血清细胞因子测定在慢性前列腺炎诊断、分型中的临床意义

目的 探讨血清中细胞因子在慢性前列腺炎（CP）诊断、分型中的意义。方法 用ELISA法检测146例临床诊断的慢性前列腺炎患者[其中慢性细菌性前列腺炎（CBP）组52例、慢性非细菌性前列腺炎（CAP）Ⅰ组66例、Ⅱ组28例]血清中的细胞因子，如IL-2、IL-4、IL-6、IL-8、TNF-α，同时，以20例健康男性作为正常对照，并对所取得的数据进行统计学分析。结果 （1）IL-2、IL-4在CBP组、CAPI组患者血清中均有不同程度的升高，与正常对照组比较差异显著（P〈0．01或P〈0．05），而CBP组与CAPⅠ、CAPⅡ组与正常对照组间比较均无显著性差异（P〉0．05）。（2）IL-6、IL-8在CBP组、CAPⅠ组、CAPⅡ组、正常对照组间相互比较均有显著性差异（P〈0．01或P〈0．05）；TNF-α在CBP组、CAPⅠ组、正常对照组间相互比较差异显著（P〈0．01或P〈0．05），CAPⅡ组与正常对照组间比较差异无显著性（P〉0．05）。结论 血清中IL-2、IL-4、IL-6、IL-8、TNF-α水平可能在CP的发生发展过程中起作用，对CP辅助性诊断有较大应用价值，其中IL-6、IL-8、TNF-α对CP的诊断、分型有-定临床意义。     

慢性非细菌性前列腺炎患者前列腺液TNF-α、IL-8的检测及临床意义

目的：探讨前列腺按摩液（EPS）中细胞因子白细胞介素-8（IL-8）及肿瘤坏死因子-α（TNF-α）在Ⅲ型前列腺炎[慢性非细菌性前列腺炎／慢性盆底疼痛综合征（CAP／CPPS）]诊断、分型中的意义。方法：ELISA法检测50例临床诊断为Ⅲ型前列腺炎患者EPS中IL-8及TNF-α水平。结果：慢性非细菌性前列腺炎EPS中ⅢA型组TNF-α水平与ⅢB型组、对照组比较,有显著性差异（P〈0．05）;ⅢB型组TNF-α水平与对照组比较,无显著性差异（P〉0．05）。ⅢA型组IL-8水平与ⅢB型组、对照组比较,有非常显著性差异（P〈0．01）;IUB型组与对照组比较,有非常显著性差异（P〈0．01）。所有患者EPS中TNF-α【水平与WBC计数无明显相关性（r=-0．167。P〉O．05）,IL-8水平与WBC计数的相关性分析显示呈正相关（r=0．836,P〈0．01）。结论：检测Ⅲ型前列腺炎患者EPS中IL-8及TNF-α水平可能有助于Ⅲ型前列腺炎的分型诊断,并口『作为了解病情和评价治疗效果的一个有价值的指标。     

地方性砷中毒患者细胞因子水平与抗氧化能力相关分析

目的：探讨地方性砷中毒患者细胞因子水平与抗氧化能力的相关性。方法：对81例地方性砷中毒患者（病例组）和对照组（88例）血清白细胞介素-2（IL-2）、自细胞介素-8（IL-8）、肿瘤坏死因子α（TNF-α）、超氧化物歧化酶（SOD）、谷胱甘肽过氧化物酶（GSHPx）、丙二醛（MDA）水平进行检测及分析。结果：与对照组相比，地方性砷中毒患者血清Ib2、IL-8和TNF-α水平显著增高（P〈0．05），SOD、GSH-Px活性明显降低，而MDA水平增高（P〈0．05）。砷中毒患者IL-2、IL-8、TNF-α含量与SOD、GSH-Px活性呈负相关性，与MDA水平呈正相关性（P〈0．05）。结论；地方性砷中毒患者血清IL-2、IL-8和TNF-α水平高于对照组，而抗氧化能力低于对照组。地方性砷中毒患者的IL-2、IL-8和TNF-α水平随抗氧化能力的降低而升高。     

