洛沙平与利培酮治疗精神分裂症的临床对照研究

目的研究洛沙平与利培酮治疗精神分裂症的临床疗效与安全性.方法80例精神分裂症患者随机分成两组,分别给予洛沙平与利培酮8周,应用PANSS量表和TESS量表分别评价临床疗效和不良反应.结果两组之间疗效无显著性差异,洛沙平起效快,其常见不良反应为锥体外系反应(EPS).结论洛沙平是一种安全、有效、起效快的抗精神病药物.     

用一种独特形态的红细胞鉴别血尿

目的　为了提高血尿鉴别诊断的准确性和特异性 ,寻找一种有具体意义的特异性形态的红细胞作为判断标准。方法　对 2 41例各类型肾小球疾病患者和 88例非肾小球性疾病患者的血尿标本 ,用位相差显微镜观察并确定具有明显的芽胞状的红细胞 (G1)。结果　用G1≥ 5 %的标准对诊断肾小球性血尿的特异性为 10 0 % ,敏感性为 82 2 % ;若在酸性浓缩尿中 ,其敏感性为 90 6 % ,特异性为 10 0 %。在非肾小球性血尿中G1<5 %。结论　该细胞形态特殊易于辩认。通过计数酸性浓缩尿中G1百分率 ,能正确诊断肾小球性血尿和非肾小球性血尿。     

透出液蛋白丢失与连续性非卧床腹膜透析患者营养不良-炎性反应-动脉硬化综合征的相关性

Objective To investigate the impact of peritoneal albumin leakage on malnutrition-inflammation-atherosclerosis (MIA) syndrome in continuous ambulatory peritoneal dialysis (CAPD) patients. Methods A cross-sectional study of a cohort of 130 CAPD patients without edema or active infection was performed. In order to identify peritoneal transport characteristics in CAPD patients, a standard peritoneal equilibration test (PET) was carried out. For malnutrition and inflammation, serum albumin and high-sensitivity C-reactive protein (hs-CRP) levels were measured. Mean-carotid artery intima media thickness (IMT) was used to determine atherosclerosis. Residual glomerular filtration rate (rGFR) was defined as the average of 24-hour urinary urea and creatinine clearances. Results Pearson and Spearman correlation analysis showed that peritoneal albumin leakage amount was positively correlated with age, body mass index, night dwell time, blood glucose, 4 h D/P creatinine levels and hs-CRP levels (r=0.204, P<0.05 ;r=0.314, P<0.01; r=0.265, P<0.01; r=0.212, P<0.05; r=0.401, P<0.01; r=0.216, P<0.05); whereas it was negatively correlated with diastolic perssure, serum albumin levels, glucose level of dialyzate and peritoneal Kt/V (r=-0.209, P<0.05; r=-0.123, P<0.05; r=-0.271, P<0.01; r=-0.212, P<0.01). Overall, there was no correlation between peritoneal albumin leakage and IMT. Patients was significantly greater (P<0.01), and there was a positive correlation between peritoneal albumin leakage amount and IMT (r=0.650, P<0.01). Conclusions Peritoneal albumin leakage is significantly associated with peritoneal transport characteristics, malnutrition and inflammatory state in CAPD patients. High peritoneal albumin leakage amount is a risk factor for atherosclerosis in patients with rGFR less than 1 ml·min-1(1.73 m2)-1.     

系统性红斑狼疮患者的Th2偏移不受CD40/CD154影响

目的 探讨系统性红斑狼疮(SEE)患者外周血Th极化状况的改变以及其受CD40/CD154和地塞米松(Dex)的影响.方法 使用ELISA法检测SEE患者和对照组血浆IFN-γ和IL-10水平,分离、培养外周血单个核细胞(PBMC),应用CD40 mAb和Dex进行干预,使用ELISA法检测培养液上清IFN-γ和IL-10水平.结果 SLE患者血浆IFN-γ水平明显低于对照组(P<0.01,P<0.05),活动期组血浆IL-10水平明显高于缓解期组和对照组(均P<0.01);CD40 mAb对PBMC培养液上清IFN-γ和IL-10水平无影响(均P>0.05);Dex可使SLE患者PBMC培养液上清IFN-γ水平升高(P<0.05,P<0.01),Dex可以明显降低SEE患者和对照组PBMC培养液上清IL-10水平(均P<0.05).结论 SEE患者血浆IFN-γ水平降低、IL-10水平增高,存在Th2偏移;此种改变不受CD40/CD154影响但能被Dex抑制.     

