慢性肾功能衰竭患者外周血细胞CD146的表达及意义

目的 探讨CD146在慢性肾功能衰竭（CRF）患者外周血细胞中的表达及意义.方法 收集本院2007年8月至2009年7月门诊及住院CRF患者51例为CRF组,33例正常人为健康对照组,流式细胞术检测两组外周血细胞CD146的表达并比较两组之间的差异,分析CRF患者外周血细胞CD146表达与血尿素氮（BUN）、血肌酐（Scr）的相关性.结果 与对照组比较,CRF组单核细胞、中性粒细胞CD146＋细胞百分率及CD45-CD146＋细胞数量均显著升高[（4.09±3.48）%比（0.20±0.10）%;（4.71±3.94）%比（0.79±0.14）%;（16.43±10.48）个/μl比（2.16±0.81）个/μl,均P〈0.001].CRF患者外周血CD45-CD146＋细胞数量与BUN、Scr均呈正相关（r=0.480、0.595,均P〈0.01）.结论 外周血单核细胞及中性粒细胞CD146的表达及升高与CRF的发生有关,CD45-CD146＋细胞数量增加与CRF的发生及严重程度有关.     

慢性肾功能衰竭患者外周血细胞CD146的表达及意义

目的 探讨CD146在慢性肾功能衰竭(CRF)患者外周血细胞中的表达及意义.方法 收集本院2007年8月至2009年7月门诊及住院CRF患者51例为CRF组,33例正常人为健康对照组,流式细胞术检测两组外周血细胞CD146的表达并比较两组之间的差异,分析CRF患者外周血细胞CD146表达与血尿素氮(BUN)、血肌酐(Scr)的相关性.结果 与对照组比较,CRF组单核细胞、中性粒细胞CD146+细胞百分率及CD45-CD146+细胞数量均显著升高[(4.09±3.48)%比(0.20±0.10)%;(4.71±3.94)%比(0.79±0.14)%;(16.43±10.48)个/μl比(2.16±0.81)个/μl,均P<0.001].CRF患者外周血CD45-CD146+细胞数量与BUN、Scr均呈正相关(r=0.480、0.595,均P<0.01).结论 外周血单核细胞及中性粒细胞CD146的表达及升高与CRF的发生有关,CD45-CD146+细胞数量增加与CRF的发生及严重程度有关.     

慢性肾功能衰竭患者外周血细胞CD146的表达及意义

Objective To study the clinical significance and expression of CD146 on peripheral blood cells in patients with chronic renal failure (CRF). Methods Expression of CD146 in peripheral blood samples from 51 ambulatory or hospitalized patients with CRF (registered between August 2007 and July 2009 to our hospital) and from 33 normal controls were determined and compared between two groups. Correlation of peripheral blood CD146 with blood urea nitrogen (BUN) , and serum creatinine (Scr) in patients with CRF was analyzed. Results Compared with normal controls, the rate of CD146* on monocyte and neutrophile in patients with CRF were significantly higher [ (4.09±3.48)% vs (0.20±0.10)% ;(4.71± 3.94)% vs (0.79±0.14)% , both P<0.001], and the number of CD45-CD146* cells in patients with CRF was obviously higher [ (16.43±10.48) /μl vs (2.16±0.81 )/μl,P<0.001) ]. The number of CD45-CD146+ cells in patients with CRF was positively correlated with BUN and Scr (r=0.480 and 0.595, both P<0.01). Conclusions Correlation between increased CD 146 on monocyte or neutrophile and the pathogenesis of CRF is found. The increase in CD45-CD146+ cell numbers is correlated with the pathogenesis and severity of CRF.     

孕妇红细胞叶酸水平与妊娠期高血压疾病的发病关系

目的探讨孕妇红细胞叶酸水平与妊娠期高血压疾病的发病关系。方法选择2007年9月至2008年12月在北京市海淀区妇幼保健院行常规产检的孕妇作为研究对象,初检孕周12～15w,其中妊娠期高血压孕妇组33例(轻度子痫前期26例,重度子痫前期7例),对照组(正常妊娠组)462例;在孕妇初诊时抽取外周血检测红细胞叶酸水平,比较组间叶酸水平有无差异。结果①妊娠期高血压疾病组红细胞叶酸水平(601.10±153.26)nmol/L,对照组红细胞叶酸水平为(608.23±222.67)nmol/L,两组比较,差异无显著性。②轻度子痫前期孕妇组红细胞叶酸水平(605.01±200.36)nmol/L,与对照组比较,差异无显著性;重度子痫前期孕妇组红细胞叶酸水平(512.30±122.34)nmol/L,与对照组比较,差异有显著性(P<0.05)。结论妊娠期补充叶酸可能降低妊娠期高血压疾病的发生或者减轻妊娠期高血压疾病的病情严重程度。     

