首发未服药精神分裂症患者血浆IL-6水平与抑郁症状的相关性

目的 探讨首发未服药精神分裂症患者血浆促炎细胞因子IL-2、IL-6、IL-8、TNF-α与抑郁症状的关系。方法 选择浙江省立同德医院(浙江省精神卫生中心)2017年10月～2018年12月诊治的首发未服药精神分裂症患者100例为精神分裂症组;选择同期该地区社会招募的健康人群80例为对照组。采用阳性和阴性症状量表(Positive and negative syndrome scale,PANSS)评估患者的精神症状,采用卡尔加里精神分裂症抑郁量表(Calgary depression scale for schizophrenia,CDSS)评估患者抑郁症状的严重程度。采用双抗体夹心ABC-ELISA法检测所有受试者血浆IL-2、IL-6、IL-8、TNF-α浓度。根据CDSS评分将精神分裂症患者分为伴抑郁症状组(CDSS≥7分)和不伴抑郁症状组(CDSS7分)。分析促炎细胞因子水平与精神分裂症抑郁症状的相关性。结果 精神分裂症患者血浆IL-6水平显著高于健康对照组(t=6.341,P0.001);精神分裂症伴抑郁症状组PANSS总分、阴性症状因子分和一般精神病性症状因子分均高于不伴抑郁症状组(P0.05)。伴抑郁症状组血浆IL-6水平明显高于不伴抑郁症状组或健康对照组(Bonferroni校正后P0.001);而不伴随抑郁症状组与对照组IL-6水平无显著差异(Bonferroni校正后P0.05)。相关性分析显示,精神分裂症患者血浆IL-6水平与抑郁症状呈明显正相关(r=0.294,P0.001)。结论 首发未服药精神分裂症患者外周高水平的IL-6与抑郁症状的发生有关。     

慢性精神分裂症患者血浆白介素17与糖脂代谢的相关性研究

背景　精神分裂症的发病机制与炎症密切相关，而炎症水平与代谢水平密切相关。白介素（IL）-17是重要的炎症早期启动因子，其与精神分裂症患者糖脂代谢的关系值得研究。目的　探究慢性精神分裂症患者血浆IL-17水平与糖脂代谢的关系。方法　选取2018年4-6月安徽医科大学附属巢湖医院、合肥市第四人民医院、马鞍山市第四人民医院收治的符合研究标准的慢性精神分裂症患者为研究对象。依据患者血浆IL-17水平的四分位点，将其分为IL-17高水平组（≥P75）和IL-17低水平组（0.05）；两组患者发病年龄、高密度脂蛋白（HDL）水平、胰岛素水平、胰高血糖素水平比较，差异有统计学意义（P<0.05）。Spearman秩相关分析显示，血浆IL-17水平与HDL（rs=0.179，P=0.001）、胰高血糖素水平（rs=0.155，P=0.005）呈正相关。二元Logistic回归分析结果显示，HDL〔OR=6.24，95%CI（2.31，16.86），P<0.001〕、胰岛素〔OR=1.05，95%CI（1.01，1.10），P=0.021〕是慢性精神分裂症患者血浆IL-17水平的影响因素。结论　IL-17高水平的慢性精神分裂症患者胰岛素、胰高血糖素、HDL水平更高，且血浆IL-17水平与糖脂代谢存在关联。     

COPD患者诱导痰Th17相关细胞因子与BODE指数和GOLD分级的相关性

目的 分析慢性阻塞性肺疾病(COPD)患者诱导痰Th17细胞相关细胞因子水平及其与BODE指数和GOLD分级的相关性。 方法 选取53例急性加重期COPD患者为研究对象,同期入院体检的40例健康志愿者为对照组,分别于治疗前(AE-COPD组)和治疗后稳定期(S-COPD组)取痰诱导液,采用ELISA试剂盒测定Th17相关细胞因子IL-23、IL-1β、IL-17A及IL-17F水平,并分析其与患者BODE指数和GOLD分级的相关性。 结果 AE-COPD组和S-COPD组IL-23、IL-1β、IL-17A、IL-17F水平显著高于对照组(P<0.05),且AE-COPD组IL-23、IL-1β、IL-17A、IL-17F水平显著高于S-COPD组(P<0.05)。AE-COPD组BODE指数和GOLD分级均显著高于S-COPD组(P<0.05)。相关分析结果显示急性期IL-23、IL-1β、IL-17A、IL-17F水平与BODE指数和GOLD分级呈正相关性(P<0.05),稳定期IL-17A、IL-17F水平与BODE指数和GOLD分级呈正相关性(P<0.05)。 结论 IL-23、IL-1β、IL-17A、IL-17F均参与了COPD的发生和发展,急性期各指标水平与BODE指数和GOLD分级呈正相关性。      