CD40在系统性红斑狼疮外周血淋巴细胞的表达

使用密度离心法分离SLE患者和正常人外周血单个核细胞 (PBMC ) ,采用流式细胞术检测B淋巴细胞白细胞分化抗原 4 0 (CD4 0 )的表达水平 ,进行SLE患者 (活动期和缓解期 )和正常人之间的比较 ;并进行B淋巴细胞CD4 0表达水平和血清抗dsDNA抗体水平及狼疮活动指数 (SLEDAI)的相关分析。结果表明 ,活动期SLE患者外周血B淋巴细胞比例 (% )和其表达CD4 0的比例 (% )均明显高于缓解期SLE患者和对照组 ,其表达CD4 0的平均荧光强度 (MFI)在活动期SLE患者最高 ,缓解期SLE患者稍低 ,对照组最低 ;相关分析结果表明 ,活动期SLE患者B淋巴细胞CD4 0的表达比例 (% )和强度 (MFI)均与血清抗dsDNA抗体及SLEDAI呈正相关 ,后两者呈高度相关 ;缓解期SLE患者B淋巴细胞表达CD4 0的强度 (MFI)和SLEDAI呈正相关。CD4 0在活动期SLE患者B淋巴细胞的表达增加 ,其水平与疾病活动度有关。     

15d-PGJ2对肾小管上皮细胞CD40及RANTES表达的影响

目的：观察过氧化物酶体增殖物激活受体γ（PPARγ）激动剂15d-PGJ2对干扰素-γ（IFN-γ）和肿瘤坏死因子α（TNF-α）诱导的人近端肾小管上皮细胞（HK-2）CD40和RANTES表达的影响。方法：体外培养人近端肾小管上皮细胞株，分组如下：（1）正常对照组；（2）IFN-γ（50μg／ml）组；（3）TNF-α（10ng／ml）组；（4）IFN-γ（50μg/ml）＋TNF—α（10ng／ml）组；（5）IFN-γ（50μg／ml）＋TNF-α（10ng／ml）分别加1、3、5μmol／L15d-PGJ2组；（6）IFN-γ＋TNF-α．刺激＋15d-PGJ2（5μmol／L）＋GW9662（PPARγ特异拮抗剂）1μmol／L组。GW9662和15d-PGJ2分别在IFN-γ和TNF-α刺激前3和2小时加入。分别采用RT-PCR、流式细胞仪（FACS）和酶联免疫法（ELISA）检测CD40和RANTES基因和蛋白的表达水平。结果：正常HK-2细胞中，CD40、RANTES有基础水平表达。IFN-γ能显著上调HK-2细胞CD40蛋白的表达；TNF-α单独刺激对CD40表达无显著影响，但能增强IFN-γ的刺激效应。IFN-γ＋TNF-α显著增加HK-2细胞RANTES的表达和分泌。15d—PGJ2呈剂量依赖式在基因和蛋白水平显著抑制IFN-γ＋TNF-α．诱导的CIMO和RANTES的表达。加入PPARγ特异拈抗剂GW9662后，能够部分逆转15d-PGJ，对CIMO和RANTES表达的抑制效应，但并不能完全阻断其作用。结论：15d-PGJ2部分通过PPARγ介导的信号途径参与抑制IFN-γ＋TNF-α．诱导的人近端肾小管上皮细胞CD40和RANTES的表达，从而在肾脏局部发挥免疫调节和抗炎作用。     

透出液蛋白丢失与连续性非卧床腹膜透析患者营养不良-炎性反应-动脉硬化综合征的相关性

Objective To investigate the impact of peritoneal albumin leakage on malnutrition-inflammation-atherosclerosis (MIA) syndrome in continuous ambulatory peritoneal dialysis (CAPD) patients. Methods A cross-sectional study of a cohort of 130 CAPD patients without edema or active infection was performed. In order to identify peritoneal transport characteristics in CAPD patients, a standard peritoneal equilibration test (PET) was carried out. For malnutrition and inflammation, serum albumin and high-sensitivity C-reactive protein (hs-CRP) levels were measured. Mean-carotid artery intima media thickness (IMT) was used to determine atherosclerosis. Residual glomerular filtration rate (rGFR) was defined as the average of 24-hour urinary urea and creatinine clearances. Results Pearson and Spearman correlation analysis showed that peritoneal albumin leakage amount was positively correlated with age, body mass index, night dwell time, blood glucose, 4 h D/P creatinine levels and hs-CRP levels (r=0.204, P<0.05 ;r=0.314, P<0.01; r=0.265, P<0.01; r=0.212, P<0.05; r=0.401, P<0.01; r=0.216, P<0.05); whereas it was negatively correlated with diastolic perssure, serum albumin levels, glucose level of dialyzate and peritoneal Kt/V (r=-0.209, P<0.05; r=-0.123, P<0.05; r=-0.271, P<0.01; r=-0.212, P<0.01). Overall, there was no correlation between peritoneal albumin leakage and IMT. Patients was significantly greater (P<0.01), and there was a positive correlation between peritoneal albumin leakage amount and IMT (r=0.650, P<0.01). Conclusions Peritoneal albumin leakage is significantly associated with peritoneal transport characteristics, malnutrition and inflammatory state in CAPD patients. High peritoneal albumin leakage amount is a risk factor for atherosclerosis in patients with rGFR less than 1 ml·min-1(1.73 m2)-1.     

