表现为肾病综合征的IgM肾病及非IgA系膜增殖性肾炎的临床病理差异

分析临床表现为原发性肾病综合征的微小病变肾病（ＭＣＤ）、ＩｇＭ肾病（ＩｇＭＮ）和非ＩｇＡ、ＩｇＭ系膜增殖性肾炎（ＭｓＰＧＮ）病理改变（微机定量图像分析）和临床表现的联系。发现：（１）３种疾病以ＩｇＭＮ发生率最高（４８．８９％），一过性肾功损害、激素依赖比例以ＭｓＰＧＮ为高，ＩｇＭＮ、ＭｓＰＧＮ存在明显血尿；（２）病理定量分析表明：ＩｇＭＮ和ＭｓＰＧＮ的系膜细胞数、系膜基质增宽及间质改变较ＭＣＤ明显增高（Ｐ＜０．０１），ＭｓＰＧＮ系膜区增宽比ＩｇＭＮ更明显（Ｐ＜０．０１）；（３）ＩｇＭＮ、ＭｓＰＧＮ间质病变越重，越易伴有高血压、血尿、一过性肾功损害和激素依赖，其中以ＭｓＰＧＮ更明显。表明ＩｇＭＮ肾病预后相对较好，而ＭｓＰＧＮ相对较差。     

表现为肾病综合征的IgM肾病及非IgA系膜增殖性肾炎的临床病…

分析临床表现为原发性肾病综合征的小病变肾病（ＭＣＤ）、ＩｇＭ肾病（ＩｇＭＮ）和非ＩｇＡ、ＩｇＭ系膜增殖性肾炎（ＭｓＰＧＮ）病理改变（微机定量图像分析）和临床表现的联系。发现：（１）３种疾病以ＩｇＭＮ发生率最高（４８．８９％），一过性肾功损害、激素依赖比例以ＭｓＰＧＮ为高，ＩｇＭＮ、ＭｓＰＧＮ存在明显血尿；（２）病理定量分析表明：ＩｇＭＮ和ＭｓＰＧＮ的系膜细胞数、系膜基质增宽及间质改变较ＭＣＤ明显增     

儿童肾小球疾病临床病理研究

为了探讨肾小球疾病的病理类型与临床治疗的关系，对肾小球疾病１３１例行肾穿刺活组织检查。其中原发性肾小球疾病１２０例，继发性肾小球疾病１１例，前者以系膜增生性肾小球肾炎（ＭｓＰＧＮ）居多，占２９．２％，其次是ＩｇＡ肾病（ＩｇＡＮ），占２５．８％。临床诊断与病理诊断符合率为５７．２％。治疗后，随访６个月至６年，总痊愈率和好转率为７６．７％，病理类型中的微小病变（ＭＣＮＳ）、轻度ＭｓＰＧＮ、ＩｇＭ肾病（ＩｇＭＮ）、毛细血管内增生性肾小球肾炎（ＥｎＰＧＮ）等的疗效及预后好，膜增生性肾小球肾炎、重度ＭｓＰＧＮ及组织损害严重的ＩｇＡＮ等疗效差。提示治疗效果、预后与病理类型密切相关     

成人原发性肾小球疾病205例病理与临床分析

２０５例成人原发性肾小球疾病肾活检结果显示系膜增生性肾小球肾炎（ＭｓＰＧＮ）最常见，占４０．５／，其次是微小病变肾病（ＭＣＤ），占１４，６％，局灶节段性肾小球硬化（ＦＳＧＳ）占１２，７％。临床表现以肾病综合征最常见共１０２例，占５０．０％，其中以ＭｓＰＧＮ和ＭＣＤ居多，分别占３６．３％和２９．４％。     

60例原发性肾病综合征临床病理观察

对６０ 例原发性肾病综合征（ＮＳ） 临床及病理进行了分析,结果表明：成人ＮＳ病理类型主要为ＭｓＰＧＮ,随着病变程度的加重,高血压及肾功能异常的发病率增加;还对ＮＳ的诱因、实验室检查及治疗进行了分析,认为早期联合用药可提高治疗效果。     

儿童单纯性蛋白尿的病因诊断分析

对２０例单纯性蛋白尿的临床和病理资料进行分析。结果发现，肾功能性蛋白尿９例（４５％），其中直立性蛋白尿（ＯＰ）、胡桃夹现象（ＮＣＰ）各３例，ＯＰ并ＮＣＰ３例；肾料质性蛋白尿１１例（５５％），其中肾小球性蛋白尿９例（系膜增生性肾炎（ＭｓＰＧＮ）３例，ＩｇＡ肾病（ＩｇＡＮ）１例，特发性膜性肾病（ＩＭＮ）２例，局部性节段性小球硬化（ＦＳＧＮ）、轻微病变（ＭＬ）、Ａｌｐｏｒｔ综合征（ＡＳ）各１例），肾小管     

