原发性高血压肾病患者血浆leptin和血清APN及尿mAlb检测的临床意义

目的:探讨了原发性高血压肾病患者血浆瘦素(leptin)和血清脂联素(APN)及尿微量白蛋白(mAlb)水平的变化及意义。方法:应用放射免疫分析、酶联免疫法和化学法对38例原发性高血压肾病患者血浆leptin和血清APN及尿mAlb进行检测,并与35名正常健康人作比较。结果:原发性高血压肾病患者血浆leptin和尿mAlb水平非常显著地高于正常人组(P<0.01)。而血清APN水平则显著地低于正常人组(P<0.01)。血清APN水平与leptin、尿mAlb水平呈显著的负相关(r=-0.4084、-0.5132,P<0.01)。结论:检测原发性高血压肾病患者血浆leptin和血清APN及尿mAlb水平的变化对了解病情、探讨其发病机理、预防和指导用药均有重要的临床价值。     

原发性高血压患者血浆ET-1水平与脂质过氧化关系的探讨

目的:探讨原发性高血压患者血浆ET-1水平与脂质过氧化的关系。方法:分别应用放免法和生化法对33例高血压患者进行血浆ET-1、丙二醛(MDA)、超氧化物岐化酶(SOD)、谷胱甘肽过氧化物酶(GSH-PX)含量测定,并与35名正常健康人作比较。结果:原发性高血压患者血浆ET-1、MDA水平非常显著地高于正常人组(P<0.01),而血清SOD、GSH-PX水平非常显著地低于正常人组(P<0.01)。相关分析显示,血清SOD、GSH-PX水平与MDA水平呈显著负相关(r=-0.4218、-0.4011,P<0.01)。结论:原发性高血压患者血清SOD、GSH-PX水平的降低与活性代谢紊乱密切相关。     

原发性高血压肾病患者血清APN、TGF-β1检测的临床意义

目的：探讨了原发性高血压肾病患者血清脂联素（APN）、TGF-β1水平的变化及意义。方法：应用ELISA在36例高血压肾病患者进行血清APN、TGF-β1检测,并与35名正常健康人作比较。结果：原发性高血压肾病患者TGF-β1水平非常显著地高于正常人组（P〈0.01）。血清APN水平则低于正常人组（P〈0.01）。两者之间呈明显负相关（r=-0.4588,P〈0.01）。结论：检测原发性高血压肾病患者血清APN和TGF-β1水平的变化对了解病情,探讨其发病机理,预防和指导用药均有重要的临床价值。     

原发性高血压合并糖尿病患者血清APN和INS的变化及意义

目的:探讨原发性高血压(PH)合并糖尿病(DM)患者血清脂联素(APN)和胰岛素(INS)变化及其临床意义.方法:采用放射免疫分析测定了126例PH合并DM患者、92例PH患者和40例健康对照者的血清APN和INS水平,并将结果进行分析.结果:PH合并DM组血清APN水平显著低于PH组(P<0.01)和健康对照组比较(P<0.01),INS水平显著高于健康对照组(P<0.01),显著低于PH组(P<0.05);PH组血清APN显著低于健康对照组(P<0.01),INS水平显著高于健康对照组(P<0.01).在PH合并DM组中,APN与INS两者间呈显著负相关(r=-0.496,P<0.01),APN与平均收缩压(SBP)(r=0.586,P<0.01)、平均舒张压(DBP)(r=0.416,P<0.05)呈显著负相关,INS与SBP(r=0.433,P<0.05)、DBP(r=0.401,P<0.05)呈显著正相关.结论:PH合并DM患者血清APN水平显著降低,INS水平显著高于健康对照组,却显著低于PH组;APN与INS相互间呈负相关.     

