ELISA技术筛选200种中草药抗HBsAg的实验研究

使用ＥＬＩＳＡ技术对２００种中草药水提取物进行抗ＨＢｓＡｇ的实验研究,共筛出有效药物７种（占总数的３．５％）。若按５种不同剂量（０．３、０．６、１．２、２．５、５．０ｍｇ／１００μｌ）的药物、２种不同浓度的ＨＢｓＡｇ（１０．９２、１４．２６Ｐ／Ｎ值）与３种不同接触时间（立即、１ｈ、２ｈ）的１０项Ｐ／Ｎ值均数来综合评价药效指数时,７种有效药物的次序为青蒿（１．６７Ｐ／Ｎ值）、大蒜（２．１９Ｐ／Ｎ值）、红孩儿（２．３１Ｐ／Ｎ值）、仙鹤草（２．３１）、魔芋（２．３２Ｐ／Ｎ值）、冬瓜皮（２．６３Ｐ／Ｎ值）和猕猴桃（２．８９Ｐ／Ｎ值）。     

应用PCR方法检测部分血液制品中HCV-RNA

应用市售丙型肝炎ＰＣＲ检测试剂盒,对１９９４ １９９６年用不同病毒灭活工艺生产的人凝血因子类制品、人静注丙球和人血白蛋白进行ＨＣＶ ＲＮＡ检测。结果表明,检测六种血液制品共２１批,１批阳性,占４８％。     

丙型肝炎病毒核心蛋白在大肠杆菌中的表达

目的：建立稳定表达丙型肝炎病毒(HCV)核心蛋白的原核表达系统,获得高产量的纯化核心蛋白。方法：应用多聚酶链反应(PCR),以HCV—H株全长cDNA序列为模板,扩增获得核心区基因片段,克隆入原核表达载体pBVIL1,构建原核表达载体pBVIL1-C,转化HB101宿主菌,通过温度诱导表达核心蛋白。结果：扩增得到目的基因长度为573bp,构建pBVIL1-C表达载体,在HB101宿主菌中通过温度诱导获得稳定表达,表达蛋白占菌体总蛋白含量的21％,Western—Blot检测证实表达产物可与HCV患者阳性血清发生特异性结合反应。结论：HCV核心蛋白可在大肠杆菌中获得高表达并具有良好的反应原性。     

脑出血和脑梗死患者血清谷氨酸,甘氨酸和丙氨酸浓度的改变及意义

目的探讨血清中谷氨酸、甘氨酸和丙氨酸含量变化与脑出血和脑梗死的关系,为今后临床深入研究提供参考资料。方法用氨基酸分析仪对２３例急性脑出血和２６例脑梗死病人谷氨酸、甘氨酸和丙氨酸进行测定,并与对照组进行比较。结果病人组的兴奋性氨基酸谷氨酸的含量明显高于对照组（Ｐ＜０．０１）,病人组的抑制性氨基酸甘氨酸和丙氨酸的含量与对照组无显著差异（Ｐ＞０．０５）。结论提示兴奋性氨基酸谷氨酸可能作为损伤因素参与脑出血和脑梗死脑损伤的发生。     

庚型肝炎病毒NS5区蛋白鼠单克隆抗体的制备

庚型病毒性肝炎是近年来世界上才确认的一种新型肝炎［１～３］。庚型肝炎病毒（ＨＧＶ）呈世界性分布,经血液传播为主,也可母婴传播。ＨＧＶ容易形成持续性感染,类似ＨＩＶ和ＨＣＶ。据粗略估计,我国大约有１００万～１０００万ＨＧＶ携带者。因此,ＨＧＶ已成为继乙...     

