血清抗核小体抗体水平与狼疮肾炎病理分型及其活动性的相关性研究

目的研究血清抗核小体抗体（AnuA）水平与狼疮肾炎（LN）病理类型及其活动性的相关性。方法选取110例系统性红斑狼疮（SLE）患者（狼疮肾炎34例进行肾脏病理,非狼疮肾炎76例）作为研究对象,同时选取健康体检者30例作为正常对照组,用酶联免疫吸附法（ELISA）检测血清中的AnuA水平,并与LN病理类型及活动性指标进行相关性分析。结果 SLE组中血清AnuA水平（107.2±86.5）RU·mL-1显著高于正常对照组（17.4±14.0）RU·mL-1（t=8.37,P〈0.05）;狼疮肾炎组血清AnuA水平（115.0±87.0）RU·mL-1明显高于非狼疮肾炎组（68.1±49.3）RU·mL-1（t=4.28,P〈0.05）;各肾脏病理类型的血清AnuA水平差异有统计学意义,IV型III型LN患者血清AnuA水平高于V型II型,V型又高于II型（P〈0.05）。血清AnuA与活动指数（AI）呈正相关（r=0.69,P〈0.05）,与慢性指数（CI）无显著相关性。血清AnuA水平与肾脏病变临床活动度的关系表现为：血清AnuA水平由高向低依次为肾炎复发组、尿蛋白复发组、部分缓解组、持续活动组和完全缓解组;肾炎复发组和尿蛋白复发组显著高于其它活动度组（P〈0.05）,肾炎复发组又显著高于尿蛋白复发组（P〈0.05）。结论 AnuA水平与SLE患者肾脏损害显著相关,不同肾脏病理类型的血清AnuA水平表达有差异,可用于评估临床治疗及预后。     

系统性红斑狼疮肾脏损害与自身抗体关系研究

目的 研究系统性红斑狼疮(SLE)患者血清抗核抗体(ANA)、抗双链DNA抗体(dsDNA)、抗核小体抗体(AnuA)、抗可提取核抗原抗体(ENA)等自身抗体水平,探讨SLE肾脏损害与自身抗体关系.方法 用间接免疫荧光法测定ANA和dsDNA,免疫斑点法测定ENA,酶联免疫吸附法(ELISA)检测AnuA.测定223例SLE患者(其中有肾损害134例,无肾损害89例)及176例疾病时照组患者(包括原发性干燥综合征,系统性硬化症、皮肌炎/多肌炎、类风湿关节炎和混合性结缔组织病)血清中的自身抗体.分析SLE组与疾病对照组患者自身抗体的阳性率及SLE肾脏损害与自身抗体变化关系.结果 223例SLE患者ANA、dsDNA、AnuA、ng.NP、sm、SSA和AtLPA的阳性率分别为95.5%、68.2%、56.5%、27.4%、35.0%、41.3%和29.1%,均明显高于疾病对照组(分别为40.3%、7.4%、1.7%、9.7%、3.4%、19.3%和2.8%),差异具有显著性(P＜0.01).SLE组患者中有肾脏损害者dsDNA、AnuA、AgPA和sm的阳性率分别为81.3%,77.6%,34.3%和44.0%,显著高于无肾脏损害组(48.3%、24.7%、21.3%和21.3%),而nR2qP低于无肾脏损害组,差异有显著性(P＜0.05或P＜0.01).两组ANA、SSA和SSB问差异无显著性(P＞0.05).结论 SLE肾脏损害与dsDNA、Sm、AnuA和AKPA密切相关,多种自身抗体联合检测可提高狼疮肾炎(LN)诊断的敏感性和特异性.     

抗核小体抗体在狼疮肾炎患者血清的表达及临床意义

目的 探讨血清抗核小体抗体(AnuA)检测在狼疮性肾炎(LN)患者中的临床意义.方法 采用免疫印迹法检测26例LN和32例系统性红斑狼疮(SLE)无肾炎患者血清AnuA.并跟踪分析了11例LN患者治疗过程中血清AnuA与尿蛋白、尿红细胞、血清白蛋白的相关性.结果 LN组与SLE无肾炎组患者AnuA阳性率差异极显著性(P＜0.001),LN组患者血清AnuA阳性率显著高于SLE无肾炎组(P＜0.01);AnuA与LN患者的尿蛋白、尿红细胞呈正相关(P＜0.01);血清AnuA与LN患者血清白蛋白呈负相关(P＜0.01).LN患者血清ANuA随着病情的好转,由强变弱直至转阴.结论 血清AnuA的检测对于LN的诊断及疗效评价具有重要意义.     

