缺氧诱导因子HIF－1a和Endoglin在子痫前期患者胎盘中的表达及其与母体血清sEng的相关性研究

目的：检测HIF－1a、Endoglin和sEng在子痫前期患者胎盘及血清中的表达,并探讨他们在子痫前期发病机制中的作用。方法：选择子痫前期病人35例,随机选取同期正常孕妇40例作为对照组。采用免疫组织化学和酶联免疫吸附试验（ELISA）分别检测各组胎盘组织中HIF－1 a、Endoglin的表达及母体血清中sEng的水平。结果：轻度子痫前期组血清sEng明显高于正常对照组（P＜0．05）,重度子痫前期组明显高于轻度子痫前期组（P＜0．05）。轻度子痫前期组HIF－1 a和Endoglin的表达均显著高于正常对照组,重度子痫前期组均显著高于轻度子痫前期组（P＜0．05）。子痫前期组胎盘组织中HIF－1a与Endoglin及sEng的表达均呈正相关（r分别为0．859,0．895）。结论：子痫前期患者胎盘HIF－1α、Endoglin和血清sEng的表达均升高,3者可能共同参与了子痫前期发病的病理生理过程。     

子痫前期与Soluble Endoglin水平的关系

目的：探讨子痫前期临床症状出现前及出现时可溶性Endoglin（soluble Endoglin,sEng）水平。方法：采用双抗体夹心酶联免疫吸附（ELISA）法检测47例子痫前期妇女和40例正常晚孕妇女血清中sEng水平。结果：①在正常对照组,sEng维持在低水平至33～36孕周,之后逐渐升高直至分娩。早发型重度子痫前期患者发病前sEng水平在17—20孕周即开始升高,之后随孕周逐渐升高,至临床症状出现时达到高峰,均显著高于对照组（P〈0．001）。晚发型重度子痫前期患者发病前sEng水平在29～32孕周开始升高,至33～36孕周明显升高,至临床症状出现时达到高峰,均显著高于对照组（P〈O．001）。②sEng水平在子痫前期组显著高于对照组（P〈0．05）。重度子痫前期组显著高于轻度子痫前期组（P〈0．05）,其中晚发型重度子痫前期组显著高于早发型重度子痫前期组（P〈0．05）。结论：sEng水平在子痫前期临床症状出现前数周就开始升高,且随子痫前期病情加重而增加,对预测或早期诊断子痫前期意义重大。     

Soluble endoglin和sFlt-1在子痫前期患者血清中的表达

目的探讨可溶性CD105淋巴细胞抗原及可溶性血管内皮生长因子受体1(sFlt-1)在子痫前期患者血清中表达水平的变化及意义。方法采用双抗体夹心酶联免疫吸附(ELISA)法测定子痫前期组、子痫前期各个亚组及正常晚期妊娠组血清sEng及sFlt-1的水平。结果①子痫前期组孕妇血清sEng、sFlt-1水平分别为(5.27±1.05)ng／mL、(391.14±70.25)pg／mL,正常晚期妊娠组分别为(1.26±0.40)ng／mL、(27.57±4.36)pg／mL,两组比较差异有统计学意义(P＜0.01);②轻度子痫前期组sEng水平与重度子痫前期组比较差异有统计学意义(P＜0.01),两组sFlt-1水平比较差异无统计学意义(P＞0.05);③早发型重度子痫前期组sEng水平与晚发型重度子痫前期组比较差异有统计学意义(P＜0.01),两组sFlt-1水平比较差异无统计学意义(P＞0.05)。结论子痫前期患者血清中sEng、sFlt-1水平显著升高,sEng在早发型重度子痫前期血清中升高更显著,对早期诊断子痫前期有重要意义。     

