肺结核患者血清透明质酸测定

采用放射免疫分析法对101例肺结核患者进行血清透明质酸(HA)的测定,并以18例正常人作对照。结果显示：结核性胸膜炎(106.9±41．2ng／ml)、浸润型肺结核活动期(251．3±133．4ng／ml)及慢性纤维空洞型肺结核(406.9±230．3ng／ml)HA含量明显高于正常人(56.4±36.5ng／ml)；浸润型肺结核稳定期(82．3±62．1ng／ml)HA含量与正常人比较,无显著性差异(P＞0．05)．提示血清HA变化对评价肺结核患者肺组织损害、继发肺间质纤维化有一定参考价值。     

诺帝对人恶性胶质瘤细胞甲酰化肽受体表达及其活化后促增殖和血管生成因子产生的影响

目的观测自行研制的脂氧化酶抑制剂诺帝（Nordy）对人恶性胶质瘤细胞系U87中甲酰化肽受体（FPR）的表达和激活后功能活性的影响。方法采用间接免疫荧光标记、激光共聚焦扫描显微术观测诺帝对U87系人恶性胶质瘤细胞FPR表达的影响;FPR激动剂N-甲酰化的甲硫酰-亮氨酸-苯丙氨酰胺（fMLF）激活FPR后加入诺帝,实验分为以下3组：①对照组,②fMLF刺激组,③诺帝处理组,分别采用四甲基偶氮唑盐（MTT）法、逆转录聚合酶链式反应（RT—PCR）和双抗夹心酶联免疫吸附法（ELISA）检测诺帝对FPR活化后引起的细胞增殖及细胞分泌血管内皮生长因子（VEGF）和白细胞介素8（IL-8）的作用。结果诺帝（100μmol／L）明显抑制U87细胞FPR受体的表达,同时对FPR激动剂fMLF（100nmol／L）诱导的U87细胞增殖和血管生成因子VEGF、IL-8 mRNA表达和蛋白的分泌具有明显的抑制作用。对照组U87细胞分泌一定量的VEGF和IL-8,分别为（4．14±0．28）ng／ml和（4．03±0．59）ng／ml;fMLF作用于U87细胞36h后,VEGF和IL-8蛋白水平均显著高于对照组（P〈0．05）,分别为（6．46±0．33）ng／ml和（7．54±0．73）ng／ml;诺帝作用于U87细胞12h后加入fMLF共同处理36h后,VEGF和IL-8蛋白水平分别为（3．59±0．33）ng／ml和（3．13±0．48）ng／ml,均显著低于对照组（P〈0．05）。结论诺帝对人恶性胶质瘤细胞的FPR表达和该受体活化后的促瘤细胞增殖及促血管生成因子VEGF、IL-8 mRNA表达和蛋白的分泌具有抑制作用,提示诺帝具有抑制肿瘤生长和抗血管生成的作用。     

内皮素受体拮抗剂Bosentan对培养乳鼠心肌细胞心钠素分泌的影响及其意义

目的观察内皮素-1(ET-1)促进心钠素(ANP)分泌作用及内皮素受体拮抗剂Bosentan对心钠素分泌的影响。方法通过SD乳鼠心肌细胞培养,分别在无或有ET-1(10-10mol／L)作用的情况下,在细胞培养液中加入Bosentan(10-8mol／L)干预,72h后收集细胞培养液测定ANP。结果ET-1刺激使心肌细胞分泌ANP由(6.46±0.38)ng／ml增加至(13.60±1.12)ng／ml,但应用Bosentan可以明显降低ANP的分泌,由(13.60±1.12)ng／ml降至(9.42±0.58)ng／ml,P<0.05。在无ET-1刺激时Bosentan也可使ANP由(6.46±0.38)ng／ml下降至(5.07±0.26)ng／ml,P<0.05。结论ET-1可使ANP分泌增加,但不论有无ET-1刺激,Bosentan均可使ANP分泌减少。提示Bosentan能抑制心肌细胞肥大,有益于心肌重构的改善。     

