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Objective To explore the prevalence of the nuclear dense fine speckled ( DFS ) immunofluorescence pattern in routine antinuclear antibodies(ANA) testing and its significance in patients with autoimmune diseases( AID) .Methods The ANA in 13 728 specimens were measured by indirect immunofluorescence( IIF) using HEp-2 cell slides from department of clinical laboratory, wenling hospital from 2011 to 2014.The frequencies, clinical manifestations and laboratory features of DFS positivity were restrospectively analyzed in patients with AID,usingχ2 test.Results ANA was positive in 20.56%(2 822/13 728) of the total patients, and the frequency of DFS pattern was observed in 1.81%(248/13 728) of the total patients and in 8.79%(248/2 822) of the patients with ANA positivity.In different age groups (≤20 years old, 21-49 years old and≥50 years old) , there were statistical significance of DFS pattern positive rate (male:χ2 =18.17,P<0.01; female: χ2 =1 500.00,P<0.01).And the highest frequency of ANA positivity was observed in patients from department of rheumatology(30.07%).The frequency of DFS pattern was higher in the departments of infection ( 32.58%) , dermatology ( 21.76%) , neurology ( 18.58%) and nephrology(6.73%) among the patients with ANA positivity(χ2 =123.00,P<0.01).Amony the 248 cases with DFS pattern positivity.41 cases were AID ( 16.53%) and 207 cases were non-autoimmune diseases ( 83.47%) . In AID group 13 cases were autoimmune thyroiditis ( 31.71%) , 12 cases were rheumatoid arthritis ( 29.27%) , 4 cases were autoimmune liver disease ( 9.76%) , 4 cases were undifferentiated connective tissue disease (9.76%), 3 cases were ankylosing spondylitis(7.32%), 2 cases were Sj?gren′s disease ( 4.88%) , 2 cases were inflammatory bowel disease ( 4.88%) and 1 case was systemic lupus erythematosus(2.44%).The titers of DFS in patients with AID were predominantly above 1∶320 and less than 1∶100 in non-AID.AID patients with DFS pattern positivity have different clinical manifestations and laboratory features.Howerer, antinuclear antibodies ( ANAs ) in 15 specific auto-antibodies were all negative.Conclusions The DFS pattern is a common pattern in ANA positivity patients and it mainly exists in non-AID patients.Further more, it is suggested that patients with DFS pattern identified by IIF should then be tested for anti-DFS70 antibodies with a specific immunoassay.
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Objective To investigate the effect of individualized therapeutic programs with combination of interferon and ribavirin (RBV) in chronic hepatitis C (CHC) and study the influential factors of virological response rates.Methods A total of 139 patients with CHC were enrolled and given the intensive treatment doses of interferon and RBV according to their basic clinical condition.At the treatment of 0,4,12,24 weeks,the end of treatment and 24 weeks after treatment stop,the serum HCV RNA was determined.Timely adjustment to dosage and time periods was made according to the virological response to treatment,and the predictive value of rapid virological response (RVR) and complete early virological response (cEVR) for sustained virological response (SVR) were analyzed.Results At the 4th week of treatment,the level of serum HCV RNA was monitored in 120 patients,and 84.2％ (101/120) of patients obtained RVR; among them,90.7％ (88/97) obtained SVR.The virus load of patients obtained RVR at pretherapy was lower than that of patients didn't obtained RVR [(5.883±1.246) lg copies/ml vs (6.502±0.693)lg copies/ml,P =0.034].The RVR rate of initial treatment patients with PEG-IFNα-2a [87.8％(79/90)]was significantly higher than that of retreatment patients with PEG-IFNα-2a [65.0％ (13/20)](P =0.031).At the 12th week of treatment,the level of serum HCV RNA was monitored in 132 patients,and 92.4％ (122/132) of patients obtained cEVR; among them,90.8％ (108/119) obtained SVR.The SVR rate of patients obtained cEVR was significantly higher than that of patients didn't obtained cEVR (5/9) (P =0.007).There was no significant difference between the cEVR rate of initial treatment patients [94.7％ (90/95)]and retreatment patients [85％ (17/20)]with PEG-IFNα-2a (P =0.158).Conclusions cEVR was predictor of SVR.Individualized therapy can increase the obtaining probability of RVR,cEVR and SVR.Adjusting drug dose timely and extending treatment period of HCV RNA-negative based on virological response to treatment are important in CHC individualized therapy.
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Objectives To characterize the assay method and the clinical symptoms of the infant infection of the human bocavirus in order to advance the diagnositic and therapeutic technology for human bocavirus. Methods The DNA and specific antibody of human bocavirus from pharyngeal extracts, nasopharyngeal swab and serum were detected using real time PCR and Western blot. The overall diagnosis and analysis of the clinical symptoms, sign and conventional experimental test were performed, and meanwhile the long-term follow-up was done. Results 7 specimens were detected as human bocavirus positive from 240 pharyngeal extracts (7/240), and the positive ratio was 2.92%. The clinical symptoms were mainly high fever and temporary cough. and the experimental index of peripheral blood leucocyte, C-reaction protein, blood sedimentation and hemobiochemistry were usually in normal region. No specific characteristic was observed by the thoracic X-ray. and cardio-pulmonary function was normal through the long-term investigation. Conclusions Human bocavirus was one of pathogens inducing children lower respiratory tract infections. The real time PCR and Western blot were sensitive and specific detection technologies.
