原发性肝癌患者外周血T淋巴细胞亚群的动态观察及其临床意义

应用间接免疫荧光法对14例肝细胞性肝癌（HCC）患者手术前后的外周血T淋巴细胞亚群分布进行动态测定。结果表明，HCC患者与对照组比较CD_3~+细胞、CD_4~+细胞降低，CD_4~+／CD_8~+细胞比值降低，CD_8~+细胞百分率增高。手术切除肿瘤后10d，CD_4~+细胞与CD_4~+／CD_8~+细胞比值开始回升，术后30d水平接近正常对照组。由此说明，手术切除肿瘤负荷能有效地提高宿     

窒息缺氧对脐血免疫功能影响的研究

目的 研究围生期窒息缺氧对脐血免疫功能的影响,探讨免疫学变化在新生儿缺氧缺血性脑病(HIE)发病中的意义,为HIE的免疫学治疗提供理论参考。方法 选取1999年5月～2000年6月3家医院出生、合并HIE的围生期窒息新生儿40例为研究对象,并取同期出生无窒息的40例正常新生儿为对照组。于婴儿出生断脐后即刻留取母体端脐动脉血3.5ml,分离血清并检测脐血T淋巴细胞亚群、血清白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)、血浆一氧化氮(NO)、可溶性白细胞介素-2受体(SIL-2R)、红细胞C_(3b)受体花环率(E-C_(3b)RR)和红细胞免疫复合物花环率(E-ICR)等免疫指标的变化。结果 与正常新生儿比较,围生期窒息患儿脐血CD_3~+、CD_4~+减少[分别为(50±8)％比(58±10)％、(32±9)％比(40±10)％,均P<0.01],CD_8~+变化不大,CD_4~+/CD_8~+比值降低[(1.8±0.7)比(2.5±1.1),P<0.01];脐血IL-6与NO水平较低[分别为(71±19)pg/ml比(82±28)pg/ml、(59±24)μmol/L比(85±31)μmol/L,均P<0.05],IL-8与TNF-α则较高[分别为(0.56±0.23)ng/ml比(0.40±0.12)ng/ml、(1.03±0.30)ng/ml比(0.82±0.31)ng/ml,均P<0.01],且窒息程度越重上述改变越明显。窒息患儿脐血SIL-2R水平明显高于正常新生儿[(672±418)U/ml比(336     

单纯性肾病综合征血T细胞亚群变化及对体液免疫功能的影响

对39例初发和复发单纯性肾病综合征病儿外周血T细胞亚群,IgG,IgA,IgM进行检测.结果表明,无论初发或复发病例外周血中CD_3~+和CD_4~+细胞水平无明显变化,CD_8~+和CD_(10)~+细胞均明显高于对照组,CD_4~+/CD_8~+细胞比值均明显低于对照组,而初发组和复发组间无明显差异;85.3%的病儿伴血清IgG降低,29.4%的病儿伴血清IgM增高,CD_4~+/CD_8~+细胞比值与血清IgG水平呈显著正相关,而与IgM水平呈明显负相关.提示单纯性肾病综合征病儿存在T细胞功能紊乱,且与病儿体液免疫功能紊乱的关系密切.     

57例小儿肺炎患者T淋巴细胞亚群及NK细胞观察

为了检测肺炎患儿的免疫功能,用 APAAP 法对57例反复患支气管肺炎的患儿进行 T 淋巴细胞亚群及 NK 细胞检测,结果 CD_3~+53.20±7.64%(对照组:62.50±9.65%),CD_4~+34.2±4.36%(对照组:38.64±4.05%),CD_8~+32.50±6.39%(对照组:26.70±4.23%)。CD_4~+/CD_8~+比值1.05±0.14(对照组:1.45±0.11),NK 细胞8.30±2.40%(对照组:6.44±3.37%)。结果证明,患儿 T 细胞亚群与对照组比较差异有显著(P<0.01),NK 细胞差异无显著性(P>0.05)。     

肺心病患者细胞免疫功能的研究

目的：探讨肺心病患者细胞免疫功能。方法：对38例肺心病患者应用双抗体夹心酶联免疫吸附法（EIJSA）检测血清可溶性白细胞介素-2受体（SIL-2R）,以碱性磷酸酶抗碱性磷酸酶（APAAP）法检测外周血T细胞亚群。结果：肺心病患者血清SIL-2R含量显著高于对照组（P＜0．01）。其T淋巴细胞亚群与正常组比较,CD4细胞显著减少,CD8细胞则显著增多,CD4／CD8比值显著降低（P＜0．01）。如以正常人血清SIL-2R含量462×103U／L为上限阈值,CD4／CDS比值125为下限阈值,其中任何一项升高或降低均可确定为免疫异常。38例肺心病患者中31例免疫异常,占81．6％。结论：SIL-2R含量及外周T淋巴细胞检测可作为判断肺心病患者病情及预后的指标。     