抗核小体抗体测定在系统性红斑狼疮诊断中的意义及价值

目的探讨血清抗核小体抗体（AnuA）检测在系统性红斑狼疮（SLE）患者中的诊断价值,评价其在SLE疾病活动性方面的参考价值。方法采用酶联免疫吸附法检测67例SLE患者、53例其他风湿性疾病患者和27名健康对照者血清中AnuA水平,同时进行其他自身抗体的检测并与AnuA比较,根据系统性红斑狼疮活动指数（SLEDAI）进行评分。结果AnuA阳性率在SLE组明显高于疾病对照组和正常对照组（P〈0.01）。在SLE组AnuA的敏感性明显高于抗dsDNA抗体、抗DNP抗体、抗Sm抗体（P〈0.05）,而特异性无差异（P〉0.05）。AnuA在其他自身抗体阴性的SLE患者中仍有较高的检出率。AnuA分别与抗dsDNA抗体、抗DNP抗体和抗Sm抗体联合检测时的敏感性均高于自身抗体单个检测时的敏感性（P〈0.05）。AnuA水平与SLEDAI显著相关（r=0.484,P〈0.01）。结论AnuA的测定是诊断SLE敏感性和特异性都很高的实验室指标之一,与其他抗体联合检测可提高对SLE诊断的敏感性。AnuA与SLE病情活动密切相关。     

检测血清抗核小体抗体水平在SLE诊断及转归中的研究

目的:研究血清抗核小体抗体(AnuA)水平监测在系统性红斑狼疮(SLE)诊断中的价值。方法:采用酶联免疫吸附法(ELISA)测定62例SLE,52例亚急性皮肤型红斑狼疮(SCLE),10例皮肌炎和30例健康人血清AnuA水平,采用SLE疾病活动指数0.05)。AnuA水平与SLEDAI有明显相关性(P=0.015,r=0.441),SLE患者治疗后血清AnuA水平与治疗前相比明显降低(P<0.05)。结论:AnuA水平高低对诊断SLE、监测病情活动和判断疗效有意义。     

抗核小体抗体与抗dsDNA抗体在系统性红斑狼疮及狼疮肾炎诊断中的意义

目的 探讨抗核小体抗体(AnuA)和抗dsDNA抗体在狼疮肾炎(LN)诊断中的价值.方法 对98例LN患者(LN组)和79例非LN的系统性红斑狼疮(SLE)患者(非LN组)采用酶联免疫吸附(ELISA)法检测AnuA和ds-DNA抗体,并进行比较.两组标本行抗Sm抗体、抗nRNP抗体、抗核糖体P蛋白和抗中性粒细胞胞浆抗体(ANCA)检测,并进行相关性分析.结果 LN组患者血清中AnuA和抗dsDNA抗体的阳性率分别为63.69％和67.86％,非LN组阳性率分别为44.21％和51.39％,LN组阳性率明显高于非LN组(P＜0.05).LN组与非LN组和ANCA比较,差异有统计学意义(P＜0.05),抗SM抗体抗nRNP抗体和抗核糖体P蛋白比较,差异无统计学意义(P＞0.05).结论 AnuA和抗dsDNA抗体可作为诊断SLE的指标,其与SLE患者发生LN密切相关.同时检测多种自身抗体有助于诊断SLE和LN.     

系统性红斑狼疮患者血浆D-二聚体水平测定及其临床意义

目的 了解系统性红斑狼疮(SLE)患者D-二聚体的水平及其临床价值.方法 用单克隆抗体乳胶凝集试验法测定62例SLE患者血浆D-二聚体水平,研究其与SLE的疾病活动、临床表现的关系及治疗前后的变化.结果 (1)SLE患者血浆D-二聚体水平较正常组显著增高(P＜0.001);治疗后血浆D-二聚体水平较治疗前明显降低(P＜0.05);(2)血浆D-二聚体水平与SLE DAI得分呈显著正相关(r=0.451,P＜0.01);(3)血浆D-二聚体水平在初发患者中明显高于复发者(P＜0.01),合并浆膜炎、白细胞降低及栓塞的患者分别显著高于无浆膜炎、白细胞正常及无栓塞的患者(均P＜0.01);(4)抗心磷脂抗体阳性、抗dsDNA抗体阳性患者的血浆D-二聚体水平高于抗心磷脂抗体阴性、抗dsDNA抗体阴性者(分别为P＜0.01,P＜0.05);(5)SLE患者血浆D-二聚体水平与血沉呈正相关(r=0.428,P＜0.001),与补体C3水平呈负相关(r=-0.275,P＜0.05).结论 SLE患者血浆D-二聚体检测有助于SLE疾病活动性和临床疗效的评估.     