老年COPD患者血清MMP-9、SAA、SOD和ET-1水平与病情急性发作的相关性分析

目的:探讨老年COPD患者四项血清炎性指标测定的临床价值。方法:血清MMP-9、SAA、SOD和ET-1测定均采用双抗体夹心ABC-ELISA测定。结果:老年COPD急性期组患者血清MMP9、SAA和ET-1水平均显著高于稳定期组和正常对照组(P<0.05,P<0.01),SOD水平则低于稳定期组和正常对照组(P<0.05,P<0.01),而两组患者的肺功能指标显示显著降低(P均<0.01)。血清MMP-9、SAA、SOD和ET-1水平与FEV1%pred的相关性分析均呈显著相关和负相关关系(r=-0.761、r=-0.902、r=0.534、r=-0.698,P<0.01,P<0.05)。结论:四项血清指标的变化与老年患者COPD的急性发作关系密切。     

CHD患者血浆ET-1、GMP-140和血清PAPP-A检测的临床意义

目的:探讨了冠心病(CHD)患者血浆ET-1、颗粒膜蛋白-140(GMP-140)和血清妊娠相关蛋白A(PAPP-A)水平的变化及临床意义。方法:应用放射免疫分析和化学发光法对98例CHD患者进行了血浆ET-1、GMP-140和PAPP-A水平的测定,其中稳定性心绞痛(SAP)38例,不稳定性心绞痛(UAP)32例。急性心肌梗死(AMI)28例,并与35名正常人作比较。结果:CHD患者血浆ET-1、GMP-140和血清PAPP-A水平均显著地高于正常人组(P<0.01),AMI和UAP组又高于SAP组(P<0.05),且血清PAPP-A水平与ET-1、GMP-140水平呈正相关(r=0.6184、0.5762,P<0.01)。结论:检测CHD患者血浆ET-1、GMP-140和血清PAPP-A水平的变化对CHD的发生和发展以及疗效和预后观察均具有重要的临床意义。     

哮喘豚鼠内皮素、心钠素含量的变化及心钠素对内皮素含量的影响

目的:探讨内皮素-1(ET-1)在哮喘发病中的可能作用及心钠素(ANF)对ET-1水平的影响。方法:采用放免法测定各组豚鼠支气管肺泡灌洗液(BALF)和血浆ET-1、ANF、cGMP含量。结果:哮喘组豚鼠血浆及BALF中ET-1、ANF、cGMP均显著高于对照组;哮喘组豚鼠血浆中ANF与ET-1含量呈显著负相关(r=-0.638,P<0.05);BALF中ET-1与ANF含量呈高度负相关(r=-0.921,P<0.01)。哮喘组豚鼠血浆中ANF与cGMP含量呈显著正相关(r=0.848,P<0.01),BALF中ANF与cGMP含量呈显著正相关(r=0.831,P<0.01)。哮喘+重组大鼠ANF(rANF)组豚鼠停止输注rANF后30min,血浆及BALF中ET-1水平均明显低于哮喘组。cGMP水平显著高于哮喘组。结论:ET-1在哮喘的发病中可能有重要作用,ANF抑制ET-1合成及分泌。     

川崎病并发冠脉病变患儿血浆ET-1和血清Hcy、cTnI检测的临床意义

目的:探讨了川崎病并发冠脉病变患儿血浆ET-1和血清Hcy、cTnI检测的变化及临床意义。方法:应用放免法、免疫结合和生化法对31例川崎病并发冠脉病变患儿进行了血浆ET-1和血清Hcy、cTnI测定,并与35例正常儿童作比较。结果:川崎病并发冠脉病变患儿血浆ET-1和血清Hcy、cTnI水平均显著地高于正常儿组(P<0.01),且血浆ET-1和血清Hcy、cTnI水平呈正相关(r=0.4782、0.5014,P<0.01)。结论:检测川崎病并发冠脉病变患儿血浆ET-1和血清Hcy、cTnI水平的变化对疾病的发生和发展及预后均有重要的临床价值。     