中国不同地区和人群HDV cDNA的筛选、克隆及抗原编码区基因异质性的分析

为研究我国不同地区不同人群中ＨＤＶ毒株的感染分子特征,从我国河南、内蒙、北京、四川、广西、西藏、新疆、辽宁、上海等地的ＨＤＶ健康携带者、慢性丁肝病人与重症肝炎病人中筛选获得１０余份ＨＤＶ－ＲＮＡ阳性血清。经逆转录一多聚酶链反应（ＲＴ－ＰＣＲ）交叉扩增获得ＨＤＶ抗原编码区的ｃＤＮＡ片段并克隆到ＰＧＥＭ－３Ｚｆ（－）或ＰＧＥＭ－Ｔ载体上,经序列分析研究其基因结构特点,结果表明：中国的ＨＤＶ毒株基因型均为Ⅰ型,但至少存在ⅠＡ、ⅠＢ两个亚型,ＨＤＶ毒株在不同地区间存在异质性,其中河南－１、－２、－３株及新疆株与台湾株同源性较高（核苷酸与氨基酸同源性分别大于９２．１％与８６．９％）．当为ⅠＡ型;内蒙－１、四川、广西、西藏－１、辽宁、北京株与美国－１株同源性较高（核苷酸与氨酸同源性分别大于９４．３％与８８．８％）,当为ⅠＢ亚型;上海株与意大利株的核昔酸同源性最高,为９８．１％。研究证明我国新疆、内蒙、西藏等地区抗ＨＤ阳性率比其他省市高并不是由于存在其他基因型所致。     

反义前S／S基因转移表达抗乙型肝炎病毒的研究

为了观察反义基因转录表达抗乙型肝炎病毒（HBV）的作用,将HBVayw前S／S基因（PreS／S）片段反向插入逆转录病毒载体质粒,构建preS／S反义基因重组体,经转染PA317细胞后,获得重组逆转录病毒颗粒。用重组病毒转导2．2．15细胞后,第3天即可见细胞培养上清HBV表面抗原（HBsAg）和e抗原（HBeAg）表达量减少,到转导后第5天,细胞培养上清中的HBsAg和HBeAg表达量降到最低水平,HBsAg抑制率为71％,HBeAg抑制率为27％,抑制作用至少可持续到转导后第11天。空载及正向插入基因的重组逆转录病毒转导对2,2．15细胞内HBV抗原表达无抑制作用。     

反义前C／C基因转移表达抗乙型肝炎病毒作用的研究

为了观察逆转录病毒载体包装细胞系统介导反义基因转移表达的抗乙型肝炎病毒（HBV）作用,将HBVayw前C／C基因（preC／C）片段反向插入逆转录病毒载体质粒。将重组体转染逆转录病毒包装细胞PA317后,获得重组逆转录病毒。用重组逆转录病毒感染2．2．15细胞后发现,感染后第3天,细胞培养上清HBV表面抗原（HBsAg）和e抗原（HBeAg）表达量即明显减少,抑制作用于感染后第5天达到高峰,其中对HBsAg表达的抑制率为27．0％,对HBeAg表达的抑制率为59.5％。反义基因重组逆转录病毒感染2.2．15细胞对HBV抗原表达的抑制作用至少可以持续到转导后的第11天。空载及正义基因重组逆转录病毒感染对2．215细胞HBV抗原表达无明显抑制作用。此外,反义基因重组逆转录病毒感染对2.2.15细胞HBVDNA复制也有抑制作用．无细胞毒性。     

生物可降解微球作为乙型肝炎基因免疫佐剂的研究

探讨生物可降解微球对基因免疫的增强作用。采用有机溶剂蒸发法制备聚乳酸聚乙醇酸共聚 物（ＰＬＧＡ）微球,构建含有乙型肝炎病毒表面抗原Ｓ基因的ｐＲＣ－ＣＭＶ真核表达载体,用微球与基因 载体共孵育法制备其混合物。肌肉注射免疫Ｂａｌｂ／ｃ小鼠。结果表明：微球注射组的血清抗体滴度达到 ｌ：１６００,其效果与乙型肝炎病毒表面抗原加铝佐剂注射组相近,而裸ＤＮＡ注射组没有反应。说明了 生物可降解微球可显著的提高基因免疫的免疫反应。     

