病毒性肝炎患者血清IL-6,IL-8水平及临床意义

了解病毒性肝炎患者血清IL－6、IL－8水平及临床意义。应用放射免疫法检测124例病毒性肝炎患者血清IL－6、IL－8水平并动态观察，其中35例慢性肝炎进行肝活检，并按肝组织病理进行分级和分期。①急性肝炎、慢性肝炎中重度、慢性重型肝炎IL－6和IL－8水平依次升高，明显高于正常对照（P＜0．01）；②IL－6、IL－8水平与肝 组织炎症坏死程度和肝纤维化程度呈正相关（P＜0．01，P＜0．01）；③IL－6、IL－8水平随急性肝炎恢复和慢性肝炎稳定而降低（P＜0．01，P＜0．05）。IL－6、IL－8水平可作为反映肝细胞坏死程度和纤维化轻重的指标。     

慢性肝病患者血清TNF—α、IL—8和血浆选择素水平的检测及其意义

目的：探讨TNF－α、IL－8和P-selectin与慢性肝病的关系。方法应用双抗体夹心酶联免疫吸附法（ELISA）测定124例慢性肝病患者血清TNF－α、IL－8和P－selectin的水平。结果：慢性肝病患者血清TNF－α、IL－8和P－selectin水平均明显高于对照组（P值均＜0．001，P－selectin组P＜0．01）。结论TNF－α、IL－8和P－selctin可能与慢性肝病免疫病理损伤过程。检测血清TNF－α、IL－8和P－selectin水平对判断患者病情和预后有临床实用价值。     

细胞因子在急性心肌梗塞中的作用

为探讨细胞因子在急性心肌梗塞（AMI）中的作用，测定了28例AMI患者血清肿瘤坏死因子α（TNFα）和白细胞介素1β（IL－β）水平，并选择13例不稳定型心绞痛（UA）患者和15例健康人作为对照。结果表明：AMI组血清TNFα水平明显高于UA组及正常组（P＜0．01），UA组血清TNFα水平明显高于正常组（P＜0．01）；血清IL－1β水平在严重的AMI患者（心功能KillipⅢ、Ⅳ级）明显高于正常组（P＜0．01）。提示血清TNFα和IL-1β水平与心肌缺血的严重程度有关。     

类风湿关节炎患者白细胞介素-6与皮质醇节律的研究

目的：研究类风湿关节炎（RA）患者血清白细胞介素（IL）－6、皮质醇节律及其临床意义。方法：36例RA患者分别为8：00，12：00，16：00，20：00，0：00，4：00用双抗体夹心酶联免疫吸附试验（ELISA）检测其血清IL－6水平，用放射免疫法（RIA）测定皮质醇。结果：36例RA患者皮质醇分泌有明显节律，但与正常对照组相比，其峰值提前，出现于凌晨4点，血清IL－6水平高于对照组（P＜0．01），也存在昼夜节律，IL－6峰值出现在皮质醇峰值之前，经治疗病情稳定后，RA患者血清IL－6水平恢复或接近正常，IL－6与皮质醇节律紊乱得以纠正，相关性分析显示，RA患者血清IL－6水平与血沉（ESR）（P＜0．01，r=0.66)，C反应蛋白（CRP）（P＜0．01，r＝0.71)皮质醇（P＜0．05，r=0.58)呈正相关，结论：RA患者血清IL－6增高，IL－6与皮质醇存在昼夜节律紊乱，这些变化在RA的发病机制中可能具有重要意义。     

乙型肝炎患者血清IL-10和IFN-γ水平检测及其意义

目的：检测急、慢性乙型肝炎患者血清IL－10和IFN－γ水平,探讨乙型肝炎慢性化的机理。方法：用双抗夹心ELISA法定量检测25例急性乙肝。35例慢性乙肝和30例正常人血清IL－10和IFN－γ水平。结果：慢性乙肝患者血清IL－10浓度明显高于急性乙肝患者（P＜0．01）,且高于正常对照组（P＜0．01）。而慢性乙肝组患者血清IFN－γ浓度明显低于急性乙肝组（P＜0．01）,两组的血清IFN－γ浓度均明显高于正常对照 组（P＜0．01）。慢性乙肝患者血清IFN－γ浓度与ALT有相关性。结论：慢性乙肝患者IL－10水平增高,限制了IFN－γ合成,削弱了其对HBV清除作用,可能是乙型肝炎慢性化机理之一;慢性乙肝患者血清IFN－γ浓度与ALT有相关性。     

