合并糖尿病白内障患者术后黄斑水肿与其房水中VEGF、白细胞介素因子的相关性分析

目的分析合并糖尿病白内障患者术后黄斑水肿与其房水中血管内皮生长因子(VEGF)、白细胞介素因子的相关性。方法选取2017年6月—2019年10月我院行手术治疗的合并糖尿病白内障患者85例(85眼),根据术后是否出现黄斑水肿分为研究组47例(出现黄斑水肿)和对照组38例(未出现黄斑水肿)。比较研究组和对照组术前及术后4周VEGF、白细胞介素因子水平及黄斑中心凹厚度;根据术后黄斑水肿分级的不同对研究组进行亚组分析,分析不同亚组间VEGF、白细胞介素因子水平及黄斑中心凹厚度;进一步分析合并糖尿病白内障患者术后4周黄斑水肿情况与房水中VEGF、白细胞介素因子的相关性。结果术后4周研究组房水中VEGF、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)及黄斑中心凹厚度较术前均明显升高,且研究组上述指标亦明显高于对照组,差异有统计学意义(P0.01)。1级亚组房水中VEGF、IL-1β、IL-6、IL-8水平及黄斑中心凹厚度均明显低于2级亚组,差异均有统计学意义(P0.01)。Pearson线性相关分析显示:合并糖尿病白内障患者术后4周黄斑中心凹厚度、黄斑水肿分级与VEGF、IL-1β、IL-6、IL-8水平呈正相关。结论合并糖尿病白内障患者术后黄斑水肿情况与其房水中VEGF、IL-1β、IL-6、IL-8水平具有相关性,临床可通过干预其水平降低术后黄斑水肿发生率。     

慢性阻塞性肺病患者IL-21表达及其与其他细胞因子的相关性

目的探讨白细胞介素-21(IL-21)在慢性阻塞性肺疾病(COPD)炎性反应中的作用。方法采用辅助性T细胞1/2/17(Th1/Th2/Th17)定量抗体芯片检测稳定期COPD组、健康吸烟组、健康无吸烟组研究对象的血清IL-21、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、白细胞介素-17(IL-17)、转化生长因子-β1(TGF-β1)等细胞因子的表达水平,并同时检测各组的肺通气功能。结果稳定期COPD组患者IL-21的表达水平与IL-6、IL-10、TGF-β1呈显著正相关(r值分别为0.902、0.589、0.683,均P0.01);与IL-17也呈正相关(r=0.313,P0.05)。结论 IL-21在COPD的发病过程中起重要促炎作用,可作为一种有效治疗手段。     

Foxp3基因在URSA患者外周血中的表达及其临床意义

目的探讨叉头样转录因子P3(Foxp3)基因在原因不明复发性流产(URSA)患者外周血中的表达及其临床意义。方法选取本院2017年9月至2018年9月收治的55例URSA早孕妇女作为研究组,同时选取同期50例正常早孕妇女为对照组。采用实时荧光定量聚合酶链反应(qRT-PCR)检测Foxp3 mRNA的表达量;采用酶联免疫吸附试验(ELISA)法检测白细胞介素17(IL-17)、白细胞介素6(IL-6)、转化生长因子-β(TGF-β)、白细胞介素2(IL-2)、α干扰素(IFN-α)、γ干扰素(IFN-γ)、白细胞介素4(IL-4)、白细胞介素10(IL-10)的水平;采用流式细胞术检测外周血T细胞免疫球蛋白和黏蛋白结构域3(Tim-3)与程序性细胞死亡分子-1(PD-1)的表达;采用Pearson法分析URSA患者外周血中Foxp3与免疫细胞因子、Th1/Th2型细胞因子、PD-1及Tim-3的相关性。结果与对照组比较,研究组外周血Foxp3 mRNA的表达水平显著降低(P0.05);与对照组比较,研究组外周血IL-17、IL-6水平显著升高,TGF-β水平显著降低(P0.05);与对照组比较,研究组外周血IL-2、IFN-α、IFN-γ水平显著升高(P0.05),IL-4、IL-10水平显著降低(P0.05);与对照组比较,研究组外周血PD-1、Tim-3的表达水平显著降低(P0.05);Foxp3与IL-17、IL-6、IL-2、IFN-α、IFN-γ呈负相关(P0.05),而与TGF-β、IL-4、IL-10、PD-1、Tim-3呈正相关(P0.05)。结论 Foxp3基因在URSA患者外周血中表达下调,并可能通过引起母体免疫机制紊乱从而促进URSA的发生及发展。     

