中国南方四省区流行的HIV-1 CRF01_AE病毒株基因特征研究

Objective To analyze the genetic characteristics of HIV-1 CRF01_AE strains prevailing in. the four provinces of southern China. Methods Plasma samples were collected from the newly diagnosed HIV-1 individuals reported in 2006 in Guangdong, Guangxi, Jiangxi and Hunan province. The gag and env gene fragments were amplified from RNA template extracted from plasma using RT and nested PCR methods. CRF01_AE sequences were analyzed by phylogcnetie methods and characterized by calculating the genetic distance and Entropy analysis. Results Two main epidemic clusters were found to exist in the CRF01 AE strains from 210 HIV-1 CRF01 AE infected individuals collected in the 4 provinces, southern China. It was found that no international reference strain was closely correlated with cluster Ⅰ , which including 123 samples. The strains in cluster Ⅱ, consisting 57 cases of samples, were closely related with the strains identified in Vietnam. Genetic distance analysis of gag and env genes showed that the diversity of cluster Ⅰ was obviously less than that of cluster Ⅱ. Data on nucleotide polymorphism showed that nucleotides compositions of 42 sites in gag and 40 sites in env wer esignificantly different between the two clusters. When compared with cluster Ⅱ , the polymorphism decreased at 61 nucleotide sites but increased at 21 sites in cluster Ⅰ. Conclusion This was the first report describing that two main epidemic clusters were existed in CRF01_AE strains prevailing in the 4 provinces, Southern China. The vires in cluster Ⅰ was the dominant strain in this region, with shorter period of circulation and higher proportion seen in the HIV-infected population, which might belong to CRF01_AE strain with certain features facilitating the spread of the virus. The virus in cluster Ⅱ was highly homology with the CRF01_AE strains from Vietnam, and seemed to have had several events of epidemics in populations in border regions of China and Vietnam.     

中国南方四省区流行的HIV-1 CRF01_AE病毒株基因特征研究

Objective To analyze the genetic characteristics of HIV-1 CRF01_AE strains prevailing in. the four provinces of southern China. Methods Plasma samples were collected from the newly diagnosed HIV-1 individuals reported in 2006 in Guangdong, Guangxi, Jiangxi and Hunan province. The gag and env gene fragments were amplified from RNA template extracted from plasma using RT and nested PCR methods. CRF01_AE sequences were analyzed by phylogcnetie methods and characterized by calculating the genetic distance and Entropy analysis. Results Two main epidemic clusters were found to exist in the CRF01 AE strains from 210 HIV-1 CRF01 AE infected individuals collected in the 4 provinces, southern China. It was found that no international reference strain was closely correlated with cluster Ⅰ , which including 123 samples. The strains in cluster Ⅱ, consisting 57 cases of samples, were closely related with the strains identified in Vietnam. Genetic distance analysis of gag and env genes showed that the diversity of cluster Ⅰ was obviously less than that of cluster Ⅱ. Data on nucleotide polymorphism showed that nucleotides compositions of 42 sites in gag and 40 sites in env wer esignificantly different between the two clusters. When compared with cluster Ⅱ , the polymorphism decreased at 61 nucleotide sites but increased at 21 sites in cluster Ⅰ. Conclusion This was the first report describing that two main epidemic clusters were existed in CRF01_AE strains prevailing in the 4 provinces, Southern China. The vires in cluster Ⅰ was the dominant strain in this region, with shorter period of circulation and higher proportion seen in the HIV-infected population, which might belong to CRF01_AE strain with certain features facilitating the spread of the virus. The virus in cluster Ⅱ was highly homology with the CRF01_AE strains from Vietnam, and seemed to have had several events of epidemics in populations in border regions of China and Vietnam.     

龋风险评估在上海市闵行区儿童龋病分级管理中的效果评价

目的探讨实施以风险评估为基础的儿童龋病分级管理的防龋效果,为制定儿童口腔疾病防治分级管理策略提供依据。方法2018年3月至2019年3月期间,采用整群抽样法在上海市闵行区抽取512名3岁幼儿园儿童和502名6岁小学生,进行口腔检查和问卷调查,按照龋病风险评估标准分为高危、中危、低危人群。以学校为单位随机分为试验组和对照组,试验组根据龋病风险等级进行分级管理,低危试验组进行口腔健康教育干预;中危试验组半年涂1次氟,进行口腔健康教育;高危试验组3个月涂1次氟,进行口腔健康教育。对照组按照上海市政府为儿童提供的基本口腔公共卫生服务常规管理。12个月后开展口腔检查,评估防龋效果。结果患龋高危儿童中,3岁对照组龋病发病率为51.22%,试验组为34.17%;6岁对照组为51.27%,试验组为33.15%,差异均有统计学意义(P<0.05)。中危儿童中,3岁对照组龋病发病率为38.71%,试验组为7.32%,差异有统计学意义(P<0.05)。但3岁儿童低风险组、6岁儿童低风险组和中风险组的两组龋病发病率差异无统计学意义。3岁、6岁儿童试验组干预1年后患龋风险等级升高比例低于对照组儿童。结论以风险评估为基础的儿童龋病分级管理在患龋高危儿童中防龋效果显著,值得推广应用。     

