补益中药复方对青少年哮喘患者缓解期IgE、IL-5Rα、HLA-A的影响

目的 研究复方中药敏康片治疗青少年哮喘的疗效和作用机理.方法 选择20例青少年哮喘患者进行治疗,19例青少年为正常对照组.哮喘组疗程为6个月,观察血清总IgE及白介素-5受体α链基因(IL-5Rα)、人类白细胞抗原(HLA-A)基因表达改变情况.结果 哮喘组IgE治疗前后有显著差异(P<0.01).IL-5Rα基因吸光度值治疗前较正常组高,治疗后降低.HLA-A基因吸光度值治疗前较正常组高,治疗后降低.结论 补益中药可以调整青少年哮喘患者相关基因表达,改善患者过敏状态,缓解临床症状.     

扶正治标法对青少年花粉症患者相关基因表达的影响

目的:研究中药治疗花粉症的作用机理。方法:选择50例花粉症患者,口服敏康片,治疗6个月后观察疗效及FcεRIβ,IL-4Rα,IL-5Rα,HLA-A基因表达情况,并以20例变应性皮炎和19例正常人为对照,用Northern blot检测FcεRIβ,IL-4Rα,IL-5Rα的变化。用RT-PCR法检测HLA-A,计算相对光密度值。结果:花粉症组患者症状有明显改善(P<0.05),治疗前后血清总IgE比较差异有统计学意义(P<0.01),花粉症组4个基因的表达治疗前与正常人比较,差异均具有统计学意义(P<0.01),治疗后与治疗前比较差异有统计学意义(P<0.01)。变应性皮炎组治疗前FcεRIβ,IL-4Rα与正常组比较差异有统计学意义(P<0.05),治疗前后FcεRIβ比较,差异有统计学意义(P<0.05)。鼻炎组、皮炎组HLA-A相对光密度值均较正常组高,两组治疗前后也有不同程度的改善(P<0.05)。结论:中药可以调整花粉症患者相关基因表达,改善患者过敏体质,缓解临床症状。     

介导过敏反应的自身抗体在自身免疫性疾病中的临床意义

自身免疫性荨麻疹的发病与机体产生针对IgE高亲和力受体α链（FcCRIα）或IgE的自身抗体、补体等免疫分子有关,同时抗FcεRIα自身抗体可能与内源性哮喘、伴有过敏症状的其他疾病密切相关。该抗体的检测将有助于相关疾病的深入研究与诊断治疗     

白细胞介素4受体基因多态性与支气管哮喘的相关性(摘要)

目的：探讨白细胞介素4受体（IL-4R）基因多态性与儿童支气管哮喘的相关性。方法：用聚合酶链反应／限制性片段长度多态性分析方法（PCR/RFLP）检测30例哮喘儿童和30例正常对照儿童IL-4R Q576R的多态性，并用酶联免疫吸附法（ELISA）检测两组儿童血浆总IgE的水平，然后进行χ^2检验及成组t检验。结果：（1）IL-4R杂合突变基因型Q576R、突变等位基因R576的分布频率在哮喘儿童及正常对照儿童中差异有显著性，     

IgE低亲和力受体基因mRNA表达水平与哮喘的关系

目的 探讨IgE低亲和力受c体(FcεRⅡ,CD23)基因表达水平在哮喘组与正常组间有无差异及基因表达与TlgE水平有无相关.方法 逆转录-聚合酶链反应(RT-Pc)检测FcεRⅡ基因表达水平,并用t检验作组间比较;直线相关分析基因表达与TlgE水平的相关性.结果 哮喘组TIgE水平与正常对照组之间差异有显著性(t=5.15,P＜0.01);FcεRⅡ基因表达水平在哮喘组与正常组之间差异有显著性(t=4.20,P＜0.01);在哮喘组与正常对照组中,FcεRⅡ基因表达水平均与TIgE水平间呈正的直线相关.结论 FcεRⅡ基因对血浆TIgE水平有调节作用,其功能变化在哮喘发病中可能有重要作用.     

哮喘患儿血清TNF-α、IL-8、IgE的动态变化及其临床意义

目的探讨哮喘儿童血清TNF-α、IL-8、IgE的动态变化及其临床意义。方法哮喘患者急性发作组88例及缓解期组78例、正常对照组70例,分别抽取其静脉血测定血清TNF-α、IL-8、IgE,IL-8、IgE应用双抗体夹心ELISA法检测,TNF-α应用ELISA法检测。结果哮喘急性发作组及缓解期组血清IgE、IL-8、TNF-α水平均明显高于对照组（P〈0．01）;哮喘急性发作期组血清IgE、IL-8、TNF-α水平也均明显高于缓解期组（P〈0．01）。结论IL-8可能参与了哮喘急性发作患儿的发病过程,可能发挥正反馈调节作用,促进哮喘患儿IgE分泌;哮喘缓解期仍存在炎症反应。TNF-α在启动哮喘气道炎症并使其持续存在中起关键作用。     

