复可托佐治小儿反复呼吸道感染的疗效及免疫学观察

目的:观察口服复可托对反复呼吸道感染的疗效及免疫学的变化.方法:收集诊断为RRT的240例小儿,将其分两组,家长同意口服复可托的与未服用复可托的RRT患儿进行比较,观察服用复可托后患儿患病次数及血中T细胞亚群的变化,采用间接免疫荧光法计算200个淋巴细胞中阳性细胞百分率.结果:经临床实践证明,观察组120例患儿口服复可托后患儿发生RRT的次数明显降低,与未服用复可托的RRT患儿比较,差异有显著性(P＜0.01),检测后发现CD3+,CD8+在治疗前后差异无显著性意义,P＞0.05,T细胞亚群CD4+/CD8+比值均明显升高,P＜0.01,有显著性意义.结论:复可托可明显改善患儿免疫功能,提高机体免疫力,降低RRT的复发率.     

匹多莫德防治反复呼吸道感染55例临床疗效分析

目的 探讨匹多莫德对反复呼吸道感染的临床疗效.方法 90例哮喘患儿随机分为治疗组55人,对照组35人,治疗组在对照组治疗的基础上,加用匹多莫德治疗2个月,治疗前后监测IL-16、免疫球蛋白及淋巴细胞亚群.结果 与对照组比较,治疗组急性病程天数、上下呼吸道感染次数均少于对照组,差异均有统计学意义(P<0.05).感染急性发作期CD3+、CD4+、CD4+/CD8+ 淋巴细胞亚群较缓解期显著下降,CD8+细胞明显升高,免疫球蛋白轻度降低,IL-16明显增高,匹多莫德治疗后三项指标均有明显改善.除IgG、IgM外,余均有统计学意义(P<0.05).结论 匹多莫德治疗反复呼吸道感染疗效显著.     

转移因子治疗儿童反复呼吸道感染的疗效观察

目的研究小儿反复呼吸道感染应用转移因子治疗的临床效果。方法选择2012年6月-2014年6月我院收治的130例小儿反复呼吸道感染患儿作为研究组(常规治疗联合转移因子治疗),并选择同期收治的130例小儿反复呼吸道感染患儿作为对照组(给予常规治疗),分析两组不良反应发生情况、外周血T淋巴细胞亚群水平及临床治疗总有效率。结果比较两组治疗前外周血T淋巴细胞亚群水平(CD3+、CD4+、CD8+、CD4/CD8),无明显差异(P0.05),比较治疗后3个月两组外周血T淋巴细胞亚群水平情况,研究组CD8+显著低于对照组(P0.05),而CD3+、CD4+、CD4/CD8则均显著高于对照组(P0.05)。研究组不良反应发生率4.6%、临床治疗总有效率96.9%,均优于对照组的10%、65.4%(P0.05)。结论反复呼吸道感染患儿采取转移因子治疗,安全性高,能明显提高患儿的机体免疫状态,值得进一步推广应用。     

玉屏风散联合穴位贴敷对反复呼吸道感染患儿血清免疫球蛋白和外周血T淋巴细胞亚群的影响

目的 观察玉屏风散联合穴位贴敷对反复呼吸道感染患儿血清免疫球蛋白和外周血T淋巴细胞亚群的影响.方法 选取我院儿科收治的反复呼吸道感染患儿86例,采用随机数字表随机分为2组,各43例,对照组给予常规护理,试验组在对照组的基础上应用玉屏风散联合穴位贴敷护理.均以15 d为1疗程,连续护理2个疗程.对比2组临床总有效率及护理前后血清免疫球蛋白和外周血T淋巴细胞亚群的情况.结果 试验组总有效率为90.70%,对照组为69.77%,2组比较,P<0.05;2组血清免疫球蛋白均有所好转,且试验组IgG、IgA、IgM水平的提高较对照组明显(P<0.05);外周血T淋巴细胞亚群2组均有所好转,但试验组CD3+、CD4+、CD4+/CD8+水平提高,CD8+降低,较对照组明显(P<0.05).结论 玉屏风散联合穴位贴敷能够补益脾肺,护卫固表,提高患儿免疫功能,明显改善反复呼吸道感染引发的各种临床症状,有效治疗反复呼吸道感染.     

脾氨肽(复可托)治疗小儿反复呼吸道感染的临床疗效观察

目的:分析探讨脾氨肽(复可托)治疗反复呼吸道感染的临床疗效。方法:选取本院近年来收治的60例反复呼吸道感染患者作为研究对象,按照数字抽签法将其随机分为研究组与对照组,每组30例,研究组在常规治疗的基础上行复可托治疗,对照组仅行常规治疗,比较两组治疗效果。结果:研究组治疗显效率为56.7%,总有效率为90.0%,对照组治疗显效率为23.3%,总有效率为50.0%,研究组患者治疗效果明显优于对照组(P0.05)。与治疗前相比,研究组患者治疗后CD8指标出现明显下降,CD3、CD4、CD4/CD8指标出现明显上升,治疗前后研究组患者T细胞亚群指标比较差异有统计学意义(P0.05)。结论:复可托治疗反复呼吸道感染可改善患者免疫失衡状态,具有显著的临床疗效。     

