中西医结合治疗慢性活动性肝炎50例疗效观察

目的从中医化瘀补虚法组方,配合西药干扰素等,治疗慢性活动性肝炎(CAH)50例,并于单纯西药组50例进行了对比观察。结果临床治愈29例(58%),好转10例(20%),无效11例(22%),总有效率为78%。临床症状体征、肝功能改善等方面均较对照组为优。提示该疗法是治疗ACH较理想的方法。     

登革病毒1型Ⅰ～Ⅴ基因亚型的基因组差异分析

目的分析登革病毒1型(Dengue virus type 1,DENV-1)Ⅰ～Ⅴ基因亚型基因组全长核苷酸及氨基酸序列差异。方法通过GenBank搜索DENV-1 5个不同基因亚型的全长基因组序列,获得其相应的氨基酸序列。采用BIOEDIT软件,统计基因亚型间核苷酸突变和氨基酸替代位点,分析其相似度,通过RNA二级结构在线预测网站预测DENV-1不同亚型间3′UTR的二级结构差异,蛋白结构在线预测网站预测主要流行于中国的Ⅰ及ⅤDENV-1基因亚型结构蛋白的二级结构,对其氨基酸组成及编码序列中可能存在的蛋白结合区域等进行差异分析。结果DENV-1 5个基因亚型核苷酸相似性为91. 40%～94. 50%,氨基酸序列相似性为97. 11%～98. 38%,5个基因亚型各自编码3 392个氨基酸,其中共有195个位点有氨基酸的变化。DENV-1不同亚型的3′UTR的二级结构各不相同。DENV-1基因型为Ⅰ、Ⅴ的775个氨基酸中占组成比例最多的均是苏氨酸(T),Ⅰ型可能的蛋白结合位点有26个,多聚核苷酸结合位点有9个。Ⅴ型可能的蛋白结合位点有24个,多聚核苷酸结合位点有7个。他们均有相同数量的螺旋和跨膜螺旋。结论通过对DENV-1 5个不同的基因亚型的全长核苷酸和氨基酸序列的比较分析,及Ⅰ、Ⅴ基因亚型结构蛋白二级结构的预测,为研究DENV-1不同基因型之间的生物学和致病性差异提供参考。     

步长稳心颗粒治疗老年室上性期前收缩的疗效及安全性

目的观察步长稳心颗粒治疗老年室上性期前收缩的效果及安全性。方法将106例老年室上性期前收缩患者随机分为两组,A组(54例):口服步长稳心颗粒;B组(52例):口服美托洛尔,治疗4周后,观察血尿常规、血脂、血糖、肝功能、肾功能、心电图及24h动态心电图的变化。结果步长稳心颗粒治疗组总有效率为83.3%,美托洛尔治疗组总有效率为82.7%,两组比效差异无统计学意义(P>0.05),步长稳心颗粒治疗组用药前后HR、PR间期、QRS波时限、QT间期变化不明显,(P>0.05),血尿常规、肝功能、肾功能、血糖、血脂无明显变化。结论步长稳心颗粒用于治疗老年室上性期前收缩有效率与美托洛尔相似,且该药安全,无明显不良反应。     

62例小儿肺炎支原体感染临床分析

目的探索小儿肺炎支原体感染病例临床特征。方法总结62例肺炎支原体感染住院患儿的临床资料并进行分析。结果婴幼儿病例29例,占46.8%;3岁以上患儿33例,占53.2%。婴幼儿病例中肺部出现湿音者13例,占44.8%;3岁以上患儿中肺部出现湿音者5例,占15.1%。婴幼儿病例中出现肺外并发症者6例,占20.7%;3岁以上患儿出现肺外并发症者14例,占42.4%。结论肺炎支原体感染患儿中婴幼儿病例和3岁以上患儿临床表现差异较大,婴幼儿病例以肺部表现明显且较重,而3岁以上患儿则肺部体征不明显,更易发生肺外并发症,所有病例阿奇霉素治疗效果好,疗程短。     

2013-2018年太原市手足口病流行特征及病原学分析

目的 分析2013-2018年太原市手足口病(hand,foot and mouth disease,HFMD)流行及病原学特征,为HFMD的防控提供科学依据.方法 用Excel 2003及SaTScan9.4.1软件对太原市2013-2018年HFMD病例资料分别进行统计描述及时空聚集性分析,采用RT-PCR对部分H...     

