Meta分析在评估基因多态性与疾病易感性关系中的应用

目的:介绍Meta分析在评估基因多态性与疾病易感性关系中的应用.方法:以细胞色素P4502D6(CYP2D6)基因多态性与肺癌易感性相关性的研究为例,详细介绍Meta分析的基本内容和分析方法.结果:携带CYP2D6非T188T基因型的个体属肺癌高危人群,突变型T188T基因型可能作为保护因素而降低肺癌发生的易感性.结论:Meta分析是一种新的文献综述分析方法,将成为医学研究的强有力工具,将会在医学研究领域发挥其独特作用.     

甲型流感患者CD_4和CD_8因子的变化及其临床意义

目的检测甲型流感患者外周血CD4及CD8因子,了解CD4+和CD8+T淋巴细胞的动态变化及其临床意义。方法收集年龄在20~55周岁之间有明显流感病毒感染症状患者的鼻咽拭子,将经流感病毒NP基因片段鉴定确诊的甲型流感患者作为研究对象,分别于感染后不同时间段采取外周血,离心取血清,应用双抗体夹心技术(ELISA)测定流感患者血清中CD4及CD8因子进行检测及分析。结果经ELISA检测,显示经流感病毒NP基因检测确诊的4例甲型流感患者中,所有病例CD4、CD8因子在感染3天时均呈下降或下降趋势,在感染7d时表达水平逐渐升高;从表达水平观察,CD4因子表达水平较低,而CD8因子处于较高水平的表达。结论流感病毒感染人体后可导致CD4+和CD8+T淋巴细胞水平的改变,在感染初期1~3d,CD4及CD8因子呈下降或下降趋势,提示CD4+和CD8+T淋巴细胞功能受到不同程度的抑制;在感染7~14d,CD4及CD8因子表达逐渐升高并可达高峰值,可能参与病毒的清除,在引发机体免疫应答中发挥重要作用。     

沙门氏菌信息管理系统的设计与应用

介绍了沙门氏菌信息管理系统的建设情况,阐述了系统的建设背景与现状、系统业务分析、系统功能模块等内容。该系统的建设为沙门氏菌监测提供了信息化监测手段,并为进一步建立全国沙门氏菌监测网络奠定了基础。     

美国技术贸易壁垒对中国药品出口影响的实证分析

采用引力模型,分析技术性贸易壁垒对中国药品出口美国的影响。结果显示,美国药品领域技术性贸易壁垒对中国药品进入美国市场有阻碍作用,并提出了跨越美国技术性贸易壁垒的建议。     

云南省普洱市镇沅县男性流动人群艾滋病相关知识、干预和行为学调查分析

目的通过对镇沅县五一水库2009—2011年男性流动人群艾滋病相关知识和行为学进行分析,了解镇沅县最近三年男性流动人群干预效果的变化,为制定防治对策提供科学依据.方法每年均采用PPS法随机抽取镇沅县五一水库施工区的部分民工,进行艾滋病相关知识和行为学调查.结果2009-2011年共进行1070份男性流动人群艾滋病相关知识和行为学问卷调查,艾滋病相关知识知晓率呈逐年上升趋势,分别为41.70%,65.63%和77.10%;接受过艾滋病相关干预服务的比例逐年有所提高,分别为59.11%,76.20%和79.36%;有过性行为的人群占92.71%,最近1年与小姐发生过性关系的人群占36.36%,最近1年与小姐发生性关系时每次均使用安全套的比例占63.50%,最近1次与小姐发生性关系时使用安全套的比例占79.70%;对1070份血清进行HIV和梅毒检测,HIV检出率分别为0.40%(1/247)、0.48%(2/416)、0.25%(1/407),梅毒检出率分别为1.62%(4/247)、0.24%(1/416)、0%(0/407).结论通过艾滋病相关知识的宣传和行为干预,艾滋病相关知识知晓率和接受过艾滋病相关干预服务的比例均有所提高,但最近1次与商业性性伴发生商业性性行为时安全套的使用率在75.33%-85.71%之间,相对于高危人群其安全套的使用率较低,应继续加强此类人群的高危行为干预,推广使用安全套,提高安全套的可及性,降低艾滋病在此类人群中的传播速度.     

