血清载脂蛋白H、B型脑钠肽与急性冠状动脉综合征患者PCI术预后的相关性

目的 探讨血清载脂蛋白H(ApOH)、B型脑钠肽(BNP)与急性冠状动脉综合征(ACS)患者经皮冠状动脉介入术(PCI)预后的相关性。方法 选取2018年9月—2020年9月在青海省心脑血管病专科医院进行PCI术治疗的126例ACS患者作为研究对象。随访1年后,根据预后情况分为良好组(85例)和不良组(41例)。采用酶联免疫吸附法检测两组患者血清ApOH、BNP水平;采用受试者工作特性(ROC)曲线评价血清ApOH、BNP对ACS患者PCI术预后不良的预测价值;采用多因素Cox回归分析影响ACS患者PCI术预后的因素。结果 不良组术前Gensini评分、肌酸激酶(CK)及其同工酶(CK-MB)明显高于良好组,不良组的左心室射血分数(LVEF)低于良好组(P<0.05)。不良组血清ApOH、BNP水平明显高于良好组(P<0.05)。血清ApOH、BNP诊断ACS患者PCI术预后的AUC(95%CI)分别为0.824(0.773～0.874)、0.871(0.823～0.921),截点值分别为275.31 mg/L、343.56 pg/mL,特异度分别为77.91%、79.53...     

利钠肽在脓毒症管理中的研究进展

脓毒症仍是全球主要的公共卫生负担。随着先进实验室技术的使用日益增多,人们对脓毒症中相关生物标志物帮助更精确、更有针对性的决策,产生了新的兴趣。利钠肽在心肺功能不全的危重患者中通常升高,但在心脏衰竭之外也发挥作用,本综述旨在描述利钠肽在脓毒症患者液体复苏、心室功能障碍、诊断和预后方面的作用。已经发现B型利钠肽(BNP)和N端B型利钠肽前体(NT-proBNP)与脓毒性心肌病患者的左心室收缩和舒张功能,以及右心功能不全相关。BNP/NT-proBNP水平尚不能准确预测容量反应性,但其变化趋势能够评估液体复苏效果。尽管有研究认为其能预测脓毒症死亡风险,但需进一步研究。     

B细胞活化因子在自身免疫疾病中的作用

B细胞活化因子影响外周B细胞的存活、成熟和免疫球蛋白的类别转换,对于临床有重要的意义.因自身抗体引起的疾病中均可不同程度的检测到血清B细胞活化因子的浓度增加.同时滑液、肺泡灌洗液、胃肠道灌洗液中都可检测到B细胞活化因子的增多,提示其可能与局部的类别转换与免疫球蛋白的产生有关.在自身免疫性疾病、过敏性疾病、恶性肿瘤及感染的临床诊断与治疗中,B细胞活化因子有重要意义.另外,B细胞活化因子拮抗剂是目前一种新的治疗B细胞相关的自身免疫疾病的手段.     

