原发性骶尾部脊索瘤的CT分型及征象

目的对治疗前原发性骶尾部脊索瘤(PSC)CT图像分型,并分析其CT征象,为诊断和个性化治疗提供依据。方法回顾性分析101例PSC患者治疗前的CT图像,包括肿瘤的部位、范围、大小、密度、肿瘤与邻近结构的关系。按照肿瘤的部位由上及下分为Ⅰ~Ⅳ型,并根据肿瘤侵犯的范围从小到大分为a^d亚型。采用Kruskal-Wallis H检验比较PSC各亚型的占比,并对各亚型之间进行两两比较。采用R×C列联表精确概率检验比较分型和亚型肿瘤钙化的发生率。采用单因素方差分析及LSD-t检验对各分型和亚型肿瘤的大小和密度进行分析、比较。结果101例PSC中,Ⅰ~Ⅳ型的发生率分别为17.8%、30.7%、36.6%、14.9%,a^d亚型的占比分别为9.9%、25.7%、58.4%、5.9%。各亚型的占比差异具有统计学意义(P=0.012)。c亚型明显高于a亚型(P=0.039),d亚型明显低于a亚型(P=0.036),其余各型之间无明显差异。各分型肿瘤内钙化的差异无统计学意义(P=0.233);各亚型肿瘤内钙化的差异有统计学意义(P=0.003),a^d亚型肿瘤钙化的比率逐渐增加。Ⅰ型肿瘤的左右径及上下径明显大于Ⅱ~Ⅳ型(P<0.05)。a亚型与b亚型肿瘤之间前后径的差异无统计学意义(P=0.102),b^d亚型之间前后径的差异均有统计学意义(P<0.05);不同亚型肿瘤之间的左右径、上下径之间的差异均有统计学意义(P<0.05),a亚型径线最小,d亚型径线最大。结论101例PSC中,Ⅱ、Ⅲ型最多见,肿瘤较少累及第一骶骨;各亚型中,a型较少见,c亚型最多见,d亚型最少见。肿瘤的密度与分型无关,肿瘤内钙化与亚型有关。Ⅰ型肿瘤侵犯的范围较Ⅱ~Ⅳ型广泛,a^d亚型肿瘤的径线逐渐增大,CT分型有利于判断肿瘤的范围。PSC诊断延迟现象比较明显,但很少发生远处侵犯和转移。CT图像可对治疗前PSC分型,为诊断和个性化治疗提供依据。     

不同类型精神分裂症患者脑脊液色氨酸及其与竞争性氨基酸比值对照研究

应用高压液相色谱（ＰＨＬＣ）对４２例阳性精神分裂症患者、２５例阴性精神分裂症患者及１０例健康正常对照组脑脊液中色氨酸（Ｔｒｙｔｏｐｈａｎ，ＴＲＰ）和酪氢酸（Ｔｙｒｏｓｉｎｅ，Ｔｙｒ）进行测试，其中ＴＲＰ／Ｔｙｒ被作为两者竞争指数，结果提示阳性、阴性精神分裂症患者脑脊液中Ｔｙｒ显著性降低，而ＴＲＰ则无显著性变化。但发现阳性精神分裂症患者的ＴＲＰ／Ｔｙｒ比值显著高于正常对照组，也显著高于阴性精神分裂症患者，本文结合ＴＲＰ／Ｔｙｒ的意义与价值进行了讨论。     

HIV-1 黑龙江省分离株CHNHLJ03009包膜克隆及分析

目的 分析黑龙江省Ⅰ型人免疫缺陷病毒（human irnmunodeficiency virus type 1，HIV-1）原代分离株包膜糖蛋白的变异性及表型特征。方法从一名HIV阳性但未发病的感染者外周血单个核细胞提取DNA，采用保守引物进行HIV包膜直接克隆，进行序列分析及系统树分析。构建了一株带该包膜蛋白的伪病毒并利用表达CXCR4和CCR5的靶细胞进行了感染实验，观察该病毒包膜利用辅助受体的表型特征。结果共获得2个有功能全长env克隆，分别命名为CHNHIJ03009c34（GenBank序列号为AY905493）和CHNHIA03009c33。用全长env氨基酸序列与国内外分离株进行同源性比较分析发现，与分离株CHNHLJ03009c34的包膜同源性最高的病毒为云南的HIV-1 B’亚型分离株RIA2，同源性为91．52％。系统发育分析结果表明，该株为泰国B’亚型，与云南分离株RIA2的遗传距离最近。对包膜蛋白结构分析结果显示，分离株CHNHLJ03009c34包膜在抗原性和亲水性上与RIA2没有明显差别。感染性检测结果显示该病毒只能感染U87．CD4．CCR5细胞，不能感染U87．CD4．CX-CR4细胞。结论本研究从黑龙江省一名HIV-1阳性者克隆到HIV-1CHNHLJ03009病毒的包膜基因，该病毒属于B’亚型（泰国亚型），为R5亲嗜性毒株。该包膜基因克隆为首次报道的黑龙江分离株。     

