TGF-β1、CTGF对判断慢性阻塞性肺疾病合并纤维化的临床意义

目的 探讨TGF-β 1、CTGF对判断慢性阻塞性肺疾病合并纤维化的临床意义.方法 选择COPD112例,根据是否合并PF分为COPD组(A组)、COPD合并PF组(B组),并选择健康人群50例为对照组(C组),分别有78、34、50例,分别对各组TGF-β1、CTGF、PⅠ NP、PⅢNP进行检测.结果 A组患者TGF-β1、CTGF水平较C组均出现显著性升高(P＜0.05),B组患者较A、C组TGF-β1、CTGF均出现显著升高(P＜0.05).A组患者PⅠ NP、PⅢNP及PⅠ NP/PⅢNP较C组均出现显著升高(P＜0.05),B组患者PⅠ NP、PⅢNP及PⅠ NP/PⅢNP较A组及C组均出现显著升高(P＜0.05).TGF-β1与PⅠ NP、PⅠ NP/PⅢNP显著正相关(P＜0.05),CTGF与PⅠ NP、PⅢNP、PⅠ NP/PⅢNP正相关(P＜0.05).结论 TGF-β1、CTGF水平升高与COPD患者肺纤维化指标密切相关,对其水平检测有助于明确肺纤维化的进展.     

TGF-β1、CTGF对慢性心衰心肌纤维化进展的临床意义

目的 探讨TGF-β 1、结缔组织生长因子(connectivetissue growthfactor,CTGF)对慢性心衰心肌纤维化进展的临床意义.方法 选择慢性心衰患者108例,根据NYHA心功能分级标准进行分级后分别检测TGF-β 1、CTGF、ALD、PI NP、PⅢNP.结果 Ⅲ级患者TGF-β1、CTGF、ALD水平较Ⅱ级患者均出现显著升高,差异有统计学意义(P＜0.05),Ⅳ级患者较Ⅱ、Ⅲ级患者TGF-β1、CTGF均出现显著性升高,差异有统计学意义(P＜0.05),ALD较Ⅲ级患者出现显著升高,差异有统计学意义(P＜0.05).Ⅲ级患者PI NP、PⅢNP及PI NP/PⅢNP较Ⅱ级患者均出现显著性变化,差异有统计学意义(P＜0.05),Ⅳ级患者PI NP、PⅢNP及PI NP/PⅢNP较较Ⅱ、Ⅲ级患者均出现显著升高,差异有统计学意义(P＜0.05).TGF-p1与PI NP、PI NP/PⅢNP正相关(P＜0.05),CTGF与PI NP、PⅢNP、PI NP/PⅢNP正相关(P＜0.05).结论 TGF-β1、CTGF与心肌纤维化指标密切相关,对其水平检测有助于明确慢性心衰的进展.     

哮喘患儿血清TGF-β_1、Smad3表达及与气道重塑的关系研究

目的:探讨不同分期哮喘患儿血清TGF-β1、Smad3表达及与气道重塑的关系。方法:将126例哮喘患儿分为急性发作期组(A组)40例、慢性持续期组(B组)41例和临床缓解期组(C组)45例,对各组TGF-β1、Smad2、PI NP、PⅢNP水平进行检测。结果:B组患儿TGF-β1、Smad3水平较A组均出现显著性下降(P<0.05);C组患儿较A、B组TGF-β1、Smad3均出现显著性下降(P<0.05);B组患儿PI NP、PⅢNP及PI NP/PⅢNP较A组均出现显著性下降(P<0.05);C组患者PI NP及PI NP/PⅢNP较A组及B组均出现显著性下降,(P<0.05);PⅢNP较A组出现显著性下降(P<0.05)。TGF-β1与PI NP、PI NP/PⅢNP显著正相关(P<0.05),与PⅢNP未见显著相关性(P>0.05),Smad3与PI NP、PI NP/PⅢNP显著正相关(P<0.05),与PⅢNP未见显著相关性(P>0.05)。结论:TGF-β1、Smad2水平升高与哮喘患儿气道胶原沉积指标密切相关,对其水平检测有助于明确气道重构的进展。     

