反复呼吸道感染患儿机体免疫功能初探

对３０例反复呼吸道感染（ＲＲＩ）患儿的体液免疫功能（血清免疫球蛋白），和细胞免疫功能（Ｔ细胞亚群）进行测定。结果表明，ＲＲＩ患儿血清ＩｇＧ与ＩｇＡ有所降低：Ｔ细胞亚群中ＣＤ４、ＣＤ８细胞均有显著变化。提示机体免疫功能低下，是ＲＲＩ发病的原因之一。     

反复呼吸道感染患儿铁营养状况及其与血清IgG亚类、T细胞亚群关系的探讨

检测４７例ＲＲＴＩ患儿铁营养状况、外周血Ｔ细胞亚群、血清ＩｇＧ亚类等。结果表明，ＲＲＴＩ患儿缺铁发生率为７８．７２％，其中约％为隐性缺铁；ＲＲＴＩ组ＣＤ＋４细胞百分率、Ｔ细胞增殖功能明显降低，血清ＩｇＧ亚类缺陷检出率为３６．１７％，以ＩｇＧ４，ＩｇＧ１缺陷居多。ＳＦ、ＦＥＰ与ＣＤ＋４细胞、ＩｇＧ亚类间存在显著相关关系。提示ＲＲＴＩ多伴有铁营养不足；铁缺乏可能通过损害Ｔｈ细胞功能而导致ＩｇＧ亚类缺陷，引起ＲＲＴＩ发作。     

儿童反复呼吸道感染与免疫球蛋白G亚类缺陷

检测９２例反复呼吸道感染和４２例健康儿童血清ＩｇＧ亚类，外周血Ｔ细胞及其亚群，结果表明，ＲＲＴＩ组ＩｇＧ亚类缺陷检出率为４５．２３％，以选择性缺陷为主，ＩｇＧ缺陷居多；ＲＲＴＩ患儿血清ＩｇＧ２均值在各年龄组中均明显低于对照组。     

丙种球蛋白治疗小儿反复呼吸道感染26例

目的：探讨静脉滴注大剂量丙种球蛋白（ＩＶＩＧ）治疗小儿反复呼吸道感染的治疗效果。方法：对２６例患儿以５００ｍｇ／ｋｇ静脉滴注ＩＶＩＧ，每月１次，连续３月。对照组２０例，按常规治疗，不用免疫制剂及血浆。用单向免疫琼脂扩散法和间接免疫荧光法，分别检测治疗前后患儿血清ＩｇＧ、ＩｇＡ、ＩｇＭ、ＣＤ３、ＣＤ４和ＣＤ８，并临床追踪观察１年。结果：ＩＶＩＧ组总有效率为８８．４％，对照组为５０．５％，差异有显著性。治疗后ＩｇＧ、ＣＤ３、ＣＤ４和ＣＤ４／ＣＤ８明显升高（Ｐ＜０．０１），ＣＤ８降低，而对照组治疗前后各免疫指标无明显差异。结论：静脉滴注大剂量ＩＶＩＧ能提高ＲＲＴＩ患儿体液和细胞免疫水平，减少发病次数，是治疗ＲＲＴＩ一种有效方法     

反复呼吸道感染患儿铁营养状况及其与血清IgG亚类,T细胞亚群…

检测４７例ＲＲＴＩ患儿铁营养状况、外周血Ｔ细胞亚群、血清ＩｇＧ亚类等。结果表明，ＲＲＴＩ患儿缺铁发生率为７８．７％，其中约２／３为隐性缺铁；ＲＲＴＩ组ＣＤ＾＋细胞百分率、Ｔ细胞增殖功能明显降低，血清ＩｇＧ亚类缺陷同率为３６．１７％，以ＩｇＧ４、ＩｇＧ、缺陷居多。ＳＦ、ＦＥＰ与ＣＤ＾＋细胞、ＩｇＧ亚类间存在显著相关关系。提示ＲＲＴＩ多伴有铁营养不足；铁缺乏可能通过损害Ｔｈ细胞功能而导致ＩｇＧ亚类缺陷     

玉屏风散治疗反复呼吸道感染T细胞亚群的变化

目的探讨反复呼吸道感染与Ｔ细胞亚群的关系以及使用中药玉屏风散后Ｔ细胞亚群的变化。方法对４８例反复呼吸道感染患儿进行了外周血Ｔ细胞亚群检测,同时对３０例反复呼吸道感染患儿进行了中药玉屏风散和常规治疗对照观察。结果反复呼吸道感染患儿ＣＤ３显著减少,ＣＤ８显著增高,ＣＤ４无显著差异,ＣＤ１／ＣＤ８比值显著下降,比例失调,导致细胞免疫功能低下,而致呼吸道感染反复发作。玉屏风散治疗组疗效明显,与常规治疗组相比有显著差异。结论玉屏风散可以提高患儿细胞免疫功能。     

