扶正固本法对青少年哮喘患者基因表达的影响

目的 研究复方中药敏康片治疗青少年哮喘的疗效和作用机理。方法 选择20例青少年哮喘患者进行治疗，另设青少年特应性皮炎患者组（20例）和青少年正常组（19例）为对照。哮喘组和皮炎组口服敏康片，疗程为6个月，观察疗效、血清总IgE及FcεRIβ、IL-4Rα基因表达改变情况。结果 哮喘组显效6例，有效12例，无效2例，总有效率90％；皮炎组显效4例，有效13例，无效3例，总有效率85％；哮喘组IgE治疗前后有显著差异（P〈0．01）。皮炎组IgE治疗前后有差异（P〈0．05）；用Northern blot法检测FctRlt3、IL-4Rα基因，IL-4Rα吸光度值两组治疗前均较正常组高，哮喘组治疗后降低。FcεRIβ吸光度值两组治疗前均较正常组高，治疗后均降低。结论 复方中药可以调整青少年哮喘患者相关基因表达，改善患者过敏状态，缓解临床症状。     

IL-13、IL-4、ADRβ2、FcεRI-β单核苷酸多态性与儿童反复喘息发作疗效及临床转归的关系

目的 了解白细胞介素-13(IL-13)、白细胞介素-4(IL-4)、肾上腺素能受体β2(ADRβ2)、免疫球蛋白E高亲和力受体β链（FcεRI-β）单核苷酸多态性（SNP）与儿童反复喘息发作的疗效及临床转归的关系。方法 选取60例喘息性支气管炎反复喘息发作患儿作为研究对象,设计IL-13 rs20541、IL-4 rs2243250、ADRβ2 R16G、 FcεRI-β E237G位点的引物,检测IL-13、IL-4、ADRβ2、FcεRI-β基因多态性,分析各基因位点SNP与患儿疗效及临床转归的关系。结果 IL-13 rs20541野生型AA和杂合型GA的治疗总有效率高于纯合型GG(P<0.01);ADRβ2 R16G不同基因型之间的治疗有效率比较差异有统计学意义（P<0.01）,其中基因型GG的治疗有效率显著高于基因型AA、AG(P<0.05);FcεRI-β E237G治疗有效率比较AA>AG> GG(P<0.05)。IL-13 rs20541野生型AA和杂合型GA发生持续性哮喘的概率低于纯合型GG(P<0.05);ADRβ2 R16...     

β-七叶皂苷钠对MS患者血清HS-CRP、TNF-α、IL-17水平的影响

目的:探讨β-七叶皂苷钠对多发性硬化(MS)患者血清中超敏C反应蛋白(HS-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-17(IL-17)水平及日常生活质量的影响。方法:采用免疫荧光干式定量法、ELISA法测定加用β-七叶皂苷钠治疗的54例MS患者(观察组)及53例未加用者(对照组)入院治疗前及治疗后血清中HS-CRP、TNF-α、IL-17水平。两组分别于治疗前后进行扩充神经功能残疾量表(EDSS)评分。结果:两组治疗前HS-CRP、TNF-α、IL-17水平比较,差异均无统计学意义(P>0.05);治疗后,两组均较治疗前明显降低(P<0.01),但观察组较对照组降低更显著(P<0.05)。两组治疗前EDSS评分比较,差异均无统计学意义(P>0.05),治疗14 d后比较差异有统计学意义(P<0.05)。结论:β-七叶皂苷钠可增强激素抑制HS-CRP、TNF-α、IL-17产生或释放的效果,进一步降低MS患者机体内炎症反应程度,达到治疗MS及提高其日常生活质量的目的。     