慢性肺原性心脏病急性加重期血液高凝状态的临床观察

目的：探讨慢性肺心病患者凝血功能变化的临床意义。方法：测定40例慢性肺心病患者急性加重期治疗前、后血浆凝血因子Ⅷ相关抗原（ⅧR：Ag）因子Ⅷ凝血活性（Ⅷ：C）Ⅲ酶抗原（AT－Ⅲ：Ag）、抗凝血酶Ⅲ活性（AT－Ⅲ：A）、纤维蛋白原含量（Fbg)及D－二聚体（D－D）的变化。结果：慢性肺心病患者急性发作期血浆血映凝血功能的指标ⅧR：Ag、Ⅷ：C及Fbg含量均明显增高（P＜0．01）;反映抗凝血功能的指标AT－Ⅲ：Ag和AT－Ⅲ：A均明显降低（P＜0．01）;纤溶指标D－dimer明显增高（P＜0．01）。治疗缓解期各项指标均明显恢复。但仍未达正常水平（P＜0．05）。结论慢性肺心病急性加重期存在在血液高凝状态及抗凝血功能障碍,肺心病急性加重期应重视抗凝治疗。     

肝炎患者血清IL—2、IFN—γ和IL—10检测的意义

目的：探讨检测IL－2、IFN－γ和IL－10对病毒性肝炎患者的临床意义。方法：利用ELISA法检测97例病毒性肝炎患者血清IL－12、IFN－γ和IL－10水平，动态观察45例接受免疫增强剂治疗的慢性肝炎患者上述细胞因子的变化，结果：急性肝炎患者血清IL－12及IFN－γ水平平均明显升高（P＜0．01）；慢性肝炎、肝硬化患者血清中IL－10明显高于正常对照组（P＜0．01）。免疫增强剂治疗获得完全应答反应的患者治疗期间血清IL－12、IFN－γ水平明显上升（P＜0．01），IL－10水平下降（P＜0．05）。无应答者治疗过程中上述细胞因子无明显变化。结论：Th1型免疫应答对机体清除病毒起关键作用。Th2型免疫应答与感染慢性化及疾病持续发展有关，免疫治疗可使部分Th2型免疫应答占优势的慢性肝炎患者转化为Th1型占优势。     

老年心力衰竭患者血清白细胞介素10水平的临床研究

目的 探讨老年充血性心力衰竭（CHF）患者血清白细胞介素10（IL－10）水平的变化及临床意义。方法 采用双抗体夹心法ELISA测定40例老年（≥60岁）CHF患者血清IL－10水平，以38例老年前期（50－59岁）CHF患者和30例健康老年人（≥60岁）作比较，分析老年CHF不同心衰程度间血清IL－10水平差异。结果 CHF患者血清IL－10水平显著低于正常对照组（P＜0．001），老年CHF患者亦低于老年前期CHF患者（P＜0．001），老年CHF不同程度心衰间血清IL－10水平差异显著（F＝101．41，P＜0．01），且随心衰的加重而降低（P＜0．05－0．01）。结论 IL－10可能参与CHF的发生和病理发展过程，监测血清IL－10水平可作为判断老年CHF免疫功能和心衰病情的指标之一。     

胃癌患者血清VEGF和IL－8水平变化及意义

目的探讨胃癌患者血清VEGF和IL－8的水平变化及意义。方法采用EHSA法测定60例胃癌患者（胃癌组）和20例胃良性病变患者（良性组）血清VEGF和IL－8水平,与20例体检健康者（对照组）进行比较。结果胃癌组血清VEGF和IL－8水平明显高于良性组和对照组;胃癌组Ⅲ、Ⅳ期患者明显高于I、Ⅱ期患者（P均〈0．05）,术后明显低于术前,但仍高于对照组（P均〈0．05）。血清VEGF和IL－8水平呈正相关（r=0．433,P〈0．05）。结论VEGF和IL－8可促进胃癌的发生、发展;血清VEGF和IL－8水平有助于胃癌病情和预后的判断。     

