Characterization of Hepatitis Delta Virus in Sub-Saharan Africa

Hepatitis D virus (HDV) is a satellite of hepatitis B virus (HBV), and infection with this virus aggravates acute and chronic liver disease. While HBV seroprevalence is very high across sub-Saharan Africa, much less is known about HDV in the region. In this study, almost 2,300 blood serum samples from Burkina Faso (n = 1,131), Nigeria (n = 974), Chad (n = 50), and the Central African Republic (n = 118) were screened for HBV and HDV. Among 743 HBsAg-positive serum samples, 74 were positive for HDV antibodies and/or HDV RNA, with considerable differences in prevalence, ranging from <2% (pregnant women from Burkina Faso) to 50% (liver patients from Central African Republic). HDV seems to be much more common in chronic liver disease patients in the Central African Republic (CAR) than in similar cohorts in Nigeria. In a large nested mother-child cohort in Burkina Faso, the prevalence of HDV antibodies was 10 times higher in the children than in their mothers, despite similar HBsAg prevalences, excluding vertical transmission as an important route of infection. The genotyping of 16 full-length and 8 partial HDV strains revealed clade 1 (17/24) in three of the four countries, while clades 5 (5/24) and 6 (2/24) were, at least in this study, confined to Central Nigeria. On the amino acid level, almost all our clade 1 strains exhibited a serine at position 202 in the hepatitis D antigen, supporting the hypothesis of an ancient African HDV-1 subgroup. Further studies are required to understand the public health significance of the highly varied HDV prevalences in different cohorts and countries in sub-Saharan Africa.     

小肠肿瘤罕见原因

小肠是消化道中最长的一段,是食物消化、吸收和能量转化的主要场所,但小肠肿瘤的相关研究却鲜有报道。原发性小肠恶性肿瘤在临床少见,由于缺乏典型临床表现及有效治疗手段,导致预后极差。小肠巨大的表面积及上皮快速更新的状态与小肠肿瘤的低发病率显然相悖。小肠肿瘤较低的发病率这一科学问题已成为困扰医学科学领域的世纪之谜。本综述主要从小肠独特的生理屏障、基因调控系统、共生菌群及黏膜免疫系统四个方面剖析小肠肿瘤罕见的原因。理解小肠精密的调控机制将为研究衰老、肠道菌群及肿瘤防治提供新思路。本文基于以往研究,结合最新进展对小肠肿瘤流行病学现状、低发病率的可能原因及其对肿瘤防治的启示进行综述。     

B-cell growth factor receptor expression and B-cell growth factor response of leukemic B cell precursors and B lineage lymphoid progenitor cells

The purpose of this study was to analyze the expression of B cell growth factor (BCGF) receptors and to elucidate the biologic effects of biochemically purified natural BCGF at the B cell precursor stage of human B lineage lymphoid differentiation. The specific binding of radioiodinated high-mol-wt BCGF (125I-HMW-BCGF) and low-molecular-wt BCGF (125I-LMW-BCGF) to fresh marrow blasts from B cell precursor acute lymphoblastic leukemia (ALL) patients was initially investigated. The estimated number of radioiodinated BCGF molecules bound per blast ranged from undetectable to 24.3 X 10(3) for HMW-BCGF, and from 11.5 X 10(3) to 457.8 X 10(3) for LMW-BCGF. In 3H-TdR incorporation assays, 75% of cases showed a significant response to LMW-BCGF with a median stimulation index of 9.3. By comparison, only 33% of cases showed a significant response to HMW-BCGF with a median stimulation index of 2.4. Subsequently, B cell precursor colony assays were performed to assess and compare the biologic effects of BCGF on leukemic B lineage lymphoid progenitor cells. Among 28 cases studied, 57% responded to both HMW-BCGF and LMW-BCGF, 21% responded only to LMW-BCGF, and the remaining cases showed no proliferative response to either growth factor. The response patterns of virtually pure populations of FACS- sorted leukemic B cell precursors were essentially identical to the proliferative responses of unsorted leukemic B-cell precursors. Synergistic effects between HMW-BCGF and LMW-BCGF were observed in 80% of the cases that responded to both. The numbers of cell-bound radioiodinated BCGF molecules, the stimulation indices, as well as the number of B cell precursor colonies in BCGF-stimulated cultures showed a marked interpatient variation. Patients with structural chromosomal abnormalities (SCAs) involving 12p11-13 or patients with a Philadelphia chromosome showed a greater HMW-BCGF response at the level of leukemic progenitor cells than did other patients (P = .02). The LMW-BCGF response was significantly greater for patients with SCA than for patients without SCA (P = .04). The response of leukemic progenitor cells to HMW-BCGF or LMW-BCGF did not correlate with sex, age, disease status, FAB morphology, WBC at diagnosis, or immunophenotype. To our knowledge, this study represents the first detailed analyses of BCGF receptor expression and BCGF effects in B cell precursor ALL. The data presented provide direct evidence for the expression of functional receptors for both HMW-BCGF and LMW-BCGF in B cell precursor ALL.     

