自身免疫性感音神经性聋基因治疗的实验研究

目的:研究以重组复制缺陷型腺病毒为载体的Fas配体(Fas-Ligand,即FasL)基因和白细胞介素10(即IL-10)基因治疗实验性自身免疫性感音神经性聋.方法:采用同种内耳组织抗原加弗氏佐剂免疫豚鼠,造成自身免疫性感音神经性聋的动物模型28只,按配对设计将其分为4组,通过鼓阶微量注射的方式,A组注入携带FasL基因的腺病毒(Ad-FasL),B组注入携带IL-10基因的腺病毒(Ad-IL-10),C组单纯注入腺病毒(携带绿色荧光蛋白,即Ad-GFP),D组注入等量的磷酸盐缓冲液.基因导入7 d后行听觉脑干诱发电位(ABR)测试,后取颞骨制作石蜡切片并行HE染色和光镜观察,每组各取两耳行螺旋韧带和基底膜透射电镜观察.每组各取3只(6耳)行免疫荧光和酶免疫组织化学试验,以检测基因产物表达和腺病毒转染情况.结果:免疫组织化学显示携带目的基因的腺病毒可以转染血管纹、螺旋韧带、Corti器、螺旋神经节、蜗轴小血管周围及其耳蜗的骨壁等部位的细胞,并产生相应的蛋白产物(IL-10和FasL).ABRⅢ波阈值的均值对比结果显示,A组和B组明显低于C组和D组.内耳组织的免疫炎性反应亦明显较C组减轻.结论:重组复制缺陷型腺病毒可以携带目的基因转导入内耳,并在内耳表达基因产物,其抑制炎症反应的作用可有效地减轻自身免疫性感音神经性聋的内耳组织免疫炎性损伤和听觉功能障碍,有望成为治疗自身免疫性感音神经性聋新的方法和途径.     

“O”型血型孕妇IgG抗体效价对新生儿溶血影响

目的:探讨"O"型血型孕妇IgG抗体效价对HDN发病的影响。方法:对248例"O"型血型孕妇行产前IgG抗A(B)抗体效价检测,且检测所生新生儿血清总胆红素水平,评价"O"型血型孕妇血清IgG抗体效价对HDN影响。结果:248例夫妻中,随着孕妇血清IgG抗A(B)抗体效价的升高,其所生新生儿发生HDN的患病率也在升高,差异有统计学意义(P<0.01),新生儿胆红素水平也随着母亲抗体效价的提高而差异有统计学意义(P<0.05)。结论:HDN的发生与"O"型血型孕妇血清中IgG抗A(B)抗体效价相关,效价越高,HDN的发生率越高,当抗体效价≥512时,新生儿血清总胆红素水平随效价升高而增高。     

二巯基乙醇和二硫苏糖醇检测IgG抗A(B)效价中和能力的比较

目的 比较二巯基乙醇(2-Me)和二硫苏糖醇(DTT)中和IgM抗体后检测IgG抗A(B)效价的能力.方法 187份O 型、RhD(+)孕妇血清分别经2-Me和DTT中和IgM抗体后,用经典抗人球蛋白法检测IgG抗A(B)效价.结果 2-Me中和IgM抗体后测得IgG抗A(B)效价的几何均数为34.198,DTT中和I...     

系统性红斑狼疮患者血清抗亲环素A抗体检测的临床意义

目的：观察血清抗亲环素(CyP)A抗体对系统性红斑狼疮(SLE)的诊断价值与临床意义。方法：用ELISA方法检测54例SLE、36例其他自身免疫病患者及40例健康对照者血清IgG、3种抗CyP A抗体并结合活动性评分、系统损害进行分析。结果：54例SLE患者中23例检出IgG型抗CyP A抗体，15例IgM型、3例IgA型抗CyP A抗体。IgG型抗CyP A抗体的灵敏度为42．6％，特异性为55．6％，IgM型CyP抗体的灵敏度为27．8％，特异性为36，1％。SLE三重度活动组两型抗CyP A抗体检出率高于稳定期及轻、中度活动组。IgG型及IgM型抗体与血中低补体及免疫球蛋白升高有关，IgG型抗CyP A抗体与SLE关节肌肉症状及白细胞减少有关。结论：IgG型抗CyP A抗体检出的临床价值优于IgM型抗体。CyP A抗体非SLE三特异性抗体，但可作为判断SLE病情活动性的参考指标之一。     

二巯基乙醇和二硫苏糖醇检测IgG抗A(B)效价中和能力比较分析

目的 比较二巯基乙醇（2-Me）和二硫苏糖醇（DTT）中和IgM抗体后检测IgG抗A(B)效价的能力。方法 187份O 型、RhD（+）孕妇血清分别经2-Me和DTT中和IgM抗体后,用经典抗人球蛋白法检测IgG抗A(B)效价。结果 2-Me中和IgM抗体后测得IgG抗A(B)效价的几何均数为34.198,DTT中和IgM抗体后测得IgG抗A(B)效价的几何均数为32.434,经成对t检验,两种方法检测结果差异无统计学意义（t =0.142,P＞0.05）。结论 用2-Me和DTT中和IgM抗体后检测IgG抗A(B)效价结果无差异。     