河南省汉族儿童哮喘易感基因多态性分布特征分析

目的研究河南地区汉族儿童哮喘易感基因多态性的频率分布特点,为本地区哮喘的个体化治疗提供新的理论基础。方法选择2018年10月至2019年4月于郑州大学第一附属医院门诊确诊的506例哮喘患儿,并收集其颊黏膜脱落细胞。对IL-13 A2044G、IL-4 C590T、ADRB2 R16G、FcεRIβ E237G这4种哮喘相关基因位点进行检测,统计分析河南地区汉族儿童哮喘基因多态性的频率分布特点,并检索中外文数据,对河南省ADRB2 R16G基因型频率与其他地区数据比较,作进一步分析。结果河南省汉族儿童的IL-13 A2044G位点AA、AG和GG基因型频率分别为12.6%、44.7%和42.7%,IL-4 C590T位点TT、CT和CC的基因型频率分别为63.1%、31.4%和5.5%,ADRB2 R16G位点AA、AG和GG基因型频率分别为30.4%、50.4%和19.2%,FcεRIβ E237G位点AA、AG和GG基因型频率分别为72.1%、24.7%和3.2%。河南地区与南京、贵州、保山地区ADRB2 R16G基因型频率分别比较,差异无统计学意义(均P>0.05);河南省ADRB2 R16G基因型频率与毛里求斯印第安相比,差异有统计学意义(P<0.05)。结论河南省汉族儿童IL-13、IL-4、ADRB2、FcεRIβ基因多态性频率有其自身一定特点,IL-4 C590T位点的风险基因型(TT)在河南省比例最高;ADRB2基因型的分布在不同地域、种族中可能存在差异。     

支原体、衣原体感染导致儿童慢性咳嗽免疫功能紊乱的研究

目的:研究肺炎支原体(MP)、肺炎农原体(CP)感染对慢性咳嗽患儿免疫功能的影响,研究其引起慢性咳嗽的可能机制.方法:检测确诊为慢性咳嗽患儿正规治疗前后IL-2、TNF-α、和T淋巴细胞亚群变化,用t检验方法与健康对照儿童进行组间比较.结果:慢性咳嗽患者治疗前CD8+较对照组降低,两组差异显著(P<0.05);CD4/CD8较对照组结果有所增高,组间比较差异有意义(P<0.01).治疗后CD4/CD8明显降低,组间比较差异有意义(p<0.01).慢性咳嗽患儿治疗前IL-2、TNF-α水平均显著高于正常对照组(P<0.01)和治疗后(P<0.01),而治疗后IL-2与正常组无统计学差异(Jp>0.05),TNF一α在治疗后较对照组仍增高(P<0.05).结论:MP、CP可以诱导慢性咳嗽患者体内T淋巴细胞亚群比例失调,并且引起TNF-α、IL-2等炎性因予分泌增加.     

壳聚糖磷脂酰胆碱对轻度认知障碍患者血清白介素-1β和肿瘤坏死因子α及海马中脑代谢物质的影响

目的探讨壳聚糖磷脂酰胆碱对轻度认知障碍(MCI)患者血清白介素-1β(IL-1β)、肿瘤坏死因子α(TNF-α)及海马脑代谢产物的影响。方法从潍坊市老人院按照MCI诊断标准选取MCI患者18例(MCI组),同时选取性别、年龄与MCI患者相匹配的健康老年人17例作为对照组。MCI组给予壳聚糖和磷脂酰胆碱,共服用2个月。对照组不服药。采用放射免疫法检测两组被检者的血清IL-1β和TNF-α水平,采用磁共振波谱成像技术检查海马N-乙酰天门冬氨酸(NAA)/肌酐(Cr)、胆碱(Cho)/Cr、肌醇(MI)/Cr的值。MCI患者分别在服用药物前后采集血标本进行检测及进行磁共振波谱成像检查。采用SPSS 13.0统计软件进行数据处理与分析。结果 MCI组治疗前血清IL-1β、TNF-α较对照组明显升高(P<0.05),MCI组治疗后血清IL-1β、TNF-α较对照组差异无统计学意义(P>0.05)。MCI组NAA/Cr较对照组降低(P<0.05),MI/Cr较对照组升高,差异有统计学意义(P<0.05);MCI组NAA/Cr及MI/Cr治疗前后比较差异均有统计学意义(P<0.05);对于Cho/Cr,对照组与MCI组比较...     

