烧伤患者外周血T淋巴细胞亚群的变化

目的　探讨烧伤患者不同时期外周血T淋巴亚群的变化。　方法　我院2003年2月~2004年12月收治烧伤患者67例,分别于烧伤1、2、3周后抽取患者外周血,用流式细胞仪检测T淋巴细胞亚群百分率,并与正常对照组(健康献血员20例)比较。　结果　烧伤面积在50%以上的患者,受伤1周后,CD3、CD4 及CD4 /CD8 比值均显著低于对照组,CD8 则显著高于对照组。烧伤面积30% ~50%的患者,受伤2周后,CD4 显著低于对照组,CD3 则在第1周及第3周显著低于对照组;CD8 在前2周无明显变化,第3周则显著高于对照组,CD4 /CD8 比值伤后一直显著低于对照组。烧伤面积在30%以下的患者,伤后2周CD4、CD4 /CD8 显著低于对照组,CD3、CD8 则变化不明显。　结论　CD4 /CD8 比值下降,主要是由CD4 下降所致;受伤面积较大的患者,其比值则是CD3、CD4、CD8 共同作用的结果。烧伤面积大的患者,其CD4 /CD8 比值下降明显,提示免疫功能缺陷越严重,易导致机体感染。     

特重度烧伤患者免疫功能的变化

研究特重度烧伤患者免疫功能的变化。方法 :选择无严重并发症的特重度烧伤患者 1 5例 ,取 5个不同时相点测定观察者外周血中T淋巴细胞亚群和免疫全套 ,再统计分析以判定其变化。结果 :特重烧伤患者伤后第 1、3、7、1 4、2 2天血中CD3、CD4 、CD4 /CD8值较正常组显著降低 (P <0 .0 1 ) ,而CD8值均显著增高 (P<0 .0 1 ) ;特重度烧伤发生后即出现IgG、IgA、IgM降低 ,于第 7天出现最低值 ,低于正常 (P <0 .0 1 ) ,至伤后第2 2天 ,均趋于正常 ;而C3、C4 值伤后即降低 ,3～ 7d达最低 ,而后渐趋于正常。结论 :特重度烧伤患者的细胞免疫、体液免疫功能均受到明显的抑制。     

不同胎龄及出生体重早产儿T淋巴细胞亚群水平及影响因素

目的 探讨早产儿免疫功能低下的因素.方法 选择62例早产儿为研究对象,对其生后T淋巴细胞亚群进行测定.结果 不同胎龄早产儿T淋巴细胞亚群结果比较:相对于胎龄≥32周早产儿,胎龄＜32周早产儿CD3.CD4细胞减少,CD4/CD8比值下降(P＜0.05);不同出生体重早产儿T淋巴细胞亚群结果比较:相对于出生体重≥1.5kg早产儿,出生体重＜1.5 kg早产儿CD3、CD4细胞减少,CD4/CD8比值下降(P＜O.05);早产儿窒息后CD3,CD4细胞减少,CD4/CD8比值下降(P＜0.05).结论 胎龄越小,出生体重越低,免疫功能越低;窒息缺氧可导致早产儿T淋巴细胞亚群紊乱.     

CD3AK细胞对烧患者T淋巴细胞亚群的影响

观察CD3AK细胞用于严重烧伤患者后对T淋巴细胞亚群的影响.观察对象为CD3AK细胞治疗的20例大面积烧伤患者.结果:经CD3AK细胞治疗后烧伤患者T细胞亚群的结构有了明显的改善,CD4细胞比例明显升高,CD3细胞比例下降,CD4/CD8比值升高.结论:CD3AK细胞对烧伤患者T细胞亚群的结构有明显的改善,从而提高烧伤患者的免疫力.     

CD3AK细胞对烧伤患者T淋巴细胞亚群的影响

观察 CD3AK细胞用于严重烧伤患者后对 T淋巴细胞亚群的影响。观察对象为 CD3AK细胞治疗的 2 0例大面积烧伤患者。结果 :经 CD3AK细胞治疗后烧伤患者 T细胞亚群的结构有了明显的改善 ,CD4细胞比例明显升高 ,CD3细胞比例下降 ,CD4/ CD8比值升高。结论 :CD3AK细胞对烧伤患者 T细胞亚群的结构有明显的改善 ,从而提高烧伤患者的免疫力。     

CD_3AK细胞对烧伤患者T淋巴细胞亚群的影响

观察 CD3AK细胞用于严重烧伤患者后对 T淋巴细胞亚群的影响。观察对象为 CD3AK细胞治疗的 2 0例大面积烧伤患者。结果 :经 CD3AK细胞治疗后烧伤患者 T细胞亚群的结构有了明显的改善 ,CD4细胞比例明显升高 ,CD3细胞比例下降 ,CD4/ CD8比值升高。结论 :CD3AK细胞对烧伤患者 T细胞     

