静脉毒瘾者84例HGV感染状况

目的调查庚型肝炎病毒（ＨＧＶ）在静脉毒瘾者中的感染状况。方法采用逆转录聚合酶链反应（ＲＴ－ＰＣＲ）检测８４例静脉毒瘾者血浆标本。ＨＧＶＲＮＡ经热变性法提取后逆转录为ｃＤＮＡ，在ＨＧＶ５′非编码区（５′ＮＣＲ）设计两对引物进行巢式扩增，产物为２３８ｂｐ，并经限制性内切酶ＨｐａⅡ鉴定扩增产物来自ＨＧＶ。结果８４例中有１５例为ＨＧＶＲＮＡ阳性，阳性率为１７．９％。ＨＧＶＲＮＡ阳性病例中１１例合并丙型肝炎病毒感染（１１／１５）。结论静脉毒瘾者是ＨＧＶ感染的高危人群；不洁注射是获得ＨＧＶ感染的重要途径。     

B超引导下经皮肺穿刺针吸活检对周围型肺肿块的诊断价值

目的探讨Ｂ超引导下经皮肺穿刺针吸活检对周围型肺肿块的诊断价值。方法对３１例患者施行Ｂ超引导肺穿刺针吸活检５６次，进行细胞学和细菌学检查。结果穿刺取材成功率为９３．６％，所获细胞学资料与手术病理诊断或临床治疗随访对照，定性诊断符合率为８９．７％。结论该诊断方法简便实用，并发症轻微，适于临床推广应用。     

Infectious meningitis with atypical cerebrospinal fluid cells

Cytologic evaluation of the CSF is often difficult when trying to distinguish between truly neoplastic and reactive cells. Several non-neoplastic conditions may be associated with atypical cells in the CSF, a fact the clinician has to consider to avoid inadequate aggressive theraphies. We report here three patients with infectious meningitis (due to Herpes zoster virus in two, and neuroborreliosis in one) and cytologically atypical cerebrospinal fluid lymphocytes. Further characterization showed that the pleocyrosis in these patients was of reactive origin. Cytomorphology is frequently insufficient and histochemical, immuncytochemical and cellular genome analysis techniques may help differentiate atypical reactive cells from neoplastic cells.     

Mass Protection Program of Perinatal Hepatitis B Virus Infection in Japan and Impact of an Optional Booster Vaccination on Its Efficacy

We assessed the efficacy of a government-sponsored mass protection program in Osaka, Japan, for perinatal HBV infection in infants born to HBeAg positive HBV carrier mothers. We also evaluated the impact of optional follow-up procedures in such infants, including an evaluation of anti-HBs response and a booster dose of HBV vaccine for poor responders. The results demonstrated that this mass protection program protected 94.4% of the infants from perinatal HBV infection in the Osaka area. However, the proportion of infants with an unprotective level of anti-HBs was higher in the standard group than in the follow-up group both at 1.0 and 1.5 years of age, which was also the case for HBV events. Furthermore, the present study showed that a booster dose of vaccine in poor responders was very effective in promoting an anti-HBs response. In conclusion, we recommend that a follow-up blood test to confirm a response of anti-HBs to HBV vaccine should be performed at 4–8 weeks after the third injection of HBV vaccine in infants born to HBeAg positive HBV carrier mothers. We also recommend that a booster injection of HBV vaccine should be immediately given to poor responding infants who otherwise are at a considerable risk of developing HBV infection in late infancy.     

