系统性红斑狼疮患者外周血Th1和Th2平衡的研究

目的 通过检测系统性红斑狼疮（SLE）患外周血中CD4^ 和CD8^ T淋巴3细胞分泌细胞因子的情况以及γ干扰素（IFN-γ)和白介素－4（IL－4）的水平，探讨T淋巴细胞亚群与SLE发病的关系。方法 采用流式细胞术分析SLE患和正常健康人外周血中淋巴细胞内细胞因子（IFNγ、IL－4）和表面抗原（CD4、CD8），用Dot blot法检测IFN－γ和IL－4mRNA的表达。以ELISA法测定血清中IFN－γ和IL－4的水平。结果 与对照组相比，SLE患外周血中1类辅助T细胞（Th1)、Th1/Th2比率、IFN－γmRNA的表达和IFN－γ水平和IFN－γ／IL－4比值均明显降低（P＜0．01），而Th2细胞、Th0细胞和IL－4 mRNA表达的水平及其外周血中IL－4的水平则无明显改变（P＞0．05）。结论 在SLE患外周血中，Th1细胞的数量及其分泌的细胞因子的水平均明显下调，提示Th1/Th2细胞的失衡在SLE发病中有着重要的作用。     

SLE患者血清IL—4、IFN—γ水平测定及意义

目的：通过检测系统性红斑狼疮（systemic lupus erythematosus,SLE)患血清细胞因子细胞介素－4（interlukin-4,IL-4)，γ－干扰素（interferon-gamma,IFN-γ）水平，探讨T淋巴细胞亚群与SLE发病的关系。方法：采用酶联免疫吸附法（ELISA）测定SLE患和健康志愿血清IL－4和IFN－γ水平。结果：（1）SLE活动组血清IL－4水平和IL－4／IFN－γ值明显升高，与非活动组、对照组比较有显性差异（P＜0．001）。（2）血清IFN－γ水平3组（SLE活动组，非活动组和对照组）间比较差异无显意义（P＞0．05）。（3）SLE患激素治疗后血清IL－4水平明显降低。结论：IL－4、IFN－γ作为区分CD4T细胞亚群的指标之一，间接反映了Th1,Th2细胞活化状态；SLE患血清IL－4水平，IL－4／IFN－γ值明显升高，且与病情活动性相关；IFN－γ水平无明显变化，说明活动性SLE患存在Th2细胞优势活化状态，破坏了体人Th1/Th2正常平衡状态。血清IL－4水平可作为SLE病情活动性监测指标之一，并可作为疗效判断指标之一。寻找有效方法调节SLE患血清IL－4水平，从而调节体内Th1-Th2平衡，将为治疗SLE开辟一条新途径。     

IL-18对慢性乙型肝炎患者Th1/Th2细胞分化的影响

目的：观察IL—18对慢性乙肝患者Thl／Th2细胞分化的影响。方法：分离40例慢性乙型肝炎患者外周血单个核细胞(peripheral blood monoclear cells，PBMC)，分别与植物血凝素(PHA，100mg/L)、HBcAg(1mg／L)、HBeAg(1mg/L)单独或联合IL—18(10μg／L)体外培养48h，ELISA法检测培养液中IL—2、IFN—γ、IL-4、IL—10水平。20例健康人群作对照。结果：IL—18对健康人群PBMC产生的Thl／Th2类细胞因子无明显影响，但对慢性乙肝患者在IL—18和HBcAg或IL—18和HBeAg联合诱导下则显著增强PBMC产生的Thl类细胞因子IL—2和IFN—γ，但对Th2类细胞因子IL-4和IL—10无明显影响。结论：IL—18增强慢性乙肝患者Thl类细胞因子的优势表达，从而促进Thl细胞的优势分化，而对Th2类细胞因子的表达无影响。     

