胰岛素样生长因子-I、瘦素与Graves病相关性研究

目的探讨血清胰岛素样生长因子-I(IGF-I)、瘦素(Leptin)及BMI在Graves病(GD)中的改变及其相互关系。方法采用放射免疫分析法(RIA)检测55例(男15例,女性40例)患者从初发病到治疗稳定、停药复发血清IGF-I、Leptin水平,并与年龄和性别相匹配的健康人(对照组)比较。结果初发组血清IGF-I水平升高明显,与对照组比较差异均有显著性(P<0.01);停药后复发组血清Leptin水平下降,差异有显著性(P<0.05)。结论IGF-I、Leptin与自身免疫性疾病GD的发病有关。     

瘦素及胰岛素样生长因子-Ⅰ与卵泡发育的关系

目的:探讨卵泡液和血清中瘦素(Leptin)与胰岛素样生长因子-Ⅰ(IGF-Ⅰ)水平与卵泡发育的关系.方法:应用放射免疫法(RIA)检测67例患者取卵日血清及卵泡液中的Leptin与IGF-Ⅰ水平.结果:(1)取卵日血清中的Leptin水平为(13.20±5.43)mg/L,显著高于卵泡液中Leptin水平(10.86±5.73)mg/L,P＜0.05;卵泡液中的Leptin水平与血清中的Leptin水平呈正相关(r=0.84,P＜0.001).血清中的IGF-I水平为(7.18±4.58)mg/L,显著高于卵泡液中IGF-I水平(4.36±3.03)mg/L(P＜0.05),卵泡液中的IGF-Ⅰ水平与血清中的IGF-Ⅰ水平呈正相关(r=0.79,P＜0.001);(2)卵巢低反应型者的血清及卵泡液中Leptin水平显著高于卵巢中高反应型者,差异有显著性(P＜0.05);(3)三种卵巢反应类型的血清及卵泡液中IGF-Ⅰ水平比较,差异无显著性(P＞0.05);(4)卵泡液及血清中的Leptin水平与IGF-Ⅰ水平无明显的相关性(r=-0.079,P＞0.05)及(r=-0.127,P＞0.05).结论:(1)卵泡液中的Leptin及IGF-Ⅰ均来自血清;(2)高浓度的Leptin可能抑制卵泡发育,而低浓度的Leptin可能对卵泡发育没有影响;(3)体内IGF-Ⅰ可能与其受体结合后发挥对卵泡发育的调节作用;(4)Leptin与IGF-Ⅰ之间无明显相关关系.     

不同类型脑肿瘤患者血清胰岛素样生长因子-Ⅰ检测的临床意义

目的 探讨血清胰岛素样生长因子Ⅰ(IGF-Ⅰ)水平与各种类型脑肿瘤的关系.方法 采用化学发光方法检测193例脑肿瘤患者及25例正常对照者的血清IGF-1水平并进行比较,其中颅咽管瘤43例,非侵袭性垂体瘤41例,胶质瘤36例,脑膜瘤33例,侵袭型垂体瘤22例,肺癌脑转移18例.结果 非侵袭性垂体瘤组患者的血清IGF-Ⅰ水平明显高于对照组,差异有统计学意义(P＜0.05);而颅咽管瘤组、脑膜瘤组患者的血清IGF-Ⅰ水平与对照组比较差异无统计学意义(P＞0.05);侵袭性垂体瘤组、胶质瘤组与对照组比较,血清IGF-Ⅰ水平间差异均有统计学意义(P＜0.05).结论 血清中IGF-1水平在不同种类的脑肿瘤中存在明显差异,可为临床诊断提供可靠的辅助诊断依据.     