Evaluation of outcomes with citalopram for depression using measurement-based care in STAR*D: implications for clinical practice

OBJECTIVE: Selective serotonin reuptake inhibitors (SSRIs) are widely used to treat depression, but the rates, timing, and baseline predictors of remission in "real world" patients are not established. The authors' primary objectives in this study were to evaluate the effectiveness of citalopram, an SSRI, using measurement-based care in actual practice, and to identify predictors of symptom remission in outpatients with major depressive disorder. METHOD: This clinical study included outpatients with major depressive disorder who were treated in 23 psychiatric and 18 primary care "real world" settings. The patients received flexible doses of citalopram prescribed by clinicians for up to 14 weeks. The clinicians were assisted by a clinical research coordinator in the application of measurement-based care, which included the routine measurement of symptoms and side effects at each treatment visit and the use of a treatment manual that described when and how to modify medication doses based on these measures. Remission was defined as an exit score of or=50% in baseline QIDS-SR score. RESULTS: Nearly 80% of the 2,876 outpatients in the analyzed sample had chronic or recurrent major depression; most also had a number of comorbid general medical and psychiatric conditions. The mean exit citalopram dose was 41.8 mg/day. Remission rates were 28% (HAM-D) and 33% (QIDS-SR). The response rate was 47% (QIDS-SR). Patients in primary and psychiatric care settings did not differ in remission or response rates. A substantial portion of participants who achieved either response or remission at study exit did so at or after 8 weeks of treatment. Participants who were Caucasian, female, employed, or had higher levels of education or income had higher HAM-D remission rates; longer index episodes, more concurrent psychiatric disorders (especially anxiety disorders or drug abuse), more general medical disorders, and lower baseline function and quality of life were associated with lower HAM-D remission rates. CONCLUSIONS: The response and remission rates in this highly generalizable sample with substantial axis I and axis III comorbidity closely resemble those seen in 8-week efficacy trials. The systematic use of easily implemented measurement-based care procedures may have assisted in achieving these results.     

Does the clinical outcome of hepatitis C infection vary with the infecting hepatitis C virus type?

Whether differences in the natural history of hepatitis C virus (HCV) can be explained by differences in the infecting HCV type is unknown. The aim of this study was to investigate whether the HCV type might influence the clinical outcome of infection. Study serum samples were assembled from 749 individuals enrolled into the UK HCV National Register from which data on clinical outcomes were extracted. HCV-RNA-positive specimens were genotyped and HCV-RNA-negative specimens serotyped. Logistic regression analysis was used to investigate the independent effect of HCV type on viral clearance by comparing patients who were HCV RNA negative (n = 86) with those who were HCV RNA positive (n = 508). The same method was used to investigate whether HCV type was associated with histological stage of liver disease. The prevalence of HCV type 1 among those who cleared infection was 69% and among those who remained HCV RNA positive was 51%: Type 1 infections were more likely to be HCV RNA negative than non-1 types (OR 0.47, 95% CI 0.29-0.78, P = 0.003). Type 1 infections were also more likely to be associated with histological stage scores above the median when compared with non-1 types (OR 2.03, 95% CI 1.07-3.83, P = 0.03). In conclusion, HCV type 1 infection was more often HCV RNA negative, suggesting that spontaneous clearance may occur more commonly with this type. Among the RNA-positive infections, type 1 infection may be more aggressive than types 2/3.     

胰腺酶原基因在混合型卟啉症模型斑马鱼montalcino中表达模式分析

目的探究胰腺酶原基因在混合型卟啉症模型斑马鱼中的表达特征。方法以原卟啉原氧化酶缺陷的混合型卟啉症斑马鱼和野生型斑马鱼为材料,利用胰腺酶原基因RNA探针进行原位杂交,从而确定胰腺酶原基因在突变体和野生型斑马鱼中的表达差异。结果胰腺酶原基因以及胰腺转录因子ptfla在混合型卟啉症斑马鱼中表达水平明显下调,氯高铁血红素处理后可以明显上调胰腺酶原基因以及胰腺转录因子ptfla在突变体中的表达水平。结论血红素调控胰腺酶原基因在混合型卟啉症斑马鱼中的表达。     

UF-100自动尿分析仪和VITROS 250生化分析仪对胸腹水检查的意义

胸腹水(hydrothorax and ascites)渗出液和漏出液的实验室鉴别方法多为手工操作,人为误差大,重复性差。目前还没有用于测定胸腹水检验的分析仪器。我们试验采用UF-100自动尿分析(UF-100)测定胸腹水白细胞(WBC)、红细胞(RBC)、细菌