铅镉砷联合毒物对人体免疫功能影响的流行病学研究

目的 探讨铅镉砷联合毒物对机体免疫功能的影响。方法 选择48名重金属中毒的矿工作为毒物组、48名同期住院病人作为对照组，分别检测患者血、尿铅、镉、砷含量，及血免疫球蛋白含量。结果 毒物组血、尿铅、镉、砷含量较对照组显著升高（P〈0．01）。与对照组比较，毒物组IgG、IgM浓度下降（P〈0．01），而IgA浓度则升高（P〈0．01）。结论 铅镉砷联合毒物损伤了机体的免疫功能。患者血液中免疫球蛋白含量能够作为铅镉砷混合物中毒的灵敏的早期诊断指标。     

狼疮肾炎患者血、尿MCP-1测定的意义

目的 :探讨狼疮肾炎患者血、尿单核 巨噬细胞趋化蛋白 1(MCP 1)的变化及其意义。方法 :应用酶联免疫法 (ELISA)分别检测 3 6例狼疮肾炎和 2 0例健康对照者血、尿MCP 1的水平。结果 :狼疮肾炎患者血、尿MCP 1水平较正常对照者明显升高(均为P <0 .0 1) ;狼疮肾炎患者活动期尿MCP 1水平较静止期明显增高 (P <0 .0 1) ,而血MCP 1水平差异不大 (P >0 .0 5 ) ;活动期患者经激素或细胞毒药物治疗后尿MCP 1明显下降 (P <0 .0 1) ,血MCP 1下降不明显 (P >0 .0 5 )。结论 :尿MCP 1的测定可作为反映狼疮肾炎活动的一个有用指标。     

急性有机磷中毒患者血、尿β2-微球蛋白变化

目的动态观察急性有机磷中毒患者的血、尿β2-微球蛋白的变化．方法采用放射性免疫方法检测50例急性有机磷中毒患者和20例健康受试者的血、尿β2-微球蛋白的含量．结果有机磷中毒组患者中毒后2d、4d、6d血、尿β2-微球蛋白含量明显升高,与健康对照组比较有统计学意义（P〈0．05）．结论急性有机磷中毒患者的血、尿β2-微球蛋白升高,有助于临床评价有机磷中毒患者肾功能损伤程度和治疗效果．     

亚急性砷中毒452例的临床表现与尿砷值关系的探讨

目的探讨452例亚急性砷中毒患者临床表现与尿砷值的关系。方法对砷污染饮用水致亚急性砷中毒452例的临床表现、诊断和实验室检查结果进行分析。结果饮用水的砷含量分别为3．19mg／L和3．26Ing／L,分别超标318倍和325倍;452例初检尿砷值为0．24～11．2mg／L[（1．41±1．52）mg／L];中毒患者出现消化系统、心血管系统和神经系统的症状分别为389、249和359例;心肌酶、肝功能、肾功能、血常规和尿常规异常分别为237、98、76、91和140例;心电图异常106例。全组452例均诊断为亚急性砷中毒,其中轻、中、重度中毒分别为370、74和8例;中毒患者尿砷含量与受损的器官数及诊断分级呈正相关关系,具有统计学意义（r=0．552,r=0．678,P均〈0．01）。结论尿砷值可作为亚急性砷中毒诊断及分级的重要指标。     

镉作业工人尿中镉和β2-微球蛋白及视黄醇蛋白的调查

目的探讨职业性镉接触者的尿中镉、β2-微球蛋白和视黄醇蛋白含量的变化情况. 方法选取某生产镍镉电池的电池厂职业接触镉作业的975名员工为接触组;没有接触有毒害因素且体检未见异常的员工885人为对照组;将体检中发现连续两次尿镉含量超过5μmol/mol 肌酐的113人列为观察组.对接触组和对照组进行尿镉、尿β2-微球蛋白和尿视黄醇蛋白含量检测,对观察组连续两年进行尿镉含量检测. 结果接触组尿镉含量明显高于对照组,差异有统计学意义（P＜0.01）,且随着镉接触工龄的延长尿镉含量逐渐升高;同时不同性别之间的尿镉水平存在明显的差别,女性高于男性（P＜0.01）.接触组尿β2-微球蛋白含量也高于对照组,差异有统计学意义（P＜0.05）,但当工龄＜3年时,与对照组比较差异无统计学意义（P＞0.05）;当工龄＞5年时与对照组比较差异有统计学意义（P＜0.01）. 结论镉接触可引起体内尿镉和尿β2-微球蛋白含量的升高,且随着镉接触工龄的延长而逐渐升高.     

某重金属污染区人群体内重金属水平及其与肝、肾功能的相关性

目的 了解某重金属污染区人群体内重金属水平及其与肝、肾功能的相关性.方法 采用分层随机抽样法选取广西西北部某重金属污染区1 050例居民为暴露组;同期在非污染区选择492例居民为对照组.对比两组重金属水平和肝、肾功能情况,并分析暴露组人群重金属水平与其肝、肾功能的相关性.结果 暴露组血铅、尿镉、尿砷、γ-谷氨酰转移酶(GGT)、TP、ALB、血尿素(Urea)水平均高于对照组,而AST、ALT、AKP、微球蛋白(β2-MG)水平均低于对照组.相关性分析显示,血铅与ALT、GGT、TP、ALB、Urea、血Cr呈正相关,与AKP呈负相关;尿砷与ALB、Urea呈正相关;尿镉与Urea呈正相关.结论 该金属污染区人群体内重金属含量及部分肝、肾功能指标升高,且重金属含量与肝、肾功能指标具有相关性.     

