荧光原位杂交法快速鉴定血培养阳性葡萄球菌的临床应用

目的快速鉴定血培养中的金黄色葡萄球菌和凝固酶阴性葡萄球菌(CoNS),结合临床快速判定是否为污染菌。方法采用荧光原位杂交法鉴定血培养中的金黄色葡萄球菌和CoNS,杂交结果若为CoNS,根据临床资料进行判断,并与文献推荐的污染判断法进行结果比较。结果探针的特异性经由标准菌株和临床分离菌株证实。金黄色葡萄球菌探针的特异性和敏感性均为100%,GoNS探针的特异性和敏感性分别为100%和95.5%。179株CoNS中117株判断为污染菌,污染率为68%,与文献推荐的污染判断方法一致。结论荧光原位杂交法适用于血培养中的金黄色葡萄球菌和CoNS的快速鉴定,以排除CoNS污染。     

偏头痛大鼠脑内5-羟色胺1F和诱导型一氧化氮合酶基因的表达变化及针刺的干预效应

目的:前期实验已证实针刺治疗偏头痛疗效优越。观察针刺对偏头痛大鼠脑内5-羟色胺1F和诱导型一氧化氮合酶mRNA表达的调控作用。方法:实验于2005-11/2006-05在中南大学湘雅医院中西医结合研究所实验室完成。①选用SD大鼠40只,按随机数字表法分为4组(n=10),除正常对照组外,其余3组均复制大鼠偏头痛模型。模型对照组只造模,不作其他处理;针刺治疗组造模后进行针刺;针刺预防组针刺后造模电刺激20min。针刺方法:针刺大鼠双侧太冲、阳陵泉穴20min。采用疏密波,电流强度0.3～0.6mA,留针20min,1次/d,共5次。②实验完毕后取脑干及三叉神经节匀浆,采用反转录-聚合酶链反应法测定5-羟色胺1F和诱导型一氧化氮合酶mRNA表达。结果:进入结果分析正常对照组10只,模型对照组、针刺治疗组、针刺预防组各9只,共脱失3只。①与正常对照组比较,模型对照组大鼠诱导型一氧化氮合酶mRNA表达显著增强(P<0.01),5-羟色胺1FmRNA表达显著减弱(P<0.01)。②与模型对照组比较,针刺预防组和针刺治疗组诱导型一氧化氮合酶mRNA表达明显减弱(P<0.01),5-羟色胺1FmRNA表达显著增强(P<0.01)。结论:针刺调控5-羟色胺1F和诱导型一氧化氮合酶mRNA的表达可能是针刺防治偏头痛的分子机制。     

Some problems related to the design and analysis of clinical trials.

The evaluation of new cancer treatments requires demonstration of their efficacy in clinical trials. Many nonrandomized clinical series have suggested benefit of a new treatment compared with historical controls or with controls from other institutions that received standard treatment. Often, however, the new treatment is not found to be beneficial when evaluated in a subsequent randomized trial. The interpretation of clinical trials has been confounded by many problems, several of which were described or summarized in the writings of Raymond S. Bush: These include (a) invalid comparison of nonrandomized controls because of patient selection or stage migration, (b) inappropriate endpoints, and in particular the failure to evaluate quality of life and complications of treatment, (c) inadequate power to detect clinically meaningful differences in randomized trials, and (d) multiple comparisons and retrospective analysis used to make inappropriate conclusions from randomized trials. The present paper reviews briefly some of these methodological issues that may lead to inappropriate interpretation of clinical trials, with particular reference to trials of combined modality therapy.     

Retrorenal colon: implications for percutaneous diskectomy

It has been recommended that computed tomography (CT) with the patient prone be performed in every patient undergoing percutaneous diskectomy; this would enable detection of a retrorenal location of the colon, which could interfere with the percutaneous procedure. In this evaluation of 346 prone CT studies, only one patient (0.29%) was found to have retrorenal or retropsoas bowel that would have been perforated at diskectomy. Because of this extremely low prevalence, the performance of prone CT in every patient undergoing percutaneous lumbar diskectomy is not believed to be necessary.     

Sequence variation in the 3'-untranslated region of the dopamine transporter gene and attention-deficit hyperactivity disorder (ADHD).

The dopamine transporter gene (DAT1) has been reported to be associated with attention-deficit hyperactivity disorder (ADHD) in a number of studies [Cook et al. (1995): Am J Human Genet 56(4):9993-998; Gill et al. (1997): Mol Psychiatry 2(4):311-313; Waldman et al. (1998): Am J Human Genet 63(6):1767-1776; Barr et al. (2001): Biol Psychiatry 49(4):333-339; Curran et al. (2001): Mol Psychiatry 6(4):425-428; Chen et al. (2003): Mol Psychiatry 8(4):393-396]. Specifically, the 10-repeat allele of the 40-bp variable number of tandem repeats (VNTR) polymorphism located in the 3' untranslated region (UTR) of the gene has been found to be associated with ADHD. There is evidence from in vitro studies indicating that variability in the repeat number, and sequence variation in the 3'-UTR of the DAT1 gene may influence the level of the dopamine transporter protein [Fuke et al. (2001): Pharmacogenomics J 1(2):152-156; Miller and Madras (2002): Mol Psychiatry 7(1):44-55]. In this study, we investigated whether DNA variation in the DAT1 3'UTR contributed to ADHD by genotyping DNA variants around the VNTR region in a sample of 178 ADHD families. These included a MspI polymorphism (rs27072), a DraI DNA change (T/C) reported to influence DAT1 expression levels, and a BstUI polymorphism (rs3863145) in addition to the VNTR. We also screened the VNTR region by direct resequencing to determine if there was sequence variation within the repeat units that could account for the association. Our results indicate that DAT1 is associated with ADHD in our sample but not with alleles of the VNTR polymorphism. We did not find any variation in the sequence for either the 10- or 9-repeat alleles in the probands screened nor did we observe the reported DraI (T/C) variation. Our results therefore refute the possibility of the reported DraI variation or alleles of the VNTR as the functional variants contributing to the disorder.     

Quantitation of Antibody to Non-Hemagglutinating Viruses by Single Radial Hemolysis: Serological Test for Human Coronaviruses

A single radial hemolysis test was developed for quantitation of specific antibody to non-hemagglutinating viruses. With the human coronaviruses as models, this test utilizes the binding properties of the chromic cation to attach viruses to glutaraldehyde-treated sheep erythrocytes. The most satisfactory system consisted of stabilizing washed sheep erythrocytes with 0.0073% glutaraldehyde for 15 min at 23 degrees C, binding a high concentration of virus to a 25% erythrocyte suspension with 0.0016% chromic chloride for 20 min at 23 degrees C, stopping the reaction with phosphate-saline, and finally mixing the treated, rewashed cells with complement and agarose at 45 degrees C to prepare a slide gel. The gel mix, which was dispensed in plastic plates (23 by 73 mm) in 3-ml volumes, consisted of 1% agarose, 0.1% sodium azide, 5% reconstituted complement, and 0.82% treated cells. Wells 2 mm in diameter were loaded with 5 mul of antiserum, incubated for 18 h at 4 degrees C for diffusion of antiserum and fixation of complement, and then incubated for 8 to 24 h at 37 degrees C for development of hemolysis zones. The diameter of a zone was linearly related to antibody concentration, as determined by conventional serological tests. This single radial hemolysis test was applicable to human and animal coronaviruses and to selected serotypes of the adenovirus, picornavirus, rhabdovirus, and rotavirus groups.