重庆地区HCV基因亚型的分布状态

目的:探讨重庆地区丙型肝炎病毒(HCV)流行的基因亚型分布状态.方法:在77份抗HCV抗体和HCV RNA均阳性的血清标本中,分别提取HCV RNA,通过逆转录巢式PCR(RT nested-PCR)扩增C基因的羧基端至E1基因的氨基端长度为474 bp的片段,测定其核苷酸序列,与GenBank中已知的HCV序列进行系谱分析,确定HCV基因亚型.结果:77份HCV感染者血清标本通过RT-nested PCR检测均获得阳性条带,该方法特异性和敏感性均较好.序列与系谱分析显示1b 29例(38%),2a 10例(13%),3a 12例(16%),3b 11例(14%),6a 15例(19%),未见1a和2b型.结论:重庆地区HCV流行的基因亚型有1b,2a,3a,3b,6a共5种,1b为流行的主要基因亚型.2a,3a,3b和6 a型均占相当比例,初步说明重庆地区HCV流行的基因亚型呈现多样性.     

南宁市102例HIV/HCV共感染者HCV基因型特征分析

目的了解南宁市静脉注射吸毒人群(IDUs)中HIV/HCV共感染者HCV基因亚型流行情况。方法收集2012—2014年间南宁市静脉注射吸毒人员HIV/HCV共感染者血浆样本总共108份,设计特异性引物,通过巢式PCR对HCV NS5B区域长339 bp的片段进行扩增并测序,构建系统进化树对HCV进行基因分型。结果 108份血浆样本中巢式PCR成功扩增基因片段102份,系统进化分析显示检出4种HCV基因型含6种基因亚型,各基因亚型所占样本比例为6a 34.31%(35/102)、3b 33.33%(34/102)、1a 20.59%(21/102)、1b 6.87%(7/102)、3a 3.92%(4/102)和2a 0.98%(1/102)。在不同人口学特征时102份样本HCV基因型组成差异无统计学意义(P0.05)。结论南宁市IDUs人群HIV/HCV共感染者中至少存在6种HCV基因亚型流行,6a、3b和1a为主要流行亚型。     

贵州地区丙型肝炎病毒基因亚型分布状态

目的:探讨贵州地区丙型肝炎病毒(HCV)基因亚型分布状态.方法:在164份抗HCV抗体和HCVRNA均阳性的血清标本中,分别提取HCV RNA,通过逆转录巢式PCR(RT nested-PCR)扩增C基因的羧基端至E1基因的氨基端长度为474 bp的片段,测定其核苷酸序列,与GenBank中已知的HCV序列进行系谱分析,确定HCV基因亚型.结果:164份HCV感染者血清标本通过RT-nested均获得阳性条带,特异性和敏感性均较好,序列与系谱分析显示1a3例(1.8％)、1b 58例(35.4％)、2a 2例(1.2％)、3a 25例(15.2％)、3b 38例(23.2％)及6a 35例(21.3％).结论:贵州地区HCV流行的基因亚型有1a,1b,2a,3a,3b,6a共6种,主要为1b、3a、3b和6a亚型,提示贵州地区HCV流行的基因亚型呈现多样性.     

广州地区丙型肝炎患者HCV基因分型研究

目的研究广州地区丙型肝炎患者HCV基因型分布的变化情况。方法收集207例HCV RAN阳性丙型肝炎患者血清,对其HCV Core区(C区)和NS5B区基因序列进行RT-nPCR扩增,两区扩增成功的PCR产物进行基因测序,测序结果分别与相应的参照株序列比对,构建系统进化树,两区基因分型结果一致者确定HCV基因亚型。结果 185例HCV C区和NS5B区都扩增成功,其中179例两区基因分型结果一致。共检出1、2、3、6型4种基因型和8种基因亚型,其中1b型占40.78%(73/179),6a型占27.37%(49/179),3b型占11.73%(21/179),3a型占8.94%(16/179),2a型占6.15%(11/179),1a型占3.91%(7/179),2b型占0.56%(1/179),6n型占0.56%(1/179)。1b株可分为A、B、C三大簇,A簇与中国广泛流行1b株接近、B簇与中国中部及南部地区流行1b株接近,6a株分为Ⅰ、Ⅱ两大簇,与献血人群及静脉吸毒人群中6a型株接近。结论广州地区丙型肝炎患者HCV基因型以1b、6a、3型为主,存在多种亚型;1b型株包含中国大部分地区的1b型株,6a、3型已取代2a型分别成为第二、三主要流行基因型;未发现6型变异株。     

广州地区无偿献血人群HCV的基因分型研究

目的 探讨广州地区无偿献血人群中丙型肝炎病毒(HCV)基因型(亚型)的分布.方法 从无偿献血人群中收集HCV RNA阳性标本,通过RT-PCR扩增NS5B基因,阳性结果进行核苷酸序列测定,然后与GenBank中已知序列进行比较和分子进化分析,以确定HCV基因型(亚型).结果 对广州地区69例HCVRNA阳性血液标本进行NS5B基因扩增,扩增阳性67例,其中lb占37.31%(25/67),2a占 4.48%(3/67),3a占7.46%(5/67),3b占4.48%(3/67),6a占44.78%(30/67),6n占1.49%(1/67).结论 HCVlb和6a为广州地区无偿献血人群中流行的主要基因型(亚型).     