外周血内T淋巴细胞亚群、IgE、CRP及PCT对儿童哮喘的临床意义

目的探讨外周血中T淋巴细胞亚群、免疫球蛋白E(IgE)、C反应蛋白(CRP)和血清降钙素原(PCT)水平改变在儿童哮喘临床治疗中的意义。方法选择84例哮喘患儿作为哮喘组,60例健康儿童作为对照组,测定并比较外周血T淋巴细胞亚群和IgE水平。哮喘组患儿根据是否合并感染,测定并比较血中CRP及PCT含量。结果哮喘组CD3~+、CD4~+和CD19~+细胞均高于对照组,CD8~+低于对照组,CD4~+/CD8~+比例高于对照组,差异均有统计学意义(P0.05);哮喘组Th2细胞和IgE高于对照组,Th1/Th2低于对照组,差异有统计学意义(P0.05)。两组Th1比较差异无统计学意义(P0.05);哮喘合并细菌感染组的患儿CRP和PCT阳性率高于其他两组哮喘患儿,哮喘合并病毒感染组患儿CRP和PCT阳性率高于单纯哮喘组,差异有统计学意义(P0.05)。结论外周血T淋巴细胞亚群和IgE水平可作为反应哮喘患儿疾病状态指标,结合检测CRP和PCT可判断哮喘患儿是否合并感染,在治疗过程中起辅助治疗及评定药物效果的作用。     

玉屏风颗粒联合铁剂和锌剂对反复呼吸道感染患儿免疫功能的影响

目的 观察玉屏风颗粒联合铁剂、锌剂对反复呼吸道感染患儿免疫功能的影响.方法 选取100例反复呼吸道感染患儿,其中50例患儿作为观察组,予口服玉屏风颗粒联合铁剂、锌剂治疗;另外50例患儿作为对照组,给予羧甲淀粉钠溶液口服治疗.观察比较两组患儿的疗效,及治疗前、治疗后6个月血清IgA、IgG、IgM以及外周血T细胞亚群CD3+、CD4+、CD8+、CD4+/CD8+的水平.结果 观察组的有效率(92.0%)显著高于对照组(64.0%),差异有统计学意义(P<0.05).开始治疗6个月后,观察组血清IgA、IgG、IgM及外周血T细胞亚群CD3+、CD4+、CD4+/CD8+较对照组升高,而外周血T细胞亚群CD8+较对照组下降,差异有统计学意义(P<0.05).治疗后经6个月至1年6个月的随访,全部患儿发生上呼吸道感染仅(3.4±1.4)次,无下呼吸道感染发生.结论 玉屏风联合铁剂、锌剂能显著提高反复呼吸道感染患儿免疫功能,并明显减少呼吸道感染发生率.     

复可托和乌体林斯联合治疗小儿反复呼吸道感染疗效观察

目的：观察复可托联合乌体林新治疗儿童反复呼吸道感染（RRI）的临床疗效。方法：26例反复呼吸道感染患儿给予口服复可托2mg／天,2周,随后给予乌体林斯1．72μg肌注．每周1次,8次。疗程结束后随访1年,观察呼吸道感染发作次数及病情轻重、药物反应等,并检测T细胞亚群变化。结果：26倒忠儿治疗后显效率53．8％,有效率23．0％,总有效率76．8％,CD3、CD4、CD4／CD8明显升高,CD8明显下降。结论：反复呼吸道感染患儿应用复可托及乌体林新联合治疗后可明显改善免疫失衡状态。     

益卫固表汤联合锌剂治疗对反复呼吸道感染患儿免疫功能及复发的影响

目的 探讨益卫固表汤联合锌剂治疗对反复呼吸道感染患儿免疫功能及复发的影响.方法 选取经确诊治疗的反复呼吸道感染患儿82例,随机分为观察组(n=42)和对照组(n=40).对照组给予常规对症及锌剂治疗,观察组在此基础上给予益卫固表汤治疗.治疗前后采用流式细胞技术检测血浆T淋巴细胞亚群(CD3、CD4、CD8)水平,随访1年,观察比较两组治疗前后疗效、免疫功能、不良反应及复发情况.结果 观察组临床疗程优于对照组,1年总复发率明显低于对照组,差异有统计学意义(P<0.05);观察组治疗后CD3、CD4、CD4/CD8水平明显高于对照组,差异有统计学意义(P<0.05);观察组和对照组不良反应发生率差异无统计学意义(P>0.05).结论 益卫固表汤联合锌剂治疗可有效改善反复呼吸道感染患儿免疫功能,有利于缓解患儿临床症状及减少复发,且具有良好的安全性,值得临床进一步推广.     

1~6岁反复呼吸道感染儿童T淋巴细胞亚群与健康体检儿童的比较分析

目的探究1~6岁反复呼吸道感染儿童T淋巴细胞亚群与健康体检儿童之间的差异性。方法选取我院儿科2018年3月至2019年3月收治的反复呼吸道感染患儿60例作为研究对象,纳入观察组;选取同期到我院进行体检的健康儿童60名为对照组。采用ACEA NovoCyteTM检测系统对2组儿童的外周血进行T淋巴细胞亚群检测并进行对比。结果观察组T辅助/诱导淋巴细胞(CD3+CD4+)、T辅助/T抑制淋巴细胞比例(CD3+CD4+/CD3+CD8+)均低于对照组,T抑制/毒性淋巴细胞(CD3+CD8+)高于对照组,差异具有统计学意义(P<0.05)。结论1~6岁反复呼吸道感染儿童的T淋巴细胞亚群与健康体检儿童的差异明显,可在诊断和治疗过程中作为参考指标。     

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.     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.