背景 艾滋病(AIDS)已經(jīng)成為人類目前所面臨的危害最為嚴(yán)重的疾病之一.艾滋病病毒(HIV)主要有三個(gè)傳播途徑:血液、性行為和母嬰垂直傳播;而通過輸血傳播的效率更高.由于缺乏有效的HIV篩檢方法或方法應(yīng)用不當(dāng)以及缺乏嚴(yán)格的管理,通過輸血傳播HIV的危險(xiǎn)極為嚴(yán)重,特別是在一些發(fā)展中國家.自從1985年FDA批準(zhǔn)第一個(gè)HIV試劑用于獻(xiàn)血員篩檢以來,迄今已經(jīng)生產(chǎn)出第4代篩檢試劑.最初HIV檢測試劑僅用于篩檢獻(xiàn)血員,后來成為了HIV預(yù)防工作的重要方面.目前HIV篩檢已被視為國家艾滋病預(yù)防和治療策略的重要內(nèi)容. 目的 評價(jià)用于獻(xiàn)血員HIV篩檢所有方法的有效性,從而找出最合適的方法,以減少HIV通過輸血傳播的危險(xiǎn). 檢索策略 以"HIV"、"AIDS"、"screening"、"test"、"blood donor"、"blood bank"等為主題,檢索了MEDLINE、CENTRAL/CCTR、AIDSLINE、EMBASE、CBM等數(shù)據(jù)庫;同時(shí)檢索了WHO、UNAIDS、CDC、FDA及其相關(guān)網(wǎng)站,并與該領(lǐng)域的專家和機(jī)構(gòu)聯(lián)系,以獲得未發(fā)表的文獻(xiàn). 資料納入標(biāo)準(zhǔn) 納入了所有與獻(xiàn)血員HIV篩檢方法有關(guān)的隨機(jī)對照試驗(yàn)(RCT)、臨床對照試驗(yàn)(CCT);同時(shí)一些觀察性研究,如隊(duì)列研究、病例對照研究和歷史對照研究等納入用于敏感性分析. 評價(jià)方法 參照Cochrane 系統(tǒng)評價(jià)的原則,選擇納入的研究,并對其進(jìn)行質(zhì)量評價(jià)、數(shù)據(jù)提取和分析.
目的 探討熱性驚厥患兒血清電解質(zhì)和血糖的變化及其臨床意義。 方法 選取2009 年6月－2010 年12月兒科住院的呼吸道感染并發(fā)熱性驚厥患兒38例和呼吸道感染無驚厥患兒42例，分別作為觀察組和對照組，測定和比較兩組患兒血清電解質(zhì)和血糖值。 結(jié)果 觀察組血清鈉離子濃度為（133.05 ± 1.74）mmol/L、氯離子濃度為（100.37 ± 1.79）mmol/L；對照組血清鈉離子濃度為（142.19 ± 1.85）mmol/L、氯離子濃度為（104.57 ± 1.55）mmol/L，差異均有統(tǒng)計(jì)學(xué)意義（P＜0.01）；觀察組和對照組血糖濃度依次為（6.93 ± 0.87）、（5.12 ± 0.55）mmol/L，差異有統(tǒng)計(jì)學(xué)意義（P＜0.01）。觀察組在治療后的血清鈉離子、氯離子濃度分別為（140.89 ± 2.68）、（103.29 ± 1.94）mmol/L，均高于發(fā)生驚厥時(shí)的濃度（P＜0.01）；觀察組在治療后的血糖濃度為（5.31 ± 0.68）mmol/L，明顯低于發(fā)生驚厥時(shí)，差異有統(tǒng)計(jì)學(xué)意義（P＜0.01）。 結(jié)論 嬰幼兒發(fā)生熱性驚厥時(shí)存在血鈉、血氯水平降低和血糖升高，在熱性驚厥患兒的治療中應(yīng)糾正血鈉水平和高血糖。Objective To explore the clinical significance of the changes in serum electrolytes and blood glucose in the children with febrile convulsion. Methods Thirty-eight children with respiratory infection combined with febrile convulsion and 42 children with single respiratory infection diagnosed between June 2009 and December 2010 were selected as the observation group and control group, respectively. Serum electrolytes and blood glucose concentration were assayed and compared between the two groups. Results The concentrations of serum sodium and chloride were (133.05 ± 1.74) mmol/L and (100.37 ± 1.79) mmol/L in the observation group, while (142.19 ± 1.85) and (104.57 ± 1.55) mmol/L in the control group; the differences between the two groups were significant (Plt;0.01). The concentrations of blood glucose were (6.93 ± 0.87) mmol/L in the observation group and (5.12 ± 0.55)mmol/L in the control group; the difference was significant (Plt;0.01). After the treatment, the serum concentrations of sodium and chloride were (140.89 ± 2.68) and (103.29 ± 1.94)mmol/L in the observation group, which were higher than those before treatment (Plt;0.01). After treatment, the blood glucose concentration was (5.31 ± 0.68）mmol/L in the observation group, which was lower than that before the treatment (Plt;0.01). Conclusion Hyponatremia, low serum chlorine and hyperglycemia occurre in the febrile convulsion in children, which should be corrected in the treatment of febrile convulsion.