首发精神分裂症患者血清细胞因子水平变化的研究

目的:探讨精神分裂症患者的免疫状态、细胞因子与精神症状的关系.方法:采用酶联免疫吸附测定法(ELISA) 检测45 例精神分裂症患者和30例健康志愿者血清IL-1β、IL-2 、TNF-α水平.结果:精神分裂症患者治疗前、后血清IL-1β、IL-2 、TNF-α含量显著高于对照组(P<0.05); 治疗后精神分裂症组血清IL-1β、IL-2水平比治疗前下降,差异有统计学意义(P<0.05),而TNF-α水平有下降趋势,但无统计学意义 (P>0.05).IL-lβ治疗前后的差值与PANSS量表减分率呈正相关(r=0.82,P＜0.05);治疗前IL-2与PANSS量表阳性症状评分呈正相关(r=0.55,P＜0.05);治疗前TNF-α与PANSS量表阴性症状评分呈正相关(r=0.69,P＜0.05).结论:精神分裂症患者处于免疫激活状态;IL-1β水平的变化也许可以作为抗精神病药物疗效的一个参考指标;细胞因子与精神病理之间存在着一定关系.     

2型糖尿病伴抑郁症患者认知受损与细胞因子的相关性

目的 探讨2型糖尿病伴抑郁症患者认知功能受损情况及细胞因子水平，了解认知功能受损与细胞因子的关系。方法 选取2019年6月至2021年12月就诊于郑州大学第一附属医院未进行抗抑郁治疗的80例2型糖尿病合并抑郁症患者(共病组),同期选取年龄、性别、受教育年限、糖尿病相关指标相匹配的82例无抑郁2型糖尿病患者作为对照组。两组均接受汉密尔顿抑郁量表评分(HAMD-17)和认知功能评定，抽取肘静脉血测定肿瘤坏死因子-α(TNF-α)和白细胞介素(IL)水平，包括IL-6、IL-2、IL-10、IL-18、IL-1β,采用Pearson偏相关分析2型糖尿病伴抑郁症患者细胞因子与认知功能的相关性。结果 (1)共病组注意/警觉性、信息处理速度、工作记忆、推理和解决问题评分低于对照组，IL-18、IL-6和IL-2水平高于对照组(P<0.05);(2)IL-6水平与推理和问题解决评分呈负相关，IL-18水平与工作记忆呈负相关(P<0.05)。结论 2型糖尿病伴抑郁症患者存在认知功能受损、细胞因子水平异常，细胞因子水平越高，患者认知功能受损越重。     

精神分裂症患者血清IL-1β、BDNF的表达与临床疗效的关系

目的：探讨血清白细胞介素-1β(IL-1β)、脑源性神经营养因子(BDNF)的表达水平与精神分裂症患者临床疗效的关系。方法：本研究采用前瞻性队列研究方法,选取2019年1月-2021年12月宜春市第三人民医院收治的84例精神分裂症患者,所有患者均接受4周的跟踪治疗。调查所有受试对象临床资料并记录,应用Spearman分析精神分裂症患者血清IL-1β、BDNF与临床疗效的相关性,采用logistic回归分析影响精神分裂症患者疗效的影响因素。结果：治疗期间,84例精神分裂症患者中,中途退出4例,最终80例患者完成治疗;治疗4周,80例患者中显效10例,显著进步26例,好转28例,无效16例;治疗无效组精神分裂症患者血清IL-1β高于治疗有效组,血清BDNF低于治疗有效组,差异均有统计学意义(P<0.05);经Spearman相关性检验,结果显示,精神分裂症患者血清IL-1β水平与临床治疗效果呈正相关(r_s=0.617,P<0.001),血清BDNF与临床治疗效果呈负相关(r_s=-0.562,P<0.001);后进一步经logis...     

Th17相关细胞因子与斑秃关系的研究

目的探讨Th17相关细胞因子与斑秃发病的关系。方法将40例斑秃患者分为活动期组20例和稳定期组20例,采用ELISA法检测患者血清中IL-17和IL-23的水平,与20例正常对照组比较,并分析IL-17和IL-23之间的相关性。结果斑秃活动期组血清IL-17水平明显高于稳定期组和正常对照组,差异有统计学意义（P〈0．01）,斑秃稳定期组血清IL-17水平亦明显高于正常对照组,差异有统计学意义（P〈0．05）;斑秃活动期组血清IL-23水平明显高于稳定期组和正常对照组,差异有统计学意义（P〈0．05和P〈0．01）,斑秃稳定期组血清IL-23水平亦明显高于正常对照组,差异有统计学意义（P〈0．05）。斑秃患者血清IL-17与IL-23水平呈正相关关系（相关系数r=0．50,P〈0．01）。结论斑秃的发病可能与Th17相关细胞因子平衡失调有关,表现为Th17相关细胞因子反应亢进。     