妊娠期高血压疾病患者血清及胎盘组织中Endoglin水平变化的研究

目的研究妊娠期高血压疾病患者血清及胎盘组织中Endoglin水平的变化及临床意义。方法采用酶联免疫吸附双抗体夹心法（ELISA）及免疫组化方法检测68例妊娠期高血压疾病患者（妊娠期高血压疾病组,其中妊娠期高血压23例、轻度子痫前期22例、重度子痫前期23例）及20例正常妊娠妇女（对照组）血清及胎盘组织中Endoglin水平。结果妊娠期高血压疾病组血清可溶性Endoglin水平（29.66±8.52 ng/ml）明显高于对照组（10.42±4.35ng/ml）,（P〈0.01）。妊娠期高血压、轻度子痫前期、重度子痫前期患者血清中可溶性Endoglin水平逐渐升高（分别为13.24±6.17ng/ml,28.28±10.19ng/ml,42.50±13.48ng/ml）,各组间差异有显著性（均P〈0.01）。妊娠期高血压疾病组与对照组比较胎盘组织中Endoglin表达明显升高（P〈0.01）。妊娠期高血压、轻、重度子痫前期胎盘组织中Endoglin表达逐渐增强,各组间差异具有显著性（P〈0.05）。两组血清中可溶性Endoglin水平与胎盘组织Endoglin表达呈正相关（r=0.504,P〈0.05及r=0.532,P〈0.05）。结论 Endoglin水平升高可能与妊娠期高血压疾病的发病及病情发展有关。     

肾小球肾炎患者外周血CD45^-CD146^＋细胞的检测及意义

目的探讨肾小球肾炎患者外周血CD45-CD146 细胞的变化及意义。方法用流式细胞术检测25例肾小球肾炎患者和20例正常人群外周血细胞CD45-CD146 细胞数量。结果与正常对照组(2.07±0.86)个/μl比较,肾小球肾炎患者CD45-CD146 细胞数量(12.25±13.11)个/μl显著升高(t=3.459,P<0.05);②肾小球肾炎患者外周血CD45-CD146 细胞数量与中性粒细胞比例(P=0.00265,r=0.613)、BUN(P=0.00302,r=0.609)、Cr(P=0.00683,r=0.571)均呈正相关。结论CD45-CD146 细胞数量与肾小球肾炎的发生、严重程度密切相关。     

肝细胞生长因子与妊娠期高血压疾病

肝细胞生长因子(hepatocyte growth factor,HGF)是一种具有多效性作用的肝素结合性酸性蛋白.HGF在胎盘中主要由绒毛核心间质细胞表达,旁分泌作用于邻近滋养细胞表面受体c-met.妊娠期高血压疾病时,HGFmRNA及蛋白产物表达下降.HGF在调节滋养细胞浸润能力、抗细胞凋亡和胎盘发生方面与妊娠期高血压疾病关系密切.     

妊娠高血压疾病眼底病变的影响因素分析

目的研究妊娠高血压疾病（PIHS）眼底病变的影响因素分析。方法分析眼底改变与PIHS的血压、蛋白尿、水肿的关系。结果 （PIHS）患者眼底改变患病率高达90%。Ⅰ期、Ⅱ期、Ⅲ期改变分别为56.2%、26.94%、17.87%。,三期病例之间差异均有显著性（P〈0.01）。说明眼底改变及严重程度与PIHS的严重程度成正比。结论高血压、水肿、蛋白尿改变愈明显,眼底改变愈严重,眼底改变可作为PIHS的诊断处理及预后的可靠依据。     

360例妊娠期高血压疾病及其并发症妊娠结局分析

目的通过对360例妊娠期高血压疾病分类比较分析,探讨新的诊断标准下妊娠期高血压疾病对母儿的影响。方法选择我院2007年1月1日～2009年8月1日在我院住院分娩的孕妇为研究对象,按新诊断标准分类分组：妊娠高血压组、轻度子痫前期组、重度子痫前期组,对比分析三组间母儿发生早产、产后出血、胎盘早剥、胎儿生长受限（FGR）、胎儿窘迫、新生儿窒息情况。结果妊娠高血压组胎儿窘迫、早产的发生率显著低于轻度组;轻度组孕产妇FGR、并发症、围产儿死亡率显著低于重度组（P〈0.01）;妊娠期高血压组产后大出血的发生率显著低于轻度组,轻度组产后出血、早产、新生儿窒息、胎儿窘迫显著低于重度组（P〈0.05）。结论妊娠期高血压疾病严重影响妊娠结局,加强孕期保健以改善母儿不良结局。     

