急性白血病患者血清血管内皮细胞生长因子测定及临床意义

目的探讨血管内皮细胞生长因子(VEGF)在急性白血病(AL)患者中的表达和临床意义.方法采用双抗体夹心ELISA法检测了41例AL初发患者(ANLL32例,其中是M14例、M24例、M38例、M44例、M512例和ALL9例)血清VEGF含量,并且检测了其中10例获得完全缓解后的AL患者血清VEGF水平;同时留取41例AL初发患者和10例获得完全缓解后AL患者骨髓涂片,进行瑞特染色后检测骨髓原始和幼稚细胞百分率.结果血清VEGF在ANLL和ALL中分别是(807.76±347.04)ng/L、(998.18±387.80)ng/L,均高于正常对照组(461.43±127.05)ng/L,均P＜0.01;ANLL和ALL之间血清VEGF水平差异无统计学意义(P＞0.05);10例完全缓解的AL患者,其血清VEGF含量为(495.28±102.79)ng/L明显低于初发时(1263.44±490.39)ng/L,P＜0.01;AL缓解组血清VEGF含量与其骨髓中原始幼稚白细胞百分率具有一定相关性,r=0.57,P＜0.01.结论血清VEGF在AL患者中明显升高,且血清VEGF水平与病情和预后密切相关.     

妊娠对乙型肝炎肝郁脾虚型患者血清细胞因子浓度的影响及临床意义

目的 :探讨妊娠对慢性乙型肝炎 (乙肝 )肝郁脾虚型患者血清白细胞介素 - 10、12 (IL - 10、IL - 12 )、γ-干扰素 (IFN-γ)浓度的影响及临床意义。方法 :用酶联免疫法 (EL ISA)检测孕期和非孕期患者 IL - 10、IL - 12及 IFN -γ血清浓度 ,并作同期肝功能指标检查。患者分为早孕期 (2 6例 )、晚孕期 (32例 )、非孕期 (31例 ) 3组。 2 0例非孕期健康者为对照组。结果 :早孕期组 IL - 10水平 [(2 6 .0± 9.8) ng/ L ]较非孕期组 [(18.0± 1.3) ng/ L ]升高 (P <0 .0 5 ) ,而与对照组 [(2 9.4± 5 .1) ng/ L ]相近 (P >0 .0 5 )。IL - 12、IFN -γ分别为 (5 4 .1± 2 6 .0 ) ng/ L和 (45 .5± 17.3) ng/ L ,较对照组 [(8.2± 2 .1) ng/ L、(2 4 .5± 6 .1) ng/ L ]和非孕期组 [(8.0± 2 .7) ng/ L、(16 .7± 3.7) ng/ L ]均明显升高 (均P <0 .0 1)。晚孕期组与其他各组比较 ,IL - 10 [(9.4± 1.9) ng/ L ]明显下降 (P <0 .0 1) ,但 IL - 12 [(16 6 8.0± 318.2 )ng/ L ]、IFN -γ[(46 1.0± 10 3.3) ng/ L ]显著升高。结论 :妊娠可使慢性乙肝肝郁脾虚型患者血清 IL - 12、IFN-γ浓度升高 ,在晚孕期表现更为明显。     

D-二聚体与冠心病病情及冠状动脉病变稳定性的相关研究

目的 :探讨血浆D 二聚体 (D dimer,DD)与冠心病(CHD)病情及冠状动脉病变稳定性的关系。方法 :对 1 1 0例观察对象按照冠状动脉造影病变形态学特征分为 :简单病变组 3 2例 ,复杂病变组 5 6例 ,正常对照组 2 2例。同时 ,根据临床CHD病情分为 :急性心肌梗死 (AMI)组 1 1例、不稳定型心绞痛 (UAP)组 49例 ,稳定型心绞痛(SAP)组 2 8例 ,正常对照组 2 2例。用酶免法 (ELASA)检测血浆DD含量 ,比较不同组间DD含量。结果 :血浆DD含量复杂病变组 [( 0 .499± 0 .2 1 4)mg/L]高于简单病变组 [( 0 .3 2 9± 0 .1 73 )mg/L]及正常对照组 [( 0 .3 1 9± 0 .1 2 6)mg/L],差异均有统计学意义 (P <0 .0 1 )。AMI组 [( 0 .5 93± 0 .3 44 )mg/L]和UAP组 [( 0 .471± 0 .2 1 4)mg/L]明显高于SAP组 [( 0 .2 92±0 .1 0 1 )mg/L]及正常对照组 [( 0 .3 1 9± 0 .1 2 6)mg/L],差异均有统计学意义 (P <0 .0 1 )。结论 :血浆DD含量与冠状动脉病变稳定性及CHD病情严重性相关 ,DD是冠状动脉病变活动性的血液标志物。     