脑出血病灶侧局部亚低温与全头低温治疗的临床对比观察

目的　探讨局部亚低温治疗对脑出血患者预后的影响。方法　对脑出血患者 ,给予出血侧大脑半球局部亚低温治疗。设定制冷器温度为 8℃～ 12℃ ,计算颅内出血区温度为 33℃左右 ,治疗时间为 72h。与全头低温组和常温治疗组进行比较 ,统计治疗前及治疗后 5、14d时患者神经功能缺损程度评分 ,并测定治疗前及治疗后 3、5d时患者血清神经元特异性烯醇化酶 (NSE)的含量。结果　治疗 5d和 14d时局部亚低温组、全头低温组、常温组患者神经功能缺损程度评分 (欧洲卒中量表 )较常温组有明显升高 ,5d时分别为 5 4 12±11 2 2 ,5 4 91± 10 0 7和 39 16± 8 71,14d时分别为 77 2 4± 2 0 32 ,75 2 3± 19 36和 5 1 4 1± 12 4 3,差异明显 (P<0 0 5 )。治疗 3d、5d时 ,3组血清NSE含量不同 ,3d时分别为 (15 5 3± 4 93)ng/ml,(16 2 1± 5 2 4 )ng/ml和(2 0 2 6± 9 0 4 )ng/ml;5d时分别为 (12 32± 4 0 3)ng/ml,(14 0 7± 4 31)ng/ml和 (18 12± 5 97)ng/ml ,差异显著(P <0 0 1)。结论　局部亚低温治疗对出血后的脑组织具有明显的保护作用 ,且无明显的并发症     

丙泊酚、咪达唑仑对小儿紫绀型先天性心脏病体外循环心内直视术的心肌保护作用

目的 比较观察丙泊酚和咪达唑仑对紫绀型先天性心脏病患儿心内直视术的心肌保护作用。方法选择ASAI～Ⅱ级心内直视手术的紫绀型先天性心脏病患儿32例,随机等分为两组,每组16例,丙泊酚复合小剂量芬太尼组（PF组）,咪达唑仑复合小剂量芬太尼组（MF组）。观察患儿血流动力学变化,脉搏血氧饱和度及体温,记录术后拔管时间及术后ICU停留时间;取主动脉阻断后10～20min（T2）和主动脉开放后10-20min（L）时的心肌组织,观察心肌血红素加氧酶．1（HO．1）的表达;采集开放静脉通路时（T0）、主动脉开放后2h（T4）、术后24h（L）的静脉血,检测血浆中肌钙蛋白I（eTnI）含量。结果PF组患儿术后的平均拔管时间和平均ICU停留时间较MF组短（分别为14．17h vs 23．65h,30．17h vs 49．47h）;两组患儿T4时（PF：97ng/ml±33ng／ml,MF：138ng／ml±56ng／m1）cTnI的水平均高于T0（PF：0．17ng／ml±0．10ng／ml,MF：0．62ng／ml±0．96ng／m1）和T5（PF：23ng／ml±13ng／ml,MF：24ng／ml±6ng／m1）,L时cTnI的水平高于T0,但两组间同时点值比较差异无统计学意义;PF和MF组T2时心肌HO-1表达均低于T,（灰度值PF：182．2±0．8vs125．6±2．1,MF：193．5±1．4VS145．5±7．4）,MF组患儿T2、T3时心肌HO-1的表达低于PF组同时点值。结论丙泊酚和咪达唑仑对紫绀型先天性心脏病患儿体外循环心内直视术心肌有保护作用,丙泊酚在刺激心肌保护性蛋白HO-1方面优于咪达唑仑。     

急性缺血性脑血管病患者血清IL-1、TNF-α和sVCAM-1动态变化及临床意义

目的　探讨脑缺血患者血清白细胞介素 -1(IL -1)、肿瘤坏死因子 -α(TNF -α)和可溶性血管细胞间粘附分子 -1(sVCAM)水平的动态变化规律及其意义。方法　应用ELISA法分别检测脑缺血后第 1、2、5天患者血清中IL -1、TNF -α、sVCAM -1水平。结果　发病后 2 4小时内患者血清中IL -1、TNF -α、sVCAM -1水平即开始升高 ,分别为 0 .3 8± 0 .16ng/ml、1.63± 0 .61ng/ml、687.19± 3 5 6.76ng/ml。其中IL -1、TNF -α血清浓度于 2 4小时内达到最高峰 ,第二天有所下降 0 .2 5± 0 .12ng/ml、1.40± 0 .71ng/ml,第五天下降至接近正常水平 0 .18± 0 .0 9ng/ml、0 .73± 0 .3 2ng/ml。sVCAM -1血清浓度于发病后第二天达到高峰 990 .79± 3 68.3 6ng/ml,第五天有所下降但仍维持在较高水平 977.70± 3 84.16ng/ml。发病后第二天IL -1水平与sVCAM -1水平升高呈线性正相关。结论　脑缺血患者血清IL -1、TNF -α、sVCAM -1水平均升高 ,表明IL -1、TNF -α和sVCAM -1可能参与了脑缺血损伤过程     

