自噬调节在脉冲射频治疗神经病理性疼痛中的作用

目的：观察腰5(L5)脊神经结扎(spinal nerve ligation,SNL)致慢性疼痛大鼠接受背根神经节脉冲射频(pulse radiofrequency,PRF)治疗后痛觉行为学的变化,检测脊髓背角自噬相关基因LC3和自噬受体蛋白P62的表达情况,研 究PRF是否能通过调节脊髓背角神经元自噬水平发挥镇痛作用。方法：36只SD大鼠随机分为假手术组(Sham组)、SNL 组(行左侧L5脊神经的暴露和结扎)和SNL+PRF组(建立SNL模型后即刻给予1次同侧背根神经节PRF治疗)。分别于手 术前1 d及术后1,3,7,14,28 d观察各组大鼠机械刺激缩足反应阈值(paw withdrawal mechanical threshold,PWMT)改 变,Western印迹检测自噬相关基因LC3和细胞自噬受体蛋白P62在大鼠损伤侧相应节段脊髓背角的表达改变。结果： 与Sham组相比,SNL组大鼠在术后各时点PWMT均明显下降(P<0.05);与SNL组相比,SNL+PRF组大鼠在PRF治疗术 后第1天即出现PWMT的升高,并持续28 d(P<0.05);与Sham组相比,SNL组大鼠在术后7 d脊髓背角LC3-II和P62蛋白 表达明显升高(P<0.05);与SNL组相比,SNL+PRF组大鼠在术后7 d脊髓背角LC3-II和P62蛋白表达明显下调(P<0.05)。 结论：SNL慢性疼痛大鼠接受背根神经节PRF治疗后出现疼痛行为学改善,PRF治疗可能通过上调脊髓背角神经元自 噬水平发挥镇痛作用。     

背根神经节巨噬细胞迁移抑制因子参与 调控神经病理性疼痛的机制研究

目的 探讨脊髓背根神经节（DRG）巨噬细胞迁移抑制因子（MIF）对神经病理性疼痛的作用及可 能的调控机制。方法 成年雄性SD 大鼠随机分为3 组（n =8）：假手术组（Sham 组）、坐骨神经结扎（CCI）模 型对照组（以下简称CCI 组）、ISO-1 组（CCI+ 鞘内注射ISO-1）。鞘内置管5 d 后予以左侧坐骨神经结扎。 CCI 组和ISO-1 组连续14 d 鞘内注射10% DMSO 10 μl 或含ISO-1 30 μg 的DMSO 10 μl,每天1 次。在术前1 天, 术后第1、3、5、7、10 及14 天（给药2 h 后）测定机械痛阈值;在第7 和14 天取大鼠DRG,ELISA 检测肿瘤 坏死因子α（TNF-α）、白细胞介素1β（IL-1β）的表达变化,Western blot 检测MIF 表达变化,并于第14 天记 录受损坐骨神经传导速度（CV）。结果 与Sham 组比较,术后CCI 组机械痛阈值均降低（P <0.05）;与CCI 组比较, ISO-1 组术后第10 和14 天机械缩足反射阈值均升高（P <0.05）。与Sham 组比较,CCI 组第7 和14 天背根神经 节MIF、TNF-α、IL-1β 表达上调（P <0.05）;与CCI 组比较,ISO-1 组第7 和14 天MIF、TNF-α、IL-1β 表达下调（P <0.05）。神经电生理的结果显示,与Sham 组比较,CCI 大鼠坐骨神经的CV 降低,差异有统计学意 义（P <0.05）;ISO-1 组与CCI 组大鼠坐骨神经的CV 比较,差异无统计学意义（P >0.05）。结论 鞘内注射MIF 拮抗剂ISO-1 可以减轻大鼠机械痛敏,下调DRG MIF、TNF-α 和IL-1β 表达,但不能修复受损坐骨神经。 MIF 拮抗剂ISO-1 可能通过抑制脊髓背根神经节炎症反应,减轻大鼠神经病理性疼痛。     

