肺癌肿瘤标志物CYFRA21-1的临床应用及其评价

应用免疫放射分析法(IRMA)检测327例肺癌,297例肺部良性疾病患者CYFRA21-1的血清水平,肺癌组水平16.9±8.4ng/ml,非肿瘤组水平1.9±1.6ng/ml(p<0.001)。肺癌阳性率62.4％,良性疾患阳性率5％。测定灵敏度为62.4％,特异性为94.5％,准确率77.9％,结果均好于CEA、NSE、CA-242。肺癌病人随病期的增加,血清CYFRA21-1含量也随之上升(P<0.02)。对8例肺癌手术病人和10例化疗病人含量变化分析,在手术3～5周后,血清含量由术前的6.4±3.1ng/ml,降到1.8±0.6ng/ml,10例化疗病人,其中8例血清含量均有降低,由17.4±9ng/ml降至4.9±2.0ng/ml,临床证实均有良好的治疗效果,另2例临床证实治疗无效,血清CYFRA21-1水平相应增高。     

正常人血清CYFRA21-1(IRMA)的含量及肺癌的判断限值的探讨

目的:探讨本地区正常人群血清CYFRA21-1的含量及肺癌的判断限值。方法:采用免疫放射分 析,分析了90例健康人和58例肺良性疾病及42例非小细胞性肺癌患者血清CYFRA21-1的含量。通过临床 可用性能的评价,确立肺癌患者血清中CYFRA21-1的判断限值。结果:健康组和肺良性疾病组及非小细胞性 肺癌组,血清CYFRA21-1的含量水平( x±s,ng/ml)分别为1.4±0.865和2.4±1.810及23.8±2.634。三组 间的血清CYFRA21-1的含量,具有非常显著性差异(P<0.001),并且发现判断界限提高到5.7ng/ml时,临床 可用性能最佳,其可用度、阳性预期值、诊断效率分别为67.9%、90.9%、85%,诊断特异性和敏感性分别为 94.8%和71.4%。结论:正常人血清CYFRA21-1水平为1.4±0.865,P95正常参考值范围为(0～3.3)ng/ml, 非小细胞性肺癌判断界限值为5.7ng/ml。     

肺癌组织培养液和病人血清对自身T细胞集落形成能力的影响

本文观察了10例肺癌病人围术期的肺癌组织、正常肺组织培养液和血清对自身外周血T细胞集落形成能力的影响,并以14例正常人的血清作为对照。结果显示:肺癌人病在去肿瘤负荷前T细胞集落产率为160.73±124.02/10~5,故低于正常人的397.81±133.89/10~5(P<0.001),也低于去肿瘤负荷后的(P<0.001)306.53±79.86/10~5(P<0.001)。术前病人的血清对T细胞集落的抑制率为46.97±21.42%,术后则下降至27.63±23.25%(P<0.01)。加进肺癌组织培养液时,病人的T细胞集落产率为224.83±104.05/10~5,正常肺组织培养液则为323.12±125.27/10~5(P<0.001),肺癌组织培养液和病人血清两者对T细胞集落产率的抑制性呈正相关关系(r=0.817,P<0.005)。本研究结果认为,肺癌组织能产生细胞免疫抑制物质进入血循环,导致病人T细胞集落形成能力明显下降。手术根治性切除肺癌组织,能有效地解除T细胞集落形成能力受抑制的情况。     

心力衰竭患者血浆sTRAIL和sDR5的水平及培哚普利对其影响

目的 :探讨充血性心力衰竭 (CHF)患者血浆可溶型TNF相关的凋亡诱导配体 (sTRAIL)和死亡受体DR5水平的变化及与培哚普利对心脏保护的关系。方法 :用ELISA法检测治疗前后 30例服用培哚普利的CHF患者、2 8例常规治疗的CHF患者及 2 0例健康人对照血浆中sTRAIL及sDR5的水平。结果 :① 5 8例CHF患者血浆sTRAIL的平均含量为 (1.4 3± 0 .4 7)μg/L ,健康人为 (0 .93± 0 .12 ) μg/L ,两者无显著性差异(P >0 .0 5 ) ;sTRAIL水平与心功能损害程度亦无明显关系。CHF患者血浆sDR5的平均含量为 (39.6 7± 6 .78)ng/L ,较健康人 (<6ng/L)明显升高 ,且随着心功能损害程度的加重而升高。②培哚普利组与常规心衰治疗组治疗后 ,血浆中sTRAIL的水平均有所降低 ,但无显著性差异。治疗前后培哚普利组血浆sDR5的平均水平 ,分别为 (31.2 3± 10 .16 )ng/L和 (8.5 0± 2 .14 )ng/L(P <0 .0 5 ) ;常规治疗组分别为 (48.81± 8.74 )ng/L和 (2 6 .6 4± 6 .2 7)ng/L(P <0 .0 5 )。培哚普利组与常规治疗组相比较 ,前者降低更明显 (分别下降 72 .7%和 4 5 .4 % )。③与其他病因所致CHF患者相比较 ,高血压心脏病所致CHF患者血浆sDR5的水平明显升高。结论 :sDR5可能在CHF患者心肌细胞凋亡的发生、发展中起着重要作用。培哚普利可降低C     

