妊娠各期孕妇甲状腺激素变化的探讨

Objective To investigate the state of thyroid hormones and thyrotropin level in different gestation periods. Methods FT3, FT4, TSH and hCG were measured in 623 patients by ACS-180 automatic chemiluninescence analyzer. The urinary iodine was random measured by the use of iodine catalytic reaction mechanism of Arsenic-Cerium, rapid urinary iodine was detected with cold digestion method of quantitative detection. Result Serum FT3,FT4 ,and hCG levels in the first and second trimester were higher than in the third trimester ( F =53. 19,78.00,58.77, P ＜0. 05) ,and TSH levels were lower than in the third trimester ( F =5.68, P ＜0.05). The incidence of thyrotropin level disorder was 7. 54%, there were no significant differences in the gestation periods ( χ2 = 3.92, P ＞ 0. 05 ). The incidence of subclinical hypothyroidism,subclinical hyperthyroidism, hypothyroidism and hyperthyroidism were 3.53%, 2. 57%, 1.12% and 0. 32%, respectively. The incidence of subclinical hypothyroidism in the first and third trimester was high, while the incidence of subclinical hyperthyroidism in the second trimester was high. Conclusions Thyrotropin level in the third trimester was lower than that of the first and second trimester. HCG changes were not the main reason that caused the thyrotropin level disorder during the pregnancy.     

妊娠各期孕妇甲状腺激素变化的探讨

Objective To investigate the state of thyroid hormones and thyrotropin level in different gestation periods. Methods FT3, FT4, TSH and hCG were measured in 623 patients by ACS-180 automatic chemiluninescence analyzer. The urinary iodine was random measured by the use of iodine catalytic reaction mechanism of Arsenic-Cerium, rapid urinary iodine was detected with cold digestion method of quantitative detection. Result Serum FT3,FT4 ,and hCG levels in the first and second trimester were higher than in the third trimester ( F =53. 19,78.00,58.77, P ＜0. 05) ,and TSH levels were lower than in the third trimester ( F =5.68, P ＜0.05). The incidence of thyrotropin level disorder was 7. 54%, there were no significant differences in the gestation periods ( χ2 = 3.92, P ＞ 0. 05 ). The incidence of subclinical hypothyroidism,subclinical hyperthyroidism, hypothyroidism and hyperthyroidism were 3.53%, 2. 57%, 1.12% and 0. 32%, respectively. The incidence of subclinical hypothyroidism in the first and third trimester was high, while the incidence of subclinical hyperthyroidism in the second trimester was high. Conclusions Thyrotropin level in the third trimester was lower than that of the first and second trimester. HCG changes were not the main reason that caused the thyrotropin level disorder during the pregnancy.     

肺结核患者外周血单个核细胞MCP-1表达上升

Objective To study the feature of MCP-1 in plasma of active pulmonary tuberculosis patients and the correlation of MCP-1 obtained from PBMCs stimulated with specific Mtb peptides with IFNγ.Methods 20 patients with active pulmonary tuberculosis and 16 healthy controls with positive PPD were enrolled.The concentration of MCP-1 and IFN-γwas analyzed with Bender Flowcytomix on flow cytometry.Results No statistical difference of MCP-1 concentration in plasma was found between TB patients and controls [(263.8 ± 25.31)pg/ml and(212.1 ± 18.04)pg/ml,P ＞ 0.05].But TB patients with continuous respiratory symptoms showed higher MCP-1 in plasma.The concentration of MCP-1 and IFN-γwas significantly elevated in PBMCs culture supernatants.It was significantly higher in TB patients than in controls [(21460 ±3376)pg/ml vs(10910 ±2141)pg/ml,P ＜0.01].There was no correlation between the concentration of MCP-1 and IFN-γ.Conclusions The concentration of MCP-1 in plasma may be related to the progress of the pulmonary tuberculosis.MCP-1 stimulated by Mtb-specific peptides may be one of the biomarkers for TB diagnosis.     