血清高半胱氨酸蛋白61及结缔组织生长因子水平与肺癌的进展关系

目的评估血清高半胱氨酸蛋白61 (Cyr61)、结缔组织生长因子(CTGF)是水平变化与肺癌进展的关系,为早期检测肺癌进展提供依据.方法选择于铜川矿务局中心医院就诊的肺癌患者117例,其中Ⅰ期39例、Ⅱ期42例、Ⅲ期20例、Ⅳ期16例,对各组cyr61及CTGF、肺癌肿瘤标志物进行检测.结果Ⅱ期较Ⅰ期Cyr61及CTGF均有显著性升高(P＜0.05),Ⅲ期Cyr61及CTGF较Ⅱ期、Ⅰ期存在显著性升高(P＜0.05),Ⅳ期Cyr61及CTGF较Ⅰ期、Ⅱ期、Ⅲ期均有显著升高(P＜0.05).Ⅱ期较Ⅰ期CEA、CA125均有显著性升高(P＜0.05);Ⅲ期CEA、CA199、CA125较Ⅱ期、Ⅰ期存在显著性升高(P＜0.05),Ⅳ期CEA、CA199、CA125较Ⅰ期、Ⅱ期、Ⅲ期均有显著升高(P＜0.05).Cyr61与CEA、CA125显著正相关(P＜0.05),与CA199未见显著相关性,差异无统计学意义(P＞0.05).CTGF与CEA、CA125显著正相关(P＜0.05).结论Cyr61及CTGF与肺癌肿瘤标志物等指标具有较好的相关性,是反映肺癌进展及侵袭能力的重要指标.     

宫颈癌患者中期因子表达及与侵袭转移能力的关系探讨

目的探讨宫颈癌患者中期因子表达及与侵袭转移能力的关系.方法选择陕西中医学院第二附属医院妇产科就诊的91例宫颈鳞癌患者,Ⅰ期34例,Ⅱ期33例,Ⅲ期患者24例,对各期患者血清MK、MMP-2、TIMP-2进行检测并对宫颈癌组织行免疫组化染色.结果Ⅱ期患者MK阳性率较Ⅰ期出现显著升高(P<0.05),Ⅲ期患者MK阳性率较Ⅰ期、Ⅱ期组均出现显著升高(P<0.05).免疫组化染色可见随着分期的进展,宫颈癌组织MK免疫组化染色强度逐渐增加.Ⅱ期患者MK及MMP-2较Ⅰ期均出现显著升高(P<0.05),TIMP-2出现下降(P<0.05).Ⅲ期患者MK及MMP-2较Ⅰ期、Ⅱ期组均出现显著升高(P<0.05),TIMP-2出现显著下降(P<0.05).MK与MMP-2呈正相关(P<0.05),与TIMP-2呈负相关(P<0.05).结论随着宫颈癌分期的进展,中期因子表达及与侵袭转移能力增强密切相关,是反映宫颈癌侵袭能力的重要因子.     

血清IGF-2及IGFBP-2与糖尿病肾病进展指标的相关性

目的 IGF-2及IGFBP-2与糖尿病肾病进展相关指标的相关性.方法 选择糖尿病患者126例,分为单纯糖尿病组(A组)、微量蛋白尿组(B组)、大量蛋白尿组(C组),分别有52例、41例、33例.对各组肾功能及尿蛋白、IGF-2、IGFBP-2水平进行测定.结果 B组Cys C、BUN、24h尿蛋白较A组差异有统计学意义(P＜0.05),C组Cys C、BUN、Cr、24 h尿蛋白较A、B组差异有统计学意义(P＜0.05).B组IGF-2、IGFBP-2较A组差异有统计学意义(P＜0.05),C组IGF-2、IGFBP-2较A、B组差异有统计学意义(P＜0.05).IGF-2与Cys C、24h尿蛋白呈正相关(P＜0.05),IGFBP-2与Cys C、BUN、24 h尿蛋白呈正相关(P＜0.05).结论 随着糖尿病肾病的进展,IGF-2及IGFBP-2水平与肾功能密切相关,是反映糖尿病肾病进展的重要因子.     

