慢性乙型肝炎患者外周血单个核细胞α干扰素及其受体1的表达与治疗的关系

慢性乙型肝炎是长期影响人类健康的一大难题，全球约有3．5亿人血清中携带乙型肝炎病毒表面抗原。我国的感染情况严重，携带率占总人口的10％以上。目前临床治疗慢性乙型肝炎的主要方法依然是干扰素（IFN）结合核苷类药物，虽然患者对重组IFN的应答率有所增加，但还是不能令人满意。慢性乙型肝炎患者对IFN治疗出现应答差异的原因还不十分清楚。为此，我们检测了慢性乙型肝炎患者外周血单个核细胞（PBMC）诱导抗病毒IFN-α的能力，并分析α干扰素治疗前后不同应答者的α干扰素受体1（IFNAR1）的表达，试图从机体自身的免疫细胞来探讨出现差异的机制。     

Clinical significance of a myeloperoxidase gene polymorphism and inducible nitric oxide synthase expression in cirrhotic patients with hepatopulmonary syndrome

The clinical significance of a myeloperoxidase (MPO) gene polymorphism and inducible nitric oxide synthase (iNOS) expression in cirrhotic patients with hepatopulmonary syndrome (HPS) was explored. Enrolled subjects were divided into three groups according to their disease/health conditions: the HPS group (cirrhotic patients with HPS; n=63), the non-HPS group (cirrhotic patients without HPS; n=182), and the control group (healthy subjects without liver disease; n=35). The distribution of the MPO-463 G/A geno...     

表达人去唾液酸糖蛋白受体分子细胞系的建立

目的 构建稳定表达人肝细胞表面分子去唾液酸糖蛋白受体(asialoglycoprotein receptor,ASGPR)的细胞系.方法 逆转录PCR扩增人肝组织ASGPR大亚基H1全编码序列,插入到真核表达载体pIRES2EGFP中,重组质粒pIRES2EGFP/ASGPRH1转染HeLa细胞,G418筛选,RT-PCR,Western印迹及免疫荧光检测ASGPRH1的表达.结果 成功构建了pIRES2EGFP/ASGPRH1重组质粒,该质粒转染HeLa细胞后,Western印迹及免疫荧光均检测到ASGPRH1蛋白的表达.结论 成功建立了稳定表达人ASGPRH1的细胞系,为进一步研究ASGPR分子奠定了基础.     

关节腔内输注抗菌药物治疗假体关节感染有效性和安全性的Meta分析

摘要：目的:系统评价关节腔内输注抗菌药物治疗膝或髋关节置换术后假体关节感染（PJI）的有效性和安全性。方法:计算机检索PubMed、Embase、Cochrane Library和Web of Science数据库,搜集采用关节腔内输注抗菌药物治疗PJI的临床研究,检索时限均为从建库至2021年1月1日。由两位评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,对相关数据适时采用描述性分析或使用R软件进行Meta分析。结果:共纳入文献12篇（包括14项研究）,合计286例患者。所有研究均为病例系列研究。对14项研究的Meta分析结果显示,PJI的总体控制率为90%[95%CI（85%,93%）]。对10项报道了不良事件的研究进行描述性分析,结果表明关节腔内输注抗菌药物的治疗方案引发不良事件主要为可逆性肾毒性和局部并发症,各项研究的不良事件发生率为0%～75%不等。结论:现有证据表明,对于膝或髋关节置换术后发生的PJI,关节腔内输注抗菌药物可以取得相对较好的感染控制率,但同时该项技术也具有引发肾毒性和局部并发症的风险。     

HIV感染最佳免疫应答探讨

艾滋病全球广泛流行、破坏性极强、死亡率高,目前无预防疫苗和根治措施.人体暴露于HIV后,HIV主要通过侵犯CD4+的免疫细胞,在侵入细胞中大量繁殖,最终使免疫细胞遭到完全破坏.然而,最近发现暴露于HIV后,有些个体并不会有HIV感染的发生,这得益于人体“沉睡”的免疫系统.因此,“沉睡”的免疫应答可能是对HIV感染的最好免疫应答方式.这种对HIV天然免疫耐受机制可用来发展新的疫苗或治疗方法.     

