多发伤合并多器官功能障碍综合征患者血浆TNF-α和IL-10水平测定的临床意义

目的探讨肿瘤坏死因子-α(TNF-α)、白介素-10(IL-10)在多发伤合并多器官功能障碍综合征(MODS)患者中的变化特点以及其意义.方法将56例多发伤患者按照是否合并MODS分为两组,在受伤后第1、3、5、7天抽取静脉血,应用双抗体夹心ELISA法检测TNF-α、IL-10水平,比较两组间和组内各时间点TNF-α、IL-10的水平,并以14例健康体检者的测定结果作为对照.结果合并MODS组伤后第1、3、5、7天的TNF-α水平和IL-10水平与对照组比较,差别都有显著性意义(均P＜0.05);未合并MODS组伤后第1、3、5、7天的TNF-α水平与对照组比较,差别都有显著性意义(均P＜0.05),IL-10水平在伤后第1天明显提高(P＜0.05),但是第3、5、7天的IL-10水平与对照组比较,差别无显著性意义(P＞0.05).两组多发伤患者的TNF-α水平和合并MODS组的IL-10水平在伤后第3、5、7天较第1天明显升高(均P＜0.05),而未合并MODS组IL-10水平在第3、5、7天的水平较第1天明显下降(均P＜0.05),但是两组多发伤患者各自第7天的TNF-α水平与第5天比较,差别无显著性意义(均P＞0.05).多发伤合并MODS组TNF-α、IL-10水平与未合并MODS组比较在伤后第1、3、5、7天都有明显的升高(均P＜0.05).结论血浆TNF-α和IL-10水平的检测对判断多发伤患者的疾病严重程度、病情发展趋势和MODS的发生都有重要的意义,而IL-10可以用于评价全身炎症反应综合征的严重程度.     

罗定市10岁以下儿童肺炎支原体感染的调查分析

目的:了解罗定市10岁以下儿童肺炎支原体(MP)感染情况。方法:对2001年7月～2004年6月在该院就诊的呼吸道感染患儿采用低效价颗粒凝集测抗体实验测定血清中MpIgM滴度。结果:1127例患儿中检出阳性病例235例,阳性检出率20.85%,其中0岁～组MP阳性率为7.37%,1岁～组为21.24%,6～10岁组为35.69%;冬春季(12～2月)为MP感染的高峰期。结论:MP是引起10岁以下儿童(特别是学龄儿童)感染的主要病原体之一,早期诊断十分重要。     

抚顺大气悬浮颗粒物、PAHs和NPAHs污染调查

目的　了解抚顺大气悬浮颗粒污染物,特别是可吸入性颗粒物(PM10 )、细颗粒物(PM2 5)和超细颗粒物(PM1 0 )、多环芳烃(PAHs)和硝基多环芳烃(NPAHs)的浓度、分布及季节变化情况。方法　选择抚顺市内距同一污染源下风侧不同距离的3所小学为监测点,于2 0 0 2年7月～2 0 0 3年4月每季监测2周,每次4 8h连续采样,重量法测定大气悬浮颗粒物浓度、粒径分布和季节变化情况;用高压液相色谱/荧光检测仪、化学发光检测仪检测PAHs、NPAHs的种类与含量。结果　3监测点的大气悬浮颗粒物污染情况相近;TSP在冬、春两季超过国家环境空气质量二级标准1. 2 8～1 .5 4倍;PM10 全年各季节、每次采样测量均超标1. 0 7～2 . 2 2倍;PM2 . 5超美国EPA细颗粒物空气质量标准3. 84～7 76倍,甚至每次采样测量值几乎都超美国标准的每日最高允许值。冬季大气悬浮颗粒物污染加重。在大气悬浮颗粒物中检出9种PAHs、12种NPAHs ,冬季浓度高于夏季,以苯并(b)荧蒽(BbF)、艹屈(Chr)和荧蒽(Flu)等4苯环的PAHs浓度较高;NPAHs在12月采暖期以2 -硝基荧蒽(2NF)为高,7月非采暖期以2 -硝基芘(2NP)为高,是其它NPAHs的几十到几千倍。PAHs、NPAHs在<2 . 1μm粒径颗粒物中的重量百分比为6 7. 2 3% ,79 .73%。结论　抚顺大气悬浮颗粒物、多环芳烃和硝基多环     

