抗癫痫药物治疗对癫痫患者血清细胞因子水平的影响

目的 :观察抗癫痫药物治疗前后癫痫患者血清细胞因子水平变化 ,探讨白细胞介素 - 2 (IL - 2 )、白细胞介素 - 6 (IL - 6 )、肿瘤坏死因子 -α(TNF -α)在癫痫神经免疫调节中的作用。方法 :采用放射免疫分析测定 4 3例癫痫患者抗癫痫药物治疗前后 ,血清IL - 2、IL - 6、TNF -α的水平 ,并与年龄和性别相匹配的 32例正常对照组进行比较。结果 :癫痫患者治疗前血清IL - 2、IL - 6、TNF -α水平均显著高于正常对照组 (p <0 0 0 1 ) ,经治疗后有 1 8人疗效显著。其发作次数降低 75 %以上 ,其中有若干病人其血清细胞水平明显降低 ,但总体水平差异呈无显著性 (p >0 0 5 ) ,其余 2 5人疗效较差 ,其水平改变不大 ,但部分反有升高。患者血清IL - 2浓度与IL- 6、TNF -α水平变化呈显著正相关。结论 :癫痫患者血清细胞因子水平增高 ,提示免疫系统处于活化状态 ,但治疗后细胞因子水平改变难以预测 ,即使疗效显著者 ,亦有一些明显降低。     

A Study of Dermatoglyphic Patterns in Epileptic Patients

The aim of study was to establish a relation of dermatoglyphic patterns of palm in epileptic and normal subjects so that it may be used as a diagnostic tool for identifying cases at risk. The dermatoglyphic study was carried out on 50 patients of epilepsy and 50 normal subjects. The dermatoglyphic traits, which presented a significant difference, were a-b ridge count, lateral deviation, c-line pattern, palmar pattern and finger tip pattern. Mean values of a-b ridge count were more in epileptic patients, especially in left hand, than controls. The ratio of ulnar and radial lateral deviation in control was 1:3 while in epileptic it was 1:5. C-line pattern presented less frequency of proximal and ulnar type patterns in cases. Radial type of C-line pattern was higher in cases. On the other hand this pattern was absent in 29% of controls than cases (8%). Arch type of palmar patterns were showing a very significant difference between controls (79%) and cases (2%). Frequency of loops were much more and vestiges were absolutely absent in cases. The frequency of Arch type of finger tip pattern was more in control. These findings suggest that antenatal factors may contribute to the etiology of epilepsy. A considerable progress in dermatoglyphics has been established as a useful diagnostic and research tool in medicine.     

IgE Concentrations Measured by PRIST® in Serum of Healthy Adults and in Patients with Respiratory Allergy

In order to establish reference values for total serum IgE in an adult non-atopic population, 175 individuals. 17–85 years of age. were investigated. The usefulness of a sensitive method (PRIST®) for serum JgK determinations in discriminating atopy from mm-atopic conditions in a Her go logical routine diagnosis was elucidated by investigating 445 patients with symptoms of asthma, rhinitis, urticaria and eczema. Comparisons were made with case histories. in viva tests and circulating IgE antibodies.
The geometric mean for serum IgE in the reference material was 13.2 kU/1 with a 2 SD range of 1.53 to 114 kU/1. No significant difference between age groups or sexes was observed. In patients classified as non-atopic and pronounced atopic, the geometric mean values for IgE were 40, 123 and 458 kU/1 respectively. The IgE level correlated with number of allergens positive in RAST and with skin test results.
It is concluded that IgE determinations are of great help in discriminating atopic conditions from other diseases with similar symptoms. A serum IgE value above 100 kU/1 in a patient is strong evidence for the presence of an atopic disease while a value below 20 kU/l indicates that the symptoms are due to intrinsic or infectious disease.     

