溃疡性结肠炎患者血浆炎性反应细胞因子水平的变化

目的:观察不同分期溃疡性结肠炎(UC)患者血浆中炎性反应细胞因子的表达情况。方法:检测24例活动期(活动期组)和18例缓解期(缓解期组)UC患者和28例健康体检者(对照组)血浆中IL-1β、IL-6、TNF-α及TGF-β等炎性反应细胞因子的浓度,并进行对比分析。结果:活动期UC患者外周血IL-6和TNF-α水平均显著高于对照组和缓解期组,而TGF-β较对照组显著降低(P<0.05)。结论:UC活动期患者血浆中促炎细胞因子水平增高,而抑炎细胞因子水平降低,细胞因子水平的变化可能在UC发病机制中起作用。     

溃疡性结肠炎患者血小板功能的临床研究

目的探讨血小板活化和溃疡性结肠炎的关系。方法对22例活动期溃疡性结肠炎、13例缓解期溃疡性结肠炎和正常对照组30例用FACSCAN型流式细胞仪检测血小板表面纤维蛋白原受体(PAC-1)和血小板α-颗粒膜糖蛋白(CD62P),用酶联免疫法检测血栓素B2(TXB2)。结果活动期UC患者血PAC-1、CD62P均较缓解期和对照组高,差异有显著性(P<0.05);活动期UC患者血浆TXB2较缓解期UC患者和对照组高,差异有显著性(P<0.01);缓解期患者PAC-1、CD62P仍高于正常对照组(P<0.05),缓解期TXB2与正常对照组无明显差异(P>0.05)。CD62P及TXB2与病情程度有关(P<0.05)。结论活动期溃疡性结肠炎体内存在血小板活化,PAC-1、CD62P是溃疡性结肠炎较特异的指标,TXB2影响血液高凝状态,抗血小板药物对溃疡性结肠炎有一定效果。     

血浆对氧磷酯酶1活性在溃疡性结肠炎中的变化及临床意义

目的探讨对氧磷酯酶1（PON1）活性在溃疡性结肠炎（UC）中的变化及临床意义。方法分别测定44例活动期UC患者、23例缓解期UC患者及32例健康对照者的血浆PON1、C-反应蛋白（CRP）及丙二醛（MDA）含量,分析其相关性。结果活动期及缓解期UC组血浆CRP、MDA含量显著高于对照组（P〈0.05）,血浆PON1活性显著低于对照组（P〈0.05）。活动期患者组血浆CRP、MDA含量显著高于缓解期患者组（P〈0.05）,血浆PON1活性显著低于缓解期患者组（P〈0.05）。UC患者组对氧磷酯酶1活性与MDA及CRP水平呈负相关（r=-0.358,P〈0.01,r=-0.422,P〈0.01）。结论UC患者PON1活性显著降低,增加的氧自由基（OFR）导致致氧化环境可能使血浆PON1活性显著降低。     

亲环素A及其自身抗体与溃疡性结肠炎的相关性

目的:探讨血浆和淋巴细胞内亲环素A(CyP A)水平及CyP A自身抗体与溃疡性结肠炎(UC)的关系。方法:用双抗体夹心ELISA法测定67例活动期、49例缓解期UC患者和50名健康体检(正常对照组)者血浆和淋巴细胞内CyP A水平同时用间接ELISA法检测抗CyP A自身抗体,统计分析其间关系。结果:UC活动期患者血浆和淋巴细胞CyP A水平均显著高于正常对照组和缓解期UC患者(P<0.01),但正常对照组与缓解期UC患者差异无统计学意义(P>0.05)。UC活动期患者抗CyPA自身抗体阳性者也显著高于缓解期UC患者及正常对照组(P<0.01)。结论:血浆和淋巴细胞内CyP A升高和抗CyP A自身抗体阳性可反映UC活动性。     

血清C反应蛋白和IL-10在溃疡性结肠炎患者临床评估中的作用

目的对溃疡性结肠炎（UC）患者进行血清中C反应蛋白（CRP）和IL-10水平的检测,并分析CRP及IL-10与UC患者的临床疗效和预后之间的关系。方法收集28例活动期UC患者、13例缓解期UC患者及42例健康成人血清标本,检测CRP及IL-10水平,观察CRP及IL-10与临床治疗效果和预后的相关性。结果活动期UC患者血清CRP水平及IL-10水平比缓解期患者及正常成人明显升高,差异有统计学意义（P〈0．001）。结论CRP和IL-10在活动性UC患者血清中显著升高,并可用于判断UC病变程度与活动度。     

血清C反应蛋白和D-二聚体联合检测在溃疡性结肠炎病情活动性判断中的价值

目的通过检测溃疡性结肠炎(UC)患者的血清C反应蛋白(CRP)及D-二聚体水平,探讨二者在UC患者病情活动及严重程度判断中的应用价值。方法分别采用胶乳增强免疫比浊法与免疫扩散比浊法检测64例活动期UC患者、45例缓解期UC患者及40例健康对照者血清CRP及D-二聚体水平,并对活动期患者行肠镜及病理组织学检查,评价病情程度。结果(1)活动期UC组患者血清CRP及D-二聚体水平与缓解期UC组及对照组比较,差异均有统计学意义(P<0.01);缓解期UC组CRP水平与对照组比较,差异有统计学意义(P<0.05),而D-二聚体水平与对照组比较,差异无统计学意义(P>0.05)。(2)重型UC患者血清CPR及D-二聚体水平与轻、中型患者比较,差异有统计学意义(P<0.05)。结论血清CRP及D-二聚体水平可作为评价UC患者病情活动性及严重程度的良好指标。     