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Objective To study the relationship of TNF-? G308A and G238A polymorphism with type 2 diabetes mellitus in elderly patients.Methods Blood specimens were collected from 60 elderly patients with type 2 diabetes mellitus and 30 normal elderly volunteers.Genomic DNA was extracted.The primers of PCR for the SNPs of G308A and G238A were optimized and the polymorphism of amplicons was analyzed by DNA sequencing.Results There was a significant difference of TNF-?-308 gene in DM patients compared with control group,while no difference of TNF-?-238.Conclusions The 308 G-A polymorphism of TNF-? promoter gene may be associated with type 2 diabetes mellitus in elderly patients.
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Objective To establish a oligochip method for detection of HBV Lamivudine drug resistance and evaluate the clinical role of the chip system.Methods 388 HBV DNA positive sera from patients receiving lamivudine treatment and 559 chronic hepatitis B patients not receiving lamivudine treatment,and 359 sera from HBV DNA negative controls were assayed for HBV mutations utilizing oligonucleotide microarray.Meanwhile,these results were contrasted with Quantitative PCR and DNA sequencing method.Results The results of clinical evaluation shows that for the codons 528,552 and 555,the agreements between the microarray and sequencing data are 96.6%,98.5% and 100%,respectively.In the 559 samples,which were detected positive for HBV DNA by quantitative PCR,all but three weak positive samples were positive by the microarray,demonstrating an agreement of 99.7%.All the 359 HBsAg negative samples were shown to be negative for HBV DNA by the microarray method.Conclusions The HBV-Lamivudine oligochip is eligible to detecting wild type HBV and HBV lamivudine-mutants in patient's sera.It has great potential application of administration for lamivudine treatment in HBV patients.
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In order to investigate the effects of TGF-beta1 on the expression of MMP-2, -9 and TIMP-1 in human retinal pigment epithelial (RPE) cells, the third-sixth passage cultured RPE cells were treated with TGF-beta1 at different concentrations (0.01, 0.1, 1.0, 10 ng/mL), the expression of MMP-2, -9 and TIMP-1 mRNA was detected by semi-quantitative RT-PCR assays. MMP-2, -9 and TIMP-1 mRNA were expressed in the cultured RPE cells. The values of MMP-2/beta-actin in the cells treated with 0.1, 1.0, 10 ng/mL TGF-beta1 were 1.04 +/- 0.04, 1.07 +/- 0.02 and 1.11 +/- 0.03, respectively, significantly higher than in the control group (0.96 +/- 0.03, P 0.05). It was concluded that TGF-beta1 might play an important role in the up-regulation of the expression of MMP-2 in RPE cells and result in a directional shift in the balance between MMP and TIMP. This may be facilitated for RPE cells to migrate in the pathogenesis of vitreoretinopathy.
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In order to investigate the effects of TGF-β1 on the expression of MMP-2, -9 and TIMP1 in human retinal pigment epithelial (RPE) cells, the third-sixth passage cultured RPE cells were treated with TGF-β~ at different concentrations (0.01, 0. 1, 1.0, 10 ng/mL), the expression of MMP-2, -9 and TIMP-1 mRNA was detected by semi-quantitative RT-PCR assays. MMP-2, -9 and TIMP-1 mRNA were expressed in the cultured RPE cells. The values of MMP-2/β-actin in the cells treated with 0.1, 1.0, 10 ng/mL TGF-β1 were 1.04±0.04, 1.07±0.02 and 1.11±0.03, respectively, significantly higher than in the control group (0. 96±0.03, P＜0. 05-0. 01). The expression of MMP-2 mRNA could be up-regulated by TGF-β1, in a dose-dependent manner. The expression of MMP-9 mRNA in the cultured RPE cells was slightly up-regulated by various TGF-β1 concentrations treatment. The values of TIMP-1/β-actin in the cells treated with 0.01 and 0. 1 ng/mL TGF-β1 were 0. 85±0.01 and 0.97 ± 0.02 respectively, significantly lower than in the control group (1.07±0.04, P＜0.01), indicating that the expression of TIMP-1 mRNA was down-regulated by TGF-β1 at low concentrations. But along with the increase of TGF-β1 concentrations (1.0 and 10 ng/mL), the expression of TIMP-1 mRNA was slightly up-regulated, not significantly different from that in the control group (P＞0.05). It was concluded that TGF-β1 might play an important role in the up-regulation of the expression of MMP-2 in RPE cells and result in a directional shift in the balance between MMP and TIMP. This may be facilitated for RPE cells to migrate in the pathogenesis of vitreoretinopathy.
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The subjective reasons for which the medical graduates have increasing difficulty finding a job are as follows:old-fashioned notions of employment,absence of trustworthiness and poor employment capability. To walk out of the difficulty of finding a job,the medical graduates must adjust psychology and have reasonable orientation,be honest and enhance their qualities,seize the opportu-nity and make appropriate choice.