血清因素对阳离子脂质体转染的影响及其对策

由于大多数阳离子脂质体在血液中的稳定性差,致使它们进一步运用于基因治疗的潜能没能完全发挥出来。本文阐述了血清因素影响阳离子脂质体转染的机制,阳离子脂质体与网状内皮细胞系统的关系以及目前消除血清影响的一些对策和亟待改进之处。

替比夫定和恩替卡韦治疗HBeAg阳性慢性乙型肝炎的疗效及HBeAg血清学转换的预测因素

目的观察分析通过替比夫定和恩替卡韦治疗HBe Ag阳性慢性乙型肝炎的临床效果并对HBe Ag血清学转换的预测因素进行探讨。方法笔者以自2012年1月至2014年6月来我院进行治疗的慢性乙型肝炎患者100例作为研究对象,将其随机均分为替比夫定治疗组和恩替卡韦治疗组,分别采取替比夫定和恩替卡韦进行治疗104周并在中期(52周时)进行初步的疗效判定,比较两组的治疗效果和影响HBe Ag血清学转换的预测的因素。结果中期HBe Ag血清学转换的出现和基线ALT及HBV DNA水平没有明显关系,与HBe Ag水平关系密切,替比夫定治疗组有12周和24周时的HBe Ag下降、基线HBe Ag三因素进入回归方程,而替卡韦治疗组有12周,24周、36周的HBe Ag下降三因素进入回归方程。结论相较于恩替卡韦,替比夫定对慢性乙型肝炎治疗效果更好,HBe Ag转换率也比较高,可以被认为是两组患者的治疗中期的HBe Ag血清学转换的最佳预测因素。

血清胆红素与冠心病心绞痛中医的病理因素痰瘀的相关性研究

目的:通过临床病例探讨血清胆红素(Bilirubin,BIL)与冠心病心绞痛中医的病理因素痰、瘀的相关性。方法:冠心病心绞痛病人123例进行中医的病理因素痰、瘀的辨证,进行统计分类积分,分析二者的相关性,并计算出回归方程。结果:瘀证的TBIL及IBIL水平与痰证、非痰非瘀证、痰瘀互结证比较时,数值最小;有"痰"组与无"痰"组比较,有"痰"组IBIL较高,有"瘀"组与无"瘀"组比较,有"瘀"组IBIL较低,TBIL及IBIL与中医痰、瘀证证候积分在诊断确立时存在直线正相关。结论:冠心病心绞痛患者TBIL及IBIL可以为冠心病心绞痛患者中医病理因素瘀的辨证提供客观依据;并为痰、瘀证的严重程度判定提供一个参考依据。

Association between serum homocysteine and arterial stiffness：role of anti-hypertensive drugs

To the Editor I read the article of Zhang, et al. with great interest. They investigated the association of homocysteine with arterial stiffness in Chinese community-based elderly persons. The carotid-femoral pulse wave velocity （PWV） was significantly higher in the high homocyteine group than in the normal one, however, there was no differences in carotid-radial PWV between the high homocyteine group and the normal one. Homocysteine levels were strongly associated with the carotidfemoral PWV even after adjustment for classical risk factors of cardiovascular disease. I congratulate the authors for this important study. However, I want to make minor criticism for this study from the methodological aspect.

