慢性肺心病患者血清可溶性白细胞介素2受体含量变化

对１６例慢性肺心病急发期、缓解期患者进行血清可溶性白细胞介素２受体（ＳＩＬ－２Ｒ）测定，并与１８例健康人对照。结果：健康人血清ＳＩＬ－２Ｒ平均值为３１４．８±７１．９Ｕ／ｍｌ，肺心病缓解期和急发期平均值为５６８．３±２１６．２Ｕ／ｍｌ，７５６．３±３８２．３Ｕ／ｍｌ，明显高于对照组，肺心病急发期明显高于缓解期（Ｐ＜０．００１）。提示慢性肺心病免疫功能低下可能与ＳＩＬ－２Ｒ升高有关     

肺癌患者血清可溶性白细胞介素6受体含量观察

目的探讨可溶性白细胞介素６受体（ｓＩＬ－６Ｒ）在肺癌免疫机制中的作用及临床意义。方法用双抗体夹心酶联免疫吸附试验检测２１例肺癌患者和２０例正常对照者的血清ｓＩＬ－６Ｒ水平。结果肺癌组患者血清ｓＩＬ－６Ｒ水平（７８．２±２２．１ｎｇ／ｍｌ）明显高于健康对照组（３６．０±１５．０ｎｇ／ｍｌ）（Ｐ＜０．０１）。肺癌Ⅰ～Ⅱ期者血清ｓＩＬ－６Ｒ水平（６５．６±１８．３ｎｇ／ｍｌ）明显低于Ⅲ～Ⅳ期者（９０．２±２６．６ｎｇ／ｍｌ）（Ｐ＜０．０１）。肺癌化疗后血清ｓＩＬ－６Ｒ水平较化疗前下降,但差异无显著性（Ｐ＞０．０５）。结论ｓＩＬ－６Ｒ参与肺癌的发生和发展。测定肺癌患者血清中可溶性白细胞介素６受体水平,对肺癌的病情监测有一定价值     

NKC,IL—2,IL—6和TNFα在海洛因依赖者戒毒过程中的变化及意义

为了解在强制戒毒过程中,外周血自然杀伤细胞（ＮＫＣ）活性及单个核细胞的分泌的ＩＬ－２活性变化,以及外周血清中ＩＬ－６及肿瘤坏死因子α（ＴＮＦα）水平的变化,对５１例吸毒成瘾者采用生物活性测定法（ＭＴＴ）测定了ＮＫＣ活性及ＩＬ－２活性,用ＥＬＩＳＡ法测定了外周血清中ＩＬ－６及ＴＮＦα水平。结果 海洛因依赖者ＮＫＣ３０．１１±５．２％;ＩＬ－２ ８．０６±１．６６ＩＵ／ｍｌ;ＩＬ－６１．１７±１２．０     

儿童急性肾小球肾炎血清白细胞介素2，6，8变化及临床意义

目的 探讨细胞因子在儿童急性肾小球肾炎（ＡＧＮ）中的变化及意义。方法 采用放射免疫法测定儿童急性肾小球肾炎急性期与恢复期血清白细胞介素２，６，８（ＩＬ－２，ＩＬ－６，ＩＬ－８）的变化并探索其临床意义。结果３５例ＡＧＮ患儿急性期ＩＬ－２，ＩＬ－６，ＩＬ－８分别为（３８±３．１）μｇ/Ｌ，（８６．８±７７．２）ｎｇ/Ｌ，（０．７６±０．５２）μｇ/Ｌ，较对照组（０．９３±０．６９）μｇ/Ｌ，（６５．９±４９．２）ｎｇ／Ｌ，（０．２４±０．３６）μｇ/Ｌ差异有显著性（Ｐ＜０．０１），恢复期接近正常。结论 儿童ＡＧＮ急性期ＩＬ－２，ＩＬ－６，ＩＬ－８增高，且在病程中发挥重要的作用。     

清热解毒中药对烧伤创面感染大鼠血浆IL－6的水平和TNF诱生量的影响

用黄连、黄柏、黄芩和金银花复方水煎剂治疗烧伤大鼠创面感染，测定血浆中白细胞介素６（ＩＬ－６）的含量和混和淋巴细胞培养上清液中的肿瘤坏死因子ＴＮＦ诱生量。大鼠随机分成假烫组、烧伤创面感染对照组（烧感组）和烧伤创面感染十中药治疗组（中药组）。烧感组和中药组在伤后８、２４和４８ｈ抽血查上述指标。结果示烧伤创面感染的大鼠自烧伤后２４ｈ起血浆ＩＬ－６均高于正常，烫伤后４８ｈ烧感组血浆ＩＬ－６显著高于中药组（Ｐ＜０．０１）。ＴＮＦ的诱生量从伤后２４ｈ起，中药组显著高于烧感组，中药组伤后２４和４８ｈＴＮＦ的诱生量分别为４．２±０．９ｎｇ／ｍｌ和２．６１±１ｎｇ／ｍｌ；烧感组分别为１．１±０．３ｎｇ／ｍｌ和０．９±０．３ｎｇ／ｍｌ（Ｐ＜０．０１）。由此说明抑制内源性致热因子ＩＬ－６和ＴＮＦ的产生是中药清热解毒的重要机制。     

