针刺配合神阙隔盐灸治疗精神分裂症疗效观察

目的观察针刺配合神阙隔盐灸治疗精神分裂症的临床疗效。方法将44例符合纳入标准的精神分裂症患者随机分为治疗组23例和对照组21例。对照组采用药物治疗,治疗组在对照组治疗基础上加用针刺配合神阙隔盐灸治疗。观察两组治疗前后大体社会功能量表(GAF)评分和个体和社会功能量表(PSP)评分,比较两组临床疗效。结果治疗组总有效率为91.3%,对照组为61.9%。两组临床疗效比较,差异有统计学意义(P0.05)。两组治疗后GAF评分及PSP评分与同组治疗前比较,差异均有统计学意义(P0.01)。治疗组治疗前后GAF评分及PSP评分差值与对照组比较,差异均有统计学意义(P0.05)。结论针刺配合神阙隔盐灸是一种治疗精神分裂症的有效方法,能明显改善患者的症状。     

穴位电刺激治疗脑出血术后尿失禁临床研究

目的 评价穴位电刺激治疗脑出血术后尿失禁的疗效.方法 将符合入选标准的80例脑出血术后尿失禁患者按随机数字表法分为2组,每组40例.治疗组采用穴位电刺激治疗,对照组口服盐酸奥昔布宁缓释片治疗.2组均治疗3周.观察患者排尿日志指标和膀胱容量指标的变化情况.结果 治疗后,治疗组与对照组综合疗效总有效率分别为87.2%(34/39)、65.8%(25/38),2组比较差异有统计学意义(χ2=4.916,P=0.027).治疗组排尿次数[(10.15±2.21)次/24 h比(18.63±3.42)次/24 h,t=12.956]、尿失禁次数[(2.18±1.04)次/24 h比(6.19±2.16)次/24 h,t=10.421]少于对照组(P<0.01),平均单次尿量[(293.38±16.32)ml比(180.82±15.43)ml,t=31.083]、膀胱初感容量[(276.73±20.95)ml比(186.43±21.14)ml,t=18.825]、膀胱最大容量[(492.81±23.72)ml比(293.81±24.46)ml,t=36.244])高于对照组(P<0.01),残余尿量[(13.25±5.83)ml比(34.63±6.25)ml,t=15.527]少于对照组(P<0.01).结论 穴位电刺激可有效改善脑出血术后尿失禁患者的尿失禁症状.     

A sensitive method to detect the hepatitis B virus mutations by using solid phase PCR on oligonucleotide array

A sensitive method based on solid phase PCR on oligonucleotide array was established to detect two point mutations 1896G-A and 1901G-A in hepatitis B virus (HBV) DNA, in which 6 probes including these two point mutations were immobilized on modified glass slides through 5' terminal linker, while the 3' terminal was made to be free. The mutated loci were designed to locate on the last nucleotides of 3' terminal respectively, and the positive control probes lacked the last nucleotide of 3' terminal in comparison with the probes used for detection. Probes fixed on oligonucleotide array were also the solid phase amplification primers. One pair of liquid primers was used to amplify the short template product from whole HBV DNA. Using target DNA as template, the solid primers were extended under the action of Taq DNA polymerase and incorporated with Cy-3dCTP as marker. During the thermal cycling reaction, probes served as solid phase amplification primers and amplification products bound to the oligonucleotide array, which could be visualized by incorporation with fluorescent dyes. After amplification, the oligonucleotide array was washed, performed with laser scanning, and then used for quantitative analysis to obtain the information for mutations. The hybridization results were compared with DNA sequencing. It was demonstrated that in case of sample A, the ratios of fluorescence intensities in wide type and in the mutated types of 1896G-A and 1901G-A mutations in HBV were 3.81:1 and 1:3.79 respectively, while, in case of sample B, those were 1:2.89 and 1:3.03 respectively, indicating the presence of point mutations in these two loci. These results correlated to those obtained from DNA sequencing analysis in which the fluorescence intensity ratios in wide type and in the mutated types of 1996G-A and 1901D-A mutations in HBV were 1.26:1 and 1.67:1 respectively. From the above observations, it is evident that the method using solid phase PCR based on oligonucleotide array appears to be a sensitive and promising way to detect mutations with low-density.     

