1H NMR检测技术结合PCA及OPLS在SLE疾病发生、发展中的应用研究

目的 了解1H NMR检测技术结合模式识别技术-主成分分析法(PCA)及正交偏最小二乘法方法(OPLS)在系统性红斑狼疮(SLE)疾病发生、发展中的应用价值.方法 采用瑞士Bruker 600MHzNMR谱仪,对34例健康志愿者(对照组)与62例SLE患者(观察组)血清样本进行检查,基于把握代谢物差异基础上取代谢物指纹图谱,综合模式识别分析方法,建立SLE诊断模型.结果 SLE对氨基酸、脂类、能量代谢具有影响作用.PCA可对观察组与对照组进行区分,PLS-DA模型预测率达0.393,OPLS-DA模型诊断特异性达97.1%左右,敏感性达60.9%左右.结论 利用1H NMR检测技术及PCA及OPLS,强化SLE疾病监测,能够指导临床治疗,改善患者预后.     

代谢组学在糖尿病肾病患者诊断中的应用

目的建立糖尿病肾病(DN)患者血清代谢物特征谱图。方法收集108例血清标本,其中DN(1～4期)患者80例、健康对照者28例。应用基于核磁共振(1H NMR)的代谢组学方法,通过CMPG波谱获取数据,并结合PCA和PLS-DA模式识别分析法对数据进一步分析处理。结果成功建立DN代谢物特征谱图,血清1H CPMG谱图主要峰值差异集中在0.5～4.5 ppm区域。超过15种主要代谢物可被1H NMR谱图识别,与健康对照者相比,DN患者血清中乳酸水平明显升高,脂质、葡萄糖、胆碱、磷酸胆碱、甘油磷酸胆碱、甜菜碱、牛磺酸和鲨肌醇水平明显下降。通过此种方法可明显区分DN(1～4期)患者与健康对照者。结论基于NMR的代谢组学技术结合模式识别分析方法可有效检测DN患者血清代谢物特征谱图的改变,有望成为诊断和分级的新方法。     

基于高效液相色谱-质谱技术的早期胃癌血清代谢组学分析

目的对比早期胃癌患者与健康人血清代谢产物的差异,寻找潜在的与早期胃癌相关的小分子代谢标志物。方法应用高效液相色谱-质谱(HPLC-MS)技术对16例早期胃癌患者与20例健康对照者的血清样本进行代谢组学检测。采用主成分分析法(PCA)、偏最小二乘判别法(PLS-DA)和t检验统计分析早期胃癌实验组与健康对照组的差异代谢物,最后将找到的差异代谢物通过人类代谢组数据库(HMDB)检索鉴定。结果与正常人相比,早期胃癌患者糖类、脂类等代谢可能存在异常,同时共筛选鉴定出9个对分类有显著贡献的代谢标志物。结论基于HPLC-MS技术的血清代谢组学分析方法能够有效区分早期胃癌与健康个体,对早期胃癌的诊断具有潜在的临床价值。     

代谢组学技术在临床诊断中的应用

代谢组学给临床诊断提供了强有利的技术手段,基于代谢组学的临床诊断通过对患者的体液进行代谢物全局分析,结合多元统计分析技术发现体液中与疾病相关的生物标志物,应用模式识别技术建立诊断模型,从而实现疾病的临床诊断。本文简要介绍代谢组学涉及的分析技术、计算技术及其在临床诊断中的应用,并探讨现阶段临床代谢组学研究中存在的问题及今后的发展趋势。     

基于高效液相色谱-电喷雾-飞行时间质谱联用技术的高血压病血浆代谢组学分析

目的研究高血压患者和健康志愿者的血浆代谢组变化,寻找高血压病的特征代谢物,揭示高血压病的生物学本质。方法根据临床高血压病的诊断标准,选择典型病例10例,健康志愿者12例,以高效液相色谱-电喷雾-飞行时间质谱联用技术(HPLC-ESI-TOFMS)分析高血压病患者和健康志愿者的血浆代谢物谱,以Mass-Profiler进行数据的匹配、对齐,将数据结果以文本文件贮存,用于模式识别分析,利用Simca-P 11.0软件进行主成分分析和偏最小二乘判别分析,寻找血浆内差异代谢物,并做出相关代谢途径的可能解释。结果主成分分析(PCA)和偏最小二乘判别分析(PLS-DA)方法处理高血压患者和健康志愿者的血浆代谢物谱数据显示,两组HPLC-ESI-TOFMS谱数据可以明显分开,与健康志愿者作比较,高血压病患者机体相关代谢发生显著变化,体内部分氨基酸代谢和磷脂代谢明显异于健康志愿者。结论 HPLC-ESI-TOFMS结合模式识别的代谢组学方法具有研究复杂条件下机体病理生理变化的优势,为理解高血压病的生物学本质和诊断该类疾病提供了科学依据。     

