目的:探讨新型冠状病毒(SARS-CoV-2)Omicron变异株BA.2感染老年病例的临床特征,为此类人群的临床防治提供参考.方法:采用回顾性研究方法,收集深圳市第三人民医院收治的101例年龄在65岁以上Omicron变异株BA.2感染患者的临床资料,分析其一般资料、疫苗接种情况、临床表现、实验室检查结果、抗体水平和病毒核酸Ct值等.结果:患者平均年龄为71.3岁,男性占比57.43％,临床分型以轻型患者(52.48％)最多,53例(52.48％)患者合并有基础疾病,以合并高血压35例(34.65％)最为常见,但是否合并基础疾病(r=0.076,P=0.450)以及合并基础疾病的数量(r=0.007,P=0.944)与临床分型的相关性均不具有统计学意义.73例(72.28％)患者具有疫苗接种史,主要接种疫苗厂家为北京科兴,其中29例(28.71％)已接种新冠疫苗加强针,22例(21.78％)患者末次接种疫苗距离发病的时间超过6个月,是否接种疫苗(r=-0.062,P=0.540)、接种疫苗的次数(r=-0.138,P=0.169)以及末次接种疫苗距离发病的时间(r=-0.058,P=0.607)与临床分型均不具有显著的相关性.61例(60.40％)患者具有临床表现,最常见的为咳嗽和咽喉痛,生化指标血小板计数(PLT)、纤维蛋白原(FIB)、白蛋白(ALB)、前白蛋白(pALB)、胆碱酯酶(CHE)、肌酸激酶(CK)、白介素-6(IL-6)的异常数量占比随着病程天数的递进呈增加的趋势,并且在不同病程天数的比较中具有显著差异(P<0.05),此外,C反应蛋白(CRP)、降钙素原(PCT)、氯(Cl-)离子、D-二聚体(D-D)的异常数量占比一直维持在较高水平.53例(52.48％)患者在入院时IgG抗体阳性,IgG是否阳性与临床分型的相关性不具有统计学意义(r=-0.048,P=0.631),但和末次接种疫苗距离发病的时间有显著的相关性(r=0.620,P=0.000),末次接种疫苗距离发病的时间大于6个月的IgG抗体水平显著低于其他组(P=0.000).临床分型小组入院时病毒ORF1ab和N基因核酸Ct值比较,具有显著差异(P<0.05),无症状感染者的病毒核酸Ct值高于轻型和普通型患者.结论:新型冠状病毒Omicron变异株BA.2感染的老年病例具有较轻的临床症状,但具有较强的病毒传播能力,患者临床分型与合并基础病、疫苗接种情况及IgG阳性与否的相关性不强,但疫苗接种6个月后的IgG抗体水平明显降低.

肺结核是由结核分枝杆菌感染引起的一种肺部慢性传染性疾病，严重威胁人类健康安全，全球每年约有400万人死于该病，我国肺结核患者数量高居世界第二位 [1-2] 。抗结核药物性肝损伤（DILI）是结核病治疗过程中常见且严重的不良反应，其发生率为2%～28% [3] 。DILI除了与环境因素有关外，遗传因素如α1-抗胰蛋白酶缺乏、代谢组学和蛋白质组学变化、基因多态性等也起重要作用 [4] 。乙醛脱氢酶2（ALDH2）主要存在于肝脏、脑、心、肾中，

Objective:To analyze the clinical characteristics of Brucella infection in Shenzhen City, and to provide reference for clinical diagnosis and treatment of patients with Brucella infection. Methods:The clinical characteristics of 57 patients with Brucella infection from January 1, 2018 to December 31, 2020 in The Third People′s Hospital of Shenzhen were retrospectively analyzed. The clinical characteristics of patients with brucellosis and latent Brucella infection, patients with or without comorbidities were compared respectively, and magnetic resonance imaging (MRI) and lumbar puncture examination findings of 57 patients were also analyzed. Statistical analysis was performed using Wilcoxon rank sum test and chi-square test. Results:Among the 57 patients with Brucella infection, 10 cases (17.5%) were latent infections and 47 cases (82.5%) were brucellosis patients. Among brucellosis patients, 91.5%(43/47) had fever and 74.4%(32/43) had maximum body temperature ≥38.1 ℃, 40.4%(19/47) had chills orshivering, 25.5%(12/47) had hyperhidrosis, 17.0%(8/47) had fatigue, 21.3%(10/47) had headache, 23.4%(11/47) had neck/back/low back pain, and 31.9%(15/47) had joint pain. A total of 18 cases (38.3%) had comorbidities. Cases with positive blood cultures in latent infection and brucellosis were seven and 39, respectively. The time from symptom onset to diagnosis was 30.0 (15.0, 67.5) days in 18 patients of brucellosis with comorbidity, which was longer than 20.0 (13.0, 30.0) days in 29 patients without comorbidity. Neck/back/low back pain and joint pain occurred in patients with brucellosis with comorbidity were seven and nine, respectively, and those without comorbidity were four and six, respectively, with statistically significant differences ( Z=-2.00, χ2=3.90 and 4.39, respectively, all P<0.050). Of the 11 brucellosis patients with neck/back/low back pain, six had spondylitis. Of the 15 brucellosis patients with joint pain, six had arthritis. Lumbar puncture examination did not indicate meningitis in six cases of latent infection, while revealed six cases of brucellosis meningitis in 32 brucellosis patients. Fifty-four patients had good outcomes, and three patients were cured after an extended course of treatment. Conclusions:Although patients with latent Brucella infection have no comorbidities, they have a high positive blood culture rate. Active standardized anti- Brucella treatment is recommended. MRI examination of relevant sites is recommended in brucellosis patients with joint, neck/back/low back pain, and lumbar puncture is recommended in brucellosis patients regardless of headache.

