MBP、抗神经节苷脂抗体与格林-巴利综合征亚型及严重度相关性分析

目的：通过检测格林-巴利综合征（GBS）患者血清麦芽糖结合蛋白（MBP）和抗神经节苷脂抗体水平,探讨其与格林-巴利综合征亚型及严重度的相关性。方法选用2009年3月至2012年3月在我院治疗的格林-巴利综合征患者90例作为观察组,选取同期其他神经系统疾病患者90例作为对照1组和健康体检者100例作为对照2组。采用酶联免疫吸附法（ELISA）检测三组受试者的血清MBP和抗神经节苷脂抗体水平,并进行对比分析。结果（1）观察组血清MBP水平、抗神经节苷脂抗体阳性率均显著高于对照1组和对照2组,其差异均有统计学意义（P〈0.05）;对照1组血清中MBP水平显著高于对照2组,两组MBP差异具有统计学意义（P〈0.05）。（2）急性炎性脱髓鞘性多发性神经根神经病（AIDP）患者血清MBP水平与急性运动轴索型神经病（AMAN）、急性运动感觉轴索型神经病（AMSAN）及米勒费雪症候群（MFS）比较差异均无统计学意义（P〉0.05）;AIDP患者血清抗神经节苷脂抗体阳性率显著高于AMAN、AMSAN及MFS ,其差异均有统计学意义（P〈0.05）。（3）病情等级越高GBS患者血清中MBP水平、抗神经节苷脂抗体阳性率越高,不同等级间的差异均有统计学意义（P〈0.05）。结论 MBP、抗神经节苷脂抗体与格林-巴利综合征严重度呈正相关,抗神经节苷脂抗体可能与格林-巴利综合征亚型AIDP相关。     

中枢神经系统疾病脑脊液寡克隆区带检测的临床意义

目的探讨脑脊液寡克隆区带（CSF—OCB）在中枢神经系统疾病中的临床意义。方法本文采用改良聚丙烯酰胺凝胶电泳-银染色的方法检测脑脊液寡克隆区带。结果中枢神经系统炎性疾病（NID）脑脊液寡克隆区带阳性率为38．7％（99／256），其中格林-巴利组（GBS）为48．5％（43／70），多发性硬化组（MS）为42．8％（30／70），脑膜炎组为21．6％（16／74），脊髓炎组为16．6％（7／42）；而中枢神经系统非炎性疾病（NNID）寡克隆区带阳性率为5．7％（7／115），其中脑梗死组5％（1／20），脑瘤组13．3％（2／15），特发性癫痫组3，3％（1／30），运动神经元病组2％（1／50）；NID组阳性率与NNID阳性率比较，差异有统计学意义（P〈0．05），MS组和GBS组分别与NID组阳性率比较差异无统计学意义（P〉0．05），但两组分别与NNID组比较，差异均有统计学意义（P〈0．05）。结论NID组的脑脊液寡克隆区带出现高阳性结果，其中GBS和MS阳性表达最为显著，NNID组阳性率较低，提示脑脊液寡克隆区带检测对诊断中枢神经系统炎性疾病，特别是对诊断GBS和MS有较大的诊断意义。     

炎性脱髓鞘疾病患者S-100b和MBP的检测及其意义

目的:通过检测炎性脱髓鞘疾病患者脑脊液(CSF)中S-100b和碱性髓鞘蛋白(MBP)的含量及其相互关系,对炎性脱髓鞘疾病的发病机制进行探讨,并对S-100b的临床意义进行评价。方法:对43名多发性硬化患者(MS)、25名格林-巴利患者(GBS)和39名正常对照者分别采用酶联免疫吸附试验检测脑脊液S-100b水平,同时应用改良的酶联免疫吸附同步法检测MBP含量以及应用改进的Thompson聚丙稀酰胺凝胶电泳法检测寡克隆IgG区带。结果:MS组和GBS组CSF中的S-100b及MBP水平均显著升高,与正常对照组比较有显著性差异(P<0.01),两者具有相关性(P<0.01);两组CSF IgG-OB阳性率(分别为83.7%、68.0%)也显著高于正常对照组(均为P<0.01)。结论:S-100b可能参与了炎性脱髓鞘疾病的发病机制,S-100b、MBP水平在一定程度上反映了脱髓鞘患者的严重程度,有助于病情预后的判断。     

格林-巴利综合征患者脑脊液和血清中髓鞘碱性蛋白与IL-16的检测

格林-巴利综合征（GBS）又称急性感染性多发性神经炎、急性炎症性脱髓鞘性多发性神经病，常可导致全身性瘫痪，是病因未明，病情进展迅速而大部分可恢复的运动神经疾病。我们对24例GBS病例的血清和脑脊液（CSF）髓鞘碱性蛋白（MBP）和IL-16和进行了研究。现报告如下。     