2型糖尿病患者外周血CD146检测的临床意义

目的 探讨外周血CD146水平在诊断2型糖尿病患者肾损伤中的临床意义.方法 检测58例2型糖尿病患者和20例正常对照组外周血CD146(ELISA法)和U-MAlb(散射比浊法)的水平.结果 2型糖尿病患者肾损伤后外周血CD146、U-MAlb水平显著高于对照组,尿蛋白定性阳性组CD146与U-MAlb呈正相关.结论 2型糖尿病患者肾损伤后外周血CD146水平显著升高.     

非小细胞肺癌患者CD44及其变异体V6的测定

目的：探讨测定粘附分子CD44及其变异体V₆在非小细胞肺癌（non-smallcelllungcarcinoma, NSCLC）中的意义。方法：采用酶联免疫吸附试验检测血清中可溶性CD44S（sCD44S）和可溶性CD44V₆（sCD44V₆）含量;流式细胞术测定细胞表面CD44S、CD44V₆的表达。结果：NSCLC患者血清CD44S、CD44V₆水平明显高于肺良性疾病（P<0.05, P<0.01）。原发肺鳞癌（SCC）和腺癌（ADC）细胞的CD44S表达率明显高于对照组（P<0.01）;3组的CD44V₆表达率均低,差异无显著。NSCLC原发癌细胞表面CD44S、CD44V₆表达与其血清的可溶性含量之间均无相关性。结论：提示血清CD44S、CD44V₆水平可作为鉴别NSCLC和肺良性疾病的辅助指标。     

CD146基因重组质粒的构建及蛋白表达

目的构建CD146原核、真核表达载体,证实融合蛋白在原核细胞的诱导表达以及在胃癌细胞内的表达和定位。方法提取人黑色素瘤细胞A875的总mRNA并进行反转。以反转录的cDNA为模板PCR扩增CD146全长编码基因,分别克隆至pCDNA3.1-myc/his以及pGEX-4T-3表达载体中。原核重组质粒鉴定后转入BL21细胞中并经了诱导表达及纯化,真核表达质粒转入胃癌MKN45细胞中,分别利用westernblot和激光共焦扫描显微技术检测了重组质粒的表达以及在胃癌细胞中的定位。结果 CD146全长基因序列克隆到原核、真核表达载体中,酶切鉴定片段为1930bp。原核诱导出了GST-CD146并进行了纯化,CD146在真核细胞中表达为113KD的糖蛋白,Westernblot检测到真核转染的myc/his-CD146表达,条带约为120KD,免疫荧光显示蛋白定位在胃癌MKN细胞膜。结论成功构建了CD146原核、真核表达载体,融合蛋白在胃癌MKN45细胞表达。     

乙型肝炎病毒感染者外周血CD4+T细胞CD25、CD127不同亚群表达的检测及临床意义

目的 研究乙型肝炎病毒(HBV)感染者外周血CD4+T细胞表面CD25、CD127不同亚群的表达情况及临床意义。方法 用荧光抗体CD127-FITC、CD4-PECY5、CD25-PE标记T细胞。用流式细胞仪分别测定53例慢性乙型肝炎患者和53例HBV携带者CD4+T细胞表面CD25、CD127不同亚群的表达情况。对20例HBV-DNA阳性乙型肝炎病毒感染者干扰素治疗进行随访。结果与健康对照组[7.26％(6.15％,8.50％)]比较,慢性乙型肝炎患者[11.23％(9.10％,14.86％)]、HBV携带者[13.34％( 10.73％,18.90％)]CD25-CD 127-均显著升高,差异均有统计学意义(Q=4.559,P＜0.05;Q=6.230,尸＜0.05)。慢性乙型肝炎患者CD25hiCD127low/-[8.78％ (7.62％,10.44％)]显著高于健康对照[6.76％(5.73％,8.23％)]和HBV携带者[6.99％(5.77％,9.34％)],差异均有统计学意义(Q=3.497,P＜0.05;Q=3.103,P＜0.05)。HBV-DNA阳性组CD25-CD127-显著低于阴性组,两者差异有统计学意义[(12.92±5.20)％比(15.78±6.91)％,t=2.290,P=0.024],而CD25+/-CD127+显著高于阴性组,两者差异有统计学意义[(79.27±5.20)％比(76.02±7.04)％,t=2.194,P=0.030]。与治疗前比较,干扰素治疗12周CD25hiCD127low/-显著升高[(9.29±2.51)％比(11.08±2.38)％,t=2.820,P=0.011],而CD4+CD25-CD127-显著降低,两者差异有统计学意义[(13.86±5.72)％比( 10.86±3.60)％,t=2.469,P=0.024]。结论 HBV感染者外周血CD4+T细胞中CD25-CD127-亚群的表达与病毒的感染和清除有关;CD25hiCD 127low/-亚群的表达升高与发病有关。外源性干扰素可升高CD25hiCD127low/-的表达,降低CD25-CD127-的表达,从而抑制免疫反应。     

