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乙型和丙型肝炎病毒核酸检测技术及进展
近年来,病毒性肝炎的实验室诊断领域取得了飞速的进展,新方法、新技术的出现提高了对病毒检测的灵敏度和准确度,使病毒性肝炎的诊断和治疗水平上了一个新的台阶.病毒性肝炎NAT分为两大类,即病毒核酸载量的检测和病毒基因型/基因突变检测.鉴于甲型、丁型和戊型肝炎病毒的检测主要以血清学检测为主,本文主要介绍乙型肝炎与丙型肝炎NAT的主要技术及进展.
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肝炎病毒DNA疫苗的研究
0 引言DNA疫苗就是将编码抗原的基因导入到体内,细胞内表达抗原,诱导特异性体液和细胞免疫应答,进行预防和治疗疾病的一种分子生物学技术.传统上用于预防病毒性肝炎的疫苗为血源性疫苗和近几年来发展的基因工程疫苗.前者如未完全纯化,则有可能使接种者感染病毒性肝炎.而后者工艺复杂,难度大,成本高,运输不便.故而人们希望找到一种新的安全有效、制造简便、廉价的疫苗.
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AIM In order to evaluate the diagnostic parameters of characteristic pathologic change in the liver biopsyspecimens, we developed a numerical scoring diagnostic standard.METHODS Ten of the eleven categories of characteristic pathologic lessions appearing in acute hepatitisand 11 categories in chronic hepatitis were selected. Each of them was graded 3 scales, then the essentialscore and scale score were set up. Adding up to all the numerical scores of individual components, formed thetotal scores of histological chronic activity index (HCAI) and histological acute activity index (HAAI). Onethousand and eight patients with various liver dieases were studied,and compared with conventional readingsand Knodell'HAI through F analysis and q test.RESULTS The HAAI of acute, subacute, and chronic severe hepatitis was 43.56±9.08, 51.63±12.13,and 65.45±17.51 respectively. There was significant difference between each other (P<0.01). TheirHCAI was 14.44±8.31, 57.39±10.98, and 58.14 12.24 respectively. HAAI of mild, moderate, andsevere chronic hepatitis was 18.57±7.00, 26.43±7.49, and 35.58±11.47 respectively (P<0.01), andHCAI was 13.2±6.90, 40.29±10.99, and 50.02±9.78 respectively. There was signficant difference(P<0.01). The HAAI of active liver cirrhosis and silent liver cirrhosis was 64.96±16.60 and 31.17±9.07respectively, the difference being significant (P < 0.01), and HCAI was 66.00±9.62 and 69.84±8.93, withno significant difference (P >0.05).CONCLUSION The diagnostic standard of histological activity index that we set up, was more useful aseither an alternative or supplement to the conventional terminology and KnodellHAI.
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慢性乙型肝炎重叠感染不同肝炎病毒的临床研究
至今确认的肝炎病毒有甲、乙、丙、丁、戊、庚等多种,相互之间没有交叉免疫力.慢性乙型肝炎(简称乙肝)患者也容易感染上其它肝炎病毒造成重叠感染.为了了解慢性乙肝患者不同类型的重叠感染的临床特性,我们对1997年3月~1999年6月收治的299例不同类型重叠感染病例进行分析.报告如下.