类风湿关节炎患者抗人、猪两种属Ⅱ型胶原抗体检测的意义

目的 :检测类风湿关节炎 (RA)患者血清中人及猪Ⅱ型胶原抗体水平 ,探讨其在RA发病中的意义。方法 :用自提取的人、猪Ⅱ型胶原包板 ,采用改良的酶联免疫吸附法 (ELISA)测定 1 0 5例RA患者血清抗人、猪Ⅱ型胶原抗体IgG及IgA ,并与正常人 ( 1 4 0例 )及疾病对照组 ( 80例 )比较分析。同时检测患者的类风湿因子(RF)、血沉 (ESR)及C反应蛋白 (CRP)。结果 :RA患者血清中抗人Ⅱ型胶原抗体IgG、IgA阳性率分别为2 5 .3%、2 7.5 % ,抗猪Ⅱ型胶原抗体IgG、IgA阳性率分别为 2 6.9%、2 5 .6% ,显著高于正常人及疾病对照组 (P<0 .0 5 )。两种属Ⅱ型胶原抗体IgG及IgA常同时存在于同一患者中。两种属Ⅱ型胶原抗体与RF、ESR及CRP异常无相关性。结论 :RA患者血清中人及猪Ⅱ型胶原抗体水平升高 ,可能在RA的发病中起着一定的作用 ;但RA患者Ⅱ型胶原抗体阳性与疾病活动指标无明显相关 ,不能作为监测RA活动的指标。     

新西兰小鼠血清抗DNA抗体水平的研究

目的::研究新西兰小鼠NZB、NZW、及其杂交子代(NZB×NZW)F1小鼠血清抗DNA抗体的水平差异.方法:酶联免疫吸附分析检测新西兰小鼠血清IgG及IgM型抗dsDNA及抗ssDNA抗体滴度.结果:与亲代NZB及NZW相比,其F1子代小鼠IgG型抗dsDNA及抗ssDNA抗体滴度明显增高(P＜0.01),IgM型抗dsDNA及抗ssDNA抗体滴度则比NZW增高(P＜0.01),比NZB反而降低.结论:致病性IgG型抗DNA抗体是促使新西兰小鼠狼疮发病的主要原因.     

血清倍比稀释量的不同对检测IgG抗A(B)效价灵敏度的影响

目的探讨血清倍比稀释量的不同对检测IgG抗A(B)效价灵敏度的影响。方法 165例孕妇血清经二巯基乙醇中和IgM抗体后采用不同的量倍比稀释,用经典抗人球试验检测IgG抗A(B)效价。结果血清倍比稀释量的多少影响IgG抗A(B)效价的测定,分别选用50、100、150、200μL的生理盐水倍比稀释血清,随着稀释量的增加效价呈增高局势,差异有统计学意义(P<0.05,P<0.01)。结论不同的血清倍比稀释量对检测IgG抗A(B)效价灵敏度有一定影响,孕妇产前IgG抗A(B)效价检测操作规程应力求统一,使检测结果具有可比性,以维持检测结果的真实性和严谨性。     

Ⅱ型胶原自身抗体与类风湿性关节炎的关系

我们用改良的酶联免疫吸附法(ELISA),分别用牛、人天然Ⅱ型胶原和用溴化氰裂解的人Ⅱ型胶原作为包被抗原,检测了112例类风湿性关节炎患者和154例健康对照血清中抗Ⅱ型胶原的IgG型和IgA型抗体。抗天然牛Ⅱ型胶原自身抗体IgG型和IgA型阳性率RA患者组分别为19.6％和12.5％,而健康对照组为0.7％和2.0％,抗天然人Ⅱ型胶原自身抗体IgG型和IgA型阳性率RA患者分别为12.5％和16.3％,而健康对照为0％和2.5％,两类抗体的阳性率均为RA患者组显著高于对照组。用牛和人的Ⅱ型胶原作为包被抗原,其阳性率无显著性差异。这也说明了Ⅱ型胶原蛋白在种属间的抗原决定簇相似。用溴化氰裂解的人Ⅱ型胶原作为包被抗原,RA患者和健康对照组在IgG型有显著性差异,而在IgA型无统计学差异,其原因有待进一步探讨。本文根据这些结果讨论了Ⅱ型胶原自身抗体在RA发病中的意义。     

自身免疫性感音神经性聋豚鼠子代的内耳功能与形态学研究

目的:观察自身免疫性感音神经性聋(ASNHL)雌性豚鼠子代内耳听觉生理功能及组织结构病理变化,探讨内耳自身免疫因素与子代内耳听觉损伤的相关性。方法:采用同种粗制内耳抗原(CIEAgs)免疫,造成雌性豚鼠ASNHL,妊娠后持续抗原强化免疫,对其所产子鼠进行相关指标测试和观察,包括听神经复合动作电位阈值、幅值和耳蜗微音器电位伪阈,血清抗CIEAgs抗体水平以及内耳病理形态学观察。结果:ASNHL雌鼠的子代36只中有18只(22耳)出现听力损伤,血清抗CIEAgs抗体增高,螺旋神经节细胞变性,数目减少,蜗螺旋管内炎性细胞浸润。结论:ASNHL所产子鼠可出现先天性感音神经性聋和内耳病理损伤,其发生可能与特异性体液免疫有关。     

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.     

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.