江苏省农村地区自然人群戊型肝炎感染状况的研究

目的:了解江苏省农村地区戊型肝炎病毒(HEV)感染的特征及相关影响因素.方法:在江苏省部分农村地区,以整群抽样的方式进行戊型肝炎感染的血清学横断面调查以及1年的随访性研究,并对分离到的毒株进行基因分型,同时调查感染的相关影响因素.结果:横断面调查的4 139例自然人群中,抗-HEV-IgG阳性率为52.0%,男性阳性率显著高于女性,各年龄组阳性率随年龄升高而增加.经1年的随访,抗.HEV-IgG年阳转率为11.6%,20岁以上年龄组的阳转率显著高于20岁以下年龄组;抗-HEV-IgG年阴转率为5.8%,0～9岁以下年龄组的阴转率显著高于10岁以上年龄组.从亚临床感染者分离到的5份HEV毒株中.基因Ⅰ型3株、基因Ⅵ型2株.相关影响因素分析显示,男性、年龄增加和接触生猪是感染的危险因素.结论:江苏省农村地区的HEV感染程度较高,亚临床感染的HEV基因分型为Ⅰ型和Ⅳ型;除性别、年龄外,接触生猪是感染的重要影响因素.     

乙型肝炎病毒B和C基因型与干扰素a-2b治疗48周效应关系的研究

目的探讨乙型肝炎病毒B和C基因型的慢性肝炎与干扰素a-2b治疗48周的疗效的关系.方法选择HbeAg阳性的慢性乙型肝炎患者46例,用PCR核酸杂交和酶联显色技术进行HBV基因分型,观察干扰素a-2b治疗48周后的疗效.结果慢性乙肝B基因型患者的综合应答率(41.6%)显著高于C基因型患者(24.1%)(P＜0.01).结论慢性乙肝B基因型对干扰素a-2b的疗效明显优于C基因型,乙型肝炎病毒基因型分析用于干扰素治疗前的疗效预测具有一定的临床现实意义.     

Relationship between matrix metalloproteinase-9 polymorphism and acute coronary syndrome

Objective： To investigate the relationship of matrix metalloproteinase-9 polymorphism to acute coronary syndrome and its affect on the severity of coronary artery disease. Methods： By means of polymerase chain reaction （PCR） and restriction fragment length polymorphism, genotypes of 245 patients with acute coronary syndrome（ACS） and 205 healthy subjects were tested. Genotypes displaying C-1562T functional promoter polymorphism （of the MMP-9 gene） were determined. The relationship between the polymorphism of the MMP-9 gene and ACS and the severity of coronary vessels diseased was analyzed. Results： The frequency of C/T plus T/T genotypes and T allele in patients with ACS was significantly higher than that in healthy subjects （22.1% vs 12.7% and 11.4% vs 6.6% respectively）. But they were not associated with the number of coronary arteries diseased. Conclusion： The MMP-9 polymorphism may be susceptible to ACS. But there was not significant difference between the AMI and UAP subgroups.     

Association of Primary Biliary Cirrhosis with Vitamin D Receptor BsmI Genotype Polymorphism in a Hungarian Population

We sought to determine the distribution of vitamin D receptor genotypes defined by the BsmI polymorphism and to investigate their association with bone mineral density in patients with primary biliary cirrhosis. Vitamin D receptor genotype and bone mineral density at the lumbar spine was determined in 31 female Hungarian patients with primary biliary cirrhosis and 51 age-matched healthy female controls. The genotype frequency (BB: 45%, Bb: 32%, bb: 22%) of the patients was significantly different from the control group (P = 0.01) due to an overrepresentation of the BB genotype. There was an apparent trend, not reaching statistical significance, for a lower bone mineral density in both the patient and control groups carrying a B allele. In conclusion, we found a strikingly high frequency of the BB genotype in patients with primary biliary cirrhosis, which raises questions about hormonal influences on the development of primary biliary cirrhosis.     

