女性系统性红斑狼疮患者血清泌乳素和生长激素水平的研究

目的 研究女性系统性红斑狼疮(SLE)患者血清泌乳素(PRL)及生长激素(GH)的变化及意义.方法 采用化学发光法检测117例女性SLE患者及30例健康体检者血清PILL和GH.结果 女性SLE患者血清PRL和GH显著高于对照组,且活动期组高于静止期组.血清PRL与GH、PRL与SLEDAI评分、GH与SLEDAI评分均呈正相关.活动期组高泌乳素血症(HPRL)和高生长激素血症(HGH)的发生率高于静止期组.抗ds-DNA抗体水平升高的患者HPRL和HGH的发生率高于其水平正常者.结论 女性SLE患者血清PRL、GH较女性健康者升高;血清PILL、GH与疾病活动性呈正相关;PRL与GH可能相互作用,共同参与SLE发病.     

狼疮性肾炎患者血清泌乳素的检测及其意义

目的探讨泌乳素（PRL）与狼疮性肾炎（LN）的关系。方法采用全自动化学发光免疫分析仪检测68例LN患者和30例健康体检者血清PRL水平。结果LN组血清PRL水平明显高于正常对照组（P〈0.05）；活动期LN组PRL水平显著高于静止期LN组（P〈0.05）；68例LN患者血清PRL水平与抗ds-DNA水平呈正相关（r=0．7183．P〈0．05）。结论LN患者血清PRL水平与病情活动有关，可将PRL作为判断LN病情活动性的指标之一；PRL在LN发病中可能起一定的作用。     

SLE患者血清甘露聚糖结合凝集素（MBL）水平检测及其意义

目的检测系统性红斑狼疮（SLE）患者血清甘露聚糖结合凝集素水平并探讨其临床意义。方法用酶联免疫吸附（ELISA）测定法检测40例SLE患者和30例正常人血清MBL水平,活动期与非活动期SLE患者血清MBL水平,按常规方法检测了血清补体,抗ds-DNA抗体,抗ENA抗体谱,免疫球蛋白IgG、IgM、IgA等指标。结果与正常人相比,SLE患者血清MBL水平下降（P〈0.05）;且活动期SLE患者血清MBL水平显著低于非活动期水平;出现抗ds-DNA抗体阳性,抗Sm抗体阳性,低补体C3血症,高IgG血症的MBL水平均分别显著低于无上述表现者。结论SLE患者血清MBL水平明显下降,且其血清水平与抗ds-DNA阳性,抗Sm抗体阳性,补体低下,高免疫球蛋白血症具有相关性,它可能在SLE的发病机制中起一定作用。     

SLE患者血清IgE水平与疾病活动性的关系

目的分别测定活动期和稳定期系统性红斑狼疮(systemic lupus erythematosus,SLE)患者血清IgE含量,以及与SLE疾病活动性相关的各项血清学指标(抗ds-DNA抗体,补体C3、补体C4),了解IgE与SLE病情活动性的关系.方法采用ELISA双抗体夹心法测定70例活动期和127例稳定期SLE患者血清IgE浓度,并与28例体检健康者血清IgE水平比较;同时采用放射免疫分析法检测这些血清抗ds-DNA抗体水平;速率散射比浊法测定这些血清中补体C3、C4含量.结果SLE活动期患者、SLE稳定期患者以及对照组血清IgE水平分别为241.10±201.40 IU/ml、132.99±59.12 IU/ml和62.30±37.15 IU/ml.SLE活动期患者血清IgE水平高于SLE稳定期和对照组,P值均小于0.01;SLE稳定期患者血清IgE水平也显著高于对照组(P《0.01);活动期SLE患者血清IgE水平与抗ds-DNA、补体C3、C4含量具明显相关性,相关系数分别为0.938、-0.877、-0.812.结论血清IgE浓度增高与SLE疾病活动性相关,血清IgE水平检测,可作为临床SLE疾病的一个实验室辅助诊断指标.     

系统性红斑狼疮患者血清中肿瘤坏死因子-α的检测

目的 研究SLE患者血清中TNF-α水平在疾病活动期、静止期及正常^群中的变化.方法 用酶联免疲吸附试验检测50例SLE患者,其中24例为活动期,26例为静止期患者,及24例正常对照血清中TNF-α的水平.并分析血清中TNF-α的水平与疾病活动及临床症状之间的关系.结果 血清INF-α的水平在活动期患者明显升高,且波动较大,而静止期患者与正常人群中血清TNF-α的水平则较低.结论 血清中TNF-α在活动期SLE患者明显高于静止期SLE患者及正常对照,而在静止期SLE患者及正常对照间无显著差异.此外,血清中TNF-α与发热有显著相关.     