Alport综合征基因点突变后蛋白结构的改变及与表型的关系

目的 分析COL4A5基因不同点突变后的蛋白结构,探讨基因突变对编码蛋白二级结构的影响及与表型的关系。方法 以临床确诊的2例X连锁遗传型Alport综合征患者为研究对象,他们的基因突变类型均为点突变导致的甘氨酸替代:患者1,其家系为症状较重的青少年型,基因检测确定为COL4A5中的g.3246G>T导致p.G1015V;患者2,其家系为症状较轻的成年型,基因检测确定为COL4A5中的g.3290G>A导致p.G1030S。应用E.coli分别表达患者α5(Ⅳ)链的含有突变位点的结构域及对照α5(Ⅳ)链的同一结构域,圆二色谱检测并比较它们二级结构的差异。结果 与对照相比,患者1重组蛋白的圆二色谱最低峰所在的波长由200 nm,变为近220 nm处,而且峰度降低。患者2重组蛋白的检测结果与对照相比改变较轻微,最低峰所在的波长不变,但峰度增加。二级结构分析显示,来自对照的重组蛋白主要以β折叠和无规卷曲为主,无α螺旋结构。与对照蛋白相比,来自患者1的重组蛋白中出现了约占八分之一的α螺旋结构;来自患者2的重组蛋白仍然以β折叠和无规卷曲为主,但是β折叠的比例下降而无规卷曲增多。结论位于α5(Ⅳ)链同一结构域的两个不同位置的甘氨酸被不同的氨基酸替代,它们的临床表型截然不同,α5(Ⅳ)链的二级结构也存在显著差异。而且,二级结构的改变程度与相应     

High rate of A2142G point mutation associated with clarithromycin resistance among Iranian Helicobacter pylori clinical isolates

This study aimed to investigate the clarithromycin resistance and its associated molecular mechanisms among Helicobacter pylori isolates from dyspeptic patients in Shiraz, Iran. From January to May 2014, 100 H. pylori strains were isolated from patients with gastroduodenal disorders. The resistance to clarithromycin was quantitatively evaluated, using Epsilometer (E‐test) method. Polymerase chain reaction‐restriction fragment length polymorphism (PCR‐RFLP) was performed on all the isolates to detect A2143G and A2142G mutations in 23S rRNA gene. The H. pylori isolation rate was found to be 31.4%. E‐test showed that 20% of isolates were resistant to clarithromycin (MIC ≥ 1 mg/L). MIC of clarithromycin ranged between 0.016 and 24 mg/L. Findings of PCR‐RFLP showed that the A2142G was the most (90%) frequently point mutation, followed by the A2143G (10%). No statistically significant difference was found between H. pylori clarithromycin resistance point mutations and patients’ gender or age. To the best of our knowledge, this is the first report of high frequency of A2142G point mutation in Iran and probably in other regions of the world. Considering the increasing trend of H. pylori resistance to clarithromycin due to these mutations, it is crucial to investigate the new therapeutic approaches against H. pylori infection.     

焦磷酸测序检测铜绿假单胞菌的SHV基因点突变

目的:通过焦磷酸测序技术检测产超广谱β-内酰胺酶(ESBLs)铜绿假单胞菌的SHV基因点突变,探讨一种快速、准确的ESBLs基因分型方法。方法:双纸片法确定产ESBLs的铜绿假单胞菌,纸片扩散法(K-B法)进行药敏试验,聚合酶链反应(PCR)法扩增ESBLs的SHV基因片段,用焦磷酸测序法检测16株产ESBLs铜绿假单胞菌的SHV基因35位和43位密码子点突变。结果:焦磷酸测序发现,本地区分离出的16株产ESBLs铜绿假单胞菌有10株扩增出SHV基因片段,且在43位密码子基因没有突变,35位密码子有基因突变,核苷酸由T突变为A,亮氨酸变为谷氨酰胺,突变发生率达到70%(7/10)。16株产ESBLs的菌株对亚胺培南全部敏感。结论:焦磷酸测序技术可快速检测产ESBLs铜绿假单胞菌的SHV基因点突变,具有准确、快速、实时和高通量等优点,可应用于产ESBLs菌株的ESBLs基因分型。     

The diagnostic accuracy of rapid diagnostic tests for Ebola virus disease: a systematic review

