脐血细胞因子水平与新生儿败血症的早期诊断

目的 :研究脐血白细胞介素 6 (IL 6 )、肿瘤坏死因子 α(TNF α)水平与新生儿宫内或产时感染所致败血症之间的关系。方法 :应用ELISA双抗夹心法检测了 72例脐血清 ,其中正常脐血清 5 2例 ,败血症 2 0例。结果 :正常脐血组IL 6 :中位数 0 .0 2 4ng/ml(范围 0 .0 2 2 1～ 0 .0 5 31ng/ml)、TNF α中位数 1.12ng/ml(范围 0 .10～ 3.85ng/ml) ;败血症组IL 6 :中位数 0 .173ng/ml(范围 0 .0 2 6 6～ 1.2 5 89ng/ml)、TNF α中位数 5 .6 1ng/ml(范围 0 .6 5～ 12 .6 0ng/ml) ;经秩和检验 ,正常脐血组IL 6、TNF α与败血症组有明显差异 (P<0 .0 1) 。结论 :脐血IL 6、TNF α可作为新生儿败血症的早期诊断指标 ,且IL 6比TNF α有更高的灵敏度和特异性。     

PDTC对重症急性胰腺炎的抑制作用

目的　探讨抗氧化剂四氢化吡咯二硫代氨基甲酸脂 (PDTC)对重症急性胰腺炎 (SAP)的抑制作用。方法　Wistar大鼠 72只 ,随机分为 :假手术组 (shamoperation ,SO)、SAP组和SAP +PDTC组。术后分四个时段 ( 1、3、6、12h)分批进行下腔静脉采血后处死 ,取胰腺组织作病理切片。采用双抗体夹心ABC ELISA法测定血浆TNF α、IL 6。结果　SAP组血浆细胞因子TNF α和IL 6浓度较SO组增高 (P <0 .0 5 ) ,其中TNF α于术后 1h达到峰值 ( 871.6± 5 .9pg/ml) ,与SO组 ( 2 5 .2± 1.2 pg/ml)差异显著 (P <0 .0 0 1)。而IL - 6于术后 3h达到峰值( 5 9.2± 4 .1pg/m) ,与SO组 ( 2 5 .2± 1.2 pg/ml)差异显著 (P <0 .0 5 )。SAP +PDTC组的血浆TNF α和IL 6浓度较SAP组明显下降 (P <0 .0 5 ) ,胰腺局部炎症反应减轻。结论　细胞因子TNF α和IL 6是SAP炎症因子网络中重要的组成部分 ,可以作为判断AP严重程度和预后的预测指标 ;PDTC抑制NF κB的活化 ,不仅抑制了SAP时SIRS的过程 ,亦改善了胰腺本身的炎症过程     

巨细胞病毒肝炎患儿血清细胞因子水平测定及其临床意义

目的　研究巨细胞病毒 (CMV)肝炎患儿血清干扰素 α(IFN α)、白细胞介素 8(IL 8)和肿瘤坏死因子 α(TNF α)水平的变化及其临床意义。方法　应用ELISA法检测 35例CMV肝炎患儿血清中上述三种细胞因子的含量 ,并对其两两之间进行了相关性分析。结果　CMV肝炎组患儿IFN α、IL 8、TNF α的含量分别为 (770 .3± 2 0 5 .4 )ng/L、(41.9± 2 2 .5 )ng/L和 (10 33.2± 388.5 )ng/L ,非常显著高于正常对照组 (P <0 .0 1)。相关性研究发现IFN α与TNF α呈显著正相关 (r =0 .35 6 ,P <0 .0 5 )。结论　血清细胞因子明显增高与CMV肝炎的病理变化和病损程度有着密切的联系     