丙型肝炎病毒免疫电镜的初步研究

采用组织匀浆免疫沉淀后负染、免疫组化块染后包埋、原位包埋等免疫电镜技术,研究丙型肝炎病毒（ＨＣＶ）。组织匀浆、免疫沉定、负染后在电镜下观察到与ＨＣＶ相关的类病毒颗粒,形态与披膜病毒相似,大小多在５５～６５ｎｍ,圆形,有包膜,边缘略有突起或比较平滑,有胶体金结合在此种颗粒上及其周围。无关单抗阴性对照无类似颗粒及胶体金。免疫酶染电镜下还见到成堆可疑颗粒。此外,ＨＣＶ－Ｅ区抗原染色后原位包埋,尚发现胶体金大多结合于大小５０ｎｍ左右圆形结构的内部,表明Ｅ区单抗针对的特异性抗原位点位于这种结构的内侧。     

丙型肝炎患者血浆和外周血单个核细胞同步检测HCV—RNA和HGV—RNA

庚型肝炎和丙型肝炎传播途径是一致的 ,主要通过血制品和注射途径 ,有可能同时或重叠感染 ,尽管ＨＧＶ感染能否导致肝损害仍有争论 ,由于国外近年做了许多研究 ,而国内仅有血清检测丙肝和庚肝重叠感染的个别报道 ,但对外周血单个核细胞和血浆未作同步检测。我们对此进行了探讨 ,现将结果报道如下。1　方法观察组 72例患者均为我院住院治疗或门诊追踪观察病例 ,所有病例通过血清学检查排除甲、乙、丁、戊型肝炎。 70 %有输血史 ,肝功能反复异常 ,抗ＨＣＶ阳性 ,临床诊断为慢性或急性丙型肝炎 ,以 2 0例健康献血员作阴性对照 ,用比重 1.0 77的…     

核酸纯化柱提取核酸定量检测丙型肝炎病毒RNA的临床应用

目的:探究核酸纯化柱提取核酸定量检测血浆标本中丙型肝炎病毒核糖核酸(HCV-RNA)的临床应用效果。方法:将2013年8-11月期间我院600例抗-HCV阳性丙肝患者的样本,按随机字数表法分为研究组对照组各300例,分别采用核酸纯化柱和酚-氯仿提取法检测,采用实时荧光定量聚合酶链反应(FQ-PCR)技术定量检测两组HCV-RNA水平。结果:研究组检测阳性率为87.67%(263/300),显著高于和对照组的54.0%(162/300),差异有统计学意义(X2=82.296,P=0.000);两组HCV-RNA检测水平差异无统计学意义(u=1.721,P=0.067)。结论:核酸柱提法定量检测血浆HCV-RNA操作简单、快速,分离效率高,容易掌握,值得临床推广。     

乙型肝炎病人重叠感染丙型肝炎的评价

应用ＥＬＩＳＡ和ＰＣＲ法检测５０２例乙肝病人血清,４０１例ＨＢｓＡｇ阳性血清中,有１１４例（２８．４％）抗－ＨＣＶ和ＨＣＶＲＮＡ双项阳性,２５例（６．２％）ＨＣＶＲＮＡ单项阳性;２１例（５．２％）抗－ＨＣＶ单项阳性。将ＨＢｓＡｇ乙肝病人分成ＨＢＶＤＮＡ,ＨＢｅＡｇ阳性组和ＨＢＶＤＮＡ,ＨＢｅＡｇ阴性组。前者抗－ＨＣＶ阳性率为１１．６％～２０．５％,ＨＣＶＲＮＡ阳性率为１６．２％～２０．５％。后者抗－ＨＣＶ阳性率为２０．２％～５５．６％,ＨＣＶＲＮＡ阳性率为２３％～６０．３％。结果说明长期携带ＨＢＶ者和慢性乙肝病人均可重叠ＨＣＶ感染。ＨＢＶＤＮＡ阳性组抗－ＨＣＶ和ＨＣＶＲＮＡ阳性率明显高于ＨＢＶＤＮＡ阳性组     