过敏性哮喘青春期缓解者外周血IL—4、IL—5活性和IgE的变化

目的：阐明过敏性哮喘青春期解者血清IL－4及IL－5活性和IgE的变化，方法采用ELISA法检测IL－4、IL－5活性和IgE，分别对16例青春期缓解者（A组），26例哮喘发作期（B组）及22例哮喘缓解解患者（C组）和20例正常人（D组）进行比较。结果（1）青春期缓解者-5在性未显著升高，明显低于哮喘发作期患者（P＜0．01）和缓解期患者（P＜0．05），与正常人比较差异无显著性（P＞0．05）。（2）青春期缓解者IL－4较哮喘发作期患者明显降低（P＜0．01），与缓解期患者和正常人比较差异无显著性（P＞0．05）。（3）IgE浓度比较作期明显降低（P＜0．01），与政党人比较差异无显著性（P＞0．05），但还未明显低于哮喘缓解期患者（P＞0．05）。结论过敏性喘喘期解者外周血IL－4、IL－5活性明显降低，IgE有一定程度下降，提示IL－4、IL－5、IgE在支气管哮喘发病机制上起着重要作用。     

Research and Evaluation of the Influence of the Construction of the Gate and the Influence of the Piston Velocity on the Distribution of Gases into the Volume of the Casting

Distribution of gasses to the cast volume and volume of pores can be maintained within the acceptable limits by means of correct setting of technological parameters of casting and by selection of suitable structure and gating system arrangement. The main idea of this paper solves the issue of suitability of die casting adjustment—i.e., change of technological parameters or change of structural solution of the gating system—with regards to inner soundness of casts produced in die casting process. Parameters which were compared included height of a gate and velocity of a piston. The melt velocity in the gate was used as a correlating factor between the gate height and piston velocity. The evaluated parameter was gas entrapment in the cast at the end of the filling phase of die casting cycle and at the same time percentage of porosity in the samples taken from the main runner. On the basis of the performed experiments it was proved that the change of technological parameters, particularly of pressing velocity of the piston, directly influences distribution of gasses to the cast volume.     

Weighing the QT Intervals with the Slope or the Amplitude of the T Wave

Objective: The reproducibility of QT interval measurements is low, even for the mean QT interval based on the standard ECG. In this study we analyzed whether the reproducibility of the mean weighed QT interval was better than the simple mean QT interval. The weighing was based on the amplitude of the T wave or the slope of the steepest tangent on the terminal part of the T wave. Material and methods: 12‐lead ECGs of 130 postmyocardial infarction patients were obtained. The QT intervals were measured by the tangent‐method on two occasions by the same observer Mismatch QT intervals were defined as QT intervals that were measured at only one occasion. Sixteen ECGs were rejected. The data were split into 34 and 80 ECGs for optimization and validation of the weighing, respectively. The weighed QT dispersion was calculated as the weighed mean of the three longest minus the weighed mean of the three shortest QT intervals. Results: Weighing with the slope increased the reproducibility by 41% (P = 3 10^‐6), but weighing with the amplitude reduced it by 20% (P = 0.02). However, if measurements with errors above 75 ms were rejected, weighing with the slope or the amplitude increased the reproducibility with 26% and 20% (P = 0.02), respectively. Weighing did not change the reproducibility of the weighed QT dispersion. Conclusion: Weighing with the slope improved the reproducibility of the mean weighed QT interval. However, if measurements with errors above 75 ms were rejected, weighing with the amplitude also increased the reproducibility. Weighing did not change the reproducibility of the weighed QT dispersion. Weighing is particularly efficient at reducing the negative impact of mismatch QT intervals on the reproducibility. A.N.E. 2002;7(1):4–9     

县级以下综合医疗机构医务人员对现代结控知识的认识现状调查

目的本文旨在了解医务人员现代结控知识掌握的现状及培训效果?方法于培训前后进行问卷调查,内容包括:病例发现?结核病诊断及化疗?结果培训前疫情报告和转诊,回答正确者占75.2%?71.7%;对临床表现?查痰和诊断依据,回答正确者占83.5%?42.5%?40.8%;抗痨药物?用药方法?化疗原则?短化方案?短化疗程?治愈标准六项,回答正确者占58%?14.4%?20.8%?9.2%?17%?24.3%?培训后再次调查发现,90%以上医务人员对现代结控基本知识已掌握?结论各级医务人员现代结控知识是很贫乏的,因此,对其进行系统培训是极为必要的,此项工作省时?省力?投入少,可收到事半功倍的效果。     

