分枝杆菌多糖治疗支气管哮喘的临床研究

对５２例支气管哮喘发作期患者进行了外周血Ｔ细胞亚群、ＩｇＧ４、ＩｇＥ、ｓＩＬ－２Ｒ、ＡＣＴＨ及皮质醇的测定。结果显示哮喘发作期ＩｇＧ４、ＩｇＥ、ｓＩＬ－２Ｒ及ＡＣＴＨ均显著升高，提示哮喘患者存在细胞免疫及内分泌功能的异常。将分枝杆菌多糖（ＭＰＳ）用于３２例哮喘患者的治疗，结果与２０例常规治疗组比较，ＭＰＳ组ＣＤ４＋／ＣＤ８＋比值明显升高，ＩｇＧ４和ｓＩＬ－２Ｒ显著下降，而皮质醇和ＡＣＴＨ无明显变化。     

支气管哮喘发病中细胞因子的作用

目的：了解Ｔ－Ｂ淋巴细胞在哮喘发病中的作用,嗜酸粒细胞（ＥＯＳ）,可溶性白细胞介素－２受体（ＳＩＬ－２Ｒ）,ＩｇＥ和Ｔ淋巴细胞亚群（ＣＤ３、ＣＤ４、ＣＤ８）,人类组织相关抗原（ＨＬＡ－ＤＲ）百分率表达与气道高反应（ＡＨＲ）的关系。方法：３０例支气管哮喘患者口服强的松２０ｍｇ／ｄ,疗程一周,治疗前后检测肺功能最高峰值流速（ＰＥＦ）,第一秒用力呼气容量（ＦＥＶ１）,并检测外周血ＥＯＳ、ＳＩＬ－２Ｒ、ＩｇＥ、ＣＤ３、ＣＤ４、ＣＤ８和ＨＬＡ－ＤＲ百分率。结果：ＥＯＳ、ＳＩＬ－２Ｒ、ＩｇＥ水平及ＣＤ４、ＨＬＡ－ＤＲ百分率明显下降（Ｐ＜０．０１）,而反映通气功能的指标ＰＥＦ,ＦＥＶ１明显好转（Ｐ＜０．０１）。结论：ＥＯＳ、ＳＩＬ－２Ｒ、ＩｇＥ和ＣＤ４、ＨＬＡ－ＤＲ百分率表达增强在哮喘发病中起着重要作用。     

婴幼儿哮喘早期长程防治方案探讨

为了探讨婴幼儿哮喘的防治方法并了解其预后，从１９９０～１９９５年，我们对陆续收治的３３０例婴幼儿哮喘随机单盲分为５组。Ａ组：６３例应用必可酮气雾剂与酮替芬防治：Ｂ组：６６例应用脱敏治疗口服酮替芬防治：Ｃ组：６７例应用必可酮气雾剂，脱敏治疗及口服酮替芬防治；Ｄ组：６７例仅口服酮替芬和氨茶硷防治：Ｅ组（对照组）：６７例仅于急性发作期治疗。防治组总疗程至少一年，平均随访２～３年，结果发明：Ａ、Ｂ．Ｃ组有效率高达８０．１％（５１／６３），８４．４％（５６／６６），９２．５％（６２／６８），令人满意。Ｄ组、Ｅ组有效率分别为５６．１％（３７／６６）与２６．５％（１８／６８），提示预后不良。作者建议对婴幼儿哮喘应采用早期、正规、长程联合防治。     

二丙酸倍氯米松联合酮替芬防治毛细支气管炎后婴幼儿哮喘的研究

目的　观察低剂量二丙酸倍氯米松和酮替芬联合应用能否降低毛细支气管炎后支气管哮喘患病率。方法　 5 6例毛细支气管炎患儿为治疗组 ,采用低剂量二丙酸倍氯米松局部吸入 ,口服酮替芬 ,疗程 6～ 9个月 ;32例毛细支气管炎患儿不用药作为对照组。临床随访≥ 1年 ,观察两组患儿哮喘发生率。同时检测治疗前、后患儿肺功能及骨密度。结果　完成随访 1年以上者 ,治疗组 5 2例中仅 3例 (5 77% )发生哮喘 ,而对照组 30例中有 14例 (4 6 6 7% )发生哮喘 ,两组比较有显著性差异 (P <0 0 1)。治疗组患儿肺功能与治疗前比较亦有显著性差异。两组骨密度检测治疗前、后比较无显著差异。结论　低剂量二丙酸倍氯米松局部吸入与酮替芬联合应用可降低毛细支气管炎后婴幼儿哮喘患病率     