冠状动脉内旋磨术的疗效观察及临床随访

目的观察冠状动脉内旋磨术对钙化、纤维化病变的疗效及临床随访结果。方法对30例冠心病患者的钙化或纤维化病变进行冠脉内旋磨术、冠脉球囊扩张及冠脉支架术,观察患者的手术成功率、围术期并发症及临床随访结果。结果行冠脉内旋磨术的30例患者冠脉造影结果均为B2、C型钙化或纤维化病变。其中1例患者旋磨头未成功通过病变,成功率96.67%;14例(46.67%)病例仅用1.25mm的旋磨头,13例(43.33%)病例仅用1.5mm的旋磨头,仅有1例(3.33%)病例选用1.75mm旋磨头,2例(6.67%)病例分别使用了1.25mm、1.5mm的旋磨头。旋磨术成功的29例患者(96.67%)均应用经皮冠脉血管成形术(PTCA),其中28例(93.33%)在旋磨术后置入支架(均为药物洗脱支架),共植入支架49枚,平均每例患者植入支架1.75枚;平均每例患者植入支架长度(52.2±30.97)mm。2例(6.67%)在术中发生轻度冠脉痉挛;1例(3.33%)发生无血流现象;1例发生一过性三度房室传导阻滞(3.33%),无围术期急性心肌梗死、死亡、冠脉穿孔及急诊冠脉旁路移植术(CABG)。对30例患者进行了(15.9±11.2)个...     

220株铜绿假单孢菌的临床分布及耐药性分析

目的本调查试图通过分析220株铜绿假单孢菌的来源和耐药性来了解铜绿假单孢菌的流行和耐药情况。方法选用220株来自永州市人民医院2009年7月至2010年1月临床标本的铜绿假单孢菌,分析其临床分布情况并用药敏试验测定其对13种抗菌药的耐药性。结果菌株来源分析显示铜绿假单孢菌可以在人体不同部位、临床不同科室引起院内感染,而感染率最高的是呼吸道和抗菌药被大量使用的呼吸内科和外科ICU。药敏试验结果显示铜绿假单孢菌对β-内酰胺类、氨基糖苷类和头孢类抗菌药不敏感,而敏感度最高的是阿米卡星(81.4%)和妥布霉素(77.7%)。结论本次调查结果可以指导临床治疗铜绿假单孢菌感染的药物选择,同时有助于了解和控制铜绿假单孢菌引起的院内感染的流行情况。     

湘潭县和融水县2岁以下婴幼儿轮状病毒腹泻病流行病学调查

目的通过对监控区域内腹泻病例的监测,获取轮状病毒(rotavirus,RV)腹泻发生率。方法在广西壮族自治区融水县、湖南省湘潭县两个地区的村卫生室及乡镇卫生院中开展腹泻监测,收集腹泻病例和流行病学信息,采集病例粪便样本。应用ELISA法检测RV,RT-PCR法对其进行基因分型。结果湘潭县和融水县RV腹泻高峰主要集中在2月份,分别占总数的45. 9%和53. 9%;两地腹泻发病率为285. 1/(1 000人·年),RV检出率为18. 0%,RV腹泻发病率为51. 2/(1 000人·年);湘潭县和融水县的轮状病毒血清型均以G9型(分别占58. 7%和73. 7%)和P8型为主(分别占67%和81. 6%)。结论 RV是导致2岁以下婴幼儿腹泻的常见病原体,湘潭和融水县的RV流行株均为G9型和P8型,流行高峰为2月。     

肝源性溃疡的临床特点

目的观察肝源性溃疡(HU)的临床特点,提高对肝源性溃疡的临床诊断意识,鉴别食管静脉曲张破裂出血与肝源性溃疡出血。方法经胃镜检查发现的41例HU病人分析其临床表现与内镜结果,并与消化性溃疡病(PUD)进行对比分析。结果HU的检出率为21.1%(41/194),大部分HU病人均症状不典型,缺乏PUD相应的节律性上腹痛、上腹烧灼感等典型表现。其中胃溃疡27例(65.8%);十二指肠溃疡14例(34.2%)。合并溃疡出血25例(60.9%)、胃粘膜下出血4例(9.7%)、合并胃粘膜糜烂13例(31.7%)。HU均伴有食管静脉曲张,静脉曲张程度为重度21例(51.2%)、中度13例(31.7%)、轻度7例(17.1%)。HU与肝功能分级的关系:A级4例(9.8%),B级17例(41.4%),C级20例(48.8%),在C、B两级中发生率高。结论肝源性溃疡发病率高,其中以胃溃疡比例增多,临床症状不典型、易出血,临床上与食管静脉曲张出血较难鉴别,早期胃镜检查是鉴别两者出血的最可靠方法。     