儿童单纯性蛋白尿的病因诊断分析

对２０例单纯性蛋白尿的临床和病理资料进行分析。结果发现,肾功能性蛋白尿９例（４５％）,其中直立性蛋白尿（ＯＰ）、胡桃夹现象（ＮＣＰ）各３例,ＯＰ并ＮＣＰ３例;肾实质性蛋白尿１１例（５５％）,其中肾小球性蛋白尿９例〔系膜增生性肾炎（ＭｓＰＧＮ）３例,ＩｇＡ肾病（ＩｇＡＮ）１例,特发性膜性肾病（ＩＭＮ）２例,局灶性节段性肾小球硬化（ＦＳＧＮ）、轻微病变（ＭＬ）、Ａｌｐｏｒｔ综合征（ＡＳ）各１例〕,肾小管性蛋白尿２例。对两类蛋白尿的临床特征及鉴别要点和病因进行了讨论,建议应先初筛有无ＯＰ和ＮＣＰ,然后再酌情进行肾活检。     

糖皮质激素加重对激素不敏感儿童肾病蛋白尿

目的：有报道糖皮质激素（ Ｇ Ｃｓ） 亦可加重肾脏病蛋白尿。本课题旨在探讨 Ｇ Ｃｓ 是否加重激素不敏感肾病综合征（ Ｎ Ｓ） 蛋白尿及其机制，以指导临床合理使用 Ｇ Ｃｓ。方法：１９ 例对激素不敏感的 Ｎ Ｓ 患儿予泼尼松每日１５ ～２ ｍｇ／ｋｇ 隔日早上０８∶００ 顿服。同时检测激素日和无激素日的尿蛋白及其成分、白蛋白和免疫球蛋白 Ｇ 及肌酐的清除率、肾有效血浆流量（ Ｅ Ｒ Ｐ Ｆ） 、尿前列腺素等并进行比较。结果：与无激素日比较，激素日尿蛋白明显增加（２４ ｇ ±０５ ｇ ｖｓ １５ ｇ ±０４ ｇ／２４ ｈ ， Ｐ ＜００１） ，其中以尿白蛋白、 Ｉｇ Ｇ 增加为主，尿β２微球蛋白无明显变化。激素日的内生肌酐清除率、白蛋白清除率及 Ｉｇ Ｇ 清除率亦明显增高，３ 例 Ｅ Ｒ Ｐ Ｆ在激素日均高于无激素日，而尿血栓素 Ｂ２ 和６酮前列腺 Ｆ１ａ 、血清总蛋白、白蛋白和 Ｉｇ Ｇ 均无明显改变。结论： Ｇ Ｃｓ 可能通过增加肾小球滤过膜的通透性及改变肾小球血流动力学，而加重激素不敏感的 Ｎ Ｓ患儿的蛋白尿；其加重蛋白尿机制并非通过肾前列腺素系统；对 Ｇ Ｃｓ 疗效不可靠的 Ｎ Ｓ 患者，不宜长期、大剂量使用 Ｇ Ｃｓ 。     

改良双倍剂量雷公藤多甙合并糖皮质激素方法治疗系膜毛细备管性肾小球肾炎

目的 观察应用改良的双倍剂量雷公藤多甙合并糖皮质激素治疗原发性系膜毛细血管性肾小球肾炎Ⅰ型（ＭＣＧＮⅠ）的效果。方法 ２３例ＭＣＧＮⅠ患者,应用双倍剂量雷公藤多甙（ＴⅡ）每天２ｍｇ／ｋｇ,２周后改１ｍｇ／ｋｇ２周,交替进行,强的松正规标准疗法每天１ｍｇ／ｋｇ,治疗６周。观察治疗前后蛋白尿、血尿和血尿白蛋白变化以及副反应。８例进行重复肾脏病理研究。结果 ２３例ＭＣＧＮ１患者经６周治疗后蛋白尿、血尿均明显减少,血浆胆固醇下降,血浆白蛋白显著升高,内生肌酐清除率、谷丙转氨酶、谷草转氨酶无显著变化。８例患者治疗后重复肾穿,见肾小球内皮下沉积物、增殖的系膜细胞和炎症细胞均明显减少,狭窄、闭塞的毛细血管再通。结论 改良双倍剂量ＴⅡ合并糖皮质激素６周治疗ＭＣＧＮⅠ方法具有良好近期效果。     

IFN-α治疗小儿乙型肝炎病毒相关性肾炎(附12例报告)

目的：观察α－干扰素（ＩＦＮ－α）对１２例小儿乙型肝炎病毒相关性肾炎的治疗效果。方法：先给予强的松１ｍｇ／（ｋｇ·ｄ）治疗２周后突然停药,此时开始应用ＩＦＮ－α１００万单位,隔天１次肌注,疗程共６个月。观察患儿血ＨＢＶ抗原的转变,尿蛋白及血生化的变化。结果：１０例患儿中的４例ＨＢｅＡｇ转阴,１２例患儿中的３例ＨＢｓＡｇ转阴,５例尿蛋白转阴,３例明显好转,总有效率为６６．７％（８／１２）。尤其是对病理类型为膜性肾病（ＭＮ）及系膜增殖性肾小球肾炎（ＭｓＰＧＮ）疗效较好,而对膜增殖性肾小球肾炎（ＭＰＧＮ）者则效果较差。结论：该剂量疗程的ＩＦＮ－α对小儿乙肝病毒相关性肾炎的治疗具有一定效果,适合我国国情,值得推广应用     

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.