脊柱化脓性感染动物模型的建立及应用进展

手术部位感染是脊柱手术后常见且非常严重的并发症,严重影响患者的身体健康。尽管手术操作无菌细致,及时给予适当的全身抗生素,但手术部位感染率仍然很高[1-2]。据报道,我国脊柱手术感染的风险从0.5%~7.8%不等[3-4]。糖尿病、肥胖、高血压等疾病显著增加脊柱术后感染,感染后治疗的费用可达10多万美元[5],大大增加了患者的经济负担。     

新疆维吾尔族空腹血糖受损人群血脂水平变化及低密度脂蛋白胆固醇升高的相关因素分析

目的 分析新疆维吾尔族（维族）IFG人群血脂代谢状况及LDL-C升高的危险因素。 方法 对新疆地区2053例30～80岁维族居民行横断面调查,筛查IFG人群,分析血脂代谢状况及LDL-C相关危险因素。 结果 该IFG人群中,血脂代谢异常的总患病率为99.8%（613/614）。高TG血症患病率为85.5%（525/614）,男女比较,差异无统计学意义（P〉0.05）;高TC血症、高LDL-C血症患病率为72.5%（445/614）和40.7%（250/614）,男性高于女性（75.0% vs 70.1%,52.4% vs 29.9%,P〈0.05）;低HDL-C血症患病率为29.8%（183/614）,男性低于女性（28.0% vs 31.4%,P〈0.05）。Logistic回归分析显示,LDL-C升高的危险因素为年龄、TC、2 hPG。 结论 维族IFG人群血脂代谢异常的总患病为99.8%,其中LDL-C升高的患病率为40.7%,其危险因素为年龄、TC和2 hPG。     

人肠道病毒71型感染免疫抑制恒河猴的分析

目的: 通过建立人肠道病毒71型(EV71)感染在免疫抑制恒河猴的动物模型,进一步分析人EV71在免疫抑制动物体内病毒增殖、病理变化以及病毒抗原在不同组织的表达情况。方法: 按照每天15 mg/kg的剂量给8只恒河猴口服环孢菌素A连续7 d后造成其免疫抑制状态,再经呼吸道和消化道感染EV71病毒FY23株,对其进行14 d的临床观察后处死,采集各器官组织进行病毒载量检测,同时对不同的组织进行病理学分析和免疫组化分析。结果: 感染EV71病毒后,免疫抑制组的临床症状、病毒载量、病理分析和免疫组化结果都明显比非免疫抑制组严重,从病毒对机体造成的影响来看呼吸系统感染较消化系统感染明显严重。结论: 本实验分析了人EV71在免疫抑制动物体内病毒增殖的情况,为建立用于EV71疫苗评价的恒河猴动物模型提供了依据,并对未来的EV71疫苗的使用人群范围做出了新的限定。     

人卵黄囊间质干细胞的分离纯化及诱导成脂的实验研究

目的:分离纯化及体外定向诱导人卵黄囊间质干细胞(YS-MSC)分化为脂肪细胞。方法:显微分离人卵黄囊, 经酶消化得到卵黄囊细胞, 卵黄囊细胞经贴壁培养、传代纯化得到人YS-MSC, 流式细胞仪检测YS-MSC表面抗原表达, 钙钴法测定碱性磷酸酶(AKP)活性;地塞米松、消炎痛、胰岛素定向诱导YS-MSC分化为脂肪细胞。油红O检测中性脂肪。结果:人卵黄囊间质干细胞易于分离、纯化, 体外培养增殖潜能大。卵黄囊间质干细胞CD29、CD44、CD166及CD105表达阳性, CD34、CD45和CD86为阴性;AKP弱阳性。卵黄囊间质干细胞经成脂诱导转化为大小不等的园形或椭圆形细胞, 可见胞浆内有少量微小脂滴形成, 随时间延长, 胞浆中脂滴相互融合, 胞核被挤于细胞的一侧, 经油红O染色脂滴染橘红色, 符合脂肪细胞的生物学特征。结论:人卵黄囊间质干细胞与成体间质干细胞表型一致, 在体外可以分化为脂肪细胞。     

