再生障碍性贫血发病机制及环孢菌素A干预的体外实验研究

目的：研究再生障碍性贫血（AA）发病机制及环孢菌素A（CsA)对AA患骨髓细胞体外培养的影响。方法：采用微量甲基纤维索法研究了18例AA患者骨髓粒一单系祖细胞（CFU－GM）集落形成及其骨髓细胞和血清对正常CFU－GM集落形成的影响,据此对AA按发病机制进行分组,同时加CsA与AA骨髓及正常骨髓共同培养。结果：干细胞缺陷组5例,微环境缺陷组4例,细胞抑制组7例,血清抑制组2例。AA骨髓CFU－GM集落产率明显低于正常对照组（P＜0．01）;CsA能显著增加AA集落,集族产率（P＜0．05）;8例AA骨髓CFU－GM集落产率明显低于正常对照组（P＜0．01）;CsA能显著增加AA集落,集族产率（P＜0．05）;8例AA骨髓对CsA敏感,其中细胞抑制组6例,干细胞缺陷组2例。结论：本研究可能为预测CsA治疗AA的临床疗效提供实验依据。     

特发性血小板减少性紫癜患者外周血T淋巴细胞亚群及HLA-DR的变化

采用一组单克隆抗体及免疫酶标技术，对42例特发性血小板减少性紫癜患者（ITP）外周血T淋巴细胞亚群及HLA－DR的表达进行了测定。结果表明，CD4＋细胞减少，CD8＋细胞增加，CD4＋／CD8＋细胞比值减低或倒置，HLA－DR的表达明显高于正常对照组（P＜0．001）。临床经免疫抑制治疗有效的ITP患者，T细胞亚群及HLA－DR的异常表达得到纠正。说明ITP患者细胞免疫功能失调在ITP的发病中起着重要作用。     

黄芪静脉滴注对慢性乙型病毒性肝炎患者细胞免疫功能的影响

目的：探讨黄芪静脉滴注对慢性乙型病毒性肝炎患细胞免疫功能的调节作用。方法：黄芪与甘草酸二胺（甘利欣）合用治疗慢性乙型病毒性肝炎轻度（CLH）及中度（CMH）患各15例,并设轻度及中度患各10例单用甘利欣治疗作对照,另设健康正常组10例。结果：治疗组CD3^ 、CD4^ 和CD4^ /CD8^ 治后均较对照组显升高（P＜0．05或P＜0．01）。治疗组CLH型治后自然杀伤（NK）细胞活性、T淋巴细胞转化率（LTR）增加,血浆可溶性白细胞介素－2受体（SIL－2R）水平降低,与对照组比较均有显性差异（P＜0．05）;CMH型与对照组相比无显变化。结论：黄芪能显提高慢性乙型病毒性肝炎患的细胞免疫功能,对轻度患的疗效优于中度患。     

三联叠加疗法对慢性乙型肝炎患者细胞免疫功能的影响

目的：考察拉米夫定，干扰素α-2b，黄芪注射液三联叠加疗法对慢性乙型肝炎（慢乙肝）患者细胞免疫功能的影响。方法：对98例慢乙肝患者用上述3种单药和三联叠加疗法分组治疗，检测各组治疗前后外周血T细胞亚群，NK细胞，IL－1α和IL－6，TNF－α和内毒素的含量及活性变化。结果：三联叠加疗法可使CD3^ ,CD4^ ,CD8^ ,CD16^ （NK细胞）和IL－2分泌细胞均非常显著增加（P＜0．01）；使IL－1α水平非常或高（P＜0．01），IL－6水平显著升高（P＜0．05）；使内毒素和TNF－α水平非常显著降低（P＜0．01）。而拉米夫定，干扰α－2b，黄芪注射液单用上述细胞免疫功能指标的影响弱于三联叠加疗法，且不尽一致。结论：三联叠加疗法可提高慢乙肝患者的细胞免疫功能，且优于其中任何单药的疗效。     

肺癌患者血清与癌肿块中细胞因子的变化及其意义

目的：探讨肺癌患血清与癌肿块中白介素－8（IL－8），白介素－18（IL－18），肿瘤坏死因子（TNFα），血管细胞粘附因子－1（sVAM-1)的变化情况，方法：采用Elisa方法检测12例正常对照，17例肺癌患手术前后IL－8，IL－18，TNFα，sVCAM-1在血清和癌旁肺组织，癌组织中的含量。结果：肺癌患手术前后血清中的IL－8，IL－18，TNFα，sVCAM-1含量均比正常对照组增高有显差异（P值均＜0．01），术后与术前两组比较术后TNFα含量有明显下降（P＜0．05），其余3项指标有一定下降但无显差异，癌肿块中IL－8，IL－18，TNFα，sVCAM-1含量比癌旁组织中的含量4项指标均显增高（P＜0．01，P＜0．05），结论：测定血清中的IL－8，IL－18，TNFα，sVCAM-1对肺癌的诊断及判断预后，鉴别良，恶性肿瘤有重要临床意义。     

