牛樟芝对易卒中的自发性高血压大鼠脑蛋白质组学的影响

目的 研究牛樟芝能否延长易卒中的自发性高血压大鼠的生存时间,并运用蛋白质组学方法对其作用机制进行探讨。 方法 先选取80只雄性易卒中的自发性高血压大鼠,随机分为给药组和对照组（每组40只）,给药组每天用牛樟芝（150 mg/kg）灌胃治疗,记录卒中大鼠的自然死亡时间。另外再选取6只易卒中的自发性高血压大鼠,随机分为给药组和对照组（每组3只）,给药组给予牛樟芝灌胃治疗（150 mg/kg）,连续90 d后取大鼠脑组织进行蛋白质组学研究,用WKY大鼠作为正常对照,对用药前后产生的差异蛋白点进行质谱鉴定,并用蛋白质印迹法进一步验证组学的鉴定结果。 结果 牛樟芝延长了易卒中的自发性高血压大鼠的生存时间（P<0.05）,蛋白质组学鉴定结果显示牛樟芝上调了脑组织抗氧化酶谷胱甘肽巯基转移酶（GST）和超氧化物歧化酶（SOD）的表达（P<0.05）,这一结果得到了蛋白质印迹法的验证。对脑组织氧化应激水平的研究发现机体的总抗氧化能力增强[T-AOC：（66.48±16.17） U/g vs （124.75±28.43） U/g, P<0.05）,表现在GST和SOD的酶活性增加[GST：（40.33±5.24） U/mg vs （70.50±6.24） U/mg, P<0.05; SOD：（109.25±23.61） U/mg vs （192.60±23.95） U/mg,P<0.05],而氧化应激产物丙二醛含量减少[（3.96±0.45） nmol/mg vs （2.04±0.31） nmol/mg,P<0.05]。 结论 长期服用牛樟芝能延长易卒中的自发性高血压大鼠的生存时间,这可能与其增加脑组织抗氧化酶的表达、减轻氧化应激的损伤有关。     

Thiopurine methyltransferase gene polymorphisms and activity in Chinese patients with inflammatory bowel disease treated with azathioprine

Background  The thiopurine drugs are well established in the treatment of inflammatory bowel disease (IBD). However, uncertainty regarding the risk for neutropenia and hepatotoxicity deters its using. Thiopurine methyltransferase (TPMT) is the key enzyme in the metabolism of thiopurine. The aim of this study was to investigate the association of TPMT polymorphisms and activity with azathioprine (AZA)-related adverse events and clinical efficacy in Chinese Han patients with IBD.

Methods  Fifty-two Han IBD patients treated with AZA were assessed for TPMT*2, *3A, *3B, and *3C, and for adverse events. Then, using reverse-phase high-performance liquid chromatography, TPMT activity was measured in 13 patients to analyze its correlation with AZA-related toxicity and clinical efficacy.

Results  Of the 52 patients, five experienced myelotoxicity and one experienced hepatotoxicity during treatment. No TPMT*2, *3A, *3B or *3C polymorphisms were detected in any of the 52 patients. In the 13 patients with TPMT activity measurement, TPMT activity ranged from 7.2 to 28.8 U/ml packed red blood cells (pRBCs). Among the 5 patients who suffered from myelotoxicity, 3 were affected in the early stage of AZA therapy. In these 3 patients, TPMT levels were significantly lower than those in patients without myelotoxicity, which reached statistical significance ((9.3±2.1) U/ml pRBC vs. (18.0±6.2) U/ml pRBC; P=0.046). One patient who had higher TPMT activity (28.8 U/ml pRBC) suffered from hepatotoxicity during AZA therapy. Patients who achieved a clinical response had lower TPMT activity than those failed to respond ((13.7±3.5) U/ml pRBC vs. (22.0±5.5) U/ml pRBC; P=0.009).

Conclusions  TPMT variants do not completely account for the AZA-related myelotoxicity in Chinese Han IBD patients. However, measurement of TPMT activity may be helpful in reducing the risk of toxicity, and predicting the therapeutic efficacy.

