缺失型Duchenne/Becker 肌营养不良家系女性携带者及新发突变的确认

应用多重PCR（multiple polymerase reaction／mPCR）技术,联合DMD基因内部及附近11个短串连重复序列（short tandem repeats,STRs）位点连锁分析,对缺失型Duchenne／Beeker肌营养不良（Duchenne／Becker Muscular Dystrophy,DMD／BMD）家系成员进行DMD基因分型,确定家系中女性成员是否携带者,并进行产前诊断。3个家系中的4名缺失型患者,其中2例为新发突变：4位女性成员中,1名为携带者。应用mPCR和11个STRs的连锁分析,能快速、准确、客观判断家系中女性成员是否携带者身份,适于DMD／BMD临床研究机构遗传咨询、基因诊断和产前诊断常规应用。但在mPCR分析过程中,发现45号外显子扩增产物在不同凝胶中电泳迁移率不同。聚丙烯酰胺凝胶电泳（Polyacrylamide Gels Electrophoresis／PAGE）对mPCR产物分析快速、清晰,但需要注意片段迁移率,以防止分析错误。     

成人不典型肺结核的CT 表现及鉴别诊断分析( 附30 例报告)

目的：回顾性分析成人不典型肺结核的CT表现,探讨与其他同影性疾病的鉴别方法,做到早诊断早治疗,减低病人的治疗成本和思想负担。方法：选择性收集病变不典型。CT影像检壹曾误诊或诊断困难的病例30例做回顾性分析。所有病例均有最后治疗结果或术后病理结果证实。结果：节段性阴影12例,局灶性斑片及斑点状影8例,散在少数小结节样影4例,多发结节并空洞影3例,肺内弥漫分布的粟粒结节影3例,肺内阴影伴有肺门淋巴结及纵隔淋巴结肿大者9例以青壮年病人吸收较快,病程较短,以粟粒影和大片影表现者吸收最快。讨论：对于不典型的成人肺结核,不能片面的强调或突出某一方面征象,年龄因素、临床症状、实验室检查如结核茵素试验（PPD）、痰结核茵培养、抗结核抗体阳性在鉴别诊断中有着重要意义。进一步正确认识及探究病变的影像特点,对于正确的诊断提供了强有力的理论根据。     

16层螺旋CT三维重建与DR平片检查对外伤性肋骨骨折的诊断价值比较研究

目的:研究16层螺旋电子计算机断层扫描(CT)三维重建与数字化摄影(DR)平片检查对外伤性肋骨骨折的诊断价值,为临床诊治提供参考。方法:将2017年6月至2018年6月期间于本院接受诊治的82例外伤性肋骨骨折患者作为研究对象,所有患者均接受16层螺旋CT三维重建与DR平片检查,观察并记录患者的骨折发生部位,并比较两种诊断方法对外伤性肋骨骨折诊断的准确率、灵敏度、特异性、阳性预测值、阴性预测值以及漏诊情况。结果:82例外伤性肋骨骨折患者经影像学与临床诊断明确发生骨折179处,多发性骨折发生率为62.20%,单发性骨折发生率为37.80%,骨折肋骨段位中4-10段骨折发生率最高为69.83%,骨折肋骨水平阶段中腋肋骨折发生率最高为59.78%。相较于DR平片,16层螺旋CT三维重建诊断外伤性肋骨骨折的准确率、灵敏度、特异性、阳性预测值、阴性预测值更高,漏诊率更低,差异有统计学意义(P0.05)。结论:相较于DR平片检查,应用16层螺旋CT三维重建检查外伤性肋骨骨折能明显提高临床诊断的准确率、灵敏度和特异性,减少漏诊,可为临床诊治提供更可靠的信息,值得临床推广。     

诺如病毒的致病机制及诊断

诺如病毒(Norovirus, NoV)是引起全人群急性胃肠炎暴发和流行的主要病原体,也是引起食源性疾病的最常见非细菌性病原体。由于缺少有效的小型动物及培养细胞研究模型,目前对NoV感染的致病机制尚不清楚。NoV实验室诊断技术发展成熟,尤其是近年来新技术的应用将进一步推动其诊断水平的提高,满足公共卫生和临床诊疗的新需求。     

胎盘特异性基因4 mRNA基因在孕妇外周血中的检测及临床价值

目的:应用实时荧光定量PCR(RT-PCR)技术对不同孕周孕妇外周血浆胎盘特异性基因4(PLAC4)m RNA基因进行检测,寻找唐氏综合征产前诊断的可靠生物学标志物,为无创性产前诊断提供新的突破口。方法:按入组标准随机选取健康育龄未妊娠女性5例,正常健康妊娠孕妇60例(早期妊娠20例、中期妊娠20例、晚期妊娠20例),唐氏筛查高危孕妇8例,正常分娩24 h女性5例。共收集外周血浆样本78例。应用RT-PCR技术,检测样本中的PLAC4 m RNA基因含量,并进行相对定量分析。结果:健康育龄未妊娠女性及正常分娩后24 h女性外周血浆中均无游离胎儿PLAC4 m RNA基因的存在;正常健康妊娠孕妇不同孕周标本均检测到PLAC4 m RNA基因,以早期妊娠作为对照,中期妊娠是早期妊娠的1.99倍,晚期妊娠是早期妊娠的3.73倍;唐氏筛查高危孕妇均检出PLAC4 m RNA基因,含量是早期妊娠的6.36倍。结论:PLAC4 m RNA基因有望成为唐氏综合征产前诊断的可靠性生物学标志物。     

