动态分析老年重症乙肝患者乙肝病毒全基因组及其表达蛋白抗原性变化

目的 动态分析1例老年重症乙型肝炎患者全基因组序列变化，在全基因组水平上阐述HBV基因组变异对其不同基因生物学特性的影响。方法 一次扩增全长乙型肝炎病毒(hepatitis B virus，HBV)DNA基因组，测序鉴定，建立HBV全基因组克隆、转染表达。结果 通过测序鉴定、同源性比较和真核细胞转染分析，显示HBV基因组序列变异集中在S基因，其表达蛋白前后有抗原性变化。结论 S基因变异可以导致S蛋白抗原性变化，打破宿主体内免疫耐受，诱发重症肝炎的发生。     

Risk genes for schizophrenia: Translational opportunities for drug discovery

Despite intensive research over many years, the treatment of schizophrenia remains a major health issue. Current and emerging treatments for schizophrenia are based upon the classical dopamine and glutamate hypotheses of disease. Existing first and second generation antipsychotic drugs based upon the dopamine hypothesis are limited by their inability to treat all symptom domains and their undesirable side effect profiles. Third generation drugs based upon the glutamate hypothesis of disease are currently under evaluation but are more likely to be used as add on treatments. Hence there is a large unmet clinical need. A major challenge in neuropsychiatric disease research is the relatively limited knowledge of disease mechanisms. However, as our understanding of the genetic causes of the disease evolves, novel strategies for the development of improved therapeutic agents will become apparent. In this review we consider the current status of knowledge of the genetic basis of schizophrenia, including methods for identifying genetic variants associated with the disorder and how they impact on gene function. Although the genetic architecture of schizophrenia is complex, some targets amenable to pharmacological intervention can be discerned. We conclude that many challenges lie ahead but the stratification of patients according to biobehavioural constructs that cross existing disease classifications but with common genetic and neurobiological bases, offer opportunities for new approaches to effective drug discovery.     

变异起源于胃十二指肠动脉的肝动脉及其临床意义

目的:分析和探讨变异起源于胃十二指肠动脉的肝动脉及其临床意义。方法:回顾分析1000例肝癌患者肝动脉的DSA,观察肝动脉的走行、起源和分布情况。并分别统计其变异类型和发生率。结果:正常型肝动脉727例,占72.7%,变异肝动脉273例,占27.3%。273例变异肝动脉中变异起源于胃十二指肠动脉的肝动脉27例,占2.7%。结论:在实施肝癌化疗药物灌注术和化疗栓塞术和肝移植时,分清变异起源于胃十二指肠动脉的肝动脉供血,对于提高手术的成功率和疗效,减少并发症的发生有重要意义。     

Partial determination of the primary structure of a variant surface glycoprotein from Trypanosoma equiperdum. Composition and location of a carbohydrate moiety

Salivarian trypanosomes have the ability to evade the immune response of their hosts by the sequential expression of different cell surface glycoproteins. Among the isolated specific antigens from cloned variants of Trypanosoma equiperdum, a structural study was undertaken on two immunologically cross-reacting variant surface glycoproteins, and results concerning the basic antigenic type are reported. The glycoprotein was cleaved by cyanogen bromide, and amino acids of several purified fractions obtained by gel filtration chromatography of this cleavage mixture were sequenced by automated Edman degradation. Sequencing in particular allowed the identification of the N-terminal portion of the molecule (residues 1–74). Sugar compositions of the fractions have demonstrated the presence of at least two carbohydrate moieties in the glycoprotein. Using a subsequent enzymatic subcleavage we were able to locate the first glycosylation site in position 57. An important observation was that the first oligosaccharide identified was rich in mannose and devoid of galactose.     

Autonomic antecedents to variant angina exacerbation after beta-blockade withdrawal

We describe a patient with nonsignificant coronary artery disease who experienced variant angina after beta -blockade withdrawal. Standard therapy with nifedipine and nitrates aimed at suppressing symptoms and typical transient ST-segment elevations was superseded by the reinstitution of metoprolol. The autonomic alternations before and after readministration of metoprolol were analyzed by time and spectral indices of heart rate variability (HRV). Metoprolol reduced the HRV and reversed the low-frequency/high-frequency power ratio toward a more physiological autonomic balance. We conclude that the reinstitution of beta -blocker acted protectively by preventing surges of sympathetic activity on an underlying basis of parasympathetic predominance.     