【摘要】 目的 研究合并2型糖尿病的冠心病患者冠狀動脈病變程度與血清視黃醇結(jié)合蛋白4（retinol-binding protein 4，RBP4）水平的相關(guān)性?！》椒ā?008年10月-2010年4月選擇性冠狀動脈造影確診的冠心病患者共120例，分為單純冠心病組（A組）60例和冠心病合并糖尿病組（B組）60例，檢測血糖、血脂、胰島素以及脂聯(lián)素、RBP4水平；根據(jù)冠狀動脈造影結(jié)果，以Gensini評分評判冠狀動脈病變程度?！〗Y(jié)果 B組空腹血糖、胰島素、RBP4均顯著高于A組（Plt;0.05）；冠狀動脈病變程度更重（Plt;0.05）。相關(guān)性分析顯示RBP4水平與低密度脂蛋白膽固醇、胰島素抵抗和冠狀動脈病變積分呈正相關(guān)（r=0.312、0.322、0.314，Plt;0.05）。與脂聯(lián)素水平呈負(fù)相關(guān)（r=-0.362，Plt;0.01）。 結(jié)論 冠心病合并2型糖尿病患者RBP4明顯升高，且與冠狀動脈狹窄程度呈正相關(guān)?！続bstract】 Objective To explore the relationship between the level of serum retinol-binding protein 4 (RBP4) and the extent of coronary lesions in coronary heart disease (CHD) patients accompanied with type 2 diabetes mellitus (T2DM). Methods A total of 120 patients with CHD diagnosed by coronary arteriongraphy between October 2008 and April 2010 were enrolled. The patients were divided into two groups: CHD group (60 patients); CHD accompanied with T2DM group (60 patients). The levels of serum insulin, adiponectin and RBP4 were measured. All the patients underwent coronary angiography and the extent of coronary lesions was assessed quantitatively based on the Gensini′s scoring system. Results The levels of serum insulin, plasma RBP4 and the extent of coronary artery stenosis in CHD accompanied with T2DM group were significantly higher than those in CHD group (Plt;0.05). Correlation analysis showed that the level of RBP4 was positively correlated with LDL-C, insulin resistance index and the coronary artery narrow degree（r=0.312, 0.322, 0.314; Plt;0.05); and negatively correlated with adiponectin (r=-0.362, Plt;0.01). Conclusion The significant elevated plasma RBP4 in CHD patients accompanied with T2DM is positively correlated with the extent of coronary artery lesion.
