肌源性肌病的免疫活性表达及其临床意义

目的研究３０例肌源性肌病，包括进行性肌营养不良症（ＰＭＤ）、多发性肌炎（ＰＭ）／皮肌炎（ＤＭ）、先天性肌病（ＣＭＤ）和代谢性肌病（ＭＭＤ）骨骼肌活检组织的体液免疫、细胞免疫与免疫调控等免疫活性表达，探讨其临床意义及与病变之间的关系。方法免疫酶组化ＳＰ法检测抗体ＣＤ３、ＣＤ４、ＣＤ８、ＣＤ６８和ＨＬＡ－ＤＲ，免疫荧光一步法检测免疫球蛋白ＩｇＧ、ＩｇＭ和补体Ｃ３。结果（１）ＰＭＤ肌组织中免疫球蛋白ＩｇＭ、ＩｇＧ和补体Ｃ３免疫复合物的阳性率分别为５０％，３１．１％和１１．１％，以ＩｇＭ有统计学意义（Ｐ＜０．０５），主要定位于肌膜和间质小血管壁上，并与ＰＭＤ肌纤维的萎缩性病变有关。（２）ＰＭＤ肌组织中有单核炎症细胞浸润，以巨噬细胞和Ｔ淋巴细胞为主，其阳性反应率分别为１００％和５５．５％。巨噬细胞多位于坏死纤维中，Ｔ淋巴细胞分布于变性坏死肌纤维和肌束衣小血管周围，ＣＤ８＋Ｔ细胞数量增多，Ｔ４／Ｔ８＜１。（３）ＨＬＡ－ＤＲ染色显示ＰＭＤ肌组织中变性萎缩的小纤维周围有ＨＬＡ－ＤＲ＋的激活单核炎症细胞浸润，与神经源性肌病组及正常对照组比较差别均有显著性（Ｐ＜０．０５）。肌纤维ＨＬＡ－ＤＲ阳性反应者占２２％（４／１８），表明     

柯萨奇B组病毒性心肌炎的自然杀伤细胞活性及T细胞亚群的研究

检测柯萨奇Ｂ组病毒（ＣＶＢ）性心肌炎７０例，正常人（ＮＣ）４０例外周血的自然杀伤细胞（ＮＫＣ）活性和Ｔ细胞亚群。结果显示病毒性心肌炎（ＶＭＣ）组ＮＫＣ活性显著低于ＮＣ组（Ｐ〈０．０１）。Ｔ细胞亚群与ＮＣ组比较，急性ＶＭＣ患者总Ｔ细胞（ＣＤ３），辅助性Ｔ细胞（ＣＤ４）和抑制性Ｔ细胞（ＣＤ８）及ＣＤ４／ＣＤ８比值均减少，Ｐ〈０．０５￣０．０１。慢性ＶＭＣ患者仅ＣＤ８减低明显（Ｐ〈０．０５），而ＣＤ３、     

柯萨奇B组病毒性心肌炎的自然杀伤细胞活性及T细胞亚群的测定

目的 了解细胞免疫功能低下或失调对病毒性心肌炎发病、预后的影响。方法 检测柯萨奇Ｂ组病毒（ＣＶＢ）性心肌炎７０例,正常人（ＮＣ）４０例外周血的自然杀伤细胞９ＮＫＣ）活性和Ｔ细胞亚群。结果 病毒性心肌炎（ＶＭＣ）组ＮＫＣ活性高于ＮＣ组。Ｔ细胞亚群与ＮＣ组比较,急性ＶＭＣ患者总Ｔ细胞（ＣＤ３）,辅助性Ｔ细胞（ＣＤ４）,和抑制性Ｔ细胞（ＣＤ８）,及ＣＤ４／ＣＤ８比值均减少,Ｐ〈０．０５￣０．０１。慢性Ｖ     

卵巢恶性肿瘤患者T细胞亚群及其与IL-2、sIL-2R的相关性研究

为探讨卵巢恶性肿瘤（ＭＯＴ）与细胞免疫的关系，对４０例ＭＯＴ患者和３０例正常对照（ＮＣ）妇女的Ｔ淋巴细胞亚群和白细胞介素－２（ＩＬ－２）、可溶性白细胞介素－２受体（ｓＩＬ－２Ｒ）进行了同步检测及相关性研究。结果：ＭＯＴ组ＩＬ－２、ＣＤ＋３、ＣＤ＋４、ＣＤ＋４／ＣＤ＋８均低于ＮＣ组，ｓＩＬ－２Ｒ、ＣＤ＋８均高于ＮＣ组（Ｐ＜０．０１～０．００１），其中ＣＤ＋３、ＣＤ＋４、ＣＤ＋４／ＣＤ＋８与ＩＬ－２呈正相关，与ｓＩＬ－２Ｒ呈负相关（Ｐ＜０．０１～０．００１）。提示本病患者Ｔ淋巴细胞免疫功能低下，ＣＤ＋３、ＣＤ＋４、ＣＤ＋４／ＣＤ＋８值的降低与ＩＬ－２活性下降和ｓＩＬ－２Ｒ水平增高有关，它们均可能是本病发生发展的重要因素。     

