腹腔镜子宫切除术对机体免疫功能的影响

目的：研究腹腔镜子宫切除术（LH）和开腹子宫切除术（AH）对机体免疫功能的影响。方法：2000年5月至2002年7月因子宫肌瘤行LH的患者48例，对照组开腹手术的患者32例。术前24h、术后24h、72h分别抽取肘静脉血，采用ELISA双抗体夹心法测定血清IL－6、TNF－α，用散射比浊法测定血清CRP水平；流式细胞仪测定CD3^ (T细胞总数）、CD4^ (T辅助／诱导细胞）、CD8^ （T抑制／杀伤细胞）、CD16^ (NK细胞）的数量。结果：手术前两组患者血清IL－6、TNF－α和CRP水无显著差异（P＞0.05)。术后24h、72h两组患者的血清IL－6、TNF－α和CRP水平与术前相比均明显升高（P＜0.01)。LH组血清IL－6、TNF－α和CRP水平的升高明显低于AH组（P＜0.01)。LH组患者的外周血T淋巴细胞亚群和NK细胞在手术前后无明显改变（P＞0.05)。AH组患者在术后24h CD3^ 、CD4^ 、CD8^ 均明显下降（P＜0.01)，在72h有所回升，但仍低于术前水平。AH组NK细胞无明显变化（P＞0.05)。结论：腹腔镜手术创伤小，对全身免疫功能影响小。     

射频热化疗对膀胱癌术后机体细胞免疫功能的影响

目的：探讨膀胱癌术后射频热化疗对机体细胞免疫功能的影响。方法：58例膀胱移行细胞癌术后患者随机分为热化疗组（n=30)和化疗组（n=28)。采用红细胞花环直接法及放免法，分别检测患者术后1周及热化疗或单纯化疗后第2周外周血T淋巴细胞亚群分布、血清白细胞介素2（IL－2）、肿瘤坏死因子（TNF）含量。30例健康体检者作为正常对照组。结果：热化疗组和化疗组患者术后外周血CD3^ 、CD4^ T淋巴细胞数、CD4^ /CD8^ 比值、IL－2含量显著低于正常对照组（P＜0．01）。CD8^ T淋巴细胞数、TNF含量与正常对照组相比差异无统计学意义。化疗后第2周，热化疗组CD3^ 、CD4^ T淋巴细胞数，血清IL－2含量显著升高，与正常对照组相比差异无统计学意义（P＞0．05），与化疗组相比，差异有统计学意义（P＜0．01）。热化疗组TNF含量升高，与对照组相比差异有统计学意义（P＜0．05）。结论：射频热化疗对膀胱癌患者的细胞免疫功能有促进作用。     

黄连解毒汤对实热证大鼠T细胞亚群和IL-2活性的影响

目的：探讨黄连解毒汤对实热证大鼠T细胞亚群和IL－2活性的影响。方法：用ELISA法测定T细胞亚群，用生物学活性检测法测定IL－2活性。结果：造模对照组CD4^-、CD4^ /CD8^ 比值及IL－2活性明显低于正常组（P＜0．01），而CD8^ 明显高于正常组（P＜0．01）。治疗组CD4^ 、CD4^ /CD8^ 比值及IL－2活性明显高于造模对照组，而CD8^ 明显低于造模对照组（P＜0．01）。造模治疗组CD4^ 、CD8^ 、CD4^ /CD8^ 比值及IL－2活性与正常组无显差异（P＞0．05）。结论：黄连解毒汤提高T细胞亚群和IL－2活性是其治疗实热证的机制之一。     

急性白血病患者血清IL-6、TNF-α检测临床意义的探讨

目的：探讨白细胞介素6（IL－6）肿瘤坏死因子α（TNF－α）水平与急性白血病（AL）发病的关系。方法：采用ELISA双抗体夹心法测定急性淋巴细胞白血病（ALL）和急性髓细胞白血病（AML）患血清IL－6、TNF－α水平。结果：AL患IL－6含量显高于正常对照组（P＜0．01），且ALL又明显高于AML（P＜0．05）；TNF－α也显高于对照组（P＜0．01），但ALL与AML两组间TNF－α水平无明显差异（P＞0．05）。结论：IL－6、TNF－α水平与AL发病，发展有密切相关；IL－6水平与白血病类型有关；而TNF－α水平与白血病类型无关。     

脑囊虫患儿细胞免疫功能观察

目的：探讨脑囊虫患儿细胞免疫功能。方法：T淋巴细胞亚群测定采用APAAP法,血清IL－2、sIL-2R测定采用ELISA法,IL－6和IL－8测定采用双抗体夹心ELISA法。结果：与对照组比较,脑囊虫患儿CD3^ 、CD4^ 和CD4^ /CD8^ 比值及血清IL－2水平明显降低（P＜0．01）;sIL-2R、IL－6和IL－8水平明显升高（P＜0．01）。结论：脑囊虫患儿细胞免疫功能低下和紊乱,细胞免疫功能测定可为患儿免疫疗法的应用提供可靠依据。     