B型利钠肽等因素在判定心力衰竭患者预后中的作用

目的 评价B型利钠肽(BNP)水平在心力衰竭患者预后中的作用,探讨和心力衰竭患者预后相关的其他因素;同时验证BNP在鉴别呼吸困难原因中的作用.方法 130例因呼吸困难而入院的的患者采用荧光免疫法进行床旁快速BNP检测,根据最后诊断分为心力衰竭组(组1)、非心力衰竭组(组2),并将组1所有患者随访180 d,再将心力衰竭组(组1)根据BNP水平分成组1a(BNP值小于200 pg/ml)、组1b(BNP值在200 pg/ml到500 pg/ml之间,包括200 pg/ml但不包括500 pg/ml)和组1c(BNP值大于等于500 pg/ml).结果 BNP、血糖与心力衰竭患者的死亡和再入院的风险显著相关(P=0.003和P=0.001),肌钙蛋白(TnI)与心力衰竭患者的死亡和再入院的风险正相关(P=0.049),左室射血分数(LVEF)与心力衰竭患者的死亡和再入院的风险负相关(P=0.028).血糖、LVEF、BNP水平和TnI影响心力衰竭患者的生存率.BNP≥500 pg/ml心力衰竭患者6个月再入院和死亡的危险性是BNP＜500 pg/ml心力衰竭患者的4.16倍(P=0.009).血糖≥7.0 mmol/L心力衰竭患者6个月再入院和死亡率为38.6%,显著高于血糖＜7.0 mmol/L者(3.8%,P=0.000).LVEF＜30%心力衰竭患者的6个月再入院和死亡率为26.5%,显著高于LVEF≥30%心力衰竭患者(12.8%,P=0.050).TnI≥0.04 ng/ml心力衰竭患者的6个月再入院和死亡率为35%,显著高于TnI＜0.04 ng/ml心力衰竭患者(14.5%,P=0.050).TnI≥0.04 ng/ml的心力衰竭患者,BNP≥500 pg/ml者发生再入院和死亡的相对危险度是BNP＜500 pg/ml者的2.64倍;对于BNP≥500 pg/ml的心力衰竭患者,TnI≥0.04 ng/ml者发生再入院和死亡的相对危险度是TnI＜0.04 ng/ml者的1.83倍;TnI≥0.04 ng/ml且BNP≥500 pg/ml的心力衰竭患者,发生再入院和死亡的危险性是TnI＜0.04 ng/ml且BNP＜500 pg/ml的心力衰竭患者的9.5倍(P=0.017).结论 高BNP浓度、高血糖、高TnI值和低LVEF与心力衰竭患者死亡和再入院的高风险相关,BNP浓度、血糖水平、LVEF和TnI值对于心力衰竭患者的预后有重要意义;BNP和TnI联合对心力衰竭患者预后和危险分层意义更大.     

穿孔素和颗粒酶B在皮肤病中的表达

穿孔素与颗粒酶B是细胞毒细胞发挥作用的主要效应分子。在抗病毒及病菌、肿瘤免疫及器官移植排斥中均有重要作用。近年来其在炎症性皮肤病及皮肤肿瘤中的作用受到人们的关注。综述了穿孔素与颗粒酶B在一些皮肤疾病中的研究进展。     

核因子κB信号通路在银屑病中的研究进展

【摘要】 核因子κB是一种蛋白转录因子,介导炎症等复杂的生物学过程,是多种免疫和炎症通路以及细胞增殖、分化和凋亡的关键调节因子。银屑病是一种炎症性皮肤病,其特征之一是磷酸化核因子κB水平升高导致角质形成细胞抗凋亡能力增强,并加重炎症反应。本文概述核因子κB信号通路及其在银屑病中的研究进展。     

血清CRP、CD25+、B型脑钠肽及高迁移率族蛋白B1在脓毒症中的表达及意义

目的探讨血清C反应蛋白(CRP)、CD25+、B型脑钠肽(BNP)及高迁移率族蛋白B1(HMGB1)在脓毒症中的表达及意义。方法选择2017年5月-2019年5月于苏州市立医院北区进行治疗的80例脓毒症患者进行研究,设为观察组,选择同期于本院进行体检的健康人群为对照组。分析脓毒症患者中血清CRP、CD25+、BNP及HMGB1的表达及其诊断价值。结果观察组患者血清CRP、CD25+、BNP及HMGB1水平显著高于对照组,差异显著(P<0.05);脓毒症组悲者血清CRP、CD25+、BNP及HMGB1水平显著低于严重脓毒症组脓毒症休克组患者;严重脓毒症组患者血清CRP、CD25+、BNP及HMGB1水平显著低于脓毒症休克组患者,差异显著(P<0.05);CRP诊断脓毒症的AUC为0.984,95%CI为0.959~0.1.000,CD25+诊断脓毒症的AUC为0.967,95%CI为0.944~0.990,BNP诊断脓毒症的AUC为0.960,95%CI为0.933~0.986,HMGB1诊断脓毒症的AUC为0.821,95%CI为0.751~0.892,联合检测诊断脓毒症的AUC为1.000,95%CI为1.000~1.000,单独检测分别和联合检测曲线下面积比较均具有显著差异(Z=2.231.2.750.2.857.4.972,P<0.05);联合检测的特异度、准确度分别为93.79%.94.15%。结论在脓毒症患者中CRP、CD25+、BNP及HMGB1的表达和疾病严重程度之间存在着密切关系,联合检测在诊断脓毒症时具有较高的准确度。     