乙肝病毒感染者T细胞亚群状态与肾脏损害的关系

目的：探讨Ｔ细胞亚群变化在乙肝病毒相关肾炎发病中的作用。方法：利用流式细胞仪,检测３０ 例乙肝病毒感染后发生肾损害者周围血ＣＤ４＋ 、ＣＤ８ ＋ 细胞的变化;并对６ 例经肾活检证明为乙肝病毒相关肾炎患者用免疫组化ＡＢＣ法检测肾组织ＣＤ４＋ 、ＣＤ８ ＋ 细胞浸润情况。结果：乙肝病毒感染后发生肾损害组周围血ＣＤ８＋ 细胞明显升高（Ｐ＜ ０．０５）;ＣＤ４＋ ／ＣＤ８ ＋ 明显下降（Ｐ＜ ０．０５）,与２４ ｈ 尿蛋白定量呈负相关（ ｒ＝ － ０．５５９６,Ｐ＜ ０．０５）;乙肝病毒相关肾炎患者肾组织ＣＤ４＋ 、ＣＤ８ ＋ 细胞数明显增加（ Ｐ＜ ０．０５）。结论：乙肝病毒感染后发生肾损害者存在周围血Ｔ细胞亚群失衡;不仅特异性体液免疫,而且特异性细胞免疫及非特异性免疫机理也参与乙肝病毒相关肾炎发病     

丙肝患者中血T细胞亚群及mIL—2R的检测

目的：探讨丙型毒性肝炎（丙肝）患者的细胞免疫水平及其在丙肝发病机理中的作用。方法：用生物素－链霉订和素法对１１２例－ＨＣＶ阳性患者中血单个核细胞进行Ｔ细胞亚群及植物血凝素（ＰＨＡ）诱导前后ｍＩＬ－２Ｒ的检测。结果：急慢性丙肝患者与正常对照相比,外周血ＣＤ３＾＋、ＣＤ４＾＋百分率降低,ＣＤ８＾＋百分率增高,ＣＤ４＾＋／ＣＤ８＾＋比值下降（Ｐ〈０．０５～Ｐ〈０．０１）。外周血单个核细胞在青息状态和在Ｐ     

胚胎胸腺细胞移植对恶性淋巴瘤患者T细胞亚群的影响

为探讨胚胎胸腺细胞（ＦＴＣ）移植的作用机理，采用单克隆抗体免疫荧光法检测了１９例淋巴细胞癌变患者ＦＴＣ移植前后Ｔ淋巴细胞亚群分布，结果表明：ＦＴＣ移植前患者ＣＤ＾＋３，ＣＤ＾＋４，ＣＤ＾＋４／ＣＤ＾＋８低于正常对照组（Ｐ〈０．０１），ＣＤ＾＋８高于对照组（Ｐ〈０．０１）；ＦＴＣ移植后ＣＤ＾＋３，ＣＤ＾＋，较移植前明业增高（Ｐ〈０．０１），ＣＤ＾＋８显著降低（Ｐ〈０．０１），ＣＤ＾＋４／ＣＤ＾＋８,     

丙肝患者外周血T细胞亚群及mIL-2R的检测

目的：探讨丙型病毒性肝炎（ 丙肝） 患者的细胞免疫水平及其在丙肝发病机理中的作用。方法：用生物素链霉亲和素法对１１２ 例抗 Ｈ Ｃ Ｖ 阳性患者外周血单个核细胞进行 Ｔ 细胞亚群及植物血凝素（ Ｐ Ｈ Ａ） 诱导前后ｍ Ｉ Ｌ２ Ｒ 的检测。结果：急慢性丙肝患者与正常对照相比,外周血 Ｃ Ｄ３ ＋ 、 Ｃ Ｄ４ ＋ 百分率降低, Ｃ Ｄ８ ＋ 百分率增高, Ｃ Ｄ４ ＋ ／ Ｃ Ｄ８ ＋ 比值下降（ Ｐ＜ ０ ．０５ ～ Ｐ＜ ０ ．０１） 。外周血单个核细胞在静息状态和在 Ｐ Ｈ Ａ 诱导状态,其ｍ Ｉ Ｌ２ Ｒ 表达水平与正常对照组相比均低下（ Ｐ＜ ０ ．０１） ,但急慢性丙肝患者中 Ｔ 细胞亚群及ｍ Ｉ Ｌ２ Ｒ 表达水平类似（ Ｐ＞ ０ ．０５） 。结论：丙肝患者体内存在明显的细胞免疫功能紊乱, Ｔ 细胞活化障碍,并与肝病的慢性化有关。     

NIDDM患者外周血T淋巴细胞亚群的变化

测定４８例ＮＩＤＤＭ患者的外周血Ｔ淋巴细胞亚群，结果显示ＣＤ＿３、ＣＤ＿４、ＣＤ＿８值均降低，与正常对照组比较，差异有高度显著性（Ｐ＜０．０１）。提示ＮＩＤＤＭ患者有Ｔ淋巴细胞功能缺陷。并讨论ＮＩＤＤＭ患者Ｔ细胞亚群变化的可能原因。     

骨髓增生异常综合征患者T淋巴细胞亚群变化

用直接ＳＰＡ菌花环法体外测定１３例骨髓增生异常综合征（ＭＤＳ）患者外周血Ｔ细胞亚群，结果表明：患者平均ＯＫＴ＋４细胞百分值、ＯＫＴ＋４／ＯＫＴ＋８比值均显著低于正常（Ｐ＜０．０５～０．００２），平均ＯＫＴ＋８细胞百分值显著高于正常（Ｐ＜０．００５）。说明ＭＤＳ患者淋巴细胞亚群分布异常。并发现Ｔ细胞亚群随病情发展而变化，提示外周血Ｔ细胞亚群的变化可以作为判断病情，预后及疗效的辅助参考指标之一。     

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.     

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.     

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.