癫痫患者IFN-r、T细胞亚群及HLA-DR的检测

本文对28例癫痫患者的外周血单个核细胞(PBMCS)进行培养,测定了诱生的IFN-γ水平,同时检测其中17例的T细胞亚群和HLA-DR抗原,对比其相关性,并与对照组比较.结果表明癫痫患者的IFN-γ诱生能力增强,且与病因、病程、脑电图、类型、药物无关;CD8细胞显著升高,CD4/CD8显著低于对照组;HLA-DR抗原异常表达;IFN-γ与HLA-DR之间呈显著正相关,IFN-γ与CD8细胞之间无相关性,提示癫痫患者体内细胞免疫调节网络失衡,活化的淋巴细胞及其产生高水平的IFN-γ通过多种机制参与癫痫的病理过程,进一步从免疫细胞和免疫分子调节水平探讨了癫痫的免疫学发病机制.     

Serum Immunoglobulins,Complement Levels and Lymphocyte Subpopulations in Phenytoin-Treated Epileptic Patients

Abstract

The peripheral blood lymphocytes, serum immunoglobulins, C3 and C4 complement protein concentrations of 20 patients with idiopathic epilepsy who were receiving phenytoin were examined and compared with 30 healthy controls in order to obtain a detailed profile of the effects of the drug on the humoral and cellular immune systems. The T-lymphocyte subsets were identified using monoclonal antibodies. A significant decrease in suppressor T-cells (p<0.05) and an increase in the ratio of T-helper to T-suppressor lymphocytes (p<0.01) have been found. Furthermore, an increase in B-lymphocytes (p<0.01) and a significant rise in serum Ig M concentrations (p<0.05) have been observed. No significant changes in serum concentrations of Ig G, Ig A and complement proteins were detected.     

男性CHD患者血清脱氢表雄酮、游离睾酮浓度的分析

目的：观察血清雄激素水平与男性 （CHD）的相关性。方法：CHD诊断和狭窄程度判断通过冠状动脉造影检查,冠状动脉至少有一处内径狭窄≥50%为诊断标准;冠状动脉狭窄评分标准：主要冠脉即左主干、左前降支、左回旋支、右冠脉,狭窄程度计分如下：无狭窄为0分,狭窄≤25%为1分,狭窄26%～50%为2分,狭窄51%～75%为3分,狭窄76%～100%为4分。若单支血管有多处病变,则以最狭窄病变的分数作为该支血管狭窄分数;若多支血管有狭窄,则将各支血管狭窄分数相加,即为该患者冠脉病变评分;左主干病变计分加倍。血清雄激素检测脱氢表雄酮和游离睾酮两个指标。脱氢表雄酮和游离睾酮采用酶联免疫吸附试验检测;并同时检测空腹血糖、三酰甘油、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、尿酸等生化指标。结果：CHD组血清脱氢表雄酮、游离睾酮水平显著低于无CHD组（P〈0.001）。多元logistic回归分析显示,血清脱氢表雄酮（OR=0.526;95%CI：0.361～0.768;P〈0.01）、游离睾酮（OR=0.995;95%CI：0.991～0.999;P〈0.05）为CHD独立危险因素;血清脱氢表雄酮（t=3.424,P〈0.01,r=-0.415）、游离睾酮（t=2.763,P〈0.01,r=-0.359）与CHD冠状动脉狭窄程度呈负相关。结论：血清雄激素水平的降低可能是导致男性CHD发病率升高的重要因素,监测血清雄激素水平有助于判断CHD病变的程度。     

中青年男性血清睾酮水平变化的初步探讨

了解健康中、青年男性血清性激素水平的变化.选取126例健康男性分为20～29岁、30～39岁、40～49岁共3个年龄组.分别测定血清睾酮(T)、游离睾酮(FT)、性激素结合球蛋白(SHBG)、雌二醇(E2)、黄体生成素(LH)、卵泡刺激素(FSH),对各组测定值进行统计学分析.结果显示:血清T、FT水平在30～39岁组...     

