类风湿关节炎患者血清激活素A、鸢尾素水平与疾病活动度、骨密度和骨骼肌质量的相关性研究

目的 分析类风湿关节炎(RA)患者血清激活素A、鸢尾素水平与疾病活动度、骨密度和骨骼肌质量的相关性.方法 选择2018年3月—2021年1月安徽医科大学第三附属医院风湿免疫科收治RA患者90例(RA组),根据28个关节疾病活动度(DAS28)评分分为低度亚组(2.6～3.2分,31例)、中度亚组(3.3～5.1分,37...     

血清激活素A与类风湿关节炎的相关性分析

目的 探讨血清激活素A(ACT-A)与类风湿关节炎(RA)的相关性.方法 收集2020年1月～8月于我院住院确诊的71例RA患者作为病例组,同期40例健康体检者作为对照组.采用ELISA法测定病例组和对照组ACT-A水平,并根据RA患者ACT-A上下四分位数(25％,75％)分为ACT-A低水平组(<27.54 ng/...     

基于微信平台的延伸性护理干预在类风湿性关节炎患者中的应用效果分析

目的:探讨基于微信平台的延伸性护理干预在类风湿性关节炎(RA)患者中的应用效果.方法:选择2018年9月—2020年9月驻马店市中心医院收治的92例RA患者,按随机数字表法分为对照组和观察组.对照组(46例)采取常规护理,观察组(46例)实施基于微信平台的延伸性护理.比较两组干预前和干预4周时遵医依从性和生活质量[生活质量综合评定量表(GQOLI-74)]评分,调查患者护理满意度.结果:观察组干预后遵医依从性中按时服药(34.52±4.28)分、生活方式改善(34.53±4.32)分、功能锻炼(38.96±4.36)分、定期复查(35.82±4.16)分,均高于对照组的(24.89±3.21)分、(24.98±3.25)分、(28.94±4.52)分、(29.94±4.05)分(P<0.05);观察组干预后GQOLI-74(66.27±6.04)分,高于对照组的(53.19±5.14)分(P<0.05);观察组护理满意度中健康指导(22.17±1.23)分、服务态度(22.28±1.03)分、生活干预(22.34±1.07)分、操作技术(22.38±1.05)分,均高于对照组的(20.56±2.14)分、(20.49±2.11)分、(20.52±2.14)分、(20.56±2.13)分(P<0.05).结论:基于微信平台的延伸性护理干预能够提高RA患者遵医依从性,促进患者生活质量和护理满意度提高,对于疾病恢复具有积极意义.     

外周血单个核细胞中VEGF mRNA的表达与类风湿性关节炎继发间质性肺疾病的关系

目的 研究类风湿性关节炎(RA)患者外周血单个核细胞(PBMC)中血管内皮生长因子(VEGF)mRNA的表达,探讨VEGF在RA发病中的作用及与RA继发间质性肺疾病(ILD)的相关因素.方法 应用半定量逆转录聚合酶链反应(RT-PCR)方法检测64例RA患者,20例健康者PBMC中VEGFmRNA的表达.其中RA组按是否存在ILD分为单纯RA组35例和RA继发ILD组29例.结果 RA患者PBMC中VECFmRNA的表达明显高于健康对照组,差异有统计学意义(P<0.05);RA继发ILD组显著高于单纯RA组(P<0.01).结论 VEGF是RA发病中重要的细胞因子,在RA继发ILD过程中对促进肺纤维化可能起着一定的作用.     

抗角蛋白抗体检测对类风湿关节炎的诊断价值

为研究抗角蛋白抗体(AKA)在类风湿关节炎(RA)的临床意义,对89例RA患者及146例非RA患者测定血清AKA,比较两组病人AKA阳性率,并对AKA与类风湿因子(RF)对RA诊断的敏感性和特异性进行比较.结果,RA患者AKA阳性率明显高于非RA患者(P＜0.001);对于RA诊断AKA特异性为92.5%,RF特异性为75.2%.提示血清AKA检测对于RA的诊断具有较高的特异性,可以弥补RF对RA诊断的不足.     

类风湿关节炎患者血清IL-13水平表达及对外周血单个核细胞中Th17细胞亚群分化的影响

目的:探讨类风湿关节炎(RA)患者血清IL-13表达及对RA患者外周血单个核细胞(PBMC)中Th17细胞亚群分化的影响.方法:通过酶联免疫吸附试验(ELISA)检测活动期RA患者(活动组,n=30)、稳定期RA患者(稳定组,n=30)和健康体检者(正常组,n=30)外周血血清白细胞介素-13(IL-13)表达水平,分...     