尿毒清颗粒对老年糖尿病肾病患者微炎性反应状态和血管内皮生长因子的影响

目的观察尿毒清颗粒对老年糖尿病肾病(DN)患者微炎性反应状态和血管内皮生长因子(VEGF)的影响。方法将老年临床期DN患者102例随机分为2组,常规治疗组50例,常规治疗加尿毒清治疗组52例,2组疗程均12周,另纳入30例同期健康体检老年人为健康对照组。比较3组间血清微炎性反应标志物白细胞介素1β(IL-1β)、白细胞介素6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)水平,并将这些促炎因子与VEGF和尿白蛋白排泄率(UAER)进行相关分析。观察2组患者治疗前、后IL-1β、IL_6、CRP、TNF-α、VEGF和UAER水平的变化。结果(1)2组老年临床期DN患者IL-1β、IL-6、CRP、TNF-α、VEGF、UAER水平均显著高于健康对照组,差异有统计学意义(P<0.05);2组间差异无统计学意义(P>0.05)。(2)治疗12周,常规治疗组IL-1β、、VEGF、UAER显著下降(P<0.05),而IL-6、CRP、TNF-α无明显变化(P>0.05);尿毒清治疗组IL-1β、IL-6、CRP、TNF-α、VEGF、UAER均明显下降,差异均有统计学意义(P<0.05)。且尿毒清治疗组各项指标下降均优于常规治疗组(P<0.05)。(3)相关性分析结果表明,VEGF与IL-1α(r=0.41,P<0.01)、IL-6(r=0.28,P<0.01)、CRP(r=0.33,P<0.01)、TNF-α(r=0.36,P<0.01)呈正相关;UAER与IL-1α(r=0.39,P<0.01)、IL-6(r=0.32,P<0.01)、CRP(r=0.29,P<0.01)、TNF-α(r=0.37,P<0.01)呈正相关;VEGF与UAER呈正相关(r=0.55,P<0.01)。结论老年DN患者存在不同程度的微炎性反应状态和VEGF增高,尿毒清颗粒治疗能有效改善微炎性反应状态。     

慢性特发性荨麻疹患者血清抗Fcε RI抗体的临床意义

目的了解慢性特发性荨麻疹(CIU)患者血清抗FcεRI抗体水平及其临床意义。方法采用酶联免疫吸附试验法((ELISA)检测50例CIU患者血清抗FcεRI抗体水平,并与20名正常人对照;分析抗FcεRI抗体水平与CIU临床表现的关系。结果CIU患者血清抗FcεRI抗体水平为2.73(0.60～14.45)U/L,正常对照为1.42(0.60～2.30)U/L,两组差异有统计学意义(P0.05);抗FcεRI抗体水平与CIU病程、瘙痒程度、风团数量和风团大小无相关性(P0.05)。结论血清抗FcεRI抗体水平增高可作为CIU的辅助诊断指标,但不能用来评价CIU的病情严重程度。     

前列腺素E1对大鼠弥漫性脑损伤后脑组织中TNFα和IL-1β的影响

目的:研究前列腺素E1(PGE1)对减轻颅脑创伤后脑组织损伤机制。方法:取雄性SD大鼠35只,随机分为假手术组、生理盐水对照组、小剂量治疗组、中等剂量治疗组、大剂量治疗组5组,每组各7只。采用Marmarou A脑损伤模型,造成大鼠弥漫性脑损伤(DBI),观察PGE1对大鼠DBI后8 h脑组织中肿瘤坏死因子(TNFα)和白细胞介素-1β(IL-1β)含量的影响。结果:中小剂量PGE1治疗后脑组织TNFα和IL-1β含量明显减少,与NS对照组比较有显著性差异(P<0.05,P<0.01),与假手术组比较无差异(P>0.05);大剂量PGE1治疗前后脑组织TNFα和IL-1β含量无改变,与NS对照组比较无差异(P>0.05),与假手术组比较有非常显著性差异(P<0.01)。结论:中小剂量PGE1能降低颅脑损伤后炎症反应,减轻脑组织损伤,对颅脑损伤有一定的脑保护作用。     

氧化苦参碱减轻肺缺血再灌注损伤的实验研究

目的探讨氧化苦参碱(OMT)减轻肺缺血再灌注损伤(LIRI)的机制。方法建立肺缺血再灌注模型,将32只大白兔随机分为对照组(n=8)、缺血再灌注组(I/R组,n=8)、OMT颈静脉给药组(OMT-1组,n=8)、OMT左肺动脉给药组(OMT-2组,n=8)。应用ELISA法测定各组再灌注后40、80、120min不同时间点肺组织中肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)、白细胞介素-10(IL-10)含量;用TUNEL法测定肺泡细胞凋亡(AI);用肺组织损伤定量评价指数(IQA)综合评价OMT对LIRI的保护作用。结果I/R组TNF-a、IL-8含量高于对照组和OMT-2组,差异有统计学意义(P<0.01),与OMT-1组比较,差异有统计学意义(P<0.05)。OMT-2组TNF-α、IL-8含量低于OMT-1组,差异有统计学意义(P<0.05)。OMT-1组和OMT-2组IL-10含量均显著高于I/R组,差异有统计学意义(P<0.01),但OMT-1组低于OMT-2组,差异有统计学意义(P<0.05)。缺血再灌注80min后I/R组AI值明显高于OMT-2组、对照组,差异有统计学意义(P<...     

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.