TCT联合HPV检测诊断宫颈病变的临床价值分析

目的:探讨新柏氏液基细胞学技术(TCT)联合人乳头瘤病毒(human papilloma virus,HPV)检测诊断宫颈病变的临床价值。方法:选择哈尔滨医科大学附属第一医院妇科门诊收治的6752例患者,采集其宫颈脱落细胞进行TCT检测,登记患者的年龄及宫颈外观。分别随机选取TCT阳性和阴性结果的患者144例进行HPV检测及阴道镜下活检,分析和比较TCT单独及联合HPV检测诊断宫颈病变的敏感性和特异性。结果:宫颈柱状上皮细胞的外移程度及患者的年龄与宫颈TCT结果均无显著相关性。单独TCT检测诊断宫颈病变的灵敏度为87.04%,特异性为58.55%;单独HPV检测诊断宫颈病变的灵敏度为62.96%,特异性为81.62%;而联合测诊断宫颈病变的灵敏度为100%,特异度为48.29%。结论:TCT联合HPV检测可显著降低宫颈病变的漏诊率。     

复方苦参汤联合美沙拉嗪对溃疡性结肠炎治疗效果及炎性因子水平的影响

目的:探讨复方苦参汤联合美沙拉嗪对溃疡性结肠炎治疗效果及炎性因子水平的影响。方法:以我院2017年1月至2019年12月中西医结合科和消化内科收治的206例溃疡性结肠炎患者为研究对象,根据随机抽样法将受试者分为对照组和研究组,每组各103例,对照组接受美沙拉嗪治疗,研究组在对照组的基础上口服复方苦参汤治疗,比较两组的治疗总有效率,治疗前后黏膜病变、疾病活动指数与各炎性因子水平变化以及用药安全性。结果:研究组治疗总有效率较对照组高(P<0.05);治疗后两组肠镜下黏膜病变与疾病活动指数较治疗前均明显改善,且研究组显著优于对照组(P<0.05);治疗后两组白细胞介素(interleukine,IL)-6、IL-8、肿瘤坏死因子(tumor necrosis factor, TNF)-α、C反应蛋白(C-reactive protein,CRP)及降钙素原(procallcitonin,PCT)等炎性因子水平较治疗前均显著下降,且研究组低于对照组(P<0.05);两组药物所致不良反应发生率比较无统计学差异(P>0.05)。结论:复方苦参汤联合美沙拉嗪可有效缓解临床症状,改善肠道黏膜病变,降低肠道炎性反应,控制病情进展,疗效安全显著,对促进溃疡性结肠炎患者病情康复具有积极意义。     

OCCURRENCE OF A TEMPERATE CYANOPHAGE LYSOGENIZING THE MARINE CYANOPHYTE PHORMIDIUM PERSICINUM1

A temperate cyanophage was found to lysogenize the marine cyanophyte Phormidium persicinum (Reinke) Com. (Provasoli strain). The lytic cycle was induced by the addition of mitomycin C or by brief illumination with ultraviolet light. The lytic process observed under the electron microscope showed that phage particles appeared in a nucleoplasm region 15 to 24 h after the addition of mitomycin C. The induction of the lytic process occurred simultaneously in almost all cells of every trichome. Matured phage particles were released to the medium 30 to 50 h after the addition of mitomycin C. Phage particles isolated from algal lysates had a polyhedral head (about 40 nm in diameter) with a long (about 300 nm) and noncontractile tail. The most abundant protein, presumably a structural protein, had an apparent molecular mass of about 38 kDa. The genome size estimated from restriction analysis was about 50 kbp. Phage DNA was digested with several restriction endonucleases including Sau3AI and DpnI. However, MboI failed to digest the phage DNA, suggesting that the phage DNA is highly methylated. Southern blot analysis suggested that some part of the phage was in the lytic cycle in algal cells growing under normal conditions. A possible role of temperate cyanophages in the regulation of cyanophyte populations in the marine environment is discussed.     

