呼吸道感染人腺病毒的分离及鉴定

目的进行呼吸道感染人腺病毒的分离以及型别鉴定。方法标本来源于本实验室检测腺病毒阳性的1例呼吸道感染临床患者痰标本,将该例标本经处理后接种肺癌A549细胞进行病毒培养,用空斑实验进行病毒的分离和纯化,以纯化后的病毒核酸提取物为模板用PCR方法扩增腺病毒六邻体蛋白基因,对扩增产物进行序列测定,测序结果进行BLAST序列分析确定其型别。结果分离到一株人腺病毒毒株,对其六邻体蛋白基因PCR产物测序和BLAST分析结果证明该腺病毒株的六邻体序列与人7型腺病毒六邻体基因同源性均为100%。结论从哈尔滨地区呼吸道感染患者痰标本中检测到的1例腺病毒经分离鉴定为人腺病毒7型。     

Isolation and identification of human adenovirus type 3 GZ13 strain and the molecular evolution of hexon protein.

目的 分离鉴定1株引起儿童急性支气管肺炎的腺病毒及分析其主要中和抗原六邻体蛋白的分子进化趋势.方法 采用荧光定量PCR方法,对1例引起严重支气管肺炎的患儿咽拭子进行检测,并从中分离得到1株腺病毒(命名为GZ13).利用型特异性引物PCR进行初步亚型鉴定;克隆该株腺病毒完整的六邻体蛋白基因,测序和序列比对,确定其型别;同时与GenBank上人3型腺病毒的六邻体蛋白进行同源性比对,分析预测六邻体蛋白的分子进化趋势.结果 该临床标本经荧光定量PCR鉴定为腺病毒强阳性,型特异性引物PCR初步鉴定为3型;完整六邻体基因比对最终确定为人3型腺病毒;GZ13株与我们先前分离的GZ01、GZ02株及台湾地区分离株核苷酸及氨基酸的同源性均大于99%.结论 引起该例儿童急性支气管肺炎的病原体为人3型腺病毒,目前在广州以及台湾地区流行的3型腺病毒仍属同一流行株,其主要中和性抗原六邻体蛋白未出现明显变异,这对今后开发研究人3型腺病毒疫苗及药物具有重要指导意义.     

人3型腺病毒GZ13株的分离鉴定及六邻体蛋白的分子进化研究

目的分离鉴定1株引起儿童急性支气管肺炎的腺病毒及分析其主要中和抗原六邻体蛋白的分子进化趋势。方法采用荧光定量PCR方法,对1例引起严重支气管肺炎的患儿咽拭子进行检测,并从中分离得到1株腺病毒(命名为GZ13)。利用型特异性引物PCR进行初步亚型鉴定;克隆该株腺病毒完整的六邻体蛋白基因,测序和序列比对,确定其型别;同时与GenBank上人3型腺病毒的六邻体蛋白进行同源性比对,分析预测六邻体蛋白的分子进化趋势。结果该临床标本经荧光定量PCR鉴定为腺病毒强阳性,型特异性引物PCR初步鉴定为3型;完整六邻体基因比对最终确定为人3型腺病毒;GZ13株与我们先前分离的GZ01、GZ02株及台湾地区分离株核苷酸及氨基酸的同源性均大于99%。结论引起该例儿童急性支气管肺炎的病原体为人3型腺病毒,目前在广州以及台湾地区流行的3型腺病毒仍属同一流行株,其主要中和性抗原六邻体蛋白未出现明显变异,这对今后开发研究人3型腺病毒疫苗及药物具有重要指导意义。     

深圳市儿童呼吸道腺病毒4型暴发流行的病原学研究

目的探讨深圳市某幼儿园一起急性呼吸道感染暴发的流行特征及病因。方法使用荧光定量PCR方法对采集的17份患儿咽拭子进行流感样病例筛查,筛查后的阴性样本进一步进行呼吸道腺病毒核酸检测,对检测出的5份腺病毒阳性标本进行病毒分离,感染Hep-2受体细胞后共获得4份腺病毒稳定细胞毒株,用腺病毒六邻体基因作为靶基因进行序列扩增及测定,测序结果在GenBank上进行序列比较,确定其病毒亚型并进行系统进化分析。结果 17份咽拭子中5份为腺病毒PCR阳性,阳性率为29.4%,用分型引物检测并分析序列确定均为腺病毒4型。结论本次急性呼吸道病毒疫情暴发由腺病毒4型引起。     