     

阻塞性睡眠呼吸暂停综合征患者体内氧自由基代谢的作用

研究持续正压通气后阻塞性睡眠呼吸暂停综合征（OSAS）患者体内超氧化物歧化酶 (SOD)、谷胱甘肽过氧化酶（GSH PX）活力和丙二醛（MDA）含量的变化，探讨OSAS患者多器官功能损害，衰老加速的机理。方法：选择OSAS患者63例行SOD、GSH PX活性和血清MDA含量检测；对OSAS患者行持续正压通气(CPAP)治疗3个月后，重新检测SOD、GSH PX活性和血清MDA含量，并选择60例健康人作为正常对照。结果：SOD、GSH PX活性和血清MDA含量，正常对照组分别为(139.6±36.6)?nmol/L、(78.6±8.0)?U/ml、(1.48±0.59)?mmol/L；OSAS患者含量分别为(104.5±39.3 )?nmol/L、(61.5±6.7)?U/ml、(5.87±1.67)?mmol/L；持续正压通气(CPAP)治疗3个月后，SOD、GSH PX活性和血清MDA含量分别为(134.5±36.1)?nmol/L、(74.6±6.6)?U/ml、(1.62±0.58)?mmol/L，与正常对照组相比，OSAS患者MDA明显升高，SOD、GSH PX活性显著降低，差异均有统计学意义（P＜0.05）；CPAP治疗3个月后，SOD、GSH PX活性、MDA含量与正常对照组相比差异无统计学意义（P＞0.05）。结论：OSAS患者体内存在严重的氧自由基代谢失衡，CPAP治疗3个月后，氧自由基代谢可基本恢复正常，OSAS患者多器官功能损害，衰老加速可能与体内存在严重的氧自由基代谢失衡有关。     

Serum level of galectin-3 and its clinical significance in patients with chronic Keshan disease

Objective: Keshan disease (KD) is a fatal endemic dilated cardiomyopathy with unclear etiology and pathogenesis, and a high mortality in China. Pathologic studies confirmed that different degree of myocardial fibrosis existed in various types of KD. Myocardial fibrosis is an important contributor to the pathophysiology of left ventricular remodeling. Recently, galectin-3 (Gal-3) as a marker of cardiac fibrosis and heart failure was approved by the US FDA. The aim of this study was to evaluate the changes of serum level of Gal-3 in chronic KD (CKD) and their clinical implications. Methods: The levels of serum Gal-3 were measured by using enzyme-linked immunosorbent assay (ELISA) in 37 CKD patients and 32 healthy controls. Echocardiography was used to determine parameter of left ventricular ejection fraction (LVEF) and left ventricular end-diastolic dimension (LVEDD). Results: The serum concentration of Gal-3 ([95.81±18.99] ng/ml versus [48.16±11.09] ng/ml, t=6.906, P<0.001) and LVEDD ([60.46±7.63] mm versus (42.69±10.66) mm, t=3.61, P<0.01) were significantly higher, while LVEF ([42.69±10.66]% versus [62.16±6.38]%, t=4.679, P<0.01) were significantly lower in CKD patients compared with healthy controls. A negative correlation was found between elevated Gal-3 and lower LVEF (r=-0.882, P<0.001) and a positive correlation was found between elevated Gal-3 levels and enlarged LVEDD (r=0.834, P<0.001) or higher NYHA class (r=0.854, P<0.01) in CKD patients. Conclusion: Serum concentration of Gal-3 is strongly correlated with poorer left ventricular systolic function, enlarged LVEDD and higher New York Heart Association (NYHA) class, which may provide indirectly diagnostic information on myocardial fibrosis and heart function in CKD patients.     

