目的 探究干扰素α(IFN-α)通过调节PI3K/Akt通路对乙型肝炎病毒(HBV)感染动物模型肝功能及磷酸化哺乳动物雷帕霉素靶蛋白(p-mTOR)、p-p70S6K蛋白的影响.方法 BALB/c小鼠,随机分为对照组、HBV组和IFN-α组(各12只).通过尾静脉注射HBV建立乙型肝炎模型.通过尾静脉注射pKCMvint.IFN-α-2a促进IFN-α的表达水平.通过酶联免疫吸附法检测血清IFN-α、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、HBV血清标志物HBeAg、乙型肝炎表面抗原(HbsAg).苏木精-伊红(HE)染色和Masson染色检测肝组织病理学改变和纤维化情况.实时荧光定量反转录聚合酶链反应(RT-qPCR)和蛋白质印迹法分别检测mRNA和蛋白的水平.结果 HBV组和IFN-α组小鼠血清中可检测出显著的HBeAg和HBsAg.IFN-α组血清HBeAg和HBsAg水平显著低于HBV组(P<0.05).IFN-α组的IFN-α水平显著高于HBV组(P<0.05).HBV组小鼠血清肝功能指标ALT和AST显著高于对照组(P<0.05),IFN-α组的ALT和AST水平显著低于HBV组(P<0.05).HBV组肝细胞出现显著形变,细胞排列异常,出现假肝小叶,并且出现炎症浸润.IFN-α组肝损伤程度较HBV组显著缓解,炎症反应较轻,细胞大小和排列基本正常.HBV组肝组织出现大量的纤维化染色,IFN-α组肝组织仅有少量的纤维化.HBV组的胶原蛋白(Collagen)Ⅰ、CollagenⅢ、金属蛋白酶组织抑制物(TIMP)-1 mRNA水平以及p-PI3K/PI3K、p-AKT/AKT、p-mTOR/mTOR、p-p70S6K/p70S6K水平显著高于对照组(P<0.05),IFN-α组的CollagenⅠ、Col-lagenⅢ、TIMP-1 mRNA水平以及p-PI3K/PI3K、p-AKT/AKT、p-mTOR/mTOR、p-p70S6K/p70S6K水平显著低于HBV组(P<0.05).结论 IFN-α可能通过调控PI3K/AKT通路抑制mTOR、p70S6K的磷酸化水平,并减少Colla-genⅠ、CollagenⅢ、TIMP-1的表达水平,从而缓解HBV引起的纤维化和肝功能损伤.

目的 对山西省丙型肝炎病毒(HCV)感染者基因分型实验室检测结果及临床资料进行分析,探讨HCV基因型的临床应用价值.方法 收集2019年1月至7月在山西医科大学第一医院感染病科就诊的HCV感染患者(抗-HCV阳性,HCVRNA≥1×103 U/ml)作为研究对象,采用聚合酶链反应(PCR)-荧光探针法检测其基因型,并检测HCV-RNA含量,丙氨酸转氨酶(ALT)、白蛋白(ALB)、总胆红素(TBIL)、甲胎蛋白(AFP)指标,根据不同基因型分组,比较不同基因型的HCV感染者的临床指标.结果 共检测90例HCVRNA≥1×103 U/ml的阳性标本,检出2种基因型,分别为1b型78例(87％),2a型12例(13％),可分型率为100％.1b基因型HCV感染患者血清HCV-RNA病毒载量、血清ALT、ALB、TBIL、AFP水平与2a基因型HCV感染者比较,差异无统计学意义(均P>0.05).结论 山西省HCV基因型主要为1b型,其次为2a型.HCV分型不足以判断HCV相关临床情况,需同时检测HCV基因型、HCV-RNA含量及肝功能等全面评估病情.