血清HBV DNA与乙肝病型及e系统之间关系探讨

目的 探讨血清ＨＢＶ ＤＮＡ与乙肝病型及ｅ系统之间的关系。方法 采用ＰＣＲ法对３１０例乙肝病毒携带者及乙肝患者进行血清ＨＢＶ ＤＮＡ检测,同时用ＥＬＩＳＡ法进行乙肝标志物测定。结果 各病型ＨＢＶ ＤＮＡ阳性率以慢性肝炎和无症状携带者最高,与急性肝炎肝硬变组比较差异显著;ＨＢｅＡｇ阳性病例中ＨＢＶ ＤＮＡ阳性率以无症状携带者,急性肝炎、慢性肝炎（轻）组最高,与慢性肝炎（中）、肝硬变组比较差异显著;在     

上海市人类免疫缺陷病毒阳性人群HIV-1分布特征分析

[目的 ]　分析上海市人类免疫缺陷病毒 (HIV )阳性人群HIV -1分布特征 ,为制定预防HIV传播措施提供科学依据。　 [方法 ]　选择 40例不同感染途径的HIV阳性者 ,提取其血浆中核酸进行扩增 ,然后进行序列测定 ,确定其HIV -1型别。　 [结果 ]　 3 8例分离到核酸的阳性者中 ,发现 4种HIV -1亚型 (A、B、B’和C)、2种重组亚型 (CRF0 1_AE和CRF0 8_BC)和 1种未见报道的亚型 (CRF0 1_AEenvBgagUpol)。不同人群感染毒株不同 ,经性接触传播感染者感染毒株较为广泛 ( 7种 ) ,而经血传播者都为B/B’亚型。　 [结论 ]　上海地区存在着多样的HIV -1亚型和重组毒株     

艾滋病病毒分子亚型流行病学研究进展

艾滋病病毒的变异度相当大,已经演化成各种不同亚型。欧洲和美洲主要流行B亚型；西非和中非主要流行A亚型和A/G重组型；南非和东非及印度、尼泊尔和中国已经形成C亚型的流行；D亚型局限于东非和中非,南非和西非存在少数散发病例。E亚型总是以A/E重组株形式出现,流行于泰国、菲律宾、中国和中非；在中非、南美和东欧已发现F亚型；G和A/G重组亚型已在西非、东非和中欧观察到；H亚型、J亚型、K亚型分别在中非、中美洲和民主刚果、喀麦隆检测到。北京国际旅行卫生保健中心艾滋病确认实验室已从中国籍出入境HIV感染者中检测到A、B、C、D、F、G、CRF01-AE、02-AG、07-BC、08-BC病毒株；从非中国籍出入境HIV感染者中检测到A、B、C、F、CRFAC、01-AE、02-AG、06-CPX、07-BC、10-CPX多种亚型的病毒株。将这些重要的分子生物的信息列入常规监测内容,可以敏感地提示HIV流行信息,对于新的HIV亚型毒株的传人可以及早发现,并可为艾滋病病毒的研制、诊断试剂的更新换代、治疗药物的评估、预测HIV流行趋势提供有意义的数据。在预防和控制艾滋病方面发挥重要作用。     

Prevalence of mild cognitive impairment and its subtypes in community-dwelling residents aged 65 years or older in Guangzhou,China

BackgroundPrevalence of mild cognitive impairment (MCI) has been reported substantial variations, and mostly in Western countries. Less is known about MCI in the south of China. The study is to estimate the prevalence of MCI and its subtypes in residents aged 65 year or older in community-dwelling residents of Guangzhou, China.MethodsThe study was a community-based, cross-sectional study conducted in rural and urban areas of Guangzhou between April and October 2009. Eight communities were randomly selected using a cluster sampling method. Each elderly was interviewed with Montreal Cognitive Assessment, the Mini-Mental state examination, Auditory Verbal Learning Test, the Clinical Dementia Rating scale et al. MCI was classified as amnestic MCI (a-MCI) or nonamnestic MCI (na-MCI).Results2427 individuals were contacted, but in-person interviews were conducted with 2111 participants. 299 participants with MCI were identified. The prevalence of MCI, a-MCI and na-MCI was 14.2%, 12.2%, 2.0% respectively. The prevalence of MCI and a-MCI increased with age, decreased with education level, and was higher in rural areas than in urban areas. The difference of prevalence of MCI and a-MCI between women with men wasn't statistically significant(MCIχ2 = 1.0, OR 0.9, 95%CI = 0.6-1.2; a-MCIχ2 = 1.0, OR 0.9, 95%CI = 0.6–1.2), when controlling for education by logistic regression analysis.ConclusionsThe results suggest that 14.2% of elderly individuals are affected by MCI in Guangzhou, China. And MCI was dominated by a-MCI. The prevalence of MCI and a-MCI increased with age, decreased with education level, and was higher in the rural population compared to the urban population.     