miR-19a对慢性压迫性损伤大鼠神经病理性疼痛的影响及其机制

目的 观察miR-19a对慢性压迫性损伤(chronic constriction injury,CCI)大鼠神经病理性疼痛的作用,并探讨其潜在机制.方法 75只雄性SD大鼠按随机数字表法分为3组:假手术组,行假手术;CCI组,坐骨神经结扎法构建CCI大鼠模型;CCI+inhibitor组,CCI大鼠鞘内注射miR-19a inhibitor.于术前当天(0 d)和术后3、7、14、21 d观察机械缩足反射阈值(mechanical withdrawal threshold,MWT)和热刺激反射潜伏期(thermal withdrawal latency,TWL)的变化.采用RT-qPCR检测腰椎脊髓中促炎因子IL-6、TNF-α、IL-1β mRNA及JAK2和STAT3表达的变化,Western blot检测SOCS3蛋白水平的表达,荧光素酶报告基因技术验证miR-19a的靶基因.结果 与假手术组比较,CCI组大鼠脊髓的miR-19a表达显著上升(P＜0.05),MWT显著降低,TWL显著缩短(P＜0.05).与CCI组比较,CCI+ inhibitor组MWT显著升高,TWL显著延长(P＜0.05).RT-qPCR检测结果表明,CCI可显著促进促炎因子IL-6、TNF-α、IL-1β mRNA的表达;而与CCI组比较,CCI+inhibitor组IL-6、TNF-α、IL-1βmRNA表达水平均显著降低(P＜0.05).另一方面,与假手术组比较,CCI组大鼠术后脊髓中JAK2和STAT3 mRNA水平明显增加;与CCI组比较,CCI+ inhibitor组术后脊髓中JAK2和STAT3的表达显著降低(P＜0.01).荧光素酶报告基因检测结果表明JAK2/STAT3上游的负调控因子SOCS3是miR-19a的靶基因.Western blot检测结果表明CCI组大鼠脊髓中SOCS3水平较假手术组升高,且SOCS3水平在CCI术后第7天达到最高,而后呈下降趋势;与CCI组比较,CCI+inhibitor组SOCS3表达明显上升(P＜0.05).结论 miR-19a inhibitor能缓解CCI大鼠机械性触诱发痛和热痛觉过敏,该作用与SOCS3介导的JAK2/STAT3通路有关.     

神经病理性疼痛大鼠脊髓背角NF-κB及其下游肿瘤坏死因子α表达的变化

目的 观察大鼠脊髓背角中NF-κB及其下游肿瘤坏死因子α(TNF-α)在慢性坐骨神经挤压性损伤(CCI)疼痛模型中表达的变化规律.方法 雄性SD大鼠76只,随机分为手术组(CCI组)和假手术组(Sham组)(n=38),于CCI前1 d、CCI后1、4、7、14、21、28 d各时间点测定机械痛阈及热痛阈后立即处死大鼠,取腰髓,采用实时荧光定量PCR和免疫荧光双标的方法分别测定NF-κB和TNF-α的mRNA含情和蛋白表达变化.结果 CCI组大鼠手术侧机械痛阈及热痛阈明显降低,脊髓背角中NF-κB水平和TNF-α的表达增加,明显高于对侧和假手术组;NF-κB和TNF-α的mRNA水平于CCI后4 d开始增加,分别为术前的(1.20±0.16,2.32±0.27)倍,7 d达到高峰,为术前的(1.75±0.20,3.38±0.41)倍,随后TNF-α迅速下降,而NF-κB于CCI后28 d仍为术前的(1.15±0.24)倍,维持于较高水平(P＜0.05).术后第7天的免疫荧光双标显示NF-κB和TNF-α在术侧脊髓后角存在共定位表达.结论 CCI致大鼠脊髓背角NF-κB活化并上调TNF-α的表达,参与神经病理性疼痛的调控过程.     