原发性高血压患者血清8-异前列腺素F2α及氧化应激相关酶水平测定的临床意义

目的探讨高血压患者血清8-异构前列腺素F2α(8-iso-PGF2α)及其氧化应激相关酶水平改变的临床意义。方法选取193例原发性高血压患者(分为1、2、3级),应用双抗体夹心酶联免疫吸附法(ELISA)检测患者血清8-iso-PGF2α的水平;分别应用黄嘌呤氧化酶法和硫代巴比妥法进行超氧化物歧化酶(SOD)和丙二醛(MDA)的检测;将结果与52名正常健康人的上述指标比较。结果原发性高血压1级、2级和3级患者的血清8-iso-PGF2α水平显著高于正常对照组(P<0.05),并与血压水平呈正相关(r=0.62,P<0.05);原发性高血压1级、2级和3级患者的血清中SOD水平明显低于正常对照组(P<0.01),随着血压的升高,SOD含量有下降的趋势,呈显著负相关(r=-0.74);而MDA水平明显高于正常对照组(P<0.01),随血压的升高,MDA含量有上升的趋势,呈显著正相关(r=0.81)。结论血清8-iso-PGF2α、SOD、MDA水平的变化与原发性高血压的发生和发展密切相关,临床检测上述指标有利于高血压病情的评估。     

老年男性代谢综合征患者血浆ET-1和CGRP检测及意义

目的:探讨血浆内皮素(ET-1)和降钙素基因相关肽(CGRP)在老年男性代谢综合征患者中的变化特征及意义。方法:采用放射免疫分析对65例临床诊断为高血压、糖尿病和35例代谢综合征的老年男性患者进行血浆ET-1和CGRP的含量检测,同步检测血脂和血糖水平,以35例健康老年男性作为对照。结果:老年男性单纯高血压和糖尿病患者血浆ET-1水平明显增高,代谢综合征组ET-1水平亦明显增高,与对照组比较有显著性差异(P<0.01,P<0.05,P<0.01),高血压组ET-1水平明显高于糖尿病组(P<0.05)。高血压组与代谢综合征组CGRP水平均明显低于对照组,有显著性差异(P<0.05,P<0.05)。两组血浆ET-1水平增高与CGRP水平下降呈显著负相关(r=-0.75,P<0.01,r=-0.53,P<0.01)。结论:老年男性代谢综合征患者血浆中ET-1和CGRP表达异常及其关联在其发病过程中具有重要临床意义,其缩、舒血管作用失调参与了高血压和糖尿病发病的病理过程。     

Improved bronchodilation with levalbuterol compared with racemic albuterol in patients with asthma

Background: Racemic albuterol is an equal mixture of (R)-albuterol (levalbuterol), which is responsible for the bronchodilator effect, and (S)-albuterol, which provides no benefit and may be detrimental. Objective: We sought to compare 2 doses of a single enantiomer, levalbuterol (0.63 mg and 1.25 mg), and equivalent amounts of levalbuterol administered as racemic albuterol with placebo in patients with moderate-to-severe asthma. Methods: This was a randomized, double-blind, parallel-group trial. Three hundred sixty-two patients 12 years of age or older were treated with study drug administered by means of nebulization 3 times daily for 28 days. The primary endpoint was peak change in FEV₁ after 4 weeks. Results: The change in peak FEV₁ response to the first dose in the combined levalbuterol group was significantly greater compared with the combined racemic albuterol group (0.92 and 0.82 L, respectively; P = .03), with similar but nonsignificant results after 4 weeks (0.84 and 0.74 L, respectively). Improvement in FEV₁ was similar for levalbuterol 0.63 mg and racemic albuterol 2.5 mg and greatest for levalbuterol 1.25 mg. Racemic albuterol 1.25 mg demonstrated the weakest bronchodilator effect, particularly after chronic dosing. The greatest increase in FEV₁ was seen after levalbuterol 1.25 mg, especially in subjects with severe asthma. All active treatments were well tolerated, and β-adrenergic side effects after administration of levalbuterol 0.63 mg were reduced relative to levalbuterol 1.25 mg or racemic albuterol 2.5 mg. At week 4, the predose FEV₁ value was greatest in patients who received levalbuterol or placebo when compared with those who received racemic albuterol. The difference was more evident and was statistically significant in patients who were not receiving inhaled corticosteroids. Conclusion: Levalbuterol appears to provide a better therapeutic index than the standard dose of racemic albuterol. These results support the concept that (S)-albuterol may have detrimental effects on pulmonary function. (J Allergy Clin Immunol 1998;102:943-52.)     

