嗜碱性粒细胞在胶原诱导性关节炎模型小鼠Th1/Th2应答失衡中的作用

目的探讨嗜碱性粒细胞在胶原诱导性关节炎模型小鼠Th1/Th2失衡中的作用。方法取4~6周龄C57/BL6小鼠,经初次和3周后二次背部和足底多点胶原免疫,建立胶原诱导性关节炎小鼠模型。分别在建模(初次免疫)前、建模后1、3、6和9周眶静脉采血和采集淋巴结细胞,利用流式细胞术对嗜碱性粒细胞数量和表达IL-4的比例检测,ELISA方法检测血清IL-4和IFN-γ水平,并对模型进行评分。结果成功建立关节炎小鼠模型;模型建立后1周CIA模型小鼠血清IFN-γ/IL-4水平的比值显著低于建模前和对照组小鼠,提示以Th2应答为主,同时外周血中嗜碱性粒细胞的数量和表达IL-4的比例显著高于对照组;而建模后6和9周CIA模型小鼠血清IFN-γ/IL-4水平的比值显著高于对照组,提示以Th1应答为主,同时外周血中嗜碱性粒细胞的数量与对照组比较有降低的趋势。结论嗜碱性粒细胞可能通过影响Th1/Th2应答失衡参与CIA模型小鼠的发病。     

宿主被中华硬蜱叮咬后局部皮肤组织病理学研究

用光镜，电镜和体视学方法观察和分析经不同抗原免疫接种兔被蜱叮咬的局部组织病理变化，以了解局部组织的反应性。结果表明佐剂对照组，纯化抗原和唾液腺抗原组兔被叮咬后均出现炎症变化，佐剂对照组和纯化抗原组反应较轻，唾液腺抗原组反应较重；佐剂对照组主要为中性粒细胞浸润，免疫接种组主要为嗜碱性细胞浸润，并可见脱颗粒现象。局部组织细胞数密度纯化抗原组织显著低于唾液腺抗原组，提示纯化抗原接种既可诱导宿主产生较强的获得性免疫力，局部反应又较轻，是抗蜱疫苗主要候选抗原之一。     

XS-1000i血液分析仪计数嗜碱性粒细胞影响原因分析

目的 分析Sysmex XS- 1000i血液分析仪计数嗜碱性粒细胞部分标本出现假性增高的影响原因.方法 对50例外周血中性粒细胞形态正常的标本使用Sysmex XE-5000、XS-1000i血液分析仪进行嗜碱性粒细胞计数,作相关统计学分析.4例使用Sysmex XS- 1000i血液分析仪计数嗜碱性粒细胞出现明显增高标本与手工计数法进行比较,做相关形态学分析.结果 50例外周血中性粒细胞形态正常的标本使用Sysmex XE-5000、XS-1000i血液分析仪进行嗜碱性粒细胞计数,两者相关系数r=0.715,嗜碱性粒细胞计数差异具统计学意义(P＜0.01).4例使用Sysmex XS-1000i血液分析仪计数嗜碱性粒细胞出现明显增高标本均出现中性粒细胞中毒颗粒、退行性变等形态学改变.结论 两仪器间计数嗜碱性粒细胞结果差异有统计学意义,外周血中性粒细胞中毒颗粒等形态改变会造成XS-1000i血液分析仪计数嗜碱性粒细胞假性增高,对嗜碱性粒细胞异常增高的结果需进行手工计数分类.     

应用BB1单克隆抗体检测嗜碱性粒细胞在支气管哮喘患者气道中的分布及其临床意义

目的 采用一种新的针对嗜碱性粒细胞的单克隆抗体，对不同程度支气管哮喘患者支气管肺组织进行免疫组织化学检测，以明确嗜碱性粒细胞在不同组织结构中的分布及其临床意义。方法 对10例致死性哮喘、9例非致死性哮喘和9例非哮喘对照组患者支气管肺组织进行戊二醛固定、石蜡包埋制片后，采用BB1单克隆抗体进行免疫组织化学染色。结果 致死性哮喘组与非致死性哮喘组、非哮喘对照组比较，其黏膜下层、平滑肌、黏液腺及肺泡中嗜碱性粒细胞均明显升高（均P〈0．05）。而非致死性哮喘组与非哮喘对照组相比，其嗜碱性粒细胞的差异无显著性意义。结论 BB1单克隆抗体可有效地用于支气管肺组织标本的嗜碱性粒细胞免疫组织化学检测，同时急性发作的致死性哮喘患者气道中嗜碱性粒细胞明显增加，可能与哮喘病情恶化、甚至死亡有关，而非致死性的慢性哮喘患者气道中嗜碱性粒细胞与对照组无异，说明嗜碱性粒细胞可能主要参与哮喘的急性病程。     