Helicobacter pylori infection in children and adults: a single pathogen but a different pathology

Background. The aims of this retrospective study were to ascertain in large series of children and adults: the relationship of the infecting strain to gastric mucosal lesions; and the relationship of the infecting strain to its duodenal localization. Materials and Methods. We studied 307 and 604 consecutive children and adults. In gastric mucosal samples H. pylori was cultured, genotyped and histologically assessed, while inflammation, activity and intestinal metaplasia were graded. In a subset of 171 patients H. pylori ureaseA (ureA) and cagA genes were amplified (PCR) using mucosal biopsies from the duodenum. Results. H. pylori infection was diagnosed in 40 children and 308 adults. cagA was identified in 50% and 65.5% of infected children and adults. Antral activity was associated with the density of infecting bacteria (p < .001) and with cagA (p < .01). Intestinal metaplasia was correlated with cagA (p < .001). The ureA gene was found in 56 duodenal samples from 82 H. pylori positive patients. Duodenal H. pylori ureA was significantly more frequent in patients with duodenal diseases than in those without (p < .01), cagA positive strains being mainly involved in the infection of this anatomical area (p < .01). Conclusions. A severe H. pylori‐associated gastritis is more prevalent when the density of infecting bacteria is high and when cagA positive strains cause the infection. The most virulent cagA positive H. pylori colonizes not only the gastric, but also the duodenal mucosa, which can be directly damaged by the bacteria itself or by its products.     

侧脑室旁白质病变患者认知功能损害的特点研究

目的:脑白质病变与老年认知功能障碍关系密切,尤其是深部白质病变更是血管性认知功能损害的常见危险因素,但临床上对于侧脑室旁白质病变与认知功能损害的关系研究较少,本研究旨在探讨侧脑室旁白质病变患者认知功能损害的特点。方法:选取2011年2月-2012年10月住院健康查体者159例,根据有无侧脑室旁白质病变分为脑白质病变组及对照组,根据侧脑室白质病变严重程度分为轻度组及中重度组。所有患者分别进行蒙特利尔认知评估表(Montreal Cognitive Assessment,MoCA)中文版、简易精神状态检查表(Mini Mental State Examination,MMSE)和画钟测验(clock drawing test,CDT)评估。结果:脑白质病变组MMSE量表总分、CDT、MoCA量表总分及视空间、计算力、延迟回忆及空间执行功能分低于对照组,差异有统计学意义(P0.05);白质病变中重度组MMSE、MoCA量表总分及计算力得分低于轻度组,差异有统计学意义(P0.05)。结论:本研究显示侧脑室旁白质病变患者总体认知功能评分明显低于对照组,中重度患者的计算力下降尤为突出,提示我们侧脑室旁白质病变是导致患者总体认知功能下降及计算力损害的危险因素,临床上应该提高对于侧脑室旁白质病变的重视。     

Induction of Epstein-Barr virus lytic replication by recombinant adenoviruses expressing the zebra gene with EBV specific promoters

The latent Epstein-Barr virus (EBV) is found in the cells of many tumors. For example, EBV is detectable in almost all cases, and in almost all tumor cells, of non-keratinizing nasopharyngeal carcinoma.Activating the latent virus, which will result in its lytic replication and the death of tumor cells, is a potential approach for the treatment of EBV-associated cancers. In this study, three recombinant adenoviruses were constructed to express the Zebra gene, an EBV gene responsible for switching from the latent state to lytic replication. EBV-specific promoters were used in order to limit Zebra expression in EBV-positive cells, and reduce the potential side effects. The EBV promoters used were Cp, Zp and a dual promoter combining both promoters, CpZp. The Zebra protein was detected in HEK293 cells as well as the EBV-positive D98-HR1 cells infected with recombinant viruses. An EBV lytic replication early antigen, EA-D, was also detected in infected D98-HR1, implying the initiation of lytic replication. In the cell viability assay, Zebra-expressing adenoviruses had little effect on EBV-negative HeLa cells, while significantly reducing the cell viability and proliferation of D98-HR1 cells. The results indicate that EBV virus promoters can be used in adenovirus vectors to express the Zebra gene and induce EBV lytic replication in D98-HR1 cells.     

