肝脏疾病病人血清ALT和ALP活性的变化

①目的　探讨肝病病人血清丙氨酸氨基转移酶 (ALT)、碱性磷酸酶 (ALP)活性变化对肝病的诊断意义。②方法　应用全自动生化分析仪 ,速率法测定 2 8例急性肝炎、2 4例慢性迁延性肝炎、18例慢性活动性肝炎、10例肝硬化、30例肝细胞性黄疸病人ALT、ALP活性 ,并与正常人进行对照。③结果　急性肝炎、慢性活动性肝炎、肝硬化、肝细胞性黄疸病人ALT、ALP含量均明显高于正常组 ,差异有显著性 (H =12 3.5 6、4 6 .36 ,q =3.0 9～ 18.2 5 ,P <0 .0 5、0 .0 1)。慢性迁延性肝炎病人ALP含量亦高于正常组 ,差异有显著性 (q =8.2 5 ,P <0 .0 1)。各组肝病病人ALT、ALP异常率均高于正常组 ,差异有显著性 (χ2 =8.4 0～ 76 .0 1,P <0 .0 1)。④结论　联合检测ALT和ALP对肝病诊断和鉴别诊断具有重要意义。     

透明质酸层粘蛋白测定对肝纤维化的诊断价值

目的 :寻找肝纤维化敏感可靠的血清学指标。方法 :对 2 87例各型肝病 (1 3 6例肝硬化 ,80例慢性活动性肝炎和 71例慢性迁延性肝炎 )检测血清透明质酸 (HA)和层粘蛋白 (L N) ,并与 2 0 0例健康对照组作对照研究。结果 :肝硬化、慢性活动性肝炎病人的血清 HA、L N水平明显高于慢性迁延性肝炎及正常人 (P<0 .0 1 ) ;肝硬化病人血清 HA和 L N水平又显著高于慢性活动性肝炎 (P<0 .0 1 ;P<0 .0 5 )而慢性迁延性肝炎病人的血清 HA和 L N水平与正常人相比无显著性差异 (P>0 .0 5 )。结论 :血清 HA、LN对慢性肝炎的诊断、疗效的评价和预后的预测具有临床价值。     

妊高症患者外周血及胎盘组织内细胞因子和一氧化氮水平的变化

目的　了解妊高症患者外周血和胎盘组织内细胞因子及 NO水平的变化及意义 .方法　采用酶联免疫吸附法及镀铜镉还原法 (Griess法 )分别检测 47例妊高症患者外周血及胎盘组织内白细胞介素 - 6 (IL- 6 ) ,白细胞介素 - 8(IL- 8) ,肿瘤坏死因子α(TNF-α)及一氧化氮 (NO)水平 ,30例正常妊娠妇女作对照 .结果　妊高症外周血组 IL - 6 ,IL - 8及 TNF-α水平分别为 (86± 33) ,(10 1± 2 5 )及 (2 97± 6 6 ) pg· L- 1 ,均显著高于对照组 (31± 11) ,(5 7± 13) ,(16 4± 42 ) pg· L- 1 (P<0 .0 1) ;妊高症轻、中、重 3组间水平差异有显著性 (P<0 .0 1) ,妊高症胎盘组织内 IL- 6 ,IL- 8及 TNF- α水平分别为 (119±35 ) ,(135± 33)及 (390± 85 ) pg· L- 1 ,显著高于外周血 (P<0 .0 1) .而妊高症外周血及胎盘组织内 NO水平分别为 (84±2 7)及 (2 9± 15 ) pmol· L- 1 ,均显著低于对照组 (P<0 .0 1) ,轻、中、重 3组间 NO水平差异有显著性 (P<0 .0 1) ,妊高症患者胎盘组织内 NO水平明显低于外周血 (P<0 .0 1) .结论　妊高症患者体内产生过多的 IL - 6 ,IL - 8,TNF-α及 NO含量降低 ,可能与妊高症的发病过程关系密切 .     

