自体脾移植术后T细胞亚群、sIL-2R、TNF变化研究

目的：探讨自体脾移植术对免疫学指标的影响。方法：将４０ 例外伤性脾破裂分为脾移植术和全脾切除术组,各２０ 例。对照组１０ 例。结果：术后１ 周,全脾切除术组和自体脾移植组,与对照组相比,ＣＤ＋３ 、ＣＤ＋４ 、ＣＤ＋８ 、ＣＤ＋４ ／ＣＤ＋８ 降低,ｓＩＬ－２Ｒ、ＴＮＦ皆升高（Ｐ＜ ０．０５）。术后３ 个月,自体脾移植组ＣＤ＋３ 、ＣＤ＋４ 、ＣＤ＋８ 、ＣＤ＋４ ／ＣＤ＋８升高,ｓＩＬ－２Ｒ、ＴＮＦ降低（Ｐ＞０．０５） 。而脾切除组,术后ＣＤ＋３ 、ＣＤ＋４ 、ＣＤ＋８ 、ＣＤ＋４ ／ＣＤ＋８ 持续下降,ｓＩＬ－ ２Ｒ、ＴＮＦ持续升高（ Ｐ＜ ０．０５）。结论：自体脾移植对维持机体的Ｔ细胞水平和增强机体的抗感染能力有益。     

慢性阻塞性肺疾病和肺心病急性加重期sIL－2R的研究

应用双抗体夹心ＥＬＩＳＡ法测定３２例慢性阻塞性肺疾病（ＣＯＰＤ）、３０例慢性肺心病急性加重期患者和３０例健康人血清可溶性白细胞介素－２受体（ｓＩＬ－２Ｒ）。结果：健康人血清ｓＩＬ－２Ｒ平均值为３１４．８±７１．９ｕ／ｍｌ。ＣＯＰＤ组和肺心病组血清ｓＩＬ－２Ｒ平均伍分别为５８２．４±２８５．９ｕ／ｍｌ、７９３．２±４７６．３ｕ／ｍｌ，明显高于健康对照组（Ｐ＜０．００１）。ＣＯＰＤ和肺心病组间比较结果：肺心病组明显高于ＣＯＰＤ组（Ｐ＜０．０５）。     

血浆免疫指标变化与糖尿病足部感染

目的:了解机体免疫功能在糖尿病足的变化,探讨糖尿病足的防治办法。方法:以健康志愿者(ＮＣ)和糖尿病(ＳＤＭ)患者为对照,动态观测糖尿病足(ＤＦ)治疗前及治疗过程中可溶性白介素－Ⅱ受体(ｓＩＬ－２Ｒ)、自然杀伤细胞活性(ＮＫＣＡ)、Ｔ淋巴细胞亚群(ＣＤ３、ＣＤ４、ＣＤ８)、免疫球蛋白(ＩｇＧ、ＩｇＭ、ＩｇＡ)、补体(Ｃ３、Ｃ４、ＣＨ５０)及空腹血糖(ＦＰＧ)、餐后２ ｈ血糖(ＰＧ２ｈ)。结果:①ＤＦ和 ＳＤＭ组ｓＩＬ－２Ｒ显著高于 ＮＣ组(Ｐ＜０．０５),ＮＫＣＡ及 ＣＤ４/ＣＤ８显著低于ＮＣ组(Ｐ＜０．０５);同时ＤＦ患者ｓＩＬ－２Ｒ较ＳＤＭ患者显著增高(Ｐ＜０．０５),ＮＫＣＡ及 ＣＤ４/ＣＤ８ 较ＳＤＭ患者显著降低(Ｐ＜０．０５);在 ＤＦ组中溃疡及坏疽患者 ｓＩＬ－２Ｒ显著高于高危足患者,ＮＫＣＡ显著低于高危足患者(均 Ｐ＜０．０５);②２５例 ＤＦ患者治疗后,ｓＩＬ－２Ｒ逐渐下降,ＮＫＣＡ、ＣＤ４/ＣＤ８逐渐升高,至观察终点与治疗前比较,三者差异均有显著性(Ｐ＜０．０５);③在ＤＦ患者,ｓＩＬ－２Ｒ与病情严重性呈显著正相关(ｒ＝０．７３４,Ｐ＜０．０１),与治疗过程中ＰＧ２ｈ变化亦呈显著正相关(ｒ＝０．４６７,Ｐ＜０．０５),ＮＫＣＡ与ＦＰＧ,ＰＧ２ｈ呈显著负相关(ｒ＝     