血清Cyr61及CTGF水平对胃癌进展的诊疗意义

目的 评估血清Cyr61及CTGF水平变化与胃癌进展的关系,为早期检测胃癌进展提供依据.方法 选择自2012年6月至2014年6月于铜川矿务局中心医院就诊的胃癌患者132例,其中Ⅰ期45例、Ⅱ期36例、Ⅲ期28例、Ⅳ期23例,对各组Cyr61及CTGF、胃癌肿瘤标志物进行检测.结果 Ⅱ期较Ⅰ期Cyr61及CTGF均有升高,差异有统计学意义(P＜0.05),Ⅲ期Cyr61及CTGF较Ⅱ期、Ⅰ期升高,差异有统计学意义(P＜0.05),Ⅳ期Cyr61及CTGF较Ⅰ期、Ⅱ期、Ⅲ期均有升高,差异有统计学意义(P＜0.05).Ⅱ期较Ⅰ期CEA、CA125均有升高,差异有统计学意义(P＜0.05);Ⅲ期CEA、CA199、CA125较Ⅱ期、Ⅰ期升高,差异有统计学意义(P＜0.05),Ⅳ期CEA、CA199、CA125较Ⅰ期、Ⅱ期、Ⅲ期均有升高,差异有统计学意义(P＜0.05).Cyr61与CEA、CA125显著正相关(P＜0.05),与CA199无相关性(P＞0.05).CTGF与CEA、CA125显著正相关(P＜0.05).结论 Cyr61及CTGF与胃癌肿瘤标志物等指标具有较好的相关性,是反映胃癌恶性程度及侵袭能力的重要指标.     

慢性阻塞性肺疾病患者SAA及IP-10与炎性因子水平相关性分析

目的 探讨慢性阻塞性肺疾病患者SAA及IP-10与炎性因子水平相关性分析.方法 选择慢阻肺患者78例,分为AECOPD组(A组)、COPD组(B组),并选择健康人群50例为对照组(C组),分别有31、47、50例,分别对各组SAA及IP-l0与炎性因子进行检测.结果 A组患者SAA及IP-10水平较B、C组均出现升高(P＜0.05),B组患者较C组SAA及IP-10均出现升高(P＜0.05).A组患者IL-1、IL-6、TNF-α较B、C组均出现升高(P＜0.05),B组患者较C组IL-1、IL-6、TNF-α均出现升高(P＜0.05).SAA与IL-6、NF-α显正相关(P＜0.05),与IL-1未见显著相关性(P＞0.05),IP-10与IL-1、IL-6、TNF-α正相关(P＜0.05).结论 SAA及IP-10水甲升高与炎性因子密切相关,共同参与慢阻肺患者病情进展.     

辛伐他汀联合培哚普利对急性冠状动脉综合征患者的血清超敏C反应蛋白影响

目的 观察辛伐他汀联合培哚普利对急性冠状动脉综合征患者血清超敏C反应蛋白的影响.方法 76例患者分为对照(A)组、辛伐他汀(B)组、辛伐他汀 培哚普利(C)3组,治疗1个月,观察治疗前后血清超敏C反应蛋白和血脂的变化.结果 治疗后,B组、C组的TC、TG、LDL均较A组明显降低(P＜0.05),HDL较A组明显升高(P＜0.05),B组、C组的TC、TG、LDL均较治疗前明显降低(P＜0.05)、HDL较治疗前升高(P＜0.05).B组、C组的hs-CRP均较A组明显降低(P＜0.05),也较治疗前明显降低(P＜0.05),B、C两组之间也有显著性差异(P＜0.05).结论 辛伐他汀和培哚普利均能发挥抗炎作用,从而达到稳定斑块的作用.     

干扰素对慢性乙型肝炎患者肝纤维化的影响

目的:探讨干扰素对慢性乙型肝炎(CHB)患者肝纤维化的治疗作用.方法:75例CHB患者随机分为治疗组(A组,n=39)和对照组(B组,n=36),A组采用干扰素和常规保肝药物联合治疗,B组仅采用常规保肝药物治疗,疗程9个月.治疗前、治疗后及停药后检测血清透明质酸酶(HA)、层黏蛋白(LN)、血清前胶原Ⅲ肽(PCⅢ)、血清Ⅳ型胶原(CⅣ)水平.结果:A组血清HA、LN、PCⅢ、CⅣ水平治疗后降低(P＜0.01),且停药后继续下降(P＜0.01);B组HA、LN、PCⅢ、CⅣ治疗后无降低,反而随时间延长升高,停药后0.5 a与A组比较各指标均升高(P＜0.01).治疗组治疗有效(n=18)及无效(n=21)者治疗后各指标较治疗前均降低(P＜0.05或0.01),除CⅣ外,有效者治疗后肝纤维化指标较无效者治疗后降低(P＜0.05).结论:干扰素治疗CHB具有较好的抗肝纤维化作用.     

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.     

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.