卡莫氟对强直性脊柱炎Th1/Th2类细胞因子表达影响的研究

目的：观察卡莫氟(1-hexylcarbamoyl-5-fluorouracil,HCFU) 和柳氮磺胺吡啶(sulfalazine,SSZ)治疗强直性脊柱炎(ankylosing spondylitis, AS)后体内Th1/Th2类细胞因子的变化。方法：19例AS患者随机分为2组，分别给予HCFU(9例)和SSZ （10例），RT-PCR检测其治疗前后外周血单个核细胞(peripheral blood mononuclear cells,PBMC)中细胞因子γ-干扰素（IFN-γ）、白细胞介素-2（IL-2）、肿瘤坏死因子-α（TNF-α）、白细胞介素-4（IL-4）、白细胞介素-6（IL-6）mRNA片段的表达。结果:HCFU治疗后AS患者PBMC中IFN-γ、TNF-α mRNA的表达率分别为33.33%、44.44%，与治疗前相比差异有统计学意义（P＜0.05），IL-2、IL-4及IL-6 mRNA的表达差异无统计学意义。SSZ治疗后AS患者PBMC中IFN-γ mRNA的阳性表达率为70%,半定量结果显示，治疗后PBMC中IFN-γ mRNA的表达水平明显降低（P＜0.05)。80% AS患者在治疗后PBMC中IL 4 mRNA呈阳性表达，较治疗前21.05%明显升高（P＜0.05）。IL-2、IL-6和TNF-α mRNA的表达无明显变化（P＞0.05）。结论：HCFU能使TNF-α mRNA表达降低，促进AS患者的免疫应答从Th1型向Th2型转变，小剂量即可使病情缓解。SSZ未发现对TNF-α mRNA表达有明显影响，可促使AS患者的免疫应答从Th1型向Th2型转变。     

慢性乙型肝炎患者PBMC内IL—4与IFN—γmRNA的表达

目的 阐明Th1/Th2类细胞因子与慢性乙型肝炎肝脏炎症活动的相关性以及这些细胞因子作为慢性乙型肝炎症活动调节剂的作用。方法 用RT-PCR法检测慢性乙型肝炎患外周血单个核细胞（PBMC）内白细胞介素-4（IL-4）及干扰素-γ（IFN-γ）mRNA的表达。结果 在静息期,无明显的IL-4及IFN-γ RNA的表达,在活动期IFN-γ的表达率（100%）明显高于恢复期（50%)(P<0.05);相反,在恢复期IL-4mRNA的表达率（87.5%)明显高于活动期(12.5%)(P<0.05).结论 在慢性乙型肝炎发病机理中,在mRNＡ的水平,ＩＦＮ－γ作为正向免疫调节性细胞因子,而ＩＬ－４作为免疫抑制性细胞因子发挥作用,结果证实Ｔhi细胞因子上调、Th2细胞因子下调慢性乙型肝炎肝脏炎症。     

系统性红斑狼疮患者IL-10、IFN-γ、IP-10和IL-12的异常表达及环孢素A和环磷酰胺对其的影响

目的:探讨系统性红斑狼疮(SLE)患者外周血单个核细胞(PBMCs)的干扰素(IFN)-γ、白细胞介素(IL)-10、干扰素-γ诱生蛋白(IP)-10和IL-12的表达水平及环孢素A(CsA)和环磷酰胺(CY)对其的影响。方法:应用酶联免疫吸附法检测血清及PBMCs培养上清上述细胞因子水平;运用流式细胞术检测CD4 T细胞中分泌IFN-γ和分泌IL-10的细胞百分率。结果:SLE患者血清及PBMCs培养中IFN-γ、IL-10、IL-12和IP-10水平增高,PBMCs中表达IL-10的CD4 T细胞比例明显增高(P<0.05),表达IFN-γ的CD4 T细胞的比例亦有所增高;CsA及CY均能抑制SLEPBMCs培养中IL-10水平,并对PHA刺激下的IFN-γ、IP-10和IL-12分泌增高有抑制作用,且CsA的抑制作用更为显著;CsA和CY还能抑制PBMCs中表达IFN-γ及表达IL-10的CD4 T细胞的比例增高,且CsA的抑制幅度更大。结论:SLE患者体内存在细胞因子网络失调。CsA与CY均能干扰SLE的细胞因子网络失调的免疫病理过程,且CsA的调节作用更为显著。     

地塞米松和甲基泼尼松龙对哮喘儿童外周血Th1/Th2类细胞因子平衡的影响

目的：观察支气管哮喘儿童外周血单个核细胞（PBMC）中CD4^4T细胞中两个功能性亚群（Th1/Th2)的功能状态及地塞米松和甲基泼尼松龙对其的影响。方法：15例哮喘及14名健康儿童，取静脉血，密度梯度离心 法分离PBMC，分别用10^-8mol/L地塞米松和甲基泼尼松龙体外干预培养48h后，用ELISA法测定培养上清中的干扰素－γ（IFN－γ）、白细胞介素－4（IL－4）和IL－10的浓度。结果：地塞米松和甲基泼尼松龙均可明显抑制哮喘儿童PBMC分泌-γ(P值分别为0．004和0．002）和IL－4（P值分别为0．002和0．001）；若以IFN－γ／IL－4表示Th1/Th2间的平衡，则甲基泼尼松龙（P＜0．05）可恢复Th1/Th2平衡；地塞米松和甲基泌尼松龙都不曩IL－10的分泌。结论：地塞米松和甲基泼尼松龙均可抑制IFN－γ和IL－4的产生，但甲基泼尼松龙抑制作用更强，从而可恢复哮喘儿童体内Th1/Th2平衡。     