支气管哮喘患儿血清中IL—8,sIL—2R水平变化及其意义

用夹心ＥＬＩＳＡ法检测小儿支气管哮喘患者血清中ＩＬ－８及ｓＩＬ－２Ｒ。结果显示：支气管哮喘组和健康对照组ｓＩＬ－２Ｒ分别为３９２．０±２５５．７Ｕ／ｍｌ和２４８．２±７１．４Ｕ／ｍｌ，ＩＬ－８阳性率分别为６０．７％和２９．４％，ＩＬ－８ 数分别为８００ｎｇ／Ｌ和１００ｎｇ／Ｌ，表明血清ｓＩＬ－２Ｒ和ＩＬ－８的检测对于支气管哮喘的病情监测和诊断是一项重要指标。     

非胰岛素依赖性糖尿病患者血中IL—2和TNF—α水平评价

测定ＮＩＤＤＭ患者５０例，正常对照组６０例的血清ＩＬ－２和ＴＮＦ－α值，结果ＮＩＤＤＭ患者血中ＩＬ－２和ＴＮＦ－α值分别为６．９３±３．４２ｎｇ／ｌ和１．０２±０．６５ｎｇ／ｌ，较正常对照组稍低，胆两且差异均无显著性（Ｐ〉０．０５）。提示早期、无并发症的ＤＩＤＤＭ患者无明显免疫功能紊乱。ＩＬ－２，ＴＮＦ－α等细胞因子在糖尿病特别是ＮＩＤＤＭ的发生，发展中所起作用有待进一步探讨。     

川崎病患儿白细胞介素6、肿瘤坏死因子变化及其意义

采用白细胞介素６（ＩＬ－６）依赖细胞（ＭＨ６０．ＢＳＦ２）增殖法及酶标双抗体夹心法，分别检测１５例急性期及部分恢复期川崎病患儿血清ＩＬ－６及肿瘤坏死因子（ＴＮＦ），并同时测定了血清免疫球蛋白。结果显示：川崎病患儿急性期ＩＬ－６及ＴＮＦ活性均明显高于对照组，Ｐ＜０．０１；二者在恢复期接近对照组，差别无显著意义，Ｐ＞０．０５，急性期患儿免疫球蛋白ＩｇＧ、ＩｇＭ、ＩｇＡ血清值亦高于正常对照组。提示ＩＬ－６、ＴＮＦ是川崎病急性期血管炎性变化重要介质，并在川崎病免疫发病机理中起重要作用。     

慢性阻塞性肺疾病和肺心病急性加重期sIL－2R的研究

应用双抗体夹心ＥＬＩＳＡ法测定３２例慢性阻塞性肺疾病（ＣＯＰＤ）、３０例慢性肺心病急性加重期患者和３０例健康人血清可溶性白细胞介素－２受体（ｓＩＬ－２Ｒ）。结果：健康人血清ｓＩＬ－２Ｒ平均值为３１４．８±７１．９ｕ／ｍｌ。ＣＯＰＤ组和肺心病组血清ｓＩＬ－２Ｒ平均伍分别为５８２．４±２８５．９ｕ／ｍｌ、７９３．２±４７６．３ｕ／ｍｌ，明显高于健康对照组（Ｐ＜０．００１）。ＣＯＰＤ和肺心病组间比较结果：肺心病组明显高于ＣＯＰＤ组（Ｐ＜０．０５）。     

血清肿瘤坏死因子α测定对消化道癌诊断的评价

本文报告６１例消化道癌、３０例消化道非肿瘤疾病和５０例正常人三组血清ＴＮＦα测定结果：分别为１４．５９±３．０１ｎｇ／ｍｌ、２．３１±０．５６ｎｇ／ｍｌ和０．０５±０．０４ｎｇ／ｍｌ，消化道癌组显著高于其他两组（Ｐ均〈０．０１）。４２例未切除肿瘤的血清ＴＮＦα水平为１５．９４±４．０１ｎｇ／ｍｌ，显著高于１９例手术切除者８．３１±３．９１ｎｇ／ｍｌ（Ｐ〈０．０１）；４ｎｇ／ｍｌ为切割值，诊断消化道     

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.