血清抗C1q抗体在系统性红斑狼疮患者中的临床价值

目的 探讨血清抗C1q抗体在系统性红斑狼疮(SLE)患者狼疮肾炎(LN)以及疾病活动中的临床价值.方法 采用ELISA法检测102例SLE患者以及35例正常对照组血清中抗C1q抗体水平,比较分析其与SLE病情活动指数(SLEDAI)评分、疾病活动性指标抗双链DNA(ds-DNA)抗体、补体C3、C4水平、超敏C反应蛋白(hs-CRP)以及肾脏损害指标24 h尿蛋白定量(24 h UPQ)、肌酐(Cr)、尿素氮(BUN)的相关性,以及通过联合检测抗ds-DNA抗体以及抗核小体抗体(AnuA)判断其在SLE中的临床价值.结果 总体SLE患者抗C1q抗体敏感性为55.9%,特异性为94.3%,在SLE中其抗体水平显著高于正常对照组,其中疾病活动LN组、疾病稳定LN组和疾病活动非LN组抗 C1q 抗体水平明显高于疾病稳定非LN组水平,差异有统计学意义(P<0.01),而疾病稳定LN组、疾病活动LN组与疾病活动非LN组之间比较,差异无统计学意义.在疾病活动期中,抗C1q抗体水平与SLEDAI评分、ds-DNA、hs-CRP呈正相关性(P<0.05),与C4呈负相关性(P<0.05),C3和24 h UPQ仅在疾病活动LN组中呈相关性;在疾病稳定期中,抗C1q抗体水平只有在疾病活动和疾病稳定LN组中与24 h UPQ呈正相关性,与C3、C4呈负相关性.联合检测抗ds-DNA抗体、AnuA、抗C1q抗体显著提高稳定期LN的诊断价值.结论 抗C1q 抗体对SLE的诊断和LN判断有重要临床价值,抗C1q 抗体参与了SLE肾脏损害的发病机制,联合检测抗ds-DNA抗体、AnuA、抗C1q抗体有助于SLE稳定期肾脏损害的诊断.     

The investigation for the relationship between serum Leptin,erythrocyte membrane Ca2+—ATPase activity and hypertensive disorder complicating pregnancy

ObjectiveTo study the significance of Leptin and the activity of erythrocyte membrane Ca²⁺ - ATPas (EMCA) in the development of hypertensive disorder complicating pregnancy.MethodsRadioimmunoassay was used to test the level of serum Leptin and the activity of EMCA was determined chemically in 38 pregnant women with hypertensive disorder complicating pregnancy, and 36 normotensive pregnant women.ResultsThe level of serum Leptin in hypertensive disorder complicating pregnancy (gestational hypertension: 13.76 ± 3.46 ng/ml; preeclampsia : 15.76 ± 5.47 ng/ml; eclampsia : 18.32 ± 6.38 ng/ml) was significantly higher than that in normotensive pregnant women (11.33 ± 2.93ng/ml), respectively. The average EMCA activity of patients with hypertensive disorder complicating pregnancy (gestational hypertension : 1.65 ± 0.24 u mol · pi/mg · h; preeclampsia: 1.37 ± 0. 19 11 mol · pi/mg · h; eclampsia : 1.12 ± 0.14 u mol · pi/mg · h) was significantly lower than that of normotensive pregnant women (l.83 ± 0.38 u mol · pi/mg · h), respectively. There was a negative correlation between the level of serum Leptin and the activity of RMCA in hypertensive disorder complicating pregnancy (r = −0. 63).ConclusionInhibition of EMCA activity of erythrocyte in hypertensive disorder complicating pregnancy may increase cytoplasmic free calcium, which contributes to the development of hypertensive disorder complicating pregnancy. The negative correlation between the level of serum Leptin and the activity of EMCA, also suggested that serum Leptin and the activity of EMCA may play a role in the development of hypertensive disorder complicating pregnancy.     