人白细胞介素—16真核表达载体的构建及其对Th2型肿瘤细胞的促逆转作用

目的：构建人IL－16真核表达载体,分析其对Th2型肿瘤细胞的逆转作用。方法：用RT－PCR技术从人外周血单个核细胞中获取IL－16cDNA,插入PUC－18T载体并测序,构建并鉴定真核表达载体PcDNA3-IL-16,转染KarpasT淋巴瘤细胞,分析阳性克隆中IFNγ,IL-2,IL-4,IL-6,IL-13,TNFα和IL－16等细胞因子的表达状况。结果：序列测定显示所克隆的人IL－16cDNA与基因库中所登录的序列完全一致,EcoRI和BamHI双酶切及PCR鉴定显示所构建的真核表达载体PcDNA3-IL-16完全正确,RT－PCR显示转染PcDNA3-IL-16的KarpasT淋巴细胞高表达IL－16mRNA,同时,Th1类细胞因子IFN－γ表达明显增高,Th2类细胞因子IL－4,IL－6,IL－13表达降低,MTT法显示KarpasT淋巴瘤细胞的增殖受到明显抑制。结论：成功构建了真核表达载体PcDNA3-IL-16,转染KarpasT淋巴瘤细胞后使其细胞因子类型由Th2型向Th0型逆转,且生长受到明显抑制,表明向肿瘤细胞转染人IL－16是一种有用的肿瘤生物治疗方法。     

狼疮肾炎患者血清及外周血单个核细胞中IL-10和γ干扰素的表达及意义

目的探讨Th1型和Th2型细胞因子在LN发病机制中的作用。方法活动期和非活动期LN患者各30例、健康对照者30例，分别采取外周静脉血，应用逆转录-荧光定量-聚合酶链反应（RT-FQ-PCR）技术及ELISA方法定量分析LN患者外周血单个核细胞（PBMC）中白介素-10（IL-10）和γ干扰素（IFN-γ）mRNA及血清中IL-10、IFN-γ的自然表达水平。结果活动期和非活动期LN患者血清和PBMC的IL-10水平均显著高于正常对照组，而活动期与非活动期LN患者的IL-10水平比较。差异无显著性。活动期LN患者IFN-γ水平显著高于正常对照组，而非活动期LN患者IFN-γ水平虽有增加趋势，但与正常对照组相比差异无显著性。活动期和非活动期LN患者血清和PBMC的IL-10／IFN-γ的比值与正常对照组比较，差异无显著性。结论LN患者血清和PBMC的IL-10自然表达水平明显增高。但其增高程度与疾病活动度无明显相关；活动期LN患者IFN-γ的表达也显著增高，提示Th1和Th2型细胞因子均可能参与活动期LN的炎症反应及组织损伤。     

IL-5上调体外培养的人嗜酸性粒细胞TGF-β1的表达

目的研究白细胞介素-5（IL-5）对人嗜酸性粒细胞（Eos）中转化生长因子-β1（TGF—β1）表达的调控作用。方法采用改良的密度梯度离心法分离并体外培养人外周血Eos，实验组加入相同浓度的白细胞介素-4（IL-4）、IL-5和干扰素γ（IFNγ）以及不同浓度的IL-5共同培养，ELISA和RT—PCR法检测细胞培养上清液TGF—β1蛋白和mRNA的表达。结果与对照组相比，浓度均为10^-9mol／L的IL-4、IL-5在蛋白水平和转录水平对TGF-β1的表达均有上调作用，而IFNγ则表现为抑制；10^-11，10^-9、10^-7mol／L IL-5均能显著增强体外培养的Eos中TGF—β1蛋白的表达。结论Th2型细胞因子IL-5可以上调人嗜酸性粒细胞中TGF—β1的表达。     

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…     

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     

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.     

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.     

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.