有机磷农药中毒与β2～微球蛋白的相关性

目的探讨血、尿β2～微球蛋白(β2～MG)在有机磷农药中的变化及意义。方法采用放射免疫分析法测定60例有机磷农药中毒(AOPP)患者和20例健康查体者(对照组)的血、尿β2～MG含量。结果有机磷中毒患者血、尿β2～MG含量高于对照组。结论AOPP时血、尿β2～MG升高越显著，提示中毒程度越重，可作为判断肾功能损害的一项指标，同时对指导治疗起了重要作用。     

探讨使用化妆品对孕产妇及其新生儿发铅、发镉含量的影响

目的 :探讨使用化妆品对孕产妇及其新生儿头发中重金属含量的影响。方法 :对在泸州医学院附属医院分娩的 1 81名产妇进行问卷调查 ,其中孕期及孕前期使用化妆品的有 1 2 5名 ,未使用化妆品的有 5 6名。然后采用火焰原子吸收法对 1 81名孕产妇及其新生儿头发中铅、镉含量进行测定。结果 :使用化妆品的孕产妇及其新生儿发铅、发镉都高于不使化妆品组 (P <0 .0 5 ) ;使用化妆品组新生儿发铅发镉含量与其母亲的含量呈明显的正相关关系 (P <0 .0 0 1 )。结论 :孕期使用化妆品可能引起孕产妇及其新生儿头发中铅、镉含量增加 ,从而影响人们的健康。     

千分之一效能白砷剂改善慢性砷中毒症状的初步临床观察（英文）

背景：全世界有数以百万计的人饮用砷污染的地下水,而目前尚未有缓解慢性砷中毒症状的有效制剂。文献报道白砷剂LM0/3作为一种顺势疗法强化制剂,对于砷中毒症状有一定的治疗作用。目的：本研究旨在验证白砷剂LM0/3对由于生活环境所致而长期饮用砷污染水的人群的慢性砷中毒症状的缓解作用。设计、场所、对象和干预措施：本研究为双盲安慰剂对照研究,参加本研究的28名志愿者来自印度西孟加拉邦纳迪亚区一村落,该村无不含砷的饮用水可用,水井中的含砷量为55～95μg/mL。受试者分别服用药物或安慰剂,在参加试验前及2个月后试验结束时提供血、尿样本。另有18名来自无砷污染饮用水村的志愿者提供血、尿样本作为阴性对照。主要结局指标：测量受试者血、尿样本中的砷含量,各类中毒生物标记物及病理生理指标。结果：28名受试者中,14名愿意提供血、尿样本,其余14名退出试验。受试者的血、尿样本检测出砷的浓度升高,碱性磷酸酶及酸性磷酸酶水平升高,脂质过氧化反应及谷胱甘肽活性升高,血糖、三酰甘油、总胆固醇及低密度脂蛋白胆固醇水平升高,天门冬氨酸氨基转移酶及丙氨酸氨基转移酶水平、γ谷氨酰转移酶及葡萄糖6磷酸脱氢酶含量降低,高密度脂蛋白胆固醇水平及红细胞压积降低。2个月后,用药组的上述指标均有所改善,基质金属蛋白酶活性较安慰剂组有所降低。结论：在尚未有更好的医疗条件和治疗手段的情况下,使用白砷剂LM0/3在饮用水受砷污染地区作为暂时的治疗手段以缓解生活在这些地区的人们的慢性砷中毒症状有一定的可行性。     

泌尿系结石患者尿NAG活性的变化及其临床意义

目的　探讨尿NAG活性测定用于监测泌尿系结石患者肾功能早期损伤及其临床意义。方法 :检测6 8例泌尿系结石患者的血、尿N 乙酰 β D氨基葡萄糖苷酶 (NAG)活性及尿 β2 MG ,血BUN、Cr等项目 ,并与 5 0例正常人群进行比较分析。结果　泌尿系结石患者尿NAG活性 (39 80± 2 0 2 8U/ gCr)、Β2 MG水平 (5 4 6± 313μg/L) ,明显高于健康对照组 (P <0 0 1) ,且两者呈显著正相关 (r =0 6 0 33,P <0 0 1)。血NAG活性与对照组比较基本无变化 (P >0 0 5 ) ,BUN、Cr无异常。患者中合并肾积水 12例 ,其尿NAG及 β1 MG含量全部大幅度升高 ,跟未伴肾积水组比较有显著性差异 (P <0 0 1)。结论　泌尿系结石患者肾功能部分受损伤 ,血NAG及BUN、Cr不能反映患者早期肾功能损伤 ,考虑方法学等因素和尿NAG活性是一种较为理想的肾功能早期损伤监测指标     

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.