卵巢功能早衰患者抗卵巢抗体及细胞免疫功能的测定

目的：探讨卵巢功能早衰（ＰＯＦ）患者细胞免疫功能的变化及其与抗卵巢抗体（ＡＯＡｂ）之间的关系。方法：检测３０例正常妇女（对照组）和３０例ＰＯＦ患者（ＰＯＦ组）的血清ＡＯＡｂ、外周血Ｔ淋巴细胞亚群及对卵巢抗原的白细胞促凝血活性（ＬＰＣＡ）。结果：对照组血清ＡＯＡｂ水平为１．３９±０．７２ｋＵ／Ｌ，ＰＯＦ组血清ＡＯＡｂ水平为６．８０±１．９１ｋＵ／Ｌ，两者比较，差异有极显著性（Ｐ＜０．０１）。与对照组比较，ＰＯＦ组ＣＤ３＋、ＣＤ４＋细胞百分率（分别为６５．４２±５．３１％和４４．７９±５．９０％）明显升高，ＣＤ８＋细胞百分率（２５．６３±４．２６％）明显降低，ＣＤ４＋／ＣＤ８＋比值（１．６６±０．２７）增加（Ｐ＜０．０１）。ＣＤ４＋／ＣＤ８＋比值升高者的ＡＯＡｂ阳性率（８５．７％，１８／２１），明显高于ＣＤ４＋／ＣＤ８＋比值正常者（３／９，Ｐ＜０．０１）。ＡＯＢｂ阳性的ＰＯＦ患者ＬＰＣＡ水平上升，且与ＡＯＡｂ之间有非常显著的相关性（χ２＝８．３７８，Ｐ＜０．０１）。结论：ＰＯＦ患者对卵巢抗原同时产生细胞免疫和体液免疫反应，ＰＯＦ的发病可能与免疫因素有关     

成都地区正常男性中老年人血清apo B100含量与脂质及apoAⅠ、AⅡ、CⅡ、CⅢ、E的关系

为研究血清ａｐｏＢ１００与血清ＴＧ、ＴＣ、ＨＤＬ－Ｃ、ＬＤＬ－Ｃ及ａｐｏＡⅠ、ＡⅡ、ＣⅡ、ＣⅢ和Ｅ的关系，对４３８例４０～７０岁正常男性中老年人空腹１２～１４小时的血清ＴＧ、ＴＣ、ＨＤＬ－Ｃ、ＬＤＬ－Ｃ及ａｐｏＢ１００、ＡⅠ、ＡⅡ、ＣⅡ、ＣⅢ和Ｅ的水平进行了全面的分析。结果表明，血清ａｐｏＢ１００水平为７４２．５±１６５．８ｍｇ／Ｌ，且有随年龄上升的趋势。其中５组及６组的ａｐｏＢ１００水平比１、２、３、４组均显著升高（Ｐ＜０．０５）。血清脂质水平（ｘ±ｓ，ｍｍｏｌ／Ｌ）：ＴＧ为１．３９±０．４５、ＴＣ为４．７９±０．８２、ＨＤＬ－Ｃ为１．６２±０．４０、ＬＤＬ－Ｃ为２．６５±０．８１，且５组及６组的ＴＧ、ＴＣ、ＬＤＬ－Ｃ水平均比１、２、３、４组显著升高（Ｐ＜０．０１）。相关分析表明：血清ａｐｏＢ１００与血清ＴＧ、ＴＣ、ＬＤＬ－Ｃ及ａｐｏＣⅡ、ＣⅢ和Ｅ均呈显著正相关（Ｐ＜０．００１）；与ＨＤＬ－Ｃ呈显著负相关（Ｐ＜０．０１）。以上结果提示：中老年男性，尤其是６０～７０岁年龄段的血清ａｐｏＢ１００水平与血清脂质及ａｐｏＣⅡ、ＣⅢ和Ｅ有密切的关系。     