上调Smad7表达对腹膜纤维化大鼠腹膜间皮细胞转分化的影响

目的探讨上调TGF-β抑制性信号蛋白Smad7表达对大鼠腹膜纤维化模型腹膜间皮细胞转分化的影响。方法30只160～170 g SD雄性大鼠.随机分为4组：正常对照组（n=6）;腹膜纤维化模型组（n=12）：予腹腔注射4.25%腹膜透析液与脂多糖;空载体组（n=6）：模型成功后转染pTRE与pEFpurop-Tet-on质粒;Smad7治疗组（n=6）：模型成功后转染pTRE- m2 Smad7与pEFpurop-Tet-on质粒。第14、28天杀检大鼠,取脏层腹膜组织,用RT-PCR方法检测TGF-B1、α-SMA、E-钙黏蛋白（E-cadherin）基因的表达;用Western杂交或间接免疫荧光的方法检测TGF-β1、Smad7、磷酸化（p）-Smad2/3、α-SMA、E-cadherin的表达。结果与正常对照组比较,模型组TGF-β1、p-Smad2/3及α-SMA的表达显著上调（p〈0.01）;E-cadherin的表达显著下调（P〈0.01）。与模型组、空载体组比较,Smad7治疗组p-Smad2/3及α-SMA表达水平显著下调（P〈0.01）;E-cadherin的表达显著上调,但仍低于正常对照组（P〈0.05）。结论Smad7可通过抑制受体调控信号蛋白Smad2/3的活化,阻止高糖透析液及脂多糖介导的腹膜间皮细胞转分化,从而防止腹膜纤维化的发生和发展。     

透出液蛋白丢失与连续性非卧床腹膜透析患者营养不良-炎性反应-动脉硬化综合征的相关性

Objective To investigate the impact of peritoneal albumin leakage on malnutrition-inflammation-atherosclerosis (MIA) syndrome in continuous ambulatory peritoneal dialysis (CAPD) patients. Methods A cross-sectional study of a cohort of 130 CAPD patients without edema or active infection was performed. In order to identify peritoneal transport characteristics in CAPD patients, a standard peritoneal equilibration test (PET) was carried out. For malnutrition and inflammation, serum albumin and high-sensitivity C-reactive protein (hs-CRP) levels were measured. Mean-carotid artery intima media thickness (IMT) was used to determine atherosclerosis. Residual glomerular filtration rate (rGFR) was defined as the average of 24-hour urinary urea and creatinine clearances. Results Pearson and Spearman correlation analysis showed that peritoneal albumin leakage amount was positively correlated with age, body mass index, night dwell time, blood glucose, 4 h D/P creatinine levels and hs-CRP levels (r=0.204, P<0.05 ;r=0.314, P<0.01; r=0.265, P<0.01; r=0.212, P<0.05; r=0.401, P<0.01; r=0.216, P<0.05); whereas it was negatively correlated with diastolic perssure, serum albumin levels, glucose level of dialyzate and peritoneal Kt/V (r=-0.209, P<0.05; r=-0.123, P<0.05; r=-0.271, P<0.01; r=-0.212, P<0.01). Overall, there was no correlation between peritoneal albumin leakage and IMT. Patients was significantly greater (P<0.01), and there was a positive correlation between peritoneal albumin leakage amount and IMT (r=0.650, P<0.01). Conclusions Peritoneal albumin leakage is significantly associated with peritoneal transport characteristics, malnutrition and inflammatory state in CAPD patients. High peritoneal albumin leakage amount is a risk factor for atherosclerosis in patients with rGFR less than 1 ml·min-1(1.73 m2)-1.     

凝血酶活性亢进加重狼疮肾炎患者Th1/Th2平衡紊乱

Th1/Th2平衡失调在狼疮肾炎 (lupusnephritis ,LN)的发病上具有重要作用 ,但Th1/Th2平衡的偏离方向尚无定论 ,各家报道不一[1 3 ] 。LN患者存在内皮细胞损伤、凝血活性亢进已众所周知[4] ,但凝血活性与Th1/Th2平衡之间存在何种关系 ?虽然Th1/Th2平衡失调引起的免疫炎症可损伤内皮细胞 ,引起凝血活性增强[4,5] 。但是 ,LN患者增强的凝血活性对Th1/Th2平衡状态又将产生何种影响 ?本文通过观察LN患者凝血状态、Th1/Th2平衡状态以及体外凝血酶刺激后外周血单个核细胞 (PBMC)表达白细胞介素(IL) 10和干扰素 (IFN) γ的变化 ,验证L…