免疫比浊法在糖尿病肾脏功能检测中的应用

目的:探讨免疫比浊法在糖尿病肾病肾脏功能检测中的应用情况.方法:将我院收治的64例糖尿病肾病患者作为观察组,入院行健康体检50例患者作为对照组,分别采用全自动生化分析仪检测BUN及Scr.采用免疫透射比浊法检测mALB,采用乳胶增强散射免疫比浊法检测Cys-C.分析两组检测指标在糖尿病肾病中的诊断价值.结果:观察组mALB、Csy-C浓度显著高于对照组,差异有统计学意义(P＜0.05),观察组BUN、Scr浓度与对照组相比,差异无统计学意义(P＞0.05).Cys-C联合mALB阳性率显著高于其他指标,差异有统计学意义(P＜0.05).结论:采用Cys-C联合mALB检测可显著提高早期肾功能损害的检出率,利于糖尿病肾病的早期预防和治疗,值得临床推广应用.     

冠心病糖尿病患者内源性洋地黄样因子心钠素浓度变化及临床意义

用放射免疫法检测15例冠心病合并糖尿病患者,42例单纯冠心病患者和30例正常人的血清内源性洋地黄样因子(EDF)浓度和血浆心钠素(ANF)浓度。结果显示:疾病组EDF ANF浓度均明显高于对照组(P<0.01)。冠心病合并糖尿病组EDF高于单纯冠心病组P<0.05,ANF二者无显著差异(P>0.05)表明胰岛素分泌异常影响EDF与ANF的代谢     

恶性肿瘤患者凝血指标浓度变化特点分析

 目的 分析恶性肿瘤患者凝血指标浓度变化的特点。方法 115例肿瘤患者分为胃癌、肠癌和肺癌组,选择健康体检者50例为对照组。分别检测患者治疗前凝血指标的水平、化疗后随时间变化凝血指标的变化和对照组凝血指标进行对比。结果 肿瘤患者血浆凝血酶原时间(prothrombin time, PT)为(12.39±1.23)s,活化部分凝血活酶时间(activated partial thromboplastin time, APTT)为(30.58±7.43)s,纤维蛋白原(fibrinogen ,FIB)为(4.71±1.72)g/L,D-二聚体(D-Dimer)为(1.32±0.16)μg/ml水平明显高于对照组,差异有统计学意义(P<0.05);不同类型肿瘤患者血浆PT、APTT、FIB、D-Dimer水平均明显高于对照组,差异有统计学意义(P<0.05)。肺癌组血浆FIB水平明显高于肠癌组、胃癌组,差异有统计学意义(P<0.05),而肠癌组血浆FIB水平与胃癌组比较无统计学意义。胃癌组、肺癌组和肠癌组血浆FIB水平在化疗不同时期均未见明显变化。结论 凝血指标对肿瘤的早期诊断、疗效监测有一定帮助,是肿瘤患者排除、预防静脉血栓的良好指标。     

超敏C反应蛋白在心脑血管疾病中的临床应用价值

目的：探讨超敏c反应蛋白在心脑血管疾病中的变化及诊断价值。方法：选择临床诊断为168例的冠心病、53例脑血管病和72例健康体检者,采用增强透射免疫比浊法,分别对上述病例组及对照组进行hs-CRP含量测定。结果：冠心病、脑血管病患者组hs-CRP含量均高于对照组,差异有显著性（P〈0.01）;心、脑血管疾病患者各组间hs-CRP含量差异也具有非常显著性（P〈0.01）。结论：血清超敏C反应蛋白水平与心、脑血管疾病发生密切相关,其含量的变化对疾病的诊断、发展及预后有重要临床价值。     

核仁形成区嗜银蛋白在肿瘤免疫监测中的意义

目的：探讨T淋巴细胞核仁形成区嗜银蛋白（Ag-NORs）的检测与肿瘤患者机体细胞免疫、生物治疗之间的关系，了解它在肿瘤免疫状态监测中的意义。方法：采用KL型肿瘤免疫图像分析系统及配套试剂对正常人、良性疾病及肿瘤患者，及肿瘤患者生物治疗前后外周血T淋巴细胞进行染色分析。结果：恶性肿瘤患者与正常人及良性疾病患者之间、化疗后完全缓解者和复发转移者间、免疫细胞治疗前后均有显著差异。结论：外周血T淋巴细胞核仁形成区嗜银蛋白检测可准确反映肿瘤患者的免疫状态，与肿瘤负荷和病情进展呈负相关，与机体免疫状态呈正相关，它是恶性肿瘤病情、免疫状态监测的重要指标。     

冠心病患者C反应蛋白与胱抑素C检测的临床价值研究

目的：探讨冠心病患者C反应蛋白（CRP）与胱抑素C（CysC）检测的临床价值。方法：选择冠心病106例,包括急性心肌梗死（AMI组）35例,不稳定型心绞痛（UA组）43例、稳定型心绞痛（SA组）28例;另选择健康体检者30例作为对照组。CRP检测采用乳胶凝集比浊法,CysC检测采用乳胶颗粒增强免疫透射比浊法。结果：CRP水平AMI组较对照组显著增高（P〈0.01）,UA组亦高于对照组（P〈0.05）,SA组与对照组比较,差异不显著（P〉0.05）。CysC水平AMI组较对照组显著增高（P〈0.01）,UA组及SA组亦高于对照组（P〈0.05）。结论：CRP与CysC水平检测对冠状动脉病变及其严重程度评定有重要参考价值。     