1起家庭聚集性肺炎病原学检测及基因特征分析

目的：分离鉴定引起家庭聚集性肺炎的病原体,并进行基因特征分析。方法采集该家庭每个成员的血清、咽拭子和肺炎患者的肺泡灌洗液,通过 PCR 方法、病毒分离、hexon 测序、BLAST 比对和血清 IgG 酶联免疫方法检测病原,并对 hexon 序列进行进化树分析。对阳性病毒分离物进行全基因组扩增。结果父母咽拭子2份、孩子肺泡灌洗液2份经 PCR 检测均为腺病毒(AdV)阳性,肺泡灌洗液病毒分离阳性,4份标本 hexon 区域 PCR 扩增测序,核苷酸同源性为99.5%～100.0%,病毒全序扩增拼接分析,BLAST 比对与腺病毒7型核苷酸同源性97.0%,基因进化树分析显示 hexon 基因分型与腺病毒7 d 位于同一分支。ELISA 方法检测一家4口均出现恢复期与急性期血清腺病毒 IgG 4倍增高现象。结论腺病毒7型是该起家庭聚集性肺炎的病因。     

深圳市一起腺病毒4型感染聚集性疫情的分子流行病学调查

目的 分析2019年2月22—28日深圳市宝安区某小学一起急性呼吸道病毒感染聚集性疫情的流行病学及病原学特点。方法 采用流行病学个案调查表对疫情进行现场调查,使用荧光定量PCR方法对采集的咽拭子标本进行流感样病例病原学筛查,筛查阴性标本进行6种常见呼吸道病毒核酸检测。对腺病毒核酸阳性的标本,用腺病毒六邻体基因作为靶基因进行序列扩增及测定,测序结果在GenBank 上进行序列比较,确定其病毒亚型并进行系统进化分析。结果 疫情发生在二年级（1）班,全班共54名学生,男29名,女25名。经调查该学校其他班级其余年级未出现相同症状病例。该起疫情共发现病例13例,其中男生7例,女生6例,男女学生罹患率分别为24.1%( 7 /29) 和24.0% ( 6 /25) 。临床特征为发热13例(100.0%),咽痛8例( 61.5%),全身肌肉酸痛8例( 61.5%),咳嗽5例(38.5%),症状均较轻,无重症病例。共采集5份咽拭子标本,经荧光定量PCR检测均为腺病毒核酸阳性,5份标本用分型引物检测并分析序列确定均为腺病毒E亚属4型。结论 此次急性呼吸道感染聚集性疫情由腺病毒4型引起,毒株序列与深圳其他区、国内其他城市分离的腺病毒4型毒株序列具有高度同源性。     

2011-2012年深圳市呼吸道腺病毒分子分型及其流行特征

目的了解2011-2012年深圳地区致病性呼吸道腺病毒(AdV)的病原体基因亚型和遗传进化及其流行特征,分析深圳地区呼吸道腺病毒的流行规律和传播途径。方法收集2011年1月至2012年12月深圳地区31个流感样病例监测哨点2 822份样本,先用荧光定量PCR方法筛查流感样病例,筛查后的阴性样本进一步进行呼吸道腺病毒等13种常见呼吸道病毒的核酸检测。对检测出的109份腺病毒阳性标本进行病毒分离,感染Hep-2受体细胞后共获得71份AdV稳定细胞毒株,用腺病毒六邻体基因作为靶基因,扩增其中的50份腺病毒阳性标本,纯化扩增产物后直接用于序列分析,在GenBank上进行序列比较,确定其病毒亚型并进行系统进化分析。结果 2011-2012年深圳市腺病毒感染患者的高发年龄段人群为小于7岁的儿童,1~2岁婴幼儿发病率最高;4-6月和10-12月为每年发病高峰期。在2 822份流感样病例咽拭子标本中,经定量PCR方法确定为AdV核酸阳性共109份,核酸阳性率为3.86%,从109份核酸阳性样本中分离病毒71份,病毒分离率为68.93%。50份分离的呼吸道腺病毒分子分型结果为1型AdV 6例,占12%;2型AdV 4例,占8%;3型AdV 27例,占54%;4型AdV 3例,占6%;5型AdV 4例,占8%;7型AdV 5例,占10%;另外有复合型AdV(HAdV-un)1例,占2%。结论近两年来深圳地区呼吸道Adv感染以3型为主,腺病毒引起的呼吸道疾病主要发生在每年的4-6月,感染人群主要是1~2岁婴幼儿。     