Clinical and epidemiological features of patients with clonorchiasis

AIM:To study the clinical and epidemiological features of patients with clonorchiasis so as to provide scientific evidences for the diagnosis and prevention of clonorchiasis. METHODS:Stools from 282 subjects suspected of having clonorchiasis were examined for helminth eggs with modified Kato's thick smear and sedimentation methods,and their sera were tested for HAV-DNA,HBV-DNA,HCV-RNA,HDV- RNA and HEV-RNA with polymerase chain reaction (PCR). Clinical symptoms of patients with clonorchiasis only were analyzed,and their blood samples were tested for circulating antigen (CAg) with Dot-ELISA,esoinophilic granulocyte count, and alanine aminotransferase (ALT).Meanwhile,they were asked to provide data of occupation,eating habit,hygienic habit and knowledge of donorchiasis.In addition,the ecosystem of the environment in epidemic areas was surveyed. RESULTS:Among the 282 patients,61 (21.43%) were infected with clonorchis sinensis only,97 (34.64%) were co-infected with clonorchis sinensis and other pathogens, 92 (32.86%) were infected with hepatitis virus only and 31 (11.07%) neither with clonorchis sinensis nor hepatitis virus. Among the 61 patients with clonorchiasis only,there were 14 (22.95%) subjects with discomfort over hepatic region or epigasfrium,12 (19.67%) with general malaise or discomfort and inertia in total body,6 (9.84%) with anorexia,indigestion and nausea,4 (6.56%) with fever,dizziness and headache (6.56%),and 25 (40.98%) without any symptoms;sixty one (100%) with CAg (+),98.33% (59160) with eosinophilic granulocytes increased and 65.00% (39/60) with ALT increased.B-mode ultrasonography revealed 61 cases with dilated and thickened walls of intrahepatic bile duct,and blurred patchy echo acoustic image in liver.Twenty-six cases had stones in the bile duct,39 cases had slightly enlarged liver with diffuse coarse spots in liver parenchyma.Twenty cases had enlarged gallbladder with thickened coarse wall and image of floating plagues,9 cases had slightly enlarged spleen.By analysis of epidemiological data,we found that the ecologic environment was favorable for the epidemiology of clonorchiasis.Most patients with clonorchiasis were lack of knowledge about the disease.Their living environment, hygienic habits,eating habits and their occupations were the related factors that caused the prevalence of the disease. CONCLUSION:The clinical symptoms of clonorchiasis are non-specific,and the main evidences for diagnosis of clonorchiasis should be provided by etiologic examination, B-mode ultrasonography and clinical history.The infection of clonorchis sinensis is related to occupations,bad eating habits and lack of knowledge about prevention of the disease.

Serum positive cagA in patients with non-ulcer dyspepsia and peptic ulcer disease from two centers in different regions of Turkey

AIM: To investigate and compare frequencies of serum positive cagA in patients from two separate regions of Turkey who were grouped according to the presence of peptic ulcer disease or non-ulcer dyspepsia.METHODS: One hundred and eighty Helicobacter pyloripositive patients with peptic ulcer disease or non-ulcer dyspepsia were included in the study. One hundred and fourteen patients had non-ulcer dyspepsia and 66 had peptic ulcer disease (32 with gastric ulcers and/or erosions and 34with duodenal ulcers). Each patient was tested for serum antibody to H. pylori cagA protein by enzyme immunoassay.RESULTS: The total frequency of serum positive cagA in the study group was 97.2 %. The rates in the patients with peptic ulcers and in those with non-ulcer dyspepsia were 100% and 95.6%, respectively. These results were similar to those reported in Asian studies, but higher than those that have been noted in other studies from Turkey and Western countries.CONCLUSION: The high rates of serum positive cagA in these patients with peptic ulcer disease and non-ulcer dyspepsia were similar to results reported in Asia. The fact that there was high seroum prevalence regardless of ulcer status suggests that factors other than cagA might be responsible for ulceration or other types of severe pathology in H. pylori-positive individuals.

SERUM HAPTOGLOBIN SUPPRESSES T-LYMPHOCYTE FUNCTIONS FOLLOWING BURNS

It is well known that serum immunosuppressive factors play an important role in the mechanism of postburn immunosuppression.This study was intended to investigate the effect of haptoglobin, purified from the serum of burned patients by affinity chromatography,on the proliferation and interleukin-2(IL-2) secretion of normal murine thymocytes induced by ConA and the proliferation of IL-2 dependent cell line(CTLL-2) stimulated by recombinant human IL-2,so as to elucidate the role of serum haptoglobin in postburn T-lymphocyte dysfunction.The results showed that purified haptoglobin,at the level equivalent to the concentration found in serum of burned patients,significantly inhibited the proliferation and IL-2 secretion of normal murine thymocytes as well as CTLL-2 proliferation;whereas it exhibited no immunosuppressive effects at the level equivalent to the concentration found in serum of nomal volunteers.According to the results reported here,it is suggested that extraordinary increase in serum haptoglobin level may be an important factor of impaired T-lymphocyte responses following burns.

