目的 探讨常见过敏原致过敏反应易感性与过敏性皮肤病患者外周血HLA DRB1*0901(rs2395185)基因多态性的关系.方法 选择广州地区皮肤科就诊患者304例,采用免疫印迹法检测患者血清19种过敏原,PCR测序检测外周血HLA DRB1*0901位点基因型,分析HLA DRB1*0901基因多态性与过敏原致过敏反应发病风险的关系.结果 户尘螨过敏原检测结果阳性、阴性患者间rs2395185的G/G基因型、G/T基因型分布差异有统计学意义(P<0.05),G/G、G/T基因型与户尘螨过敏的发病风险有关(OR=2.940,95％CI:1.167～7.407;OR=2.889,95％CI:1.136～7.348).轻度过敏与中重度过敏患者的G/T基因型分布差异有统计学意义(P<0.05),G/T基因型是过敏原反应严重程度的危险因素(OR=8.681,95％CI:1.077～69.989).结论 广州地区居民户尘螨皮肤过敏发病风险可能与其外周血HLA DRB1*09:01(rs2395185)位点G/G、G/T多态性有关,19种过敏原过敏的严重程度可能与rs2395185位点G/T多态性有关.

目的 探讨血清抗甲状腺过氧化物酶抗体(TPOAb)、抗甲状腺球蛋白抗体(TGAb)和补体C3、C4与桥本甲状腺炎(HT)的关系.方法 将2015年8月至2017年4月接诊的HT患者60纳入观察组(n=60),其中甲状腺功能减退29例(甲减亚组),甲状腺功能亢进3例(甲亢亚组)和甲状腺功能正常28例(甲状腺功能正常亚组);选取同时期行健康体检的志愿者60例为对照组.比较观察组和对照组TGAb、TPOAb、甲状腺刺激抗体(TSAb)、补体C3和C4水平,比较观察组各亚组血清游离甲状腺素(FT4)、血清游离三碘甲状腺原氨酸(FT3)、促甲状腺激素(TSH)、补体C3和C4水平.结果 观察组TGAb、TPOAb、TSAb水平及阳性率均高于对照组(P＜0.05),补体C3、C4水平均低于对照组(P＜0.05).FT4、FT3水平:甲减亚组＜甲状腺功能正常亚组＜甲亢亚组(P＜0.05);TSH水平:甲减亚组＞甲状腺功能正常亚组＞甲亢亚组(P＜0.05);补体C3、C4水平甲减亚组明显低于甲状腺功能正常亚组和甲亢亚组(P＜0.05).结论 HT患者血清TPOAb、TGAb水平较高,补体C3、C4水平较低,而且甲减患者C3、C4水平最低,可通过以上指标的检测辅助临床治疗.

目的 探讨痰结核分枝杆菌噬菌体生物扩增法(TB-PhaB)、痰结核菌脱氧核糖核酸(TB-DNA)联合检测对诊断痰菌阴性肺结核的临床应用价值. 方法 选取我院2015年2月～2017年9月期间93例痰菌阴性肺结核患者均接受痰结核分支杆菌噬菌体生物扩增法、痰结核菌脱氧核糖核酸检测,记录二者联合检查诊断结果并将其与病理诊断结果做统计学分析. 结果 93例痰菌阴性肺结核患者经不同方法检查完成率均为100.00%,分析可知痰结核分支杆菌噬菌体生物扩增法联合痰结核菌脱氧核糖核酸检测对疾病确诊率为94.62%,病理诊断为100.00%;痰结核分支杆菌噬菌体生物扩增法联合痰结核菌脱氧核糖核酸检测对肺结核的诊断敏感性为94.62%. 结论 应用痰结核分支杆菌噬菌体生物扩增法、痰结核菌脱氧核糖核酸检测法联合诊断肺结核具有较为理想的临床检出率,有利于尽快确诊患者病情并提供对症救治,对保障其生活质量、生命安全均具有积极意义.

Objective To explore the clinical significance and risk factors of serum C-reactive protein(CRP) and procalcitonin(PCT) levels in patients with bacterial pneumonia.Methods Serum CRP and PCT levels were measured in 82 patients with bacterial pneumonia(study group) and 63 patients with bronchial asthma(control group).Clinical data on complications of bacterial pneumonia(cardiovascular disease,cerebrovascular disease,fever(T≥38 ℃) and shock) were collected,and the risk factors for bacterial pneumonia were analyzed by the unconditional multivariate logistic regression.Results Compared with control group,serum CRP and PCT levels significantly increased in study group(P<0.05).The risk factors for bacterial pneumonia included the fever(T≥38 ℃,OR=2.341,95%CI 1.298-5.342,P<0.01),cardiovascular disease(OR=1.776,95%CI 1.015-3.628,P<0.05),cerebrovascular disease(OR=1.994,95%CI 1.015-3.307,P<0.05),shock(OR=3.038,95%CI 3.201-7.179,P<0.01),serum CRP levels(OR=4.825,95%CI 4.118-18.784,P<0.01),and serum PCT levels(OR=6.336,95%CI 5.720-26.911,P<0.01).Conclusion Patients with bacterial pneumonia have increased serum levels of CRP and PCT,which can be used as the diagnostic indicators of bacterial pneumonia.The fever(T≥38 ℃),cardiovascular disease,cerebrovascular disease and increase in CRP and PCT levels are the risk factors for bacterial pneumonia.Early intervention should be carried out to prevent the occurrence of complications of bacterial pneumonia.