不育症患者精浆中细胞因子测定的临床研究

目的　 探讨精浆中白细胞介素 1β(IL 1β)、白细胞介素 2 (IL 2 )、白细胞介素 4 (IL 4 )、白细胞介素 6 (IL 6 )、白细胞介素 8(IL 8)、白细胞介素 10 (IL 10 )、肿瘤坏死因子 α(TNF α)等细胞因子浓度与不育症患者之间以及精子的各项功能指标之间的相互关系。方法　 应用放射免疫分析(RIA)技术对 12 6例不育男性精浆中IL 1β、IL 2、IL 4、IL 6、IL 8、IL 10、TNF α水平进行了检测。结果　 不育症组精浆IL 1β、IL 2、IL 6、IL 8、TNF α含量均高于生育组 ,两组间均存在显著性差异(P <0 .0 5或P <0 .0 1) ;精浆IL 4、IL 10含量均低于生育组 ,两组间均存在显著性差异 (P <0 .0 1)。不育症组精浆中IL 1β、IL 2、IL 4、IL 6、IL 8、IL 10、TNF α含量在WBC精液组与非WBC精液组、血清AsAb阳性组与血清AsAb阴性组之间均存在显著性差异 (P <0 .0 5或P <0 .0 1) ;精浆中IL 4、TNF α含量在精子活动力、活动率、精子穿透力、顶体完整率、尾部肿胀率正常组与不正常组之间均存在显著性差异 (P <0 .0 5或P <0 .0 1)。 结论　 精浆中IL 1β、IL 2、IL 4、IL 6、IL 8、IL 10、TNF α含量与男性不育症患者之间存在密切关系 ,检测精浆中IL 1β、IL 2、IL 4、IL 6、IL 8、IL 10、TNF α的含量可以反映男性     

脑梗死患者ET、CGRP、TNF-α和IL-2水平及其临床意义

目的　探讨脑梗死患者血浆、脑脊液中内皮素 (ET)、降钙素基因相关肽 (CGRP)、肿瘤坏死因子 (TNF α)和白细胞介素 2 (IL 2 )水平变化及临床意义。方法　对 43例脑梗死患者血浆、脑脊液中ET、CGRP、TNF α和IL 2进行检测 ,ET、CGRP采用放射免疫法检测 ,TNF α和IL 2采用酶联免疫吸附法检测 ,并与 30例健康人各项检测指标作比较。结果　 ( 1)脑梗死患者血浆ET与CGRP呈正相关 (r=0 .5 6 ,P <0 .0 1) ;( 2 )脑梗死患者血浆TNF α与ET呈正相关 (r=0 .5 0 ,P <0 .0 1) ;( 3)患者脑脊液中IL 2与CGRP呈负相关 (r =-0 .5 7,P <0 .0 1)。结论　细胞因子的异常表达能影响血管活性物的合成与释放 ,造成ET与CGRP比例失衡 ,提示使用细胞免疫抑制剂可为脑梗死的防治开辟一条新途径。     

心力衰竭患者可溶性细胞间粘附分子-1的变化及意义

目的 :探讨可溶性细胞间粘附分子 1(SICAM 1)与充血性心力衰竭 (CHF)的关系。方法 :心衰患者 45例和年龄相匹配的对照组 2 0例。测定血清SICAM 1、白介素 6(IL 6)、肿瘤坏死因子 α(TNF α)、血浆内皮素 1(ET 1)等 ,SICAM 1用ELISA检测 ,IL 6、TNF α、ET 1用放射免疫法检测。结果 :CHF患者血清SICAM 1、IL 6、TNF α、血浆ET 1浓度较对照组明显升高 (分别为P <0 .0 0 1、0 .0 0 1、0 .0 5、0 .0 1)。血清SICAM 1与血清IL 6呈正相关 (r =0 .45 11,P <0 .0 1) ,与血浆ET 1也呈正相关 (r =0 .4179,P <0 .0 1)。结论 :细胞间粘附分子 1在充血性心力衰竭中的作用可能与免疫功能激活及内皮损伤有关。     