肾病综合征病人抗氧化功能的研究

为研究肾病综合征（ＮＳ）时抗氧化功能状况，我们测定３６例患者血超氧化物歧化酶（ＳＯＤ）、丙二醛（ＭＤＡ）及维生素Ｅ，以及尿ＳＯＤ、ＭＤＡ。结果表明：ＮＳ患者血总ＳＯＤ、Ｃｕ－Ｚｎ－ＳＯＤ及维生素Ｅ水平明显低于正常对照组（分别为７６．２２±２７．４８μＵ／Ｌ比１０４．２０±１８．８０μＵ／Ｌ，Ｐ＜０．００１；２０．４０±２２．６３μＵ／Ｌ比６２．９９±１５．６０μＵ／Ｌ，Ｐ＜０．００１；６．６８±３．５２ｍｇ／Ｌ比１６．３８±１．０５ｍｇ／Ｌ，Ｐ＜０．００１）；尿ＳＯＤ及ＭＤＡ明显高于对照组（分别为：１１４．９８±３１．７３μＵ／Ｌ比８２．３４±２６．５０μＵ／Ｌ，Ｐ＜０．００１；３．９９±１．９８μｍｏｌ／Ｌ比２．６４±０．７８μｍｏｌ／Ｌ，Ｐ＜０．００１）．研究提示，ＮＳ时抗氧化功能减退，肾脏易遭受氧自由基损害。     

慢性阻塞性肺疾病肿瘤坏死因子的检测意义

目的 探讨肿瘤坏死因子α（ＴＮＦ－α）与慢性阻塞性肺疾病（ＣＯＰＤ）的发病关系和临床意义。方法 采用酶联免疫吸附法（ＥＬＩＳＡ）检测１０例慢性阻塞性肺疾病急性发作期及１０例正常人痰和血清的ＴＮＦ－α水平。结果：慢性阻塞性肺疾病急性发作期痰中的ＴＮＦ－α水平［（９８．０±２０．５）ｎｇ／Ｌ］明显高于血清［（１２．５±４．０）ｎｇ／Ｌ］和正常对照组痰液［（２２．０±６．８）ｎｇ／Ｌ］（Ｐ〈０．０５）。     

CD4T细胞活化与白细胞介素5释放在过敏性哮喘发病中的作用

目的了解特异性过敏原刺激下ＣＤ４Ｔ细胞活化以及白细胞介素５（ＩＬ５）释放在过敏性哮喘发病中作用。方法对１２例过敏性哮喘（ＡＡ组）、９例过敏性非哮喘（ＡＮ组）患者以及１０例正常对照者（Ｎ组）用过敏原屋尘螨提取液（ＨＤＭ）进行全肺吸入激发,测定激发前后支气管肺泡灌洗（ＢＡＬ）液和周围血单个核细胞（ＰＢＭＣ）的ＣＤ４ＣＤ２５细胞、嗜酸粒细胞（ＥＯＳ）、ＩＬ５、嗜酸细胞阳离子蛋白（ＥＣＰ）水平。结果ＡＡ组迟发气道反应（ＬＡＲ）发生率明显高于ＡＮ组,差异有非常显著意义（Ｐ＜００１）,此种差异与ＢＡＬ液中的ＥＯＳ计数（ｒ＝０５３９,Ｐ＜００５）、ＣＤ４ＣＤ２５细胞、ＩＬ５及ＥＣＰ水平相关。结论ＣＤ４Ｔ细胞活化与哮喘状态有关,也与过敏状态有关;特异过敏原刺激是过敏性哮喘病人ＣＤ４Ｔ细胞活化的重要原因;ＩＬ５是ＥＯＳ选择性活化因子,它主要在气道局部调控ＥＯＳ的聚集和活化     

支气管哮喘急性发作期患者血浆内皮素水平的变化

为探讨内皮素（ＥＴ）与支气管哮喘急性发作的相互关系，采用放射免疫分析法对２３例支气管哮喘急性发作期患者和１２例正常人血浆ＥＴ水平进行检测，并与动脉血氧分压（ＰａＯ２）和最大呼气流量（ＰＥＦ）进行相关分析。结果发现哮喘急性发作期患者血浆ＥＴ水平为８９．２±８．４ｎｇ／Ｌ，明显高于正常组的５２．２±６．５ｎｇ／Ｌ（Ｐ＜０．００１）；且ＥＴ水平与ＰａＯ２和ＰＥＦ呈明显负相关（ｒ分别为－０．７８９３和－０．７１２４，Ｐ＜０．０１）。提示ＥＴ可能与哮喘患者的急性发作有一定的关系，并可反映病情的严重程度。     