子痫前期患者血清中sEng水平的研究

目的通过对子痫前期患者血清中的可溶性Endoglin（soluble Endoglin,sEng）的表达水平的测定,探讨其与子痫前期发病的关系及意义。方法选取2008年10月~2009年10月在泸州医学院附属医院产科住院分娩的子痫前期患者40例与同期健康孕妇40例作为对照组。采用酶联免疫吸附试验（ELISA）夹心法检测子痫前期患者与正常妊娠妇女血清中的sEng的表达水平。采用SPSS 14.0统计软件包进行统计学分析,数据以均数±标准差（x-±s）表示;两样本均数比较用随机独立样本均数t检验。取α=0.01作为检验水平,P〈0.01差异有统计学意义。结果子痫前期组血清中sEng为7.38±1.78 ng/ml,正常妊娠组为2.17±0.59 ng/ml,两组比较差异有显著性（P〈0.01）。重度痫前期组血清中sEng为7.94±1.27 ng/ml,轻度痫前期组血清中sEng为5.72±1.09 ng/ml,重度子痫前期与轻度子痫前期比较,差异有显著性（P〈0.01）。血清中sEng的水平随疾病病情的加重而升高。结论 sEng在子痫前期患者的外周血中高表达,sEng水平升高的程度能与疾病的严重程度相关。     

血清CysC、β2-MG在妊娠期高血压疾病早期肾功能损伤中的意义

目的：探讨血清胱抑素（CysC）及血清β2‐微球蛋白（β2‐MG）在评估妊娠期高血压疾病（HDCP）患者早期肾功能损伤中的临床价值。方法采用全自动生化分析仪检测108例 HDCP 患者（妊娠期高血压组41例,轻度子痫前期组30例,重度子痫前期组37例）及孕周相近的健康单胎妊娠妇女（对照组40例）血清中 CysC 、β2‐MG 、肌酐（Cr）的水平。结果妊娠期高血压组、轻度子痫前期组、重度子痫前期组患者血清 CysC 、β2‐MG 水平均显著高于对照组（P＜0．05）;妊娠期高血压组、轻度子痫前期组、重度子痫前期组3组间血清 CysC 、β2‐MG 水平比较,差异均有统计学意义（妊娠期高血压组＜轻度子痫前期组＜重度子痫前期组,P＜0．05）。妊娠期高血压组、轻度子痫前期组和对照组之间血清 Cr 水平比较差异均无统计学意义（P＞0．05）,而重度子痫前期组与对照组之间血清 Cr 水平差异有统计学意义（P＜0．05）。相关分析结果显示 HDCP 患者血清 CysC 与β2‐MG 、Cr 呈正相关。结论联合检测血清 CysC 、β2‐MG 、Cr 对判断 HDCP 孕妇病情严重程度及诊断早期肾功能损伤具有重要的临床价值。     

子痫前期患者血清炎性因子水平变化和铁蛋白的临床意义

目的：探讨子痫前期患者血清炎性因子C-反应蛋白（ CRP ）、肿瘤坏死因子α（ TNF-α）、γ干扰素（ IFN-γ）水平变化和血清铁蛋白（ SF）水平的临床意义。方法：ELISA法检测血清CRP、TNF-α、IFN-γ和血清铁蛋白在53例轻度子痫和47例重度子痫前期及100例正常孕妇中的水平。结果：正常妊娠孕妇的CRP、TNF-α、IFN-γ水平与子痫前期患者比较差异有统计学意义（ P＜0．05）;重度子痫前期组的CRP、TNF-α、IFN-γ水平与轻度子痫前期组比较差异有统计学意义（ P＜0．05）;三者随病情的加重逐渐升高。各组间血清铁蛋白水平差异均无统计学意义（ P＞0．05）。结论：CRP、TNF-α、IFN-γ参与子痫前期的发生及发展,可作为其进展性的预测指标。     

子痫前期胎盘中HIF 1α和Endoglin的表达及其与血清中sEng的相关性研究

目的探讨子痫前期患者胎盘组织中缺氧诱导因子 1α（HIF 1α）、Endoglin和血清中可溶性Endoglin(sEng)的表达。方法用免疫组织化学SP法检测20例正常妊娠妇女（对照组）和40例子痫前期患者（子痫前期组,其中轻度子痫前期组10例,重度子痫前期组30例）胎盘组织中HIF 1α和Endoglin的表达,双抗体夹心酶联免疫吸附(ELISA)法检测血清sEng的水平,并进行统计分析。结果①HIF 1α、Endoglin及sEng水平在子痫前期组中的表达较对照组明显升高（P<0.01）,三者在重度子痫前期组中的表达较轻度子痫前期组明显升高（P<0.01）;②子痫前期组HIF 1α的表达与Endoglin及血清中sEng的表达均呈正相关关系（r分别为0.686、0.866）。结论子痫前期患者胎盘HIF 1α的表达增高可引起胎盘中Endoglin和血清中sEng增多,从而共同参与子痫前期的病理过程。     