Atazanavir Plasma Concentrations Vary Significantly Between Patients and Correlate with Increased Serum Bilirubin Concentrations

Abstract

Background: Atazanavir (ATV) is recommended to be dosed at 400 mg once daily or 300 mg daily coadministered with 100 mg ritonavir (RTV). Method: 31 male patients receiving ATV either alone or boosted with RTV for more than 2 weeks had ATV concentration measured by high performance liquid chromatography (HPLC). ATV concentrations were adjusted to obtain a 24-hour trough level using a standard pharmacokinetic formula. Results: 25 samples were taken from patients who received 300 mg ATV, 6 with 200 mg, 3 with 400 mg, and 2 with 150 mg, all boosted with 100 mg RTV. In the unboosted group, patients received 400 mg (7) or 600 mg (2). The median adjusted 24-hour trough ATV concentration was 630 ng/mL (interquartile range [IQR] 355-1034) in the boosted and 113 ng/mL (IQR 50-225) in the unboosted group (p = .001). Median serum bilirubin concentration was 34 IU/L (IQR 27.5-49) and 41 IU/L (IQR 31-45) in the boosted and unboosted groups, respectively. In the boosted group, high ATV concentrations were significantly correlated with increased serum bilirubin concentrations (p = .003). Conclusion: ATV concentrations showed considerable interpatient variability. Bilirubin concentrations are an indicator of high ATV concentrations and may prove to be useful in selecting patients for therapeutic drug monitoring (TDM).     

Altered extracellular levels of DOPAC and HVA in the rat nucleus accumbens shell in response to sub-chronic nandrolone administration and a subsequent amphetamine challenge

The present work was undertaken to examine the central pharmacokinetics of phenytoin (PHT) in an experimental model of epilepsy, induced by administration of 3-mercaptopropionic acid (MP), and possible participation of P-glycoprotein in this model of epilepsy. Repeated seizures were induced in male Wistar rats by injection of 3-MP (45 mg kg(-1), i.p.) during 10 days. Control rats (C) were injected with saline solution. In order to monitor extracellular PHT levels, either a shunt microdialysis probe or a concentric probe was inserted into carotid artery or hippocampus, respectively. All animals were administered with PHT (30 mg kg(-1), i.v.) 30 min after intraperitoneal administration of vehicle (V) or nimodipine (NIMO, 2 mg kg(-1)). No differences were found in PHT plasma levels comparing all experimental groups. In pre-treated rats with V, hippocampal PHT concentrations were lower in MP (maximal concentration, C(max): 2.7+/-0.3 microg ml(-1), p<0.05 versus C rats) than in C animals (C(max): 5.3+/-0.9 microg ml(-1)). Control rats pre-treated with NIMO showed similar results (C(max): 4.5+/-0.8 microg ml(-1)) than those pre-treated with V. NIMO pre-treatment of MP rats showed higher PHT concentrations (C(max): 6.8+/-1.0 microg ml(-1), p<0.05) when compared with V pre-treated MP group. Our results indicate that central pharmacokinetics of PHT is altered in MP epileptic rats. The effect of NIMO on hippocampal concentrations of PHT suggests that P-glycoprotein has a role in reduced central bioavailability of PHT in our epileptic refractory model.     

Phenytoin, hemorrhage, skeletal defects and vitamin K in the newborn

The vitamin K-dependent hemostatic factors are present in reduced quantities at birth and may decrease further in the first few days of life. Administration of vitamin K1 on day 1 prevents hemorrhagic disease of the newborn. Maternal ingestion of anticonvulsants puts the newborn at greater risk from hemorrhage, possibly as a result of induction of fetal microsomal enzymes with a resultant increased oxidative degradation of vitamin K which gives rise to a vitamin K deficiency and other concomitant clinical results, for example skeletal defects. Evidence for this sequence of events is presented and the widespread effect of vitamin K deficiency on the fetus is discussed.     

放射免疫法测定抑郁症患者血清脱氢表雄酮变化

了解放射免疫法测定血清脱氢表雄酮（dehydroepiandrostemne,DHEA）的可靠性、抑郁症患者DHEA水平及抗抑郁治疗后的变化。选取抑郁症患者及正常对照志愿者各40名,8：00-9：00AM空腹时抽取肘静脉血,放射免疫分析法测定对照组和患者组治疗前后DHEA浓度。结果显示,患者组治疗前血清DHEA水平明显低于对照组（P=0．001）,治疗后明显升高（P=0．000）,且高于对照组（P=0．001）;男性组和女性组治疗前后血清DHEA浓度均有显著性差异（P值均为0．000）。结论：放射免疫法测定DHEA简便、可靠、易行,适合临床及研究应用;血清DHEA水平低下可能与抑郁有关,抗抑郁药物治疗后DHEA升高,这种变化与性别无关。     