输尿管软镜碎石术后肾包膜下血肿的危险因素分析

目的：探讨输尿管软镜碎石术后继发肾包膜下血肿的危险因素。方法：回顾性分析2007年1月至2017年12月1 705例行输尿管软镜碎石术后出现肾包膜下血肿的11例患者临床资料,其中男3例,女8例。应用ｔ检验、卡方检验及多因素logistic回归分析输尿管软镜术后发生肾包膜下血肿的独立危险因素。结果：将患者分为实验组和对照组。实验组21例均经术后泌尿系B超或CT检查确诊肾包膜下血肿。女性、尿培养阳性、肾积水、术中是否手工灌洗在2组患者间存在显著性差异（P<0.05）,同时多因素logistic分析显示,尿培养阳性、肾积水、术中是否手工灌洗是行输尿管软镜碎石术后发生肾包膜下血肿的独立危险因素。结论：女性、尿路感染、肾积水、术中是否手工灌洗是输尿管软镜碎石术后继发肾包膜下血肿的危险因素。     

微创经皮肾穿刺取石术并发症的防治

目的探讨微创经皮肾穿刺取石术常见并发症的原因及其防治措施。方法回顾性分析我院428例微创经皮肾穿刺取石术产生的并发症及其相关处理的临床资料。结果143例（33.41％）术中／后出现各种并发症,其中严重的并发症37例（8.64％）,包括术中大出血5例（1.17％）,上尿路损伤7例（1.64％）,液气胸4例（O.93％）,茵／毒血症15例（3.50％）,术后继发性大出血6例（1.40）。结论微创经皮肾穿刺取石术有一定的并发症,了解其发生的原理,作好充分术前准备,术中规范操作,可以预防和妥善处理这些并发症。     

开展基层卫生监督工作的实践与成效

按照卫生部关于深化卫生监督体制改革,加强卫生监督体系建设的精神要求,北京市海淀区卫生局卫生监督所作为基层卫生监督机构,在加强机构队伍建设、推行卫生监督综合执法、加大执法力度、创新工作模式等方面进行了积极地探索和实践。作者将工作中的实践、成效进行了简要阐述。     

子宫内膜和卵巢原发性双重癌合并子宫内膜异位症及子宫肌瘤1例报告

1 临床资料患者57岁,G2P2+1绝经6年,因发现盆腔占位性病变8年,绝经后阴道不规则流血2月于2003年12月入院.8年前患者体检时发现盆腔囊性占位性病变,未诊治.2个月前患者出现阴道不规则流血,B超示左附件8.5cm×10.2cm×10.3cm囊性占位性病变.诊刮示子宫内膜高分化宫内膜样腺癌.15年前行阑尾、右附件切除.妇科检查见子宫前位正常大小,左附件区10cm左右囊性占位病变与盆侧壁及子宫粘连.肿瘤标记物CA-125,CA-199等均正常,人院后考虑为子宫内膜癌,附件占位性病变(卵巢癌?),行剖腹探查术.术中见盆腹腔无腹水,子宫正常大小外观无异常,左附件囊实性多房占位病变直径10cm左右,其下部实性部分直径约4cm左右,剖视如鱼肉状;上部多房囊性部分直径约7cm左右,剖视内有巧克力样粘稠液体,囊内壁有乳头状突起;右附件缺失,其余盆腹腔器官表面未见异常.     

吉西他滨联合顺铂3周方案治疗非小细胞肺癌

目的：观察吉西他滨（健择）联合顺铂（GP方案）对晚期非小细胞肺癌的疗效。方法：自1999年6月-2001年11月,对26例晚期非小细胞肺癌采用21天GP方案治疗。结果：26例病例中,无GR、PR11例,SD12例,PD3例,总有效率CR PR为42.3％（11/26）。中位生存期（MST）为9.3个月。Ⅲ-Ⅳ度白细胞下降占23.1％（6/26）。结论：治疗晚期非小细胞肺癌,吉西他滨联合顺铂21天方案是有效、经济和安全的。     

双频双脉冲激光碎石术治疗输尿管结石临床分析

随着碎石技术的不断发展及碎石设备的不断更新，绝大多数输尿管结石均可采用微创的方法进行治疗，其中体外震波碎石、输尿管镜下碎石及经皮肾镜碎石应用已较为广泛。对于输尿管中、下段结石的治疗，输尿管镜下激光碎石术，尤其是双频双脉冲激光碎石成功率高，并发症少，疗效较为确切。现对本院采用输尿管镜双频双脉冲激光治疗的输尿管结石患者的临床资料作一回顾性分析，报道如下。     

一种制作胎盘组织微阵列的简易方法

1998年Kononen等[1]首先制作成乳腺癌组织芯片,被广泛应用,但仍主要用于检测肿瘤基因[2]。我们用免疫组化对妊娠期肝内胆汁淤积症(Intrahepatic Cholestasis of Pregnancy,ICP)胎盘的过程中,探索了制作胎盘组织微阵列(Tissue mi-croarray,TMA)的简易方法,此法不需特殊仪器和设备,一般人员均能掌握,且时间短,费用少,现介绍如下。1材料与方法1.1标本来源胎盘组织均源于2005年3月至2005年9月四川大学华西第二医院妇产科的孕晚期患者,均为剖宫产分娩,共124例,其中正常胎盘34例,ICP胎盘90例。1.2组织微阵列的制作方法1.2.1石蜡包埋胎盘娩出…