流行性感冒发病初期利用流式细胞仪检测相关细胞因子的临床应用价值探讨

目的通过观察流感患者发病初期细胞因子水平变化,初步建立以流式多重微球芯片技术为主要方法的临床细胞因子检验方法,并探讨其临床意义。方法选取54例甲流病毒核酸阳性和20例甲流病毒核酸阴性的流感样患者作为流感发病组,其中甲流病毒核酸阳性患者分为轻症组和重症组,甲流病毒核酸阴性的流感样患者为甲流核酸阴性组;另选取35例健康对照人群作为对照组,对所有全血标本的细胞因子进行检测和统计学分析。结果细胞因子白细胞介素-6(IL-6)、白细胞介素-21(IL-21)、白细胞介素-12p70(IL-12p70)、白细胞介素-1β(IL-1β)、白细胞介素-10(IL-10)、趋化因子-10(IP-10)、白细胞介素-2(IL-2)、单核细胞趋化蛋白-1(MCP-1)水平在流感患者发病初期明显升高,差异具有统计学意义(P0.05);γ-干扰素(IFN-γ)在流感发病组和对照组中比较,差异无统计学意义(P0.05);重症组IL-6、IP-10水平比轻症组、甲流病毒核酸阴性组高,差异有统计学意义(P0.05)。结论 IL-6、IL-21、IL-12p70、IL-1β、IL-10、IP-10、IL-2、MCP-1均可作为发热患者的临床生物学评价指标,其中IL-6、IP-10可作为病情进展评估的重要指标。     

老年MODS患者细胞因子的变化及临床意义

目的探讨肿瘤坏死因子α(TNF-α)、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)在老年多脏器功能障碍综合征(MODS)患者中的病理生理作用及其临床意义.方法采用放射免疫法检测80例老年MODS患者的血清TNF-α、IL-1β、IL-6、IL-10的动态变化.结果老年MODS组的血清TNF-α、IL-1β、IL-6、IL-10浓度较正常对照组明显升高(P＜0.01),TNF-α、IL-1β、IL-6升高的峰值较IL-10早,死亡组血清IL-10浓度较存活组明显升高(P＜0.01).结论细胞因子TNF-α、IL-1β、IL-6、IL-10的异常释放参与了老年MODS的病理生理过程,选择不同时机以纠正细胞因子的失衡可能是今后的救治方向.     

手足口病患儿Th17/Treg及其相关细胞因子的临床意义

目的探讨外周血辅助性T细胞17(Th17)与调节性T细胞(Treg),血清中相关细胞因子白细胞介素-17(IL-17)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、转化生长因子-β(TGF-β)在手足口病(HFMD)中的作用。方法选取125例HFMD急性期患儿和45例健康体检者,其中急性期HFMD患儿分为普通组(69例)和重症组(56例)。外周血Th17、Treg百分数检测采用流式细胞术,血清IL-17、IL-6、IL-10、TGF-β水平检测利用酶联免疫吸附试验测定。结果和对照组相比,重症组和普通组患儿外周血Th17百分比和Th17/Treg比值,以及血清IL-17、IL-6水平均升高(均P0.05),外周血Treg百分比和血清IL-10、TGF-β水平均降低(均P0.05)。重症组患儿外周血Th17百分比和Th17/Treg比值,以及血清IL-17、IL-6水平均高于普通组(均P0.05),外周血Treg百分比和血清IL-10、TGF-β水平均低于普通组(均P0.05)。结论 Th17和Treg及其相关细胞因子水平变化异常与HFMD发病及疾病进程相关。     

宫颈癌患者血清鳞状细胞癌相关抗原、白细胞介素-6及转化生长因子水平变化及相关性

目的探讨血清鳞状细胞癌相关抗原(SCC-Ag)联合白细胞介素(IL)-6、转化生长因子(TGF)-β检测宫颈癌的价值。方法 2015年12月至2016年12月该院收治的宫颈癌患者58例纳入观察组,同期健康体检者41例纳入对照组。采用酶联免疫吸附法测定两组研究对象血清SCC-Ag、IL-6、TGF-β水平。比较两组研究对象,以及研究组中不同临床分期及分化程度患者上述指标,并分析SCC-Ag与IL-6、TGF-β的相关性分析。结果观察组血清SCC-Ag、IL-6、TGF-β水平高于对照组,差异均有统计学意义(P0.05);Ⅰ~Ⅱ期血清SCC-Ag、IL-6、TGF-β水平低于Ⅲ~Ⅳ期,差异均有统计学意义(P0.05);高分化血清SCC-Ag、IL-6、TGF-β水平低于中分化和低分化,中分化血清SCC-Ag、IL-6、TGF-β水平低于低分化,差异均有统计学意义(P0.05);SCC-Ag与IL-6、TGF-β呈正相关(r=0.371、0.497,P0.05)。结论宫颈癌患者SCC-Ag、IL-6、TGF-β水平明显升高,且随着病情程度的加重,上升越明显,SCC-Ag与IL-6和TGF-β呈正相关。     

