补体C3与肾损害性疾病临床关系探讨

目的:探讨补体C3与肾损害性疾病的关系.方法:采用快速免疫比浊法检测急性肾炎、慢性肾炎、尿毒症、肾病综合征、系统性红斑狼疮(SLE)、糖尿病及正常对照组血清补体C3水平.结果:急性肾炎、慢性肾炎、尿毒症、系统性红斑狼疮(SLE)补体C3水平显著低于正常对照组(P＜0.05);肾病综合征、糖尿病患者补体C3水平与正常对照组无明显差异(P＞0.05).结论:血清补体C3水平的测定有助于肾脏损害性疾病的诊断、疗效观察及预后判断.     

可溶性黏附分子水平与系统性红斑狼疮中医辨证分型的关系

目的 检测系统性红斑狼疮(SLE)患者血清可溶性黏附分子水平,并分析其与SLE不同中医辨证分型的相关性及诊断价值.方法 选取SLE患者46例,辨证分型为热毒炽盛型19例,脾肾阳虚型14例,肝肾阴虚型13例,取晨起空腹静脉血,采用ELISA法检测其血清可溶性细胞间黏附分子-1(SICAM-1)及血管内皮细胞黏附分子-1(SVCAM-1)水平变化,并设同期来院体检正常者40例为对照组,进行对比分析.结果 各证型血清SICAM-1、SVCAM-1水平均显著高于对照组(P＜0.05);热毒炽盛型血清SICAM-1、SVCAM-1水平显著高于脾肾阳虚型及肝肾阴虚型(P＜0.05);脾肾阳虚型2项指标显著高于肝肾阴虚型(P＜0.05);SLE狼疮活动积分及ESR以热毒炽盛型最高,依次为脾肾阳虚型及肝肾阴虚型(P＜0.05);热毒炽盛型及脾肾阳虚型补体C3滴度显著低于肝肾阴虚型(P＜0.05);SICAM-1与SVCAM-1两种分子间呈正相关性(P＜0.01);血清SICAM-1、SVCAM-1水平与狼疮积分、ERS呈正相关(P＜0.01);与补体C3呈负相关(P＜0.01).结论 血清SICAM-1、SVCAM-1水平测定可作为判定SLE活动的重要指标,检测SLE患者血清可溶性黏附分子水平可作为中医辨证论治辅助指标.     

肝癌患者31例血清免疫球蛋白、补体的检测及临床意义

目的:了解肝癌患者血清免疫球蛋白lgG、lgA、lgM及补体C3、C4的变化.方法:采用免疫比浊法对31例肝癌患者血清免疫球蛋白、补体进行测定.结果:肝癌患者血清免疫球蛋白lgG、lgA及补体C3明显高于对照组,且具差异有显著性(P＜0 05);免疫球蛋白lgM、补体C4虽高于对照组,但无显著性差异(P＜0 05).结论:肝癌患者体液免疫功能增强.     

SLE患者血清IgE水平与疾病活动性的关系

目的分别测定活动期和稳定期系统性红斑狼疮(systemic lupus erythematosus,SLE)患者血清IgE含量,以及与SLE疾病活动性相关的各项血清学指标(抗ds-DNA抗体,补体C3、补体C4),了解IgE与SLE病情活动性的关系.方法采用ELISA双抗体夹心法测定70例活动期和127例稳定期SLE患者血清IgE浓度,并与28例体检健康者血清IgE水平比较;同时采用放射免疫分析法检测这些血清抗ds-DNA抗体水平;速率散射比浊法测定这些血清中补体C3、C4含量.结果SLE活动期患者、SLE稳定期患者以及对照组血清IgE水平分别为241.10±201.40 IU/ml、132.99±59.12 IU/ml和62.30±37.15 IU/ml.SLE活动期患者血清IgE水平高于SLE稳定期和对照组,P值均小于0.01;SLE稳定期患者血清IgE水平也显著高于对照组(P《0.01);活动期SLE患者血清IgE水平与抗ds-DNA、补体C3、C4含量具明显相关性,相关系数分别为0.938、-0.877、-0.812.结论血清IgE浓度增高与SLE疾病活动性相关,血清IgE水平检测,可作为临床SLE疾病的一个实验室辅助诊断指标.     

类风湿性关节炎患者血清CRP和补体水平的检测分析

目的:探讨类风湿性关节炎(RA)患者血清中CRP和补体的变化及临床意义.方法:采用免疫散射比浊法检测患者治疗前后血清CRP和补体水平,并与正常对照组比较.结果:患者血清CRP和C3水平显著高于对照组(P＜0.01),C4与对照组无显著差异;治疗后血清CRP显著低于治疗前(P＜0.01),而血清C3、C4无显著变化(P＞0.05).结论:动态观察类风湿关节炎患者血清CRP对疾病的病情监测和疗效判断有参考意义.     

原发性高血压患者血清ficolin-3、免疫球蛋白、补体及CRP水平研究

目的 分析原发性高血压患者血清纤维胶凝蛋白3(ficolin-3)、免疫球蛋白、补体及CRP水平与原发性高血压的关系.方法 选取大连医科大学附属第一医院高血压患者98例(其中单纯高血压88例,合并2型糖尿病10例),同时选取血压正常并无其他疾病的同期健康体检者42例作为对照组.采用ELISA法测定两组血清ficolin-3水平,采用散射比浊法测定两组血清补体(C3、C4)、免疫球蛋白(IgA、IgG、IgM)及CRP水平.比较各组各指标的变化.结果 高血压组ficolin-3、C3、C4水平均高于对照组(均P＜0.01),CRP水平高于对照组(P＜0.05),IgM水平低于对照组(P＜0.05),IgG和IgA水平与对照组比较未见显著性差异(P＞0.05).ficolin-3、C3、C4和CRP水平与血压呈正相关(P＜0.05);ficolin-3与C3、C4水平呈正相关,与高血压病程也呈正相关(均P＜0.05).结论血清ficolin-3水平与原发性高血压病的发展有关,对原发性高血压发病机制的研究、病情观察和预后有一定的价值.     