登革病毒Ⅰ型拷贝数标准质粒和检测体系的建立及其应用

目的建立登革病毒Ⅰ型(dengue virus-Ⅰ,DENV-Ⅰ)拷贝数标准质粒及其检测体系。方法将DENV-Ⅰ的前膜蛋白基因克隆至pMD19-T载体,建立DENV-Ⅰ标准质粒,采用实时荧光定量PCR法进行扩增,获得Ct值与病毒拷贝数的关系,绘制标准曲线,得到相应的标准曲线方程。采用建立的标准质粒及检测体系对3份2017年云南西双版纳DENV-Ⅰ患者的血清进行检测。结果经双酶切及测序鉴定,DENV-Ⅰ拷贝数标准质粒构建正确。实时荧光定量PCR得到的标准曲线方程为y=-0. 300 5 x+12. 133,R~2=0. 991 9。3份血清样品原液的病毒拷贝数分别为9 417 703. 12、21 949 591. 01及19 027 096. 91 copies/μL。结论成功建立了DENV-Ⅰ拷贝数标准质粒及其检测体系,且准确性较好,灵敏度较高,可用于血清样品中DENV-Ⅰ拷贝数的检测。     

Instability of the NS1 Glycoprotein from La Reunion 2018 Dengue 2 Virus (Cosmopolitan-1 Genotype) in Huh7 Cells Is Due to Lysine Residues on Positions 272 and 324

La Reunion island in the South West Indian Ocean is now endemic for dengue following the introduction of dengue virus serotype 2 (DENV-2) cosmopolitan-I genotype in 2017. DENV-2 infection causes a wide spectrum of clinical manifestations ranging from flu-like disease to severe dengue. The nonstructural glycoprotein 1 (NS1) has been identified as playing a key role in dengue disease severity. The intracellular NS1 exists as a homodimer, whereas a fraction is driven towards the plasma membrane or released as a soluble hexameric protein. Here, we characterized the NS1 glycoproteins from clinical isolates DES-14 and RUN-18 that were collected during the DENV-2 epidemics in Tanzania in 2014 and La Reunion island in 2018, respectively. In relation to hepatotropism of the DENV, expression of recombinant DES-14 NS1 and RUN-18 NS1 glycoproteins was compared in human hepatoma Huh7 cells. We observed that RUN-18 NS1 was poorly stable in Huh7 cells compared to DES-14 NS1. The instability of RUN-18 NS1 leading to a low level of NS1 secretion mostly relates to lysine residues on positions 272 and 324. Our data raise the issue of the consequences of a defect in NS1 stability in human hepatocytes in relation to the major role of NS1 in the pathogenesis of the DENV-2 infection.     

Ligand Accessibility Insights to the Dengue Virus NS3-NS2B Protease Assessed by Long-Timescale Molecular Dynamics Simulations

Dengue is a tropical disease caused by the dengue virus (DENV), with an estimate of 300 million new cases every year. Due to the limited vaccine efficiency and absence of effective antiviral treatment, new drug candidates are urgently needed. DENV NS3-NS2B protease complex is essential for viral post-translational processing and maturation, and this enzyme has been extensively studied as a relevant drug target. Crystal structures often underestimate NS3-NS2B flexibility, whereas they can adopt different conformational states depending on the bound substrate. We conducted molecular dynamics simulations (∼30 μs) with a non- and covalently bound inhibitor to understand the conformational changes in the DENV-3 NS3-NS2B complex. Our results show that the open-closing movement of the protease exposes multiple druggable subpockets that can be investigated in later drug discovery efforts.     