基于~1H-NMR的模式识别方法在慢性心力衰竭患者血清代谢组学中的应用

目的探讨基于1H-NMR的模式识别方法应用于慢性心力衰竭(CHF)血清代谢组学研究的可行性。方法应用1H-NMR技术对9例CHF患者和6例健康人血清进行检测,对所得数据分别采用主成分分析法(PCA)和正交信号校正偏最小二乘法(OPLS)进行模式识别分析,确定CHF患者与健康人血清差异代谢物,比较两种模式识别方法判别能力。结果 CHF患者与健康人血清1H-NMR图谱有明显差异。其中PCA模式识别法未能将CHF组和健康对照组区分开,而用OPLS模式识别方法两组可明显区分。结论 1H-NMR技术是研究CHF代谢组学的有效技术手段,CHF患者血清代谢组与健康人存在明显差异。OPLS模式识别法明显优于PCA法,能够去除非实验因素的影响,提高分类效果。     

运用蛋白质指纹图谱技术建立系统性红斑狼疮诊断模式的研究

目的 运用蛋白质指纹图谱技术筛选系统性红斑狼疮(SLE)患者血清中的特异性蛋白标志物,建立SLE疾病相关的蛋白质组学诊断模型.方法 联用弱阳离子磁珠与蛋白质芯片阅读仪绘制64例SLE患者组及168例对照组的血清蛋白质指纹图谱,用Biomarker Patterns Software 5.0(BPS)软件筛选特异性的血清蛋白标志物并建立SLE诊断模型.结果 在SLE患者组和对照组之间找到60个差异蛋白峰(P<0.05),其中28个蛋白峰在SLE患者表达增高,32个蛋白峰表达降低.由BPS软件筛选的4个蛋白标志物(质荷比为3376.02、4070.09、7770.45、28045.10)建立的诊断模型能很好的把SLE患者与其他自身免疫性疾病和健康对照者区分出来,经过盲法验证,其对SLE的诊断敏感性为78%,特异性为96%.结论 采用蛋白质指纹图谱技术能筛查识别出与SLE疾病相关的特异性血清蛋白标志物,由4个质荷比分别为3376.02、4070.09、7770.45和28045.1的SLE特异性血清蛋白标志物建立的SLE疾病诊断模型具有高敏感性及特异性.     

基于核磁共振波谱的鼻咽癌患者血清代谢组研究

目的 应用核磁共振氢谱(nuclearmagnetic resonancc1H,1H NMR)和偏最小二乘法.判别分析(partial least square-discriminant analysis,PLS-DA)研究鼻咽癌(NPC)患者血清中代谢物的代谢组变化.方法 健康人血清10例和鼻咽癌患者血清2l例,采用...     

主成分分析方法在食管癌患者血清代谢物研究中的应用

目的:应用主成分分析方法分析食管癌患者血清代谢组核磁共振氢谱的特征及其变化。方法:对健康人血清(健康组,10例)和食管癌患者血清(食管癌组,20例)样本检测核磁共振氢谱,运用主成分分析方法研究食管癌患者血清代谢组的特征及其改变。结果:健康组与食管癌组患者血清代谢组差异显著,通过主成分分析得到:食管癌患者血清中脂和乳酸的含量升高,葡萄糖和胆碱的含量降低。结论:通过运用主成分分析方法能够得到食管癌患者血清中具有较大变化的血清代谢物,对食管癌的诊断提供代谢依据。     

Characteristics of urine metabonomics in patients with blood stasis syndrome of CHD unstable angina

目的 利用磁共振波谱代谢学方法研究冠心病不稳定心绞痛血瘀证患者和健康志愿者尿液代谢物的变化.方法 通过临床横断面调查研究,收集冠心病不稳定心绞痛血瘀证患者和健康志愿者的一般资料和尿液样品,采用磁共振(NMR)和模式识别技术对磁共振氢谱进行分析,对谱图去水峰后采用0.01化学位移分段积分和归一化处理.所得数据输入SIMCA-P软件,采用偏最小二乘-判别分析法(PLS-DA)对结果进行分析.结果 冠心病不稳定心绞痛血瘀证患者尿液中脯氨酸、丙氨酸、异亮氨酸、葡萄糖、缬氨酸、组氨酸、马尿酸等物质的含量升高;柠檬酸、肌酸酐、牛磺酸等物质的含量下降.结合PLS-DA对尿液样品的分析结果显示冠心病患者与健康人在代谢组学方面存在差异,且化合物分布在性别方面也有差异.结论 研究表明尿液样品中柠檬酸、脯氨酸、异亮氨酸、牛磺酸等代谢物的改变构成了冠心病不稳定性心绞痛血瘀证患者的代谢组学特征,从而为疾病的诊断和治疗以及中医证候研究提供了新思路和新方法.     

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.     

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.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…