宿主红细胞免疫功能在抗蜱免疫作用中的实验研究

观察了宿主（家兔）被中华硬蜱（Ixodes sinensis)叮咬后，体内红细胞功能原变化，结果显示：中华硬蜱成虫初次和再次叮咬家兔，宿主红细胞C3b受体花环试验（C3bR)较正常对照组家兔降低，但第三次感染（叮咬）后宿主红细胞C3bR、红细胞免疫复合物花环试验（ICR）较正常对照组兔明显升高（P＜0．05），第三次感染家兔其红细胞增强白细胞吞噬试验的蚕噬增强率为41．86±10．29，较正常对照组家兔（28．04±6．25）显升高（P＜0．01），结果表明，在抗蜱免疫作用中，家兔除体液免疫和细胞免疫参与免疫应答作用外，宿主红细胞免疫功能也具有重要作用。     

中华硬蜱叮咬105kDa纯化抗原免疫接种宿主后中肠组织化学变化的动态观察

目的 观察虽华硬蜱叮咬105kDa纯化抗原免疫接种宿主后，其中肠组织化学变化。方法 采用茚三酮法、PAS法、Feulgen法及图像分析仪，对中华硬蜱叮咬不同免疫力宿主后中肠蛋白质、糖原及多糖定位和分布以及DNA的含量进行研究。结果 中华硬蜱叮咬105kDa纯化抗原宿主后，中肠上皮细胞蛋白质含量较对照组明显降低，但糖原及多糖含量与初次叮咬或佐剂对照组相比无显性变化；随着叮咬时间的延长，纯化抗原组DNA含量明显低于对照组，且以2－4倍体为主。结论 105kDa纯化抗原组诱导的抗蜱免疫作用可干扰中肠消化细胞蛋白南和核酸的合成，而对中肠糖代谢无明显影响。     

白细胞疾病

一、白细胞（WBC）升高未必是感染,感染时WBC未必升高 血液中的WBC包括中性粒细胞、单核细胞、淋巴细胞、嗜酸性粒细胞、嗜碱性粒细胞。各类WBC的生理功能有所区别,不同疾病可引起不同类型的WBC数量发生变化。临床常用血WBC总数升高（主要是中性粒细胞升高）来判断感染存在,但二者关系并不绝对。     

血液分析仪散点图异常对疟疾诊断的应用价值

目的利用疟原虫感染后患者血常规参数及散点图变化规律，探索快速简便发现疟原虫感染的方法。方法对15例疟疾患者的血常规参数及散点图进行分析，总结出疟原虫感染散点图的变化规律。结果疟疾患者外周血在SysmexXE2100的DIFF散点图和白细胞／嗜碱性粒细胞散点图中嗜酸性粒细胞、不典型淋巴细胞、嗜碱性粒细胞等特定区域出现异常散点图，并伴有不同程度的血细胞减少。结论分析血细胞分析仪的DIFF散点图和白细胞／嗜碱性粒细胞散点图时，疑有疟原虫感染，进行血涂片镜检，将提高疟原虫检出率。     

粉尘螨脱敏治疗对过敏性皮炎患者嗜硷性粒细胞释放能力和总IgE的影响

选择40例过敏性皮炎患以及30例健康对照应用嗜碱性粒细胞脱颗粒试验（HBDT），检测嗜碱性粒细胞释放能力，同时应用亲和素－生物素酶联免疫吸附试验（BA－ELISA）测定血清总IgE。实验结果显示：过敏性皮炎患的嗜硷性粒细胞释放能力和血清总IgE显高于正常人（P＜0．01），粉尘螨注射液脱敏治疗一年后，过敏性皮炎患的嗜碱性粒细胞释放能力和血清总IgE均显降低。提示粉尘螨脱敏治疗对患具有稳定嗜碱性粒细胞的功能和调节IgE合成的作用。     

老年支气管哮喘患者嗜碱性粒细胞水平及嗜酸性粒细胞水平与病情关系的研究

目的：通过对老年支气管哮喘患者的嗜碱性粒细胞水平及嗜酸性粒细胞水平的观察比较,探讨其与病情的关系。方法：对56例在我院住院治疗的老年支气管哮喘患者进行外周静脉血细胞检测,分析其嗜碱性粒细胞水平及嗜酸性粒细胞水平,并将结果进行回顾性研究。结果：老年支气管哮喘患者嗜酸性粒细胞计数与病情轻重有明显相关性（P〈0．05）,嗜碱性粒细胞计数与病情轻重无明显相关性（P〉0．05）,与发病频率有正相关。结论：嗜酸性粒细胞计数是判断老年支气管哮喘患者病情的重要指标,嗜碱性粒细胞计数在对老年支气管哮喘患者病情病情的判断上亦有一定意义。     

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.     

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.     

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.