小儿病毒性心肌炎血清肌钙蛋白Ⅰ测定的意义

目的 :通过对病毒性心肌炎患儿血清心脏肌钙蛋白I(cTnI)的检测 ,判断cTnI对诊断病毒性心肌炎 (VM )的意义。方法 :以固相免疫层析法测定病毒性心肌炎患儿的血清cTnI。结果 :病毒性心肌炎患儿入院后第 1天的血清cTnI阳性率为 70 .73% ( 2 9/4 1) ,对照组阳性率 4 .35% ( 1/2 3) ,差异非常显著 (P <0 .0 1)。第 2周和第 4周VM组的血清cTnI阳性率分别为 10 0 .0 0 % ( 2 9/2 9)和 51.72 % ( 15/2 9)。结论 :测定cTnI对VM早期诊断有较大的临床意义     

MBP,TNF-α在格林-巴利综合征与多发性硬化发病机制中的作用

目的了解格林-巴利综合征(GBS)和多发性硬化(MS)患者血清髓鞘碱性蛋白(MBP)和肿瘤坏死因子-α(TNF-α)的水平,探讨MBP及TNF-α在GBS和MS发病过程中的作用。方法采用ELISA对24例GBS和36例MS患者的血清MBP和TNF-α进行测定,并与28例其他神经系统疾病(OND组)和30例正常对照(NC组)进行比较。结果MS组和GBS组的MBP,TNF-α水平均高于OND组及对照组(均P<0.01),且GBS组的MBP,TNF-α的水平高于MS组(P<0.01)。结论MBP,TNF-α水平在GBS和MS均升高,尤其是在GBS中,MBP,TNF-α升高较明显。MBP,TNF-α在GBS和MS发病机制中起重要作用。     

格林-巴利综合征患者血清肿瘤坏死因子α及髓鞘碱性蛋白水平变化

目的探讨格林-巴利综合征患者血清肿瘤坏死因子α（TNF-α）及血清髓鞘碱性蛋白（MBP）的变化情况及两者在格林-巴利综合征发病中的作用。方法选择我院2005~2010年收治的格林-巴利综合征患者30例,作为研究组,选择同期健康体检者30例作为对照组,分别检测各组患者血TNF-α及MBP变化情况,并进行组间及组内比较。结果研究组患者血清TNF-α及MBP水平均高于对照组,差异均有统计学意义（P〈0.05）;在格林-巴利综合征患者中,血TNF-α及MBP水平随病情的加重而升高,且不同病情分级患者上述指标差异有统计学意义（P〈0.05）。结论血清肿瘤坏死因子-α及髓鞘碱性蛋白与格林-巴利综合征患者发病及病情轻重有重要关系,临床密切监测该指标有助于格林-巴利综合征的发现及病情判断。     

儿童急性格林─巴利综合征血清IL-6水平研究(论著摘要)

为探讨白细胞介素6（interleukin6，IL－6）在儿童格林一巴利综合征（GBS）免疫发病机制中的作用，检测了23例急性GBS患儿血清IL－6的水平。研究对象和方法GBS组23例，男14例，女9例，年龄2～14岁，平均7.3岁，诊断均符合Asbury（199）修订的诊断标准，病情轻重按HughesRAC（1978）分为轻型和重型。病后2～13d抽血。正常对照组25例，男16例，女9例，年龄4～13岁，平均8岁。取静脉血2ml离心收集血清，-70C冻存。IL－6试剂盒购自法国国际免疫技术有限公司。3．99Pg／ml以下为阴性。实验方法略。结果GBS患儿检出阳性数为12，阳性率为…     

MAG抗体和硫脂抗体在格林-巴利综合征中的意义

目的探讨MAG抗体和硫脂抗体在格林-巴利综合征(GBS)中的意义。方法应用ELISA方法检测33例GBS、32例多发性硬化(MS)患者、21例其他周围神经疾病(OPN)患者、100例健康对照者(NC)血清和(或)脑脊液中MAG抗体、硫脂抗体的阳性率。结果GBS患者血清上述抗体阳性率与MS组及OPN组相比较差异均有显著性(P0.05)。MAG抗体的产生与前驱感染关系密切,同对照组相比差异有显著性(P0.05)。GBS患者血清和脑脊液中上述抗体之间无明显相关性(P0.05)。结论血清和脑脊液上述抗体增高对格林-巴利综合征的诊断和治疗有临床意义,并有助于进一步揭示其发病机制。     

格林-巴利综合征患儿淋巴细胞亚群的变化

本文测定了32例格林-巴利综合征(GBS)患儿,15例健康小儿外周血T淋巴细胞亚群、B细胞,血清免疫球蛋白的含量,结果表明:(1)患儿组与对照组比较,T细胞亚群没有明显变化;(2)B细胞及血清中免疫球蛋白含量均高于对照组。提示:GBS患儿机体免疫功能紊乱可能主要涉及B细胞及血清中免疫球蛋白的变化。     

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.