Non-A,Non-B hepatitis; Factors involved in progression to chronicity

A cross-sectional, longitudinal study was undertaken on a group of acute non-A, non-B hepatitis patients, as well as on a control group of hepatitis B patients, in order to assess both the prevalence of the most important factors favoring infection, and the relevance of these factors in promoting evolution towards chronic liver disease. Exposures to unknown risk factors were present in 47.4% of acute non-A, non-B infections, followed by blood transfusions (17.9%), sporadic exposures (17.9%) and drug addiction (16.6%). Unknown as well as sporadic exposures showed a greater prevalence in control population if compared to non-A, non-B cases, while drug addiction was equally represented in the two groups, and blood transfusion nearly absent from control group. The risk of evolution to chronic liver disease was about 13 times greater in non-A, non-B group than in controls, with the greatest risk for drug addicts and the lowest for patients with unknown exposures. Among patients with known exposures, the lowest risk of chronic hepatitis was observed in post-transfusion and in sporadic cases, while the greatest was observed in drug addicts.Corresponding author.     

Wortmannin-mediated inhibition of phosphatidylinositol 3-kinase activity triggers apoptosis in normal and neoplastic B lymphocytes which are in cell cycle

The B cell functional response following ligation of surface(s) lgM is dependent upon the differentiation stage of the populationstudied: cross-linking slgM promotes proliferation of restingtonsillar follicular mantle (FM) B lymphocytes but induces apoptosisin the susceptible Epstein- Barr virus genome-negative Burkittlymphoma (BL) cell line Ramos (Ramos-BL). This study investigateswhether phosphatidylinositol-3-kinase (Pl3-kinase), which hasbeen reported to be intimately involved in the regulation ofcellular growth, plays a role in the regulation of these sig-promoted B cell responses, and uses the selective and irreversibleinhibitor of Pl3-kinase activity, wortmannin (Wm). In Ramos-BLB cells, at 8 h post-treatment, Wm triggers a transient increasein apoptosis of 16 ± 6.9% with a concomitant cellularloss of 16 ± 6.1% from the G₁ phase of cell cycle; [³H]thymidineincorporation also decreases by 33 ± 5.0%, from 37,274c.p.m. ± 10% to 25,127 c.p.m. ± 4.0%. Moreover,at 72 h culture, Wm inhibits anti-lgM-induced FM B lymphocytelevels of [³H]thymidine incorporation typically by 47% and triggers80% apoptosis from the G₀G₁ phase of cell cycle. Ramos-BL Bcells exhibit high basal levels of Pl3-kinase activity, as determinedby immunoprecipitation with antibody to the p85 regulatory subunitof Pl3-kinase and ³²P incorporation into phosphatidylinositol,which is not significantly affected by anti-lgM stimulation;by contrast, anti-lgM stimulates significant Pl3-kinase activityover negligible basal levels in FM B lymphocytes. Pre-treatmentwith Wm inhibits Pl3-kinase activity in both cell types. Takentogether these data indicate that in Ramos-BL B cells slgM-triggeredgrowth arrest and apoptosis is Pl3- kinase independent, whereasPl3-kinase activity is critical for slgM-triggered mitogenesisof FM B lymphocytes. Thus Pl3-kinase plays a pivotal role inthe regulation of both normal and neoplastic B lymphocyte progressionthrough the cell cycle, such that if this Pl3-kinase-dependentpathway is inhibited these cells default to apoptosis.     

丙型肝炎病毒H株包膜蛋白在昆虫细胞中的表达及意义

目的　获得丙型肝炎病毒 (HCV) H株包膜糖蛋白的重组杆状病毒 ,在昆虫细胞中稳定表达包膜糖蛋白 E1和 E2 ,并初步应用于丙型肝炎患者血清抗体的检测。方法　用 PCR方法自 HCV H株扩增出包膜蛋白 E基因 ,构建重组杆状病毒 ,并在昆虫细胞中稳定表达包膜糖蛋白 E1和 E2。免疫荧光及 Western blot方法鉴定表达产物。用表达的 E1和 E2蛋白与 35例丙型肝炎患者血清反应。结果　昆虫细胞中表达的 E蛋白呈现 3种分子大小 ,E1的相对分子量为 2 1× 10 3和 33× 10 3 ,E2的相对分子量为 6 0× 10 3。在 35份感染者血清中 ,有 4例 E1抗体阳性 ,其中 1例检出 E2抗体。在 9例 PCR检测 HCV RNA阳性而抗 HCV检测阴性的血清中 ,有 3例血清与表达的 E蛋白反应。结论　 HCV E蛋白基因可在昆虫细胞中稳定表达 ,表达的 E1和 E2蛋白可用于 HCV患者的血清学诊断     