Objective To investigate the relationship between the expression of miR-122 in HBV-related acute-on-chronic liver failure (HBV-ACLF) and clinical indicators, and to analyze the role of miR-122 in evaluating the severity and diagnosis of HBV-ACLF. Methods Serum samples from 49 patients with HBV-ACLF, 30 patients with chronic hepatitis B (CHB) and 30 healthy volunteers were collected from the First Affiated Hospital of Shanxi Medical University. The relative expression of miR-122 in each sample was detected by fluorescence real-time quantitative PCR. With the u6 as endogenous control, the relative expression of miR-122 was expressed as 2-ΔCT. Patients with HBV-ACLF were divided into early stage, middle stage and late stage groups according to the severity of clinical manifestations. The levels of miR-122 expression between different groups were compared, and the correlation between the expression of miR-122 and biochemical markers were analyzed, respectively. Furthermore, the role of miR-122 in the progression of HBV-ACLF was analyzed by Unconditional Logistic regression model, thus reflecting the association between miR-122 and disease severity. Receiver operating characteristic curve (ROC) was used to evaluate the value of serum miR-122 in the diagnosis of HBV-ACLF. Results The expression level of miR-122 in serum of patients with HBV-ACLF was significantly higher than those of healthy subjects and patients with CHB (P < 0.001), and the level of miR-122 expression in advanced HBV-ACLF was significantly higher than those of the early and middle stages (P < 0.001, P = 0.048). The serum level of miR-122 in patients with HBV-ACLF was positively correlated with the level of serum total bilirubin (TBil) (r = 0.508, P < 0.001) and negatively correlated with PTA (r =-0.797, P < 0.001). Unconditional Logistic regression model showed that an increase of one unit of relative expression of miR-122 (2-ΔCT) was associated with 5.8％ (95％CI: 1.013-1.104) increase in the risk of progression from HBV-ACLF early stage to middle stage and 13.0％ (95％CI: 1.034-1.235) increase in the risk from early stage to late stage. The ROC analysis showed that the area under the curve (AUC) of disease diagnosis was 0.942 (95％CI: 0.903-0.982), the sensitivity and the specificity were 83.7％ and 86.7％. Conclusions The expression level of miR-122 in serum could be used as a biomarker for the diagnosis and the severity of HBV-ACLF.

目的了解山西省医务人员对丙型肝炎职业暴露及防护方面的知识掌握情况,为医务人员开展预防丙型肝炎职业暴露感染提供科学依据。方法以不记名问卷调查方式,对山西省23所二级、三级综合医院2300名医院人员进行丙型肝炎职业暴露及防护认知调查分析。结果问卷正确率:最低14.8%,最高98.3%,平均59.8%;三级医院52.0%,二级医院48.0%;医生40.0%,护理人员40.0%,辅助科室工作人员及行政管理人员20.0%;32.3%进行过培训,67.7%未进行过培训;82.3%意识到丙型肝炎职业暴露危险,63.4%采取防护措施。结论山西省医务人员职业暴露及防护知识并不理想,必须进一步加强培训学习,以便有效的预防丙型肝炎职业暴露感染。

Objective To explore the protective effect of bone marrow mesenchymal stem cells (BMSCs) trans- plantation against intestinal endotoxemia (IETM) from thioacetamide-induced (TAA) acute liver failure in rats. Meth- ods The BMSCs were purified and amplified by adherent culturing in vitro from bone marrow of male Wistar rats. Thirty female Wistar rats were randomly assigned to control group, thioacetamide model group and BMSC treated group (n=10). The rat models of acute liver failure were induced by gavage of 300 mg/kg TAA in two consecutive days, while the normal group received gavage of 2 ml PBS at the same time. After the second gavage, the BMSC treated group was given caudal injection of BMSCs while the normal and TAA groups were injected with same volume of PBS. All rats were sacrificed at 72 hours after BMSCs transplantation. The serum ALT and AST, and plasma endotoxin (ET) levels were measured. The liver and ileum tissues were collected and examined for routine pathohistology. Results The lev- els of ALT, AST and ET were significantly increased in the TAA model group compared with the normal group (P< 0.05), and in the BMSCs group compared with the TAA model group (P<0.05). Pathological study showed notably less inflammatory damage in rat liver tissues associated with BMSC transplantation. Conclusion Caudal transplantation of BMSC appeared protective against IETM in rats with TAA-induced acute liver failure.

目的评价本实验室制备的抗变异乙型肝炎(乙肝)表面抗原单克隆抗体检测野生及变异表面抗原的能力.方法用酶联免疫吸附试验(ELISA)评价本实验室制备的抗变异乙肝表面抗原的单克隆抗体,以及国内常用的8种乙肝检测试剂盒,对3种野生乙肝表面抗原和15种变异乙肝表面抗原的检测效果.结果本实验室制备的抗乙肝变异表面抗原单克隆抗体对变异表面抗原的检测能力明显优于国内常用检测试剂盒.结论该单克隆抗体为进一步研制高敏感性乙肝检测试剂盒提供了前提.