病毒性心肌炎肿瘤坏死因子-α的检测及意义

目的：探讨病毒性心肌炎患者血清肿瘤坏死因子-α（TNF-α）的变化及临床意义。方法：采用酶联免疫吸附试验（ELISA）法测定44例病毒性心肌炎患者血清TNF-α，并与正常对照组30例进行比较。结果：病毒性心肌炎患者急性期TNF-α明显高于恢复期及正常对照组；急性期血清TNF-α水平与磷酸肌酸激酶同工酶（CK-MB）、乳酸脱氢酶同工酶（LDH1）呈正相关，恢复期血清TNF-α水平与CK-MB、LDH1无相关性。结论：血清TNF吨与VMC的心肌损害过程及病情程度密切相关，TNF-α检测可作为判断VMC患者病情及预后的指标之一。     

病毒性心肌炎患者血清TNF-α、IL-6和IL-8的变化

目的检测病毒性心肌炎（VMC）患者血清TNF-α、IL-6和IL-8的水平变化,探讨其在临床的意义。方法采用酶联免疫吸附试验（ELISA）法测定48例病毒性心肌炎急性期和恢复期患者血清TNF-α、IL-6和IL-8水平,与正常对照组进行比较。结果VMC患者急性期血清TNF-α、IL-6、IL-8均显著高于恢复期及正常对照组（P〈0．01）,而恢复期与正常对照组比较差异无显著性意义（P〉0．05）,且VMC患者急性期血清CK-MB与TNF-α、IL-6、IL-8均呈良好的正相关（P〈0．01）。结论VMC患者血清TNF-α、IL-6、IL-8的检测对VMC患者病情评估和预后判断具有重要意义。     

TNF-α及可溶性受体P55在病毒性心肌炎小儿血清表达及意义

目的:探讨病毒性心肌炎患儿血清TNF-α及受体P55表达的意义.方法:采用比色法检测72名病毒性心肌炎患儿(患儿组)血清TNF-α及P55的表达水平,并同60正常健康同龄儿童(对照组)对照,比较病毒性心肌炎患儿同正常健康儿童血清TNF-α及P55表达差异.结果:患儿组血清TNF-α及P55表达水平正常儿童组差异具有统计学意义.结论:TNF-α及P55在小儿病毒性心肌炎血清高表达,其同心肌损伤有关,同时可能参与抗病毒等保护作用.     

病毒性心肌炎患者IL-17、IL-18和TNF-α的改变及临床意义

目的观察病毒性心肌炎患者患者血液白介素-17（IL-17）、白介素-18（IL-18）和肿瘤坏死因子-α（TNF-α）的表达及其临床意义。方法选择无心肌炎的患者40例为对照组,选择同期病毒性心肌炎患者25例为实验组。采用酶联免疫吸附法（ELISA）测定各组患者血清IL-17、IL-18和TNF-α的含量。结果实验组患者血清IL-17和TNF-α水平与对照组相比,明显升高（P〈0.05）;实验组患者血清IL-18水平与对照组相比,明显降低。结论血清IL-17、IL-18和TNF-α在病毒性心肌炎患者发病中有重要作用,通过降低IL-17和TNF-α水平的水平,并采用IL-18合成药物治疗,可干预病毒性心肌炎的发生和发展。     

病毒性脑炎患儿血清和脑脊液TNF-α的变化及其临床意义

目的探讨肿瘤坏死因子-α（TNF-α）在病毒性脑炎患儿血清和脑脊液中的变化及临床意义。方法118例病毒性脑炎患儿进行脑脊液及血清TNF-α测定,另有15名临床排除中枢神经系统感染的儿童作为对照组,也进行TNF-α测定。TNF-α应用ELISA法检测。结果病毒性脑炎组急性期血清、脑脊液TNF-α水平明显增高,较对照组差异有统计学意义（P〈0.01）,恢复期显著下降（P〈0.01）,较对照组差异无统计学意义（P〉0.05）,病毒性脑炎组急性期脑脊液及血清TNF-α水平呈显著正相关（P〈0.01）。结论TNF-α不仅具有抗病毒的作用,还参与了儿童病毒性脑炎的病理过程,血清及脑脊液中TNF-α水平检测对儿童病毒性脑炎的诊断有一定临床意义。     