血清基质金属蛋白酶3与颈动脉粥样硬化斑块及缺血性脑卒中的关系

Objective To investigate the relationship between the matrix metalloproteinase-3(MMP-3)and the stability of carotid artery plaque,and explore MMP-3's prediction role on the attack and relapse of acute ischemic cerebrovascular events.Methods 100 patients with the first ever acute cerebral infarction,100 patients with chronic cerebral circulation insufficiency(CCCI)and 40 persons without cerebrovascular diseases were enrolled in this study.According to the carotid ultrasound examination,100 cerebral infarction patients were divided into three subgroup: unstable plaque group(45 patients,mixed plaque,soft plaque),stable plaque group(35 patients,plaque Group)and endometrial coarse group(25patients).Matrix metalloproteinase-3(MMP-3)levels of all the subjects were measured by enzyme-linked immunosorbent assay(as basal level).All the subjects were followed up for one year to observe cerebral infarction events.Serum MMP-3 levels of each group,and the basic serum MMP-3 levels were compared among patients who were attacked or relapsed cerebral ischemic with those who had not been attack cerebral ischemic during this period of time.Results 5 patients in the cerebral infarction group had relapse (5%),2 patients in the CCCI group were attacked by cerebral ischemic(2%),and no one in the normal control group was attacked by cerebral ischemic.Serum MMP-3 levels in the acute cerebral infarction group were significantly higher than CCCI group,and both groups were significantly higher than normal control group (P ＜0.05).The basic serum MMP-3 levels in all patients who were attacked by cerebral ischemic were significantly higher than those who had not been attack by cerebral ischemic during this period of time(P ＜0.05).The serum MMP-3 levels of the unstable plaque group were significantly higher than stable plaque group.And both groups were significantly higher than endometrial coarse group(P ＜0.05).Conclusions Elevated levels of matrix metalloproteinase-3(MMP-3)might have something with the stability of carotid atherosclerotic plaque,and participate the attack and the relapse of acute cerebral infarction.Determination of MMP-3 might be used to predict the attack and relapse of acute cerebral infarction.     

慢性乙型肝炎患者血清XCL1与免疫损伤的相关性分析

Objective To explore the relevance between serum XCL1 levels and liver damage in hepatitis B patients.Methods The serum concentration of XCL1 was detected by enzyme linked immu-nosorbent assay (ELISA).Peripheral blood T-cell subsets were detected by flow cytometry (FCM).Liver function was assayed by automatic biochemistry analyzer, hepatitis B antigen/antibody semi-quantitative index was detected by time-resolved fluorescence analyzer, and HBV-DNA load was detected by automatic fluorescence quantitative PCR.Results Serum concentration of XCL1 in control group ( n = 20), mild chronic hepatitis B (CHB) group ( n =29), moderate CHB group ( n =20) and severe CHB group ( n =26)were (8.24±1.94) pg/ml, (10.99±1.94) pg/ml, (12.83 ±2.59) pg/ml, (13.72 ±3.13) pg/ml,respectively.The concentration of XCL1 in all CHB groups was significantly higher than control group ( P＜ 0.05 ).The concentration of XCL1 in severe CHB group was significantly higher than mild CHB group (P ＜ 0.05).XCL1 was positively correlated with ALT, AST, TBIL and DBIL, and the coefficients were (r =0.463、 0.472、 0.413、 0.440, P ＜0.01 ), respectively.The serum XCL1 levels in hepatitis B virus with low load group was lower than hepatitis B virus with high load group.The percentage of CD4 + T in hepatitis B virus with low load group and high load group were (41.26 ± 11.33)%, (33.01 ± 5.96)%,and the difference was statistically significant.Conclusion Serum concentrations of XCL1 were closely related to the degree of liver inflammation in hepatitis B patients.XCL1 may be involved in the process of chronic hepatitis B.     