冠心病患者血浆循环游离线粒体DNA定量分析及其临床意义

目的:检测冠心病(CHD)患者外周血血浆循环游离线粒体DNA(ccf-mtDNA)含量并初步探讨其临床应用价值。方法:收集106例CHD患者和106例健康志愿者的外周血样本,以荧光实时定量PCR方法检测各组血浆ccf-mtDNA含量,比较分析血浆ccf-mtDNA水平与CHD的临床相关性。结果:CHD患者血浆ccf-mtDNA含量明显高于对照组(P<0.01)。以CHD组血浆ccf-mtDNA含量绘制ROC曲线,曲线下面积为0.724(95%可信区间为0.665～0.783),以血浆ccf-mtDNA含量≥0.71×106为临界值,用ccf-mtDNA诊断CHD的敏感度为74.7%,特异度为73.0%。血浆ccf-mtDNA含量与CHD患者SBP、DBP、TC、LDL-C、FPG显著正相关(P<0.05),与年龄、HDL-C显著负相关(P<0.05)。结论:血浆ccf-mtDNA含量对CHD患者的早期诊断及病程监测具有重要的临床价值,可作为CHD事件发生的监测指标。     

测定急性冠脉综合征患者同型半胱氨酸和白细胞介素-18的意义

目的探讨不同类型冠心病患者血浆同型半胱氨酸(Hcy)和白细胞介素-18(interleukin-18,IL-18)的变化及意义.方法92例冠心病(coronary heart disease,CHD)患者,根据病情分为2组,急性冠脉综合征(ACS)组62例,稳定型心绞痛(SAP)组30例,健康对照组40例.分别检测各组患者血浆Hcy、IL-18.对冠心病患者的冠状动脉损害行Gensini评分,并比较各组间的差异.结果①ACS组、SAP组的Hcy、IL-18高于对照组(P＜0.01),②随着冠状动脉病变Gensini评分的增加,Hcy,IL-18浓度升高越明显.结论 冠心病患者血浆Hcy、IL-18显著升高,其升高程度与病情严重程度及血管病变程度相关.     

冠心病患者循环内皮细胞与血浆内皮素的相关性研究

为探讨冠心病患者血管内皮细胞损伤与血浆内皮素浓度的关系,本文以循环内皮细胞(CEC)数量作为判断体内血管内皮细胞损伤的指示物,同时以放免法检测血浆内皮素含量,对36例冠心病患者与30例正常人的循环内皮细胞数及血浆内皮素含量进行了测定。结果表明,冠心病组与正常组相比,CEC数量和血浆内皮素浓度显著增高(P<0.001),CEC数量和血浆内皮素浓度呈显著正相关,r=0.81,P<0.001。提示冠心病人存在明显的血管内皮细胞损伤和内皮素分泌增多,两者呈显著正相关,共同参与冠心病的病理过程。     

腹腔镜手术和开腹手术对于妇科肿瘤患者凝血功能和免疫指标的影响

目的：对比分析不同手术方式对于妇科肿瘤患者凝血功能和免疫功能的影响。方法将接受手术治疗的317例妇科肿瘤患者分为腹腔镜组165例（腹腔镜手术治疗）和开腹组152例（开腹手术治疗）,在手术治疗前后分别检测凝血功能指标（包括血浆凝血酶原时间、活化部分凝血活酶时间、凝血酶时间、纤维蛋白原以及血小板）和免疫功能指标（包括IgG、IgA、IgM抗体和CD3＋、CD4＋、CD8＋T淋巴细胞亚群比例）变化,对比两组间检测结果的差异性。结果手术后两组的PT、APTT、FIG都出现了明显波动,开腹组PT、APTT、FIG明显区别于腹腔镜组,组间数据明显差异（ P＜0.05）;手术后,两组免疫球蛋白IgG含量、T淋巴细胞亚群比例均有明显变化,手术后对照组的CD3＋、CD4＋、CD8＋波动幅度明显高于腹腔镜组,组间对比,P＜0.05,差异有统计学意义。结论腹腔镜手术和开腹手术都能够引发妇科肿瘤患者凝血功能和免疫功能变化,腹腔镜手术作为微创手术,对于患者机体的应激性损伤更微小。     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.     

Bronchial stump fistula :treatment with covered retrievable hinged metallic stents-preliminary clinical experience

Objective To evaluate the preliminaily clinical efficacy and retrievability of a retrievable hinged covered metallic stent in the treatment of the bronchial stump fistula （BSF）. Methods Between April 2003 and March 2005, 8 patients with bronchial stump fistula after pneumonectomy or lobectomy were treated with two types （A and B） of retrievable hinged covered metallic stents. Type A stent was placed in 6 patients and type B in 2 under fluoroscopic guidance. The stent was removed with a retrieval set when BSF was healed or complications occurred. Results Stent placement in the bronchial tree was technically successful in all patients, without procedure-related complications. Immediate closure of the BSF was achieved in all patients after the procedure. Stents were removed from all patients but one. Removal of the stents was difficult in two patients due to tissue hyperplasia. Patients were followed up for 6 - 21 months. Placement of the stents remained stable in all patients except one due to severe cough. Permanent closure of BSF was achieved in 7 （87.5%） of 8 patients. Conclusion Use of a retrievable hinged covered expandable metallic stent is a simple, safe, and effective procedure for closure of the BSF. Retrieval of the stent seems to be feasible. （J Intervent Radiol, 2007, 16： 253-257）