Sequential therapy with entecavir and PEG‐INF in patients affected by chronic hepatitis B and high levels of HBV‐DNA with non‐D genotypes

Complete eradication of hepatitis B virus (HBV) is rarely achieved. Treatment options include currently available nucleos(t)ide analogues and pegylated interferon. The aim of our exploratory study was to assess the effectiveness of sequential therapy for chronic hepatitis B (CHB) vs the current standard of care. We evaluated an association with entecavir and pegylated interferon alfa‐2a (PEG‐IFN) in 20 patients with hepatitis B, high HBV viremia and genotypes A, B, C and E. Patients received entecavir alone for 12 weeks, then entecavir and PEG‐IFN for 12 weeks, lastly PEG‐IFN alone for 36 weeks. The results were compared with 20 patients (control group) treated in the past with 48 weeks of PEG‐IFN monotherapy. Our results show that complete sustained virological response (SVR) and partial SVR were, respectively, 60% and 80% in the study group and 10% and 30% in the control group; anti‐HBe seroconversion rate were 76.9% vs 15%, and anti‐HBs seroconversion were 20% vs 0%, respectively. We found a correlation among different genotypes and virological and serological outcomes – genotype C has a better virological response, while genotype A had a better serological response, and E genotype had a poor response. These results show that a sequential approach is a promising strategy of treatment in patients with CHB and high viremia in comparison with PEG‐IFN monotherapy. The E genotype seems to have the worse rate of response and requires other treatment strategies.     

红霉素耐药葡萄球菌中erm和msrA基因检测

目的检测临床分离的葡萄球菌（金黄色葡萄球菌和表皮葡萄球菌）对红霉素耐药的基因型别。方法在299株红霉素耐药葡萄球菌（金葡菌158株,表葡菌141株）中,聚合酶链反应（PCR）检测耐药基因ermA、ermB、ermC和msrA。结果158株红霉素耐药金葡菌中,ermA、ermB、ermC、msrA基因的阳性率分别为3．2％、7．0％、39．9％、7．0％;141株红霉素耐药表葡菌中,ermA、ermB、ermC、msrA基因的阳性率分别为2．8％、2．1％、55．3％、14．2％;少数菌株同时存在两种耐药基因。结论本地区葡萄球菌对红霉素的耐药基因主要是ermC。     

Association between Helicobacter pylori genotypes and gastric disorders in relation to the cag pathogenicity island

Helicobacter pylori is a bacterium associated with upper gastrointestinal diseases in humans. However, only a small proportion of infected people become sick. Although several studies have tried to establish an association between known virulence markers and clinical outcomes, in many cases the results have been conflicting. The aim of this study was to investigate the importance of virulence markers to predict clinical outcome in Brazil. Mixed infections by genetically unrelated strains detected by vacA genotyping were found in 18% of the patients. The cagA and cagE genes and the vacAs1 genotype were associated with the development of peptic ulcer disease (PUD). The cagAvacAs1m1 genotype was associated with PUD and duodenal ulcer (DU). Conversely, jhp947 was not associated with DU or PUD, indicating that this gene is not a universal virulence marker. These results also show that a high proportion of the patients were simultaneously infected by cag-positive and cag-negative H. pylori types. This finding suggests the existence of a dynamic equilibrium between the loss and gain of the cag pathogenicity island, probably depending on the physiologic conditions of the patient's stomach. To the best of our knowledge, this is the first study that has documented this finding in Brazil.     

Valuable antibody detection method for classifying hepatitis E virus genotypes

Nucleotide‐based methods are conventionally used to classify the hepatitis E virus (HEV) genotypes. A serological enzyme immunoassay (EIA) using open reading frame 3 (ORF3) C‐terminal peptides was developed to conveniently and accurately classify and evaluate the genotypes of HEV. The sera of mice immunized with HEV genotype 1, 3, and 4 reacted highly specifically to the peptides of the corresponding genotypes. Most (84.2%) clinical sera infected with HEV genotype 4 were positive for anti‐HEV antibodies when tested with the ORF3 peptides of genotype 4, but were negative for genotypes 1 and 3. Monkey and clinical serial sera infected with HEV reacted strongly to the homologous genotype ORF3 peptides. The indirect EIAs were more sensitive, with stronger reactivity, than commercial anti‐HEV immunoglobulin G assays when serial sera from monkeys infected with HEV genotype 1 or 4 were tested. All our results indicate that the serological typing EIA assays described in this study are more effective and convenient for the classification of HEV genotypes than molecular approaches, and can be used to screen large numbers of serum samples and differentiate genotypes for the diagnosis of HEV infections.