慢性乙型肝炎患者血清XCL1与免疫损伤的相关性分析

Objective To explore the relevance between serum XCL1 levels and liver damage in hepatitis B patients.Methods The serum concentration of XCL1 was detected by enzyme linked immu-nosorbent assay (ELISA).Peripheral blood T-cell subsets were detected by flow cytometry (FCM).Liver function was assayed by automatic biochemistry analyzer, hepatitis B antigen/antibody semi-quantitative index was detected by time-resolved fluorescence analyzer, and HBV-DNA load was detected by automatic fluorescence quantitative PCR.Results Serum concentration of XCL1 in control group ( n = 20), mild chronic hepatitis B (CHB) group ( n =29), moderate CHB group ( n =20) and severe CHB group ( n =26)were (8.24±1.94) pg/ml, (10.99±1.94) pg/ml, (12.83 ±2.59) pg/ml, (13.72 ±3.13) pg/ml,respectively.The concentration of XCL1 in all CHB groups was significantly higher than control group ( P＜ 0.05 ).The concentration of XCL1 in severe CHB group was significantly higher than mild CHB group (P ＜ 0.05).XCL1 was positively correlated with ALT, AST, TBIL and DBIL, and the coefficients were (r =0.463、 0.472、 0.413、 0.440, P ＜0.01 ), respectively.The serum XCL1 levels in hepatitis B virus with low load group was lower than hepatitis B virus with high load group.The percentage of CD4 + T in hepatitis B virus with low load group and high load group were (41.26 ± 11.33)%, (33.01 ± 5.96)%,and the difference was statistically significant.Conclusion Serum concentrations of XCL1 were closely related to the degree of liver inflammation in hepatitis B patients.XCL1 may be involved in the process of chronic hepatitis B.     

股骨头成形术治疗股骨头无菌性坏死的动物实验研究

Objective An experiment study on the femoral head plastic operation to prevent and treat aseptic necrosis of the femoral head. Methods 60 Chinese white rabbits were equally random divided into 4 groups. The four groups except A group were made a globose defect and filled with 95% alcohol tampon for 30 minutes. The B group was natural repair group. The C group was filled with bone cement after being made defect. The D group was filled with bone cement added barium sulfate agent after being made defect. After 12 weeks, all rabbits in four groups were killed. The specimens were random divided into two parts. The articular cartilage was observed and measured immediately. The other specimen was determined with histological examination and extreme anti-pressure rigidity test . Result The femoral heads of bone cement group and the femoral heads of contrast agent bone cement group kept their outline all the time through the articular cartilage observation. After 12 weeks the cartilage thickness of natural repair group (511.74 ± 69.00) was thinner than the other three groups [ control group ( A group ) (511.74 ± 69 00 );Bone cement group ( C group) (468. 36 ± 82. 99 ); Bone cement group contrast agent ( D group ) ( 515.61 ±64. 65 ) ], and it had significant difference ( P < 0. 05, P < 0. 01 ). The rigidity of natural repair group [ (676. 57 ±50. 92) N/mm] had significant difference with that of the other three groups[ A group( 884. 66±52. 29)N/mm;C group(1178.40 ± 170.45) N/mm;D group(928.60 ± 104.42) N/mm] ( P <0.05, P<0. 01 ). Conclusions Femoral head plastic operation was simple and it could release pain. And femoral head outline could be kept integrity. It would be a new operation which was used to treat young patients in Ficat Ⅱ～Ⅲ period to postpone or substitute total hip replacement.     

脓毒症血清对大鼠小肠微血管内皮细胞ICAM-1的影响及肾上腺髓质素的干预作用

Objective To observe the levels of intercellar adhesion molecule-1(ICAM-1)of rat intestinal mucosa microvascular endothelial cells in sepsis rat,and to investigate the possible protective effect of adrenomedullin on the expression of intercellar adhesion molecule-1(ICAM-1)of rat intestinal mucosa microvascular endothelial cells,and to confirm whether adrenomedullin can decrease released inflammatory factors to slow down or inhibit the occurrence and development of sepsis.Methods The rat intestinal mucosa microvascular endothelial cells were isolated and cultured in vitro,and it was divided into sham operated(sham operated serum),sepsis serum(with addition of sepsis serum)and ADM serum(with 0.lng/kg adrenomedullin 6h after sepsis treatment)groups.The soluble ICAM-1(sICAM-1)content in RIMMVECs culture supernatant was measured by ELISA at the 24th hour after serum stimulation.Results The ICAM-1 content in the supernatant of sepsis group [(0.33 ±0.04)ng/L] was obviously higher than that in sham operated [(0.15 ± 0.02)ng/L] and ADM [(0.17 ± 0.04)ng/L] group(P ＜ 0.05),but ADM group was no significantly different compared with sham operated group(P ＞ 0.05).Conclusions ADM could decrease the expression of ICAM-I in RIMMVECs,and the low level of ICAM-1 could suppress its downstream inflammation factors and inhibit the occurrence and development of sepsis.     