AM检测对肺癌与肺结核鉴别诊断价值的研究

目的:研究肾上腺髓质素(adrenomedullin,AM)对肺癌与肺结核鉴别诊断的意义,为肺癌与肺结核 的诊治提供实验依据。方法:应用放射免疫分析(RIA)分别检测肺癌、肺结核组病人及正常对照组外周血中 AM含量。结果:肺癌组病人血浆中AM含量(98.46±29.28)ng/ml明显高于肺结核组(61.46±19.57)ng/ml 及正常对照组(40.22±8.23)ng/ml,有极显著差别(P<0.01)。小细胞肺癌组病人AM含量较鳞癌、腺癌组病 人AM含量低,有显著性差异(P<0.05)。鳞癌、腺癌组病人AM含量无明显差异(P>0.05)。随着肺癌病情 的进展,从肺癌Ⅰ期至Ⅳ期AM逐渐升高,有显著性差异(P<0.05)。结论:AM的检测可作为肺癌诊断及与肺 结核鉴别诊断的实验室指标。AM的含量对肺癌的分期和预后的评价有重要价值,尤其对缺少病理资料的肺 癌患者有初步诊断的意义。     

IgA肾病患者血清瘦素水平变化及其临床意义

目的:探讨IgA肾病患者血清中瘦素(leptin)水平变化的特点及其临床意义。方法:选取40例IgA肾病患者,按照是否需要透析治疗标准划分为A组(无需透析治疗)、B组(需长期透析治疗)及C组(健康体检者),每组各20例(n=20)。收集晨起空腹血清(B组外加透析前后的血清),采用竞争性放射免疫分析法(RIA)检测leptin的水平并分析其临床意义。结果:A、B、C组血清leptin的平均水平分别为(4.98±0.78)μg/L、(6.45±0.76)μg/L及(3.96±0.56)μg/L。A、B组血清leptin的平均水平显著高于正常对照C组(P<0.05);B组血清Leptin的平均水平明显高于A组(P<0.05);B组患者透析前后血清leptin的平均水平分别为(6.50±0.86)μg/L及(5.21±0.66)μg/L,透析后血清leptin的平均水平显著低于透析前(P<0.05)。结论:IgA肾病患者存在血清leptin的水平明显升高,血液透析能降低其血清水平,提示leptin可能在IgA肾病发生发展中起着重要的作用。     

IGF-1、IGFBP-3在2型糖尿病周围神经病变诊断中意义的研究

目的探讨外周血IGF-1和IGFBP-3在2型糖尿病周围神经病诊断中的意义。方法研究对象分为2型糖尿病周围神经病组、2型糖尿病无周围神经病组和健康人群组3组,以化学发光法检测血清中IGF-1和IGFBP-3水平。结果 IGF-1和IGFBP-3水平在周围神经病组[IGF-1:(132.65±50.78)ng/ml;IGFBP-3:(3.43±1.05)μg/ml]明显低于无周围神经病组[IGF-1:(160.25±66.13)ng/ml;IGFBP-3:(4.37±1.35)μg/ml)]和健康对照组[IGF-1:(174.95±64.38)ng/ml;IGFBP-3:(4.75±3.39)μg/ml](P0.05),而后两组间无统计学差异(P0.05)。结论 IGF-1和IGFBP-3水平减少与2型糖尿病周围神经病的发生相关,对两者的监测有利于2型糖尿病周围神经病的诊断。     

