慢性乙型肝炎恩替卡韦治疗过程中病毒动力学特点分析

Objective To analyze the viral dynamics and clinical significance during the antiviral treatment by a mathematical model.Methods Six chronic hepatitis B patients were evaluated with a kinetic model(Neumann model)during dose of 0.5 mg/d oral entecavir.Blood samples were drawn for HBV DNA measurement at week 0,2,4,12,24.Non-linear modeling was used to fit individual patient data.Results The median effectiveness in blocking viral production was 99.970%(n=6).The median half-life of viral turn-over was 1.6 d(n=6).The median half-life of infected hepatocytes was 21.3 d(n=5).Compared with the other patients,the c(virions are cleared at a rate)、ε(effectiveness)、δ(infected cell are lost at a rate)value of one patient(eg.6)were all lower and the half-life of virus and infected cells were higher,and eg.6 developed viral break-through after 38 weeks of follow-up.Conclusions Viral load decay showed a biphasic pattern during entecavir therapy which can be described with a mathematical model.The model relates processes of viral infection and replication as well as drug efficacy to model parameters.It indicates the prediction of bio-mathematical model during antiviral treatment.     

乙型肝炎免疫球蛋白聚氰基丙烯酸正丁酯纳米粒抑制HBsAg、HBV DNA分泌的体外实验

Objective To investigate the inhibitive activities of hepatitis B immunoglobulin(HBIG)poly(butylcynaoacrylate)nanoparticles(HBIG-PBCA-NP)to hepatitis B surface antigen(HBsAg)and hepatitis B virus(HBV)DNA secretions using HBV infected cell model in vitro.Methods HepG 2.2.15 cells were cultured with media containing HBIG-PBCA-NP or HBIG for several days,or cultured with HBIG-PBC-NP and HBIG for 2 days and without HBIG-PBCA-NP and HBIG from day 3.The supernatants at different time points were collected for quantitative detection of HBsAg and HBV DNA.The comparisons between groups were done by variance analysis.Resalts Secretions of HBsAg and HBV DNA in supernatants of HepG2.2.15 cultured with 0.1-10.0 IU/mL of HBIG-PBCA-NP and HBIG were inhibited significantly compared with control group.HBsAg titers and HBV DNA levels in supernatants of HBIG-PBCA-NP group and HBIG group cultured with media without HBIG-PBCA-NP and HBIG kept decreasing at day 5 and 7,then rebounded at day 9 and 11.HBsAg titera in supernatants of 0.1,1.0,5.0 IU/mL HBIG-PBCA-NP group were all significantly different from those in HBIG group at day 9[(31.31±1.98)μg/L vs(40.62±2.99)μg/L,(23.79±1.31)μg/L vs(36.51±2.12)μg/L,(19.91±1.74)μg/L vs(33.03±1.65)μg/L;F=412.24,P＜0.01].Couclusion HBIG-PBCA-NP can inhibit secretions of HgsAg and HBV DNA in vitro,which is more effective than HBIG.     

HBV感染血清标志物、HBV DNA水平与性别的关系

探讨HBV感染者血清标志物、HBVDNA水平和性别之间的关系.选择495例HBsAg阳性的血清标本和502例HBV DNA高于1×108copy/ml以上的血清标本,分别通过ELISA法以及实时荧光定量法进行HBV感染血清标志物HBV DNA的检测.三种组合[组合1为HBsAg( )HBeAg( )抗-HBc( ),组合2为HBsAg( )抗-HBe( )抗-HBc( ),组合3为HBsAg( )抗-HBc( )]的HBV DNA阳性率(分别为95%、18%和53%)存在极显著差异(P＜0.01);女性在HBAg阴性模式中的比例与在HBeAg阳性模式中的比例差异显著(P＜0.05).HBV感染血清标志物、HBV DNA水平和性别之间存在着重要的关系;对于组合3的患者要给予足够重视;女性在高HBV DNA水平而且HBeAg阴性组合中的比例非常小,这也许与女性在肝癌患者中所占比例较低存在着一定的关系.     

改良的端粒DNA检测方法及其在无偿献血中的应用

目的 建立非同位素标记的探针杂交测定外周血白细胞端粒DNA长度的方法，并探讨其在无偿献血中的应用。方法 酚／氯仿提取基因组DNA，限制性内切酶消化，琼脂糖凝胶电泳，非同位素标记的探针Southern印迹杂交，化学发光X线片曝光显示杂交谱带，积分光密度扫描计算TRF值。结果 所测样本获得了较好的低背景杂交谱带，测得35～40岁无偿献血组TRF值平均为11．73kb，相应无献血史对照组平均为11．78kb。结论 建立了非同位素标记的探针检测端粒DNA的方法，用上述方法初步显示了固定的长期无偿献血并未对端粒的长度产生影响。     