子宫内膜异位症与T辅助细胞亚群及其细胞因子的关系

目的　探讨T辅助细胞 (Th)亚群中的T辅助细胞 1(Th1)和T辅助细胞 2 (Th2 )所分泌的细胞因子在子宫内膜异位症 (EM )发病中的作用。方法　应用细胞因子体外诱生培养技术对 35例EM患者及 18例健康育龄妇女外周血单个核细胞 (PBMC)加入植物血凝素 (PHA)进行培养诱生 3天 ,收集上清液。采用酶联免疫吸附试验双抗体夹心法 (ELISA)分别测定血浆及PBMC培养上清中Th1类因子干扰素 γ(IFN γ)及Th2类因子白细胞介素 (IL) 4、6、10的含量。结果　EM患者PBMC诱生培养上清中IL 4、IL 6、IL 10水平 [(37 36±13 6 5 )、(6 94 32± 110 93)、(80 39± 2 3 0 2 )ng/L]比对照组 [(2 6 36± 4 32 )、(5 2 6 35± 10 2 34)、(5 9 73±2 0 32 )ng/L]明显升高 ,差异有显著性 (P均 <0 0 1)。EM患者的IFN γ为 (10 87 3± 380 9)ng/L ,与对照组的(16 37 8± 340 8)ng/L比较差异有显著性 (P <0 0 1)。EM患者PBMC诱生培养上清中IFN γ/IL 4为 36 4 7±19 4 1,与对照组的 74 86± 13 4 2比较差异有显著性 (P <0 0 1)。在血浆中 ,除了EM组的IL 4、IL 6水平[(36 2 8± 17 4 6 )、(16 4 6± 5 4 8)ng/L]与对照组 [(2 2 4± 5 2 0 )、(12 32± 3 6 7)ng/L]比较差异有显著性 (P均<0 0 5 )外 ,两组IL 10、IFN      

血浆中性粒细胞弹性蛋白酶与冠心病的关系

目的 :探讨血浆中性粒细胞弹性蛋白酶 (neutrophilelastase,NE)与冠心病 (CHD)的关系。方法 :对85例观察对象进行分组 ,根据冠状动脉造影结果分为 :简单病变组 2 4例 ,复杂病变组 5 1例 ,正常对照组 10例。根据CHD病情分为 :急性心肌梗死 (AMI)组 9例 ,不稳定型心绞痛 (UAP)组 4 5例 ,稳定型心绞痛 (SAP)组 2 1例 ,正常对照组 10例。用酶联免疫吸附法 (ELASA)检测血浆NE含量 ,比较不同组间NE含量。结果 :血浆NE含量 :复杂病变组 [(6 3.4 2± 13.6 2 ) μg/L]高于简单病变组 [(4 4 .5 0± 12 .73) μg/L],差异有统计学意义 (P <0 .0 1)。AMI组 [(71.4 8± 10 .16 ) μg/L]高于UAP组 [(6 1.2 7± 14 .5 7) μg/L],但差异无统计学意义 (P >0 .0 5 ) ,明显高于SAP组 [(4 0 .95± 10 .0 9) μg/L]及正常对照组 [(36 .6 3± 12 .35 ) μg/L],差异均有统计学意义 (P <0 .0 1) ,后两组间比较差异无统计学意义 (P >0 .0 5 )。UAP组明显高于SAP组及正常对照组 ,差异有统计学意义 (P <0 .0 1)。结论 :血浆NE含量与冠状动脉病变稳定性及CHD病情严重性相关 ,NE可能是冠状动脉病变活动性的标志物。     