散发性戊型急性黄疸型肝炎外周血T淋巴细胞亚群检测报告

通过对急性戊型肝炎患者又急性甲型肝为患者各23例外周血T淋巴细胞亚群检测发现两组CD_4~+％、CD_4~+／CD_8~+比率相近，分别为20．85±8．58、25．46±8．49及1．35±0．59、1．25±0．61；而CD_8~+％急性戊型肝炎组明显低于急性甲型肝炎组，分别为18．02±7．85和23．02±8．25。但与正常值比较，两组患者CD_4~+及CD_8~+降低例数无显著差异，从而说明两组患者均存在细胞免疫功能紊乱表现。     

鼻咽癌患者和EB病毒血清学阳性者外周血CD_4及CD_8细胞的变化

本文测定了鼻咽癌(NPC)患者和EB病毒(EBV)血清学阳性及阴性者T细胞亚群的变化。结果表明,这三组人群的CD_4~+细胞百分率分别为33.72±6.83,43.78±11.46和49.16±9.14;CD_8~+细胞百分率分别为31.26±5.64,43.88±10.69和35.74±8.53。各组之间相差有显著统计学意义。NPC患者和VCA-IgA抗体阳性者的CD_8/CD_4细胞比值下降。提示体内EBV激活和增殖与T调节细胞变化有关。     

医学生外周血T细胞mIL-2R的表达

目的:测定正常医学生外周血T细胞数量及其亚群比例和活化后mIL-2R的表达水平,为正常机体细胞免疫功能状态提供参考数据.方法:用生物素-链霉亲和素法对49名在校医学生外周血T淋巴细胞亚群及mIL-2R进行检测.结果:男生外周血淋巴细胞中总T细胞亚群(CD3+)占(64.90±4.11)%,其中CD4+和CD8+ T细胞亚群分别为(42.84±4.08)%和(30.23±2.03)%,CD4+/CD8 +比例为1.42±0.10;植物血凝素(PHA)诱导前后淋巴细胞的mIL-2R表达水平分别为(3.08± 1.22)%和(3 1.76±3.52)%;女生T细胞亚群阳性百分率分别为CD3+(66.61±3.36)%、CD4+(43.83± 3.85)%、CD8+(29.06±2.53)%、CD4+/CD8+1.52±0.16,PHA诱导前后的mI L- 2R表达水平分别为(3.48±1.41)%和(34.58±3.05)%.虽然女生CD3+、CD4+和mIL- 2R表达水平偏高,CD8+偏低,但差异均无显著性(P＞0.05);女生CD4+/CD8+ 比值及诱导期mIL-2R表达水平较男生增高(P＜0.05和P＜0.01). 结论:医学生外周血T淋巴细胞亚群的百分率均在正常范围,男生和女生之间无明显差异,但女生CD4+/CD8+比值较高;PHA刺激诱导mIL-2R正常表达,但在女生较高.     

原发性肾脏病患者不同时期肾功能血可溶性IL-ZR及T-淋巴细胞亚群观察

对36例原发性肾小球疾病患者血液中可溶性SIL-2R及T-淋巴细胞亚群进行观察,结果表明:尿毒症组CD_4~+数量增加明显多于正常对阴组、CD_8~+数量减少明显少于正常对照组及肾功能正常组,CD_4/CD_8比值增多高于正常对照组及肾功能正常组;尿毒症组及氮质血症组血SIL-2R浓度增高分别与肾功能正常组及正常对照组有显著意义,各组血SlL-2R与BUN、SCr无相关性。     

流行性出血热外周血淋巴细胞亚群的变化及特异性免疫球蛋白对它的影响

作者用淋巴细胞分化抗原的系列单克隆抗体,动态观察流行性出血热(EHF)外周血淋巴细胞亚群的变化。发现CD_8~+细胞数在2-5及9-12病日明显增加(分别为41.7±3.7和40.7±5对31.7±4.5,P<0.01),CD_4~+/CD_8~+比值倒值或下降(分别为0.3±0.07,1.0±0.16对1.30±0.20,P<0.01)。16-19病日逐渐恢复正常,B~+,IL-2R~+和HLA-DR~+细胞数在病程的不同阶段均显著增高,在疾病早期、重、中型患者B~-,IL-2R     

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.