必思添对慢性支气管炎患者免疫学影响

目的：观察必思添对慢性支气管炎患者免疫学指标的影响。方法：将50例慢性支气管炎患者随机分为治疗组与对照组，治疗组在对照组治疗的基础上加用必思添。治疗前两组临床资料和各项免疫学指标大致相同（P＞0．05）。结果：口服必思添组3个月末免疫学指标（IgG、IgM、CD4^ 、CD8^ )均有不同程度改善（P＜0．05或P＜0．01），而对照组免疫学指标均无明显改变（P＞0．05）。     

IMB理念护理措施对重症肝炎并发细菌性腹膜炎的预防研究

目的探讨IMB理念护理措施在预防重症肝炎并发自发性细菌性腹膜炎方面的临床效果。 V将2016年8月～2018年1月我院传染科收治的131例重症肝炎患者作为研究对象，按照入院先后顺序将其分为观察组67例和对照组64例。对照组患者给予常规护理干预和治疗，观察组患者则在此基础上实行IMB理念护理措施，分析、比较两组患者的的SBP发生情况、转归情况、各项血生化指标变化以及各临床症状持续时间。 结果 观察组患者的SBP发生率和死亡率分别为25.37%、10.45%，明显低于对照组（51.56%，25.00%），其转归结果则显著优于对照组，差异有统计学意义（P＜0.05）。护理前，两组的各项血生化指标比较差异无统计学意义（P＞0.05），护理后，观察组的ALB和PTA水平明显高于对照组，ALT、TBIL水平明显低于对照组，差异有统计学意义（P＜0.05）。护理干预后，观察组的各项临床症状持续时间均明显短于对照组（P＜0.05）。 结论 IMB理念护理措施的实行，能够有效预防重症肝炎患者并发自发性细菌性腹膜炎的机率，有利于重症肝炎患者的临床治疗及预后。     

t(8,21)易位急性髓细胞性白血病免疫学表型分析

用流式细胞仪检测21例t（8；21）易位急性髓细胞性白血病细胞的免疫学表型，并与无t（8；21）易位急性髓细胞白血病（M2）病人比较．结果：t（8；21） 组与t（8；21）-组CD1，阳性率分别为62％、9％（P＜0．01）．CD34阳性率分别为76.2％、36％（P＜0．05），t（8；21） 组中皆无表达CD7，而t（8；21）-组中CD7阳性率为27．2％（P＜0．05）；两组间CD15、CD13、CD33、CD10表达无显著差异．提示t（8；21）急性髓细胞白血病有独特的免疫学表型特点，对形态学分类法难以分类的急性白血病诊断有一定的价值．     

免疫学检验联合检测诊断系统性红斑狼疮价值探讨

目的：探讨免疫学检验联合检测诊断系统性红斑狼疮的临床价值。方法：选取2014年7月至2015年7月期间来治疗的80例系统性红斑狼疮患者作为研究对象为观察组，根据是否在病情活动性期把80例患者随机分为活动组（36例）、非活动组（44例），另外选取同一时期来我院体检的80例健康人员作为对照组。对所有受检人员均使用免疫学检验联合检测诊断，把3组检验结果进行比较分析，观察分析观察组患者阳性检出率。结果：活动组与非活动组患者的血清 IgM、IgA、IgG、C3、C4各指标与对照组健康人员有明显差异，P ＜0．05，具有统计学意义。观察组阳性检出率明显高于对照组，P ＜0．05，具有统计学意义。结论：对系统性红斑狼疮患者使用免疫学检验联合检测诊断在临床上有良好效果，可及时判断患者疾病实际情况并提示患者预后情况，可在临床上广泛推广运用。     

信息-动机-行为技巧模型的延续护理对脑卒中患者照顾者的影响

目的 探讨基于信息-动机-行为技巧模型（IMB）对脑卒中患者照顾者的影响。方法 选择2017 年1 月至2019 年1 月在我院接受治疗的84 例脑卒中患者照顾者为研究对象,最终研究组35 例、对照组34 例完成研究。研究组基于IMB 模型对患者照顾者进行护理干预,对照组行常规护理。对比干预前后两组照顾者的照顾准备度、积极感受量表评分（PAC）、中文版照顾负担量表评分（ZBI）和焦虑抑郁自评量表评分（SAS、SDS）结果。结果 干预前两组照顾者的照顾准备度、积极感受量表评分、照顾负担量表评分、焦虑抑郁状况比较,差异无统计学意义（P＞0.05）;予以IMB 模型干预后研究组照顾者的照顾准备度为（20.05±3.35）分,PAC 评分为（39.20±4.81）分,均高于对照组（P＜0.05）;研究组ZBI 评分为（35.91±9.11）分,SAS 评分为（37.51±11.68）分,SDS 评分为（34.40±9.33）分,均低于对照组（P＜0.05）。结论IMB 模型的延续性护理可提高脑卒中患者照顾者的照顾准备度及积极感受,减轻照顾负担,缓解照顾负面情绪,提高脑卒中患者的护理质量。     