BackgroundEbola virus disease (EVD) is a dangerous condition that can cause an epidemic. Several rapid diagnostic tests (RDTs) have been developed to diagnose EVD. These RDTs promise to be quicker and easier to use than the current reference standard diagnostic test, PCR.ObjectivesTo assess the diagnostic accuracy of RDTs for EVD.MethodsA systematic review of diagnostic accuracy studies.Data sourcesThe following bibliographic databases were searched from inception to present: MEDLINE (Ovid), Embase, Global Health, Cochrane Central Register of Controlled Trials, WHO Global Index Medicus database, Web of Science, PROSPERO register of Systematic Reviews, and Clinical Trials.Gov.Study eligibility criteriaDiagnostic accuracy studies.ParticipantsPatients presenting to the Ebola treatment units with symptoms of EVD.InterventionsRDTs; reference standard, RT-PCR.Assessment of risk of biasQuality Assessment of Diagnostic Accuracy Studies-2 tool.Methods of data synthesisSummary estimates of diagnostic accuracy study were produced for each device type. Subgroup analyses were performed for RDT type and specimen material. A sensitivity analysis was performed to assess the effect of trial design and bias.ResultsWe included 15 diagnostic accuracy studies. The summary estimate of sensitivity for lateral flow assays was 86.1% (95% CI, 86–86.2%), with specificity of 97% (95% CI, 96.1–97.9%). The summary estimate for rapid PCR devices was sensitivity of 96.2% (95% CI, 95.3–97.9%), with a specificity of 96.8% (95% CI, 95.3–97.9%). Pre-specified subgroup analyses demonstrated that RDTs were effective on a range of specimen material. Overall, the risk of bias throughout the included studies was low, but it was high in patient selection and uncertain in the flow and timing domains.ConclusionsRDTs possess both high sensitivity and specificity compared with RT-PCR among symptomatic patients presenting to the Ebola treatment units. Our findings support the use of RDTs as a ‘rule in’ test to expedite treatment and vaccination.     

基于片段长度差异应用HPLC快速检测β-地中海贫血

目的 通过高效液相色谱检测β-地中海贫血常见的基因型.方法 通过多重引物延伸反应同时扩增β-地中海贫血常见的突变位点,基于长度区分不同位点野生型引物和突变型引物扩增产物,并将待检品与标准品检测结果 进行对比,以辨别待检样本的基因型.结果 建立了稳定的高效液相色谱检测点突变技术平台,实现了对β-地中海贫血常见基因型的快速检测,通过对质粒样本、临床病例样本的验证,完全符合质粒样本测序、患者基因组检测的结果.结论 高效液相色谱检测β-地中海贫血具有快速、简便、样品量少等优点,其为遗传病点突变提供了新的检测手段.     

高分辨率熔解曲线分析技术检测苯丙酮尿症患者的苯丙氨酸羟化酶基因突变

目的 应用高分辨率熔解曲线（HRM）分析技术检测苯丙酮尿症患者苯丙氨酸羟化酶基因突变.方法 利用PCR扩增13例苯丙酮尿症（PKU）患者的苯丙氨酸羟化酶（PAH）基因第6、7、11及12外显子,然后对PCR产物进行HRM分析,通过DNA测序对HRM结果进行验证.结果 在13例PKU患者的26个PAH等位基因中共检测出5种不同突变基因,总检出率为38.5％.常见的突变类型是R243Q和A434D.检测出两种多态性位点为Q232Q和V245V.HRM分析结果与测序结果完全一致.结论 HRM技术具有简单、快速、易操作、准确等优点,可用于PKU患者PAH基因突变筛查.     

Point-of-care measured serum cholinesterase activity predicts patient outcome following severe burns

Risk stratification is of utmost importance in burn therapy. However, suitable bedside biomarkers to evaluate the emerging inflammatory response following burn injuries are missing. Serum cholinesterase (butyrylcholinesterase, BChE) has been shown to be a clinically relevant biomarker in acute inflammatory diseases including burns.In this observational cohort study BChE activity was measured by using point-of-care testing (POCT), a novel method in acute burn care. POCT measurements were performed at emergency room admission (ERA) of 35 patients and repeated 12, 24 and 48 h later. All patients or their legal designees gave informed consent.Patients with burn injuries showed sustained BChE activity reduction following hospital admission. BChE activity correlated negatively with burn injury severity, organ failure severity and intensive care unit resource requirements. BChE activity measured at ERA and 12 h later identified survivors and predicted 28-day patient outcome with noninferior efficacy compared to the abbreviated burn severity index (ABSI) scoring. Finally, POCT-measured BChE activity might complement ABSI scoring and possibly improve early risk stratification in acute burn care therapy.