血浆置换对患者血清细胞因子的变化及其临床意义

目的 :探讨血浆置换疗法对重型病毒性肝炎患者血清中细胞因子的变化及其对临床的影响。方法 :随机选择 4 0例经血浆置换治疗的重型病毒性肝炎患者 ,治疗前后测定血清中 TNF- α和 IL- 4的水平 ,观察其和愈后、肝功能、并发症间的关系。结果 :4 0例患者经治疗后 TNF- α由79.32± 2 2 .39下降到 2 0 .0 1± 2 2 .2 5 pg/ml(t=5 .873P<0 .0 0 1) ,IL- 4由 0 .6 1± 0 .0 7下降到 0 .5 7± 0 .0 6 pg/ml(t=2 .74 0 P<0 .0 1) ,好转出院的患者较恶化出院的患者下降尤其明显 (P均 <0 .0 5 ) ;肝功能的恢复同样是好转出院的患者较恶化出院的恢复得更为好 (P<0 .0 5～ 0 .0 0 1) ,对嗜睡、定向能力也均有明显的改善 (t值分别为 6 .6 6 7和 4 .2 7P值 <0 .0 0 1和 <0 .0 5 ) ,对治疗各种并发症更好 (t=14 .5 3P<0 .0 0 1)。结论 :血浆置换能清除以 TNF- α和 IL- 4为代表的细胞因子 ,是防治各种并发症的有效措施。同时提示愈后不佳的患者与炎症的持续存在 ,导致血清中 TNF-α和IL- 4水平较高有关。     

血清CA19-9测定对肝病诊断的评价

目的 :为观察血清CA19 9对肝病诊断价值。方法 :采用免疫放射分析技术 (IRMA)检测了 15 0例正常对照组和 93例肝病患者血清CA19 9。结果 :KU L :正常对照组 (n =15 0 )为 (13 .9± 9.2 ) ,急性肝炎组 (n =2 6 )为 (94.1± 181.9) (P<0 .0 5 ) ,慢性活动性肝炎组 (n =2 7)为 (387.8± 488.6 ) (P <0 .0 0 1) ,慢性迁延性肝炎组 (n =2 1)为 (5 35 .3± 92 6 .1) (P <0 .0 0 1) ,肝硬化组 (n =19)为 (15 3 .8± 14 5 .5 ) (P <0 .0 0 1)。 93例肝病组CA19 9总阳性率为 6 5 .6 % ,ALT总阳性率为 88.2 %。而 15 0例非肝病组CA19 9阳性率为 3.1% ,ALT阳性率为 8.8%。结论 :CA19 9升高可反映肝脏中肝细胞实质性损伤 ,具有一定临床使用价值     

妊娠高血压综合征患者血液VEGF、TNF及胎盘NO含量测定

目的:测定妊娠高血压综合征(妊高征)患者血液血管内皮生长因子 (VEGF)、肿瘤坏死因子 (TNF)、胎盘一氧化氮(NO)的含量。方法:选择妊高征患者 46例,其中轻度 14例,中度 15例,重度 17例;选择同期正常晚期妊娠妇女 16例为对照。采用酶联免疫吸附法测定各组孕妇血清VEGF水平,放射免疫法测定血浆TNF α含量,用硝酸还原法测定胎盘组织NO浓度。结果:①轻度妊高征患者血清VEGF水平及胎盘组织NO含量与对照组相比,差异无统计学意义(P>0. 05),中、重度妊高征患者 2指标均低于对照组 (P均 <0. 05)。②各组妊高征患者血浆TNF -α水平均较对照组明显增高(P<0. 05),其中以中重度增高明显。③妊高征孕妇血清VEGF水平与胎盘组织NO含量呈正相关(r=0. 68, P<0. 01),而TNF- α水平与NO含量呈负相关 (r=-0. 71, P<0. 01 )。结论:血清VEGF、TNF的改变在妊高征发病中起重要作用,它们还可通过影响NO的合成进一步在妊高征发病中发挥作用。     