单克隆IgH基因重排检测在B-NHL诊断和随访中的意义

目的　评价单克隆IgH基因重排检测在恶性淋巴瘤 (B NHL)临床中的应用价值。方法　用半巢式PCR检测单克隆IgH基因重排。病例组为B NHL ,包括 6 9例石蜡包埋组织切片、治疗前 16例骨髓和 2 9例外周血、阳性者治疗后复查骨髓和外周血 ;对照组为 10例慢性淋巴结炎、3例T NHL和 2例HD。结果　对照组均阴性。病例组 :切片中单克隆IgH基因重排阳性率为 6 3.8% (44 / 6 9) ;骨髓和外周血阳性率分别为 43 .8%(7/ 16 )和 41.4% (12 / 2 9) ,细胞形态学检查未见异常细胞者阳性率分别为 33 .3% (3/ 9)和 31.3% (5 / 16 )。 16例同时采集骨髓和外周血者 ,阳性率分别为 43 .8% (7/ 16 )和 37.5 % (6 / 16 ) ,两者无统计学差异。治疗前单克隆IgH重排阳性者 ,6例完全缓解 (CR)后转阴 ,处于持续缓解状态 ,1例临床缓解后 13个月仍阳性 ,现在继续随访中 ,另 1例CR后持续阳性者 ,6个月后复发。结论　切片、骨髓和外周血中检测单克隆IgH基因重排可以作为B NHL诊断和随访微小残留病灶的辅助手段     

体外循环对TXB2／6—keto—PGF1α的影响

对１３例体外循环病人进行了观察，发现体外循环后ＴＸＢ２／６－ｋｅｔｏ－ＰＧＦ１α显著增高，表明体外循环使血小板受损，而血小板受损是体外循环后失血的主要原因之一。     

腺病毒介导的HSV—tk基因治疗大鼠脑胶质瘤实验研究

目的：带有ＨＳＶ－ｔｋ基因的重组腺病毒（ＡｄＨＣＭＶ－ｔｋ）结合核苷类似物（ＮＡ）治疗大鼠Ｃ６脑胶质瘤。方法：用Ｘ－ｇａｌ染色测定ＡｄＨＣＭＶ－ｌａｃＺ转染大鼠Ｃ６胶质瘤细胞的效率。用ＡｄＨＣＭＶ－ｔｋ／ＡＣＶ、ＧＣＶ离体及活体治疗大鼠Ｃ６胶质瘤。结果：ＡｄＨＣＭＶ－ｌａｃＺ感染Ｃ６细胞效率达１００％，ＡｄＨＣＭＶ－ｔｋ感染Ｃ６细胞，在病毒感染复数为１０００时，ＧＣＶ和ＡＣＶ半致死剂量分别为３μｇ／ｍｌ和２０μｇ／ｍｌ，Ａｄ－ＨＣＭＶ－ｔｋ／ＡＣＶ治疗大鼠Ｃ６胶质瘤模型，大鼠生存期超过９０天，而对照组分别为１７．０±１．６天（生理盐水组）、１４．５±１．３天（ＡｄＨＣＭＶ－ｌａｃＺ组），Ｐ＜０．００１。结论：重组腺病毒对靶细胞感染效率可达１００％，ＡｄＨＣＭＶ－ｔｋ用ＧＣＶ的杀伤Ｃ６胶质瘤细胞比ＡＣＶ强，而ＨＳＶ－ｔｋ／ＡＣＶ用腺病毒介导治疗大鼠脑肿瘤疗效显著。