不同电损伤面积的外周血T细胞亚群动态变化

目的探讨电损伤面积对患者T淋巴细胞亚群变化的影响。方法电损伤病人26例,按电损伤后Ⅲ度面积的不同分为三组,A组(11例):面积≤5%;B组(8例):5%<面积≤10%;C组(7例):面积>10%。健康组和普通重度烧伤组各10例作为对照组,检测不同时相点的CD4、CD8及CD4/CD8值,加以比较。结果各组与健康组比较:除CD8在烧伤4周和A组4周组比较无意义外,其余均有统计学意义。与烧伤组及组间比较;伤后1周各组间比较均无统计学意义;伤后2周仅CD4/CD8在烧伤组与C组,B组与C组间比较有统计学意义;伤后4周CD4、CD8和CD4/CD8在烧伤组与A组,B组与C组间比较无统计学意义,其余各组比较均有统计学意义。结论Ⅲ°面积大于5%的电损伤即能引起相当于重度烧伤病人之T淋巴细胞亚群比例失调,由于CD8持续升高故造成的损害较普通烧伤持续时间更持久。     

肝动脉化疗栓塞术对原发性肝癌合并HIV/AIDS患者T淋巴细胞亚群的影响

目的 探讨原发性肝癌(primary hepatic carcinoma,PHC)合并人类免疫缺陷病毒(human immunodeficiency virus,HIV)/获得性免疫缺陷综合征(acquired immune deficiency syndrome,AIDS)患者肝动脉化疗栓塞术(transcatheter arterial chemoembolization,TACE)前后T细胞亚群的变化.方法 采用回顾性病例对照研究,选取2014年7月至2016年6月在成都市公共卫生临床医疗中心就诊的17例PHC合并HIV/AIDS患者为试验组,同期HIV阴性的PHC患者32例为对照组.采用流式细胞术(FCM)检测两组患者术前1 d及试验组患者术后1、4周外周血CD3、CD4、CD8 T细胞及CD4/CD8的比值,比较两组患者术前1 d及试验组术后1、4周外周血T细胞亚群各指标的动态变化.结果 试验组术前外周血T细胞亚群CD3、CD4、CD4/CD8比值明显低于对照组,而CD8明显高于对照组(P<0.05);试验组治疗1周后,外周血T细胞亚群CD3、CD4、CD4/CD8比值明显较治疗前下降,CD8明显增高(P<0.05),而4周后外周血T细胞亚群CD3、CD4及CD4/CD8比值较治疗1周后明显增高,CD8明显下降(P<0.05).结论 TACE对PHC合并HIV/AIDS患者是安全、有效的治疗方法.PHC合并HIV/AIDS患者细胞免疫较HIV阴性的PHC患者明显低下,TACE治疗PHC合并HIV/AIDS患者,细胞免疫状态呈现先抑制后恢复的趋势.     

严重烧伤患者外周血T淋巴细胞亚群、NK细胞活性及sIL-2R水平的变化

目的观察严重烧伤患者伤后T淋巴细胞亚群、NK细胞活性和sIL2R水平的变化,探讨其免疫功能改变的可能机制。方法测定35例严重烧伤患者伤后T淋巴细胞亚群,NK细胞活性和sIL2R的水平,并与正常对照组进行比较。结果与正常对照组比较,烧伤组:CD3+、CD4+和CD4+/CD8+比值均明显下降(P均<0.01),CD8+明显升高(P<0.05),烧伤组NK细胞活性明显下降(P<0.05),sIL-2R明显升高(P<0.01)。结论严重烧伤患者T淋巴细胞亚群中细胞比例发生了明显改变,NK细胞活性降低sIL-2R水平升高,三者互相影响,共同构成烧伤患者伤后免疫功能紊乱的因素之一。     

大肠癌患者化疗前后淋巴细胞亚群变化分析

目的：探讨分析大肠癌患者化疗前后淋巴细胞亚群的变化。方法：选取我院收治的60例接受FOLFOX4方案化疗的大肠癌患者,分析化疗前后大肠癌患者淋巴细胞亚群变化。结果：化疗后CD3＋CD8＋与CD4＋CD25＋细胞百分比上升明显, CD19＋与HLA－DR ＋细胞百分比下降明显,P＜0．05,有统计学意义;化疗≤4周的患者CD3＋和CD3＋CD8＋及CD45RO ＋以及CD4＋CD45 RO＋细胞百分比上升明显,化疗5周～8周的患者HLA－DR ＋细胞百分比下降明显,化疗≥9周的患者CD29＋细胞百分比上升明显,P＜0．05,有统计学意义。结论：大肠癌患者化疗前后淋巴细胞亚群变化明显,接受FOLFOX4方案化疗可对机体细胞免疫功能产生抑制,化疗≤4周的可使机体的细胞免疫功能增强。     

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.