胰岛素样生长因子Ⅰ、脐血瘦素及胰岛素与胎儿宫内发育迟缓的相关关系

目的:探讨胰岛素样生长因子-Ⅰ(IGF-Ⅰ)、脐血瘦素(Leptin)及胰岛素(Ins)与胎儿宫内发育迟缓(IUGR)的相关关系.方法:应用放射免疫分析法和酶联免疫吸附试验,分别测定46例IUGR患儿、孕妇(IUGR组)血清IGF-Ⅰ和脐血瘦素、Ins水平,同期住院的正常晚期妊娠妇女52例(正常妊娠组)作为对照.结果:①IUGR组孕妇血清IGF-Ⅰ为(112.58±21.23)ug/L,低于正常妊娠组的(209.13±25.98)ug/L,两者比较,有显著性差异(P＜0.01);IUGR组脐血清IGF-Ⅰ为(15.68±6.76) ug/L,低于正常妊娠组的(45.19±11.25) ug/L,两者比较,有极显著性差异(P ＜0.001).②IUGR儿脐血瘦素为(5.35±3.02)ng/ml,低于正常妊娠组的(8.97±4.34) ng/ml,两者比较,有显著性差异(P ＜0.05).③IUGR儿脐血Ins为(8.98±5.60)mU/L,低于正常妊娠组的(16.19±8.15) mU/L,两者比较,有显著性差异(P ＜0.05).结论:IGF-Ⅰ、Ins及瘦素可能参与IUGR的病理生理过程.     

胎儿生长受限与瘦素、胰岛素样生长因了-Ⅰ水平的相关性

目的研究胎儿生长受限(FGR)与瘦素、胰岛素样生长因子-Ⅰ(IGF-Ⅰ)的关系,探讨脐血瘦素、IGF-Ⅰ的临床检测价值.方法采用放射免疫法检测40例正常孕妇(对照组)和24例FGR孕妇(FGR组)的血清与脐血(脐A和脐V)中瘦素和IGF-Ⅰ水平,并对其结果进行相关性分析.结果(1)FGR组血清瘦素及IGF-Ⅰ水平与对照组比较,差异无显著性(P＞0.05);(2)FGR组脐血瘦素和IGF-Ⅰ水平均明显低于对照组(P＜0.01,P＜0.05).(3)两组孕妇血清瘦素和IGF-Ⅰ水平与脐血瘦素和IGF-Ⅰ水平无相关性(r=0.129,r=-0.059,均P＞0.05);脐血瘦素水平与新生儿出生体重呈正相关关系(r=0.600,P<0.05),与胎盘重量亦呈正相关关系(r=0.44,P<0.05);脐血IGF-Ⅰ水平与新生儿出生体重呈正相关关系(r=0.469,P<0.05),与胎盘重量无相关关系(r=0.30,P>0.05).(4)脐A瘦素和IGF-Ⅰ水平与相应脐V瘦素和IGF-Ⅰ水平差异无显著性(P>0.05).(5)脐血瘦素与IGF-Ⅰ水平无相关关系(r=0.397,P>0.05).结论脐血瘦素和IGF-Ⅰ水平与胎儿生长发育状态密切相关;脐血瘦素或IGF-Ⅰ水平降低可能是FGR发生的原因之一;瘦素调控胎儿生长发育没有IGF-Ⅰ的直接参与;脐A与脐V血瘦素及IGF-Ⅰ水平均可作为评价胎儿生长发育的临床指标.     

INS、IGF-1和IGFBP-3在子宫内膜癌患者血清中的表达及其临床意义

目的 探讨胰岛素(INS)、胰岛素样生长因子-Ⅰ(IGF-Ⅰ)和胰岛素样生长因子结合蛋白-3(IGFBP-3)在子宫内膜癌患者血清的表达及临床意义.方法 采用电化学发光法和免疫放射法检测30例子宫内膜癌患者血清INS、IGF-Ⅰ及IGFBP-3的表达水平.结果 子宫内膜癌组胰岛素水平显著升高(158.06±47.82),与对照组( 57.30±33.21)差异有显著性(P＞0.01).而IGF-Ⅰ及IGFBP-3两组间差异无统计学意义(均P＞0.05).子宫内膜癌临床病理各期血清INS、IGF-Ⅰ及IGFBP-3水平比较差异无显著性意义(均P＞0.05).结论 高胰岛素血症与子宫内膜癌发生有关.检测血INS有助于发现子宫内膜癌高危人群,从而有利于早期预防.     

