儿童与成人慢性乙型肝炎患者的临床特征差异明显。乙型肝炎病毒(Hepatitis B virus,HBV)病毒准种特征与其致病特性紧密相连,HBV病毒Core基因区富含免疫表位,该区域的准种特征直接反映病毒变异与病毒应对宿主免疫压力间的动态过程。文章...儿童与成人慢性乙型肝炎患者的临床特征差异明显。乙型肝炎病毒(Hepatitis B virus,HBV)病毒准种特征与其致病特性紧密相连,HBV病毒Core基因区富含免疫表位,该区域的准种特征直接反映病毒变异与病毒应对宿主免疫压力间的动态过程。文章通过扩增170名儿童慢性乙型肝炎患者及121名成人慢性乙型肝炎患者病毒Core基因区,按照病毒基因型以及病毒e抗原(Hepatitis B virus e antigen,HBe Ag)状态进行分组,使用序列复杂度、多样性、非同义突变率(Non-synonymous substitution ratio,d N)、同义突变率(Synonymous substitution ratios,d S)等指标衡量不同组别之间的病毒准种特征;使用不同模型计算不同组别中受到正选择压力的位点,进一步结合HBV Core基因区免疫表位信息,进行正选择位点的定位分析。结果发现,儿童乙型肝炎病毒患者体内病毒Core基因区序列复杂性和多样性低于成人患者,且前者Core基因区正选择位点个数显著低于后者,这说明儿童慢性乙型肝炎患者体内病毒受到的选择压力低于成人患者。在儿童及成人慢性感染病人组中,HBe Ag阳性病人体内病毒受到的选择压力低于HBe Ag阴性病人。儿童及成人慢性感染患者体内病毒存在13个正选择位点,大多数正选择位点位于已知的抗原表位上。本研究从分子进化角度揭示了儿童与成人慢性乙型肝炎病例体内病毒Core基因区序列准种差异,为两类病人显著不同的临床表征提供了群体遗传学的解释。展开更多
AIM:Inflammatory fibroid polyp (IFP) is a rare benign lesion that may occur throughout the digestive tract.IFP is more commonly found in the antrum of the stomach in particular. It mostly affects adults at the average...AIM:Inflammatory fibroid polyp (IFP) is a rare benign lesion that may occur throughout the digestive tract.IFP is more commonly found in the antrum of the stomach in particular. It mostly affects adults at the average age of 60 years.These polyps are able to cause abdominal pain,gastrointestinal bleeding,intestinal obstruction or intussusception.In this paper we report a case of gastric TIP with unusual presenting features. METHODS:A child with gastric IFP was described and the literature was reviewed, RESULTS:A 4-year-old girl presented with fever for 2 months,arthralgia of knees and ankles,iron defidency anemia, and hypoalbuminemia.Her stool examination was positive for occult blood.The upper gastrointestinal study demonstrated a large Iobulated mass at the upper part of gastric body.Partial gastrectomy en blocwith this 5 cm×8 cm mass was subsequently performed.Pathological examination was consistent with IFP.Following the mass excision,her fever abruptly declined and disappeared together with anemia and arthralgia.She remained asymptomatic and the abdominal ultrasonography performed at the 24-month follow-up demonstrated no recurrence of the tumor. CONCLUSION:The etiopathogenesis of IFP still remains unclear,The presence of IFP throughout the gastrointestinal tract and its variable clinical appearances make it difficult to diagnose,The inflammatory symptoms found in this patient support the hypothesis of inflammatory benign lesions of IFP.展开更多
基金Supported by the Thailand Research Fund and Center of Excellence,Viral Hepatitis Research Unit,Chulalongkorn University
文摘AIM:Inflammatory fibroid polyp (IFP) is a rare benign lesion that may occur throughout the digestive tract.IFP is more commonly found in the antrum of the stomach in particular. It mostly affects adults at the average age of 60 years.These polyps are able to cause abdominal pain,gastrointestinal bleeding,intestinal obstruction or intussusception.In this paper we report a case of gastric TIP with unusual presenting features. METHODS:A child with gastric IFP was described and the literature was reviewed, RESULTS:A 4-year-old girl presented with fever for 2 months,arthralgia of knees and ankles,iron defidency anemia, and hypoalbuminemia.Her stool examination was positive for occult blood.The upper gastrointestinal study demonstrated a large Iobulated mass at the upper part of gastric body.Partial gastrectomy en blocwith this 5 cm×8 cm mass was subsequently performed.Pathological examination was consistent with IFP.Following the mass excision,her fever abruptly declined and disappeared together with anemia and arthralgia.She remained asymptomatic and the abdominal ultrasonography performed at the 24-month follow-up demonstrated no recurrence of the tumor. CONCLUSION:The etiopathogenesis of IFP still remains unclear,The presence of IFP throughout the gastrointestinal tract and its variable clinical appearances make it difficult to diagnose,The inflammatory symptoms found in this patient support the hypothesis of inflammatory benign lesions of IFP.
