目的 观察遗传性血色素沉着症候选基因HFE多态性检测判断CHC疾病活动的价值.方法 2016年11月～2018年11月我院收治的257例丙型肝炎病毒感染者,其中病毒感染者131例和慢性丙型肝炎(CHC)患者126例.采用酶结合免疫吸附法测定血清铁蛋白(SF)水平,使用ABIPrismsTM-7900实时荧光定量PCR仪和TaqMan-MGB荧光探针,以实时定量PCR法检测HFE基因rs2071303和rs9366637位点基因型.结果 病毒感染者SF水平为(97.5±4.1)μg/L,显著低于CHC患者[(202.1±24.5)μg/L,P＜0.05],血清ALT水平为(34.0±4.5) U/L,显著低于CHC患者[(88.4±5.6)U/L,P＜0.05],AST为(37.5±4.2) U/L,显著低于CHC患者[(70.0±5.4) U/L,P＜0.05];病毒感染者HCV基因非Ⅰb型频率为29.8％,显著高于CHC患者13.5％ (P＜0.05),病毒感染者HCV基因型中混合型频率为9.1％,显著低于CHC患者的21.4％ (P＜0.05);病毒感染者rs2071303位点GG基因型患者SF水平为(97.6±4.2) μg/L,显著低于CHC患者[(199.5±45.4) μg/L,P＜0.05],GA基因型SF水平为(97.6±4.1)μg/L,显著低于CHC患者[(207.5±34.7) μg/L,P＜0.05],AA基因型SF水平为(96.7±3.7)μg/L,显著低于CHC患者[(198.0±44.8)μg/L,P＜0.05];病毒感染者rs9366637位点TT基因型患者SF水平为(97.4±4.0) μg/L,显著低于CHC患者[(206.4±35.6) μg/L,P＜0.05],TC基因型SF水平为(97.2±4.0)μg/L,显著低于CHC患者[(208.5±34.0) μg/L,P＜0.05],CC基因型SF水平为(99.1±4.5) μg/L,显著低于CHC患者[(178.5±58.6) μg/L,P＜0.05];病毒感染者rs2071303位点AA基因型频率为13.7％,显著低于CHC患者的21.4％ (P＜0.05),病毒感染者AC单倍型频率为3.1％,显著低于CHC患者的8.3％(P＜0.05).结论 HFE基因多态性与CHC疾病活动密切相关,临床应引起足够的重视.

Objective To analyze the preoperative personal characteristics of glioma patients and to explore the association of their personal characteristics with clinical factors.Methods A retrospective analysis was conducted on 85 patients with gliomas (tumor group) who were admitted to Department of Neurosurgery of Affiliated Hospital of Southwest Medical University from February 2016 to December 2018.Minnesota Multiphasic Personality Inventory (MMPI) was used for assessment before surgery.Meanwhile,41 healthy volunteers who volunteered to undergo the MMPI assessment at Mental Health Center of Affiliated Hospital of Southwest Medical University during the same period were enrolled as controls (healthy control group).The results of MMPI scores were compared between the 2 groups.The relationship between Karnofsky Performance scale(KPS) score,tumor grade,location and side of patients with glioma and MMPI score was further analyzed.Results There was no significant difference in age,gender,education level or income between the 2 groups (all P ＞0.05).Compared with normal control group,the scores of 9 scales of MMPI in tumor group,including Lie (56.0 ± 11.5 vs.50.0 ±10.0),Validity (53.0 ± 10.6 vs.41.7 ± 8.8),Hypochondriasis (55.6 ± 11.2 vs.44.2 ± 8.3),Depression (49.2 ±9.6 vs.42.2 ± 10.3),Masculinity-femininity (49.9 ±9.4 vs.42.8 ± 14.0),Psychasthenia (51.5 ± 10.0 vs.40.9 ± 11.5),Schizophrenia (51.2 ± 10.6 vs.40.2 ± 10.6),Hypomania(51.8 ± 9.1 vs.47.7 ± 9.4),Social introversion (46.6 ± 8.7 vs.36.7 ± 13.0),were significant increased (all P ＜ 0.05).Meanwhile,compared with normal control group,the score of Correction in tumor group was significant decreased (52.1 ± 13.9 vs.58.8 ±12.1,P =0.009).The scores of Lie,Correction,Hypochondriasis and Hysteria were significant different statistically between KPS ＞80 group and KPS≤80 group (P ＜0.05).The scores of Depression were significantly different between frontotemporal group and non-frontotemporal group (P ＜ 0.05).Moreover,the scores of Masculinity-femininity were significantly different between low grade glioma group and high grade glioma group (P ＜0.05).There was no significant difference in the scores of each scale among right,left and bilateral glioma patients (all P ＞ 0.05).Conclusions Patients with gliomas usually have some abnormal psychological personality,including evasion,over self-worry,emotional depression,nervousness,anxiety and so on.The KPS scores,tumor grade and location seem to have certain effects on their psychological personal characteristics respectively.

Objective To discuss the prevalence and clinical features of pre-and post-operative mood disorders in patients with gliomas.Methods A retrospective analysis was conducted on 76 patients of gliomas who underwent surgical resection between July 2015 and June 2017 at Neurosurgery Department of the Affiliated Hospital of Southwest Medical University.Hamilton depression scale (HAMD),Hamilton anxiety scale (HAM-A) and Bech-Rafaelsen Mania rating scale (BRMS) were used for evaluation at 2-3 days before surgery and 5-7 days post surgery.Results Compared with the pre-operative conditions of 76 patients with gliomas,their postoperative HAMD scores were significantly decreased (13.5 ± 3.2 vs.9.8 ± 1.5,t =3.010,P ＜ 0.05).Significant reduction was seen in the proportion of patients with postoperative depression [42.1％ (32/76) vs.15.8％ (12/76),x2 =12.795,P ＜ 0.01].There was no significant difference between pre-and post-operative HAMA scores (10.1 ± 2.8 vs.12.8 ± 4.6) or between pre-and post-operative proportions of patients with anxiety [38.2％ (29/76) vs.50.0％ (38/76)] (both P ＞ 0.05).No significant difference was observed between pre-and post-operative BRMS score (7.5 ± 2.1 vs.8.7 ± 2.5) or pre-and post-operative proportions of patients with mania [2.6％ (2/76) vs.3.9％ (3/76)] (both P ＞0.05).The results showed that postoperative HAMD scores in pathologically high level group,frontal and temporal lobes group and right side group were significantly lower than those prior to surgery (all P ＜ 0.05).Multiple linear stepwise regression analysis showed that household income was vital to preoperative HAMD scores of glioma patients (β =-0.573,t =-3.427,P ＜ 0.01) and was negatively correlated with preoperative HAMD scores.Conclusions Some glioma patients may present with mood disorders of varying extent and types both before and after surgery.Depression seems to be closely related to the location of glioma.Family income could be an independent influencing factor for preoperative HAMD score.