癌胚抗原、糖类抗原199及甲胎蛋白联合检测对结直肠恶性肿瘤的诊断价值分析

目的探讨癌胚抗原(CEA)、糖类抗原199(CA199)及甲胎蛋白(AFP)联合检测对结直肠恶性肿瘤的诊断价值。方法选取该院2017年6月-2018年5月收治的127例结直肠病变患者作为研究对象,根据内镜及病理结果分为结直肠恶性肿瘤组(n=78)及结直肠良性病变组(n=49),选取同期于该院体检的50例健康者作为对照组。所有入选者均行血清CEA、CA199及AFP检测,对比3组CEA、CA199及AFP水平;对比不同分期结直肠恶性肿瘤组患者CEA、CA199及AFP水平;对比3项指标单独检测及联合检测的灵敏度及特异度。结果结直肠恶性肿瘤组患者CEA、CA199及AFP水平均较结直肠良性病变组及对照组高,差异有统计学意义(P0.05);结直肠良性病变组患者CEA、CA199及AFP水平均较对照组高,差异有统计学意义(P0.05);I、II期组患者的血清CEA及CA199水平较II、IV期组低,差异有统计学意义(P0.05);CEA、CA199及AFP联合检测准确度、灵敏度及特异度均较3项指标单独检测高,差异有统计学意义(P0.05)。结论结直肠恶性肿瘤患者采用CEA、CA199及AFP联合检测诊断价值较高,可有效提升诊断准确率、灵敏度及特异度。     

卵巢子宫内膜异位囊肿粘连程度及相关因素分析

Objective To investigate the relationship between degree of endometrioma adhesions and clinical feature, surgical treatment and postoperative recurrence. Methods From Jan 2003 to Mar 2008, 662 patients with endometrioma undergoing laparoscopic ovarian endometrioma excision in Peking Union Medical College Hospital were studied retrospectively. All patients were classified into four groups according to the extent of adhesions: 31 cases in none adhesions group, 123 cases in mild adhesions group (filmy thickness, avascular, easily separated adhesions), 310 cases in moderate adhesions group (less than a half of ovary was adjacent to dense thickness adhesions which was difficult to separate, or above a half of ovary were adjacent to filmy thickness adhesions) and 198 cases in severe adhesions group (above a half of ovary was adjacent to dense thickness, well vascularized adhesions which was difficult to separate, and always involved the other pelvic organs, observed angiogenesis). The comparison of degree, characteristics, period of pain, lab test, surgical management and postoperative recurrence was performed among those above groups. In the mean time, risk factors and multinomial logistic regression were analyzed. Results (1)Clinical characteristics: The incidence of patients with dysmenorrhea, dyspareunia, straining feeling in anus, chronic pelvic pain and the level of CA125 (>35 kU/L) was remarkably higher in moderate-to-severe adhesion groups than in none-to-mild adhesions groups (P=0.000, 0.000, 0.001, 0.006 and 0.000, respectively). Infertility rate were significantly higher in severe adhesions group(15.7%,31/198) than none adhesions group(3.2%,1/31), mild adhesions group(11.4%,14/123) and moderate adhesions group(9.7%,30/310, OR=1.728, P<0.05).(2)Operating time and blood loss: Operating time of each groups was as followed: (37±15) min in none adhesions group, (42±19) min in mild adhesions group, (50±20) min in moderate adhesions group and (63±22) min in severe adhesion group. Blood loss was (23±12) ml in none adhesion group, (31±27) ml in mild adhesion group, (40±32) ml in moderate adhesion group and (70±67) ml in severe adhesions group. Thicker adhesions result in longer operation time and more blood loss. (3)Combined with other disease: The ratio of patients who combined with adenomyosis or deeply infiltrating endometriosis in moderate-to-severer adhesion groups was higher than patients in none-to-mild adhesions groups (OR=3.466, P=0.000). (4) Postoperative recurrence: It was categorized into recurrence of pain and cyst. Moderate-to-severe adhesions was related to higher recurrence rate of pain (OR=1.685,P=0.046), but was irrelevant to recurrence of cyst. Conclusion The more extent of endometrioma adhesions was related to severer pelvic pain symptoms, longer operating time and more blood loss. Postoperative pain recurrence rate was observed in moderate-to-severe adhesion group. Extent of adhesions was irrelevant to cyst recurrence.     

人OX40-Fc分子的构建、真核表达及活性研究

目的构建人OX40-Fc基因的真核表达质粒，并表达有生物学活性的纯化人OX40-Fc融合蛋白。方法从活化的人T细胞cDNA文库中以PCR方法扩增OX40膜外区cDNA编码基因，并导入真核表达载体pcDNA3中。测序证实后，进行酶切并与人IgG1Fc基因一起装入真核表达载体pcDNA3中，采用脂质体法稳定转染COS-7细胞，用夹心ELISA检测其表达情况，经蛋白A亲和纯化，用SDS-PAGE与Western blotting进行鉴定。检测其对活化后Jurkat细胞增殖的抑制活性。结果测序证实构建的OX40膜外区与OX40-Fc cDNA阅读框完整，连接部位序列正确；ELISA证实OX40-Fc蛋白的表达；SDS-PAGE与Western blotting证实其为OX40-Fc蛋白。增殖实验证明其对活化后的Jurkat细胞有抑制增殖作用。结论成功构建了人OX40-Fc真核表达载体，并使有生物学活性的OX40-Fc融合蛋白在COS-7细胞上获得了稳定表达。为进一步研究该蛋白在自身免疫性疾病治疗中的作用及调节免疫自稳机制中的地位奠定了基础。     

