抗HCV-IgM抗体测定及临床初步应用

将市售ＨＣＶ－ＩｇＧ诊断试剂盒加以改良，建立了ＨＣＶ－ＩｇＭ抗体检测方法，与抗ＨＢｃ－ＩｇＭ，抗ＨＢｓ－ＩｇＭ，抗ＣＭＶ－ＩｇＭ，抗ＲＶ－ＩｇＭ，ＲＦ及抗核抗体（ＡＮＡ）阳性血清均不起反应。正常人群中抗ＨＣＶ－ＩｇＭ阳性率为１．５％（１／６８），抗ＨＣＶ－ＩｇＧ阳性的４３例血透患者检出抗ＨＣＶ－ＩｇＭ１４例（３２．６％），１２例输血后肝炎抗ＨＣＶ－ＩｇＭ全部阳性。以上结果表明，抗ＨＣＶ－ＩｇＭ可作为输血后ＨＣＶ感染的一个敏感指标     

ELISA法检测孕妇巨细胞病毒抗体

应用ＥＬＩＳＡ技术，对６０名正常育龄妇女，５８名正常孕妇、５３名有异常妊产史孕妇进行巨细胞病毒抗体ＣＭＶ－ＩｇＧ、ＣＭＶ－ＩｇＭ检测，结果正常孕妇及异常妊产史孕妇的ＣＭＶ－ＩｇＭ检出率分别为１２．１％和１７％，明显高于正常育龄妇女的ＣＭＶ－ＩｇＡ检出率１．７％，ＣＭＶ－ＩｇＧ检出率无显著性差异。     

病毒性肝炎患者肝病变及临床分析

笔者观察了１０７例经病理证实的各型病毒性肝炎,对其临床与病理诊断符合情况及各型乙肝患者血清乙型肝炎病毒标记物（ＨＢＶ－Ｍ）和ＨＢＶ－ＤＮＡ的关系进行了分析,现报道如下。１　材料与方法１．１　病例来源　１０７例均为北京佑安医院１９９３～１９９６年住院病人,全部经肝穿刺病理诊断。同时检测血清甲型肝炎抗体（抗ＨＡＶ－ＩｇＭ）,ＨＢＶ－Ｍ,ＨＢＶ－ＤＮＡ,抗ＨＣＶ－ＩｇＭ,抗ＨＣＶ－ＩｇＧ,抗ＨＤＶ－ＩｇＭ,抗ＨＤ及丁型肝炎抗原（ＨＤＡｇ）,抗ＨＥＶ－ＩｇＭ。其中男８０例,女２７例,年龄１７～６８岁。病…     

60例散发性急性病毒性肝炎的病原学分型

对６０例已排除甲型、乙型肝炎病毒（ＨＢＶ）感染的急性病毒性肝炎患者，以酶联免疫吸附试验（ＥＬＩＳＡ）检测抗－ＨＣＶ、抗－ＨＥＶ、抗－ＨＥＶ－ＩｇＭ、ＨＤＶ－Ａｇ、抗－ＨＤＶ－ＩｇＭ，抗－ＨＤＶ、抗－ＣＭＶ－ＩｇＭ及抗－ＥＢＶ－ＩｇＭ，同时应用聚合酶链反应（ＰＣＲ）检测ＨＣＶ－ＲＮＡ。结果表明：１３．３％（８／６０）为丙型肝炎病毒（ＨＣＶ）感染，６１．７％（３７／６０）为戊型肝炎病毒（ＨＥＶ）感染，     

血透患者病毒感染状况初步调查

目的与方法：对４３例血液透析患者的五种肝炎相关病毒（ＨＢＶ、ＨＣＶ、ＨＥＶ、ＨＧＶ和ＣＭＶ）标志物进行了检测。结果：以单项抗－ＨＣＶＩｇＧ检出率最高,达５８．１％;抗－ＣＭＶＩｇＭ检出率次之,为４１．９％;其持依次为ＨＢｓＡｇ３０．２％,抗ＨＣＶＩｇＭ２５．６％,抗－ＨＢｃ１８．６％,抗－ＨＢｓ１６．３％,抗－ＨＧＶＩｇＧ９．３％,ＨＢｃＡｇ７．０％,抗ＨＢｅ４．７％,抗ＣＮＭＶ－ＩｇＧ４．７5,ry     