消化道恶性肿瘤27例根治术后免疫治疗分析

应用大剂量免疫药物（ＩＬ－２、ＩＦＮ－ｒ、ＴＮＦ）对２７例消化道恶性肿瘤根治术后进行治疗，采用单克隆抗体全组微量细胞毒技术检测患者术前、术后及免疫治疗后Ｔ细胞亚群变化。结果，术后Ｔ细胞亚群与术前比较：ＣＤ４下降，ＣＤ８上升，ＣＤ４／ＣＤ８下降（Ｐ＜０．０１）；免疫治疗后与术后比较：ＣＤ４上升，ＣＤ８下降，ＣＤ４／ＣＤ８升高（Ｐ＜０．０１）；免疫治疗后与术前比较：ＣＤ４变化不显著（Ｐ＞０．０５），ＣＤ８下降、ＣＤ４／ＣＤ８上升（Ｐ＜０．０１）。由此表明，肿瘤患者术后细胞免疫功能受到抑制，而术后进行免疫治疗后可显著提高机体的细胞免疫功能     

类风湿性关节炎患者免疫功能的研究

本文检测４８例ＲＡ患者免疫学指标，结果表明：外周血Ｔ淋巴细胞亚群ＣＤ３细胞明显低于正常对照组（Ｐ＜０．０１），ＣＤ４细胞、ＣＤ４／ＣＤ８比值显著高于正常对照组（Ｐ＜０．０１），而ＣＤ８细胞与正常人相近（Ｐ＞０．０５），血清ＩｇＧ、ＩｇＡ、ＩｇＭ、ＣＲＰ、ＩＬ－２及ＳＩＬ－２Ｒ显著高于正常对照组（Ｐ＜０．０１），提示ＲＡ患者细胞及体液免疫功能严重紊乱，本文对其发病机理及治疗中不可忽视的问题进行了讨论     

反复呼吸道感染病儿红细胞免疫功能、T细胞亚群和血清sIL－2R水平的变化

对６２例反复呼吸道感染（ＲＲＩ）病儿的红细胞免疫功能、Ｔ淋巴细胞亚群和血清可溶性白细胞胞介素－２受体（ｓＩＬ－２Ｒ）水平的变化进行了检测，并与正常对照组比较。结果表明，ＲＲＩ病儿红细胞Ｃ３ｂ受体花环率（Ｅ－Ｃ３ｂＲＲ）、红细胞免疫复合物受体花环率（Ｅ－ＩＣＲ）和红细胞Ｃ３ｂ受体花环形成促进率（ＲＦＥＲ）均明显低于对照组，而循环免疫复合物（ＣＩＣ）和红细胞Ｃ３ｂ受体花环形成抑制率（ＲＦＩＲ）明显高于对照组，差异均有极显著性（Ｐ均＜０．０１，０．００１）；ＲＲＩ病儿ＣＤ４，ＣＤ４／ＣＤ８明显降低，而ＣＤ８明显增高，与对照组比较差异有极显著性（Ｐ＜０．００１）；ＲＲＩ病儿血清ｓＩＬ－２Ｒ水平明显高于对照组（Ｐ＜０．００１）。ＲＲＩ病儿的Ｅ－Ｃ３ｂＲＲ与ＣＤ４／ＣＤ４／ＣＤ８呈正相关，而与ＣＤ８和ｓＩＬ－２Ｒ则呈负相关（ｒ＝０．５２７，０．４０９，Ｐ均＜０．００１）；ｓＩＬ－２Ｒ与ＣＤ４，ＣＤ４／ＣＤ８呈负相关，与ＣＤ８呈正相关（ｒ＝—０．５３０，—０．４９１，Ｐ＜０．００１）。提示ＲＲＩ发生与红细胞免疫功能降低、Ｔ淋巴细胞亚群异常和血清ｓＩＬ－２Ｒ水平增高有密切关系。     

胸腺肽佐治48例旋毛虫患者免疫功能的研究

本文应用胸腺肽佐治４８例旋毛虫患者，并观察治疗前后免疫球蛋白、Ｔ淋巴细胞亚群、ＩＬ－２和ＣＲＰ的变化。结果显示治疗前ＩｇＧ及ＣＲＰ明显升高（Ｐ＜０．０１），ＩＬ－２活性、ＣＤ３、ＣＤ４百分率及ＣＤ４／ＣＤ８比值明显降低（Ｐ＜０．０１）；ＩｇＡ、ＩｇＭ及ＣＤ８无明显改变（Ｐ＞０．０５）；胸腺肽治疗二月后，其ＩｇＧ无明显改变，ＣＲＰ恢复正常，ＣＤ３、ＣＤ４及ＣＤ４／ＣＤ８明显升高（Ｐ＜０．０１）。结果表明急性期旋毛虫患者细胞免疫功能低下，且Ｔ细胞亚群紊乱，胸腺肽有助于调节Ｔ细胞亚群间的平衡，促进细胞免疫的恢复。     