核因子κB和c-myc在尖锐湿疣皮损角质形成细胞中的表达

目的 探讨核因子-κB(NF-κB)和c-myc在尖锐湿疣皮损角质形成细胞中的表达。方法 采用原位杂交方法检测尖锐湿疣50例,确定为HPV6/11阳性;采用免疫组化En Vision二步法检测50例尖锐湿疣患者皮损和25例正常人皮肤(包皮)中NF-κB和c-myc的表达及分布。结果 ①与正常人皮肤对照组相比,尖锐湿疣皮损角质形成细胞中NF-κB和c-myc的表达均有不同程度增强(前者U=6.286,P<0.01;后者U=4.356,P<0.01)。NF-κB表达主要分布于棘细胞层,阳性信号定位于胞浆。c-myc表达主要分布于表皮全层或棘细胞层和基底层,阳性信号定位于胞核。②尖锐湿疣皮损中,NF-κB与c-myc的表达呈正相关(r=0.89,P<0.01)。结论 在HPV6/11感染时,角质形成细胞中转录因子NF-κB和c-myc的表达增高,可能均参与HPV感染细胞增殖的调控。     

BMI-1在皮肤恶性肿瘤中的研究进展

B细胞特异性小鼠白血病病毒插入位点1(B-cell-specific moloney murine leukemia virus insection site 1, BMI-1)是多梳蛋白(Polycomb-group, PcG)家族的成员之一。目前研究发现BMI-1通过多种机制参与肿瘤的发生发展。在皮肤恶性肿瘤中,尤其是基底细胞癌、鳞状细胞癌与黑素瘤中,BMI-1的表达影响其生长、侵袭和转移。本文综述其在皮肤恶性肿瘤中可能的机制及研究现况,为皮肤恶性肿瘤的治疗靶点提供新的思路。     

寻常型银屑病患者血清载脂蛋白A—Ⅰ及B—100测定

为了探讨银屑病患者易并发心血管疾病的原因，我们采用免疫定量法、酯法及三唑法分别对３０例寻常型银屑病患者血清载脂蛋白Ａ－Ⅰ、Ｂ－１００及胆固醇、甘油三酯进行了测定。结果表明，与对照组相比，患者组载脂蛋白Ａ－Ⅰ和甘油三酯正常，载脂蛋白Ｂ－１００和胆固醇升高（Ｐ均＜０．０５），且二者呈显著正相关（Ｐ＜０．０５），载脂蛋白Ａ－Ⅰ／Ｂ－１００比值降低（Ｐ＜０．０５），且与胆固醇呈显著负相关（Ｐ＜０．０５）。表明载脂蛋白Ｂ－１００升高及载脂蛋白Ａ－Ⅰ／Ｂ－１００比值降低导致了寻常型银屑病患者血清胆固醇升高和心血管疾病的发生。     

银屑病检测血脂及载脂蛋白AI、B_(100)的临床意义

检测34例寻常性银屑病患者血脂、脂蛋白及载脂蛋白（apo）AI、B100水平。结果表明，银屑病患者血脂、脂蛋白及apoAI、B100与健康对照组比较均有非常显著性差异至极显著性差异（P＜0．01～0．001），进行期及皮损泛发者较静止期及皮损散在着改变显著，5年以上患者部分脂质指标略比5年以内者改变显著。     