特发性中枢性性早熟女童血清瘦素和胰岛素样生长因子-1的变化

目的研究特发性中枢性性早熟(ICPP)女孩血清瘦素(Leptin)和胰岛素样生长因子1(IGF-1)的变化及其意义。方法测定37例ICPP女孩体重和体质指数(BMI)及血清Leptin和IGF-1的水平,同时以10例同龄正常女孩作为对照。观察血清Leptin和IGF-1水平的相互关系、及两者与体重和BMI的关系。结果ICPP患儿的体重高于正常对照组(P0.01),其血清Leptin及IGF-1水平亦高于正常对照组(均P0.05);ICPP组Leptin水平与体重、BMI均呈正相关(P0.01),IGF-1与体重、BMI均呈正相关(P0.01,P0.05),Leptin水平与IGF-1水平亦呈正相关(P0.01)。结论ICPP的发生需要一定的体重和体脂;ICPP患儿性成熟的提前伴随着体重的增加、Leptin及IGF-1水平升高;Leptin和IGF-1水平的测定可能作为ICPP诊断的参考指标;Leptin与GH-IGF-1轴在ICPP的病理发生中有密切关系;IGF-1升高与ICPP患儿体重及BMI增加密切相关。     

血清胰岛素样生长因子及其结合蛋白水平与2型糖尿病视网膜病变的关系

目的 探讨血清胰岛素样生长因子及其结合蛋白水平与2型糖尿病患者糖尿病视网膜病变(diabetic retinopathy,DR)的关系.方法 用免疫放射分析法测定28例合并DR、68例无DR的2型糖尿病患者以及156例正常对照者的空腹血清IGF-Ⅰ,Ⅱ,IGFBP-1,3水平.结果 ①与正常对照人相比,2型糖尿病患者无论有否DR,血清IGF-Ⅰ(ng/ml)降低[256.1±163.99(对照组),184.73±110.97(DR组),163.12±11.97(NDR组),P＜0.05],糖尿病合并与不合并DR两组间差异无显著性;②与正常对照相比,糖尿病患者不伴DR者IGF-Ⅱ(ng/ml)水平较低(863.82±268.27 vs 703.31±295.12,P＜0.05),正常对照组与糖尿病合并DR组之间,糖尿病两组间差异无显著性;③糖尿病无论是否合并DR血IGFBP-1水平(ng/ml)都显著高于正常对照组(均P＜0.05),糖尿病二组间差异无显著性(54.06±30.85,75.81±58.91,68.17±36.54);④IGFBP-3水平三组间差异无显著性.结论 糖尿病患者血浆IGF-Ⅰ,Ⅱ,IGFBP-1,3水平与DR的关系不明确,尚需进一步研究.     

血清锌、生长激素和IGF-1与儿童银屑病的关系

目的探讨血清锌（Zn）、生长激素（GH）和胰岛素样生长因子-1（IGF-1）与儿童银屑病发病的关系.方法采用原子吸收分光光度法（AAS）检测52例银屑病病儿和46例健康对照者血清Zn的水平;采用放射免疫分析法（RIA）检测血清GH基础值和IGF-1的水平.结果银屑病病儿血清Zn水平明显低于正常对照组,差异有极显著性（t=4.59,P〈0.01）.青春期前银屑病病儿血清GH基础值和IGF-1水平均高于正常对照组,差异有极显著性（t=-4.17、3.55,P〈0.01）;青春期银屑病病儿血清GH基础值和IGF-1水平与正常对照组比较差异无显著性（t=1.55、-1.98,P〉0.05）.结论 Zn、GH和IGF-1可能参与了儿童银屑病的发病.     

血清IGF-1水平在前列腺癌诊断中的意义

目的 研究前列腺癌(Pca)患者的血清胰岛素样生长因子-1(insulin-like growth factor-1,IGF-1)水平,以了解IGF-1在Pca诊断中的意义.方法 应用免疫放射分析法(IRMA)测定30例前列腺癌患者血清胰岛素样生长因子-1水平,并以30例健康组和30例良性前列腺增生症(BPH)组患者作对照.结果 前列腺癌组血清IGF-1含量显著上升(148±49.6)μg/L,与BPH(91.0±32.8)μg/L及健康组(105±25.6)μg/L差异有显著性(均P＜0.01).BPH组血清IGF-1含量与健康组差异无显著性(P＞0.05);前列腺癌组各期IGF-1含量比较差异无显著性(P＞0.05);IGF-1与BPH无关,其水平升高增加前列腺癌的危险性,与健康组比较,高IGF-1水平患者前列腺癌的相对危险度(OR)为11.23,95%CI3.09～40.7,前列腺癌患者与健康组之间有统计学意义(P＜0.01).结论 IGF-1可能增加PCa的危险性.检测血清IGF-1水平对提高Pca的诊断率可能有帮助.     

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.