自制营养不良风险评估量表在原发性肝癌患者中的应用

目的：应用自制营养不良风险评估量表（以下简称自制量表）和欧洲营养风险筛查量表2002（NRS2002）对原发性肝癌患者进行营养评估,考查自制量表的适用性。方法选取2015年3～5月在天津市第三中心医院住院治疗的原发性肝癌患者100例,采用自制量表和NRS2002对患者进行营养评估,比较分析两种方法的关系及其与传统单项指标、肝功能分级的相关性。结果自制量表得分与体质量指数（BMI）、肱三头肌皮褶厚度（TSF）、上臂肌围（AMC）、血清前清蛋白（PA）、血清清蛋白（Alb）、血红蛋白（Hb）、淋巴细胞计数（TLC）均呈负相关（rs值分别为－0．436、－0．638、－0．312、－0．496、－0．386、－0．589、－0．407,P＜0．01）,与NRS2002评分呈正相关（rs＝0．893,P＜0．01）。自制量表以1．5分为截断判定患者是否需要给予营养支持,与NRS2002判定结果一致性较高（κ＝0．779,P＜0．01）。肝功能A、B、C级患者自制量表与NRS2002评定结果比较,差异均无统计学意义（P＞0．05）。结论自制量表评定结果可靠,具有一定的应用价值。     

血清与血浆免疫学检测结果一致性评价

目的对血清和血浆免疫学检测结果进行一致性评价。方法对20例受试者同时抽取血清和血浆,分析其免疫学检测定性结果的一致性,包括乙肝标志物6项、乙肝前S1抗原、梅毒特异性抗体（TP）、艾滋病毒抗体（Anti-HIV）、丙肝抗体、丙肝核心抗原（HCV-cAg）和TP-TRUST法共12项指标;并对除TP-TRUST外的前11项指标的ELISA法吸光度/临界（S/CO）值进行一致性评价。结果血清与血浆比较,所有免疫学检测指标定性结果完全一致,一致率为100%（P〉0.05）;前11项指标ELISA法S/CO值比较,Anti-HBs和HCV-cAg差异有统计学意义（P〈0.05）,其余9项指标差异无统计学意义（P〉0.05）。结论在样本分析前处理过程中,无论抽取受试者血清或血浆,对免疫学检测定性结果均无影响;但对乙肝表面抗体（Anti-HBs）和HCV-cAg的S/CO值有影响。建议免疫学定量试验抽取受试者血清。     

Bell氏麻痹的临床和免疫学检测

目的：探讨Bell氏麻痹与免疫功能的关系。方法：采用单向琼脂环状扩散法及聚乙二醇环状沉淀法，对35例Beel氏麻痹病人进行了血清免疫学指标IgG、IgA，IgM及CIC测定。结果：Bell氏麻痹组IgG，IgM和C3明显高于对照组（P＜0.01）；IgA在两组间无差异（P＞0.05）；Bell氏麻痹组CIC的阳性率明显高于对照组（P＜0．01）。结论：Bell氏麻痹与免疫功能异常有关。     

慢性肾衰患者应用肾康与自由饮食的比较研究

目的：探索解决慢性肾功能不全病人的营养疗法问题。方法：用用自制肾康对34例慢性肾功能不全患者进行营养治疗，采用随机对照法与常规疗法进行比较，结果：肾康能使患者（1）临床症状减轻；（2）血尿素氮治疗后较治疗前显著下降（P＜0．001），与对照组比较差异有显著性，（P＜0．001）；（3）血清磷较治疗前显著下降（P＜0．01）与对照组比较有显著性差异P＞0．05）。（4）血清钙较治疗前升高（P＜0．05）。与对照组比较差异无显著性（P＜0．05），未发现明显副作用，结论：肾康治疗慢性肾功能不全优于常规疗法，且服用方便。     

乙肝后肝硬化患者内源性一氧化氮水平与临床表现的关系

目的探讨肝硬化患者体内一氧化氮（NO）产生量与临床表现的关系。方法以Rivonal反应法检测血浆NOZ，评估NO产量，同时检测患者肝功、电解质、尿钠，对结果进行统计学分析。结果各组肝硬化患者血浆NO2-含量均高于对照组（分别为P＜0．05和P＜0．01），但与肝功各指标无相关性。高NO2-组平均动脉压、尿钠显著减少（P＜0．01），腹水、功能性肾衰发生率明显增加（P＜0．01和P＜0．05）。结论肝硬化时NO合成增加并可能介导高动力循环，从而引起腹水、浮肿等并发症。     

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.