Dengue virus type 2 envelope protein displayed as recombinant phage attachment protein reveals potential cell binding sites

A method to map the specific site on dengue virus envelope protein (E) that interacts with cells and a neutralizing antibody is developed using serially truncated dengue virus type 2 (DENV-2) E displayed on M13 phages as recombinant E-g3p fusion proteins. Recombinant phages displaying the truncated E consisting of amino acids 297-423 (EB2) and amino acids 379-423 (EB4) were neutralized by DENV-2 patient sera and the DENV-2 E-specific 3H5-1 monoclonal antibodies suggesting that the phages retained the DENV-2 E antigenic properties. The EB4 followed by EB2 recombinant phages bound the most to human monocytes (THP-1), African green monkey kidney (Vero) cells, mosquito (C6/36) cells, ScFv specific against E and C6/36 cell proteins. Two potential cell attachment sites were mapped to loop I (amino acids 297 to 312) and loop II (amino acids 379-385) of the DENV-2 E using the phage-displayed truncated DENV-2 E fragments and by the analysis of the E structure. Loop II was present only in EB4 recombinant phages. There was no competition for binding to C6/36 cell proteins between EB2 and EB4 phages. Loop I and loop II are similar to the sub-complex specific and type-specific neutralizing monoclonal antibody binding sites, respectively. Hence, it is proposed that binding and entry of DENV involves the interaction of loop I to cell surface glycosaminoglycan-motif and a subsequent highly specific interaction involving loop II with other cell proteins. The phage displayed truncated DENV-2 E is a powerful and useful method for the direct determination of DENV-2 E cell binding sites.     

长春市2018~2019年婴幼儿口服轮状病毒减毒活疫苗不良反应分析

目的分析长春市2018~2019年婴幼儿口服轮状病毒减毒活疫苗(简称轮状病毒疫苗)不良反应。方法以2018年6月~2019年8月于长春市所有预防接种门诊口服轮状病毒疫苗的2~47月龄婴幼儿为研究对象,监测接种后30 min、3 d、30 d内发生的发热、乏力、烦躁、胃肠道反应及变态反应等情况,监测数据采用卡方检验进行统计分析。结果长春市2018年6月~2019年8月口服轮状病毒疫苗的2~47月龄婴幼儿共10822人次,发生不良反应1624例次,排在前5位不良反应依次为吐出疫苗、哭闹不止、发热、食欲下降及恶心呕吐,且未见变态反应等异常反应。月龄及疫苗复温情况是发生吐出疫苗的重要影响因素;月龄是发生哭闹不止的重要影响因素;性别、月龄及疫苗复温情况是发生发热重要影响因素;疫苗复温情况是发生食欲下降的重要影响因素。结论疫苗复温及降低接种年龄可缓解轮状病毒疫苗接种后的不良反应。     

Cytokine Signature of Dengue Patients at Different Severity of the Disease

Clinical presentations of dengue fever (DF) are diverse and non-specific, causing unpredictable progression and outcomes. Its progression and severity have been associated with cytokine levels alteration. In this study, dengue patients were classified into groups following the 2009 WHO dengue classification scheme to investigate the cytokine signature at different severity of the disease: dengue without warning sign symptoms (A); dengue with warning signs (B); severe dengue (C); other fever (OF) and healthy (Healthy). We analyzed 23 different cytokines simultaneously, namely IL-1b, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12p70, IL-17A, IL-33, CD14, CD54, CD62E, CD62L, CD62p, CD106, CD121b, CD154, CD178, GM-CSF, IFN-g, MIF, ST2 and TNF from patients admitted to National Cheng Kung University Hospital during the 2015 Taiwan dengue outbreak. Cytokines TNF, CD54, CD62E, CD62L, CD62P, GM-CSF, IL-1b, IL-2, IL-6, IL-8, IL-10, IL-12p70, IL-17A, INF-g and MIF were elevated while CD106, CD154, IL-4 and L-33 were decreased when compared to the control. IL-10 demonstrated to be a potential diagnostic marker for DF (H and A group; AUC = 0.944, H and OF group; AUC = 0.969). CD121b demonstrated to be predictive of the SD (A and B group; AUC = 0.744, B and C group; AUC = 0.775). Our results demonstrate the cytokine profile changes during the progression of dengue and highlight possible biomarkers for optimizing effective intervention strategies.     