强直性脊柱炎患者Th17/Treg相关细胞因子及 miR-155与脊柱活动度的关系

探讨强直性脊柱炎患者辅助性T细胞17（Th17）/调节性T细胞（Treg）相关细胞因子、微小核糖核酸-155（miR-155）与脊柱活动度的关系。方法 回顾性分析2018年1月～2021年3月 我院收治的强直性脊柱炎患者116例为观察组,根据强直性脊柱炎疾病活动指数（BASDAI）分为活动期（BASDAI≥4,n=52）、稳定期（BASDAI＜4,n=64）;另选取同期于我院进行健康体检的健康志愿者97例为对照组。对比各组Th17/Treg相关细胞因子、miR-155表达水平;对比活动期和稳定期的脊柱活动度Bath AS测量指数（BASMI）,分析强直性脊柱炎患者Th17/Treg相关细胞因子、miR-155与脊柱活动度的相关性。结果 观察组IL-17、IL-23、miR-155表达水平明显高于对照组（P＜0.05）。活动期IL-17、IL-23、miR-155表达水平明显高于稳定期（P＜0.05）。活动期强直性脊柱炎患者BASMI评分明显高于稳定期（P＜0.05）。经 Pearson相关系数分析显示,强直性脊柱炎患者IL-17、IL-23、miR-155表达水平与BASMI评分呈正相关,IL-10、TGF-β表达水平与BASMI评分呈负相关（P＜0.05）。结论 强直性脊柱炎患者高表达miR-155、Th17相关细胞因子、低表达Treg相关细胞因子,Th17/Treg呈失衡状态,且Th17/Treg相关细胞因子、miR-155与强直性脊柱炎患者脊柱活动度具有一定的相关性,可作为临床评估病情的辅助检查。     

首发精神分裂症患者治疗前后血清中细胞因子水平的变化

目的：观察抗精神病药物治疗精神分裂症患者前后血清细胞因子的变化,探讨细胞因子在精神分裂症病理、生理机制中的作用.方法：70例首发精神分裂症患者作为研究组,应用利培酮治疗8 周,采用阳性症状评定量表和阴性症状评定量表（PANSS）评定患者的精神症状.ELISA方法检测患者治疗前后血浆白细胞介素1（IL -1β）、白细胞介素2（IL - 2）、肿瘤坏死因子 （TNF-α）水平.35例健康成年人作为对照组,同样方法检测细胞因子水平.结果：①治疗前研究组IL -1β、TNF-α水平显著高于对照组,IL-2显著低于对照组.IL-1β、TNF-α水平在Ⅰ型和Ⅱ型精神分裂症患者之间无显著性差异,Ⅰ型精神分裂症患者IL-2水平显著高于Ⅱ型患者.②治疗后IL -1β水平与治疗前相比显著性降低,IL-2水平显著性增高,但与对照组比较仍有显著性差异.结论：①精神分裂症患者存在免疫激活,细胞因子水平的变化可能与精神分裂症的亚型有关;②抗精神病药利培酮对精神分裂症激活的免疫应答产生一定程度的抑制作用.     

首发精神分裂症患者调节性T细胞及相关细胞因子变化

目的 探讨首发精神分裂症患者调节性T细胞及细胞因子变化及与精神症状的关系。方法 采用流式细胞仪技术检测27例首发精神分裂症患者和27例健康体检者外周血CD4+CD25+Foxp3+调节性T细胞（Treg）占CD4+T细胞的百分率,酶联免疫吸附试验检测血清IL-10及TGF-β1水平,采用阳性与阴性症状量表（PANSS）评定精神分裂症患者精神症状。Treg细胞、TGF-β1与年龄、病程、教育年限和精神症状以及细胞因子的相关性采用Spearman相关分析。结果首发精神分裂症患者Treg细胞百分率为（0.03±0.01）%,明显低于对照组（0.04±0.02）%（t=-3.681,P=0.001）;首发精神分裂症患者血清TGF-β1[（1.40±1.16）pg/ml]水平明显高于对照组[（0.75±0.81）pg/ml]（t=2.376,P=0.021）,但IL-10水平在精神分裂症组[（0.12±0.25）pg/ml]和对照组[（0.12±0.26）pg/ml]间比较差异无统计学意义（t=0.432,P=0.668）。首发精神分裂症患者的Treg百分率与教育年限呈正相关（r=0.452,P=0.018）,与年龄、病程和精神症状无相关性;TGF-β1与年龄、病程、教育年限和精神症状之间均无相关性。首发精神分裂症患者的Treg细胞百分率与IL-10、TGF-β1间均无相关性。结论首发精神分裂症存在免疫抑制机制受损,Treg及TGF-β1可能在首发精神分裂症患者免疫失衡的病理生理机制发挥着重要的作用。     

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.