瘦素、脂联素与子痫前期-子痫关系的研究

目的：探讨子痫前期（PE）患者血清瘦素、脂联素水平的变化及其意义。方法：选择38例子痫前期孕妇作为研究组,其中子痈前期轻度患者16例（B组）,子痫前期重度患者22例（C组）;选择同期分娩的正常孕妇40例作为对照组（A组）。采用放免法检测血清瘦素水平,采用ELISA法检测血清脂联素水平。同时检测患者尿蛋白、肾功能（BUN、Cr）水平。结果：（1）PE重度组患者血清瘦素水平（29．45±7．93）ng／ml,最高;PE轻度组患者血清瘦素水平（16．64±5．29）ng／ml,居中;对照组血清瘦素水平（10．51±3．16）ng／ml,最低,三者两两相比,差异有统计学意义（P〈0,05）。PE重度组患者血清脂联素水平（1．06±0．35）mg／L,最低;PE轾度组患者血清脂联素水平（2．33±1．46）mg／L,居中;对照组脂联素水平（4．21±0．96）mg／L,最高,三者两两相比,差异有统计学意义（P〈0．05）。（2）子痫前期患者血清瘦素和脂联素呈高度负相关（r=0．825,P〈O．01）。结论：瘦素、脂联素在PE的发病过程中可能起一定的作用,高瘦素血症和低脂联素血症可能与PE的发生、发展有关。     

子痫前期患者血清中IGF-1和PLGF的表达及临床意义

①目的研究子痫前期患者血清IGF-1及PLGF的袁达,分析二者与子痫前期的关系,探讨IGF-1及PLGF在子痫前期发病及诊疗中的作用。②方法选取子痫前期住院患者60例,分为两组（轻度子痫前期30例,重度子痫前期30例）;另选同期住院正常孕妇30例作为对照组。各组于分娩前5min取静脉血5mL,采用酶联免疫吸附法（ELISA）检测血清中IGF-1和PLGF的表达。③结果正常对照组IGF-1含量为（42．25±10．21）ng／mL,轻度子痫前期组（21.52±5．17）ng／mL,重度子痫前期组（16．75±3．16）ng／mL;正常对照组PLGF含量为（387±26）ug／L,轻度子痫前期组（232±34）ug／L和重度子痫前期组（121±23）ug／L。（D结论在子痫前期患者血清中,IGF-1和PL—GF的表达明显高于重度子痫前期组,IGF-1和PLGF表达均呈正相关。     

孕妇血清 sEng、sFlt －1及 PLGF 浓度变化对子痫前期的预测价值

目的：探讨孕妇血清可溶性内皮因子（sEng）、胎盘生长因子（PLGF）及可溶性血管内皮生长因子受体1（ sFIt－1）的浓度变化对子痫前期的预测价值。方法选择子痫前期孕妇68例,其中重度子痫者28例,轻度子痫者40例,采用ELISA法检测血清sEng、sFIt－1及PLGF水平,并与同期35例正常孕妇的血清上述指标进行比较,分析上述指标浓度改变对子痫前期的预测价值。结果重度子痫孕妇sEng水平显著高于轻度子痫孕妇和正常孕妇,sFIt－1水平也显著高于轻度子痫孕妇和正常孕妇,PLGF水平显著低于轻度子痫孕妇和正常孕妇,轻度子痫孕妇sEng和sFIt－1水平均显著高于正常孕妇,PLGF水平显著低于正常孕妇,差异均有统计学意义（P＜0.05）。结论孕中期sEng、sFIt－1水平升高,PLGF水平降低可提示子痫前期。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.