冠心病患者血浆NPY、β2-m、CTnI和Ferritin水平的改变

目的:观察冠心病患者血浆中NPY、β2-m、CTnI和Ferritin水平的改变.方法:我们应用放射免疫分析和化学发光免疫分析测定了86例急性心肌梗死(AMI);145例不稳定型心绞病(UAP)、28例稳定型心绞痛(AP)和40例正常对照组血浆NPY、β2-m、CTnI和Ferritin的水平.结果:40例正常对照组血浆NPY、β2-m、CTnI和Ferritin分别为(151.31±22.82)pg/ml,(2.23±0.46)μg/ml、(0.011±0.006)ng/ml和(230.10±46.30)ng/m,除男性血浆Ferritin水平稍高于女性外,血浆NPY、β2-m、CTnI水平男女之间无差异.86例AMI血浆中NPY、β2-m、CTnI和Ferritin分别为(345.12±68.71)pg/ml、(6.31±1.94)μg/ml、(0.091±0.027)ng/ml和(694.2±205.8)ng/ml,明显高于40例正常对照组(P均＜0.001);145例UAP血浆中NPY、β2-m、CTnI和Ferritin分别为(225.61±40.7)pg/ml、(4.85±1.55)μg/ml、(0.059±0.013)ng/ml和(584.6±191.2)ng/ml,明显高于正常组(P均＜0.01);而28例AP血浆CTnI和Ferritin分别为(0.031±0.014)ng/ml和(387.1±168.6)ng/ml,也明显高于正常对照组(P分别＜0.05,＜0.05).结论:冠心病患者血浆NPY、β2-m、CTnI和Ferritin的水平是衡量心肌细胞损伤的重要标志物,并且与病情的进展有较为密切关系,可作为诊断和治疗的指标.     

B淋巴细胞刺激因子及其受体与多发性骨髓瘤关联性的临床实验诊断研究

目的:探讨B细胞激活因子(BLyS) 及其受体在多发性骨髓瘤(MM)发病中的作用机制.方法:用酶联免疫吸附测定法(ELISA)和实时荧光定量聚合酶链反应 (RFQ-PCR),对19例MM患者和30名健康人血清BLyS含量、外周血单个核细胞(PBMCs) 中BLyS及其受体mRNA 含量进行检测;并比较MM患者血清BLyS含量与外周血BLyS及其受体基因表达水平和免疫球蛋白(IgG、IgA、IgM)浓度、乳酸脱氢酶(LDH)、轻链(kap、lam)的相关性.结果:MM患者血清 BLyS含量[(7.95±4.93) g/L 明显高于健康对照组[(2.70±1.09) g/L,P<0.01 ,并与LDH浓度呈正相关性(r=0.734,P<0.001);97.4% (18/19),84.2% (16/19)的MM患者PBMCs中BLyS、BCMA mRNA表达水平较正常人明显增高,并且也与LDH的含量呈正相关;而47.32% (9/19)患者TACI mRNA表达水平降低.结论:MM患者的血清BLyS蛋白浓度和PBMCs中BLyS及其受体基因表达水平有异常改变,说明BLyS及其受体可能参与MM的发病;BLyS及其受体表达水平也许可作为预后的一个指标.     

C反应蛋白酶联免疫分析和化学发光免疫分析的建立及其初步应用

采用高纯度的C反应蛋白(CRP)免疫兔,获取高效价的CRP抗体.提取抗血清中IgG,包被酶标板.用生物素标记CRP抗原,辣根过氧化物酶标记亲和素,建立CRP的ELISA和化学发光免疫分析法(CLIA).用ELISA测定正常人80名,心梗患者43例和重症监护室(ICU)病人39例的血清CRP水平,发现心梗患者(27.21±38.67μg/mL)明显高于正常人(0.57±2.99μg/mL)(P《0.05);ICU病人(117.48±97.05μg/mL)明显高于正常人及心梗患者(P《0.001和P《0.01).用CLIA检测正常人68名,结果为0.77±3.29μg/mL.随机收集病人血清样品73份,分别用免疫比浊法、ELISA和CLIA检测,经统计三种方法高度相关.结果提示:ELISA和CLIA是一种简便、灵敏和特异的CRP测定方法,可用于人血清中CRP的测定.     

Secular change in menarche in women in Madrid

The age at menarche was estimated by recollection in 1617 women between the ages of 18 and 60 in Madrid and a nearby suburb, Pinto. The population of Pinto is working-class and the Madrid group, taken from residential neighbourhoods , belongs to the upper middle class. In both groups we found a diminution in average age at menarche, from 14.04 to 13.02 years in Madrid and from 14.55 to 13.16 years from about 1935 to about 1965 in Pinto. These changes have been more intense in the group which is less well-off economically, where living conditions have varied much more drastically.     

