测NG、CT和UU三种性病混合感染的分析

目的：探讨泌尿生殖道感染患者淋球菌（NG）、沙眼衣原体（CT）和解脲支原体（UU）的混合感染现状、特点和规律性。方法：采用FQ—PCR方法对674例泌尿生殖道感染患者淋球菌、沙眼衣原体和解脲支原体同时进行检测。结果：患者同时感染CT和UU、CT和NG、NG和UU及NG、UU、CT的阳性率存在着差异。结论：NG、UU、CT三种致病微生物混合感染检测结果中，CT＋UU感染率最高，CT＋UU＋NG感染率最低。     

广东地区淋球菌、沙眼衣原体及解脲脲原体感染脲的分子行病学调查

目的：了解广东地区淋球菌(NG)、沙眼衣原体(CT)、解脲脲原体(UU)等性病的流行病学状况。方法：对广东地区76家基层医院性病门诊就诊的1949例生殖道感染患者取其分泌物，用PCR方法检测NG，CT，UU—DNA。结果：262例男性患者NG，CT，UU阳性检出率分别为7．63％，23．28％，10．69％；1687例女性患者NG，CT，UU阳性检出率分别为9．19％，17．90％，17．19％。男性CT感染率23．28％明显高于女性17．90％(P＜0．05)，女性UU感染率17．19％高于男性10．69％(P＜0.05)，男、女性NG阳性率分别为7．63％和9．19％差异无显著性(P＞0．05)。NG CT混合感染率为3．27％，NG UU混合感染率为2．34％，CT UU混合感染率为8．88％，NG CT UU混合感染率为0．93％。1999—2001年3种性病感染率分别为26．11％，43．81％和51．52％。结论：广东地区NG，CT，UU 3种性病的流行较为严重、总感染率高达43．92％；反呈递年增长的趋势。     

荧光探针定量PCR在检测HBV-DNA的应用

目的　用荧光定量聚合酶链反应 (FQ PCR)方法准确地定量检测血清中的HBV DNA数量和免疫指标 ,以指导临床。方法　用FQ PCR方法和酶联免疫吸附试验 (ELISA)方法分别检测 184份临床血清标本的HBVDNA和免疫指标。结果　用 (ELISA)作对照 ,经FQ PCR检测 ,HBeAg(+)组 (82份 )的阳性率为 10 0 % ,HBV DNA阳性拷贝数范围在 10 5～ 10 10 /ml;HBeAb(+)组 (5 2份 )的阳性率为 5 5 8% ,HBV DNA阳性拷贝数范围在 10 4～ 10 7/ml;HBsAb(+)组 (2 0份 )的阳性率为 15 % ,HBV DNA阳性拷贝数范围在 10 4～ 10 5/ml;对照组 (30份 )的阳性率为 0。HBeAg(+)组血清中HBV DNA含量 (10 7 2± 1 13 )显著高于HBeAb(+)组 (10 5 8± 1 4)和HBsAb(+)组 (10 4 67± 0 58)。结论　FQ PCR检测HBV DNA具有较高的灵敏度和特异性 ,且能准确定量 ,FQ PCR可以检测HBV的真实感染和复制情况 ,对乙型肝炎临床诊断 ,治疗及疗后观察有重要意义。     

荧光定量聚合酶链反应检测淋病奈瑟菌

目的　评价荧光定量聚合酶链反应 (FQ -PCR)技术检测淋病奈瑟菌的临床应用。方法　采用FQ -PCR技术检测疑似淋病患者泌尿生殖道标本 80例 ,并同时进行淋病奈瑟菌培养 ,对两种方法的检测结果进行比较分析。结果　测试 80例标本 ,FQ -PCR法 30例为阳性 ,DNA拷贝数从 3× 10 5/ml至 6× 10 10 /ml不等 ,阳性率为 37.5 %(30 / 80 ) ;培养法 2 4例阳性 ,阳性率 30 .0 % (2 4/ 80 ) ;FQ -PCR较培养法差异有显著性 (P <0 .0 0 5 )。结论　FQ -PCR技术可定量检测标本中的DNA拷贝数 ,较培养法简单、敏感、准确 ,对于淋病的早期确诊 ,治疗期间疗效的判断具有重要价值     

荧光定量PCR方法检测男性三种标本的分析

目的:分析荧光定量PCR方法检测1256例前列腺液、尿道分泌物、精液标本解脲支原体(UU)和(或)沙眼衣原体(CT),了解三种标本感染UU、CT的情况。方法:对2007年1256例怀疑感染UU或CT的患者和不孕不育症患者标本检测。结果:149例前列腺标本中UU阳性率为42.3%(63/149)、136例前列腺标本CT阳性率为19.9%(27/136);361例尿道分泌物UU阳性率为21.1%(76/361)、346例尿道分泌物CT阳性率为10.4%(36/346);141例精液UU阳性率为11.3%(16/141)、123例精液CT阳性率为7.3%(9/123)。结论:三种标本的UU、CT阳性率相差显著,P<0.005。前列腺标本检测的阳性率明显高于尿道分泌物标本,精液检测的阳性率最低。不同类型的标本检测的UU、CT的结果有很大的差异,送检的标本最好是前列腺液。     

荧光定量PCR技术对1235例NGU病原体基因检测结果分析

目的用实时荧光定量PCR（FQ—PCR）技术准确定量检测非淋菌性尿道炎（NGu）中解脲支原体（UU）、沙眼衣原体（CT）基因，进一步了解UU、CT感染情况，为临床治疗提供依据。方法采用FQ—PCR技术检测标本1235份。结果UU阳性率是27．5％，其中男性UU阳性率是12．4％，女性UU阳性率是42．0％。CT阳性率是12．1％，其中男性CT率是11．2％，女性CT率是13．2％。UU感染率在男性、女性患者有极显著性差异（P〈0．01），而CT感染率在性别之间无显著性差异（P〉0．05）。结论实时荧光定量PCR检测UU、CT基因具有操作简单、反应时间短、重复性好、结果客观准确、敏感性和特异性好等优点，其结果对临床诊断、治疗有一定指导意义。     

实时荧光定量PCR检测乙型肝炎病毒DNA的临床应用价值

目的: 探讨实时荧光定量PCR(F Q-PCR)检测乙型肝炎病毒DNA的临床应用价值。方法: 采用FQ-PCR方法检测196例患者血清中HBV-DNA。结果: 112例HBeAg(+)/HBeAb(-)标本中FQ-PCR均阳性,HBV-DNA拷贝数1.08×107/ml;68例HBeAg(-)/HBeAb(+)标本中,平均拷贝数6.12×105/ml,其阳性率为66.2%;16例HBeAg(-)/HBeAb(-)标本中,平均拷贝数为2.72×104/ml。结论: 实时FQ-PCR可以实现准确定量,是了解HBV在体内复制和判断疗效的有利手段。     

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.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

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.     

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.