Effect of transforming growth factor-β2 on phagocytosis in cultured bovine trabecular meshwork cells

Summary The effect of transforming growth factor-β₂ (TGF-β₂) on phagocytosis in bovine trabecular meshwork cellsin vitro was investigated. After the cultured bovine trabecular meshwork cells were treated with 0 ng/ml, 0.32 ng/ml, 1 ng/ml, 3. 2 ng/ml TGF-β₂ for 24 h, latex beads were added into the incubation medium, and the numbers of the latex beads in 20 adjacent cells were counted under a microscope 24 h later, after treatment with Wright’s stain. Our results showed that the average numbers of the latex beads in the trabecular meshwork cells treated with TGF-β₂ of different concentrations were 53. 1±1. 7 beads/cell, 56. 4±2. 9 beads/cell and 77. 9±6. 5 beads/cell respectinvely, in comparison with 45. 5 ±3. 3 beads/cell of the control group. TGF-β₂ significantly increased the number of the latex beads phagocytosed by cultured bovine trabecular meshwork cells in a dose-dependent manner. TGF-β₂ could promote the phagocytosis of bovine trabecular meshwork cellsin vitro. It may be involved in the cellularity decrease of the trabecular meshwork in the patients of primary open angle glaucoma through promoting the phagocytosis of trabecular meshwork cells. This project was supported by a grant from the National Natural Science Foundation of China (No. 38970758).     

Effect of Yangqixue Qufengshi Recipe on rheumatoid arthritis model mice under different genetic backgrounds

Objective: To study the effect of Yangqixue Qufengshi Recipe (YQXQFS) on rheumatoid arthritis (RA) model mice under different genetic backgrounds.Methods: Collagen Induced Arthritis (CIA) were established on HLA-DR4 transgenic (TG) mice and non-transgenic (NTG) mice, which partly were raised with YQXQFS, and the onset day of CIA, the level of type II collagen (C II)-reactive antibodies and the pathological scores of CIA were assessed.Results: Under HLA-DR4 TG background (compared with NTG mice), the earlier onset day of CIA (11.22 ± 3.35 days vs 16.56 ± 4.75 days,P<0.05) and higher level of C II-reactive antibodies (0.2274 ± 0. 1390 μg/ml vs 0. 1101 ± 0.0560 μg/ml,P<0.05) were observed, but the pathological scores of CIA remained unchange. YQXQFS could not influence the onset day of CIA and the level of CII -reactive antibodies, but had a certain effect on the total pathological scores (6.56 ± 3.43 scores vs 11.11 ± 5.64 scores) and bone erosion (0.22 ± 0.44 scores vs 1.67 ± 1.50 scores) of CIA on NTG mice (P<0.05), NTG YQXQFS group compared with NTG experimental group.Conclusion: YQXQFS had a certain effect on RA model, but had no significant effect on HLA-DR4 related CIA.     

乙肝肝硬化合并自发性细菌性腹膜炎患者血清和腹水中糖链抗原125及降钙素原的变化情况

目的 探讨乙肝肝硬化合并自发性细菌性腹膜炎患者血清和腹水中糖链抗原125(sugar chain antigen 125,CA125)及降钙素原(procalcitonin,PCT)的变化情况。 方法 选择2013年1月—2016年6月杭州市西溪医院乙肝肝硬化腹水合并自发性细菌性腹膜炎患者60例作为观察组、乙肝肝硬化腹水未合并自发性细菌性腹膜炎患者60例作为对照组。测定2组患者血清和腹水中CA125、PCT水平。 结果 观察组血清CA125和PCT水平[(425.76±157.43) U/L、(1.326±0.434) ng/ml]均高于对照组[(314.27±132.95) U/L、(0.587±0.276) ng/ml],P<0.05。观察组腹水CA125和PCT水平[(567.34±213.75) U/L、(0.983±0.316) ng/ml]均高于对照组[(378.52±167.53) U/L、(0.214±0.105) ng/ml],P<0.05。抗生素治疗有效患者47例中,治疗后血清和腹水CA125、PCT水平[(411.53±152.13) U/L、(1.279±0.424) ng/ml;(558.76±202.14) U/L、(0.946±0.307) ng/ml)]均低于治疗前[(331.86±143.25) U/L、(0.635±0.265) ng/ml;(385.42±197.47) U/L、(0.546±0.324) ng/ml],P<0.05。血清CA125和腹水CA125呈正相关(r=0.882,P<0.001),血清PCT和腹水PCT呈正相关(r=0.856,P<0.001)。血清CA125水平和血清PCT水平无显著相关性(P>0.05)。 结论 乙肝肝硬化合并自发性细菌性腹膜炎患者血清和腹水中CA125、PCT水平升高,经抗生素治疗有效患者血清和腹水中CA125、PCT水平下降。      

