肿瘤坏死因子-α、内皮素-1、免疫球蛋白E和血栓素B2水平与肺炎支原体感染老年哮喘患者病情严重程度的关系

目的:探讨肿瘤坏死因子-α(TNF-α)、内皮素-1(ET-1)、免疫球蛋白E(IgE)和血栓素B₂(TXB₂)与肺炎支原体感染(MP)老年哮喘患者病情严重程度的关系。方法:选取治疗的MP感染老年支气管哮喘患者88例(支气管哮喘合并MP感染组),同时选取无MP感染支气管哮喘患者90例(支气管哮喘组),健康志愿者80例作为对照(健康对照组),检测血清TNF-α、ET-1、IgE和TXB₂水平以及第1秒用力呼气容积(FEV₁)/用力肺活量(FVC)。结果:支气管哮喘合并MP感染组患者血清TNF-α、ET-1、IgE和TXB₂分别为(177.28±34.49)pg/ml、(87.29±30.33)ng/L、(101.10±23.39)IU/ml和(370.40±61.19)ng/L,明显高于支气管哮喘组和健康对照组(均P<0.05);支气管哮喘合并MP感染组患者FEV₁/FVC为(60.03±7.78)%,明显低于支气管哮喘组和健康对照组(均P<0....     

肺炎支原体感染与支气管哮喘的关系探讨

目的:分析肺炎支原体感染与支气管哮喘之间的关系。方法:研究选取单纯呼吸道感染患者44例为对照组,呼吸道感染伴支气管哮喘患者44例为实验组。收集血液样本对比两组患者的血清MP-IgM阳性率、血清总IgE水平。结果:对照组血清MP-IgM阳性5例(11.4%),实验组血清MPIgM阳性23例(52.3%);血清MP-IgM阳性患者血清总IgE为(144.52±42.13)IU/ml,血清MP-IgM阴性患者血清总IgE为(65.48±38.46)IU/ml。结论:MP与支气管哮喘发作有一定的相关性,在临床诊断中对于无其他病因的患者要考虑MP感染的可能,提高诊断治疗的准确性。     

应用化学发光法测定成人红皮病患者血清总IgE水平

目的 :探讨血清总免疫球蛋白E(IgE)水平在红皮病发病中的意义。 方法 :应用化学发光法检测 116例成人红皮病患者血清总IgE水平 ,并与 4 2例正常人对照组进行比较。 结果 :成人红皮病患者血清总IgE水平为 (15 88.4 3± 2 6 4 7.0 5 )IU/ml,明显高于正常人对照组的 (47.82± 2 9.6 2 )IU/ml(P <0 .0 0 1) ,其中血清总IgE水平超过正常值上限 (16 5 .3IU/ml)的 81例患者中 4 5例高于 10 0 0IU/ml。结论 :异位性疾病史在红皮病患者中占有一定比例 ,但成人红皮病患者血清总IgE水平升高并非对异位性疾病特异 ,很可能还与某些肿瘤及机体免疫细胞功能缺陷有关     

支原体肺炎患儿的喘息症状,气道高反应性与过敏史,血清总Ig …

目的探讨肺炎支原体肺炎患儿出现喘息症状及气道高反应性与个人过敏史、血清总IgE水平的关系。方法对支原体肺炎伴喘息者24例、支原体肺炎不伴喘息者76例、支气管哮喘患者20例、正常健康学龄儿童20例,采用潮气呼吸法测定气道反应性,酶联免疫法测定血清总IgE,并对每一位儿童进行个人过敏史调查。结果支原体肺炎伴喘息组个人过敏史阳性率95.8％、气道反应性阳性率91.6％、血清总IgE(404.0±24.2)IU/ml,显著高于支原体肺炎不伴喘息组的6.6％、3.9％和(180.0±22.3)IU/ml,亦显著高于正常对照组的5.0％、5.0％和(160.0±23.1)IU/ml,接近于支气管哮喘组的95.0％、95.0％和(444.0±22.4)IU/ml。结论肺炎支原体肺炎患儿出现喘息症状及高气道反应性,与个人过敏史血清总IgE水平关系密切,有个人过敏史,血清总IgE水平高者,感染肺炎支原体后容易出现喘息症状。     