Intestinal helminthiasis in school children in Haiti in 2002

A survey on intestinal helminths in school children was conducted in Haiti in 2002. This first nationwide study involving the entire country was stratified by department according to urban and rural zones using the cluster method. Focusing on elementary school children (n=5792; age range 3 to 20 years), it involved 26 urban and 49 rural schools randomly selected. Stools were preserved in formalin and examined by the Ritchie technique. Thirty-four per cent of stools (1981/5792) tested positive for intestinal helminths with the following parasites identified: Ascaris lumbricoides (27.3%), Trichuris trichiura (7.3%), Necator americanus (3.8%), Hymenolepsis nana (2%), Taenia sp. (0.3%) and Strongyloides stercoralis (0.2%). The helminth prevalence was higher in rural (38.4%) compared to urban areas (30%). There was no significant difference in prevalence by sex and age. The importance of geohelminths changed from one department to another with the highest prevalence found in the Southern department of Grande Anse (73.7%) and the lowest prevalence in the Center department (20.6%). Five out of the country's nine departments had a similar prevalence varying from 25.5% to 28.2%. Intestinal helminthic polyparasitism was observed in a percentage of infested school children comprise between 3.4% and 28.6% according in relation to the geographical area. A program to fight against geohelminths in school children should be initiated as a public health priority. Albendazole is the drug of choice. Frequency of drug distribution should be based on the prevalence of geohelminths in each department.     

Experience in adult population in dengue outbreak in Delhi

A dengue outbreak has recently hit the Indian capital. We studied the clinical profile of adult patients. Five hundred and sixty patients of dengue infection were admitted in a specially created ward according to the criteria laid down by WHO. Haematemesis (28.28%), epistaxis (26.78%) and malena (14.28%) were some of the common presentations. Similarly lymphadenopathy, especially cervical (30.89%), palatal rashes (26.96%) and hepatomegaly (23.75%) were the most commonly encountered findings on physical examination. Most of the cases were of dengue fever with haemorrhage and only 2.5% cases were classified under dengue haemorrhagic fever or dengue shock syndrome. The average hospital stay was 3.4 days but only 9.8 hours in the eleven patients who died, suggesting their late arrival in preterminal situation giving little time for resuscitation. Thrombocytopenia was not a feature and only 12.85% patients had platelet count less than 70,000/cmm. Most of the patients who were admitted with thrombocytopenia, showed normalization in their platelet counts in next few days. Serological examination demonstrated evidence of recent dengue infection in 41.17% patients. Few patients required blood or platelet concentrate transfusion. Eleven patients died, three due to DIC, one of intracranial haemorrhage and seven due to massive gastric haemorrhage. Rest of the patients recovered completely. Thus we can conclude that recent outbreak in Delhi was of dengue fever with haemorrhage and mortality was very low in patients who came early to the hospital.     

Changes in the hypothalamic nuclei in in experimental allergy

Summary In rabbits subjected to prolonged sensitization and in which the Arthus phenomenon was induced there was a marked reaction of the hypothalamic nuclei. Staining by Gomori's method indicated a cellular swelling, loss of granules, and protoplasmic vacuolization in the supraoptic nucleus. There was a considerable increase in the size of the cross-sectional area of the cells. The same effects were much less well shown in the paraventricular nucleus. These results show that marked signs of increased neurosecretion developed in the animals at the height of the Arthus phenomenon.(Presented by Active Member AMN SSSR V. V. Parin) Translated from Byulleten Éksperimental'noi biologii i Meditsiny, Vol. 55, No. 4, pp. 110–113, April, 1963.     

Development in in vitro toxicology

There are three principal pressures driving the development of in vitro toxicology: (1) the need for more efficient testing systems to cope with the large number of xenobiotics currently being developed; (2) public pressure to reduce animal experimentation; and (3) a need for a better understanding of the mechanisms of toxicity. Within this, in vitro toxicology is focused on local, systemic, and target-organ toxicity. It is becoming increasingly apparent that a step or decision-tree approach using input of a variety of experimental data (physicochemical properties, biokinetics, cytotoxicity) provides the most efficient system for predicting toxicity. Examples of the use of in vitro toxicity systems for prediction of systemic toxicity and target-organ (liver) toxicity are presented.Originally presented at ECCP 93.