不稳定型心绞痛患者冠脉血管内斑块的超声影像特征

目的 观察不稳定型心绞痛（UA）患者冠状血管内超声（IVUS）的影像学特征. 方法 对明确诊断的24例稳定型心绞痛（SA）和33例不稳定型心绞痛（UA）患者行冠状动脉造影（CAG）检查,再对犯罪血管行IVUS检查,观察病变部位的斑块特性、血栓形成、重构（正性、负性）面积. 结果 UA患者病变血管面积、斑块面积及血管重构指数明显大于SA患者（P＜0.05）,软斑块、正性重构更多见于UA患者（P＜0.05）. 结论 UA患者和SA患者冠状动脉斑块成分和结构存在显著差异,UA患者冠状动脉病变中软斑块、斑块破裂、血栓形成和正性重构更常见.     

Exercise-induced ventricular tachycardia associated with J point ST-segment elevation in inferior leads in a patient without apparent heart disease: a variant form of Brugada syndrome?

Exercise-induced monomorphic ventricular tachycardia originating in the right ventricular outflow tract without evidence of structural heart disease can be idiopathic or can be the harbinger of structural abnormalities such as arrhythmogenic right ventricular dysplasia. Recently, the so-called variant Brugada syndrome has been reported in very few cases in the literature and is much less electrophysiologically defined in terms of its clinical significance. We present the case of a 21-year-old man with exercise-induced monomorphic ventricular tachycardia (left bundle-branch block/right axis deviation), without detectable structural heart disease, with evidence of J point and ST-segment elevation in electrocardiogram leads II, III, and aVF after intravenous administration of propafenone. This is followed by a brief discussion on the new concept of “variant Brugada syndrome,” drug-induced electrocardiographic changes, normal-variant repolarization abnormality, and idiopathic right ventricular outflow tract tachycardia.     

氨氯地平治疗变异型心绞痛的系统评价

目的:系统评价氨氯地平治疗变异型心绞痛的临床疗效。方法:计算机检索MEDLINE、EMBASE、中国期刊全文数据库、中国生物医学文献数据库、万方数据库等,使用RevMan4.2软件进行评价。结果:共纳入3篇随机对照试验进行Meta分析,1篇进行描述性分析。结果显示:与地尔硫相比,氨氯地平可降低心血管事件的发生率,与贝尼地平相当,但差异无统计学意义[OR=0.79,95%C(I0.57,1.10),P=0.16];氨氯地平的临床有效率优于消心痛,差异有统计学意义[OR=7.33,95%C(I1.47,36.66),P=0.02];与安慰剂相比,氨氯地平能显著减少心绞痛发作次数。结论:氨氯地平可用于变异型心绞痛的治疗,且可降低变异型心绞痛患者心血管事件的发生率。     

沙美特罗替卡松联合孟鲁司特钠治疗儿童变异性哮喘疗效和安全性分析

目的探讨沙美特罗替卡松联合孟鲁司特钠治疗儿童变异性哮喘（variant asthma,VA）的临床疗效及安全性。方法分析我院自2008年4月～2012年4月收治的变异性哮喘患儿124例,按随机数字表法分为治疗组64例、对照组60例。治疗组给予沙美特罗替卡松和孟鲁司特钠。对照组单用沙美特罗替卡松。两组均以6个月为一个疗程。观察两组肺功能变化、临床总体疗效及安全性问题。结果 （1）治疗前两组肺功能达标率（25.0%、23.3%）,两组比较差异无统计学意义（P〉0.05）。治疗后3个月（67.2%、41.4%）、6个月（79.7%、57.1%）、12个月（87.5%、65.0%）,两组肺功能达标率比较差异有统计学意义（P〈0.05）。（2）治疗组与对照组总有效率分别为95.3%（61/64）、80.0%（48/60）,两组比较差异有统计学意义（χ2=6.828,P〈0.01）。（3）治疗组与对照组复发率分别为4.7%、18.6%,两组比较差异有统计学意义（P〈0.05）。结论沙美特罗替卡松联合孟鲁司特钠治疗儿童变异性哮喘可以增加患者肺功能,提高临床有效率,减少疾病的复发,值得临床推广。