不同糖代谢人群血尿酸、血脂及胰岛素抵抗相关性研究

Objective To study the levels of senlm uric acid(UA)in normal glucose(NC),impaired glucose regulation(IGR)and type 2 diabetes mellitus(T2DM),and investigate its relationship with insulin resistance and dyslipidemia.Method The levels of blood glucose,lipids,fasting insulin(HNS)and serum UA were measured in patients of 45 T2DM(T2DM group),20 IGR(IGR group)and 29 NC(NC group).Status of insulin resistance and insulin secretion function was evaluated by HOMA-IR and ISI.Results The levels of triglyceride(TG)and UA in T2DM group and IGR group were significantly higher than those in NC group[(3.34±8.77),(1.85±0.67),(1.26±0.38)mmoi/L and(316.71±96.20),(403.62±76.80),(325.45±94.43)mmol/L](P<0.01).HDL-C levels in T2DM group were significantly lower than those in IGR and NC group[(1.05±0.30),(1.07±0.21),(1.12±0.20)mmol/L](P<0.01).NO significant difference of FINS levels was found in the three groups.HOMA-IR level in T2DM and IGR group was higher than that in NC group(3.84,3.77,2.34)(P<0.01).ISI in T2DM and IGR group was lower than that in NC group(-4.52±0.79,-4.44±0.19,-4.03±0.58)(P<0.01).Correlation analysis indicated that the level of UA was positively related with BMI.TG and negatively related with HDL-C.Conclusion Increased UA in IGR indicates that hyperurieacidemia developes before DM.     

不同糖代谢人群血尿酸、血脂及胰岛素抵抗相关性研究

Objective To study the levels of senlm uric acid(UA)in normal glucose(NC),impaired glucose regulation(IGR)and type 2 diabetes mellitus(T2DM),and investigate its relationship with insulin resistance and dyslipidemia.Method The levels of blood glucose,lipids,fasting insulin(HNS)and serum UA were measured in patients of 45 T2DM(T2DM group),20 IGR(IGR group)and 29 NC(NC group).Status of insulin resistance and insulin secretion function was evaluated by HOMA-IR and ISI.Results The levels of triglyceride(TG)and UA in T2DM group and IGR group were significantly higher than those in NC group[(3.34±8.77),(1.85±0.67),(1.26±0.38)mmoi/L and(316.71±96.20),(403.62±76.80),(325.45±94.43)mmol/L](P<0.01).HDL-C levels in T2DM group were significantly lower than those in IGR and NC group[(1.05±0.30),(1.07±0.21),(1.12±0.20)mmol/L](P<0.01).NO significant difference of FINS levels was found in the three groups.HOMA-IR level in T2DM and IGR group was higher than that in NC group(3.84,3.77,2.34)(P<0.01).ISI in T2DM and IGR group was lower than that in NC group(-4.52±0.79,-4.44±0.19,-4.03±0.58)(P<0.01).Correlation analysis indicated that the level of UA was positively related with BMI.TG and negatively related with HDL-C.Conclusion Increased UA in IGR indicates that hyperurieacidemia developes before DM.     