哮喘患者白细胞介素(IL)-12和IL-13的变化及糖皮质激素对其的影响

目的　观察哮喘患者血清中白细胞介素 (IL) 12和IL 13水平的变化及糖皮质激素对其的影响。方法　采用ELISA法分别检测中度哮喘急性发作期患者 (2 5例 )口服泼尼松治疗 1周前后、缓解期患者 (2 0例 )和健康对照组者 (15例 )血清中IL 12和IL 13水平 ,并同时测 1秒钟用力呼气容积(FEV1)占预计值的百分比和气道阻力 (R5)占预计值的百分比。结果　IL 12水平急性发作期治疗前[(5 8 5± 14 2 )ng/L]较缓解期 [(71 3± 16 2 )ng/L]为低 (P <0 0 5 ) ,与健康对照组 [(85 5± 13 1)ng/L]、急性发作期治疗后 [(79 3± 19 1)ng/L]比较 ,差异均有显著性 (P <0 0 1)。IL 13水平急性发作期治疗前 [(131 3± 2 8 4 )ng/L]较缓解期 [(113 1± 2 6 5 )ng/L]为高 (P <0 0 5 ) ,与健康对照组 [(92 3± 14 4 )ng/L]、急性发作期治疗后 [(84 1± 19 8)ng/L]比较 ,差异均有显著性 (P <0 0 1)。FEV1占预计值的百分比下降和R5占预计值的百分比升高 (P <0 0 1)。直线相关分析表明 ,血清中IL 12与FEV1占预计值的百分比呈正相关 (r=0 4 85 ,P <0 0 5 ) ,与R5占预计值的百分比呈负相关 (r =- 0 5 16 ,P<0 0 5 ) ,与IL 13呈负相关 (r =- 0 5 4 9,P <0 0 1) ;IL 13与FEV1占预计值的百分比呈负相关 (r =- 0 4 93,P <     

脑源性神经营养因子在多发性骨髓瘤患者血浆中的表达

目的 :研究多发性骨髓瘤 (MM )患者血浆中脑源性神经营养因子 (BDNF)、血管内皮细胞生长因子(VEGF)的表达情况及与相应临床检测指标的关系 ,初步探讨BDNF在多发性骨髓瘤的发生与发展中的潜在作用。方法 :用酶联免疫吸附试验 (ELISA)测定MM患者与健康体检者血浆BDNF、VEGF的浓度 ,同时观察MM患者血常规、肾功能、电解质、影像学等指标。结果 :患者血浆BDNF浓度为 (4 .2 2± 0 .6 4 ) μg/L ,与健康体检者(2 .0 3± 0 .38) μg/L比较 ,差异有统计学意义 (P <0 .0 5 ) ;患者血浆VEGF浓度为 (79.35± 13.2 5 )ng/L ,与健康体检者 (34.4 1± 1.78)ng/L比较 ,差异有统计学意义 (P <0 .0 1)。BDNF与VEGF水平间存在着相关性 (r =0 .4 30 ,P =0 .0 2 5 )。结论 :MM患者血浆BDNF和VEGF显著增高 ,BDNF可能是继VEGF后又一促进血管增殖活性的细胞因子     