B细胞型非何杰金氏淋巴瘤患者外周血T细胞亚群和NK细胞检测与疗效的关系

目的：研究B细胞型非何杰金氏淋巴瘤（B－NHL）患外周血T细胞亚群分布和NK细胞与疗效的关系。方法：利用流式细胞术对20位正常人和24例B－NHL患治疗前后的外周血T细胞亚群和NK细胞进行分析。结果：（1）B－NHL患外周血CD4^ T细胞亚群、NK细胞和CD4：CD8比值显低于正常人（P＜0．05）。（2）经CHOP方案治疗后有效组外周血中CD4^ T细胞数量明显升高（P＜0．01），CD4：CD8比值增大（P＜0．01）；无效组外周血T细胞亚群分布治疗前后无显区别（P＞0．05）；（3）有效组患外周血NK细胞治疗前后存在显差异（P＜0．01），无效组外周血NK细胞治疗前后不存在显差异（P＞0．05）。结论：测定B－NHL患的外周血T细胞亚群和NK细胞可作为观察疗效的有效指标之一。     

黄芪静脉滴注对慢性乙型病毒性肝炎患者细胞免疫功能的影响

目的：探讨黄芪静脉滴注对慢性乙型病毒性肝炎患细胞免疫功能的调节作用。方法：黄芪与甘草酸二胺（甘利欣）合用治疗慢性乙型病毒性肝炎轻度（CLH）及中度（CMH）患各15例,并设轻度及中度患各10例单用甘利欣治疗作对照,另设健康正常组10例。结果：治疗组CD3^ 、CD4^ 和CD4^ /CD8^ 治后均较对照组显升高（P＜0．05或P＜0．01）。治疗组CLH型治后自然杀伤（NK）细胞活性、T淋巴细胞转化率（LTR）增加,血浆可溶性白细胞介素－2受体（SIL－2R）水平降低,与对照组比较均有显性差异（P＜0．05）;CMH型与对照组相比无显变化。结论：黄芪能显提高慢性乙型病毒性肝炎患的细胞免疫功能,对轻度患的疗效优于中度患。     

大黄对体外内毒素诱生的肺泡巨噬细胞分泌功能的影响

采用细胞分离及培养技术观察了中药大黄对内毒素（LPS）体外诱生的肺泡巨噬细胞分泌细胞因子，如肿瘤坏死因子（TNF－α），白细胞介素-1（IL－1）和白细胞介素-6（IL－6）的作用。结果表明，大黄能够明显抑制LPS诱生的肺泡巨噬细胞分泌TNF－α、IL－1和IL－6，与对照相比P＜0．01。从而减轻由于TNF－α、IL－1、IL－6过度分泌所致的肺脏损害，这可能是大黄对肺脏具有保护作用的分子机制。     

肺癌患者血清与癌肿块中细胞因子的变化及其意义

目的：探讨肺癌患血清与癌肿块中白介素－8（IL－8），白介素－18（IL－18），肿瘤坏死因子（TNFα），血管细胞粘附因子－1（sVAM-1)的变化情况，方法：采用Elisa方法检测12例正常对照，17例肺癌患手术前后IL－8，IL－18，TNFα，sVCAM-1在血清和癌旁肺组织，癌组织中的含量。结果：肺癌患手术前后血清中的IL－8，IL－18，TNFα，sVCAM-1含量均比正常对照组增高有显差异（P值均＜0．01），术后与术前两组比较术后TNFα含量有明显下降（P＜0．05），其余3项指标有一定下降但无显差异，癌肿块中IL－8，IL－18，TNFα，sVCAM-1含量比癌旁组织中的含量4项指标均显增高（P＜0．01，P＜0．05），结论：测定血清中的IL－8，IL－18，TNFα，sVCAM-1对肺癌的诊断及判断预后，鉴别良，恶性肿瘤有重要临床意义。     

尖锐湿疣和寻常疣患者外周血细胞因子和T-淋巴细胞亚群的变化

目的：观察尖锐湿疣和寻常疣患者外周血细胞因子的变化。方法：应用流式细胞仪和双抗体夹心ELISA法分别检测125例尖锐湿疣患者和100例寻常疣患者外周血T－淋巴细胞亚群（CD3^ ,CD4^ 和CD4^ /CD8^ 的比值）、可溶性白细胞介素－2受体（sIL-2R)、白细胞介素－2（IL－2）、肿瘤坏死因子－α（TNF-α）水平的变化。结果：（1）125例尖锐湿疣患者和100例寻常疣患者外周血清中sIL-2R,IL-2和TNF-α的水平明显高于正常对照组（P＜0．01），CD3^ ,CD4^ ,CD4^ /CD8^ 的比值明显低于正常对照组（P＜0．01）。（2）尖锐湿疣患者组与寻常疣患者组相比各项参数差异不显著，无统计学意义（P＞0．05）。结论：尖锐湿疣患者与寻常疣患者存在着明显的细胞免疫功能低下和紊乱。     

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.