I b 型慢性丙肝患者血清IL-10、IL-12 水平 与HCV-RNA 载量关系的研究*

目的:研究I b型慢性丙肝患者血清IL-10、IL-12水平与HCV-RNA载量的关系,探讨难治性丙肝的免疫发病机制。方法:选取HCV-RNA阳性的I b型慢性丙肝患者48例,依据病毒载量将其分为三个组,低病毒载量组(1.0*103IU/mL1.0*106IU/mL)13例,另选HCV-RNA阴性的慢性HCV感染者15例,健康献血员15例作为对照组;应用ELISA法检测所有研究对象的血清IL-10、IL-12水平。结果:慢性丙肝患者外周血IL-10水平显著高于健康献血员(P=0.003),IL-12水平低于健康献血员(P=0.045);随着HCV-RNA载量的升高,HCV-RNA阳性的I b型慢性患者外周血IL-10水平逐渐升高,组间比较差异具有统计学意义(F=18.65,P=0.000);血清HCV-RNA载量与血清IL-10水平呈正相关(相关系数r=0.71,P=0.000),与血清IL-12水平无相关性(P=0.479)。结论:慢性HCV感染者与患者的细胞免疫均倾向于TH2型;I b型慢性丙肝患者外周血IL-10水平与HCV-RNA病毒载量呈正相关。     

HCV-RNA和抗-HCV的联合检测在丙型肝炎确诊中的临床意义

目的:探讨抗-HCV和HCV-RNA的联合检测在丙型肝炎确诊中的临床意义。方法:采用ELISA法检测抗-HCV及实时荧光定量PCR检测HCV-RNA。结果:在急性丙型肝炎组中抗-HCV和HCV-RNA同时阳性所占百分率(29.8%)显著低于慢性丙型肝炎患者(62.3%)(P<0.05);抗-HCV阴性和HCV-RNA阳性在急性丙型肝炎组所占百分率(58.3%)显著高于慢性丙型肝炎患者(24.6%)(P<0.05);经相关性分析,ALT含量与HCV-RNA含量呈正相关性(r=0.725,P<0.05)。结论:临床抗-HCV和HCV-RNA的联合检测有助于丙型肝炎的早期明确诊断。     

Hepatitis C virus-RNA, immunoglobulin M anti-HCV and risk factors in haemodialysis patients

In order to evaluate hepatitis C virus-RNA (HCV-RNA), immunoglobulin M (IgM) anti-HCV and risk factors in haemodialysis patients, 180 subjects (45 HCV negative and 135 HCV positive) were studied. Sex, age, duration of dialysis, number of transfusions and ALT were also considered. HCV-RNA was determined by the Amplicor HCV test, and IgM anti-HCV by the Abbott HCV IgM EIA. These markers were present in 40% and 30.4% of anti-HCV positive subjects. The agreement between the two tests employed was 77%. The results showed a close association between HCV-RNA and IgM anti-HCV with abnormal ALT levels and between HCV-RNA and the number of transfusions. Both of these markers were different when correlated with age and time on dialysis, respectively. Therefore, IgM anti-HCV may also serve as a serological marker of HCV infection and a complementary marker of virus replication.     