坐骨神经脉冲射频对慢性坐骨神经压迫损伤模型大鼠脊髓背角胶质细胞活化水平的影响及其镇痛作用

目的：观察坐骨神经结扎处脉冲射频（PRF）对慢性坐骨神经压迫损伤（CCI）模型大鼠脊髓背角小胶质细胞和星形胶质细胞活化水平的影响,探讨坐骨神经PRF镇痛机制与脊髓背角小胶质细胞和星形胶质细胞活化水平的关系。方法：雄性SPF级SD大鼠40只随机分为CCI假造模PRF假治疗组（SS组）、CCI假造模PRF治疗组（SP组）、CCI造模PRF假治疗组（CS组）和CCI造模PRF治疗组（CP组）,每组10只。CCI造模成功后4 d行PRF治疗,在坐骨神经结扎处行标准PRF （120s、42℃）。于CCI造模前1d （D₀）及造模后1、3、5和7 d （D₁、D₃、D₅和D₇）测定大鼠患侧机械缩足反射阈（MWT）和热缩足反射潜伏期（TWL）。疼痛行为学测试完成后（D₇）取患侧L3~5脊髓背角,Western blotting法检测脊髓背角小胶质细胞特异性蛋白（Iba-1）和胶质原纤维酸性蛋白（GFAP）的蛋白表达水平。结果：与SS组比较,CCI造模后不同时间点CS组大鼠患侧出现足外翻、跛行、脚趾弯曲聚拢和行走时抬足等行为学表现,MWT和TWL均明显下降（P<0.01）,脊髓背角Iba-1和GFAP蛋白表达水平明显升高（P<0.05）;与CS组比较,CP组大鼠（D₅和D₇） PRF后足外翻、跛行、脚趾弯曲聚拢和行走时抬足等行为学变化明显缓解,MWT和TWL值明显升高（P<0.01）,脊髓背角Iba-1蛋白表达水平明显下调（P<0.05）,GFAP蛋白表达水平差异无统计学意义（P>0.05）。结论：坐骨神经PRF能有效缓解CCI模型大鼠的神经病理性疼痛（NP）,坐骨神经PRF可抑制脊髓背角小胶质细胞活化水平,其镇痛机制可能与抑制脊髓背角小胶质细胞活化有关。     

脊髓背根神经节ZXDC介导CCL2对慢性压迫性神经损伤小鼠神经性疼痛的作用

目的 探讨脊髓背根神经节(dorsal root ganglion, DRG)中转录因子锌指X连锁复制C(zinc finger X-linked duplicated C,ZXDC)介导CCL2/CCR2信号通路对慢性压迫性神经损伤(chronic construction injury model, CCI)诱导神经性疼痛的作用及机制。方法 构建小鼠坐骨神经慢性压迫性损伤模型,免疫荧光染色、Western blot法和实时荧光定量PCR(RT-qPCR)检测正常情况和CCI造模后DRG中ZXDC及CCL2表达变化;将实验动物分为假手术(Sham)组、CCI+AAV-NC组和CCI+AAV-ZXDC siRNA组;Western blot法和免疫荧光染色检测各组小鼠CCI造模后各时间点DRG中ZXDC、CCL2和CCR2表达,RT-qPCR检测DRG中促炎性细胞因子TNF-α和IL-1β mRNA表达,机械性缩足反射测试检测神经性疼痛行为改变。结果 ZXDC表达定位在DRG大、中、小神经元。CCI损伤后1~3天 DRG中ZXDC和CCL2 蛋白和mRNA表达显著增高,CCI后7天二者表达显著降低,ZXDC和CCL2mRNA表达量呈正相关(P均<0.05)。CCI后3天,与Sham组比较,CCI+AAV-NC组和CCI+AAV-ZXDC siRNA组ZXDC、CCL2、CCR2蛋白表达、TNF-α和IL-1β mRNA表达显著增高,其中CCI+AAV-ZXDC siRNA组较CCI+AAV-NC组ZXDC、CCL2、CCR2蛋白表达、TNF-α和IL-1β mRNA显著降低(P均<0.05)。与Sham组比较,CCI+AAV-ZXDC siRNA组和CCI+AAV-NC组CCI后各时间点机械缩足阈值均显著降低,其中CCI后7天,CCI+AAV-ZXDC siRNA组机械缩足阈值显著高于CCI+AAV-NC组(P均<0.05)。结论 脊髓背根神经节ZXDC基因敲减通过抑制CCL2/CCR2信号通路介导CCI诱导的神经性疼痛。     