肺炎支原体性肺炎患儿血清中IL-6、IL-10水平测定及意义

目的:探讨支原体性肺炎患儿血清中细胞因子的变化及意义。方法:应用酶联免疫吸附试验(ELISA)双抗体夹心法检测60例支原体性肺炎患儿急期和恢复期血清中白细胞介素6(IL-6)、白细胞介素10(IL-10)的含量,同时对57例同期健康儿童血清中IL-6、IL-10进行检测。结果:①支原体性肺炎患儿急性感染时血清中IL-6明显高于健康儿童,差异显著(P<0.01),而恢复期时血清中含量和健康儿童差异无显著性(P>0.05)。②支原体性肺炎患儿急性感染期和恢复期血清中IL-10均高于健康儿童,差异显著(P<0.01),且恢复期时血清中含量高于急性感染期。结论:细胞因子IL-6、IL-10在支原体性肺炎患儿感染中起着重要的作用,参与了其发病过程。     

芪贞汤对人大肠癌纤维粘连蛋白黏附能力的影响

[目的]探讨扶正解毒活血法中药芪贞汤对人大肠癌高转移细胞株L-10细胞纤维粘连蛋白黏附能力的影响。[方法]通过体外细胞培养法,观察该方对L-10细胞纤粘连蛋白黏附能力的阻碍作用。[结果]芪贞汤对L-10细胞纤维粘连蛋白黏附能力明显抑制,并且显示了芪贞汤高浓度优于低浓度,有明显的浓度依存性;随着时间的推移,其抑制作用在变化,当作用120min时,阻碍作用达到高峰,随后其阻碍作用逐渐减低。[结论]扶正解毒活血法中药芪贞汤对人大肠癌高转移细胞株L-10细胞具有明显的抗纤维粘连蛋白黏附能力的作用,从而提示芪贞汤有可能通过抑制纤维粘连蛋白黏附能力,实现抑制癌的浸润和转移的作用。     

双向电泳分析快速老化痴呆鼠脑蛋白质的异常表达及针刺的影响

目的:从整体上观察快速老化及伴随的痴呆对脑蛋白质组的影响以及针刺对其的调节作用。方法:以8月龄快速老化痴呆鼠SAMP10和同源正常老化鼠SAMR1为材料,分为P10针刺组、P10非穴组、P10对照组和R1对照组。针刺组施以“益气调血,扶本培元”针法,针刺“膻中”“中脘”“气海”“血海”“足三里”;非穴组针刺双胁下非穴固定点。双向电泳展示各组小鼠大脑蛋白图谱。结果:双向电泳显示,伴随着快速老化和痴呆,3个蛋白发生了质的变化,其中一个蛋白为P10所特有,两个为R1所特有;9个蛋白发生了量的变化,其中7个蛋白伴快速老化和痴呆高表达,2个低表达。针刺穴位具有良性调节作用,可明显改善上述某些蛋白的表达异常,减缓衰老;而非穴无特异性。结论:伴快速老化,SAMP10痴呆鼠大脑某些蛋白的表达发生了异常,针刺可改善其中某些蛋白的异常,并具有穴位特异性。     

洋参王浆咀嚼片的质量标准研究

目的制定洋参王浆咀嚼片质量标准。方法 采用TLC法对处方中的西洋参、蜂王浆两种组分进行定性鉴别；采用HPLC法对处方中西洋参的人参皂苷Re、Rg1和Rb1进行了含量测定。结果本方法线性关系良好，平均回收率为101．52％，RSD为0.51％。结论本法定性、定量检测准确、可靠，能有效控制洋参王浆咀嚼片的质量。     

Preoperative diagnosis of lymph node metastases in gastric cancer by magnetic resonance imaging with ferumoxtran-10