The role of CD146 (Mel-CAM) in biology and pathology

CD146, also known as Mel-CAM, MUC18, A32 antigen, and S-Endo-1, is a membrane glycoprotein which functions as a Ca²⁺-independent cell adhesion molecule involved in heterophilic cell–cell interactions. Based on homology of the nucleotide sequence, CD146 is classified as a member of the immunoglobulin gene superfamily, since it contains the characteristic V-V-C2-C2-C2 immunoglobulin-like domain structure. Using immunohistochemistry with CD146-specific antibodies, CD146 expression has been demonstrated in a relatively limited spectrum of normal human tissues and malignant neoplasms. The lineage-specific expression pattern of CD146 can be useful in the differential diagnosis of certain lesions including melanomas and various types of gestational trophoblastic lesions. Although the biological role of CD146 in normal tissue and malignant tumours remains unclear, CD146 has been suggested to play an important role in tumour progression, implantation and placentation. CD146 expression can promote tumour progression in human melanoma, possibly through enhanced interaction between melanoma cells and endothelial cells. In contrast, CD146 may act as a tumour suppressor in breast carcinoma. CD146 expression is frequently lost in breast carcinomas and overexpression of CD146 in breast carcinoma cells results in a more cohesive cell growth and the formation of smaller tumours in nude mice. During implantation and placentation, CD146 expressed by the intermediate trophoblast in the placental site binds to its putative receptor in uterine smooth muscle cells and limits trophoblastic invasion in the myometrium. In conclusion, CD146 is a recently identified novel cell adhesion molecule and its biological functions and role as a diagnostic marker in pathology are now being recognized. Identification of the receptor for CD146 and the development of experimental models that can account for the complex interactions between CD146-expressing cells and their microenvironment are needed to investigate further the functions of this molecule in biology and in pathological states. Copyright © 1999 John Wiley & Sons, Ltd.     

Systematic review with meta-analysis: Non-alcoholic fatty liver disease and the association with pregnancy outcomes

Background/AimsMaternal and fetal outcomes in pregnant patients with Non-alcoholic fatty liver disease (NAFLD) have been largely unexplored. To determine the level of evidence associated with maternal and fetal outcomes in pregnant women with NAFLD.MethodsWe conducted a comprehensive literature search. The studies included pregnant patients with a previous, current or subsequent diagnosis of NAFLD. We used a random-effects model using odds ratios (OR) with 95% confidence intervals (CI).ResultsTwenty-two studies, with 13,641 female NAFLD patients were reviewed. The results highlight that NAFLD patients had a statistically significant increased likelihood of baseline diabetes mellitus (OR, 6.00; 95% CI, 2.21–16.31; P<0.001; n=7), baseline Hypertension (OR, 3.75; 95% CI, 2.13–6.59; P<0.001; n=4), gestational hypertension (OR, 1.83; 95% CI, 1.03–3.26; P=0.041; n=2), and pre-eclampsia (OR, 2.43; 95% CI, 1.46–4.04; P=0.001; n=3). The odds for a past and current history of gestational diabetes mellitus were OR, 3.78; 95% CI, 2.21–6.44; P<0.001; n=5 and OR, 3.23; 95% CI, 1.97– 5.31; P<0.001; n=6, respectively. As for fetal outcomes, pregnant NAFLD patients were significantly more likely to have a premature birth (OR, 2.02; 95% CI, 1.44–2.85; P<0.001; n=4), large for gestational age birth (OR, 2.01; 95% CI, 1.72–2.37; P<0.001; n=2) or a history of prior miscarriage or abortion (OR, 1.15; 95% CI, 1.02–1.30; P=0.02; n=2). Egger’s regression revealed no evidence of publication bias (P>0.05).ConclusionsThis meta-analysis provides pooled evidence that NAFLD is associated with a substantial increase in maternal diabetic and hypertensive complications and multiple adverse fetal outcomes. This data is important for clinicians managing these patients before, during and after pregnancy.