RELEASE OF SERUM TROPONIN I AND ITS RELATIONSHIP TO MULTIFACTORS FOLLOWING OPEN HEART SURGERY IN CHILDREN

Objective To be released specifically after myocardial damage. The goal of this study was to measure serum cardiac troponin I levels after open heart surgery in children, and to evaluate relevance between TnTi and perioperative multi-factors. Methods Fifty-seven consecutive pediatric patients undergoing elective correction of congenital heart diseases were divided into group A （ TOF, n =31 ） and group B （ VSD, n =26）. Blood sampies were drawn preoperatively, 5min（ T0 ） , 6h（ T6 ） , 12h（ T12 ） , 24h（ T24 ） , 48h（ T48 ） , 72h（ T72 ） after removal of aortic cross clamping. Myocardial protection consisted of moderate systemic hypothermia （ 30℃- 32℃ ）, cold crystalloid cardioplegia and topical cooling. Demographic information, cardiac defect, repair procedure, duration of bypass （ CPBT） , cross-clamping time （ CCT） , clinical score for cardiac function, electrocardiographic changes and outcomes were recorded. Results Compared with the baseline value, serum concentration of troponin I peaked at T0 （ P 〈 0. 01 ）, and fell to normal level at T72 （ P 〉 0. 05 ）. Peak CTnI was 118 and 55 times higher than the baseline value, respectively in group A and group B. There was a positive correlation between peak CTnI and CPBT, CCT （ r = 0. 51 ; P 〈 0. 01 ）, myocardial operative injury after ventriculotomy and muscle resection （ r = 0. 35, P 〈0. 01 ）. Also the peak CTnl value was correlated to the clinical score for cardiac function （r = -0. 52; P 〈0. 01）. 2.3μg/L was a cutoff value which was highly predictive for postoperative recovery and inotropic support. Conclusion Postoperative serum troponin I is a highly specific and sensitive marker for myocardial ischemia and injury; therefore, its measurement may contribute to the assessment of recovery and outcome after open heart surgery.

EFFECT OF ACUPUNCTURE OF "ZUSANLI" AND "WEISHU" ACUPOINTS ON EXPERIMENTAL GASTRIC ULCER

Objective: To observe the therapeutic effect of electroacupuncture (EA) of "Zusanli"(ST 36) and "Weishu"(BL 21)on the experimental gastric ulcer in Xu period of a day for analyzing the best opportunity of acupuncture treatment of gastric ulcer. Methods:49 Wistar rats were randomly divided into ① control group, ② ST 36 Xu group, ③ BL 21 Xu group, ④ ST 36 Chen group, ⑤ BL 21 Chen group, ⑥ ST 36 IT group, and ⑦ BL 21 IT group, with 7 rats in each group. Rat gastric ulcer model was established using intra gastric administration of glacial acetic acid. Gastric mucosal thickness,mucosal muscular defect width,superficial mucosal mucus index (MI),intramucosal MI ,Total MI,plasma 6 keto PGF1α ,serum NO and gastric tissue CGRP concentrations were used as the indexes. The EA treatment was conducted once daily at Xu period (7-9 o’clock in the evening), Chen period (8-10 o’clock in the morning) and irregular time (IT) with 6 days being a therapeutic course, two courses altogether. Results:After EA treatment,①the regenerated mucosal thickness values of the aforementioned 6 EA groups, particularly ST 36 Xu group and BL 21 Xu group, were all apparently higher than that of control group (P<0.05-0.01), while the mucosal muscle layer defect width values of different EA groups, particularly ST 36 Xu group and BL 21 Xu group, were strikingly lower than that of control group (P<0.05-0.01); ②the 3 MI of the 6 EA groups, particularly those of ST 36 Xu group were all significantly higher than those of control group (P<0.05-0.01); ③plasma 6 keto PGF1α contents of the 6 EA groups, particularly those of ST 36 Xu and BL 21 Xu groups, were all significantly higher than that of control group (P<0.05-0.01); ④serum NO and gastric tissue CGRP concentrations of the 6 EA groups, particularly those of ST 36 Xu and BL 21 Xu groups and CGRP concentration of ST 36 Chen group, were all significantly higher than those of control group (P<0.05-0.01);and ⑤there were positive correlation between superficial MI or total MI and NO level (r=0.858, 0.987, P<0.05,and 0.01),and between the superficial mucus index and CGRP concentration (r=0.9051, t=4.68, P<0.01), suggesting that the increase of the secretion function of the regenerated mucosal mucus is related to acupuncture induced increase of release of both NO and CGRP.Conclusion:The therapeutic effect of EA of ST 36 and BL 21 in Xu period is better in the treatment of gastric ulcer,and that of EA of ST 36 is the best.