内毒素对肝硬化患者可溶性CD14的影响

目的　研究肝硬化时外周血单个核细胞 (PBMC)在内毒素刺激后可溶性CD14 (sCD14 )的变化。方法　选择肝炎后肝硬化患者 5 9例 ,分为伴有内毒素血症 (IETM ,A组 ) 2 9例和不伴有IETM (B组 ) 30例 ,19名健康人作为对照组。采用梯度离心法得到PBMC ,按每 2× 10 6个细胞给予内毒素 1ng的比例刺激 ,于 0、3、6h抽取培养液 ,分别检测sCD14和肿瘤坏死因子 (TNF) α。结果　肝功能分级 :Child PughC级者血浆sCD14水平为 (4 .79± 1.91) μg/ml,明显高于Child pughA级者的 (2 .91± 0 .14 ) μg/ml和Child PughB级者的 (3.6 8± 0 .91) μg/ml。A组血浆sCD14水平为 (4 .85± 1.11) μg/ml,其PBMC在内毒素刺激 6h后所释放的sCD14及TNF α的浓度分别为 (10 1.5 4± 7.6 3)和 (4 33.2 5± 12 3.4 5 )ng/ml;而B组分别为 (3.6 8± 0 .91)、(73.84± 6 .94 )和 (2 10 .18± 81.0 1)ng/ml;对照组分别为 (2 .31± 0 .2 1)、(70 .82± 5 .16 )和 (12 2 .2 1± 0 .34)ng/ml。在培养后第3、6小时 ,A组sCD14、TNF α水平与对照组相比 ,差异有显著性 (P <0 .0 5 )。结论　肝硬化伴IETM的PBMC对内毒素的敏感性增加 ,提示PBMC处于预致敏状态     

盐酸西替利嗪片的人体药代动力学研究

目的　用进口盐酸西替利嗪片 ( A)为对照品 ,评价片剂 B的相对生物利用度和生物等效。方法　 采用随机交叉分组试验设计 ,1 0名健康成年男性受试者分别口服单剂量 2 0 mg测试品和对照品 ,采用HPLC法测定人血清中药物浓度进行生物等效性的研究。结果　对照品和测试品的 tmax分别为 ( 1 .72±0 .39) /h和 ( 1 .65± 0 .5 5 ) /h,cmax分别为 ( 6.1 3± 1 2 1 .7) ng/ml和 ( 5 97± 1 1 9.8) ng/ml,AUC0 - 2 4分别为( 2 85 5 .1± 5 2 8.3) h/( ng.ml)和 ( 30 1 6.4± 70 2 .8) h/( ng.ml) ,t1 /2分别为 ( 1 1 .5± 2 .7) h和 ( 1 2 .0± 2 .9) h;片剂 B相对 A的平均生物利用度为 ( 1 0 0 .2± 7.4) %。结论　测试片剂 B与对照片剂 A具生物等效性     

糖尿病伴高血压病人测定β_2—MG、u—ALB、u—IgG变化的临床意义

测定尿常规，肾功能正常的NIDDM＋HP62例、NIDDM45例、HP48例、健康人40例。4组的S—β2—MG、u—β2—MG、u—ALB、u—IgG的水平。结果显示NIDDM、HP伴存时4项指标的水平明显增高，分别为1994．3±712．5ng／ml、124．4±92．3ng／ml、21．33±18．04μg／ml、8．74±8．09μg／ml；分泌、排泄异常率分别为20．97％、29．03％、62．9％、37．1％，与其他3组比较有显著性差异。实验结果表明NIDDM或HP病人检测β2—MG、u—ALB、u－IgG等，可早期发现肾损害，及时治疗，可以减轻肾脏病变的进程。     

神经生长因子在肝纤维化大鼠肝星状细胞凋亡中的作用

目的探讨神经生长因子(NGF)在肝纤维化大鼠肝星状细胞(HSC)增殖、凋亡中的作用。方法HSC株分别在实验组(分别以NGF 50、100和150ng／ml干预HSC)和对照组(单纯HSC培养)中体外培养24、48和72 h。应用四甲基偶氮唑盐(MTT)法检测细胞增殖率;原位杂交凋亡检测(TUNEL)法观察HSC凋亡状况;流式细胞术检测细胞凋亡率;显微镜观察细胞形态学变化。结果①MTT法显示,不同浓度的NGF作用HSC 24 h,实验组HSC增殖率均低于对照组,差异有统计学意义(均P<0．05)。NGF浓度为100 ng／ml时,HSC增殖率低于对照组最显著(0．63±0．02 vs 0．77±0．03,P<0．05);②最适浓度的NGF(100 ng／ml)作用HSC 24、48和72 h,第72小时的HSC增殖率低于对照组最显著(0．48±0．03 vs 0．89±0．01,P<0．05),增殖率的降低呈时间依赖性;③最适浓度的NGF(100 ng／ml)作用HSC 24 h,TUNEL法显示HSC凋亡率显著高于对照组(10．2％±1．2％vs 1．6％±0．1％,P<0．05);同时,流式细胞术显示HSC凋亡率为6．2％±0．2％,而对照组无凋亡;④NGF对HSC形态没有明显影响。结论NGF可诱导体外活化的HSC凋亡。     

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.