6min步行试验对心力衰竭患者细胞因子水平的影响

目的采用6min步行试验,观察充血性心力衰竭（CHF）患者运动前后血清肿瘤坏死因子α（TNF-α）和白细胞介素10（IL-10）水平的变化。方法34例CHF患者和22例健康对照者进行了6min步行试验（6-MWT）,于运动前后采取静脉血,使用双抗体夹心ABC-ELISA法测量血清IL-10和TNF-α的浓度。结果CHF组基础状态的血清TNF-α水平显著高于对照组（P〈0．01）,而IL-10水平和6min步行距离（6-MWTO）均低于对照组,但IL-10的变化差异无统计学意义（P〉0．05）。与运动前相比,对照组运动后即刻TNF-α水平无显著性改变（P〉0．05）,但IL-10水平显著性升高（P〈0．05）;CHF组,INF-α水平运动后即刻呈明显升高（P〈0．01）,而IL-10水平运动后即刻并无显著意义的升高（P〉0．05）。结论CHF患者较正常人运动耐量下降,一次6min步行运动使CHF患者炎症性细胞因子水平进一步增加,抗炎症性细胞因子水平不增加,从而加重了细胞因子之间的网络调控紊乱。     

细胞因子网络在充血性心力衰竭中的变化及其意义

目的　观察白细胞介素- 6 (IL - 6 )、IL - 10、肿瘤坏死因子-α(TNF -α)和转化生长因子- β1 (TGF -β1 )在充血性心力衰竭(CHF)患者中的变化及其意义。方法　用放免法测定4 9例CHF患者及30例健康体查者血清IL - 6、IL - 10、TNF -α,用ELISA测定TGF - β1 ,并进行分析比较。结果　(1)CHF组TNF -α、IL - 6、IL - 10水平明显高于正常组(P <0 .0 1) ,TGF - β1 水平明显低于正常组(P <0 .0 1)。心衰程度越重,变化越显著。(2 )TNF -α、IL- 6与LVEF呈负相关(r=- 0 .82 3、P <0 .0 0 0 1,r=- 0 .85 1、P <0 .0 0 0 1) ,而TGF - β1 与LVEF呈正相关(r=0 .814、P <0 .0 0 0 1)。结论　CHF时TNF -α、IL - 10和IL - 6水平升高,TGF - β1 降低,细胞因子网络处于失衡状态。TNF-α、IL - 10和TGF - β1 水平与心衰严重程度相关,可作为判断心衰严重程度的辅助指标之一。     

肝癌患者血清IL-10,IL-12和TNFα水平的变化

目的 :探讨细胞因子IL 10 ,IL 12和TNFα与原发性肝癌之间的关系及临床意义。方法 :采用ELISA法检测了 40例原发性肝癌患者 ,36例肝炎后肝硬化患者和 33名健康人的血清中IL 10 ,IL 12和TNFα的浓度。结果 :在肝硬化患者三项指标较健康人显著升高 (P <0 .0 1) ,而肝癌患者与健康人比较除IL 10升高外 ,IL 12和TNFα差异无显著性 (P >0 .0 5 ) ;IL 10在肝癌肿块直径 >5 .0cm的患者中比直径 <5 .0cm的患者显著升高 (P <0 .0 5 ) ,而IL 12和TNFα则显著降低 (P <0 .0 5 )。结论 :原发性肝癌患者免疫功能异常可能与IL 10的增高有关 ;IL 12 ,TNFα水平降低和IL 10水平升高有助于鉴别肝硬化结节和肝癌的临床诊断及提示癌变倾向。     