2017-2018年中山市急性出血性结膜炎病原学监测结果

目的了解中山市急性出血性结膜炎的致病病原体及其基因分型,分析急性出血性结膜炎病原体流行规律及其分子流行特征。方法采集临床急性结膜炎病例眼拭子标本,荧光定量PCR法检测肠道病毒70型(EV70)、柯萨奇A24病毒变种(CVA24V)和腺病毒(Adv)核酸,用PCR法扩增腺病毒六邻体(Hexon)片段基因和基因测序,在Genbank上进行序列比对分型。结果从2017年3月-2018年12月,共检测中山市哨点医院眼科医院门诊急性结膜炎病例眼拭子标本384份。核酸检测结果EV70和CVA24v均为阴性,152份标本Adv阳性,阳性率为39.58%。腺病毒六邻体片段基因测序成功的124份样本中,检测到Adv3、4、7、8、37、53、64等基因型,主要型别为Adv3型(26.61%,33/124)、Adv64型(20.16%,25/124)和Adv8型(20.16%,25/124)。结论腺病毒是引起中山市2017-2018年急性结膜炎的主要病原体,且基因型别以3型、64型以及8型为主。     

基因扩增联合测序法对痰标本分离的60株真菌病原学鉴定

目的:应用PCR扩增真菌ITS2区基因,结合基因测序法对痰标本中分离的60株真菌进行病原学鉴别。方法:收集痰标本分离的真菌菌落60份及2种真菌标准菌株(白色念珠菌,烟曲霉菌)培养菌落,分别提取基因组DNA,半巢式PCR扩增ITS2区,扩增产物经测序后,结果与NCBI基因库中的核酸序列进行比对,确定致病菌的种属,并对其分布特征进行分析。结果 :2种真菌标准菌株的ITS2区基因序列比对结果与种属一致。痰标本中60株真菌测序鉴定结果为:曲霉菌属24株(其中烟曲霉菌17例、黑曲霉菌3例、黄曲霉菌2例、土曲霉菌1例、变色曲霉1例),青霉菌属3株(小刺青霉菌1株、娄地青霉菌1株、产黄青霉菌1株),念珠菌属29株(白色念珠菌20株、热带念珠菌3株、近平滑念珠菌2株、光滑念珠菌2株、鲁西坦念珠菌1株、季也蒙毕赤酵母菌1株),其它丝状菌还有暗孢节菱孢菌2株,淡紫拟青霉菌1株和串珠状赤霉菌1株。结论:基因测序法能快速、简便、准确地鉴别痰培养的真菌种属,为本地区呼吸道真菌性疾病病原菌流行病学调查及个性化治疗奠定基础。     

人腺病毒五邻体基因重组质粒的构建及鉴定

目的 构建腺病毒五邻体基因重组表达质粒.方法 通过PCR方法扩增获得腺病毒五邻体基因的完整序列,将此片段定向克隆到pQE30载体的多克隆位点区,筛选重组阳性菌株,提取重组质粒,利用酶切鉴定方法与核酸序列测定验证重组质粒构建的正确性.结果 用PCR法获得了人腺病毒的五邻体基因,将该基因正确地重组到表达质粒pQE30中,构建出腺病毒五邻体基因重组表达质粒pQE30-penton.结论 构建腺病毒五邻体基因重组表达质粒pQE30-penton.     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.