目的:探讨慢性乙型肝炎患儿应用聚乙二醇干扰素(polyethylene glycol interferon，PEG-IFN)α-2a和恩替卡韦治疗的效果。方法:选取2016年1月至2020年6月在深圳市第三人民医院就诊的慢性乙型肝炎患儿，根据治疗用药分为PEG-IFNα-2a组和恩替卡韦组，分别比较两组患儿基线，治疗12、24、48周的丙氨酸转氨酶(alanine aminotransferase，ALT)、乙型肝炎病毒(hepatitis B virus，HBV)血清标志物、HBV DNA变化及不良反应。统计学分析采用 χ2检验。 结果:共纳入54例患儿，其中PEG-IFNα-2a组31例，恩替卡韦组23例。恩替卡韦组治疗48周的ALT复常率达87.0%(20/23)，高于PEG-IFNα-2a组的40.0%(12/30)，差异有统计学意义( χ2＝12.00， P＝0.001)。PEG-IFNα-2a组治疗48周的乙型肝炎e抗原(hepatitis B e antigen，HBeAg)转阴率为48.4%(15/31)，HBeAg血清学转换率为45.2%(14/31)，乙型肝炎表面抗原(hepatitis B surface antigen，HBsAg)转阴率为35.5%(11/31)；恩替卡韦组治疗48周的HBeAg转阴率为47.8%(11/23)，HBeAg血清学转换率为43.5%(10/23)，HBsAg转阴率为13.0%(3/23)，两组上述指标比较差异均无统计学意义( χ2＝0.00、0.02、3.46，均 P>0.050)。PEG-IFNα-2a组治疗48周时HBsAg血清学转换率为25.8%(8/31)，高于恩替卡韦组的4.3%(1/23)，差异有统计学意义( χ2＝4.38， P＝0.036)。将PEG-IFNα-2a组患儿在治疗12周时根据HBsAg下降水平分为HBsAg<1 500 IU/mL组和HBsAg≥1 500 IU/mL组，18例HBsAg<1 500 IU/mL组患儿在治疗24周时7例HBsAg转阴，48周时10例转阴，而13例HBsAg≥1 500 IU/mL组患儿治疗24周时无一例HBsAg转阴，治疗48周时1例转阴，差异均有统计学意义( χ2＝2.56、2.75，均 P<0.050)。 结论:恩替卡韦改善肝脏炎症的效果更明显，短期内抑制病毒复制的能力更强，安全性较好；PEG-IFNα-2a的治疗效果与HBsAg快速下降有关，治疗中HBsAg快速下降(12周HBsAg<1 500 IU/mL)的患者，治疗24周和48周的HBsAg转阴率更高。

目的 比较不同方法分离培养人胎盘绒毛膜间充质干细胞(MSC)的差异,并鉴定其生物学特性.方法 选取健康孕妇胎盘绒毛膜组织分别采用组织块贴壁法、胶原酶消化法、胰酶消化法进行分离培养,流式细胞仪分析细胞表面标志物的表达,台盼蓝染色计数方法绘制细胞生长曲线并计算群体倍增时间,逆转录聚合酶链反应和成脂诱导分化试剂盒分别检测细胞多能性相关基因及分化潜能.结果 胶原酶消化法原代培养周期均明显短于组织块贴壁法和胰酶消化法,培养相同时间内获得的活细胞数量均明显高于组织块贴壁法和胰酶消化法,差异均有统计学意义(P<0.05);3种方法来源细胞均表达MSC表面标志物——CD44、CD105,不表达造血细胞表面标志物——CD34、CD45;3种方法来源细胞生长曲线均呈"S"形,第4代细胞群体倍增时间比较,差异均无统计学意义(P>0.05);3种方法获得细胞均表达多能性相关基因——Oct4、Nanog,且具有成脂分化能力.结论 组织块贴壁法、胶原酶消化法、胰酶消化法均可分离培养获得绒毛膜MSC,但结合培养时间及细胞纯度等因素认为,胶原酶消化法更具有优势.