脑梗死患者血ET和TNF-α含量变化的研究

目的　研究脑梗死 (CI)患者发病初期及第 3周血中 ET和 TNF- α含量变化。方法　用放射免疫分析法检测 6 8例 CI患者发病 2～ 5天和病程第 3周初及 36例对照组血中 ET和 TNF- α水平。结果　 CI发病初期两种因子均显著升高 ,CI各组间及与对照组间有显著性差异 (P<0 .0 1) ;病程第 3周比病初血中含量明显下降 (P<0 .0 1) ,ET在重型组和大灶组仍明显高于对照组 (P<0 .0 1) ,TNF- α在 CI各组间及中重型 /大中灶组与对照组间仍具显著性差异。结论　 CI患者发病初期血 ET和 TNF- α水平显著升高 ,在此时检测其含量高低 ,有助于临床诊断、判断病情及推测预后     

山莨菪碱对创伤性肺损伤细胞因子及其mRNA表达的影响

为研究山莨菪碱 (6 5 4- 2 )对创伤性急性肺损伤 (AL I)家兔血浆中肿瘤坏死因子 - α(TNF- α)、白细胞介素 - 6 (IL- 6 )的含量及其在内脏组织中 m RNA表达的影响 .用 EL ISA和 RT- PCR方法测定 2 4只大耳白兔血浆中 TNF-α,IL - 6的含量及其在内脏组织中 m RNA的表达 .结果 :创伤性 AL I家兔与正常组比较 ,血浆中 TNF- α,IL- 6的含量升高 (P<0 .0 5 ) ,内脏组织中 TNF- α,IL - 6 m RNA的表达显著增多 (P<0 .0 1) .6 5 4- 2治疗后明显降低 AL I家兔血浆中 TNF-α,IL - 6的含量 (P<0 .0 5 ) ,抑制内脏组织 TNF- …     

新生儿HIE脐血IL—6,TNF—α与NO变化及临床意义探讨

目的 :探讨新生儿缺氧缺血性脑病 (HIE)脐血 IL- 6、TNF- α与 NO变化的临床意义。方法 :分别用放射免疫法与硝酸盐还原酶两点法检测了 4 0例 HIE患儿及 4 0例正常新生儿脐血 IL- 6、TNF- α与 NO水平。结果 :与正常新生儿比较 ,HIE患儿脐血 IL- 6水平分别为 70 .53± 18.86对 81.80± 2 7.96 pg/ ml(p=0 .0 38) ,TNF- a分别为 1.0 3± 0 .30±对 0 .82± 0 .31ng/ ml(p=0 .0 0 1) ,NO分别为59.17± 2 4 .11对 85.0 5± 31.36 μmol/ L(p=0 .0 0 1) ,而且病情越重改变越明显。结论 :围产期窒息与HIE患儿脐血 IL- 6与 NO水平减低 ,TNF- α水平升高 ,它们可能参与了新生儿缺氧缺血性脑损伤的某些发病过程 ,脐血免疫指标的检测可用于 HIE的早期预测。     

急性颅脑损伤患者外周血TNF-α、IL-6、IL-8和NO水平的变化及临床意义

目的 :探讨急性颅脑损伤患者外周血TNF -α、IL -6、IL- 8和NO水平的变化及其临床意义。方法 :采用ELISA法检测TNF- α、IL- 6和IL -8,化学比色法检测NO。结果 :中、重型颅脑损伤患者外周血中TNF- α、IL- 6、IL -8和NO浓度明显高于对照组和轻型颅脑损伤患者 (P <0 . 0 1) ;轻型组颅脑损伤患者TNF- α高于对照组 ,但IL -6、IL- 8和NO浓度与对照组比较无显著意义。不同病情颅脑损伤患者外周血TNF α、IL- 6、IL -8和NO浓度与病情呈正相关。结论 :TNF- α、IL -6、IL- 8和NO参与了急性颅脑损伤的病理生理过程 ,其测定对于早期评估脑损伤的严重程度和预后有重要的临床意义。     

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.