脊髓损伤后外周组织炎症反应在并发2型糖尿病中的作用研究

目的通过观察SD大鼠脊髓损伤后血糖的变化及其外周组织炎症反应状态,探讨脊髓损伤并发2型糖尿病的可能机制。方法将24只SD大鼠随机分为两组:假模组和脊髓损伤组,其中假模组又分为假模普通饲料组(Sham+LFD)和假模三高饲料组(Sham+HFD)两个亚组,脊髓损伤组分为脊髓损伤普通饲料组(SCI+LFD)和脊髓损伤三高饲料组(SCI+HFD)两个亚组。以改良的Allen’s撞击法制作脊髓损伤动物模型,在实验开始前及8周时监测各组体重、血糖、葡萄糖耐量试验指标。于8周时取大鼠肝脏、脾脏及内脏脂肪组织,应用实时荧光定量PCR方法观察各组织胰岛素、TNF-α、IL-1β、IL-6及IL-10等炎症因子的表达情况。结果各组大鼠体重均有明显增长。脊髓损伤后大鼠血糖较损伤前明显升高,外周组织TNF-α、IL-1β、IL-6表达较假模组明显升高,IL-10则较假模组明显下降。相比Sham+LFD组,Sham+HFD组、SCI+LFD组以及SCI+HFD组大鼠组织中胰岛素、TNF-α、IL-1β含量显著增加,IL-10显著减少;相比Sham+HFD组,SCI+HFD组大鼠组织中胰岛素、TNF-α、IL-1β含量进一步增加,IL-10则进一步减少。结论脊髓损伤后外周炎症反应在脊髓损伤后并发2型糖尿病中有重要作用。     

加巴喷丁治疗神经病理性疼痛的作用及可能机制

目的观察TRPA1在加巴喷丁（gabapentin,GBP）治疗神经病理性疼痛（neuropathicpain,NPP）大鼠模型背根神经节（DRG）中的表达变化,探讨GBP治疗神经病理性疼痛的作用及可能机制。方法健康雄性SD大鼠48只,采用随机数字表法分为假手术对照组（Sham组）、慢性坐骨神经压榨性损伤（CCI）组、CCI＋生理盐水组（CCI＋NS组）、CCI＋小剂量GBP组（CCI＋GBP1组）、CCI＋中剂量GBP组（CCI＋GBP2组）、CCI＋大剂量GBP组（CCI＋GBP3组）,每组8只。术后14天,CCI＋GBP1组、CCI＋GBP2组、CCI＋GBP,组分别鞘内注射GBP1g／L、3g／L和10g／L,CCI＋Ns组给予等渗生理盐水。术前1天、给药前1h及给药后2、4、6、8h分别测定各组机械缩足阈值（MWT）和热缩足潜伏期（TWL）。给药后9h取大鼠腰段脊髓,ELISA法检测肿瘤坏死因子α（TNF—α）、白细胞介素（IL）-6、IL-10表达和核因子KB（NF—KB）的活性。同时,选Sham组、CCI组、CCI＋NS组及CCI＋GBP,组给药后9h取大鼠背根神经节,应用RT—PCR技术检测TRPA1离子通道mRNA的表达。结果①与Sham组比较,CCI、CCI＋NS、CCI＋GBP1、CCI＋GBP2、CCI＋GBP,组术后MWT和TWL均下降（P〈0．叭）。与CCI组比较,GBP治疗后,CCI＋GBP1、CCI＋GBP2、CCI＋GBP,组MWT和TWL上升（P〈0．05）。②与Sham组比较,CCI、CCI＋NS、CCI＋GBP1、CCI＋GBP2、CCI＋GBP3组腰段脊髓NF—κB、TNF-α、IL-6及IL-10表达上升（P〈0．05）。GBP治疗后,CCI＋GBP2、CCI＋GBP3组NF—κB、TNF-α、IL-6表达下降,IL-10表达上升（P〈0．05）。③与Sham组比较,CCI、CCI＋NS及CCI＋GBP,组TRPA1表达上升（P〈0．05）。与CCI组及CCI＋NS组相比,CCI＋GBP,组TRPA1表达下降（P〈0．05）。结论GBP可有效治疗大鼠CCI后NPP,其镇痛机制可能与减低脊髓NF—κB活性,抑制TNF—α及IL-6表达,增强IL-10表达有关,同时可降低TRPA1的表达。     

坐骨神经周围注射可乐定对CCI大鼠促炎性细胞因子表达的影响

目的：观察损伤坐骨神经周围注射可乐定对慢性坐骨神经结扎模型（chronic constriction injury,CCI）大鼠促炎性细胞因子表达的影响,探讨α2-肾上腺素受体激动剂是否对已经形成的神经病理性疼痛产生作用。方法：雄性SD大鼠32只,随机分为4组,每组8只。Sham组：只分离皮肤、肌肉,不结扎坐骨神经;Sal组：形成CCI后注射生理盐水组;Clo组：形成CCI后注射可乐定组;Clo＋Yo组：形成CCI后注射可乐定和育亨宾组。在注射药物3 d后急性处死动物,取患侧脊髓L4、L5、L6背根神经节采取全自动化学发光法检测TNF-α和IL-6浓度。结果：术后从7 d开始CCI大鼠脊髓背根神经节TNF-α和IL-6浓度有明显增高。损伤坐骨神经周围注射可乐定能明显抑制CCI引起的脊髓背根神经节TNF-α和IL-6的表达（P〈0.01）。结论：损伤的坐骨神经周围注射可乐定可以降低促炎性细胞因子的表达。     