白细胞介素6及肿瘤坏死因子-α对体外受精-胚胎移植结局的影响

目的 :探讨在体外受精 -胚胎移植 (IVF -ET)过程中血清及卵泡液中的白细胞介素 -6(IL -6)、肿瘤坏死因子 -α(TNF -α)水平与卵泡发育、卵巢内分泌、激素反应类型、年龄、胚胎质量及妊娠之间的关系。方法 :用放射免疫方法检测了 98例患者 (共 10 2周期 )卵泡早期、卵泡中期和取卵日血清中的IL -6、TNF -α水平及取卵日卵泡液中的IL -6、TNF -α水平。结果 :⑴在超促排卵周期中 ,血清中的IL -6水平及IL -6/TNF -α比值随着卵泡的逐渐发育成熟而逐渐升高 ,但血清TNF -α的水平则随着卵泡发育进程而逐渐降低 ,各组间存在极显著性差异 (P均 <0 .0 0 1) ;⑵取卵日卵泡液中的IL -6、TNF -α水平显著高于血清中上述细胞因子的水平 (P <0 .0 0 1) ,⑶随着获卵数的增加 ,卵泡液中IL -6、TNF -α水平显著降低 (P均 <0 .0 0 1) ;而卵泡液IL -6/TNF -α比值则随着获卵数的增加显著升高 (P均<0 .0 5) ;⑷年龄≤ 3 0岁组卵泡液中的IL -6水平小于年龄 >3 1岁组 (P <0 .0 5) ,年龄 3 1～ 3 5岁组与年龄 >3 5岁组之间的卵泡液IL -6水平无显著性差异 (P >0 .0 5) ,不同年龄组间卵泡液TNF -α水平及IL -6/TNF -α比值均无显著性差异 (P >0 .0 5) ;⑸高质量胚胎比≥ 0 .5组的卵泡液IL -6、TNF -α浓度较 <0 .5组显著降低 (P     

多巴酚丁胺对严重心衰患者左室射血分数及细胞因子的影响

目的 :观察小剂量多巴酚丁胺对严重的充血性心力衰竭 (Congestiveheartfailure ,CHF)患者左室射血分数(Leftventricurlarejectionfraction ,LVEF)及肿瘤坏死因子 -α(Tumornecrosisfactore -alpha ,TNF -α)和白细胞介素 - 6 (Interleukin - 6 ,IL - 6 )的水平的影响。方法 :30例心功能正常的心脏病患者和 5 2例CHF患者作为研究对象。 5 2例CHF患者被随机地分为多巴酚丁胺治疗组和对照组。对照组给予卡托普利、利尿剂、洋地黄类和硝酸酯类 ;治疗组在此基础上加用多巴酚丁胺 ,剂量为 2 .5～ 5ug/kg/min ,共 10d。测定左室射血分数、血清TNF -α和IL - 6及其变化。结果 :CHF组血清TNF -α和IL - 6水平明显高于无心衰组 (P <0 .0 0 1)。治疗后两组LVEF均有所提高 ,但多巴酚丁胺组更明显 ,两组比较具有统计学差异 (P <0 .0 5 )。治疗后与治疗前比较 ,对照组血清TNF -α和IL - 6有显著性意义的降低 ,而多巴酚丁胺治疗组无显著性变化。结论 :CHF患者血清TNF -α和IL - 6水平明显增高 ;多巴酚丁胺虽然可以改善临床症状及提高LVEF ,但无改善血清TNF -α和IL - 6的作用。     

脑梗死患者白细胞介素-6和肿瘤坏死因子α变化的研究

目的 :探讨白细胞介素 6(IL 6)和肿瘤坏死因子α(TNF α)在脑梗死 (CI)发病中的作用。方法 :应用ELISA方法检测 3 8例CI患者在发病急性期、亚急性期和恢复期的血清IL 6和TNF α水平 ,并比较不同梗死灶体积上述细胞因子血清水平的变化。结果 :CI患者急性期的血清IL 6水平均较亚急性期、恢复期以及对照组明显升高 (P <0 .0 5 ) ;TNF α水平急性期比对照组升高 (P <0 .0 5 )而与亚急性期、恢复期之间无统计学差异 ;中、大梗死体积组的急性期TNF α水平比小体积组显著升高 (P <0 .0 5 ) ,IL 6水平则无统计学差异。结论 :细胞因子参与了急性脑梗死的发病过程。     