瘦素、肿瘤细胞坏死因子α与COPD患者营养状况及免疫功能关系分析

目的探讨瘦素、肿瘤细胞坏死因子仪与慢性阻塞性肺病（COPD）患者营养状况及免疫状态的关系。方法采用放射免疫法测定血清瘦素和TNF-α的水平，免疫球蛋白检测采用比浊法，淋巴细胞亚群检测采用FACS400型流试细胞仪测定，与反映营养状况的各参数、各组进行比较。结果①COPDⅠ组血清瘦素浓度“高于及Ⅱ组对照组，Ⅱ组血清瘦素浓度低于对照组；COPDⅠ、Ⅱ组TNF-α高于对照组；COPDⅠ、Ⅱ组TNF-α水平差异亦有显著性（P〈0．05）。②COPDⅡ组及对照组血清瘦素浓度与BMI、NW％呈显著正相关（P〈0．05），而与身高、体重无相关性；3组血清浓度与TNF-α水平无显著相关性。③COPDⅠ与对照组的免疫功能指标：同对照组比较，COPDⅠ的细胞免疫指标TLC，CD3^＋，CD4^＋T，CD8^＋T明显降低，差异有显著性（P〉0．05）；而2组体液免疫IgA、IgM、IgG无明显差异（P〉0．05）；COPDⅠ患者血清瘦素浓度与TLC，CD3^＋，CD4^＋T，CD8^＋T呈正相关。④3组血清TNF-α浓度与BMI、NW％、身高、体重均无显著相关性（P〉0．05）。结论①急性期COPD患者血清瘦素浓度高于稳定期组及对照组。②瘦素的调节不受TNF-α系统的控制，也表明TNF-α水平在COPD患者明显增加不依赖于瘦素。③COPDⅠ患者的细胞免疫功能低于正常，瘦素可能参与了T细胞介导的免疫。④血清瘦素浓度水平与营养状态的关系密切。     

心搏骤停复苏后不同预后患者血清细胞因子变化及意义

目的探讨心搏骤停复苏（CPR）后患者血清细胞因子的动态变化及其临床意义。方法将27例CPR自主循环（ROSC）还真分为复苏失败组（A1）19例和存活出院组（A2）8例,22例死亡者做对照组（B）,用ELISA法动态检测CPR时、24、48、72h、7d患者血清IL-4、IL-8、IL-10、IL-8水平变化。结果B组CPR时TNF-α含量高于A1组、A2组（P〈0．05）,IL-1β、IL-4、IL-8、IL-10水平三组之间差异无统计学意义（P〉0．05）。A1组复苏后多脏器功能衰竭发病高于A2组（14／19,2／8,P〈0．05）,ROSC 24h TNF-α水平高于其CPR时和A2组（P〈0．05）,ROSC 48h TNF—α、IL-8水平达峰值,且高于A2组,IL-4、IL—10水平高于其CPR时（P〈0．05）,与A2组相比差异无统计学意义（P〉0．05）,ROSC 72h TNF-α水平下降,IL-4高于A2组（P〈0．05）。结论细胞因子异常释放参与复苏后缺血-再灌注损伤病理过程,选择时机干预其失衡,提高复苏存活率,改善预后。     

病毒性心肌炎患者血清TNF-α、IL-6和IL-8的变化

目的检测病毒性心肌炎（VMC）患者血清TNF-α、IL-6和IL-8的水平变化,探讨其在临床的意义。方法采用酶联免疫吸附试验（ELISA）法测定48例病毒性心肌炎急性期和恢复期患者血清TNF-α、IL-6和IL-8水平,与正常对照组进行比较。结果VMC患者急性期血清TNF-α、IL-6、IL-8均显著高于恢复期及正常对照组（P〈0．01）,而恢复期与正常对照组比较差异无显著性意义（P〉0．05）,且VMC患者急性期血清CK-MB与TNF-α、IL-6、IL-8均呈良好的正相关（P〈0．01）。结论VMC患者血清TNF-α、IL-6、IL-8的检测对VMC患者病情评估和预后判断具有重要意义。     

卡托普利对急性肺损伤大鼠血清TNF—α和IL-8浓度的影响

目的：探讨烟雾吸入导致大鼠急性肺损伤（ALI）时血清TNF—α、IL-8含量变化及卡托普利对ALI和TNF-α、IL-8的影响。方法：36只健康成年Wistar大鼠随机平均分成正常对照组、烟雾致伤组（ALI组）和卡托普利干预组（CAP组）。CAP组腹腔注射卡托普利（5mg／kg），对照组和ALI组则腹腔注射等量生理盐水。15min后复制大鼠重度烟雾吸入性肺损伤模型。致伤后5min、5h分别采动脉血进行血气分析，检测烟雾致伤后5h血清TNF—α、IL-8含量，光镜观察肺病理形态学变化。结果：ALI组致伤后5h血清TNF-α、IL-8含量明显高于正常对照组（P〈0．01），肺组织病理学改变明显；CAP组致伤后5h血清IL-8含量显著低于ALI组（P〈0．05），肺损伤相对较轻。结论：TNF-α、IL-8可能在烟雾吸入性ALI中起重要作用，卡托普利能降低大鼠ALI时血清IL-8浓度，减轻烟雾吸入致ALI时的肺组织损伤。     