葡萄糖6-磷酸异构酶在类风湿关节炎中的诊断意义

目的:探讨葡萄糖6-磷酸异构酶在类风湿关节炎中的诊断意义。方法:应用ELISA方法检测血清中的GPI和抗CCP抗体。结果:①312例RA患者血清GPI平均浓度为(0.86±1.01)μg/ml,333例非RA患者的GPI平均浓度为(0.23±0.54)μg/ml;RA组抗环瓜氨酸(抗CCP)抗体平均浓度是(35.61±45.32)Ru/ml,非RA组抗CCP平均浓度为(2.54±3.85)Ru/ml,均有显著差异;②敏感性:GPI为89.74%,抗CCP为97.56%;特异性:GPI为90.03%,抗CCP为98.71%,均无显著差异;③通过回归分析发现关节肿胀、疼痛与GPI浓度相关。结论:GPI可能成为诊断RA及判断疾病活动性的一个新指标。     

子宫肌瘤腹腔镜剥除术中止血药物效果分析

目的 探讨垂体后叶素与缩宫素在腹腔镜下肌壁间子宫肌瘤剥除术的临床效果。方法 选取2015年10月~2016年12月行腹腔镜下子宫肌瘤剥除术的患者60例,分成两组各30例。治疗组注射6IU垂体后叶素+10ml生理盐水,对照组注射20U缩宫素+10ml生理盐水,按照两组的用药情况,观察比较血压变化和其他情况。结果 治疗组与对照组比较,手术时间明显减少（98.13±5.07min vs 110.83±8.03min,t=-7.324,P=0.000）,术中出血量明显减少（67.50±10.24ml vs 97.83±16.10ml,t=-8.705,P=0.000）,血红蛋白术前术后变化（9.67±2.09g/L vs 11.53±2.21g/L,t=-3.362,P=0.001）。术中用药后15min,治疗组收缩压上升,显著高于对照组（150.77±5.57mmHg vs 142.03±5.21mmHg,t=6.273,P=0.000）。结论 腹腔镜下肌壁间子宫肌瘤剥除术应用垂体后叶素止血效果明显优于缩宫素,但会引起短暂性血压升高,临床使用应结合患者病情个性化选择。     

氧糖剥夺条件下p75神经营养素受体在人神经母细胞瘤细胞中的表达和作用

目的 探讨氧糖剥夺（OGD）条件下p75神经营养素受体（p75NTR）在人神经母细胞瘤细胞（SH-SY5Y）中的表达变化和作用。方法 SH-SY5Y细胞OGD模型的建立采用三气培养箱无糖无血清培养方法。模型成功建立后设立3组：无血清常规培养组（对照组）、OGD组和OGD+p75NTR竞争性阻断剂LM11A-31处理组（OGD+LM11A-31组）。在细胞培养12 h时用利用四甲基偶氮唑盐（MTT）法检测3组细胞存活率,乳酸脱氢酶（LDH）活力检测试剂盒测定LDH释放活力,流式细胞术检测凋亡细胞比例,蛋白质印迹法检测p75NTR的蛋白表达。结果 成功构建SH-SY5Y细胞OGD模型。细胞培养12 h时,对照组、OGD组和OGD+LM11A-31组细胞存活率分别为（94.80±4.06）%、（50.34±5.55）%、（64.68±4.59）%,LDH释放活力分别为（46.93±5.49）U/L、（353.09±30.67）U/L和（282.20±25.60）U/L,凋亡细胞比例分别为（1.82±0.45）%、（14.98±2.59）%和（7.36±1.98）%,p75NTR蛋白相对表达量分别为0.06±0.01、0.41±0.02和0.19±0.03,差异均有统计学意义（F=67.94、142.10、36.28、221.20,P均<0.05）。多重比较显示,OGD组细胞存活率低于对照组,LDH释放活力高于对照组,凋亡细胞比例高于对照组,p75NTR蛋白表达高于对照组,差异均有统计学意义（Bonferroni法,P''均<0.05）;而LM11A-31处理后OGD+LM11A-31组细胞存活率高于OGD组,LDH释放活力低于OGD组,凋亡细胞比例低于OGD组,p75NTR蛋白表达低于OGD组,差异均有统计学意义（Bonferroni法,P''均<0.05）。结论 OGD条件下p75NTR在人神经母细胞瘤细胞SH-SY5Y中表达增加,可能促进了神经损伤和凋亡。     