哮喘患者IL-4R基因多态性与sIL-4R、TIgE水平相关性研究

目的：探讨白细胞介素4受体（IL-4R）Ile50 Val多态性与哮喘患者血浆可溶性白细胞介素4受体（sIL-4R）、血浆IgE（IgE）水平及其相关性.方法：用等位基因特异性聚合酶链反应（Allele-speccifc PCR）检测哮喘与对照组位点多态性,用酶联免疫分析法（ELSIA）测定哮喘与对照组血浆IgE、可溶性白细胞介素4受体（sIL-4R）水平.结果：IL-4Rα链Ile50Val位点等位基因在哮喘组及对照组间分布的差异有显著性（P＜0.01）,等位基因Ile携带者其哮喘患病危险性较非携带者高2.64倍（P＜0.01）,三种基因型的分布在两组间的分布有显著性差异（P＜0.01）.在同一组内,Ile/Ile基因型血浆IgE水平高于Ile/Val及Val/Val基因型（P均＜0.01）,对血浆sIL-4R的影响相反.Ile/Val基因型血浆IgE、sIL-4R水平与Val/Val基因型之间无显著差异（P＞0.05）.结论：IL-4Rα链Ile50Val基因多态性是影响哮喘的重要候选基因.     

咳嗽变异型哮喘患者脱敏治疗前后γ干扰素和IL-4的水平

对30例咳嗽变异型哮喘患者脱敏治疗前和治疗1年后检测血清中γ干扰素（IFN-γ）、白细胞介素4（IL-4）以及总IgE的水平，并与30例对照者进行比较。结果显示脱敏治疗1年后，血清IFN-γ水平明显增高，IL-4和总IgE水平明显降低，治疗前后差异有统计学意义。提示脱敏治疗可调节咳嗽变异型哮喘患者血清IFN-γ和IL-4水平，降低总IgE，有效控制临床症状。     

细胞因子和IgE检测在支气管哮喘诊断中的价值

目的探讨支气管哮喘患者血清白细胞介素一6（IL-6）、白细胞介素一10（IL-10）、白细胞介素-16（IL-16）和免疫球蛋白IgE的动态变化和检测的临床意义。方法收集30例支气管哮喘发作期患者（哮喘组）和30例正常对照者（对照组）的血清,采用酶联免疫吸附试验（ELISA）测定血清中IL-6、IL-10、IL-16和总IgE。结果与正常对照组比较,哮喘组血清IL-6、IL-16和总IgE水平明显增高,相比较有显著性差异（P〈0．05）;而IL-10水平明显降低,相比较有显著性差异（P〈0．05）;哮喘组总IgE与IL-6、IL-16之间呈正相关（r=0．6871,r=0．8633,P〈0．01）;与IL-10之间存在负相关（r=-0．4782,P〈0．01）。结论IL-6、IL-10、IL-16和总IgE与哮喘发病机制有关,动态测定这些指标有助于病情评估。     

FcεRⅠβ基因多态性与湖北地区儿童变应性哮喘的关系

目的　探讨IgE高亲和力受体 β链基因 (FcεRⅠβ)启动子 - 10 9位和编码区Glu2 37Gly基因多态性与湖北儿童变应性哮喘及血浆总IgE的关系。方法　采用聚合酶链反应 限制性片段长度多态性技术检测 110例儿童变应性哮喘患者和 92例相匹配对照者FcεRⅠ β基因启动子区 - 10 9位和编码区Glu2 37Gly两位点多态性。结果　①儿童变应性哮喘患者FcεRⅠ β基因启动子区 - 10 9位T/T、T/C和C/C基因型频率是 0 391、 0 4 91和 0 118;与对照相比差异无显著性意义 (χ2 =0 0 2 34,P >0 0 5 ) ,但儿童变应性哮喘组T/T基因型患者血浆总IgE对数值为 2 4 78± 0 94 4 ,与T/C基因型的 2 2 87± 1 114和C/C基因型的 2 315± 0 86 6相比差异具有显著性意义 (F =4 336 ,P <0 0 1)。②FcεRⅠ βGlu2 37Gly位点Glu/Glu、Glu/Gly和Gly/Gly型频率为 0 5 91、 0 36 4和 0 0 4 5 ,与正常对照相比差异具有显著性意义 (χ2=6 5 86 ,P <0 0 5 ) ,Gly/Gly型血浆总IgE对数值为 2 6 2 3± 0 96 2 ,与Glu/Glu的 2 30 6± 0 915和Glu/Gly的 2 4 18±0 894相比差异具有显著性意义 (F =6 6 5 4 ,P <0 0 1)。结论　IgE高亲和力受体 β链启动区 - 10 9位T/T型与血浆总IgE相关 ,编码区 2 37位Gly/Gly型与儿童变应性     

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.