目的 了解对碳青霉烯类药物耐药的肺炎克雷伯菌(CRKP)碳青霉烯酶基因的携带情况.方法 收集本院2013年1月至2016年6月临床标本中分离的630株肺炎克雷伯菌,采用VITEK-2 Compact全自动微生物鉴定系统进行细菌鉴定和药敏检测以及改良Hodge试验筛选CRKP,采用聚合酶链反应(PCR)检测碳青霉烯酶基因,采用多位点序列分型(MLST)技术对CRPK进行分子遗传学分析.结果 630株肺炎克雷伯菌中,61株对亚胺培南耐药,为CRKP,占9.7%,CRKP对多种临床常用抗菌药物均显著耐药,对替加环素具有良好的敏感性.PCR结果显示59株CRKP携带碳青霉烯酶基因,其中53株携带bla KPC-2型基因(89.8%),4株携带bla NDM-1型基因(6.8%),2株携带bla OXA-48型基因(3.4%).MLST分型主要以ST11为主(49株,80.3%).结论 我院CRKP基因型主要为KPC-2型,另外有散在NDM-1和OXA-48型,MLST分型主要为ST11型.

Objective To explore the relationship between visfatin rs13237989 ,rs13224516 and type 2 diabetes mellitus (T2DM ) in Guangdong .Methods Totally 181 patients with newly diagnosed T 2DM in the second affiliated hospital of Guangzhou medical university from January 2013 to December 2014 were selected as the case group ,meanwhile 180 healthy people were select‐ed as the control group .The distribution frequency of C and T genotype in rs13237989 site as well as A and C genotype in the rs13224516 site were compared between the case group and the control group .In addition ,biochemical indicators ,including choles‐terol (CHOL ) ,triacylglycerol (TG) ,high density lipoprotein cholesterol (HDL‐C) and low density lipoprotein cholesterol (LDL‐C) were compared in different genotypes of rs13237989 and rs13224516 site in case group .Results The allelic genes distributions frequency of rs13237989 and rs13224516 conformed to the laws of genetic inheritance and the samples in the study were representa ‐tive .The differences of distribution frequencies of genetic polymorphism and allelic genes in the case group and control group had no statistical significance (P > 0 .05) .Logistic regression showed that genetic polymorphism were not correlated with T 2DM (P>0 .05) .TG ,CHOL ,HDL‐C and LDL‐C of different genotypes in patients with T 2DM had no statistical significance (P > 0 .05) . Conclusion There are no difference in genetic polymorphism of visfatin rs13237989 and rs13224516 between case group and control group ,and both of the two kinds of genotypes have no correlation with T 2DM in Guangdong .

目的：探讨全自动快速微生物检测系统（VITEK MS）在鉴定流感嗜血杆菌的应用价值。方法收集广州市黄埔区红十字会医院与广东省中医院2014年3月至2015年1月从痰液或咽拭子标本中分离的流感嗜血杆菌35株，用16S rDNA测序确证。并且用VITEK MS质谱仪，API NH常规生化鉴定与MH琼脂平板上V＋X因子需求性试验3种方法对上述菌株鉴定分析。结果在35株流感嗜血杆菌细菌中，VITEK MS质谱仪与API NH常规生化鉴定差异无统计学意义（P＞0．05），而VITEK MS与M H琼脂平板上V＋X因子需求性试验差异有统计学意义（P＜0．05）。结论对于API NH常规生化鉴定与M H琼脂平板上V＋X因子需求性试验，VITEK MS能快速、准确地鉴定流感嗜血杆菌，对临床诊治提供很大的帮助，有非常好的应用前景。

Objective At the molecular diagnosis technology,this paper discusses the chronic hepatitis b(CHB) patients serum virus replication index(HBV-DNA) and hepatitis b markers(HBV-M) and liver function relations. Methods Using fluorescence quantitative PCR(FQ-PCR) testing hepatitis b patients serum HBV-DNA,and using ELISA method of two half-and-half index test,with automatic biochemistry analyzer test liver function,and the results were correlation discussion. Results The small HBV-DNA positive rate was 52.2%,the big HBV-DNA positive rate was 96.1%(P0.05);ALT and HBV-DNA significant difference(P0.05),and chronic hepatitis B in the crowd into A,B,C,D four type. Conclusions The region in patients with chronic hepatitis B type B in the majority,small HBV is still in active period,the virus copy inside its body don't stop or disappear,there is no necessary relevance between ALT and HBV-DNA.