不稳定型心绞痛患者肿瘤坏死因子-α和白细胞介素-6活性水平的观察

目的　探讨不稳定型心绞痛(UA)患者血清肿瘤坏死因子-α(TNF -α)和白细胞介素- 6 (IL - 6 )的变化关系。方法　测定4 5例UA患者(UA组)和36例正常对照组(对照组)血清TNF -α和IL - 6浓度,并进行比较分析。结果　UA组血清TNF -α和IL - 6水平明显高于对照组(P <0 .0 1) ;UA组患者12周后发生急性心肌梗死(MI)者TNF -α和IL - 6水平明显高于无心肌梗死者,有显著性差异(P <0 .0 1) 。结论　UA患者血清TNF -α、IL - 6水平明显升高,12周后发生MI的患者血清TNF -α、IL - 6水平明显高于无MI者,血清TNF -α、IL - 6可作为冠心病预后的参考指标。     

急性冠状动脉综合征患者炎性细胞因子水平的变化及其临床意义

目的　观察冠心病 (CHD)不同类型患者血中促炎性细胞因子 :肿瘤坏死因子 (TNF -α)、白细胞介素 6(IL - 6 )、白细胞介素 8(IL - 8)和C反应蛋白 (CRP)的水平变化及其与血脂之间的关系。方法　检测 6 0例冠心病患者和 2 8例正常对照者血清中CRP、TNF -α、IL - 6和IL - 8的浓度和血脂水平。结果　 30例急性冠状动脉综合征患者血清中CRP、TNF -α、IL - 6和IL - 8的浓度均显著高于对照组 (P <0 .0 0 1) ,与 30例稳定性冠心病患者组比较亦有明显差异 (P <0 .0 5 )。单因素回归分析胆固醇与CRP、TNF -α、IL - 6和IL - 8均显著相关 (P <0 .0 5 )。结论　急性冠状动脉综合征患者血中的促炎性细胞因子水平的升高可能与急性冠状动脉综合征的发生有关 ,是动脉粥样硬化斑块不稳定的标志。     

下呼吸道感染患者血清IL-2、TNF变化的研究

目的　探讨白介素 -2 (IL -2 )、肿瘤坏死因子 (TNF -α)在下呼吸道感染中的作用。方法　采用RIA液相竞争法测定IL -2 ,RIA平衡法测定TNF -α。从 2 96例急性下呼吸道感染患者中选 49例痰菌培养阳性者及 2 0例正常对照组进行对比观察。结果　G- 菌感染组及G 菌感染组患者血清IL -2较健康对照组降低 (P <0 0 5 ) ,而血清TNF -α较健康对照组升高(P <0 0 5 )。结论　IL -2、TNF -α在下呼吸道感染中起重要作用。故对于下呼吸道感染的治疗 ,应提高患者IL -2水平 ,降低TNF -α水平。在下呼吸道感染的治疗过程中 ,除积极的抗生素治疗外 ,还应适当地给予重组细胞因子或细胞因子拮抗剂 ,以调节体内微环境细胞因子水平 ,来改变体内紊乱的免疫反应 ,以达到治疗的目的。     

充血性心力衰竭患者血清肿瘤坏死因子-α水平的变化

目的　研究充血性心力衰竭 (CHF)患者血清中肿瘤坏死因子 -α(TNF -α)含量的变化及其与心功能的关系 ,探讨它们在CHF发病过程中的意义。方法　选择 5 1例CHF患者及 3 2例健康体检者用ELISA法检测其血清中TNF -α含量。结果　CHF组中TNF -α水平比正常组显著升高 (P <0 .0 1) ,与心功能级别有关 (P <0 .0 1)。结论　CHF患者血浆中TNF -α水平显著升高 ,是促成心衰进一步发展的重要因素。     

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.