芍药甘草汤对坐骨神经慢性压迫性损伤大鼠痛阈和脊髓SIRT1表达的影响

[目的]观察芍药甘草汤(shaoyao-gancao decoction,SGD)对坐骨神经慢性压迫性损伤(chronic constriction injury,CCI)大鼠机械痛敏和热痛敏的影响,并研究SGD对CCI大鼠脊髓沉默信息调节因子2相关酶1(silent mating type information regulation 2 homolog 1,SIRT1)表达的影响。[方法]SD大鼠随机分为5组:假手术组(Sham组)、CCI组、SGD组、SGD+SIRT1-si RNA(small-interfering RNA,si RNA)和SGD+MM-si RNA(阴性对照)组,SGD组大鼠在CCI模型建立前6h开始灌胃给予40g·kg-1 SGD,1次/d,连续4d,而Sham组和CCI组大鼠则灌胃给予同体积的0.9%生理盐水;SGD+SIRT1-si RNA组大鼠除灌胃给予40g·kg-1 SGD,还鞘内给予10μL(2.5μg)的SIRT1-si RNA,SGD+MM-si RNA组则给予同剂量的MM-si RNA。各组分别在术前和术后第1、3、5、7d测定机械缩足反射阈值(mechanical withdrawal threshold,MWT)和热缩足潜伏期(thermal withdrawal latency,TWL),手术结束后提取大鼠脊髓测定SIRT1和Ac-NF-κB/NF-κB的蛋白表达。[结果]和Sham组相比,CCI组术后MWT及TWL均下降(P0.05),SGD组与CCI组相比,MWT和TWL在术后1、3和7d均明显增加(P0.05)。和Sham组相比,CCI组SIRT1和Ac-NF-κB/NF-κB表达降低(P0.01),和CCI组比较,SGD+SIRT1-si RNA组SIRT1和Ac-NF-κB/NF-κB表达增加(P0.01),而鞘内预先给予SIRT1 si RNA组则可逆转SGM的作用(P0.05,P0.01)。[结论]SGD能抑制CCI大鼠的机械痛敏和热痛敏,其作用可能和增加脊髓SIRT1的表达有关。     

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.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

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.     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.     

Possible Spread of adenovirus type 3 from poultry to humans ：indirect evidence from an outbreak in China

Objective:To explore the epidemiology and etiology for an outbreak of acute respiratory tract infection that occurred in one county of Jiangsu Province, China 2004. Methods: Only cases meeting the case definition were included in the study. We reviewed the medical records of the cases who were admitted to the local hospitals, interviewed cases by a standard questionnaire, and then described the epidemiotogic features and analyzed risk factors by means of a case-control study. We collected pharyngeal swab specimens and sent them to different laboratories for isolation and culture. The laboratory used different detection methods such as DIP, PCR, electron microscope examination and microneutralization assay, to identify and then type the positive specimens. Results:A total of 871 cases were reported during the period from April 18 to July 4,2004. The distribution of onset times presented two peaks, one in late May and another in middle June. The epidemic occurred mainly in the elementary and junior high schools in ten townships of one county, and the mean age of the cases was 12 years (range 7 months to 18 years). The course of the disease was acute, and was characterized by fever accompanied with sore throat and tonsillitis. The WBC count of cases was normal or elevated. The mean duration of illness was 5 days (range 2 to 12 days). No fatalities from illness were reported. A case-control study indicated that the possible risk factors were close contact with a case and/or poultry before onset and sharing of towels among members of the family. The typical CPE was observed through inoculating pharyngeal swab specimens into the HEP-2 cell cultures in different laboratories. An infection of adenovirus type 3 was verified by detecting positive specimens in different methods. Conclusion:This investigation demonstrated that the acute respiratory infection in cases was caused by adenovirus type 3. Cases occurred in over 70 schools in ten townships in 2004, and the route of transmission was possibly close contact with cases or droplet transmission.