献血员人群HCV感染状况及其输血传播的调查

采用ELISA对1572份献血员血清进行抗HCV检测,阳性率为12.15％。其中女性献血员抗HCV阳性率较男性为高、单采浆献血员者较单纯献血全血者为高,抗HCV检测阳性率随献血员年龄增长而增高。近期ALT升高的单采浆献血者血清抗HCV阳性者显著地高于无近期ALT升高史的同类单采浆献血员。结果证实严格开展献血员HCV感染者筛选将有助于输血相关性的丙肝的预防。     

Statistical analysis on 2213 inpatients with traffic injuries from January 2003 to September 2005 in Ningbo city

Objective: To analyze the epidemiological conditions and characteristics of inpatients with traffic trauma in order to provide objective data for basic research and clinical application of traffic trauma. Methods: The data of 2213 inpatients with traffic trauma admitted to Lihuili Hospital, Ningbo Medical Centre, Ningbo, China, from January 2003 to September 2005 were studied retrospectively. According to the transportation ways, the patients were divided into four groups; pedestrians, bicyclists, motorcyclists, and automobilists. And the data of injured regions, combined injuries and causes of death were analyzed statistically. Results: Among the 2213 patients, there were 550 pedestrians (23. 5%), 521 bicyclists (24.9%), 738 motorcyclists (33.3%), and 404 automobilists (18.3%). Male patients were more than female ones, with the ratio of male to female of 2.8:1. Single region injury was found in 1663 patients (75.15%) and multiple injuries in 550 patients (24.85%). In total, 2849 regions were injured. Fracture of extremities (53.3%) occurred most often, craniocerebral trauma (19.4%) next, then followed in turn by thoraco-abdominal visceral injury (6.56%), spine fracture (5.37%), fracture of ribs (4.88%), and pelvic fracture (4.18 %). The percentage of multiple injuries (33.2%) was highest and the percentage of thoraco-abdominal injury (18.0%) was higher in motorcyclists. The percentages of craniocerebral trauma in pedestrians and bicyclists were 27.8% and 28.2%, respectively. The incidence of fracture of extremities in motorcyclists reached 73.8%, but with the lowest case-fatality ratio of 1.4%. The incidence of traffic accidents caused by motorcyclists themselves (32.8%) was highest. A total of 56 patients died, with the case-fatality ratio of 2.53%. Among the deaths, 47 died from craniocerebral injury, 6 from multiple fractures combined with hemorrhagic shock, 2 from combined injury in the thoraco-abdominal region, and 1 from cervical cord injury. Conclusions: Nowadays, the patients with traffic trauma are mainly pedestrians, bicyclists and motorcyclists, and they suffer generally from fracture of extremities and craniocerebral injury. The main cause of death is craniocerebral injury. Another characteristic of traffic trauma is that the ratio of multiple injuries is higher.     

HBV G145R突变对S蛋白及“a”决定簇合成肽抗原性影响

人工合成G145R突变后HBsAg"a"决定簇多肽G145R-SP24,将G145R-SP24、重组G145R变异S蛋白及重组野生型HBsAg分组免疫BALB/c小鼠,制备相应抗血清。通过观察各免疫原与抗血清或抗G145R变异HBsAg McAb的免疫反应特征,分析并比较G145R突变后对S蛋白及"a"决定簇合成肽抗原性的影响。结果,几种免疫原均取得理想的免疫效果,ELISA证实各抗血清均有较好的特异性。G145R-SP24和G145R变异S蛋白免疫小鼠获得的抗血清效价较野生型HBsAg略低,且抗原性也发生了明显改变,G145R突变后"a"决定簇仍然具有较好的免疫原性;另外G145R-SP24与G145R变异S蛋白之间也显示出不同的抗原性,提示孤立的G145R变异HBsAg"a"决定簇与完整G145R S蛋白的"a"决定簇可能形成不同的空间构象。本研究为进一步探讨"a"决定簇突变后空间结构的变化规律与抗原性改变的特点奠定一定的基础。     

经皮肝穿刺置管引流治疗肝脓肿

198 8年以来我们共收治肝脓肿 12 8例 ,除 3例脓肿破裂行手术引流外 ,12 5例均行经皮肝穿刺置管引流治疗 ,取得了满意效果 ,现报告如下。1　临床资料1 1　一般资料　本组 12 5例。男 86例 ,女 3 9例 ;年龄 2 1～ 72岁 ;细菌性肝脓肿112例 ,阿米巴性肝脓肿 7例 ,混合感染 4例 ,未查到病原菌者 2例 ;肝右前叶 5 3例 ,右后叶 44例 ,左内叶 2 5例 ,左外叶 3例 ;发病短者 4d ,长者 2 5d ;细菌性肝脓肿及混合感染者术前均有不同程度的发热、肝区疼痛、肝脏肿大、白细胞总数升高 ,2 2例有贫血 ,6例有黄疸 ,1例感染性休克 ,12例反应性胸水 ,1例肝内…