汉族炎症性肠病患者硫嘌呤甲基转移酶多态性与硫唑嘌呤药物毒副作用及疗效的相关性研究

研究目的：探讨汉族炎症性肠病（IBD）患者硫嘌呤甲基转移酶（TPMT）基因多态性及活性与硫唑嘌呤药物毒副作用及疗效的关系,从而提高用药安全性,建立个体化治疗方案。研究方法：对52例接受硫唑嘌呤(AZA)维持治疗的IBD患者监测骨髓抑制及肝脏毒性的发生情况,并运用引物特异性PCR及PCR-RFLP方法进行TPMT*2,*3A,*3B,*3C四种突变等位基因检测。进一步采用反相高效液相色谱法（HPLC）,对其中13例患者进行红细胞内TPMT活性检测,初步探讨汉族IBD患者TPMT基因多态性及活性与AZA药物毒副作用及疗效的关系。研究结果：在对52例接受AZA治疗的IBD患者的随访中,观察到有5例患者发生了骨髓抑制,1例发生了肝脏毒性。而基因多态性检测发现该6例患者均不存在TPMT*2,*3A,*3B,*3C这4种常见的TPMT突变等位基因。在TPMT 活性的研究中发现,发生早期骨髓抑制的3例患者TPMT平均活性低于没有发生骨髓抑制的患者（9.3±2.1 U/ml pRBC vs 18.0±6.2 U/ml pRBC;p=0.046）,并且低于早期未发生骨髓抑制的患者组（9.3±2.1 U/ml pRBC vs 17.7±5.5 U/ml pRBC;p=0.029）。发生肝脏毒性的患者1例,TPMT活性为28.8 U/ml pRBC,明显高于没有发生肝脏毒性的患者（14.7±4.8U/ml pRBC）。AZA治疗中维持缓解的IBD患者TPMT活性显著低于没有诱导缓解的患者（13.7±3.5 U/ml pRBC vs 22.0±5.5 U/ml pRBC;p=0.009）。结论： TPMT基因多态性检测并不能很好地解释AZA药物毒副作用;而初步研究发现TPMT活性能较好的预测早期药物毒副作用的发生及治疗疗效。     

胃癌患者手术前后血清CA724和CA50水平及临床意义

目的:研究血清糖链抗原(CA724)和糖链抗原(CA50)在胃癌患者手术前后的水平变化及临床意义。方法:胃癌患者33例,良性胃疾病患者31例,在33例胃癌患者中有6例复发转移,采用免疫放射分析法(IRMA)分别检测了空腹血清CA724和CA50水平。结果:胃癌组血清CA724和CA50水平分别为21.7±44.6U/ml,27.8±37.5U/ml,胃良性疾病组血清CA724和CA50水平分别为2.98±1.64U/ml,6.78±7.45U/ml,差异显著(P<0.01)。胃癌患者术前组血清CA724、CA50水平分别为21.7±44.6U/ml,27.8±37.5U/ml高于术后14.3±26.6U/ml,22.5±31.4U/ml,差异显著(P<0.01)和(P<0.05)。胃癌患者有淋巴结转移组血清CA724、CA50水平分别为27.3±64.5U/ml,30.6±48.8U/ml,高于无淋巴结转移组17.4±30.8U/ml,19.9±27.3U/ml,差异显著(P<0.01)。结论:手术切除肿瘤特别是行根治性切除术后,血清CA724水平显著降低。动态观察CA724、CA50水平及其变化,表明CA724、CA50水平与肿瘤的浸润及转移过程密切相关,胃癌患者手术前后的测定对有无复发转移是一项重要的判断指标。     