恶性肿瘤致继发型贲门失驰缓症17例临床分析

目的探讨恶性肿瘤致继发型贲门失驰缓症的临床特征及诊断。方法分析归纳17例恶性肿瘤致继发型贲门失驰缓症患者临床症状、体征、辅助检查资料，结合复习国内外相关文献。结果17例患者平均年龄43．26岁，平均病程2．41月，平均体重减轻12．49kg，与原发型贲门失驰缓症患者差异有统计学意义；患者均表现有吞咽困难，15例类似改变；原发病均为为首发症状，误诊率达82．3％，胃镜和上消化道钡餐检查与原发型患者有恶性肿瘤。结论对年龄〉30岁、病程短、病情进行性加重的贲门失弛缓症首诊患者，宜仔细全面检查。     

Clinical significance of anti-beta 2 glycoprotein Ⅰ antibodies in patients with systemic lupus erythematosus complicated with thrombocytopenia

Objective To investigate the clinical significance of anti-β2 glycoprotein Ⅰ(anti-β2GP Ⅰ)antibodies in patients with systemic lupus erythematosus(SLE)and to assess their association with lupus thrombocytopenia.Methods Anti-β2GP Ⅰ antibodies were tested in 108 SLE patients(including 37thrombocytopenia patients),30 patients with rheumatoid arthritis(RA)and 30 healthy individuals by enzyme-linked immunosorbent assay(ELISA).The clinical features and laboratory findings were collected,and the associations of anti-β2GP Ⅰ antibody with laboratory findings and disease activity were analyzed.Results Sensitivities of anti-β2GP Ⅰ antibody were 19.44%(21/108)in SLE and 10%(3/30)in RA,respectively.The specificity of anti-β2GP Ⅰ antibody was 95.0% in SLE.The anti-β2GP Ⅰ antibody titers of the SLE group were significantly higher than normal group(P ＜ 0.05).There was no significant correlation between anti-β2GP Ⅰ antibodies and thrombocytopenia(r =-0.028,P ＞0.05).Anti-β2GP Ⅰ antibody was positively correlated to anticardiolipin antibody(r = 0.566,P ＜ 0.01).No associations were found between anti-β2GP Ⅰ antibody and other clinical and laboratory features.There was no statistical correlation between the level of anti-β2GP Ⅰ antibody and SLEDAI scores.Conclusions Anti-β2GP Ⅰ antibody had high specificity in SLE.There was no significant correlation between anti-β2GP Ⅰ antibodies and lupus thrombocytopenia.     

老年人高血压、抑郁与认知功能减退的相关性研究

目的分析老年人高血压、抑郁患者认知功能状况及其相关性。方法共收集207例患者,分为单纯高血压组、单纯抑郁组、高血压合并抑郁组和正常对照组。采用简易精神状况检查表（MMSE）进行认知功能检查,采用汉密顿抑郁量表（HAMD）进行抑郁程度的评定,并收集相关资料。结果抑郁老人中独居比例较大。与正常对照组比较,单纯高血压组的注意力和计算力明显下降（P〈0．01）,单纯抑郁组的MMSE总分、定向力、注意力和计算力、语言能力明显下降（P〈0．05）;与单纯高血压组比较,高血压合并抑郁组的MMSE总分、定向力、回忆力、语言能力明显降低（P〈0．05）;与单纯抑郁组比较,高血压合并抑郁组的注意力和计算力明显降低（P〈0．05）。抑郁患者的MMSE得分与HAMD得分呈负相关（r=一0．706,P〈0．01）。Logistic回归结果显示抑郁及高血压合并抑郁均为认知功能减退的影响因素（P〈0．01）。结论老年人高血压和抑郁均会引起认知功能的减退,高血压合并抑郁者认知功能减退更为严重,抑郁的严重程度与认知功能减退有关。有效的控制高龄老人的血压和抑郁状态,可能有助于降低其认知功能减退发生的危险。     

大鼠脑损伤后脑水肿与精氨酸加压素含量的相关性研究

目的探讨颅脑损伤后血浆中精氨酸加压素（AVP）的动态变化与继发性脑水肿的关系。方法以自由落体硬膜外撞击方法制作轻度和重度大鼠脑损伤模型，应用放射免疫法检测大鼠脑伤后24h、48h、72h和5d血浆中AVP的含量，干湿重法测定脑组织含水量。结果颅脑损伤早期血浆AVP含量与脑水肿严重程度呈正相关。颅脑损伤越严重，AVP升高越明显，脑水肿程度越重（P〈0．05）。结论颅脑损伤后血浆中AVP的含量与继发性脑水肿密切相关，AVP是参与颅脑损伤后继发性脑水肿形成的重要因素之一。     