系统性红斑狼疮合并乙肝病毒相关性肾炎1例

报告1例系统性红斑狼疮合并乙肝病毒相关性肾炎。患者男，51岁，面部出现片状红色斑丘疹伴脱皮8个月，同时伴光敏感、血液系统异常、肾损害，血清抗核抗体、抗ds-DNA、抗Sm抗体均阳性，肾脏组织病理和免疫组化染色均符合乙肝病毒相关性肾炎的改变。1     

1-2B7B: Monoclonal antibody reacting to the 120 kDa polypeptide component of human epidermal hemidesmosomes

Summary Immunohistochemical and immunochemical analyses were performed on a monoclonal antibody designated 1-2B7B which was derived from immunizing mice with human prostate epithelial tissue. The 1-2B7B antigen was expressed not only along the acinous basement membrane zone (BMZ) of the prostate and testis, but also along the BMZ of the epithelia of several other organs including the skin, oesophagus, urinary bladder, ureter, stomach, intestine and bile duct. The antigenic epitope was not expressed in these tissues of lower mammals. Immunoelectron microscopic studies on normal human skin revealed that the 1-2B7B antigen was localized mainly just beneath the hemidesmosomes of basal keratinocytes, but not beneath melanocytes. Indirect immunofluorescence and immunoelectron microscopic studies on 1 M NaCl-split skin confirmed that this antigen was not separated from the cytoplasmic membrane of basal cells after salt treatment. SDS polyacrylamide gel electrophoresis of immunochemically purified protein from the epidermis demonstrated the molecular weight of the antigen to be 120 kDa. 1-2B7B monoclonal antibody should be a useful probe for studying the pathomechanism of some blistering diseases, as well as the assembly and function of the epidermal-dermal junction.     

血清载脂蛋白A1、B、E与儿童特应性皮炎的相关性研究

目的 研究血清载脂蛋白A-1、B、E(apo A1、apo B、apo E)的含量与儿童特应性皮炎(AD)的发生是否存在相关性.方法 收集于本院皮肤科就诊的2～7岁儿童AD患者血清标本共300例,其中男126例,女174例,平均年龄(4.0±1.4)岁,检测患者血清中过敏原和总IgE水平.收集年龄、性别与病例组匹配的健...     

Elevated serum BAFF levels in patients with localized scleroderma in contrast to other organ-specific autoimmune diseases

Serum levels of B-cell activating factor belonging to the tumor necrosis factor family (BAFF), a potent B-cell survival factor, are elevated in patients with systemic autoimmune diseases, such as systemic lupus erythematosus (SLE), rheumatoid arthritis and systemic sclerosis (SSc). The objective of this study was to determine serum BAFF levels and relate the results to the clinical features in patients with organ-specific autoimmune diseases of the skin, such as localized scleroderma and autoimmune bullous diseases. Serum BAFF levels were examined by enzyme-linked immunosorbent assay in 44 patients with localized scleroderma, 20 with pemphigus vulgaris/pemphigus foliaceus, 20 with bullous pemphigoid and 30 healthy controls. Twenty patients with SSc and 20 with SLE were also examined as disease controls. Serum BAFF levels were elevated in localized scleroderma patients compared with healthy controls. Concerning localized scleroderma subgroups, patients with generalized morphea, the severest form of localized scleroderma, had higher serum BAFF levels than linear scleroderma or morphea patients. The BAFF levels of generalized morphea were comparable with those of SSc or SLE. Furthermore, serum BAFF levels correlated positively with antihistone antibody levels and the severity of skin lesion as well as the number of skin lesions. By contrast, serum BAFF levels were not significantly elevated in patients with pemphigus or pemphigoid. These results suggest that BAFF may be contributing to autoimmunity and disease development in localized scleroderma.     

