碘对自身免疫性甲状腺疾病外周血单个核细胞HLA—DR表达的 …

目的：探讨碘在自身免疫性甲状腺疾病（ＡＩＴＤ）发病中的作用及机制。方法：选择具有遗传倾向疾病Ｇｒａｖｅｓ病一级亲属的外周血单个核细胞（ＰＢＭＮＣ）,采用细胞培养和免疫印迹技术,检测Ｎａｌ对ＰＢＭＮＣ ＨＬＡ－ＤＲ表达的影响。结果：Ｇｒａｖｅｓ病一级亲属：ＰＢＭＮＣ ＨＬＡ－ＤＲ表达量随培养液Ｎａｌ浓度增加而递增;而对正常无遗传倾向者ＰＢＭＮＣ ＨＬＡ－ＤＲ表达量无影响。结论：过多的碘可以上调有遗传     

肝细胞癌HLA-DR抗原的表达及干扰素对其增强作用

目的　探讨人白细胞 DR抗原 (HL A- DR)在人原发性肝细胞癌 (简称肝癌 )的表达情况 ,以及干扰素 (IFN)对其调节作用 .方法　分别采用免疫组化 ABC法和流式细胞仪检测 HL A- DR在 46例人肝癌组织和 4种培养的人肝癌细胞系 (SMMC- 772 1,HCC- 92 0 4,BEL- 740 2和 HHCC)的表达情况 ,并用 EL ISA法分别检测 IFN-γ或 IFN-α刺激前后 HL A-DR在上述 4种肝癌细胞系以及正常人肝细胞系 QZG的表达情况 .结果　 39.1% (18例 / 46例 )的肝癌组织肿瘤细胞可表达 HL A- DR,而在癌旁非肿瘤细胞均为阴性 ;4种肝癌细胞系都基本不表达 HL A- DR;IFN- γ或 IFN- α刺激之后 ,上述 5种细胞系的 HL A- DR表达都有所增强 ,并且 QZG不如肝癌细胞明显 ,IFN-γ的作用强于 IFN-α.结论　肝癌组织在一定程度上可表达 HL A- DR,但是培养的肝癌细胞系基本上不表达 ;IFN可以上调肝癌细胞对 HL A- DR的表达 .     

嗜酸性粒细胞可作为抗原呈递细胞

目的 :探讨 HL A - DR 嗜酸性粒细胞 (EOS)在体外培养条件下作为抗原呈递细胞将破伤风类毒素抗原 (TT)呈递给T淋巴细胞的能力。方法 :新分离的 EOS经人重组粒细胞 -巨噬细胞集落刺激因子刺激 2 4h以诱导 HL A - DR的表达后将其暴露于不同浓度的 TT,然后检测 HL A- DR EOS对自身 T细胞增殖反应的影响以评价 EOS呈递抗原的能力。结果 :HL A-DR EOS于 TT存在时可以明显促进 T细胞的增殖反应 ,并与 TT的浓度呈刘量相关性。此外 ,抗 HL A- DR单克隆抗体则可以明显地抑制 EOS的抗原呈递过程。结论 :人 EOS可摄入和处理抗原并能将其传递给自身 T细胞 ,而 EOS呈递抗原的过程具有明显的 HL A- DR依赖性。     

亲属活体供肾移植2例报告

我院于 2 0 0 0年 4～ 5月分别对 2例尿毒症患者施行亲属活体供肾移植 ,两名受者术后 3d内肾功能恢复正常 ,无急性排斥反应发生 ,随访 6个月 ,肾功能未见减退。取得满意疗效 ,现报告如下。1　资料与方法1.1　一般资料例 1,男性 ,43岁。原发疾病为慢性肾小球肾炎。供者为其同母异父的兄长 ,5 1岁。二人血型均为“O”型。淋巴细胞毒交叉配合试验为 0 .0 1,PRA为 0 .0 5 ,HL A- A2位点相同 ;HL A-A33(19)位点供者缺少 ,HL A - B5 1(5 )位点相同 ;HL A- B5 8(17)位点错配 ;HL A- Bw4位点相同 ;HL A- Bw6受者缺少 ;HL A- DR、HL A…     

病理性瘢痕组织中角朊细胞的免疫诱导作用

目的　探讨增生性瘢痕 (HS)和瘢痕疙瘩 (Ks) ,角朊细胞 (KC)表达 ICAM- 1和 HL A- DR) ,及≤ 1m o的 HS(HS1) ,2～ 6 m o的 HS(HS2 )和 7～ 2 4mo的 HS(HS3)标本 ,分别作抗 ICAM- 1,HL A- DR,CD3,CD4和 CD8的 Mc Ab的SABC方法免疫组化染色和观察 .结果　各组 KC表达 I-CAM- 1和 HL A- DR抗原的阳性检出率 (% )、CD3+ 细胞密度(cells/ mm2 )及 CD4+ / CD8+比值 (x±s) ,并作统计学处理 .各组标本的 KC表达 ICAM- 1和 HL A- DR抗原的阳性检出率依次为 :Ks- I>Ks- P>Ks- A,HS1>HS2 >HS3(t,P<0 .0 5～0 .0 0 1) .各组 KC表达 ICAM- 1和 HL A- DR的阳性率与组织内浸润的 CD3+细胞密度和 CD4+ / CD8+比值呈明显正相关 (P<0 .0 5～ 0 .0 1,r=0 .2 49～ 0 .32 4) .结论　 KS和 HS的 KC通过表达 ICMA- 1和 HL A- DR抗原 ,诱导 T细胞浸润 ,上调局部免疫炎性反应 ,可能是病理性瘢痕形成的重要因素     