随机引物PCR法分型大肠艾希菌及其在判断医院感染中的应用

目的对大肠艾希菌(艾希菌)进行随机引物PCR(AP—PCR)法基因分型并应用于医院感染的判断。方法以优化的随机引物、反应体系和扩增条件对临床分离的161株艾希菌进行AP—PCR法基因分型并按指纹图上DNA条带数及片段大小绘制基因分型图谱，同时对艾希菌的医院内感染进行了观察与分析。结果161株艾希菌共得AP—PCR型120种；艾希菌的医院内感染确实存在。结论AP—PCR法可对艾希菌有效分型并可用于艾希菌医院内感染的判断。     

肥厚性心肌病患者心脏β－肌凝蛋白重链基因点突变的研究

应用聚合酶链式反应（ＰＣＲ）与ＤＮＡ单链构象多态（ＳＳＣＰ）技术，分析３２例肥厚性心肌病患者心脏β－肌凝蛋白重链（β－ＭＨＣ）基因第１３、１６、２０和２３外显子区域，发现１例患者第１３外显子ＰＣＲ产物的单链电泳带与正常对照有明显的差异；对其核苷酸顺序分析表明，该患者β－ＭＨＣ基因第３８３密码子位置发生Ｇ→Ｔ颠换，导致赖氨酸（Ｌｙｓ）变成天冬酰胺（Ａｓｎ）。由于此突变发生在β－ＭＨＣ基因种系进化中高度保守的区域，故提示其突变是引起患者发生心肌肥厚的主要病因。家系调查显示，该患者父母、姐姐、妹妹及女儿心脏超声及ＰＣＲ－ＳＳＣＰ检查均未见异常。在β－ＭＨＣ基因第３８３密码子区域合成一对正常及发生Ｇ→Ｔ突变的等位基因特异性寡核苷酸探针，分别与患者、其家系成员及对照个体相应区域的ＰＣＲ产物进行杂交，结果显示仅患者的ＰＣＲ产物能与突变探针杂交，说明此患者的点突变为发生在胚细胞水平的新生突变，患者的肥厚性心肌病为散发性。这是在中国人群中发现心脏β－ＭＨＣ基因突变的首例报道，亦是一种新的β－ＭＨＣ基因突变类型     

HBV转基因小鼠暴露ATB-1后肝脏ATB-1-DNA加成物水平的测定

目的探讨ＨＢＶ与ＡＴＢ１协同致肝癌的机理．方法用ＲＩＡ法测定ＨＢＶ转基因小鼠与正常小鼠暴露ＡＴＢ１后０，０５，１，２，４，８，２４ｈ７个不同时相肝脏ＡＴＢ１ＤＮＡ加成物的含量变化．结果暴露ＡＴＢ１后，ＨＢＶ转基因小鼠肝脏ＡＴＢ１ＤＮＡ加成物含量在各时相均高于正常小鼠，尤以１ｈ高峰时相值（５５９２ｐｍｏｌ／ｍｇ±４１５ｐｍｏｌ／ｍｇ比４１３６ｐｍｏｌ／ｍｇ±２８２ｐｍｏｌ／ｍｇＤＮＡ，Ｐ＜００１）及２４ｈ时相值（２４８７±２０３比９８９±８５，Ｐ＜００１）最显著．２４ｈ后，转基因小鼠肝脏ＡＴＢ１ＤＮＡ加成物仍维持高水平，但正常小鼠已基本恢复至暴露前水平．结论ＨＢＶ转基因小鼠暴露ＡＴＢ１后肝脏ＡＴＢ１ＤＮＡ加成物含量增加可能为ＨＢＶ与ＡＴＢ１协同致肝癌的直接原因．     

狼疮脑病自身抗体谱研究进展

系统性红斑狼疮（systemic lupus erythematosus．SLE）是一种以B细胞和T细胞功能障碍、细胞因子失调以及免疫复合物沉积，并引起多系统症状等为特点的自身免疫性疾病。SLE的主要标志物包括抗双链DNA（dsDNA）抗体、抗核抗体（ANA）、抗核糖体蛋白抗体和抗细胞表面抗原抗体等多种自身抗体。其中一些特定的抗体与狼疮特殊临床症状密切相关，如抗dsDNA抗体与狼疮。     

HBV感染者血清中HBVcccDNA、HBeAg及HBV DNA的关系

探讨HBV感染者血清HBVcccDNA与血清HBV DNA及HBeAg的关系。分别以PER分子信标技术和ELISA方法对非HBV相关肝炎、HBV健康携带者、急性乙型肝炎（AHB）、慢性乙型肝炎（CHB）、乙肝肝硬化、乙肝患者血清中HBVcccDNA HBV DNA含量及HBeAg进行了检测。HBVcccDNA仅见于HBV DNA阳性血清中；HBeAg阳性组的HBVcccDNA阳性率显著高于HBeAg阴性组（P〈0．05）；145例HBV DNA阳性患者中，HBVcccDNA阳性组HBVD—NA水平显著高于HBVcccDNA阴性组（P〈0．01）。血清HBVcccDNA可能是乙肝病毒在患者体内大量复制的血清标志。