支气管哮喘急性发作与支原体感染的关系

目的探讨支气管哮喘急性发作与支原体感染的关系。方法选取支气管炎哮喘急性发作患儿64例(哮喘组),肺炎患儿78例(肺炎组),分别送检血清支原体抗体IgM(MP-IgM)及血清总IgE。结果哮喘急性发作组MP-IgM阳性率明显高于对照组(48.4%vs 30.8%)(P0.05)。哮喘急性发作患儿血清总IgE显著升高[(327.7±124.2)U/ml vs(189.4±113.6)U/ml](P0.05)。在哮喘急性发作的患儿中,MP-IgM阳性的患儿血清总IgE水平明显高于MP-IgM阴性患儿[(437.4±58.2)U/ml Kpa vs(323.8±103.2)U/ml](P0.05)。结论哮喘急性发作与支原体感染有关,支原体感染是哮喘急性发作的重要病原体。     

反复呼吸道感染儿童伴IgG亚类缺陷病

目的　探讨反复呼吸道感染 (RRTI)儿童的免疫发病机制。方法　用单克隆抗体ELISA测 4 4例RRTI儿童血清IgG亚类水平和 17例RRTI儿童外周血单个核细胞 (PBMC)培养上清白细胞介素IL 2、IL 4水平 ,7名同龄健康儿童为对照组。结果　 3 6例无哮喘RRTI患儿中IgG亚类缺陷 (ISD) 9例 (占 2 5 % ) ,ISD患儿IL 2、IL 4 (10 6 65± 85 4 3pg/ml、12 93± 2 19pg/ml) ,较对照组IL 2、IL 4 (15 3 3± 4 65 82pg/ml、16 3 7± 2 75 pg/ml)明显降低 (IL 2P <0 0 1,IL 4P <0 0 5 )。 8例哮喘患儿均有IgE升高 ,5例IgG4升高 ,IL 2。 (2 ) (73 85± 72 4 9pg/ml) ,较对照组明显降低 ,高于ISD组 (均为P <0 0 1)。IL 4 (19 96±2 19pg/ml) ,高于对照组和ISD组 (均为P <0 0 1)。结论　反复呼吸道感染儿童的免疫发病机制不同 ,无哮喘者更易发生ISD和Th1/Th2同时降低 ;有哮喘者常有IgE、IgG4升高 ,Th1轻度降低、Th2亢进。     

桂西地区哮喘儿童皮肤点刺试验和血清总IgE水平的研究

目的　探讨桂西地区哮喘儿童对变应原的反应和血清IgE水平。方法　选择 98例确诊为哮喘患儿用皮肤变应原试剂进行皮肤点刺试验 ,用ELISA法测定血清总IgE水平 ,同时选择 1 0 0例健康儿童作为对照。结果　哮喘儿对一种以上变应原阳性反应 78例 (76 .5 % ) ,对照组 1 8例 (1 8% ) ,差异有高度显著性 (P <0 .0 1 )。变应原以螨为最多 (58.2 % ) ,蟑螂次之 (40 .8% )。哮喘组阳性反应年龄分布 2～ 6岁 32例 (64 % ) ,～ 1 4岁 46例 (95 .5 % ) ,差异有高度显著性 (P <0 .0 1 )。哮喘组血清总IgE1 4 8.8± 2 7.5μg/L与对照组 1 1 5 .1± 2 2 .6μg/L比 P <0 .0 0 1。结论　哮喘儿对多种变应原有阳性反应 ,以螨、蟑螂为主 ,且随着年龄的增长 ,阳性反应增加 ,哮喘儿同时存在着高IgE血症。清除和避免变应原的接触 ,对防治儿童哮喘有重大意义     