慢性阻塞性肺疾病急性发作期痰及血清白介素-8的测定及意义

目的 探讨白介素－８（ＩＬ－８）在慢性阻塞性肺疾病（ＣＯＰＤ）气道炎症中的作用。方法 采用酶不联免疫吸附法（ＥＬＩＳＡ）检测１０例ＣＯＰＤ急性发作期和１０例正常对照组及血清的ＩＬ－８水平。结果 ＣＯＰＤ患者痰ＩＬ－８水平为（１９８２．２４±９０１．０７）ｎｇ／Ｌ、血清ＩＬ－８水平为（６６８．１６±３９８．０５）ｎｇ／Ｌ,明显高于正常人痰（７６９．６±５７０．１４）ｎｇ／Ｌ及血清（１１７．７８±１２     

羟乙基淀粉及动脉灌注法结合持续低流量灌注对兔心肺联合保存的作用

目的研究胶体物质羟乙基淀粉（ＨＥＳ）及低流量灌注技术（ＬＦＰ）对兔心肺联合保存的作用。方法选用健康家兔５０只，２只用于正常心肺组织的超微结构观察，４８只随机均分为晶体液（ＣＳ）组、ＨＥＳ组及ＬＦＰ组，每组８对供、受体。用Ｓｔ．Ｔｈｏｍａｓ液及改良Ｅｕｒｏ－Ｃｏｌｌｉｎｓ液灌注ＣＳ组心、肺，含５％ＨＥＳ的Ｓｔ．Ｔｈｏｍａｓ液及改良Ｅｕｒｏ－Ｃｏｌｌｉｎｓ液灌注ＨＥＳ组及ＬＦＰ组心、肺，取心与左肺整体４℃保存７ｈ，保存期间ＬＦＰ组经主、肺动脉持续低流量（０．２５ｍｌ／ｇ心肺重量／ｈ）灌注４℃相应保存液。移植后每３０ｍｉｎ测定供体心左室收缩压（ＬＶｓｐ）、左室舒张末压（ＬＶｅｄｐ）、右房压（ＲＡＰ）及供体肺气道峰压（Ｐａｗ），取动脉血测氧分压（ＰａＯ２），实验结束时记录异丙肾上腺素用量，计算心肺重量增值，测定心肺组织丙二醛（ＭＤＡ）含量，取心肺组织观察超微结构。结果ＣＳ组心肺重量增值高于ＨＥＳ组（Ｐ＜０．０１），ＨＥＳ组与ＬＦＰ组无明显差异。ＣＳ组ＬＶｓｐ均低于ＨＥＳ组（Ｐ＜０．０５或＜０．０１），３０，６０ｍｉｎ时ＬＦＰ组高于ＨＥＳ组（Ｐ＜０．０５）。ＣＳ组ＬＶｅｄｐ均高于ＨＥＳ组（Ｐ＜０．０５或Ｐ＜０．０１）     

缓解期哮喘患者T细胞亚群变化与血清总IgE相关关系的研究

应用Ｔ淋巴细胞亚群单克隆抗体对缓解期内，外源性哮喘患者外周血Ｔ细胞亚群及血清总ＩｇＥ进行检测，结果提示：①缓解期哮喘患者外周血ＣＤ３±和ＣＤ４±细胞百分率与对照组相近，而ＣＤ８±细胞百分率低于对照组（Ｐ＜０．０１），ＣＤ４＋／ＣＤ８＋比值高于对照组（Ｐ＜０．０１）；②外源性哮喘组血清总ＩｇＥ含量明显高于对照组（Ｐ＜０．０１），并与ＣＤ８＋细胞百分率呈明显负相关（ｒ＝一０．７３３）。此结果说明缓解期哮喘患者存在着体内细胞免疫失衡，其可能与哮喘的发病机制有关。而外源性哮喘患者外周血ＩｇＥ增高可能与Ｔ细胞亚群的比例失衡有关。     

支气管哮喘患者外周血白细胞中糖皮质激素受体的研究

采用３Ｈ－Ｄｅｘ放射配体结合分析法测定２２例正常人及２０例哮喘患者在糖皮质激素（ＧＣ）治疗前后外周血白细胞中糖皮质激素受体（ＧＣＲ）水平。结果：哮喘患者外周血白细胞ＧＣＲ（３９６６±１１０９位点／细胞）明显低于健康正常人（５２５４±１２８９位点／细胞）（Ｐ＜０．０５）；哮喘患者经ＧＣ治疗一周后，其白细胞中ＧＣＲ（２０９１±４９４）明显低于治疗前（Ｐ＜０．０５）；但哮喘患者ＧＣ敏感组白细胞中ＧＣＲ与ＧＣ耐受组之间无显著差异（Ｐ＞０．０５），并对其发生机制作了初步探讨     

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.