Treatment of chronic hepatitis C

Chronic hepatitis C entails a life-long risk of developing cirrhosis and hepatocellular carcinoma and eradication of the hepatitis C virus (HCV) is the only realistic approach for lowering the risk of disease progression. Treatment is indicated for patients with high transaminases and histologic signs of chronic hepatitis: 6-12 month therapy with 3-6MU interferon alfa thrice weekly combined with 1-1.2 grams ribavirin yielded up to 30% sustained virological responses (SVR). SVR raised up to 50% with pegylated interferons combined with ribavirin. Favourable predictors of response to the former treatment are genotype 2 or 3, less than 2 million copies of HCV, no or portal fibrosis at biopsy, age less than 40 yr and female gender. The same was true for the latter treatment, however, with body weight less than 82 kg replacing female gender. Six month treatment is enough for treating genotype 2 or 3 patients whereas 12-month therapy is indicated for the more resistant patients with genotype 1 or 4.98% cure of community-acquired acute hepatitis C was achieved with early treatment with daily doses of 5MU interferon, compared to a calculated 30% virus clearance occurring in untreated patients. Cost-effective stopping rules based upon early clearance of serum HCV-RNA, are under investigation. A cut-off equal or more than 2 log decrease in serum HCV-RNA at week 12, has 97% negative predictive value and 60% positive predictive value. Treatment could be optimized also by retreatment with combination therapy of relapsers and non-responders to monotherapy, with SVR rates of 50% and 25%, respectively. Difficult-to-treat patients include patients who have high genotype 1 and 4 viremia or coinfection with HIV or hepatitis B virus as well as patients who carry an organ graft. Extended treatment of virological non responders with pegylated interferons might slow down progression of hepatic fibrosis and prevent hepatocellular carcinoma.     

Monitoring of early events of experimental woodchuck hepatitis infection: Studies of peripheral blood mononuclear cells by cytofluorometry and PCR

Abstract The peripheral blood mononuclear cells (PBMC) of woodchucks experimentally infected by woodchuck hepatitis virus (WHV) were examined simultaneously for the presence of membrane associated WHV antigens by cytofluorometry, and for WHV DNA and RNA sequences by the polymerase chain reaction (PCR). Four woodchucks were inoculated: two with a well-defined infectious inoculum and two with an inoculum obtained from an animal at the late incubation phase, which was positive for WHV DNA by PCR but still devoid of WHV markers. Infection was demonstrated in all four inoculated woodchucks by the appearance at different times of WHV DNA and WHV antigens in both leucocytes and serum. WHV DNA was first detected by PCR either in the serum (two cases) or in leucocytes (two cases). The mean percentage of cells positive for membrane associated WHsAg or WHcAg detected by cytofluorometry were 37%±25 and 17%±15 respectively. After 8 weeks, all inoculated animals were WHsAg positive in serum. These data suggest that PBMC are involved in the early events of hepadnavirus infection. They also show that sera which are positive by PCR for WHV DNA may transmit viral infection even while still seronegative for WHV markers and for WHV DNA by dot blot.     

Detection of HCV-RNA in liver tissue does not correlate with inflammatory process and fibrosis activity in chronic hepatitis C

The significance of HCV-RNA presence in the liver tissue in chronic hepatitis C activity or prognosis has not yet been clearly explained. Therefore, we have examined the relationship between the presence of HCV-RNA in the liver and selected parameters of disease activity and liver damage. A group of 48 chronically HCV infected patients (7-63 years old, mean 39 years) was evaluated. In the patients we assessed the activity of transaminases (ALT, AST), gammaglutamyltransferase (GGTP), and alkaline phosphatase (ALP). The patients underwent routine liver biopsies and the liver tissue was examined histopathologically and in order to detect the presence of HCV-RNA, by means of a combined procedure joining a new method of HCV-RNA extraction from the liver tissue and HCV-RNA detection with RT-PCR automatic Cobas Amplicor Hepatitis C ver. 2.0 assay (Roche Diagnostics). At the time of the liver biopsy, 44 of the patients were identified as having detectable serum HCV-RNA (as examined by means of Cobas Amplicor Hepatitis C ver. 2.0 assay), 3 patients were negative, and 1 was not tested. The presence of HCV-RNA in the liver tissues was detected in 39 cases (81.2%). In the parameters examined we have not found any significant differences between currently liver HCV-RNA positive and negative patients. Presence of the detectable HCV-RNA in the liver bioptats from chronic hepatitis C patients does not correlate with disease activity or level of liver damage.