Changes in left atrial functional indexes in ischemic stroke patients

BackgroundIncreased left atrial (LA) size has been proposed as a predictor of multiple adverse cardiovascular events including stroke. LA dysfunction can occur in the absence of increased LA size. However, the relationship between stroke and changes in LA function is not well known.MethodsPatients with acute ischemic stroke and healthy controls were enrolled prospectively. Stroke patients received standard work-ups to determine the etiology of their strokes. Those patients with significant cardiac arrhythmia and heart failure were excluded. All participants received echocardiography examination. Conventional echocardiographic parameters were calculated and cardiac contractile characteristics of the left atrium and left ventricle were analyzed using vector velocity imaging (VVI) technique.ResultsIn total, 87 patients with acute ischemic stroke and 20 controls were recruited. The mitral inflow E-wave velocities were lower and A-wave velocities were higher in stroke patients (0.76 ± 0.19 vs. 0.84 ± 0.16, p = 0.048; and 0.97 ± 0.20 vs. 0.76 ± 0.11, p < 0.001 respectively). Stroke patients had a higher active emptying percent of total LA emptying (60.5 ± 19.0%) compared with that in controls (33.5 ± 11.7%, p < 0.001). The minimal LA volume was larger in stroke patients (15.0 ± 10.5 mL) than that in controls (9.9 ± 4.2 mL, p = 0.021), whereas there was no difference in maximal LA volume between stroke patients (37.3 ± 16.5 mL) and controls (33.3 ± 9.9 ml, p = 0.366). The diastolic emptying index of the LA was significantly lower in stroke patients compared with that in controls (61.4 ± 14.6% vs. 70.2 ± 11.0%, p = 0.016). The mitral A-wave velocity and active emptying percent of total LA emptying were significantly higher in all stroke subtypes than those in controls.ConclusionAcute ischemic stroke patients had altered mitral inflow velocities and emptying function of the left atrium. VVI is convenient for quantitative assessment of left atrial volumes and contractile characteristics. Functional changes of LA may occur without significant structural changes. Therefore, the clinical implications of LA functional indexes require further study.     

Determination of Serum Interleukin-13 and Nerve Growth Factor in Patients with Systemic Lupus Erythematosus and Clinical Significance

Systemic lupus erythematosus (SLE) is an au-toi mmune disease characterized by B-cell hyperac-tivity , production of autoantibody and abnormali mmunoregulation. At present , both interleukin-13 (IL-13) and nerve growth factor ( NGF) havebeen provedto play a rolein sti mulatingthe prolif-eration and differentiation of human B-cells andin-ducing i mmunoglobulin (Ig) synthesis . The pur-pose of this study was toinvestigate the changesinthe levels of serumIL-13 and NGFin patients withSLE an…     