非肥胖的高血压病患者的非酒精性脂肪肝与代谢综合征的关系

目的探讨非肥胖的不伴有糖尿病的高血压病患者的非酒精性脂肪肝（NAFLD）与代谢综合征（MS）的关系。方法84例非肥胖的不伴有糖尿病的高血压病患者,根据B超诊断有无脂肪肝分为高血压伴NAFLD组42例,高血压不伴NAFLD组42例。对2组患者的体重指数（BMI）、血压、血糖、血脂、血胰岛素、胰岛素抵抗指数（HOMA-IR）、转氨酶及MS患病率等指标进行比较分析,并对MS与上述指标的关系进行多因素的logistic回归分析。结果高血压伴NAFLD组的BMI、甘油三酯、胰岛素、HO-MA-IR、转氨酶及MS患病率较不伴NAFLD组显著增高,而且MS与NAFLD呈独立相关。结论MS不但明显增加NAFLD发生率,而且还加重肝脏损害。     

2型糖尿病患者高尿酸血症的临床特征及血尿酸与代谢综合征组分数目的关系

目的分析2型糖尿病（T2DM）高尿酸血症的临床及生化特征，并探讨血尿酸（UA）与代谢综合征（MS）组分数目的关系。方法采用横断面研究方法，将547例T2DM患者按UA分为高尿酸血症组和正常尿酸组；按具有代谢综合征组分的数目不同分为4组（MS1，MS2,MS3及MS4），分析临床资料。结果T2DM并高尿酸血症组的体重指数（BMI）、收缩压（SBP）、舒张压（DBP）、空腹血糖（FPG）、肌酐（Cr）、甘油三酯（TG）、总胆固醇（TC）、糖化血红蛋白（HbAlc）明显高于正常尿酸组（P〈0．05，P〈0．01），高密度脂蛋白胆固醇（HDL-C）明显低于正常尿酸组（P〈0．05），低密度脂蛋白胆固醇（LDL-C）2组间差异无统计学意义（P〉0．05）；MS1—4组间UA、BMI、SBP、DBP、Cr、TG、TC、LDL—C、HDL-C差别均有统计学意义（P均〈0．05），年龄、FPG差别无统计学意义；UA与性别、TG、HbAlc、HDL-C、Cr有线性回归关系（P〈0．05，P〈0．01），其中与HbAlc、HDL-C负相关，TG对UA影响最大。结论随着代谢综合征组分数目的增加，T2DM患者UA增加，异常TG对UA影响最大，因此UA水平升高是代谢综合征的危险因素。     

安体舒通对自发性高血压大鼠肾小球纤维化的影响

目的观察安体舒通对自发性高血压大鼠（SHR）肾小球纤维化的影响及可能机制。方法16只14周龄雄性SHR随机等分为安体舒通组和对照组,分别以安体舒通30mg／（kg·d）及等量生理盐水灌胃12周,8只同龄雄性SD大鼠作为正常对照组,免疫组化和RT-PCR检测结缔组织生长因子（CTGF）、转化生长因子β1（TGF—β1）的表达;MASSON染色分析测量胶原容积分数（CVF）;碱水解法测定羟脯氨酸（Hypro）含量。结果SHR对照组CVF[（7．78±0．28）％]、Hypro[（491±35．0）μg／g],CTGF（14．87±0．73）、TGF—β1（18．31±0．86）表达明显高于正常对照组[分别为（4．36±0．41）％,（321±53．8）μg／g,8．40±0．67,12．04±0．71,P〈0．01];相对于SHR对照组,安体舒通组则显著降低[分别为（6．35±1．12）％,（429±53．7）μg／g,13．02±0．92,16．37±1．24,P〈0．05]。结论安体舒通能明显改善SHR肾小球纤维化,其作用可能是通过阻断盐皮质激素受体和抑制CT—GF及TGF-β1的表达而实现的。     