24例系统性红斑狼疮免疫球蛋白及补体检测结果分析

目的　探讨血清免疫球蛋白 (Ig)及补体 (C)系统水平与系统性红斑狼疮 (SLE)的关系和意义。 方法　采用日立 7170S全自动生化分析仪对 2 4例SLE患者和 3 1例健康对照组的血清IgG、IgA、IgM、C3、总补体溶血活性 (CH5 0 )进行检测并比较其结果。结果　 2 4例SLE患者血清IgG、IgA、IgM、C3、CH5 0与对照组比较差异有高度显著性 (P均 <0 .0 1)。结论　血清Ig及C系统水平对SLE疾病的监测有临床意义     

抗C1q 抗体与系统性红斑狼疮及狼疮肾炎的相关性

［摘要］ 目的　研究系统性红斑狼疮（systemic lupus erythematosus,SLE）患者抗C1q 抗体与疾病活动及狼疮性肾炎（lupus nephritis,LN）的相关性．方法　采用ELISA法测定62例SLE患者和47 例其他风湿性疾病患者及21名健康对照者血清中抗C1q抗体的浓度．62例SLE分为疾病活动组（36例）和疾病稳定组（26例）,并按LN判定标准分为LN 组（32例）和非LN组（30例）．分析各组抗C1q抗体水平与SLE患者补体指标、SLE活动性评分间的相关性．结果　SLE患者中血清抗C1q抗体阳性率为64.51%,显著高于疾病对照组和正常对照组 （P＜0.05）．SLE活动组抗C1q抗体水平显著高于稳定组（P＜0.01）．LN组患者血清抗C1q 抗体的水平显著高于非LN组SLE患者（P＜0.01）．血清中抗C1q抗体水平与SLEDAI评分、抗dsDNA抗体水平显著正相关,与补体C3、C4含量显著负相关．结论　C1q抗体水平能反映SLE的疾病活动程度,并与SLE肾损害相关,对活动性LN敏感度高．     

血清抗核小体抗体水平与系统性红斑狼疮活动性及脏器损害的相关性研究

目的 检测系统性红斑狼疮(SLE)患者血清中抗核小体抗体(AnuA)的水平,探讨AnuA与SLE疾病活动性及脏器损害的相关性.方法 选取宁夏医科大学总医院风湿免疫科134例住院SLE患者作为研究对象,同时选取该院健康体检者30例作为正常对照组,用酶联免疫吸附法(ELISA)检测血清中的AnuA水平.结果 SLE组中血清AnuA水平[(97±76)RU/mL]显著高于正常对照组[(13±15)RU/mL,=7.34,P＜0.01)];SLE患者病情活动组血清AnuA水平明显高于非活动组(P＜0.01);肾脏损害组血清AnuA水平明显高于无肾脏损害组(P＜0.01);神经精神狼疮组血清AnuA水平明显高于非神经精神狼疮组(P＜0.01);肺脏损害组血清AnuA水平明显高于无肺脏损害组(P＜0.05);SLE患者是否出现心脏损害、血液系统损害、肝脏损害和关节炎与血清AnuA水平无明显相关性(P ＞0.05);AnuA血清水平与补体C3、C4呈负相关(分别为r=-0.397,P=0.001;r =-0.405,P=0.001),与血沉呈正相关(r=0.563,P＜0.01),与尿蛋白定量呈正相关(r=0.437,P＜0.01);但与IgG、球蛋白、白蛋白和C反应蛋白等临床各项指标间统计无相关性(P＞0.05),SLE患者血清AnuA水平与抗ds-DNA抗体、抗Sm抗体、ANA、抗心磷脂抗体(ACA-lgG)等比较无统计学意义(P ＞0.05);SLE血清AnuA水平[(97±76)RU/mL]与SLE的SLEDAI[(16±7)分]评分高低呈明显的正相关(r=0.364,P＜0.05). 结论 AnuA在SLE患者血清中水平明显增高,SLE患者血清AnuA水平高低能够反映SLE患者的病情活动及脏器损害的发生.     

系统性红斑狼疮患者血清IP-10表达水平与疾病活动性关系的研究

目的 探讨趋化因子干扰素诱导蛋白-10(IP-10)在系统性红斑狼疮(SLE)患者血清中表达水平及其与疾病活动性关系.方法 对86例病情活动的SLE患者、59例缓解期SLE患者以及31名健康对照者,采用ELISA方法检测IP-10的血清浓度,并且结合抗ds-DAN抗体、补体C3、C4水平,分析其与IP-10的关系.结果 活动期SLE组IP-10水平明显高于缓解期和正常对照组(P＜0.01),且与抗ds-DAN抗体呈明显正相关(r=0.441 P=0.00085),但与补体C3、C4没有明显相关性(r=0.141,P=0.0714;r=0.123,P=0.0546).结论 SLE患者血清IP-10的水平可反映病情活动的程度.     

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.