射频热化疗对膀胱癌术后机体细胞免疫功能的影响

目的：探讨膀胱癌术后射频热化疗对机体细胞免疫功能的影响。方法：58例膀胱移行细胞癌术后患者随机分为热化疗组（n=30)和化疗组（n=28)。采用红细胞花环直接法及放免法，分别检测患者术后1周及热化疗或单纯化疗后第2周外周血T淋巴细胞亚群分布、血清白细胞介素2（IL－2）、肿瘤坏死因子（TNF）含量。30例健康体检者作为正常对照组。结果：热化疗组和化疗组患者术后外周血CD3^ 、CD4^ T淋巴细胞数、CD4^ /CD8^ 比值、IL－2含量显著低于正常对照组（P＜0．01）。CD8^ T淋巴细胞数、TNF含量与正常对照组相比差异无统计学意义。化疗后第2周，热化疗组CD3^ 、CD4^ T淋巴细胞数，血清IL－2含量显著升高，与正常对照组相比差异无统计学意义（P＞0．05），与化疗组相比，差异有统计学意义（P＜0．01）。热化疗组TNF含量升高，与对照组相比差异有统计学意义（P＜0．05）。结论：射频热化疗对膀胱癌患者的细胞免疫功能有促进作用。     

原发性肝癌患者细胞免疫功能变化的研究

对27例肝癌（HCC）、17例肝硬化及15例正常人外周血作了表型分析（CD3、CD4、CD8、CD16、CD25、CD56、Trδ）及肿瘤坏死因子（TNF）和IL－6检测，并按Child分级对HCC病人作了分级比较。结果表明：肝癌和肝硬化组外周血CD3、CD44／CD8比值均显著低于正常组（P＜0．05），HCCChildB级组T细胞下降比A组更显著；IL－6和TNF水平均高于正常组（P＜0．05）。初步认为：CD3、CD4阳性率下降及CD4／CD8比例倒置能较客观反应HCC免疫功能，细胞免疫功能水平与其肝功能状况直接相关。     

胸腺肽α1对正常人造血功能和免疫功能的影响以及抗肿瘤作用

目的 探讨胸腺肽α1抗肿瘤的机制。方法 用间接酶联免疫吸附试验检测经胸腺肽α1刺激的8份正常人外周血单个核细胞培养上清液中的白细胞介素2（IL－2）、肿瘤坏死因子α（TNFα）、可溶性TNFα受体（sTNFαR）和白细胞介素12（IL－12）含量，集落培养检测15份骨髓损捐献者骨髓单个核细胞粒单细胞集落形成单位（CFU－GM）、红细胞集落形成单位（CFU－E）。直接细胞计数法、MTT法检测胸腺肽α1对K562细胞的直接抑制作用。结果 胸腺肽α1能刺激正常人外周血单个核细胞产生IL－2 TNFα、sTNFαR和IL－12增多；胸腺肽α1浓度≥1μg/ml时CFU－GM、CFU－E集落数增多36.9%和70.3%（P＜0.001）；同时胸腺肽α1能直接抑制K562细胞的生长。结论 胸腺肽α1能促进造血干细胞增生，通过细胞因子途径和直接抑制作用发挥其抗肿瘤作用。     

白细胞介素、肿瘤坏死因子、一氧化氮对2型糖尿病胰岛分泌功能的影响

目的：探讨一氧化氮（NO），白细胞介素（IL），肿瘤坏死因子（TNF－α）对2型糖尿病β细胞胰岛素分泌功能的影响。方法：测定53例2型糖尿病（T2DM）及30例健康人（NGT）的IL－1β，IL－2，TNF－α，NO水平，分析其对2型糖尿病β细胞胰岛素分泌功能（HBCI）的影响。结果：2型糖尿病患IL－1β，TNF－α，NO较正常组显增高，IL－2显下降，HBCI糖尿病组显低于正常组。单相关分析显示IL－1β，TNF－α，NO与HBCI呈显负相关，IL－1β，TNF－α与NO呈显正相关，IL－2与NO呈显负相关。多元逐步回归分析显示IL－1β为HBCI最为危险的因素。结论：IL－1β，IL－2，TNF－α，NO在2型糖尿病的发生发展中起重要作用。     

不同期别子宫内膜异位症患者细胞免疫功能变化的研究

目的：探讨不同期别子宫内膜异位症（内异症）患细胞免疫功能的变化。方法：采用红细胞直接花环法,检测不同期别子宫内膜异位症患100例（Ⅰ期19例、Ⅱ期11例、Ⅲ期31例、Ⅳ期39例）、同期健康妇女31例（对照组）、外周血总T淋巴细胞（CD3）、T辅助细胞（CD4）、T抑制细胞（CD8）的值、CD4／CD8比值。结果：子宫内膜异位症组CD4值低于对照组P＜0．01有极显差异,其中内异症Ⅰ期组与对照组比较P＞0．05无显差异。而Ⅱ、Ⅲ、Ⅳ期分别与对照组比较,均P＜0．05有显性差异。内异症CD4／CD8低于对照组P＜0．05有显差异,其中内异症Ⅳ期与对照组比较P＜0．01有极显差异,Ⅲ期组与对照组比较P＜0．05有显差异,Ⅰ期、Ⅱ期组与对照组比较P＞0．05无显差异。结论：在子宫内膜异位症的诊断中,CD3、CD4、CD4／CD8的检测,可以作为诊断内异症的依据之一。     

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.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

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.