Serum Leptin and Skeletal Differences between Obese and Non-Obese Patients with Chronic Obstructive Pulmonary Disease

ObjectiveChronic obstructive pulmonary disease (COPD) affects body composition, adipokine secretion, and skeletal integrity. The aim was to determine the association between leptin, body mass (BM) and body composition parameters - fat mass (FM) and fat mass index (FMI), lean tissue mass (LTM), lean tissue mass index (LTMI) and bone mineral density (BMD) in 67 male COPD patients.MethodsBM, body composition and biochemical indicators were measured or calculated using standard methods. Data were analyzed according to groups: non-obese (N = 48, BMI 21.0-29.9 kg/m²) and obese (N = 19, BMI ≥ 30.0 kg/m²).ResultsIn the non-obese group statistically significant correlations were observed: negative ones of age with most BMD T scores, positive ones of BMI with all T scores, FM, FMI, LTMI and leptin, of FMI with leptin and all T scores, and of LTMI with most T scores. In the obese group also statistically significant correlations were found: positive ones of BMI with FMI, LTM, leptin and T scores (trochanter, total hip); of FMI with leptin; and of leptin with total hip T score.ConclusionA positive relationship between FMI and BMD was found only in non-obese but not in obese COPD patients. Leptin concentration was associated positively with the total hip T score only in obese COPD patients, suggesting its protective role on the skeleton of obese COPD patients.Key Words: Body mass, Body mass index, Fat mass, Fat mass index, Lean tissue mass, Lean tissue mass index, 25-OH vitamin D, Leptin, Bone mineral density     

Association between HLA-G 14bp Gene Polymorphism and Serum sHLA-G Protein Concentrations in Preeclamptic Patients and Normal Pregnant Women

Background: Preeclampsia (PE) is a multisystem syndrome that is a primary source of fetal–maternal morbidity and mortality. Human leukocyte antigen-G (HLA-G) is a nonclassical Major histocompatibility complex (MHC) class-Ib molecule expressed on the extravillous trophoblast and seems to have immunomodulatory functions during pregnancy. The purpose of our study was to investigate whether HLA-G may be a vital marker in the modulation of the pregnancy.

Methods: In this case-control study, a number of 150 healthy pregnant women and 150 patients with PE had been genotyped for the 14 base-pair (bp) insertion/deletion polymorphism in exon 8 of the HLA-G gene, and the serum level of soluble HLA-G (sHLA-G) protein was measured using the enzyme-linked immunosorbent assay.

Results: Data showed that the PE syndrome was not related to the HLA-G 14 bp genotype. But, the serum level of sHLA-G in PE patients was significantly lower than that in healthy pregnant women in the third trimester (11.74 and 24.48 U/ml, respectively, p < 0.001). However, no significant association was observed between the HLA-G 14 bp genotype and serum sHLA-G level.

Conclusion: Our results demonstrate that measurement of sHLA-G protein level may be helpful as a primary diagnosis for the pathogenesis of PE. Overall, this study suggests that the association between HLA-G 14 bp polymorphism and serum sHLA-G level in different ethnic populations of PE should be taken into consideration.     

原发性癫痫患者血清泌乳素含量变化及其与脑电图表现的关系

研究对照组及原发性癫痫患者发作间歇期血清泌乳素（ＰＲＬ）含量变化及其与脑电图（ＥＥＧ）表现的关系。结果显示癫痫组ＰＲＬ含量（男性３０．４±２３．９ｎｇ／Ｌ，女性３４．１±２１．７ｎｇ／Ｌ）显著高于对照组（男性１０．６±３．４ｎｇ／Ｌ，女性１６．５±４．６ｎｇ／Ｌ）。ＥＥＧ显示有痫性放电组患者血清ＰＲＬ含量（３５．２±２８．１ｎｇ／Ｌ）显著高于ＥＥＧ呈非特异性异常组（２４．８±１８．３ｎｇ／Ｌ）和Ｅ     