血清IgE和最大呼气中期流速在儿童哮喘中的临床意义

目的 探讨支气管哮喘儿童血清总IgE与最大呼气中期流速变化的意义.方法 选择支气管哮喘患儿23例和正常对照组16例为研究对象,采用双抗体夹心ELISA法检测血清总IgE水平,外周血嗜酸细胞计数采用全自动血液分析仪计数法.同时检测肺功能指标中的最大呼气中期流速.结果 支气管哮喘患儿血清总IgE水平为(242.50±54.48)IU/ml,明显高于正常对照组(50.40±8.58)IU/ml,差异有统计学意义(P<0.01).与正常对照组相比,哮喘组的外周血嗜酸细胞计数明显升高[(300.00±84.05)vs(140.55 ±23.35)个/ul,P<0.05],而最大呼气中期流速显著降低[(75.40±25.48)%vs(92.32±28.20)%,P<0.01].线性回归分析表明血清总IgE水平与外周血嗜酸细胞计数、体质指数、最大呼气中期流速无相关性.结论 支气管哮喘患儿血清总IgE水平和外周血嗜酸细胞计数明显升高.IgE在儿童哮喘的发病机制中具有重要作用.     

旋毛虫感染对过敏性哮喘小鼠肺泡灌洗液中总IgE、IL-4及IL-5的影响

目的:通过观察小鼠感染旋毛虫并诱发过敏性哮喘后,肺泡灌洗液中总IgE、IL-4及IL-5的变化,探讨旋毛虫感染对小鼠过敏性哮喘的影响.方法:将15只8周龄、BALB/c雌性小鼠,随机分为3组,每组各5只,Ⅰ组为空白对照组,Ⅱ组为单纯过敏性哮喘组,Ⅲ组为感染旋毛虫并发哮喘组.Ⅲ组小鼠经口感染200～300条旋毛虫囊包幼虫,建立旋毛虫感染动物模型模型.28 d后,以卵清白蛋白致敏(Ovalbumin,OVA)激发Ⅱ组和Ⅲ组小鼠,建立过敏性哮喘小鼠模型;56 d后,取小鼠肺泡灌洗液,以ELISA双抗体夹心法法检测总IgE、IL-4及IL-5水平.结果:Ⅰ、Ⅱ、Ⅲ3组小鼠总IgE水平分别为(43.70±29.49)、(387.49±148.32)、(102.50±49.55) ng/mL; IL-4水平分别为(169.16±10.00)L、(232.91±17.95)、(172.35±19.19)pg/L;IL-5水平分别为(12.86±1.78)、(23.85±5.51)、(15.76±4.54) ng/L,与Ⅱ组相比较,Ⅲ组肺泡灌洗液中总IgE、IL-4及IL-5水平降低(P＜0.05).结论:旋毛虫感染对过敏性哮喘小鼠肺泡灌洗液中总IgE、IL-4及IL-5的表达有抑制作用.     

尘螨过敏性哮喘患者特异性抗体的检测及其临床意义

目的探讨尘螨过敏性哮喘患者血清免疫球蛋白IgE、IgG亚类的临床意义。方法采用ELISA法检测36例尘螨过敏性哮喘患者血清免疫球蛋白值，以20名健康人群为对照。结果尘螨过敏性哮喘患者血清总IgE，特异性IgE、IgGl、IgG2、IgG3、IgG4的值依次为（688．28±79、16）IU／ml、（33、25±9．38）IU／ml、（44．06±7．31）IU／ml、（53．00±16、73）IU／ml、（28．69±8．46）IU／ml、（47．00±8．91）Iu／ml，与对照相比，总IgE、特异性IgE、IgGl、IgG4增高，差异具有显著性（P〈0．01）。结论尘螨过敏性哮喘患者体内除特异性IgE增高，IgG1、IgG4也增高，可能与哮喘发作有关，建议临床重视此项检查。     

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.