【摘要】 目的 了解北京地區(qū)400例新型甲型H1N1流感患者的流行病學(xué)和臨床特征，總結(jié)規(guī)律，進(jìn)一步指導(dǎo)臨床診治?！》椒ā?009年5-12月期間，收治400例甲型H1N1流感確診病例，主要采用描述性流行病學(xué)方法對患者資料進(jìn)行回顧性分析，并運(yùn)用單因素方差分析的方法對結(jié)果進(jìn)行檢驗(yàn)。 結(jié)果 患者以青年和兒童人群為主，47.0%的患者有明確甲型H1N1流感接觸史，主要癥狀包括發(fā)熱（98.8%）、咳嗽（85.8%）、咽痛（58.5%）。咽部充血（94.0%）和扁桃體腫大（49.5%）為主要體征。外周血白細(xì)胞正?；蚱?，349例（82.3%）患者血清鐵降低，268例（72.6%）患者C反應(yīng)蛋白升高。在發(fā)病后不同時(shí)間內(nèi)給予奧司他韋治療的患者發(fā)熱持續(xù)時(shí)間和咽拭子的陰轉(zhuǎn)時(shí)間有顯著差異（Plt;0.001）?！〗Y(jié)論 新型甲型H1N1流感發(fā)病多以青年和兒童人群為主，以流感樣癥狀為主，多數(shù)癥狀輕微，預(yù)后良好，C反應(yīng)蛋白和血清鐵的變化可能對于早期診斷有指導(dǎo)價(jià)值，奧司他韋早期抗病毒治療可以縮短病程。【Abstract】 Objective To investigate the clinical and epidemiologic characteristics of pandemic influenza A (H1N1) virus infection in Beijing. Methods The epidemiological information and clinical characteristics of 400 patients with pandemic influenza A (H1N1) virus infection hospitalized in Beijing 302 Hospital from May to December, 2009 were analyzed retrospectively by descriptive epidemiology. One-way ANOVA was used to assess the results. Results H1N1 virus infection preferentially affected adolescents and young adults. The mean age of the patients was 23 years. A total of 189 (47.0%) of the patients had an identifiable epidemiologic link to another confirmed patient. The most common symptoms were fever (98.8%), cough (85.8%) and sore throat (58.5%). The main physical signs were pharyngeal portion congestion (94.0%) and antiadoncus (49.5%). The number of leukocytes in the peripheral blood was normal or low. The decreased serum iron and elevated C-reaction protein were found in 82.3% and 72.6% of the patients. There was significant difference in the duration of fever and viral shedding from throat swabs among the patients who accept the antiviral medication within the different time. Conclusion H1N1 virus infection preferentially affects adolescents and young adults, and presents with influenza-like illness. The clinical course of H1N1 virus infection is generally mild. The change of C-reaction protein and serum iron may be favorable for the diagnosis of H1N1. Early antiviral treatment may shorten the duration of fever and viral shedding.