慢性阻塞性肺疾病患者炎症反应与营养不良的相关性研究

目的探讨慢性阻塞性肺疾病(COPD)炎症反应与营养不良的相关性。方法选取BMI<18.5 kg/m2的COPD患者为观察组,18.5 kg/m2≤BMI<24 kg/m2的患者为对照组。采用诱导痰方法检查痰细胞的总数以及中性粒细胞、巨噬细胞、嗜酸粒细胞、淋巴细胞所占比例;采用酶联免疫吸附法(ELISA)测定血清C反应蛋白(CRP)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)的水平;分析BMI与各炎症指标的相关性。结果观察组痰细胞总数和中性粒细胞所占比例显著高于对照组(P<0.01);观察组CRP、IL-6、IL-8、TNF-α水平明显高于对照组(P<0.01);观察组BMI与痰细胞总数(r=-0.493,P=0.004)、中性粒细胞百分比(r=-0.504,P=0.003)以及系统炎症指标CRP(r=-0.481,P=0.007)、IL-6(r=-0.423,P=0.015)、IL-8(r=-0.397,P=0.041)、TNF-α(r=-0.422,P=0.016)水平呈显著负相关。结论气道和系统炎症反应均与COPD患者的营养不良密切相关。     

7种细胞因子在卵泡液和血清中浓度水平的对比分析

目的了解胰岛素样生长因子2(IGF-2)、白细胞介素1β(IL-1β)、白细胞介素6(IL-6)、白血病抑制因子(LIF)、血管内皮生长因子(VEGF)、肿瘤坏死因子α(TNF-α)和转化生长因子β1(TGF-β1)7种细胞因子对卵母细胞发育成熟的影响。方法用酶联免疫吸附双抗夹心法(ELISA)检测卵泡液、取卵日血清以及移植日血清中7种细胞因子浓度水平,比较分析7种细胞因子在卵泡液和血清中的浓度水平。结果 (1)IGF-2、IL-6和VEGF卵泡液中的浓度显著高于取卵日血清中的浓度,差异有显著性意义(P0.05),IGF-2和IL-6卵泡液中浓度与取卵日血清中浓度呈正相关(r=0.537,r=0.336,均P0.05),而VEGF卵泡液中浓度与取卵日血清中浓度无相关性(r=0.098,P0.05)。(2)TGF-β1在卵泡液中的浓度显著低于取卵日血清中的浓度,差异有非常显著性意义(P0.05),并且TGF-β1卵泡液中浓度与取卵日血清中浓度无相关性(r=0.021,P0.05)。(3)IL-1β、LIF和TNF-α卵泡液中的浓度和取卵日血清中的浓度差异无统计学意义(P0.05),IL-1β、LIF和TNF-α卵泡液中浓度与取卵日血清中浓度呈正相关(r=0.218,r=0.703,r=0.219,均P0.05)。结论 IGF-2、IL-6和VEGF对卵母细胞的发育成熟起关键性作用,而IL-1β、LIF、TNF-α和TGF-β1可能对卵母细胞发育成熟的生物活性较弱。     

酒精性肝病患者血清TGF-β、IL-6和IL-8水平及临床意义

目的探讨酒精性肝病患者血清转化生长因子（transforming growth factor-β,TGF-β）白细胞介素-6（inter-leukin-6,IL-6）和白细胞介素-8（interleukin-8,IL-8）在酒精性肝病中的作用。方法 60例酒精性肝病患者按酒精性脂肪肝（n=20）、酒精性肝炎（n=20）和酒精性肝硬化（n=20）分为3组。采用ELISA法检测20例健康对照组和60例各类酒精性肝病患者血清中TGF-β、IL-6和IL-8水平。结果血清TGF-β、IL-6和IL-8水平随着肝脏病变程度加重而递增,酒精性脂肪肝组、酒精性肝炎组和酒精性肝硬化组3项指标水平均高于正常对照组,差异显著（P〈0.01）,其中以酒精性肝硬化组3项指标水平为最高。结论 TGF-β、IL-6和IL-8在酒精性肝病中具有重要作用,酒精性肝病患者血清TGF-β、IL-6和IL-8水平的检测可作为酒精性肝病病情监测和预后判断的有效指标。     