SLE患者血清中抗核小体抗体浓度与脱氧核糖核酸酶Ⅰ活性的相关分析

目的:探讨系统性红斑狼疮(SLE)血清抗核小体抗体(AnuA)浓度与脱氧核糖核酸酶Ⅰ(DNaseⅠ)活性的关系。方法:采用DNA-甲基绿比色法和间接ELISA法检测76例SLE患者(活动期40例,缓解期36例)与50例健康对照组DNaseⅠ的活性和血清AnuA浓度,并分析二者之间关系。结果:SLE患者血清DNaseⅠ活性水平明显低于健康对照组(P<0.01),而疾病活动期与缓解期相比未见明显差别(P>0.05);与健康对照组相比,血清AnuA浓度升高明显(P<0.01),并且疾病活动期浓度高于缓解期(P<0.01);AnuA浓度和DNaseⅠ的活性成负相关关系(r=-0.43,P<0.01)。结论:SLE患者中DNaseⅠ的活性下降可能导致血清AnuA的浓度升高。     

抗核小体抗体检测对系统性红斑狼疮诊断的意义

目的 探讨抗核小体抗体(AnuA)的检测对系统性红斑狼疮(SLE)诊断的敏感性和特异性,并探讨AnuA与其他自身抗体和SLE活动性的关系.方法 选择SLE患者65例(SLE组)、疾病对照组(包括类风湿性关节炎、混合性结缔组织病、原发性干燥综合征、多发性肌炎、系统性硬化症患者)38例和正常对照组30例,采用免疫印迹法测定血清中的AnuA,同时检测并分析抗dsDNA抗体、抗Sm抗体和抗组蛋白抗体及其他实验室指标.结果 AnuA、抗dsDNA抗体、抗Sm抗体的阳性率在SLE组中分别为58.5%、52.3%、30.7%,均显著高于疾病对照组(5.3%、0、7.9%)和正常对照组(0、0、0)(均P＜0.05).AnuA对SLE患者诊断的敏感性为58.5%,与抗dsDNA抗体和抗组蛋白抗体差异无统计学意义(均P＞0.05),特异性为97.1%,与抗dsDNA抗体、抗Sm抗体差异无统计学意义(均P＞0.05),但与抗组蛋白抗体差异有统计学意义(P＜0.05).AnuA 与抗Sm抗体之间无关(P＞0.05),而与抗dsDNA抗体相关(P＜0.05).AnuA与抗dsDNA抗体、抗Sm抗体联合检测诊断SLE的敏感性达83.1%.SLE组中AnuA阳性者的Hb、C3、C4水平低于AnuA阴性者(P＜0.05).结论 AnuA对SLE诊断敏感性高、特异性强,是对SLE诊断有价值的实验室指标之一,并与SLE疾病活动性有关,与抗dsDNA抗体、抗Sm抗体联合检测可提高诊断敏感性.     

血清和唾液抗核小体抗体在系统性红斑狼疮中的诊断意义

目的:检测血清和唾液抗核小体抗体(AnuA)对系统性红斑狼疮(SLE)诊断的敏感性和特异性,探讨二者关系及其与SLE活动性和SLE机体损伤机制的关系。方法:用双抗体夹心ELISA法定量检测72例SLE组、30例疾病对照组和24例正常组血清AnuA水平,并检测42例SLE患者和20例正常人唾液AnuA水平,记录SLE患者的各种临床表现及实验室指标,并分析它们之间的关系。结果:血清AnuA在SLE检测中的敏感性和特异性分别为56.94%和98.15%。血清AnuA和抗双链DNA抗体水平呈正相关(r=0.55,P<0.01),且与系统性红斑狼疮疾病活动性指数(SLEDAI)记分正相关(r=0.629,P<0.001)。唾液AnuA水平与血清AnuA水平正相关(r=0.380,P<0.01)。结论:血清AnuA对SLE诊断的敏感性高、特异性强,可作为判断疾病活动性的指标;唾液AnuA水平与血清AnuA水平正相关,对SLE的诊断和疾病活动性的判断有一定意义。     

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…     

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.     

Analysis of CK-19,PDX-1,Nestin,Ngn3 in different donor islet purity in rats

Objective: To investigate if there are the CK-19, PDX-1, Nestin, Ngn3 positive cells in the donor islets of different purity in rats. Methods: Thirty male adult SD rats were randomly divided into 3 groups. Islets were isolated using digestion by ductal injection of collagenase. Group Ⅰ (n=10): Separating cell preparations were not purified, Group Ⅱ(n=10): Islet sediment was purified with 25% Ficoll400 ,Group Ⅲ (n=10): Islet sediment was purified with 25% and 11% Ficoll-400. The levels of protein of CK-19, PDX-1, Nestin and Ngn3 were detected by immunohistochemistry and the mRNA of CK-19, PDX-1, Nestin, Ngn3 was amplified by RT-PCR. Results: After two different purification methods applied, three islet preparations of different purities were obtained. The difference of islet purity was significant among various groups (P＜0.05). Compared with group Ⅱ and group Ⅲ,the protein and mRNA of CK-19, PDX-1, Nestin,Ngn3 were both higher in group Ⅰ; group Ⅲ was poorly expressed. Conclusions: The three different islet purity donor islet have different CK-19, PDX-1, Nestin, Ngn3 positive cells within them, indicating that there are some islet stem cells in the purified donor islet.     

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.