2017～2018年宁波市出生儿童13价肺炎球菌结合疫苗接种率分析

目的分析2017~2018年宁波市出生儿童13价肺炎球菌结合疫苗(13-valent pneumococcal conjugate vaccine,PCV13)的接种率。方法收集宁波市“免疫预防管理信息系统”中2017~2018年出生儿童的PCV13接种信息,采用描述性流行病学方法进行统计分析。结果宁波市2017~2018年出生儿童221921人,接种PCV13有25124人,≥1剂次接种率为11.32%,其中至少接种3针PCV13的有19212人,≥3剂次接种率为8.66%。25124名<2岁儿童中,首针疫苗接种年龄≤1、2、3、4和≥5月龄者分别为5428、11287、5556、2608和245人,分别占21.60%、44.93%、22.11%、10.38%和0.98%。不同地区、户籍类型、出生年份儿童PCV13≥1和≥3剂次接种率差异均有统计学意义(P均<0.001),不同地区、性别、户籍类型、出生年份儿童PCV13首针疫苗接种年龄差异有统计学意义(P均<0.01)。结论宁波市儿童PCV13接种率处于较低水平,建议将PCV13纳入国家免疫规划项目。     

登革病毒反向遗传学技术的研究进展

登革病毒(dengue virus,DENV)是流行于世界范围内的重要虫媒病毒之一,近年来其传播范围的不断扩大给疾病防控带来了极大困难。反向遗传学技术作为一种重要手段,广泛应用于RNA病毒的相关研究,自1991年第1次成功构建DENV感染性克隆以来,明显加速了DENV相关领域的研究。本文总结了DENV反向遗传学技术的构建策略及技术突破,为DENV致病机制研究及疫苗研发提供新思路。     

Canavalia ensiformis neutral lipids,a rich source of lupeol

The composition of the neutral lipids ofCanavalia ensiformis, which represent 2.21% of whole seeds, has been investigated. The fatty acid composition is characterized by the presence of palmitic (15%), oleic (54%), linoleic (7%) and linolenic (8%) acids. The unsaponifiable matter (7.9% of the neutral lipids), was examined for sterol, 4α-methylsterol and triterpene alcohols. The occurrence of lupeol in high amount in the last fraction (96%) constitutes an interesting source for this compound.     

岳阳市献血者Rh血型系统表型的调查及Rh阴性献血者档案库的建立

目的调查岳阳市无偿献血人群Rh血型系统的表型,建立Rh阴性献血者档案库。方法使用Rh血型定型试剂,采用平板法进行初筛,结果可疑者用试管法确认。初筛阴性标本送血型参比室做确认试验,并进行Rh因子C、c、E、e和不规则抗体筛选。结果在183 596名无偿献血者中共筛出RhD阴性献血者404名(0.22%),弱D 5名(0.003%)。404名Rh阴性献血者中共检出A型112名(27.7%),B型112名(27.7%),O型128名(31.7%),AB型52名(12.9%)。表型共7种:ccdee 212名(52.5%),Ccdee 124名(30.7%),CCdee 30名(7.4%),ccdEe 18名(4.4%),ccdEE 8名(2.0%),CcdEe 8名(2.0%),CCdEe 4名(1.0%)。结论已建立了岳阳市Rh阴性献血者档案库。     

Cell Sheet Comprised of Mesenchymal Stromal Cells Overexpressing Stem Cell Factor Promotes Epicardium Activation and Heart Function Improvement in a Rat Model of Myocardium Infarction

Cell therapy of the post-infarcted myocardium is still far from clinical use. Poor survival of transplanted cells, insufficient regeneration, and replacement of the damaged tissue limit the potential of currently available cell-based techniques. In this study, we generated a multilayered construct from adipose-derived mesenchymal stromal cells (MSCs) modified to secrete stem cell factor, SCF. In a rat model of myocardium infarction, we show that transplantation of SCF producing cell sheet induced activation of the epicardium and promoted the accumulation of c-kit positive cells in ischemic muscle. Morphometry showed the reduction of infarct size (16%) and a left ventricle expansion index (0.12) in the treatment group compared to controls (24–28%; 0.17–0.32). The ratio of viable myocardium was more than 1.5-fold higher, reaching 49% compared to the control (28%) or unmodified cell sheet group (30%). Finally, by day 30 after myocardium infarction, SCF-producing cell sheet transplantation increased left ventricle ejection fraction from 37% in the control sham-operated group to 53%. Our results suggest that, combining the genetic modification of MSCs and their assembly into a multilayered construct, we can provide prolonged pleiotropic effects to the damaged heart, induce endogenous regenerative processes, and improve cardiac function.