复方多黏菌素B软膏治疗细菌性皮肤病临床实验研究

目的评价复方多黏菌素B软膏与环丙沙星软膏治疗细菌性皮肤病1周的疗效和安全性。方法入组包括脓疱疮、毛囊炎、甲沟炎、伤口感染等细菌性皮肤病48例,采用随机、双盲、平行组对比研究。受试者3次/d外用患处,疗程1周。结果治疗1周,试验组靶皮损总积分(TSS)由治疗前15.67±2.28降至3.25±3.90,症状体征改善率为(79.90±24.21)%;对照组总积分由治疗前14.71±2.90降至3.38±2.62,改善率为(76.44±19.40)%。临床有效率试验组和对照组分别为83.33%和75.00%。细菌学清除率试验组为83.33%,对照组为91.67%。临床和细菌学综合疗效评价显示,试验组总有效率为75.00%,对照组为70.83%。两组在临床疗效、细菌学疗效和总体疗效的比较差异均无统计学意义。结论复方多黏菌素B软膏与环丙沙星软膏相似,治疗细菌性皮肤病安全有效。     

细胞自噬及与皮肤病的研究进展

自噬是一种细胞自我降解的过程,清除受损或多余的蛋白质和细胞器.当细胞代谢能量不足时,细胞依靠自噬作用实现细胞内成分的循环利用,从而维持自我稳态和生存.自噬与凋亡虽同为程序性细胞死亡,但两者既有区别又相互作用.近来研究表明,多种皮肤病的病理过程中均伴有细胞自噬功能的改变,如带状疱疹、系统性红斑狼疮、黑素瘤和白癜风等.因此,研究皮肤病的细胞自噬具有重要的临床意义,为通过调节细胞的自噬水平来控制和治疗皮肤病打下基础.     

Sexually transmitted diseases in children

Sexually transmitted diseases (STDs) cause considerable morbidity among their victims. This is true even for children. Unfortunately, this aspect has not received due attention and remains a relatively ignored field. We carried out a study of the clinico-epidemiological profile of STDs among the pediatric patients who attended the STD clinic of a tertiary care hospital. Pediatric patients who presented with STDs from January of 1995 to February of 2001 constituted the subject material of this study. A detailed clinical examination and relevant laboratory investigations were carried out in all patients. A total of 15,453 STD patients were seen during this period, out of which 127 were children, giving a prevalence of 0.82% pediatric STD cases. The peak incidence of STDs was seen in the age group of 10-14 years (66.1%). Most of them were illiterate (61.4%) and from low socio-economic backgrounds (70.9%). Notably, 17.3% were from remand homes. The predominant STDs observed among these children were syphilis (25.2%), including six cases of congenital syphilis, vulvo-vaginal candidiasis (11.8%), condyloma-acuminata (14.2%), herpes progenitalis (8.7%) and traumatic lesions (7.9%). Histories or signs of abuse were present in 74% of the patients. Only two cases during the span of the study were HIV positive. Pediatric STDs remain a hidden and neglected problem. Children constituted 0.82% of all STD patients in our series. This may represent only the tip of the iceberg, because several features, including some operational problems, are responsible for underdiagnosis of pediatric STDs. If not treated promptly and adequately, they may result in significant physical and emotional sequelae in children. Thus, it is essential to develop strategies to prevent sexual abuse and to have adequate counselling measures, especially in juvenile delinquents.     

IL-18在免疫相关皮肤病中的作用机制究进展

白介素18是由单核细胞、巨噬细胞等多种细胞产生的一种具有多功能和多效应的前炎性因子,是固有和适应性免疫之间的一种重要联系,是细胞及体液免疫的调节物.通过激活多个信号转导途径、诱导干扰素γ的产生、调节免疫细胞功能参与机体免疫,其作用也体现在支持不同的Th细胞亚型的分化,促进Th1和Th2两型免疫应答.研究显示,白介素18在某些炎症、自身免疫性疾病和肿瘤中表达异常,提示白介素18与这些疾病的发生有一定的相关性.