白细胞介素10抑制枯否细胞诱导的肝星状细胞激活的研究

目的　研究白细胞介素 10 (IL 10 )对与枯否氏细胞 (KC)共培养的肝星状细胞 (HSC)激活的影响 ,并初步探讨其作用机制。方法　采用肝脏离体胶原酶灌注消化 ,及密度梯度离心的方法来分离培养HSC和KC ;将原代培养 2d的HSC和KC分为HSC单独培养、KC单独培养和HSC与KC共培养 3大组 ,分别加 2ng/ml和 2 0ng/ml的IL 10处理。 2d后 ,分别采用3 H 胸腺嘧啶脱氧核苷 (3 H TdR)掺入法检测HSC的增殖 ,Western印染法检测HSC中α 平滑肌肌动蛋白 (α SMA)的表达和酶联免疫吸附分析 (ELISA)法检测培养上清中肿瘤坏死因子 α(TNF α)的含量。结果　IL 10对单独培养的HSC的增殖 (P >0 .0 5 )和α SMA表达 (P >0 .0 5 )无明显影响。共培养组HSC的增殖和α SMA表达分别增加了 2 .4倍和 6倍 ;2ng/ml和 2 0ng/ml的IL 10分别使共培养组HSC的增殖降低了 2 3%和 33% ,α SMA表达降低了 35 %和 4 9% ,均呈浓度依赖性 ,和HSC单独培养组相比 ,差异有显著意义 (P <0 .0 5或P <0 .0 0 1)。HSC单独培养组未检测出TNF α ;共培养组的TNF α量比KC单独培养组增加了 74 %(P <0 .0 1) ;2ng/ml和 2 0ng/ml的IL 10分别使共培养组的TNF α量降低了 2 7% (P <0 0 1)和 36 % (P<0 0 1) ,使KC单独培养组的TNF α量降低了 2 9% (P <0 0 5 )和 4     

益气温阳活血利水法对心力衰竭患者细胞因子和氧化应激改变的影响

目的 :探讨充血性心力衰竭患者 (CHF)血清肿瘤坏死因子 α(TNF α)、白细胞介素 6 (IL 6 )、超氧化物歧化酶 (SOD)、丙二醛 (MDA)的改变及益气温阳活血利水法的调控作用。方法 :将 6 6例CHF患者随机分为治疗组和对照组。对照组采用常规治疗 ,治疗组在常规治疗的基础上加用益气温阳活血利水中药。两组疗程均为 10周。在治疗前后测定TNF α、IL 6、SOD、MDA和心功能的变化。结果 :治疗后两组血清TNF α、IL 6、MDA水平均明显下降 (P <0 .0 5 ,P <0 .0 1) ,且治疗组TNF α、IL 6较对照组降低更为显著 (P <0 .0 5 ) ;SOD水平均明显上升 (P<0 .0 5 ,P <0 .0 1) ,且治疗组较对照组上升更为显著 (P <0 .0 5 )。治疗后两组心功能均有明显改善 (P <0 .0 5 ,P <0 .0 1)。结论 :益气温阳活血利水中药可能通过调控细胞因子水平、减轻机体的氧化应激 ,起到防止和逆转心肌重构、改善心功能的作用。     

哮喘患者血清IL-13、TNF-α与IgE的测定及意义

目的　探讨支气管哮喘患者IL 13、TNF α与IgE的变化及其在哮喘发病中的意义。方法　采用固相ELISA法检测 5 7例支气管哮喘患者和 2 3例健康者血清IL 13、TNF α和IgE浓度。结果　支气管哮喘组IL 13、TNF α与IgE水平均显著高于健康组 (P <0 .0 1)。IL 13水平在外源性哮喘急性期明显高于内源性哮喘急性期 (P <0 .0 1) ,而缓解期无明显差异 (P >0 .0 5 )。TNF α水平在急性期和缓解期无明显差异 (P >0 .0 5 )。经直线相关分析显示 ,支气管哮喘组IL 13与IgE呈正相关 (r=0 .88,P <0 .0 1)。结论　IL 13、TNF α升高是哮喘发病的重要因素 ;IL 13在哮喘患者IgE产生过程中起促进作用     

IL-13和TNF-α在慢性阻塞性肺疾病的表达及意义

目的 :探讨白细胞介素 13(IL 13)和肿瘤坏死因子 α(TNF α)与慢性阻塞性肺疾病 (COPD)发生及发展的关系。方法 :根据中华医学会呼吸分会慢性阻塞性肺疾病诊治指南 ,将受试者分为COPD急性加重期组 (n =2 0 ) ,COPD稳定期组 (n =15 )和正常对照组 (n =2 2 ) ,用双抗夹心ABC ELISA法同时测定血清IL 13和TNF α水平。结果 :IL 13和TNF α在COPD急性加重期组、COPD稳定期组中水平均分别显著高于正常对照组 (P <0 .0 1) ,且COPD急性加重期组显著高于COPD稳定期组 (P <0 .0 5 )。COPD急性加重期组IL 13和TNF α水平呈直线正相关 (r =0 .91,P <0 .0 0 1)。结论 :IL 13和TNF α均与COPD的发病有关 ,且与导致COPD急性加重的感染有关     

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.     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.