Selective and interactive neural correlates of visual dimension changes and response changes

In an event-related fMRI study, we investigated the neural correlates of visual dimension and response changes. We used a compound task, which required target selection by a singleton feature, a unique color or motion direction, before the appropriate motor response, which was determined by target orientation, could be selected. Both types of change elicited distinct patterns of activation, with dimension-change-related activation primarily in posterior visual areas and response-related activation primarily in motor-related areas of the parietal and frontal cortices. Response-change-related activation was delayed by about 1 s relative to dimension-change-related activation, suggesting that the latter is elicited by perceptual processes, whereas the former reflects response-related or post-response processes. Although dimension changes and response changes rely on different processes, they are not independent: response facilitation was observed for combined dimension and response repetitions, this facilitation, however, was disrupted by dimension changes.     

脊髓组织细胞外液腺苷含量变化对脊髓损伤的保护性机制探讨

目的腺苷是中枢神经系统内重要的抑制性保护递质之一，本研究旨在通过观察大鼠脊髓损伤后细胞外腺苷含量的变化，探讨腺苷在脊髓继发性损伤中的作用。方法采用大鼠T     

Electrocardiographic changes and intracranial pathology

A young woman who sustained severe head trauma presented to the operating room for emergent surgical intervention. Her electrocardiogram (ECG) exhibited signs of myocardial ischemia, which resolved several days postoperatively. ECG changes suggestive of cardiac pathology can be associated with intracranial pathology, most notably subarachnoid hemorrhage. Delay of operative therapy may have catastrophic results. Experimental data indicates massive sympathetic outflow results from stimulation of the lateral and posterior hypothalamic regions. Large amounts of norepinephrine are released into the systemic circulation, resulting in hypertension, tachycardia, dysrhythmias and ECG changes. Myocardial ischemia and injury can occur from the effects of this excessive sympathetic stimulation. In certain case reports, neurologic patients who experienced ECG changes had normal hearts on postmortem examination. This implies that myocardial recovery can occur despite the appearance of an abnormal ECG in the neurologic patient. Anesthetic management of these patients involves prevention of further increases in intracranial pressure and avoidance of hyperventilation in the presence of hypotension or vasospasm. Continuous ECG monitoring is essential. Ventricular dysrhythmias may prove resistant to conventional pharmaceutical management. Beta blockade may be indicated to prevent excessive cardiac stimulation by endogenous catecholamines, and, in addition, may prevent the formation of the microscopic cardiac lesions typical of this hyperstimulation.     

New medications and medication changes

When nurses in orthopaedic settings are educating a patient about the medications, they address not just those medications related to the current orthopaedic problem, but all medications the patient is using. During these education sessions, nurses will often be asked about new medications, changes in medications, or medication recalls the patient may have heard about from friends or through media sources. One up-to-date resource for drug information that nurses can readily access is the U.S. Food and Drug Administration Web site. In the following article, selected examples of information available from the Food and Drug Administration includes recently approved drugs, new drug combinations, new formulations of established drugs, and drug alerts or warnings. Informed nurses, able to educate patients with accurate information about all the medications they are using, can reduce the potential for harm and decrease unnecessary stress and anxiety.     

Aging and physiological changes of the kidneys including changes in glomerular filtration rate

In addition to the structural changes in the kidney associated with aging, physiological changes in renal function are also found in older adults, such as decreased glomerular filtration rate, vascular dysautonomia, altered tubular handling of creatinine, reduction in sodium reabsorption and potassium secretion, and diminished renal reserve. These alterations make aged individuals susceptible to the development of clinical conditions in response to usual stimuli that would otherwise be compensated for in younger individuals, including acute kidney injury, volume depletion and overload, disorders of serum sodium and potassium concentration, and toxic reactions to water-soluble drugs excreted by the kidneys. Additionally, the preservation with aging of a normal urinalysis, normal serum urea and creatinine values, erythropoietin synthesis, and normal phosphorus, calcium and magnesium tubular handling distinguishes decreased GFR due to normal aging from that due to chronic kidney disease.