应用合成肽检测病毒性心肌炎患者血清中柯萨奇B组病毒抗体

目的研究应用合成肽代替完整病毒检测柯萨奇Ｂ组病毒（ＣＶＢ）抗体及其在病毒性心肌炎（ＶＭＣ）病因诊断中的作用。方法从ＣＶＢ衣壳蛋白ＶＰ１及ＶＰ３的保守区及ＣＶＢ３衣壳蛋白ＶＰ２的非保守区各选出一段多肽（分别称为ＶＰ１－１肽、ＶＰ３－１肽、ＶＰ２－１肽）进行化学合成,应用酶联免疫吸附法（ＥＬＩＳＡ）检测这几条多肽与型特异性ＣＶＢ１～６抗体的结合反应。以ＶＰ１－１肽、ＶＰ３－１肽作包被抗原,用间接ＥＬＩＳＡ检测患者血清中ＣＶＢＩｇＧ及ＶＣＢＩｇＭ抗体。结果ＶＰ１－１肽和ＶＰ３－１肽与型特异性ＣＶＢ１～６抗体均有良好的结合反应。８５例健康人、６７例急性ＶＭＣ、３９例慢性ＶＭＣ患者血清ＣＶＢＩｇＧ阳性率分别为２３．５％、５３．７％、３８．５％,ＣＶＢＩｇＭ阳性率分别为７．１％、４９．３％、２８．２％。ＣＶＢＩｇＭ抗体与中和抗体检测结果之间有良好的相关性（Ｐ＜０．００１）,阳性率无明显差别（Ｐ＞０．０５）。结论应用合成肽抗原检测ＣＶＢＩｇＭ抗体有较好的敏感性和特异性。     

321例EB病毒抗体在多种疾病的分布

采用免疫酶法检测３２１例患者血清的抗ＥＢ病毒壳抗原抗体（ＥＢ－ＶＣＡ－ＩｇＡ）结果，鼻咽癌患者ＥＢ－ＶＣＡ－ＩｇＡ阳性率为７５％，其他各系统也都可以不同的阳性率，运用ＥＬＩＳＡ法检测了８８例疾患的抗ＥＢ病毒的早期抗体，抗ＥＢ病毒核抗原抗体（ＩｇＧ／Ｍ）提示血液系统，消化道系统的部分肿瘤及乳癌，甲状腺癌等与ＥＢ病毒有一定的关系。     

重型病毒性肝炎的血清病原学研究

为了解重病毒性肝炎（重肝）的病的分型及其与预后的关系，应用酶联免疫法对１２０例重肝患者进行了甲型肝炎病毒抗体（抗－ＨＡＶ）ＩｇＭ、ＨＢＶ标志（ＨＢＶＭ）、丙型肝炎病毒抗体（抗－ＨＣＶ）的检测。结果显示，抗ＨＡＶ－ＩｇＭ阳性１９例（１５．８％）；ＨＢＶＭＢ阳性９０例（７５．０％）；抗－ＨＣＶ阳性２９例（２４．２％）其中１９例登工ＨＢＶ感染，单纯抗－ＨＣＶ阳性６例；三型病毒标志阴性者１６例（１３．３％     

贺州地区重型肝炎甲～庚型肝炎病毒感染模式的研究

目的：了解贺州地区重型肝炎中甲～庚型肝炎病毒感染状况及其与发病的关系。方法：应用酶联免疫吸附法检测血清中的抗ＨＡＶ－ＩｇＭ、ＨＢｓＡｇ、ＨＢｅＡｇ、抗ＨＣＶ－ＩｇＭ、抗ＨＤＶ－ＩｇＭ、抗ＨＥＶ－ＩｇＧ、抗ＨＥＶ－ＩｇＧ、抗ＨＧＶ－ＩｇＧ。结果：重肝组病毒检出率有ＨＡＶ６．７９％、ＨＢＶ７７．６８％、ＨＣＶ６．７９％、ＨＤＶ５．３６％、ＨＥＶ３２．１４％、ＨＧＶ８．０３％,其中ＨＶＢ＋ＨＥＶ,其病死率高达７０％。结论：贺州地区重肝甲～庚型病毒均有不同程度感染,ＨＶＢ、ＨＥＶ是主要危险因素,两者重叠感染机率高,预后差;ＨＧＶ在重肝发病作用值得重视。     

散发性急性病毒性肝炎的血清学调查

笔者对２００８例散发性急性病毒性肝炎的血清标本，用ＥＬＩＳＡ方法进行ＨＡＶ－ＩｇＭ，ＨＢｓＡｇ／或抗ＨＢｃ－ＩｇＭ，ＨＣＶ－Ａｂ，ＨＥＣ－Ａｂ检测，结果发现ＨＡＶ－ＩｇＭ阳性９６７例，ＨＢｓＡｇ和／或抗ＨＢｃ－ＩｇＭ阳性５６２例，ＨＣＶ－Ａｂ阳性６９例，ＨＥＶ－Ａｂ阳性２４６例，尚有１６４例，为非甲乙丙戊型肝炎，结果提示人群中甲型肝炎发病率最高。     

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.