B淋巴细胞刺激因子及其受体与系统性红斑狼疮的相关性研究

目的：探讨B淋巴细胞刺激因子（BLyS）及其特异性受体（BAFF-R）与系统性红斑狼疮（SLE）的相关性。方法 SLE患者33例,根据SLE疾病活动指数（ SLEDAI）评分,分为活动组20例和缓解组13例。同期体检健康者30例为对照组。应用酶联免疫吸附试验法检测3组研究对象血清BLyS 、BAFF-R水平,观察SLE患者血清BLyS、BAFF-R水平与抗核抗体（ANA）、抗双链DNA抗体（ds-DNA）、白细胞（WBC）、补体C3、C4和SLEDAI评分的相关性。结果活动组患者血清BLyS、BAFF-R水平均明显高于缓解组及对照组（ P＜0．05）,缓解组患者血清BLyS水平明显高于对照组（P＜0．05）,但缓解组与对照组血清BAFF-R水平比较,差异无统计学意义（P＞0．05）;SLE患者血清BLyS、BAFF-R水平均与SLEDAI呈正相关关系（P＜0．05）;BLyS水平与ANA呈正相关关系（P＜0．05）;BAFF-R与ANA无明显相关关系（P＞0．05）;SLE患者血清BLyS、BAFF-R水平与ds-DNA无明显相关关系（ P ＞0．05）;SLE 患者血清 BLyS、BAFF-R 水平与 WBC、C3、C4水平均呈负相关关系（ P＜0．05）。结论 SLE患者血清BLyS、BAFF-R水平与SLE病情密切相关,对SLE病情的评价有重要价值,且BLyS可能比BAFF-R更有效。     

白细胞介素-18在SLE、RA不同病期水平变化

目的本文观察血清白细胞介素-18（IL-18）水平在系统性红斑狼疮（SLE）、类风湿关节炎（RA）不同病期表达,并探讨中药红花和常规药物干预治疗对IL-18的影响。方法采用酶联免疫吸附法（ELISA）测定70例SLE、RA患者血清中IL-18水平,结果与20例对照者对照。结果活动期SLE、RA患者血清IL-18水平显著高于缓解期及对照组（P〈0．05）,且活动期患者治疗后有显著降低（P〈0．05）,红花注射液联合西药治疗差异更著（P〈0．01）,缓解期与对照组相比无差异（P〉0．05）。结论IL-18水平与SLE、RA疾病进展和活动性呈正相关,可作为疾病活动期的诊断指标之一。中药红花具抗炎及免疫调节作用,联合常规药物有利于病情的改善和预后,并减少西药不良反应。     

ANA、DS-DNA抗体滴度与SLE活动期的关系研究

目的了解SLE患者活动期与非活动期时抗核抗体(ANA),抗双链DNA(ds-DNA)抗体的滴度的关系。方法用间接免疫荧光法和金标免疫斑点法分别测定21例活动期系统性红斑狼疮(SLE)住院病人及47例非活动期SLE病人的抗核抗体(ANA),抗双链DNA(ds-DNA)抗体的滴度。结果活动期病人ANA滴度与抗-dsDNA抗体滴度与非活动期病人组经比较,差异有统计学意义(P<0.05),活动期病人组两种抗体平均滴度显著高于非活动期组。结论 ANA、抗ds-DNA抗体的滴度会随着病情的变化而改变,因而可作为SLE病人活动期与非活动期判断指标之一。     

血清sCD40L和TGF—β1对系统性红斑狼疮活动性及治疗转归的预测价值

目的: 探讨系统性红斑狼疮(SLE)患者血清中共刺激分子sCD40L、转化生长因子TGF-β1的测定对疾病活动性的预测价值.方法: 采用酶联免疫吸附试验(ELISA)检测SLE患者和正常人血清sCD40L和TGF-β1的水平,分析两种指标的含量与SLE患者的疾病活动度指数SLEDAI和免疫学指标(ANA,ds-DNA等)的相关性,并进行SLE病例的前瞻性和治疗前后对照研究.结果: (1)SLE患者血清sCD40L水平为5.87 μg/L,显著高于正常对照组2.31 μg/L;而SLE患者血清TGF-1为48.3 μg/L,显著低于正常对照组70.4 μg/L. (2) SLE患者血清sCD40L水平活动期高于稳定期(P<0.05),ANA高滴度组高于ANA低滴度组,ds-DNA抗体阳性组高于ds-DNA抗体阴性组,并与SLE患者SLEDAI呈正相关(r=0.253);SLE患者血清TGF-1水平活动期与稳定期差异无统计学意义(P>0.05),与SLE患者SLEDAI亦无明显相关(r=-0.071).(3)以SLE非活动性组的x±s作为评判临界值,定量检测sCD40L对SLE活动性的预测具有较好的灵敏度、特异度.结论: sCD40L与SLE发病有关,可反映SLE患者的疾病活动性,定量检测可有助于预测患者的病情活动和转归.     

自身抗体与狼疮活动性相关的临床研究

目的探讨自身抗体中抗dsDNA抗体，ANCA，抗磷脂抗体及补体C3、C4与系统性红斑狼疮（SLE）患者狼疮活动相关的临床研究。方法回顾性分析88例符合美国ARA标准（1982）的SLE病人的临床情况，并对抗dsDNA抗体，补体，ANCA，抗磷脂抗体等指标与SLE活动的关系进行了探讨与分析。结果C3下降较C4下降对诊断SLE活动更具价值，dsDNA抗体升高（尤其是〉30％），对SLE活动的判断很有价值。C3下降（尤其是〈0．5s／L）及dsDNA抗体升高，应对病情活动加以判断，当补体C，、C。均低而dsDNA抗体升高时对诊断SLE活动价值最大。64例活动期患者ANCA阳性率略高于非活动期患者，检测SLE患者的ANCA可能有助于判断该疾病的活动性。抗磷脂抗体对病情活动监测有意义，联合测定对于SLE的早期诊断、监测、治疗更有意义。结论血清中自身抗体：ds-DNA抗体、ANCA、抗磷脂抗体及补体与系统性红斑狼疮病情活动性高度相关。     

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…     

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.     

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.     

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.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.