轮状病毒肠炎患儿免疫功能动态变化及其临床意义

采用透射比浊法和抗体致敏红细胞花环试验检测了３８例生长发育正常的轮状病毒肠炎（ＲＶＥ）患儿血清免疫球蛋白和Ｔ细胞亚群。结果显示：急性期血清ＩｇＧ、ＩｇＡ、ＩｇＭ、ＣＤ３、ＣＤ４、ＣＤ４／ＣＤ８比值明显降低于对照组及恢复期（Ｐ＜００１），尤其是ＩｇＡ、ＣＤ４／ＣＤ８比值较对照组降低更为明显（Ｐ＜０００１），ＣＤ８明显高于对照组及恢复期（Ｐ＜００１）。恢复期随着临床症状逐渐消失，ＩｇＧ、ＩｇＡ、ＩｇＭ、ＣＤ３、ＣＤ４、ＣＤ４／ＣＤ８比值升高，ＣＤ８降低、并逐渐恢复正常，与对照组之间无显著性差异（Ｐ＞００５）。结果表明：细胞免疫和体液免疫功能参与了ＲＶ的感染过程，ＩｇＡ、ＣＤ４／ＣＤ８比值与疾病的预后有关。     

烹调油烟接触者外周血T淋巴细胞亚群的调查

目的：了解烹调油烟接触者的免疫状况。方法：采用抗人Ｔ淋巴细胞亚群单克隆抗体ＡＰＡＡＰ桥联酶标法对４４名厨师及３１名服务员外周血Ｔ淋巴细胞亚群进行了测定,同时应用单向免疫扩散法测定了调查者血清抗体滴度。结果：烹调油烟接触者外周血Ｔ淋巴细胞ＣＤ＋３、ＣＤ＋４细胞百分率明显低于对照组（Ｐ＜００１）,ＣＤ＋８细胞百分率明显高于对照组（Ｐ＜００１）,ＣＤ＋４／ＣＤ＋８比值明显低于对照组（Ｐ＜００１）。烹调油烟接触者血清ＩｇＧ抗体滴度明显高于对照组（Ｐ＜００１）。结论：烹调油烟可致细胞免疫功能抑制,体液免疫功能增强     

分枝杆菌多糖治疗小儿反复呼吸道感染的临床观察

对２３例反复呼吸道感染小儿采用分枝杆菌多糖（ＭＰＳ）系统治疗观察，检测用药前后Ｔ细胞亚群ＣＤ_４、ＣＤ_８及ＣＤ_４／ＣＤ_８之变化，并与健康对照组相比，同时进行临床疗效判断。结果患儿组治疗前ＣＤ_４及ＣＤ_４／ＣＤ_８均较对照组降低。经ＭＰＳ治疗后两者均明显上升，且与健康对照组无显著差异。临床疗效判断显效和有效２２例，无效１例。提示反复呼吸道感染小儿Ｔ细胞免疫功能受到抑制，ＭＰＳ对改善其细胞免疫功能状态有一定作用。     

反复呼吸道感染儿童血清12种微量元素、T细胞亚群检测及其相关性探讨

检测９２例反复呼吸道感染（ＲＲＴＩ）患儿血清Ｚｎ、Ｍｎ、Ａｌ、Ｃｄ、Ｆｅ、Ｃｕ、Ｐｂ、Ｎｉ、Ｔｉ、Ｃｏ、Ｌｉ、Ｃｒ含量，以及外周血Ｔ细胞亚群、Ｔ细胞增殖功能、血清免疫球蛋白等指标，结果表明ＲＲＴＩ患儿血清Ｚｎ、Ｆｅ、Ｐｂ、Ｎｉ、Ｔｉ、Ｃｏ、Ｌｉ均值明显低于正常对照组，各年龄中亦以Ｚｎ、Ｆｅ、Ｃｏ、Ｌｉ降低多见；外周血Ｔ细胞增殖功能、ＣＤ３＋细胞百分率、ＣＤ４＋细胞百分率以及ＣＤ４＋／ＣＤ８＋细胞比值均显著下降，ＣＤ８＋细胞百分率明显高于正常儿童。上述免疫功能指标与血清Ｆｅ、Ｚｎ、Ｃｒ、Ｎｉ等存在显著性相关关系。提示ＲＲＴＩ时不仅免疫功能广泛受损，而且伴有多种微量元素缺乏或失衡；血清微量元素缺乏、免疫功能低下与ＲＲＴＩ三者间可能互为因果，临床上及时补充铁、锌等微量元素对防治ＲＲＴＩ的发生发展是十分必要的。     

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.