血管内皮生长因子和内皮素在低氧性肺血管重建中的作用

目的探讨血管内皮生长因子(VEGF)和内皮素(ET)-1在低氧性肺动脉高压(HPH)及其肺血管重建中的作用,并观察钾通道开放剂(pinacidil)对HPH的防治作用及对VEGF和ET-1的影响.方法Wister大鼠46只,随机分为3组,对照组15只,低氧组16只,治疗组15只.缺氧组和治疗组大鼠缺氧[氧浓度为(10.0±0.5)%]4周,每天缺氧8h,其中治疗组大鼠于每天缺氧前腹腔注射pinacidil3mg/kg.缺氧4周后测定各组大鼠血清VEGF和血浆ET-1水平、平均肺动脉压(mPAP)、右心室(RV)/[左心室(LV)+室间隔(S)]比值及肺小动脉病理及其形态计量学.结果(1)缺氧组大鼠血清VEGF[(118.73±55.40)ng/L]和血浆ET-1[(221.2±56.2)ng/L]水平明显高于对照组(P＜0.01);缺氧组较对照组mPAP升高,RV/(LV+S)比值增高,肺小动脉血管壁显著增厚,管腔明显狭窄.(2)治疗组大鼠血清VEGF[(78.20±16.45)ng/L]和血浆ET-1[(181.6±30.5)ng/L]水平明显低于缺氧组(P＜0.01);治疗组较缺氧组mPAP下降(P＜0.01),肺小动脉血管壁增厚、管腔狭窄等明显减轻,但治疗组上述各指标仍未完全恢复到对照组水平.结论VEGF和ET-1在HPH及其肺血管重建中发挥重要作用,钾通道开放剂对HPH及其肺血管重建具有一定的逆转作用.     

急性有机磷农药中毒患者血浆内皮素的变化及临床意义

目的　探讨急性有机磷农药中毒 (AOPP)患者血浆内皮素 (ET)的变化及其临床意义。方法　将 6 9例AOPP患者分成轻度、中度、重度中毒组 3组 ,另选取 2 5例健康人为正常对照组 ,各组均采用放射免疫法检测血浆ET含量。同时进行对比分析。结果　AOPP轻度中毒组患者血浆ET的含量 (5 6 18± 12 80 )ng/L仅轻度升高 ,与正常对照 (5 0 85± 8 93)ng/L比较 ,差异无显著性 (P >0 0 5 ) ;中度、重度中毒组患者血浆ET含量分别为 :(72 6 1± 14 2 1)ng/L ,(110 32± 17 38)ng/L较正常对照组明显升高 (P均 <0 0 1) ,中度中毒组患者血浆ET含量较轻度中毒组明显升高 (P <0 0 1) ;重度中毒组患者血浆ET含量较中度中毒组明显升高 (P <0 0 1)。结论　随着AOPP中毒程度的加重 ,血浆ET含量逐渐上升 ,血浆ET的检测可作为判断AOPP患者病情轻重、治疗效果及预后的参考指标     

急性淋巴细胞白血病患儿血清sTNFRs水平测定的临床价值

目的 :探讨急性淋巴细胞白血病患儿血清 TNFa、s TNFR- 和 s TNFR- 水平及其临床意义。方法 :采用 EL ISA法测定血清 TNFa、s TNFR- 和 s TNFR- 水平。结果 :2 4例 AL L患儿血清 TNFα〔(173.2 2±74.5 1) ng/L〕明显高于 2 0例正常对照儿童〔(78.5 9± 18.45 ) ng/L〕,初发与复发患儿血清 s TNFR- 〔(2 .76±1.0 5 )、(2 .44± 1.37) μg/L〕、s TNFR- 〔(2 .33± 1.18)、(2 .0 9± 1.2 2 ) μg/L〕明显高于正常儿童〔(0 .75± 0 .2 6 )、(0 .71± 0 .14) μg/L〕,均为 P <0 .0 1;血清 TNFα与 s TNFR- 呈显著性正相关 (r =0 .6 31,P <0 .0 1) ;8例患儿经有效治疗完全缓解后血清 s TNFRs均降至正常水平〔(0 .83± 0 .2 5 )、(0 .92± 0 .17) μg/L〕;血清 s TNFRs在WBC≥ 10 0× 10 9/L患儿的阳性率明显高于 WBC<10 0× 10 9/L者 (P <0 .0 1) ,其与外周血幼稚细胞数呈显著正相关 (R =0 .72 4 ,R =0 .582 ,P <0 .0 5)。结论 :AL L患儿血清 s TNFRs异常升高与白血病细胞有关 ,血清 s TNFRs水平可作为估计肿瘤负荷及治疗效果的一项指标。     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.