IgG-RF ELISA定量检测法的建立和应用

本工作以 Ｉｇ Ｇ Ｆｃ 片断为靶抗原, 用自制抗人 Ｉｇ Ｇ Ｆａｂ Ｈ Ｒ Ｐ 标记物为第二抗体, 建立了定量测定血中 Ｉｇ Ｇ Ｒ Ｆ 的 Ｅ Ｌ Ｉ Ｓ Ａ。经验证, 本法可测范围为１０ ～２５６０ Ｉ Ｕ／ｍｌ, 批内 Ｃ Ｖ４８ ％ , 批间 Ｃ Ｖ１１７ ％ 。１００ 例健康人血清 Ｉｇ Ｇ Ｒ Ｆ 值为（４１０ ±３４３ ） Ｉ Ｕ／ｍｌ, 以高于珋ｘ ±ｓ 值的上限１１０ Ｉ Ｕ／ｍｌ 为阳性。９９ 例类风湿关节炎（ Ｒ Ａ） 患者血清 Ｉｇ Ｇ Ｒ Ｆ 值为（４３０ ±６０４） Ｉ Ｕ／ｍｌ,阳性率为６１５ ％ 。临床应用提示 Ｉｇ Ｇ Ｒ Ｆ 是判断 Ｒ Ａ 活动性的良好指标之一。     

癫痫病人血液和脑脊液中胆碱能受体自身抗体检测

胆碱能受体抗体是一种自身抗体, 可能与癫痫的发生与发展过程有关。本文应用 Ｅ Ｌ Ｉ Ｓ Ａ 方法测定了８８ 例癫痫病人血清和 Ｃ Ｓ Ｆ中胆碱能受体抗体。结果表明： 癫痫病人血清和脑脊液（ Ｃ Ｓ Ｆ） 中抗胆碱能受体抗体阳性率分别为４０９ ％ 和３６７ ％ 。抗体阳性组 Ｃ Ｓ Ｆ Ｉｇ Ｇ 指数异常者占５４５ ％ , 而阴性组仅为１５８ ％ 。提示部分癫痫病人存在胆碱能神经元突触前后膜的自身免疫损害, 并与鞘内特异免疫球蛋白的合成相一致。脑的自身免疫反应在某些癫痫发病中具有意义。     

Serum Cholesterol Concentrations and Mood States in Violent Psychiatric Patients: An Experience Sampling Study

The well-documented negative association between serum cholesterol and aggressive behavior has led Kaplan to propose a cholesterol–serotonin hypothesis of aggression. According to this hypothesis, low dietary cholesterol intake leads to depressed central serotonergic activity, which itself has been reported in numerous studies of violent individuals. In the present study, 25 violent psychiatric patients participated in a microbehavioral experience sampling procedure to examine differences in self-reports of affective and cognitive experiences as a function of serum cholesterol concentrations. For 7 days, they wore signaling devices that emitted an average of seven signals a day. Following each signal, patients filled out a mood questionnaire. Total serum cholesterol (TSC) concentration was positively associated with measures of affect, cognitive efficiency, activation, and sociability, suggesting a link between low TSC and dysphoria. These findings are consistent with the cholesterol–serotonin hypothesis and with the substantive literature linking both aggression and depression to depressed central serotonergic activity.     

急性脑梗死患者血清hs-CRP浓度的变化及其临床意义

目的：探讨急性脑梗死患者血清超敏C反应蛋白（hs—CRP）浓度的动态变化及其与梗死体积及神经功能缺损程度的关系。方法：测定116例脑梗死患者发病后1、3、7、14d和34例有脑梗死危险因素而未发生脑梗死的患者（对照组A）及32例健康人（对照组B）的血清hs—CRP浓度并分析其与脑梗死体积及神经功能缺损程度的关系。结果：脑梗死组发病后1d、3d、7d、14d四个时相点血清hs—CRP浓度明显高于对照组A和对照组B（P〈0．001），对照组A高于对照组B，差异有显著性（P〈0．001）。hs—CRP浓度越高，脑梗死灶越大，神经功能缺损程度越重。结论：hs—CRP可能不仅是缺血性脑卒中预后的重要标志物，还是急性脑梗死的致病因素之一。