HLA—及其临床意义的研究进展

HLA- I类分子由经典的 HL A- Ia(HL A- A、B、C)和非经典的 HL A- Ib(HL A- E、F、G)构成。其中 HL A-G作为一种非经典的 MHC- I类分子与经典的 MHC- I类分子相比 ,具有以下特点 :1限制性组织分布 ;2低度多态性 ;3原始转录产物经选择性剪接编码至少 6种亚型 ,即 4种膜结合型 (HL A- G1、G2 、G3 、G4)和两种可溶型 (HL A- G5、G6)。由于 HL A- G最初主要发现在母体胎儿交界处表达 ,故对其在母体胎儿免疫耐受中的作用研究较多。本文就目前国内外对 HL A- G结构、生物学功能及其与肿瘤、器官移植之间关系等方面的研究…     

类风湿关节炎的病因,诊断与治疗

类风湿关节炎 (RA)是以滑膜炎为特征的全身炎症性、自身免疫性疾病。在我国患病率均为 0 .2 4%～ 0 .4% [1 ] ,国外报道为 0 .3%～ 1.5 % ,而美国本土出生者高达 3.5 %～5 .5 % [2 ]。由于诊治困难 ,常造成终身残疾。1　病因目前病因尚不十分清楚 ,但与遗传易感性有一定关联。RA有家族聚集倾向 ,单卵双生子为 30 % ,双卵双生子为5 % [2 ] 。 HL A抗原与 RA的相关性研究证实 HL A- DR4- SRA最为密切。西欧白种人 RA血清阳性患者 HL A- DR4基因频率明显高于正常人 ,前者为 6 0 %～ 70 % ,后者为 2 5 %～ 30 %。HL A- DR4主要为 D…     

~(131)I治疗Graves病320例疗效影响因素分析

目的 :探讨Graves病13 1I治疗 32 0例疗效影响因素。方法 :Graves病患者 32 0例 ,根据预测影响因素 :性别、年龄、病程、停ATD时间、甲状腺最高吸碘率、有效半衰期、TT4、TT3 、FT4、STSH、TgAb、TmAb、Tg、甲状腺质量、每克甲状腺组织给予13 1I计量、甲状腺质地、有无突眼、分别量化各项指标值。疗效按甲低、治愈、未愈进行评价 ,经统计学处理。结果 :13 1I治疗 12个月出现甲低者 19.71% ,治愈 (治疗后正常 +甲低 )者 90.0 3% ,未愈者 10.0 0 %。年龄、甲状腺最高吸碘率、有效半衰期、甲状腺质量、每克甲状腺组织给予13 1I计量对13 1I治疗疗效有统计学意义 (P<0.0 5 )。结论 :对甲状腺最高吸碘率低伴有效半衰期长、甲状腺质量较小、年龄较小、每克甲状腺组织给予13 1I计量应偏小 ,否则13 1I计量应偏大     

含碘食物对Graves病患者甲状腺131I与99mTc摄取的不同影响

目的探讨含碘食物对Graves病患者摄取99mTc与131I的影响。方法选择曾食含碘食物的Graves病患者20例,在禁食含碘食物前后分两次进行摄131I试验与甲状腺99mTc显像,前者测定3、24 h摄131I率,后者计算摄锝指数(TI)及估算甲状腺质量(TW)。采用Wilcoxon 符号秩和检验对数据进行对比分析。结果20例患者禁止含碘食物前后的摄131I率显著不同,所有患者禁食含碘食物后3和24 h摄131I率均显著增高。TI 2例未变、2例增高、16例降低;TM18例减小、2例增大。较未禁食含碘食物的首次检测,两者均有显著性变化。结论含碘食物对甲状腺摄取Na99mTcO4的影响与Na131I显著不同,含碘食物100%减低甲状腺131I的摄取而90%锝摄取增高。     

131碘治疗Graves病的临床价值

目的探讨放射性131碘(131I)治疗弥漫性毒性甲肿(Graves病)的临床应用价值。方法对93例Graves病进行首次131I治疗后观察其效果,并与抗甲亢药物(85例)和手术治疗(82例)的效益比对,进行相关分析。结果首次131I治疗Graves病总治愈率为68.8%。总好转率为11.8%,总有效率为80.6%;Graves病131I治疗与抗甲亢药物治疗治愈率差异有统计学意义(P<0.05),治疗周期明显缩短;与手术治疗治愈率比较差异无统计学意义(P>0.05),但治疗费用大幅下降。结论放射性131碘治疗毒性弥漫性甲肿具有稳定有效、周期短、价格低、安全性高等特点,在治疗甲亢的领域值得推广。     

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…     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

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.     

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.