Objective To investigate the clinical characteristics and laboratory tests of severe acute respiratory syndrome coronavirus 2 （SARS-CoV-2） Delta and Omicron variant infections cases,and to provide reference for the prevention and treatment of SARS-CoV-2.Methods A retrospective study was conducted to collect the clinical data of 23 cases of SARS-CoV-2 Delta variant admitted to Shenzhen Third People’s Hospital from June 11,2021 to November 8,2021,and 34 patients with Omicron variant admitted from February 21,2022 to March 9,2022.We compared and analyzed the clinical symptoms,vaccination,laboratory test results,and chest CT imaging features of patients infected with different variants.Results Among patients infected with the Delta and Omicron variants,35 cases （61.4%） were males,and 56 cases （98.2%） were young and middle-aged.The main clinical manifestations were cough,sore throat and fever,clinical staging was predominantly mild （χ~2=11.797,P＜0.05）,and no severe cases.Comparing the two groups of patients receiving COVID-19 vaccine vaccination,it was found that the number of patients in Omicron group received booster shots of COVID-19 vaccine than Delta group （χ~2=12.853,P＜0.05）.The time from the last vaccination to the onset was more than 1 month in 90.9%（50 cases） patients,but there was no significant difference between the two groups （χ~2=3.079,P＞0.05）.In comparison of laboratory test results between the two groups,IL6 levels were higher while serum K and LDH levels were lower in the Delta group,with statistically significant differences （all P＜0.05）.The median Ct value of viral nucleic acid in both groups at admission were lower than 20,and the nucleic acid Ct values in the Omicron group at day 3,7,14,and 21 were significantly higher than that in the Delta group （all P＜0.05）,the number of viral nucleic acid negative cases at day 14 and 21 was significantly higher than those in the Delta group （all P＜0.05）.The positive duration of viral nucleic acid and hospital stay were also significantly shorter than those in Delta group （all P＜0.05）.In comparison of antibody levels between the two groups,the IgG positive rate of Omicron and Delta group at admission was 64.7% and 34.8%,respectively,the median level of IgM and IgG in Omicron group was significantly higher than that in Delta group （all P＜0.05）.On day 7,the IgG positive rate of Omicron and Delta group was 93.7% and 75.0%,respectively,and there was no significant difference in the comparison of IgM and IgG between the two groups （all P＞0.05）.Conclusion Patients infected with Delta and Omicron variants both have strong infectivity,and the Omicron variant infected patients with the virus’s nucleic acid turned negative more quickly.Both may have certain immune escape against the existing COVID-19 vaccines.

ObjectiveTo investigate the influence of nonalcoholic fatty liver disease (NAFLD) on the antiviral response of patients with chronic hepatitis B (CHB), and to provide a reference for clinical treatment of such patients. MethodsA total of 187 patients who attended Shenzhen Third People’s Hospital from January 2011 to December 2017 were enrolled and divided into CHB group with 43 patients, NAFLD group with 41 patients, and CHB+NAFLD group with 103 patients. Related indices were measured at enrollment different time points of follow-up, including body height, body weight, alanine aminotransferase (ALT), aspartate aminotransferase, four blood lipid parameters, four indicators of liver fibrosis, aspartate aminotransferase-to-platelet ratio index, HBsAg, HBeAg, anti-HBe, and HBV DNA quantification, and the CHB patients and the CHB+NAFLD patients receiving antiviral therapy were compared in terms of treatment outcome at weeks 12, 24, 48, 72, and 96 of antiviral therapy. The Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups, and the Wilcoxon rank-sum test was used for comparison between two groups; the chi-square test was used for comparison of categorical data between groups. ResultsCompared with the NAFLD group at baseline, the CHB group and the CHB+NAFLD group had significantly lower platelet count, ALT, gamma-glutamyl transpeptidase (GGT), alkaline phosphatase, and right lobe of liver oblique diameter (all P＜0.05), and compared with the CHB group, the CHB+NAFLD group had significantly higher body mass index, total cholesterol, and triglyceride and a significantly lower spleen thickness (all P＜0.05), while there were no significant differences in the other indicators between the two groups at baseline (all P＞0.05). At week 12 of antiviral therapy, there were no significant differences in liver fibrosis markers and inflammatory indices between the CHB group and the CHB+NAFLD group (all P＞0.05); compared with the CHB+NAFLD group at weeks 24 and 48, the CHB group had significantly greater reductions in ALT (Z=-2.128 and -3.055, both P＜0.05) and GGT (Z=-2.025 and -1.631, both P＜0.05); at week 48, the CHB group and the CHB+NAFLD group had a significant reduction in HBV DNA (Z=-6.445 and -4.415, both P＜0.001), and the CHB group had a significantly greater reduction. The CHB+NAFLD group had a significantly lower HBV DNA clearance rate than the CHB group at different time points of antiviral therapy (χ2=14.237, 13.961, 15.226, 10.462, and 13.030, all P＜0.05). At week 48 of antiviral therapy, the CHB+NAFLD group had a significantly lower HBeAg clearance rate than the CHB group (χ2=5.309, P=0.021), while there was no significant difference between the two groups at week 96 (χ2=0.117, P=0.732). At weeks 24, 48, 72, and 96 of antiviral therapy, the CHB+NAFLD group had a significantly lower ALT normalization rate than the CHB group (χ2=12.049, 5.287, 11.407, and 11.375, all P＜0.05). ConclusionNAFLD reduces the antiviral response of CHB patients and prolongs the duration of antiviral therapy.