目的:觀察急性時(shí)相反應(yīng)指數(shù)在成人Still病中的變化規(guī)律。方法：以32例成人Still病患者為觀察組，以50例門診體檢者為對照組，檢測其血清鐵蛋白和C反應(yīng)蛋白水平。結(jié)果：觀察組檢測結(jié)果在SF、CRP和APRI三項(xiàng)較對照組均有顯著的差異（Plt;0.05），其中APRI最為顯著（Plt;0.001）。結(jié)論：急性時(shí)相反應(yīng)指數(shù)在成人Still病的診斷中有較高的應(yīng)用價(jià)值。
目的：本研究通過觀察經(jīng)地塞米松處理前后培養(yǎng)的人小梁細(xì)胞的變化,探討激素性青光眼房水排出阻力增加的機(jī)制。方法：將人類小梁細(xì)胞培養(yǎng)至接近體內(nèi)的高分化狀態(tài)，用地塞米松處理后,觀察細(xì)胞形態(tài)的變化，并檢測以下蛋白的分布和表達(dá)：(1)myocilin/TIGR蛋白；(2)纖連蛋白；(3)肌動蛋白交聯(lián)網(wǎng)的形成；(4)血清淀粉樣物質(zhì)A蛋白。結(jié)果：人小梁細(xì)胞經(jīng)地塞米松處理后(1)胞體變大，排列不規(guī)則，邊界模糊，呈“融合”狀；(2)細(xì)胞內(nèi)外myocilin/TIGR蛋白表達(dá)均明顯增加，其胞外表達(dá)與纖連蛋白位置一致,提示相互作用；(3)纖連蛋白表達(dá)增加；(4)CLANs形成，細(xì)胞間連接增強(qiáng)；(5)血清淀粉樣物質(zhì)A蛋白表達(dá)增加。結(jié)論：人類小梁細(xì)胞經(jīng)地塞米松處理后形態(tài)發(fā)生變化，可能與應(yīng)力纖維變化及myocilin蛋白在細(xì)胞內(nèi)積聚有關(guān)。細(xì)胞間邊界不清，與細(xì)胞外基質(zhì)蛋白過度表達(dá)、沉積有關(guān)。小梁細(xì)胞外基質(zhì)沉積以及異常的細(xì)胞間連接等改變與房水排出阻力增加的病理過程有關(guān)。
目的 利用表面增強(qiáng)激光解析離子化飛行時(shí)間質(zhì)譜儀及其配套蛋白質(zhì)芯片篩選胃癌生物學(xué)標(biāo)志物，初步探討建立的診斷模型在胃癌診斷中的臨床意義。方法 用美國Ciphergen公司研制的蛋白指紋圖譜儀和蛋白質(zhì)芯片檢測40例胃癌患者、20例胃潰瘍患者和20例正常人血清蛋白質(zhì)的相對含量，用SPSS 11.5軟件分析處理數(shù)據(jù)，篩選標(biāo)志物，建立診斷模型。結(jié)果 在正常人中未發(fā)現(xiàn)差異蛋白質(zhì)峰表達(dá)； 胃潰瘍患者中僅1例有差異蛋白質(zhì)峰表達(dá)，質(zhì)荷比分別為5 910和4 095； 在胃癌中共發(fā)現(xiàn)5個(gè)差異有統(tǒng)計(jì)學(xué)意義的蛋白質(zhì)峰表達(dá)，質(zhì)荷比分別為： 3 300、5 329、4 095、5 910 和8 691。篩選質(zhì)荷比為4 095、5 910和8 691建立診斷模型，診斷靈敏度和特異度分別為92.5% 和97.5% 。結(jié)論 蛋白指紋圖譜技術(shù)在胃癌的早期診斷及篩選生物學(xué)標(biāo)志物方面有很大的價(jià)值，值得進(jìn)一步研究及推廣應(yīng)用。
目的 制備抗人大腸癌免疫毫微球，并觀察其活性及療效。方法 抗人大腸癌單克隆抗體SC3Ab通過異型雙功能交聯(lián)劑SPDP與載5-Fu人血清白蛋白毫微球［HSA(5-Fu)-NS］偶聯(lián)，制成抗人大腸癌免疫毫微球SC3Ab-HSA(5-Fu)-NS。使用凝集試驗(yàn)及免疫熒光檢測其活性，光鏡和電鏡下觀察其與大腸癌細(xì)胞SW1116的特異性結(jié)合。MTT法檢測該免疫毫微球的體外殺傷性。于人大腸癌裸鼠模型上分別使用SC3Ab-HSA(5-Fu)NS、HSA(5-Fu)NS及5-Fu，檢測三者的腫瘤抑制率。結(jié)果 SC3Ab-HSA(5-Fu)-NS具有單抗活性，能與大腸癌細(xì)胞特異結(jié)合；其體外殺傷SW1116細(xì)胞IC50值為24.6 μg/ml，與HSA(5-Fu)-NS(345.3 μg/ml)及5-Fu(325.6 μg/ml)相比，明顯降低；體內(nèi)腫瘤抑制率比HSA(5-Fu)NS及5-Fu明顯增強(qiáng)(P＜0.001)。 結(jié)論 SC3Ab-HSA(5-Fu)-NS具有免疫活性，對大腸癌細(xì)胞有主動靶向性，體內(nèi)外均具有比HSA(5-Fu)-NS及5-Fu更強(qiáng)的抗癌效果。
目的 觀察胰腺癌患者血清腫瘤標(biāo)記物的表達(dá)，以尋找對胰腺癌診斷與隨訪有價(jià)值的血清腫瘤標(biāo)記物。方法 采用免疫分析法和放射免疫法檢測62例胰腺癌患者血清AFP、CEA、CA50、CA15-3、CA19-9、CA72-4和CA125共7種腫瘤標(biāo)記物的表達(dá)，并取以胃腸道腫瘤患者和良性疾病患者各16例作為對照。 結(jié)果 7種腫瘤標(biāo)記物中，CA19-9、CA50和CA125對胰腺癌診斷的相對價(jià)值較高，尤以CA19-9的診斷價(jià)值最高，靈敏度和特異度分別為90.6%和86.7%，切除術(shù)后監(jiān)測上述三項(xiàng)指標(biāo)呈下降趨勢。結(jié)論 血清CA19-9、CA50和CA125的檢測對胰腺癌的診斷和隨訪是有價(jià)值的。