版纳藤黄化学成分的研究

目的:研究版纳藤黄Garcinia xipshuanbannaensis枝叶的化学成分.方法:利用正相硅胶、反相RP-18柱色谱及葡聚糖凝胶Sephadex LH-20等手段进行分离纯化,根据波谱数据鉴定化合物的结构.结果:分离鉴定了15个化合物,分别为bannaxanthone E(1),大叶藤黄醇(xanthochymol,2),异大叶藤黄醇(isoxanthochymol,3),环大叶藤黄醇(cycloxanthochymol,4),osajaxanthone(5),gentisein(6),mangostinone(7),山柰酚(8),槲皮素(9),牡荆素(10),2"-O-acetylvitexin(11),3-乙酰齐墩果酸(12),(-)-表儿茶素[(-)-epicatechin,13],β-谷甾醇(14),胡萝卜苷(15).结论:化合物4～9,11～13为首次从该种植物分离得到,化合物11～13为首次从该属植物分离得到.     

学龄期喘息儿童雾化吸入全程行为干预的效果研究

目的 探讨雾化吸入全程中行为干预对学龄期喘息儿童的治疗效果的影响.方法 将141例学龄期喘息儿童于雾化过程中按是否自愿接受行为干预分为实验组75例和对照组66例,2组患儿雾化前均进行喘息知识认知和"呼吸"指导.实验组在此基础上由专科人员陪护整个吸入过程且进行"呼吸"、吞咽唾液或用鼻呼气、握持雾化罐、保持体位等行为干预.比较2组患儿雾化结束后肺部哮鸣音及患儿主诉是否改善、经皮测血氧饱和度以及患儿依从性的差异.结果 雾化完成后实验组患儿主诉较雾化前舒服73例占97.3%,SaO_2＞95%69例占92.0%;而对照组主诉较雾化前舒服53例占80.3%,SaO_2＞95%50例占75.8%,差异显著;实验组平静呼吸哮鸣音改善情况和医嘱依从情况与对照组相比差异显著.结论 雾化吸人全程中持续行为干预能显著提高喘息儿童雾化吸入的效果和吸入治疗依从性.     

肠道病毒中枢神经系统感染病儿免疫功能紊乱与神经元损害的相关性

目的通过检测肠道病毒（EV）中枢神经系统感染病儿脑脊液中白细胞介素-10（IL-10）、γ-干扰素（IFN-γ）及神经元特异性烯醇化酶（NSE）的水平,探讨EV引起病儿免疫功能紊乱的机制。方法收集2008年1月—2009年1月青岛大学医学院附属医院和滨州医学院附属医院临床诊断为无菌性脑膜炎、脑炎病儿的急性期脑脊液标本100例。采用逆转录聚合酶链反应（RT-PCR）方法,检测标本中的EV RNA;应用双抗体夹心ELISA法检测EV感染组和对照组脑脊液中IL-10、IFN-γ及NSE的表达水平。结果 100例急性期病儿脑脊液中,经RT-PCR和二次PCR共获得阳性结果78例（78.0%）;EV感染组IFN-γ的表达水平高于对照组（t=4.24,P〈0.01）,重症组高于轻症组（t=4.13,P〈0.01）;IL-10表达水平低于对照组（t=7.89,P〈0.01）,重症组低于轻症组（t=2.97,P〈0.01）;NSE表达水平高于对照组（t=7.02,P〈0.01）,重症组高于轻症组（t=2.79,P〈0.01）。EV感染组NSE与IFN-γ水平呈正相关（r=0.673,P〈0.05）,与IL-10水平呈负相关（r=-0.587,P〈0.05）。结论 IL-10和IFN-γ参与EV对中枢神经系统免疫损害的过程,并与神经元的损害程度密切相关。