粪便钙卫蛋白联合血清C-反应蛋白对溃疡性结肠炎活动性判定的临床意义

目的研究粪便钙卫蛋白(fecal calprotectin,FC)联合血清C-反应蛋白(C-reactive protein,CRP)对溃疡性结肠炎(Ulcerative colitis, UC)活动性判定的意义。方法收集2017年10月至2018年5月牡丹江医学院红旗医院门诊及住院UC患者共80例,其中缓解期36例,活动期44例(轻度16例、中度23、重度5例),采用ELISA方法定量检测FC浓度,同时采集空腹静脉血6mL,行血清CRP测定,另选择30例体检患者设为正常对照组并行FC检测。结果 UC患者中粪便钙卫蛋白浓度高于正常对照组(P0.01),且在UC患者中活动期各组均高于缓解期组(P0.05),活动期各组之间两两比较均有明显差异(P0.05)。血清CRP在UC患者中活动期各组均高于缓解期组(P0.05),活动期各组之间两两比较均有明显差异(P0.05);FC及血清CRP在UC患者各组均升高,且随着UC活动性分级相关。结论 FC作为一种新型的炎症标记物,联合血清CRP检测对溃疡性结肠炎活动性判定的临床意义。     

溃疡性结肠炎患者外周血中性粒细胞凋亡与CRP、IL-6水平的关系

目的 观察溃疡性结肠炎(UC)患者外周血中性粒细胞(PMN)凋亡的变化，并检测C反应蛋白(CRLP)、IL-6水平的变化，探讨UC患者PMN凋亡与CRP、IL-6水平的关系。方法 采用流式细胞术检测28例UC病人外周血PMN凋亡。结果 活动期UC患者PMN凋亡率明显低于健康人对照组和缓解期UC患者。缓解期UC患者PMN凋亡率与对照组无差别。不同病情活动期UC患者PMN凋亡有显著性差异。活动期UC患者外周血中CRP、IL-6水平均高于对照组和缓解组，且与PMN凋亡呈负相关，与病情呈正相关。缓解组患者CRP、IL-6与对照组无显著性差异。结论 UC患者PMN凋亡延迟，且与病情及疗效密切相关。IL-6产生过多可导致肝脏合成CRP增高，同时可能是导致PMN凋亡延迟的重要因素。适度调控PMN凋亡。有可能会成为治疗UC的有效途径。     

大麻素受体在溃疡性结肠炎患者血清和肠组织中的表达

目的检测大麻素受体1(CNR1)和大麻素受体2(CNR2)在溃疡性结肠炎(UC)患者血清和肠组织中的表达,探讨其与UC的关系及临床意义。方法连续收集35例UC(UC组)、20例已排除炎症性肠病的普通肠炎患者(疾病对照组)和15例肠黏膜病理正常者(正常对照组),用酶联免疫吸附(ELISA)法检测其血清中CNR1、CNR2、C反应蛋白(CRP)和白介素(IL)-10表达水平;免疫组化法检测肠道黏膜中CNR1和CNR2的表达情况。结果 UC患者血清中CNR1、CNR2含量明显高于两个对照组(P<0.05)。UC活动期血清中CNR1、CNR2、IL-10表达量要低于缓解期,而CRP高于缓解期(P<0.01)。UC肠道黏膜CNR1、CNR2表达率明显高于普通肠炎黏膜以及正常肠黏膜(P<0.05),而后两者相比差异无统计学意义。结论 CNR在UC中表达显著上调,表明CNR对UC的发生发展可能起着重要作用。     

溃疡性结肠炎患者血浆P-选择素、血小板膜糖蛋白Ⅰb/Ⅸ/Ⅴ复合物与疾病活动性的关系

目的探索溃疡性结肠炎(ulcerative colitis,UC)患者血浆P-选择素(P-selectin)、血小板膜糖蛋白(GP)Ⅰb/Ⅸ/Ⅴ复合物与疾病活动性的关系。方法选择28例UC活动期、16例UC缓解期患者和26例健康志愿者,采用ELISA法检测血浆P-selectin,比浊法检测血小板最大聚集率(MAR),并采用流式细胞仪检测GPⅠb/Ⅸ/Ⅴ复合物。结果活动期UC患者血浆P-selectin、血小板MAR较缓解期患者及健康者明显升高(P0.01或P0.05),而GPⅠb/Ⅸ/Ⅴ复合物的表达显著降低(P0.01或P0.05)。结论溃疡性结肠炎患者存在血小板激活,血浆P-selectin和GPⅠb/Ⅸ/Ⅴ复合物作为血小板激活的标志物,与疾病的活动程度相关,可以作为UC活动期的指标。     

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.