急性病毒性心肌炎患儿血清MIF、TNF-α、IFN-γ探讨

目的探讨巨噬细胞移动因子（MIF）、肿瘤坏死因子（TNF-α）、干扰素-γ（IFN-γ）在急性病毒性心肌炎（AVM）患儿血清中水平及相互关系。方法采用ELISA方法检测32例急性期和21例恢复期病毒性心肌炎患儿及20例健康儿童血清MIF、TNF-α、IFN-γ水平。采用日立7180型全自动生化分析仪检测磷酸肌酸激酶同工酶（CK—MB）,并与20例健康儿童作对照。结果AVM患儿血清MIF、TNF-α、IFN-γ及CK—MB水平明显高于恢复期及健康对照组。有显著性差异（P〈0．01）,且血清MIF、TNF-α、IFN-γ及CK—MB水平随病情加重而增高。MIF、TNF-α、IFN-γ均与CK—MB呈正相关（P〈0．05）;AVM恢复期MIF、TNF-α、IFN-γ及CK-MB水平与健康对照组比较,无显著性差异（P〉0．05）,且MIF、TNF-α、IFN-γ与CK—MB无相关性。结论AVM患儿急性期血清MIF、TNF-α、IFN-γ明显增高,并参与AVM的发病免疫过程,并可作为病情判断及疗效的观察指标之一。     

大剂量VitC联合辅酶Q10治疗病毒性心肌炎的疗效分析

目的观察大剂量高浓度VitC及辅酶Q10联合治疗对病毒性心肌炎患者血液白介素17(IL-17)、白介素18(IL-18)和肿瘤坏死因子α(TNF-α)的表达及其临床意义。方法按年龄、病程将临床条件基本相同的患者随机分为两组:其中40例为对照组,25例为观察组。采用酶联免疫吸附法(ELISA)测定各组患者血清IL-17、IL-18和TNF-α的含量。结果观察组疗效明显优于对照组;与对照组相比,观察组患者血清IL-17和TNF-α水平明显降低(P<0.05),而观察组患者血清IL-18水平明显升高(P<0.05)。结论大剂量高浓度VitC及辅酶Q10联合治疗可降低IL-17和TNF-α的水平,并影响IL-18的表达,可干预病毒性心肌炎的发生和发展。血清IL-17、IL-18和TNF-α在病毒性心肌炎患者发病中有重要作用。     

病毒性心肌炎患儿血清IL-6、IL-8和TNF-α水平变化动态研究

目的 探讨白细胞介素(IL)6、8及肿瘤坏死因子(TNF-α)等细胞因子在病毒性心肌炎预后中的意义.方法 对确诊为病毒性心肌炎患儿及健康对照组进行白细胞介素6、8和肿瘤坏死因子检测.结果 急性期TNF-α、IL-6和IL-8水平明显高于恢复期与对照组,差异有统计学意义(P<0.01);恢复期较急性期下降,但仍高于对照组,差异无统计学意义(P>0.05);IL-8恢复较慢.结论 IL-6、IL-8与TNF-α共同参与病毒性心肌炎的发病及病理变化过程,IL-8可作为判断小儿病毒性心肌炎预后的指标.     

辛伐他汀对BALB/c小鼠病毒性心肌炎急性期的作用及其机制

目的:研究辛伐他汀对小鼠病毒性心肌炎急性期的作用及其机制。方法:应用柯萨奇B3病毒制作BALB/c小鼠病毒性心肌炎模型,辛伐他汀混悬液灌胃,按辛伐他汀剂量不同分为1mg/kg组、10mg/kg组及100mg/kg组,并设正常对照组及病毒对照组,7d后观察心肌组织病理学改变、血清白细胞介素6(IL-6)水平、心肌组织中肿瘤坏死因子α(TNF-α)表达水平,并做心肌组织中病毒滴度检测。结果:辛伐他汀1mg/kg组各检测指标较病毒对照组无显著性改变(P>0.05)。辛伐他汀10mg/kg组及100mg/kg组心肌组织损伤程度较病毒对照组均明显减轻(P<0.05)、心肌组织中病毒滴度显著性增高(分别为P<0.05,P<0.01)、IL-6和TNF-α水平明显降低(分别为P<0.05,P<0.01);辛伐他汀100mg/kg组与10mg/kg组比较,各检测指标差异显著(P<0.05)。心脏重/体重各组间差异不具有显著性(P>0.05)。结论:辛伐他汀在小鼠病毒性心肌炎急性期对心肌具有保护作用,呈剂量依赖性。这种作用可能与IL-6、TNF-α水平降低而免疫损伤减弱有关。应用辛伐他汀后病毒性心肌炎小鼠清除病毒的能力减弱,但没有导致病毒性心肌炎急性期心肌损伤加重。     

TNF-α和IL-1β在细菌性脑膜炎患儿血清中的表达及其临床意义

目的 观察急性期细菌性脑膜炎和病毒性脑炎患儿血清中肿瘤坏死因子α（TNF-α）、白细胞介素-1β（IL-1β） 的水平变化及临床意义.方法 收集在本院治疗的细菌性脑膜炎患儿27例,病毒性脑炎患儿23例的血清,采用双抗体酶联免疫吸附法（ELISA） 检测各组对象血清中TNF-α和IL-1β的表达水平.结果 细菌性脑膜炎组血清TNF-α水平明显高于病毒性脑炎组（P 〈 0.05）.结论 血清TNF-α与IL-1β的检测可以用于对细菌性脑膜炎患儿的诊断.     

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.