Background Knowledge regarding the presence and location of lymph node metastasis in gastric cancer is essential in deciding on the operative approach. Lymph node metastases have been diagnosed with imaging tests such as computed tomography (CT) and ultrasonography (US); however, the accuracy of such diagnoses, based on size and shape criteria, has not been adequate. Ferumoxtran-10 (Combidex; Advanced Magnetics) is a lymphotropic contrast agent for magnetic resonance imaging (MRI) whose efficacy for the detection of metastatic lymph nodes in various cancers has been reported by several investigators; however, its efficacy for this purpose has not been reported for gastric cancer. We investigated the efficacy of ferumoxtran-10-enhanced MRI for the diagnosis of metastases to lymph nodes in gastric cancer. Methods Seventeen consecutive patients who were diagnosed with a nonearly stage of gastric cancer were enrolled in the study. All the patients were examined by MRI (Signa Horizon 1.5 T; GE Medical; T2*-weighted images) before and 24 h after the intravenous administration of ultrasmall particles of superparamagnetic iron oxide — ferumoxtran-10 (2.6 mg Fe/kg of body weight) — and the presence or absence of metastasis was determined from the enhancement patterns. The imaging results were compared with the corresponding histopathological findings following surgery. Results Of 781 lymph nodes dissected during surgery, the imaging results of 194 nodes could be correlated with their histopathological findings. Fifty-nine lymph nodes from 11 patients had histopathological metastases. In nonaffected normal lymph nodes, we observed dark signal intensity on MRI caused by the diffuse uptake of the contrast medium by macrophages resident in the lymph nodes, which phagocytose the iron oxide particles of ferumoxtran-10. The number of phagocytic macrophages was decreased in metastatic lymph nodes, and they showed various patterns of decreased uptake of ferumoxtran-10. Three enhancement patterns were observed in lymph nodes: (A) lymph nodes with overall dark signal intensity due to the diffuse uptake of ferumoxtran-10; (B) lymph nodes with partial high signal intensity due to partial uptake; and (C) no blackening of lymph nodes due to no uptake of ferumoxtran-10. Patterns (B) and (C) were defined as metastatic. The sensitivity, specificity, positive predictive value, negative predictive value, and overall predictive accuracy of postcontrast MRI were 100% (59/59), 92.6% (125/135), 85.5% (59/69), 100% (125/125), and 94.8% (184/194), respectively. These parameters for predictive accuracy were much superior to these parameters previously evaluated by CT or US. Nodes in the retroperitoneal and paraaortic regions were more readily identified and diagnosed on the MR images than those in the perigastric region. Conclusion The present study confirmed that ferumoxtran-10-enhanced MRI is useful in the diagnosis of metastatic lymph nodes and that the use of this modality will be helpful in treatment decision-making for gastric cancer patients.     

Serum levels of coenzyme Q10 in patients with amyotrophic lateral sclerosis

Summary. To elucidate whether serum coenzyme Q₁₀ levels are related with the risk for amyotrophic lateral sclerosis (ALS), we compared serum levels of coenzyme Q₁₀ and the coenzyme Q₁₀/cholesterol ratio, in 30 patients with ALS and 42 matched controls using a high performance liquid chromatography technique. The mean serum coenzyme Q₁₀ levels and the coenzyme Q₁₀/cholesterol ratio did not differ significantly between the 2 study groups. These values were not influenced by the clinical form (spinal vs. bulbar) of ALS, and they did not correlate with age, age at onset, and duration of the disease. These results suggest that serum coenzyme Q₁₀ concentrations are unrelated with the risk for ALS. Received September 1, 1999; accepted January 4, 2000     

肝硬化病人血清IL-10、IL-18水平变化的临床意义

目的探讨血清白细胞介素10（IL-10）、血清白细胞介素18（IL-18）在肝炎后肝硬化发病机制中的作用。方法采用ELISA法检测103例肝炎肝硬化病人和20例健康献血员血清IL-10、IL-18的水平，观察肝功能child-pugh分级、腹水、血清白蛋白和血清总胆红素水平与血清IL-10、IL-18水平之间的关系。结果肝功能child-pughA、B、C级组血清IL-18水平均明显高于对照组（P〈0．01），肝功能child-pughA级组血清IL-10水平略高于对照组，但无显著性差异（P〉0．05）；肝功能child-pughB、C级组明显低于对照组（P〈0．05）；有腹水组、无腹水组血清IL-18水平均明显高于对照组（P均〈0．01），有腹水组血清IL-10水平明显低于无腹水组、对照组（P〈0．05，P〈0．01）；血清IL-10水平与血清IL-18水平呈负相关（r=-0．51，P〈0．01）；血清白蛋白水平与血清IL10水平呈正相关（r=0．566，P〈0．01），与血清IL-18水平呈负相关（r=-0．315，P〈0．01）；血清总胆红素水平与血清IL-18水平呈正相关（r=0．677，P〈0．01），与血清几-10水平呈负相关（r=-0．339，P〈0．01）。结论IL-10、IL-18在肝炎肝硬化的发病机制中起一定的作用，其水平与肝损害程度密切相关。