慢性肾功能衰竭患者血清 SIL-2R 水平与外周血 T 淋巴细胞亚群变化的观察

检测３０例慢性肾功能衰竭（ＣＲＦ）患者血清可溶性白介素２受体（ＳＩＬ－２Ｒ）和外周血Ｔ淋巴细胞亚群，结果表明：ＣＲＦ患者ＳＩＬ－２Ｒ水平显著高于正常对照组（Ｐ＜０．０１），ＣＤ３、ＣＤ４、ＣＤ４／ＣＤ８显著低于正常对照组（Ｐ＜０．０１）；ＳＩＬ－２Ｒ水平与ＣＤ３、ＣＤ４呈负相关，与ＣＤ８呈正相关；ＳＩＬ－２Ｒ与ＢＵＮ、ＳＣｒ呈正相关，ＣＤ３、ＣＤ４与ＢＵＮ、ＳＣｒ呈负相关，ＣＤ８与ＢＵＮ、ＳＣｒ呈正相关。提示：ＣＲＦ患者细胞免疫功能低下；ＳＩＬ－２Ｒ水平与Ｔ淋巴细胞亚群变化有一定关系；ＳＩＬ－２Ｒ水平与Ｔ淋巴细胞亚群变化可作为肾功能恶化的指标。     

肺炎支原体感染对慢性阻塞性肺疾病患者免疫功能的影响

采用ＰＣＲ方法对１３３例慢性阻塞性肺部疾病（ＣＯＰＤ）急性发作期患者（包括支气管哮喘并感染患者）的肺炎支原体（ＭＰ）进行检测；同时采用酶联免疫方法测定ＭＰ感染的肺心病患者的ｓＩＬ－２Ｒ水平及血清总ＩｇＥ水平。结果显示：ＣＯＰＤ急性发作期患者的ＭＰ感染率为３４．５９％；肺心病加重期组及支气管哮喘感染组的ＭＰ感染率明显高于慢性支气管炎急性发作组（Ｐ＜０．０１）；ＭＰ感染的肺心病组的ｓＩＬ－２Ｒ水平显著高于普通细菌感染的肺心病患者组及正常对照组（Ｐ＜０．０１）。单纯ＭＰ感染的ＣＯＰＤ患者ｓＩＬ－２Ｒ水平与周围血象淋巴细胞成负相关（ｒ＝－０．７０８４，Ｐ＜０．０１），单纯ＭＰ感染的肺心病患者的血清ＩｇＥ水平高于普通细菌感染的肺心病患者（Ｐ＜０．０５）。     

梗阻性黄疸胆道压力和门静脉血流与白细胞介素Ⅱ、补体水平关系的临床研究

研究了１９例梗阻性黄疸（Ａ）组和１０例单纯胆囊结石（Ｂ）组的ＩＬ—２、Ｃ－３、Ｃ－４和ＰＶＢＦ水平变化，并对Ａ组中ＢＴＰ、ＰＶＢＦ与ＩＬ—２、Ｃ－３、Ｃ－４关系进行分析。Ａ组根据阻塞性质分为Ａ－１组（恶性梗阻）和Ａ－２组（良性梗阻）。结果显示Ａ－１组ＴＢ、ＢＴＰ显著高于Ａ－２组（Ｐ＜０．０１）；Ａ－１、Ａ－２、Ｂ组ＩＬ—２、Ｃ－３、Ｃ－４、ＰＶＢＦ方差分析显示有显著差异（Ｐ＜０．０５或Ｐ＜０．０１），除Ａ－２与Ｂ组Ｃ－３外（Ｐ＞０．０５）；ＴＢ、ＢＴＰ与ＩＬ—２、Ｃ－３相关分析呈显著负相关（Ｐ＜０．０５或Ｐ＜０．０１）；ＰＶＢＦ与ＩＬ—２、Ｃ－３相关分析呈显著正相关（Ｐ＜０．０５或Ｐ＜０．０１）。结果表明梗阻性黄疸时机体的细胞免疫功能明显降低，可能由于肝脏活性的巨噬细胞功能降低和抑制性巨噬细胞被活化，导致淋巴细胞活化降低。     

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.