连续肾替代治疗在外科严重脓毒症并发毛细血管渗漏综合征中的治疗价值

目的 探讨连续肾替代治疗在外科严重脓毒症毛细血管渗漏中的临床治疗价值.方法 38例脓毒症患者按治疗方案不同分为实验组和对照组,对照组常规综合治疗,实验组在常规综合治疗的基础上加连续肾替代治疗.分别监测两组患者治疗后（0、12、24、48、72 h）红细胞计数、血红蛋白含量、血小板计数、白细胞计数、红细胞压积、血浆白蛋白含量变化.中心静脉压（CVP）、有创动脉压（ABP）、每小时尿量变化、氧合指数情况.血清IL-6、IL-8、TNF-α水平变化.结果 实验组血小板计数、红细胞压积、血浆白蛋白含量明显高于对照组[72 h：（211.75±45.23）×109 vs（135.67±41.45）×109;0.43±0.05 vs 0.35±0.04;（48.60±4.76）g/L vs（41.17±4.64）g/L,P〈0.01],白细胞计数低于对照组[72 h：（7.58±2.31）×109 vs（13.77±2.67）×109,P〈0.01],有创动脉压（ABP）、氧合指数P02／Fi02、每小时尿量变化高于对照组[72 h：（94.25±8.60）mmHg vs（84.22±7.37）mmHg;345.25±35.21 vs 304.22±38.74;（80.15±14.54）ml vs（62.72±12.33）ml,P〈0.01],血清IL-6、IL-8、TNF-α水平显著低于对照组（72 h：249.55±99.60 vs 368.83±97.11;600.75±98.31 vs 718.94±92.00;665.35±138.44 vs 843.22±123.95,P〈0.01,P〈0.05）.结论 连续肾替代治疗是治疗外科严重脓毒症毛细血管渗漏的有效治疗方法,明显改善患者病情.     

Nrf2在烧伤脓毒症肺中的动态表达研究

-目的探讨Nrf2在烧伤脓毒症大鼠肺组织中的表达规律。方法将Wistar大鼠分为正常对照组、单纯烫伤组、烫伤复合金葡菌脓毒症组和烫伤复合绿脓杆菌脓毒症组。依不同时相（2、8、24h）,分为三个亚组,检测肺脏组织中Nrf2mRNA、Nrf2的蛋白质表达情况。结果正常大鼠肺组织中Nrf2mRNA较高表达（74．0±7．0）;单纯烫伤大鼠肺组织中Nrf2mRNA表达明显下调,分别为34．5±1．9、50．4±2．2、32．1±1．4（t=5．69～14．63,P〈0．01）;金黄色葡萄球菌所致烫伤脓毒症大鼠肺组织中Nrf2mRNA明显下调,分别为53．1±5．0、14．4±1．6、48．5±1．9,其中伤后8h达峰值（t=5．59-29．3,P〈0．01）;绿脓杆菌所致烫伤脓毒症大鼠伤后2hNff2mRNA表达无明显下降（71．0±8．1,P〉0．05）,但伤后8、24h均明显下调（24．8±2．1、4．1±2．0,t=21．33,68．1,P〈0．01）。结论Nrf2直接参与了烧伤后免疫应答反应。     

老年冠心病合并高血压患者的颈动脉硬度与冠脉造影的相关性研究

目的探讨合并高血压病的老年冠心病患者颈动脉硬度与冠状动脉粥样硬化的关系。方法通过对40例合并高血压病的老年冠心病患者行冠状动脉造影，明确冠状动脉病变并评分；同时行颈动脉超声检查，检测颈动脉硬度。结果合并高血压病的老年冠心病患者的颈动脉紧张度、扩张性较老年冠心病组及健康老年组低，而僵硬度则增高，差异有统计学意义（P〈0．01）；不同支数冠状动脉病变之间比较颈动脉硬度差异有统计学意义（P〈0．01）；冠状动脉病变积分与颈动脉紧张度、扩张性呈负相关（r=-0．353，-0．125，P〈0．01），而与僵硬度呈正相关（r=0.376，P〈0．01）。结论合并高血压病的老年冠心病患者的颈动脉硬度与冠状动脉病变程度明显相关，可通过了解颈动脉病变间接了解冠状动脉病变。