目的:探讨艾滋病(AIDS)合并非结核分枝杆菌(NTM)病的临床特点及耐药特征，为临床诊治提供参考。方法:选取2014年1月至2019年4月在深圳市第三人民医院就诊的AIDS合并NTM病患者43例为研究对象，分析其临床症状、实验室检查、对抗结核药物的耐药情况。采用SPSS 22.0软件和Excel表格对数据进行整理和分析。结果:37例(86.0%)为NTM肺病，3例(7.0%)为肺外NTM病，3例(7.0%)为播散性NTM病。NTM肺病以鸟-胞内分枝杆菌复合群(MAC)为优势菌种，占53.5%。所有患者年龄中位数为41.0岁，男性占38/43(88.4%)；临床表现以发热(79.1%)、咳嗽(72.1%)为主，其他常见的临床表现包括气促(41.9%)、纳差(32.6%)、腹痛腹泻(32.6%)、乏力(27.9%)和淋巴结肿大(18.6%)，少数患者会出现消瘦(7.0%)和咯血(7.0%)。基准CD4 +T淋巴细胞中位数为21.0个/μL，<200个/μL的患者占41/43(95.3%)。NTM对多种抗结核药物具有耐药性，以对氨基水杨酸耐药率最高(87.5%)，其次为卷曲霉素(84.4%)、丁胺卡那霉素(78.1%)、链霉素(68.8%)、异烟肼(62.5%)、利福平(62.5%)，对乙胺丁醇(6.3%)和丙硫异烟胺(6.3%)耐药率相对较低。 结论:在深圳地区，AIDS合并NTM病多发生于免疫力低下患者，特别是CD4 +T淋巴细胞<200个/μL的患者，主要病原谱为MAC，临床上主要表现为NTM肺病，具有发热、咳嗽、气促、纳差等症状，耐药程度严重，乙胺丁醇和丙硫异烟胺的耐药率相对较低，临床上用药可优先选择。

该文旨在比较不同的转染试剂介导两种荧光素酶报告基因转染人胚肾细胞293T的效果.采用月旨质体转染试剂Lipofectamine(R) 2000、非脂质体成分X-tremeGENE HP DNA和FuGENE(R)HID转染试剂,选取不同配比的质粒DNA和转染试剂分别将含有绿色荧光蛋白(GFP)和红色荧光蛋白(RFP)的质粒转入293T细胞中,应用倒置荧光显微镜和流式细胞仪分析转染效率,锥虫蓝染色法检测细胞存活率.X-tremeGENE HP DNA转染试剂转染293T细胞的效率最高,不管目的 基因、质粒DNA和转染试剂的配比如何,其转染效率均显著高于脂质体转染试剂(P均＜0.05);在相同的质粒DNA和转染试剂比例下,FuGENE(R) HD试剂介导GFP转染的效率显著高于脂质体试剂Lipofectamine(R)2000(P均＜0.05),但二者介导RFP转染的效率无显著性差异(P均＞0.05);在质粒DNA和转染试剂比为1∶2时,X-tremeGENE HP DNA试剂转染GFP和RFP的效率均显著高于FuGENE(R) HD试剂(P均＜0.05),当比例递变为1∶4时,二者的转染效率无显著性差异(P均＞0.05).随着转染试剂使用量的增多,Lipo-fectamine(R) 2000和FuGENE(R)HD试剂的转染效率明显升高,而X-tremeGENE HP DNA试剂的转染效率则下降.与转染GFP基因相比,三种试剂的转染效率均随着目的 基因RFP片段的增大而显著降低(P均＜0.05).在质粒DNA和转染试剂的比例相同的情况下,三种试剂转染后的存活率无显著性差异(P均＞0.05),但随着转染试剂用量的增加,三种试剂转染后的细胞存活率均显著降低(P均＜0.05).目的 基因大小与转染效率成反比,综合考虑转染试剂用量、转染效率和细胞活性,该研究认为X-tremeGENE HP DNA转染试剂效果最好.