大骨节病病区水,粮实验对动物的骨和软骨中化学元素组成的影响

用质子激发 X 线荧光分析方法(PIXE)测定了大骨节病病区和非病区的水、粮以及用该水粮喂养的大白鼠的肋软骨和硬骨中22种化学元素的含量。结果发现水粮中存在差异的元素反应在用该水粮喂养的大白鼠的骨、软骨中也存在差异,含量都低的元素有 P、Mn、Cu、As、Zn。都高的有铅。其中锌低在水、粮、硬骨和软骨中都完全一致呈非常显著性差异(p<0.01)。提示病区水、粮中化学元素对骨质的影响不是单一元素缺乏或过多所致,而是多种元素的复合因素。     

Assessment of the Soft-Tissue Seal at the Interface between the Base of the Fixed Denture Pontic and the Oral Mucosa

Fixed dentures (bridges) are often selected as a treatment option for a defective prosthesis. In this study, we assess the contact condition between the base of the pontic and oral mucosa, and examine the effect of prosthetic preparation and material biocompatibility. The molars were removed and replaced with experimental implants with a free-end type bridge superstructure after one week. In Experiment 1, we assessed different types of prosthetic pre-treatment: (1) the untreated control group (Con: mucosa recovering from the tooth extraction); (2) the laser irradiation group (Las: mucosa recovering after the damage caused by a CO₂ laser); and (3) the tooth extraction group (Ext: mucosa recovering immediately after the teeth extraction). In Experiment 2, five materials (titanium, zirconia, porcelain, gold-platinum alloy, and self-curing resin) were placed at the base of the bridge pontic. Four weeks after the placement of the bridge, the mucosa adjacent to the pontic base was histologically analyzed. In Experiment 1, the Con and Las groups exhibited no formation of an epithelial sealing structure on the pontic base. In the Ext group, adherent epithelium was observed. In Experiment 2, the sealing properties at the pontic interface were superior for titanium and the zirconia compared with those made of porcelain or gold-platinum alloy. In the resin group, a clear delay in epithelial healing was observed.     

高胆红素血症对肿瘤标志物测定的影响探讨

目的探讨高胆红素血症对Ca19-9、Ca24-2和CEA检测的影响.方法对320例胆管、胆囊良恶性疾病病人,15例胆囊炎病人的胆汁和血清以及10例肝硬化、10例黄疸肝炎病人进行Ca19-9、Ca24-2和CEA检测.结果在良性胆管、胆囊疾病中,Ca19-9的假阳性最高;在胆红素增高的良性疾病中,Ca19-9假阳性率达46.7%;15例胆汁和血清以及10例肝硬化和10例黄疸肝炎病人中,Ca19-9的假阳性率分别为93%、20%、80%和80%.结论高胆红素血症对Ca19-9检测影响最明显,胆囊、胆管良恶性疾病鉴别时,以Ca24-2和CEA检测为佳.     

Echocardiography in the Emergency Department: From the Perspective of the Emergency Physician and the Cardiologist

Echocardiography performed in the emergency department must adapt to this new setting for noninvasive diagnostic testing. Emergency physicians require echocardiography to provide rapid diagnosis in life-threatening emergencies. New initiatives are being proposed by emergency physicians in the delivery of this test. Cardiologists now use echocardiography in the emergency-department to make the diagnosis of heart disease earlier and with greater accuracy.     

Tracing the protectors path from the germ line to the genome

One of the basic principles that nature uses in evolution is to recycle successful concepts and create new functions by modifying existing units. This conservatism in evolution has resulted in an astonishingly high sequence identity of genes, even between evolutionarily distant species such as the nematode Caenorhabditis elegans and Homo sapiens. The recycling of successful concepts in conjunction with gene duplication events has also led to the existence of highly homologous proteins within the genome of many species. Often, these homologous proteins show similar, yet distinct functions that, in combination with their individual tissue distribution, define their specific physiological role. One prominent example is the p53 protein family, which consists of p53, p63, and p73. Recent advances in understanding the specific biological functions of these members have shed some light onto the evolution of this crucial protein family, from a germ line-specific quality-control factor to a somatic tumor suppressor. Furthermore, structures of the oligomerization domains of the mammalian paralogs, p53 and p73, and invertebrate orthologs, CEP-1 and DMP53, have delineated evolutionary changes and revealed that the oligomerization domain of p53 lacks additional stabilizing structural elements present in all other p53 family members. This suggests that p53 is the most recent evolutionary member of this protein family and predicts a mechanism for p53 activation.