7例影像学表现为弥漫肺间质性病变的肺结核报道及文献复习

目的:通过对7例高分辨CT(High Resolution Computed Tomography,HRCT)表现为弥漫肺间质性病变的肺结核患者的相关资料进行分析,结合相关文献,提高对该类肺结核的认识。方法:分析本院2012.2~2015.3确诊的7例HRCT表现为弥漫肺间质性病变的肺结核的临床症状、体征、影像学资料及痰抗酸杆菌、结核菌素纯蛋白衍生物(Purified Protein Derivative,PPD)试验、T细胞斑点试验(T-SPOT.TB)、抗结核抗体、血常规、血沉(Erythrocyte Sedimentation Rate,ESR)等实验室检查、病理检查等资料。结果:6例经2次以上痰涂片阳性确诊为肺结核,1例抗结核治疗有效诊断为肺结核;弥漫肺间质性病变的肺结核患者HRCT上间质性病变的范围与抗酸杆菌的检出及发热症状的出现有关联;与盗汗、乏力、咯血等结核中毒症状及PPD、结核抗体、ESR等指标无明显相关关系。结论:弥漫肺间质性病变也可为肺结核的一种特殊表现,极易误诊为其他间质病变。当患者临床表现及实验室检查无特殊发现时,需考虑肺结核的可能并进行结核病相关检查,尤其是抗酸杆菌及肺组织病理检查,以尽早明确诊断。     

Distinct changes of dendritic cell number and IL-12 mRNA level in adjacent mucosa throughout the colorectal adenoma–carcinoma sequence

Adjacent mucosa may reflect the conflicting of host factors in response to the establishment or invasion of cancers. Characterization of anti-tumor immunity in this region may add help in understanding the immune-related mechanisms of colorectal carcinoma (CRC). In this study, adjacent non-tumor mucosa from 36 patients with colorectal adenoma (CRA), 26 with CRC and normal mucosa from 15 health controls were included, immune cell populations of dendritic cell, lymphocyte and macrophage were characterized with immunohistochemistry (IHC) and tissue messenger RNA (mRNA) levels of Th1 cytokines interferon (IFN)-gamma and its upstream inducers interleukin (IL)-12 and IL-18 were quantified with real-time PCR; In addition, dendritic cell differentiation and function inhibitors cyclooxygenase-2 (COX-2) and IL-6 mRNA levels were also quantified. By IHC, a significant decreased dendritic cell density in the non-tumor mucosa adjacent to CRC was detected (P < 0.05) as compared to the normal controls or adjacent mucosa of CRA. The grading scores for lymphocyte number in the adjacent mucosa of CRA and CRC were gradually non-statistically increased, while the grading scores for macrophages number was not changed. By quantitative real-time PCR, distinct local cytokine gene expression profile was demonstrated. In which, the Th1 cytokines, particularly IL-12, were increased in adjacent mucosa of CRA, but all significantly decreased in adjacent mucosa of CRC. In addition, the mRNA levels of IL-6 and COX-2 were significantly higher in adjacent mucosa of CRC than that in adjacent mucosa of CRA (both P < 0.05). Therefore, dendritic cell functional changes could be one of the important mechanisms for altered anti-tumour immunity in the adjacent non-tumor mucosa throughout adenoma–carcinoma sequence. The increased COX-2 and IL-6 might contribute to dendritic cell funtional defect in adjacent mucosa of CRC.     

High-density lipoproteins： an emerging target in the prevention of cardiovascular disease

High-density lipoproteins （HDLs） have been well established to protect against the development of atherosclerotic cardiovascular disease. It has become apparent that in addition to the promotion of reverse cholesterol transport, HDLs possess a number of additional functional properties that may contribute to their beneficial influence on the arterial wall. A number of exciting therapeutic strategies have been developed that target HDL and its ability to protect against the development of atherosclerotic plaque. This paper will review how the promotion of the functional properties of HDL inhibits the formation of atherosclerotic plaque and stabilises lesions in patients with established disease.