可溶性转铁蛋白受体对类风湿性关节炎伴贫血疾病的诊断价值

目的 探讨外周血可溶性转铁蛋白受体(sTfR)水平对类风湿性关节炎(RA)伴贫血疾病的诊断价值.方法 采用酶联免疫吸附实验(ELISA)方法 检测105例RA伴贫血患者(RA伴IDA患者73例,RA伴ACD患者32例)和健康体检者(健康对照组)168例的sTfR的血清水平,同时测定血红蛋白(Hb)、血清铁蛋白(SF)和转铁蛋白(Tf)水平.结果 sTfR,Hb,SF和Tf在RA伴贫血患者组、RS伴IDA患者组、RA伴ACD患者组和健康对照组间差异有显著性(P＜0.01).对于sTfR而言,健康对照组与RA伴ACD组间差异无显著性(P＞0.05)外,其他组间差异均有显著性(P＜0.01),且RA伴IDA组血清sTfR水平明显高于RA伴ACD组(P＜0.01).结论 sTfR血清水平的升高有助于RA伴贫血的诊断,并且在鉴别RA伴贫血类型的诊断中有一定的参考价值.     

B7-H1在类风湿关节炎滑膜组织中的表达及意义

目的 研究分析类风湿关节炎(RA)患者关节滑膜组织中B7-H1蛋白的表达,旨在探讨其在RA发病中的意义.方法 采用免疫组织化学SABC法检测24例RA患者膝关节滑膜组织中B7-H1蛋白的表达,并以骨关节炎患者(OA)和健康人膝关节滑膜组织做对照研究.结果 24例RA患者膝关节滑膜组织中21例(87.5%)B7-H1蛋白表达阳性,10例OA患者中3例(30.0%)B7-H1蛋白表达阳性,而6例正常对照组中有1例(16.7%)表达阳性,三者比较差异有显著性(P＜0.05).且B7-H1蛋白在滑膜增生严重的RA患者中表达更高.结论 B7-H1在RA患者的膝关节滑膜组织中高表达,可能直接参与了RA的发病过程.     

类风湿关节炎患者血清巨噬细胞集落刺激因子与心脏受累的关系

目的 观察类风湿关节炎(RA)患者血清巨噬细胞集落刺激因子(M-CSF)水平,探讨其与RA心脏受累的关系.方法 选取64例RA患者及20例健康体检者(健康对照组).根据RA患者的临床症状体征、心电图诊断结果、心脏彩超检查及X线等辅助检查结果将患者分为RA心脏受累组(40例)和RA非心脏受累组(24例).应用ELISA法检测RA组及健康对照组受检者血清M-CSF 水平,应用酶标仪测量各样本的吸光度值(OD值),并将其在标准曲线下换算成浓度.分别比较健康对照组与RA组,RA心脏受累组与RA非心脏受累组受检者血清M-CSF 、IgA、IgM、IgG、C反应蛋白(CRP)水平及血小板计数(PLT),了解M-CSF水平与RA患者心血管事件之间的相关性,探讨RA心脏受累的相关因素.结果 (1)RA组患者血清IgA、IgG、M-CSF 水平显著高于健康对照组,差异均有统计学意义(P均＜0.01).(2)RA心脏受累组患者血清CRP、PLT、M-CSF水平显著高于RA非心脏受累组,差异均有统计学意义(P均＜0.05).(3)Logistic回归分析显示,IgA、IgG、M-CSF与RA无相关性(P均＞0.05);而血清M-CSF水平与RA心脏受累相关(P＝0.011).结论 RA心脏受累患者血清M-CSF水平显著高于RA非心脏受累患者,血清高水平M-CSF提示可能会出现心脏受累.     

抗环瓜氨酸肽抗体检测对类风湿性关节炎的价值

目的 检测抗环瓜氨酸肽(CCP)抗体,探讨其对类风湿性关节炎(RA)的诊断、治疗和预后的价值.方法 采用酶联免疫吸附试验(ELISA)检测110例RA患者(RA组)、40例其他的类风湿疾病患者(对照组)和40例健康查体者(正常组)血清中抗CCP抗体.结果 血清中抗CCP抗体,RA组(90.5±46.3)Ru/ml,对照组(23.3±10.1)Ru/ml,正常组(20.2±7.2)Ru/ml,RA患者血清中存在高浓度的抗CCP抗体,与其他两组比较差异显著(P<0.01).结论 RA患者血清中有高浓度抗CCP抗体,可作为RA患者的检测指标.     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.