Satellite RNA associated with bamboo mosaic potexvirus shares similarity with satellites associated with sobemoviruses

Summary A putative nonstructural protein encoded by a satellite RNA associated with bamboo mosaic potexvirus shares 46% identity with the capsid protein of satellite virus of panicum mosaic sobemovirus. The sequence similarity among satellite plant viruses which have no apparent relationship implies a common origin.     

拉米夫定与泛昔洛韦联合治疗乙型肝炎病毒慢性感染的临床研究

目的 观察拉米夫定与泛昔洛韦联合治疗乙型肝炎病毒(HBV)慢性感染的临床疗效。方法 慢性乙型肝炎患者90例。设联合治疗组28例，单用拉米夫定组30例，单用泛昔洛韦组32例。联合治疗组给予口服拉米夫定0．1g／d(PO)，泛昔洛韦1．5g／d(PO)，24周。拉米夫定、泛昔洛韦单用组剂量及疗程分别同联合治疗组。结果 3组均无明显副反应，丙氨酸转氨酶(ALT)复常率无差异。3组HBV DNA阴转率分别为89．3％、66．7％、40．6％，差异有显著性。乙型肝炎表面抗原(HBeAg)阴转率分别为28．6％、23．3％、21．9％，差异无显著性。结论 拉米夫定与泛昔洛韦联合用药安全、耐受性好，临床显示联合治疗对HBV DNA的抑制作用显著优于单用药。     

Infectious diseases and immunological markers associated with patients with non-Hodgkin lymphoma treated with rituximab

Background: The use of rituximab (RTX) is increasing, even in developing countries. It has become the first-line therapy or adjuvant to chemotherapy (CHOP; cyclophosphamide, hydroxydaunorubicin, oncovin and prednisone) for various diseases, including B cell lymphoma and autoimmune diseases.

Aim: We describe the infectious diseases and immunological markers associated with RTX treatment of patients with non-Hodgkin lymphoma (NHL).

Methods: Serum immunoglobulins were determined before and after intravenous immunoglobulin (IVIg) administration. Pneumo-23IgG-specific anti-pneumococcal antibodies were evaluated before and after vaccination. Immunophenotyping and lymphocyte proliferation were determined in the course of the treatment.

Results: Seven patients were followed and median age was 56.0?±?5.0?years (range, 41.9–71.6?years). At baseline, the mean level of IgG was 333.7?±?40.8?and IgM 40.9?±?11.3?mg/dL, respectively; immunoglobulin A and E (IgA and IgE) were under the limit of detection. Two patients had reduced or absent B cells and T cell subsets were at normal levels in five patients. All patients failed to mount an efficient post-vaccination immune response against hepatitis B virus, tetanus, diphtheria and against the 23-valent pneumococcal polysaccharide vaccine. During RTX/CHOP treatment, human-IgG-immunoglobulin (IVIg) therapy was introduced in six patients after recurrent infections, including community-acquired pneumonia (85.7%), chronic sinusitis (85.7%) and gastroenteritis (42.9%).

Conclusion: Poor response against pneumococcal vaccines increases the susceptibility of respiratory diseases in these patients. In patients with NHL treated with RTX, the benefits achieved with IVIg replacement for the control of recurrent infectious diseases is of paramount importance. Clinicians dealing with monoclonal antibodies against cancer therapy, especially RTX, should be aware of the increasing risks for symptomatic induced hypogammaglobulinemia and respiratory infections.     

Gynecomastia with marked cellular atypia associated with chemotherapy

Gynecomastia is a common benign male breast disease, which may exhibit mild cellular atypia in cytology specimens. However, marked cytologic atypia can be seen in gynecomastia superimposed by chemotherapy. The case described in this report demonstrated severe cytologic atypia of gynecomastia mimicking carcinoma in a patient treated with chemotherapy for acute leukemia. A distinct cytologic feature helpful in avoiding the diagnostic error is described, namely, atypical cells admixed with bland ductal cells and appearing at a different plane. The importance of applying strict diagnostic criteria in breast cytology and clinical correlation is also emphasized.