血清TNF-α、IL-4在AITD中的表达特征

目的研究血清中TNF—α、IL-4在自身免疫性甲状腺疾病（AITD）中的表达特征及其在免疫反应中的作用。方法对71例Graves病（GD）非突眼患者（45例未治疗的初诊患者为GDI组，26例治疗缓解患者为GDⅡ组）、35例桥本氏甲状腺炎（HT）患者及36例正常者（对照组）检测了血清中rrNF—α、IL-4的表达水平和甲状腺激素及相关抗体水平。TNF—α、IL-4测定及抗甲状腺球蛋白抗体（TgAb）、抗甲状腺微粒体抗体（TmAb）测定采用放射免疫分析法（RIA）；血清总T3（TT3）、总T4（TT4）、促甲状腺激素（TSH）测定采用化学发光免疫分析法。结果与正常对照组比较，各组TNF—α、IL-4显著增高（P〈0．05，P〈0．01）。GDI组的IL-4显著高于其他各组（P〈0．01）；TNF-α／IL-4比值与对照组比较，显著降低（P〈0．05）。GDII组的IL-4显著低于GDI组（P〈0．01）。HT组的TNF—α较GD组显著增高（P〈0．01）；IL-4较其他各组显著降低（P〈0．05，P〈0．01）；TNF-α／IL-4比值显著高于GD组（P〈0．01）和对照组（P〈0．05）。各组中TNF—α和TNF-α／IL-4比值与TgAb、TmAb存在正相关（P〈0．01）。结论TNF—α、IL-4共同参与AITD的发生。GD非突眼患者以IL-4升高为主，提示Th2所介导的体液免疫占优势；HT患者以TNF—α升高为主，提示Th1所介导的细胞免疫占优势。     

正常妊娠不同孕期血清hCG及IL-1β、IL-6和TNF-α水平的变化趋势

【目的】探讨正常妊娠妇女在妊娠过程中血清IL-1β、IL-6和TNF-α水平随人绒毛膜促性腺激素hCG水平的变化规律。【方法】采用放射免疫测定法检测正常妊娠妇女在妊娠早、中、晚期血清hCG、TNF-α、IL-1β、IL-6水平，并与未孕妇女（对照组）进行对照研究。【结果】1．妊娠早期血清hCG浓度迅速升高，妊娠中晚期明显降低，但与正常对照组比较仍有显著性差异（P〈0．01）2．IL-1β血清水平在妊娠早期达到较高水平，中期有所下降，晚期又有所升高。3．与对照组比较，正常妊娠TNF-α血清水平在妊娠早、中、晚期均有所下降，但差异无显著性（P〉0．05）。4．正常妊娠早期血清IL-6水平随血清hCG浓度增高而增加，至妊娠中期血清IL-6水平持续增高，妊娠晚期达高峰。5.妊娠早期血清IL-1β／IL-6浓度的比值与对照组比较无显著性差异（P〉0．05），而妊娠中期和晚期差异有显著性（P〈0．01）。血清TNF-α／IL-6的浓度比值在妊娠早期、中期与对照组相比无显著差异（P〉0．05），晚期与对照组相比差异有显著性（P〈0．01）。【结论】妊娠期间细胞因子IL-1β和IL-6血清水平增高；妊娠期间正常分泌的hCG可能在细胞因子的产生中发挥作用；妊娠期间宿主的免疫反应可能发生了Th1向Th2型的转变。     

妊娠期高血压疾病患者血清中TNF-α和IL-10水平及其意义

目的观察妊娠期高血压疾病患者血清中Th1型细胞因子（TNF-α）和Th2型细胞因子（IL-10）水平，以及Th1／Th2（TNF-α／IL-10）比值的变化，探讨上述指标在妊娠期高血压疾病中的意义。方法采用ABC-ELISA法检测64例妊娠期高血压疾病患者血清中TNF-α．和IL-10的水平、TNF-α／IL-10比值，并与正常对照组比较。结果（1）与对照组相比较，妊娠高血压组TNF-α．水平无显著差异（P〉0．05）；子痫前期组及子痫组TNF-α．水平均有极显著差异（P〈0．001）；（2）与正常对照组相比较，妊娠高血压疾病组IL-10水平随宿隋加重而呈下降趋势，其中妊娠高血压组无显著差异（P〉0．05）；子痫前期组及子痫组IL-10水平均有极显著差异（P〈0．001）；（3）与正常对照组相比较，妊娠高血压组TNF-α／IL-10比值无显著差异护〉0．05）；子痫前期组及子痫组TNF-α／IL-10比值均有显著差异（P〈0．001）。结论妊娠期高血压疾病患者存在着免疫失衡，细胞因子TNF-α和IL-10水平以及TNF-α／IL-10的平衡改变是其重要的病理生理变化之一，可能与妊娠期高血压疾病的发生、发展有关。     

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.