广东地区丙型肝炎患者的HCV基因分型研究

目的了解广东地区慢性丙型肝炎患者的HCV基因分型情况,为丙型肝炎病毒的诊断和预防提供有力依据。方法根据丙型肝炎病毒RNA全序列,在5′-NCR区设计引物,通过套式PCR扩增,特异性产物测序分析并分型。结果检测HCV感染样本58例,扩增出阳性样本47例,共检出3种基因型,分别为1b,2a和4型,其中1b占85.1%,2a占12.8%,4型占2.1%,4型为中国人群中极少报道被检出的罕见型。结论广东地区HCV基因型主要为1b型,其次为2a型,与中国其它地区HCV基因型分布比较一致。     

山东地区丙型肝炎病毒基因型及相关因素分析

目的 探索山东地区丙型肝炎病毒(HCV)基因分型及其相关关系.方法 采用基因芯片技术检出了448例HCV感染者的血清HCV基因型,同时检测了其中388例血清HCV RNA的含量,并对HCV基因型与HCV感染者的性别、年龄和HCV RNA含量进行了相关性分析.结果 检测到4种基因亚型(1a、1b、2a、3b),呈8种组合;其中1b和2a亚型多见,分别占61.2%(274例)和32.8%(147例).Logistic多因素分析表明,基因1b型与HCV高病毒载量独立相关.结论 山东地区HCV基因分型以1b型为主,且与HCV高病毒载量相关.     

乌鲁木齐地区82例丙型肝炎患者基因型分布研究

目的 观察乌鲁木齐地区丙型肝炎患者的丙型肝炎病毒(HCV)基因型分布情况,了解HCV基因型与民族、年龄的关系.方法 在82份抗HCV抗体和HCV RNA均阳性的血清标本中,分别提取HCV RNA,通过PCR-反向点杂交法进行基因分型检测.结果 82例血清标本检测示,基因分型率95.12%,其中1型占60.26%(47/78),2型占20.51%(16/78),3型占16.67%(13/78), 6型占2.56%(2/78).≤40岁和＞40岁基因型总体分布上存在差异(P＜0.05),维吾尔族、汉族间基因型分布无统计学差异.结论 乌鲁木齐地区流行的HCV基因型为1(1b)、2(2a)、3(3a、3b)、6(6a)4型,1型为流行的主要基因型, 2、3、6型均占相当比例,初步说明乌鲁木齐地区HCV流行的基因型呈现多样性.     

云南省曲靖市非高危人群丙型肝炎病毒基因型分析

目的对曲靖市感染丙型肝炎的非高危人群进行丙型肝炎病毒(HCV)基因分型研究,寻找本地区流行基因型,为丙型肝炎的科学防治提供依据。方法采集住院病人血液,提取RNA,采用HCV特异性引物进行巢式RT-PCR扩增,PCR产物直接测序,采用生物信息学软件进行序列分析。结果共采集228例病人血清,排除具有高危因素影响的血清29例,非高危人群丙型肝炎病人血清199例。共检出4个基因型(1、2、3、6),5个基因亚型(1b、2a、3a、3b和6a),有37例不能鉴别的基因亚型。其中1b型78例(39. 2%)、2a型42例(21. 1%)、3a型15例(7. 5%)、3b型23例(11. 6%)、6a型4例(3. 0%)和未能分型37例(18. 6%)。根据文献检索提取云南省HCV基因分型流行情况,对于HIV/HCV共感染的静脉吸毒者(Intraductal Ultrasonography,IDUS)和静脉吸毒HCV感染者,前3位的基因亚型分别为3b、3a、1b;对于标本来源为医院病人,未进行感染途径分类,前3位的基因亚型分别为1b、3b、2a。结论曲靖市丙型肝炎非高危感染人群主要HCV基因亚型1b型和2a型与我国的主要基因亚型基本一致,与云南省主要的HCV基因亚型略有区别,但与同地区的HIV/HCV共感染的静脉吸毒者HCV基因型有着明显区别。     

海南省163例汉族HCV慢性感染者中的基因型分布

目的了解丙型肝炎病毒(HCV)在海南省汉族HCV慢性感染者中的基因型分布特点。方法选择在海南省人民医院就诊的176份汉族本土HCV慢性感染者(HCV-Ab和HCV RNA均阳性)血清标本,通过提取HCV-RNA,然后使用RT-PCR、巢式PCR(Nested-PCR)方法来扩增Core-E1区并测定其核苷酸序列,最后与已知HCV基因型序列构建系统发育树分析、确定其基因亚型及分布。结果成功提取HCV-RNA和测序的海南省汉族HCV慢性感染者标本为163例,检出阳性率为92.6%,其基因型分布和比率如下:1a型占3.1%(5/163),1b型占33.1%(54/163),2a型占6.7%(11/163),3a型占8.6%(14/163),3b型占14.7%(24/163),6a型占33.7%(55/163)。结论海南省汉族HCV慢性感染者中基因型分布与全国的HCV基因型分布一样,基因型为1a、1b、2a、3a、3b和6a。海南省汉族同属我国汉族HCV传播圈,本研究发现6a是海南省汉族HCV慢性感染者中最主要的基因亚型,提示6a可能在海南省汉族人群中发生迅速传播。     

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.     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.