总IgG和特异性IgG相关性初探

为探讨特异性ＩｇＧ和ＩｇＧ的相关性,用常规方法检测多份血清总ＩｇＧ,抗核抗体（ＡＮＡ）,抗双链ＤＮＡ抗体（ｄｓＤＮＡ）,抗盐水可提取核抗原（ＥＮＡ）抗体、巨细胞病毒（ＣＭＶ）特异性抗体、单纯疱疹病毒Ⅰ型（ＨＳＶ－Ⅰ）特异性抗体及抗链球菌溶血素“０”抗体（ＡＳＯ）和抗“Ｈ”。结果显示：两种自身抗体（ＡＮＡ,抗ＥＮＡ抗体）及ＣＭＶ抗体各阳性组总ＩｇＧ水平明显高于各阴性组,有显著性差异;Ｓｍ和（或）ｄｓ     

快速抑制性ELISA法检测人血清抗dsDNA抗体及其临床意义

应用一种快速改良ＥＬＩＳＡ法检测２４４例人血清抗ｄｓＤＮＡ抗体（包括ＩｇＧ、ＩｇＡ及ＩｇＭ类）。结果示，本法特异性及阳性率优于目前常规ＥＬＩＳＡ法及间接免疫荧光法。ＳＬＥ患者血清中抗ｄｓＤＮＡ抗体阳性率为８６．２％（１１２／１３０），活动期ＳＬＥ患者阳性率为９４．７％（５４／５７）。抗上ＤＮＡ抗体主要见于ＳＬＥ（占９５．０％），也见于ＤＬＥ、ＳＣＬＥ、ＲＤ及ＭＣＴＤ患者血清中。８９例非ＣＴＤ的其它患者或健康人中有３例假阳性。本法优，久之一是避免了抗ｓｓＤＮＡ或ＲＮＡ抗体影响，结果更为准确，阳性率大为提高，有利于ＳＬＥ诊断及疗效判断。     

抗心磷脂抗体与反复自然流产关系的探讨

目的：探讨抗心磷脂抗体（ＡＣＡ）与反复自然流产（ＲＳＡ）的关系。方法：应用间接酶联免疫吸附试验（ＥＬＩＳＡ）法检测３２例ＲＳＡ患者血清中的ＡＣＡ，同时测定了抗核抗体（ＡＮＡ）、抗单链ＤＮＡ（抗ｓｓ－ＤＮＡ）、抗双链ＤＮＡ（抗ｄｓ－ＤＮＡ）、ＲＦ、抗平滑肌抗体（抗Ｓｍ抗体）。结果：ＳＲＳ组ＡＣＡ的阳性率为３１．２５％，明显高于其他自身抗体及对照组（Ｐ〈０．０１）。三种类别Ｉｇ中，以ＩｇＧ、ＩｇＭ型Ａ     

血浆置换疗法在自身免疫性疾病治疗中的意义

目的探讨血浆置换疗法在自身免疫性疾病中的治疗作用。方法用血浆置换疗法治疗１８例病人，其中格林—巴利综合征１２例，狼疮性肾炎急性活动期５例，重症肌无力危象１例。并测定血浆置换前后血浆白蛋白、球蛋白、免疫球蛋白、Ｃ３、Ｃ４、ＳＣｒ、ＡＮＡ、ｄｓＤＮＡ抗体的变化。结果血浆置换后较置换前血浆球蛋白、Ｃ３、Ｃ４、ＩｇＧ存在显著性差异（Ｐ＜０．０１）。狼疮性肾炎急性活动期经治疗后，尿蛋白减少，肾功能恢复，ＡＮＡ、ｄｓＤＮＡ抗体转阴。格林—巴利综合征的病人在发病３ｄ内行血浆置换２次即能迅速控制呼吸肌麻痹。结论血浆置换疗法能迅速地移除大量的致病抗原、抗体及免疫复合物。     

联合检测ANA、ENA及抗ds-DNA抗体对监控SLE的价值

应用间接免疫荧光法、免疫印迹法及金标渗滤法分别检测２３例活动期和３４例非活动期系统性红斑狼疮（ＳＬＥ）患者血清中的抗核抗体（ＡＮＡ）、ＥＮＡ多肽抗体谱及抗ｄｓ－ＤＮＡ抗体。结果显示：活动期与非活动期ＳＬＥ患者血清中的ＡＮＡ、ＥＮＡ抗体阳性率差异无显著性（Ｐ＞０．０５）,活动期ＳＬＥ患者血清中的ＡＮＡ抗体滴度、抗ｄｓ－ＤＮＡ阳性率和滴度均明显高于非活动期,两者之间差异有显著性（Ｐ＜０．０５）。抗核抗体、ＥＮＡ及抗ｄｓ－ＤＮＡ抗体的联合检测对ＳＬＥ的诊断分型、治疗预后均有重要的临床价值。     

ConA活化的淋巴细胞诱导自身抗核抗体生成的实验研究

系统性红斑狼疮（ＳＬＥ）患血清中出现的大量致病性抗核抗体（ＡＮＡ）的免疫原至今不明,本实验试图阐明活化的淋巴细胞（Ｔ细胞）是诱导ＡＮＡ生成的免疫原。方法：用ＣｏｎＡ活化的Ｆ１代鼠淋巴细胞免疫Ｆ１小鼠,用ＥＬＩＳＡ法测定ｌｇＧ类抗ｄｓ－ＤＮＡ抗体、抗组蛋白抗体,用免疫荧光检测ＡＮＡ核型和免疫复合物沉积,用免疫印迹法测定抗可溶性核抗原抗体,结果：用ＣｏｎＡ活化的淋巴细胞能诱导抗ｄｓ－ＤＮＡ抗体、抗组蛋白抗体等多种ＡＮＡ,免疫小鼠的肾脏有显的免疫复合物沉着,揭示活化的淋巴细胞可能是诱导抗ｄｓ－ＤＮＡ抗体和其他ＡＮＡ生成的免疫原。     