TK1与LDH联合检测对非霍奇金淋巴瘤鉴别诊断及疗效评估的作用

目的:探讨联合检测血清胸苷激酶1(TK1)与乳酸脱氢酶(LDH)水平在非霍奇金淋巴瘤(NHL)患者鉴别诊断及疗效监测中的临床意义。方法:收集2016年1月至2018年6月我院诊治的111例非霍奇金淋巴瘤的初诊患者血清标本,并选择50例正常人血清标本作为对照,采用免疫印迹增强发光法检测TK1浓度,比色法检测LDH浓度。所有患者随访至少1年,分析和比较惰性NHL与侵袭性NHL及各自四类分期之间血清TK1和LDH水平的差异,化疗后完全缓解、部分缓解与未缓解组LDH水平以及NHL患者中血清TK1和LDH的阳性率。结果:高度侵袭性NHL患者和侵袭性NHL患者血清TKI和LDH水平与惰性NHL患者相比显著增高(P0.05),但惰性NHL患者血清TK1和LDH水平与正常组之间差异无统计学意义(P0.05);Ⅲ、Ⅳ期侵袭性NHL患者血清TK1和LDH水平与Ⅰ、Ⅱ期患者相比显著增高(P0.05)。与化疗前相比,四次化疗后,完全缓解组NHL患者血清LDH水平下降21.05%,部分缓解组为16.66%,病情稳定组血清LDH水平升高至11.54%,三组NHL患者血清LDH水平比较差异具有统计学意义(P0.008),两组之间的差异均有统计学意义(P0.05)。结论:联合检测血清TK1和LDH水平对于NHL患者的鉴别诊断、疗效评估均具有重要参考价值。     

Occurrence and molecular identification of the zoysiagrass mite Aceria zoysiae (Acari: Eriophyidae) in turfgrasses in Korea

Mites are one of the serious pests of turfgrass. Our survey of turfgrass fields from 2013 to 2015 in Korea showed that the occurrence of leaf chlorotic symptom has gradually extended to at least 60% of the examined golf courses. We identified the zoysiae mite Aceria zoysiae in most damaged zoysiagrasses. Artificial infestation of A. zoysiae into zoysiagrasses in pots resulted in symptoms of chlorosis and marginal rolling of the leaves within 3 weeks. We firstly determined the nucleotide sequence of mitochondrial cytochrome c oxidase subunit I (COI) and internal transcribed spacer 2 (ITS2) of the nuclear ribosomal DNA region of A. zoysiae. The variations in COI and ITS2 between A. zoysiae and other species of the genus were 20.9%–43.0% and 7.5%–67.3%, respectively, suggesting significant genetic divergence within the genus. Our study provides valuable information for the rapid diagnosis and infestation monitoring of A. zoysiae in turfgrass fields.     

Detection of dental plaque and its potential pathogenicity using quantitative light‐induced fluorescence

Quantitative light‐induced fluorescence (QLF) technology can detect some dental plaque as red fluorescence. This in vivo study aimed to identify the microbial characteristics of red fluorescent (RF) dental plaque using 16S rRNA gene sequencing and evaluate the correlations between RF plaque and the clinical symptoms of dental diseases. Paired supragingival plaque samples collected from each 10 subjects and consisted of RF and non‐RF dental plaques as observed by QLF technology using a 405 nm blue light source for excitation. The characteristics of the bacterial communities in the RF and non‐RF plaque samples were compared by sequencing analysis. An increase in microbial diversity was observed in RF plaque compared with the non‐RF plaque. There were significant differences in the community compositions between the 2 types of dental plaque. Periodontopathic bacteria were significantly more abundant in the RF plaque than non‐RF plaque. The fluorescence intensity of RF plaque was significantly related to the proportion of the periodontopathic bacterial community and the presence of gingival inflammation. In conclusion, the plaque red fluorescence is associated with changes in the microbial composition and enrichment of periodontopathic pathogens, which suggests that RF plaque detected by QLF technology could be used as a risk indicator for gingival inflammation.      

Distinguishing structural features between Crohn's disease and gastrointestinal luminal tuberculosis using Mueller matrix derived parameters

Recently, the incidence of inflammatory bowel diseases, especially the Crohn's disease (CD) and gastrointestinal luminal tuberculosis (ITB), has grown rapidly worldwide. Currently there is no general gold standard to distinguish between CD and ITB tissues, which both have tuberculosis and surrounding fibrous structures. Mueller matrix imaging technique is suitable for describing the location, density and distribution behavior of such fibrous structures. In this study, we apply the Mueller matrix microscopic imaging to the CD and ITB tissue samples. The 2D Mueller matrix images of the CD and ITB tissue slices are measured using the Mueller matrix microscope developed in our previous study, then the Mueller matrix polar decomposition and Mueller matrix transformation parameters are calculated. To evaluate the distribution features of the fibrous structures surrounding the tuberculosis areas more quantitatively and precisely, we analyze the retardance related Mueller matrix derived parameters, which show clear different distribution behaviors between the CD and ITB tissues, using the Tamura image processing method. It is demonstrated that the Mueller matrix derived parameters can reveal the structural features of tuberculosis areas and be used as quantitative indicators to distinguish between CD and ITB tissues, which may be useful for the clinical diagnosis.