轮状病毒肠炎患儿免疫功能动态变化及其临床意义

采用透射比浊法和抗体致敏红细胞花环试验检测了３８例生长发育正常的轮状病毒肠炎（ＲＶＥ）患儿血清免疫球蛋白和Ｔ细胞亚群。结果显示：急性期血清ＩｇＧ、ＩｇＡ、ＩｇＭ、ＣＤ３、ＣＤ４、ＣＤ４／ＣＤ８比值明显降低于对照组及恢复期（Ｐ＜００１），尤其是ＩｇＡ、ＣＤ４／ＣＤ８比值较对照组降低更为明显（Ｐ＜０００１），ＣＤ８明显高于对照组及恢复期（Ｐ＜００１）。恢复期随着临床症状逐渐消失，ＩｇＧ、ＩｇＡ、ＩｇＭ、ＣＤ３、ＣＤ４、ＣＤ４／ＣＤ８比值升高，ＣＤ８降低、并逐渐恢复正常，与对照组之间无显著性差异（Ｐ＞００５）。结果表明：细胞免疫和体液免疫功能参与了ＲＶ的感染过程，ＩｇＡ、ＣＤ４／ＣＤ８比值与疾病的预后有关。     

儿童呼吸道疾病外周血淋巴细胞CD23水平的临床意义

（目的）探讨呼吸道疾病患儿外周血淋巴细胞（ＰＢＬ）ＣＤ２３百分率的变化及临床意义。（方法）利用间接玫瑰花结法测定了２０例支气管肺炎患儿（Ａ组）及９例毛细支气管炎并心衰的重症肺炎患儿（Ｂ组）ＰＢＬ的ＣＤ２３百分率，并用ＥＬＩＳＡ方法测定了Ｂ组血清总ＩｇＥ水平。（结果）与正常对照组比较。Ａ组ＣＤ２３百分率增高，且急性期患儿高于恢复期患儿。Ｂ组血清总ＩｇＥ水平亦明显增高。（结论）ＰＢＬ的ＣＤ２３百分率的     

34例婴幼儿哮喘发作期的免疫学改变

对３４例婴幼儿哮喘发作期患儿进行外周血Ｔ淋巴细胞亚群、血清总ＩｇＥ及ＩｇＧ、ＩｇＡ、ＩｇＭ测定，并设健康儿为对照组进行了比较。结果表明观察组ＣＤ＋２、ＣＤ＋４及ＣＤ＋４／ＣＤ＋８比值比对照组减少（前者Ｐ＜０．０５，后二者Ｐ＜０．０１）；观察组血清总ＩｇＥ平均值为１４０８．７ＩＵ／ｍｌ，明显高于本院正常值（＜４５０ＩＵ／ｍｌ），而ＩｇＧ、ＩｇＡ、ＩｇＭ值经统计学处理与本院正常值对比差异无显著性。     

哮喘患儿外周血淋巴细胞CD23分子表达和IgE水平相互关系探讨

目的：探讨哮喘患儿外周血淋巴细胞ＣＤ２３分子表达与ＩｇＥ水平相互关系。方法：用单克隆抗体结合ＡＰＡＡＰ桥联酶标技术和ＩＲＭＡ技术对６１例哮喘患儿外周血淋巴细胞ＣＤ２３分子表达和血清总ＩｇＥ水平进行研究测定。结果：哮喘组外周血单个核细胞和Ｂ细胞中ＣＤ２３＋细胞百分率明显高于正常对照组（Ｐ＜０．００１）；Ｂ细胞中ＣＤ２３＋细胞的比例高于外周血单个核细胞（Ｐ＜０．０１）；外源型哮喘与内源型相比，ＣＤ２３＋细胞百分率有显著性差异（Ｐ＜０．０５）。哮喘组血清总ＩｇＥ水平明显高于对照组（Ｐ＜０．００１），以外源型哮喘升高为明显。哮喘患儿Ｂ细胞中ＣＤ２３＋细胞百分率与血清总ＩｇＥ水平之间显著正相关。结论：提示ＣＤ２３主要表达于活化的Ｂ细胞，并直接参与了ＩｇＥ介导的过敏性哮喘的发病。     

自体瘤苗预防膀胱癌术后复发的近期效果观察

目的：研究石蜡包埋癌组织制备的自体瘤苗（ＰＥＴＶ）预防膀胱癌术后复发的近期效果。方法：ＰＥＴＶ１．０ｍｌ多点皮内注射，每周１次，４次为一疗程。每疗程前后测定ＣＤ３＋、ＣＤ４＋、ＣＤ８＋、ＣＤ４＋／ＣＤ８＋、ＬＴＴ、ＮＫ和ＩｇＡ、ＩｇＧ、ＩｇＭ。结果：１６例患者治疗后ＣＤ３＋、ＣＤ４＋、ＣＤ４＋／ＣＤ８＋、ＬＴＴ、ＮＫ和ＩｇＧ比治疗前明显增高（Ｐ＜０．０５）。随访１２～２０个月，未见肿瘤复发。结论：ＰＥＴＶ抗原容易获得，用以预防膀胱癌术后复发近期效果满意     

转移因子加IVIG佐治营养不良并肺炎的临床及免疫学研究

本文用转移因子加丙种球蛋白（ＩＶＩＧ）治疗营养不良并肺炎患儿２７例，与２５例对照组比较，退热、止咳、止喘、肺部罗音消失时间和平均住院天数明显缩短；血清ＩｇＧ、ＩｇＡ和外周血ＣＤ３、ＣＤ４、ＣＤ８细胞及ＣＤ４／ＣＤ８比值均明显提高，无不良反应及副作用。本文认为转移因子加丙种球蛋白佐治营养不良并肺炎，效果确切，安全可靠。     

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.