天然DNA和细胞因子对系统性红斑狼疮患者淋巴细胞体外分泌抗双链DNA抗体的影响

检测６例活动期、６例缓解期系统性红斑狼疮（ＳＬＥ）患者和１０例正常人血清和外周血单个核细胞（ＦＢＭＣ）自发及经天然ＤＮＡ（ｎＤＮＡ）、重组白介素２（ｒＩＬ－２）和重组γ干扰素（ｒＩＦＮ－γ）锈导后分泌ＩｇＧ类抗双链ＤＮＡ（ｄｓＤＮＡ）特异性抗体水平，观察到活动期患者血清中含量和自发分泌量显著高于缓解期，后者又显著高于正常人，且体外细胞分泌水平与血清中含量密切相关（ｒ＝０．９８８２）。ｎＤＮＡ能特异地激发ＳＬＢ患者的ＰＢＭＸＣ分泌抗ｄｓＤＮＡ抗体，但对正常人无作用。ｒＩＬ－２和ｒＩＦＮ－γ皆能增强ＳＬＥ患者ＰＢＭＣ产生抗ｄｅＤＮＡ抗体。ｎＤＮＡ和ｒＩＬ－２联合应用时对活动期患者ＰＢＭＣ分泌抗ｄｓＤＮＡ抗体有协同作用。作者未发现重组白介素６（ｒＩＬ－６）对抗ｄｓＤＮＡ抗体分泌的影响。     

速率散射比浊法测定164例各型病毒性肝炎患者血清特定蛋白

目的观察各型病毒性肝炎血清中主要特定蛋白（ＩｇＧ、ＩｇＡ、ＩｇＭ、Ｃ３、Ｃ４等）的变化及其临床意义。方法采用速率散射比浊法测定血清特定蛋白，并用ＥＬＩＳＡ法检测乙型肝炎核心抗体（ＩｇＧ、ＩｇＭ）。结果乙肝患者血清特定蛋白ＩｇＧ、ＩｇＡ、ＩｇＭ的上升幅度与病情严重程度相平行，即病情愈重，其含量愈高；但ＩｇＭ在急性肝炎病人升高并不明显，而且抗ＨＢＣ－ＩｇＭ特异性抗体对其含量的影响不大。补体Ｃ３、Ｃ４成分并不是所有肝病都呈下降趋势，且与病情的严重程度并不呈平行关系，但其下降与肝炎活动期或病毒持续感染有关。结论采用速率散射比浊法测定血清特定蛋白，有助于对临床肝病的病情评估、鉴别诊断及预后判断等。     

重症肌无力自身抗体、T淋巴细胞亚群及其临床意义的探讨

目的：探讨重症肌无力（ＭＧ）抗乙酰胆碱受体抗体（ＡｃｈＲａｂ）、抗突触前膜受体抗体（ＰｓｍＲａｂ）和Ｔ淋巴细胞亚群与临床的关系。方法：应用ＥＬＩＳＡ法检测４０例重症肌无力病人血清中上述两种自身抗体，应用Ｔ淋巴细胞亚群单克隆抗体微量细胞毒法检测该组病人Ｔ淋巴细胞亚群。结果：①ＡｃｈＲａｂＩｇＧ型阳性２４例（６０％）、ＩｇＭ型阳性１５例（３７．５％），ＰｓｍＲａｂＩｇＧ型阳性２４例（６０％）、ＩｇＭ型阳性１１例（２７．５％）；②仅ＡｃｈＲａｂＩｇＧ型阳性３例（７．５％）、ＩｇＭ型阳性１例（２．５％），只有ＰｓｍＲａｂＩｇＧ型阳性２例（５％），二种抗体的ＩｇＧ型和ＩｇＭ型均阴性７例（１７．５％）；③ＡｃｈＲａｂ与ＰｓｍＲａｂ存在直线正相关；④本组病人ＣＤ＋４增高、ＣＤ＋８降低、ＣＤ＋４／ＣＤ＋８比率增高；⑤ＣＤ＋４／ＣＤ＋８比率与这两种自身抗体无相关关系；⑥年龄大于４０岁组的ＣＤ＋８低于４０岁以下组，而ＣＤ＋４／ＣＤ＋８高于４０岁以下年龄组；⑦病程大于或等于３年组的ＣＤ＋８、ＣＤ＋４／ＣＤ＋８分别低于、高于病程小于３年组。结论：ＭＧ病人存在体液免疫和细胞免疫的异常；ＭＧ可受到ＡｃｈＲａｂ和ＰｓｍＲａｂ的免疫性损害     

胎盘免疫调节因子对妇科恶性肿瘤病人免疫功能的影响

目的：观察胎盘免疫调节因子（ＰＩＦ）对病人细胞免疫功能及体液免疫功能的影响，方法：利用ＰＩＦ治疗妇科恶性肿瘤６３例，并设对照组６３例。治疗组病人第天肌注ＰＩＦ４ｍ，３０ｄ为一疗程，对照组不注射ＰＩＦ。两组病人治疗前及治疗３０ｄ后抽血检测Ｔ淋巴细胞亚群（ＣＤ３、ＣＤ４、ＣＤ８）、ＮＫ细胞活性、淋巴细胞转化率（ＬＴ）及免疫球蛋白（ＩｇＡ、ＩｇＧ、ＩｇＭ）。结果：经ＰＩＦ治疗后，治疗组病人ＣＤ３、ＣＤ４     

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.