耳穴特异性与生物分子活性的关系

目的　研究耳穴特异性与机体生物分子活性之间的关系。方法　通过 18例SLE患者和 17位健康者的同体双盲试验及统计和相关分析 ,并结合抗体基因结构与功能的研究。结果　证实耳穴电特性具有反应SLE病理变化的特异性 ;7项抗体指标 (含DNA、补体、类风湿因子、免疫球蛋白等 )与耳穴电特性存在不同程度的相关性。结论　耳穴特异性与机体生物分子活性存在密切的联系 ;耳穴反应病变的特异性可能源于机体内生物分子的活性 ,其中包括基因突变、基因表达及其调控。     

鞘内注射治疗狼疮中枢损害8例临床观察

系统性红斑狼疮 (ＳＬＥ)合并中枢神经系统损害比率高达14%～ 83% [1] ,其死亡率仅次于肾脏病变和继发感染[2 ] 。狼疮脑病 (ＣＮＳ ＳＬＥ)可以表现为癫痫、精神异常、狼疮性头痛、器质性脑病综合征、横断性脊髓炎等[3 ,4 ] 。目前除甲基强的松龙和环磷酰胺冲击治疗外 ,尚无其他确切有效的方法[5] 。本文报道 8例ＣＮＳ ＳＬＥ用甲氨蝶呤 (ＭＴＸ)和地塞米松 (ＤＸＭ)鞘内注射治疗情况 ,以探讨在全身用药的基础上鞘内治疗的作用。1　资料和方法一般资料 :8例患者为 1997～ 1999年 3月在本院住院及门诊的病例 ,符合美国风湿病学会 1982年修…     

脑通胶囊的质量控制

脑通胶囊由丹参、川芎、延胡索、石菖蒲、桂枝、三七等组成 ,用于冠心病、脑梗塞及后遗症。笔者经研究制定如下质量标准 ,对其质量进行严格控制。1　仪器与试药点样仪 (NanomateⅡ ,瑞士CAMAG公司 ) ,计算机 ,定量毛细管 (瑞士CAMAG公司 )。丹参酮IIA对照品 ,川芎对照药材 ,延胡索乙素对照品 ,石菖蒲对照药材 ,桂皮醛对照品 (中国药品生物制品检定所 ) ,硅胶G(青岛海洋化工厂 ) ,双槽层析缸 (上海信谊仪器厂 )。所用试剂均为分析纯。2　方法与结果2 1　丹参的鉴别取本品 8粒内容物 (4g) ,加乙醚 15ml,置具塞三角瓶中 ,振摇 ,放置 1h…     

HPLC法测定心脑舒胶囊中人参皂苷Rg1的含量

目的:建立高效液相色谱法测定心脑舒胶囊中人参皂苷Rg1含量的方法.方法:采用ODS C18色谱柱,乙腈-0.02%磷酸(20.6:79.4)为流动相,流速为1ml/min,柱温:40℃;检测波长203nm.结果:本法可测定心脑舒胶囊中人参皂苷Rg1含量,回收率为97.55%,RSD为1.79%.结论:该方法简便、准确,可作为心脑舒胶囊中人参皂苷Rg1的含量测定方法.     

小儿CD_7抗原阳性急性髓系白血病55例临床研究

目的 　研究小儿CD7抗原阳性急性髓系白血病 (CD7+AML)的临床生物学特征及治疗效果。方法 　对 55例初治小儿AML进行细胞形态学、免疫表型、多药耐药P糖蛋白 (P1 70 )检测 ,临床观察 ,并常规采用HAE方案诱导治疗 ,判定疗效。结果2 3例CD7+小儿AML在FAB分型中以M2 、M5 多见。M3 中无一例CD7抗原表达 ,将CD7+与CD7-两组小儿AML进行对比 ,CD7+AML具有肝脏明显增大 (P <0 0 0 5) ,外周血白细胞数、原始细胞比例及P -糖蛋白表达增高等特点 (P <0 0 0 5,P <0 0 1及P <0 0 5) ,且年龄偏低 ,中位数年龄 7 6岁 (P <0 0 1 ) ,治疗效果差 ,完全缓解率4 3% ,达首次缓解中位时间为 55 5天。结论 　小儿CD7+AML具有独特的临床生物学特征 ,常表达P -糖蛋白 ,临床症状重 ,治疗效果差 ,完全缓解率低 (P <0 0 5) ,达首次缓解时间长 (P <0 0 5)。     

玻璃体切割术治疗复杂性玻璃体视网膜病变

目的：回顾性分析玻璃体切割术治疗复杂性玻璃体视网膜病变的疗效。方法：对58例（61日艮）复杂性玻璃体视网膜病变病人行常规睫状体平坦部三通道玻璃体切割术。并根据病情相应处理视网膜病变，选择眼内激光及眼内填充物。结果：随访3～13mo，术后矫正视力不同程度改善46眼（75％），12眼（20％）不变，3眼（5％）视力减退。结论：玻璃体切割术联合视网膜手术及光凝、眼内气体、硅油填充治疗复杂性玻璃体视网膜病变有效。