托吡酯治疗癫痫患儿20例临床分析

目的 探讨托吡酯治疗癫痫患儿的临床疗效,并分析托吡酯对癫痫患儿血糖、胰岛素、皮质醇、瘦素、胃饥饿素和神经肽Y水平及对患儿体重指数的影响。 方法 回顾性分析2011年10月—2013年10月间在浙江省人民医院儿科进行治疗的20例癫痫患儿病例资料。所有患儿均给予5 mg/(kg·d)托吡酯进行治疗,于治疗前、治疗后3个月和6个月时测定患儿空腹血糖、胰岛素、血清瘦素、神经肽Y、胃饥饿素、皮质醇的水平和患儿体重指数。 结果 治疗3个月时,患儿胰岛素水平、身体质量指数(BMI)分别为(4.65±2.28) μU/ml和(15.87±1.90) kg/m2,均显著低于治疗前的(5.83±2.72) μU/ml和(16.44±1.84) kg/m2(P＜0.05);而治疗6个月时,胰岛素水平比治疗3个月时升高,且与治疗前比较差异无统计学意义(P＞0.05)。治疗6个月时,患儿血清皮质醇和瘦素水平分别为(10.13±4.17) μg/dl和(2.14±2.03) ng/ml,显著低于治疗前的[(13.25±5.50) μg/dl和(2.89±2.63) ng/ml](P＜0.05);治疗前后,患儿的血糖、胃饥饿素和神经肽Y水平无显著性变化(P＞0.05)。 结论 托吡酯治疗癫痫患儿,血清瘦素、皮质醇水平降低,这可能是托吡酯治疗导致癫痫患儿身体质量指数水平下降的重要原因。      

Effect of Technetium-99 Conjugated with Methylene Diphosphonate on IgM-RF,IgG-RF and IgA-RF

Technetium 99conjugatedwithmethylenediphosphonate(99Tc MDP)hasbecomeafirstclassofnewdruginrecentyearsbecauseofitsspecialphar macologicaleffectonrheumatoidarthritis (RA) [1] .Rheumatoidfactors (RFs) (includingIgM RF ,IgG RFandIgA RF)aretheimportantmarkersofdiag nosis,activitydegree ,drugtherapeuticefficacyandprognosisjudgementofRA ,whichplayanimportantroleontheonsetandproceedingofRA[2 ] .Toexplorethetherapeuticeffectof99Tc MDPonRAfurther ,thisstudywasdesignedtoobserveespeciallytheef…     

精准肝切除在结直肠癌肝转移同期切除中的临床应用

目的 探讨精准肝切除在结直肠癌肝转移同期切除的临床疗效。方法 回顾性分析2004年1月~2014年6月符合研究条件的61例患者的临床资料,分为精准肝切除组(A组,n=31),Pringle法的传统肝切除组(B组,n=30),对比分析两组临床相关指标。结果 两组患者术前资料具有方差齐性(P>0.05),具备可比性。A组手术时间(318.3±50.6min)比B组(176.1±55.9min)长(P<0.05),但A组的术中出血量少(354.9±69.8mlvs543.4±114.8ml)、术后肝功能恢复快(ALT:383.7±100.9U/Lvs555.0±91.3U/L,AST:329.6±77.9U/Lvs406.6±105.2U/L,Alb:31.7±2.1g/Lvs30.5±1.7g/L)、并发症少(8例vs16例)、住院时间短(16.6±2.9天vs20.4±2.7天,P<0.05)。A组使用术中超声较术前新发现肝转移灶7例。结论 在结直肠癌肝转移同期手术中,精准肝切除优于传统肝切除。     

Surgical techniques for improving hemostasis during Bentall procedure

Objective： To evaluate the effect of modified surgical techniques on hemostasis used in aortic root replacement with a composite graft （Bentall procedure）. Methods： Data on 15 patients who underwent Bentall procedure during 2005 to 2007 were analyzed. The first 5 patients （Group 1） received the standard procedure. Then next 10 patients （Group 2） received the modified procedure. Techniques including ＂tandem suture line＂, ＂endo-button buttress＂, ＂sandwich anastomosis＂ and ＂left ventricle filling＂ were added to the standard procedure. Perioperative bleeding and the volume of blood transfusion required were compared to estimate hemostasis in different groups. Results： Between groups 1 and 2, a significant difference was found in postoperative bleeding [（2193±383） ml vs （1012±258） ml, respectively; P〈0.05] and in volume of blood transfusion required [（7242±1416） ml vs （2520±708） ml, respectively; P〈0.05]. Conclusion： The modified surgical techniques used in our study are effective in the improvement of the hemostasis in Bentall procedure.