Reproductive Factors and Subtypes of Breast Cancer Defined by Estrogen Receptor,Progesterone Receptor,and Human Epidermal Growth Factor Receptor 2: A Register-Based Study From Korea

BackgroundThe relationship between reproductive breast risk factors and breast cancer survival in patients with different breast cancer subtypes is not well known.MethodsWe examined a large-sized, retrospective study of 23,882 subjects from the Korean Breast Cancer Registry. The breast cancer subtype was determined by immunohistochemical staining for estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 (HER2). Information regarding reproductive factors, including breastfeeding, age at first birth (AFB), and parity, was gathered. Multivariate Cox regression analysis was used to estimate the association among breast cancer subtypes, such as luminal A, luminal B, Her-2/neu overexpressing, and triple negative breast cancer (TNBC), and breast cancer survival as dependent variables and adjusting for age and stage.ResultsHigh parity (≥ 5) increased the recurrence risk of luminal A and B breast cancer (hazard ratio [HR], 1.95; 95% confidence interval [CI], 0.96-3.97; P = .0055 and HR, 1.12; 95% CI, 0.42-3.02, respectively; P = .0073) in breast cancer–specific survival (BCSS), but 1 to 3 child births decreased the recurrence risk of luminal A breast cancer (HR, 0.56; 95% CI, 0.34-0.91; P = .0055) and luminal B breast cancer (HR, 0.32; 95% CI, 0.17-0.61; P = .0073) in BCSS. Early AFB (< 20 years) increased the recurrence risk of luminal A breast cancers (HR, 1.61; 95% CI, 0.62-4.26; P = .039) in BCSS and of TNBC (HR, 1.31; 95% CI, 0.78-2.21; P = .0006) in overall survival. Her-2/neu overexpressing breast cancer had no correlation with parity and AFB in breast cancer survival.ConclusionsHigh parity (≥ 5) and early AFB (< 20 years) were correlated with worse clinical outcomes in patients with luminal breast cancer, but not with other subtyped breast cancers.     

腹泻型、便秘型及混合型肠易激综合征患者肠道菌群的差异性比较

目的 比较腹泻型、便秘型及混合型肠易激综合征(IBS)患者肠道菌群的差异性.方法 选取本院消化内科腹泻型、便秘型、混合型IBS患者各40例,同时选取同期在本院体检的健康者40例作为对照,比较四组患者肠道菌群差异.结果 对照组肠道菌群密集度Ⅰ级、Ⅱ级、Ⅲ级、Ⅳ级分别为0％、10％、35％、55％,腹泻组10％、60％、25％、5％,便秘组5％、25％、35％、35％,混合组5％、20％、40％、35％,腹泻组肠道菌群密集度与其他三组比较差异有统计学意义(P＜0.05);对照组肠道菌群多样性Ⅰ级、Ⅱ级、Ⅲ级、Ⅳ级分别为5％、20％、65％、10％,腹泻组15％、50％、15％、20％,便秘组10％、30％、45％、15％,混合组10％、45％、30％、15％,腹泻组、混合组与对照组比较差异有统计学意义(P＜0.05),腹泻组和便秘组比较差异有统计学意义(P＜0.05);对照组肠杆菌、肠球菌、双歧杆菌、乳杆菌、拟杆菌分别为(8.18±0.68)、6.74±0.89)、(8.93±0.87)、(7.05±1.07)、(8.42±0.64)logCFU/g湿便,B/E值为(1.08±0.15),而腹泻组分别为(8.81±1.04)、(6.40±0.87)、(8.26±0.94)、(6.32±1.05)、(8.62±0.62) logCFU/g湿便和(0.95±0.14),便秘组(8.24±0.87)、(6.58±1.05)、(8.54±1.04)、(6.48±0.84)、(9.24±0.64)logCFU/g湿便和(1.04±0.18),混合组(8.83±1.12)、(6.78±1.19)、(8.62±0.91)、(6.21±1.04)、(8.48±0.69) logCFU/g湿便和(0.98±0.16),与对照组比较,IBS组肠杆菌、拟杆菌增多(P＜ 0.05),双歧杆菌、乳杆菌和B/E值减少(P＜0.05),肠球菌差异不显著(P＞0.05).结论 肠易激综合征患者均存在不同程度肠道菌群紊乱,其中以腹泻型IBS菌群失调最为严重,肠道菌群是影响IBS发生的因素之一.