血清前列腺特异性抗原浓度改变对慢性前列腺炎的临床意义

目的:探讨慢性前列腺炎患者血清前列腺特异性抗原(PSA)浓度改变及其对本病诊断和治疗的作用。方法:选择20-60岁的 慢性前列腺炎患者360例,测定血清PSA浓度。根据前列腺按摩液(EPS)中的白细胞(WBC)记数的多少,将患者分为轻度炎症 (WBC<10/HP)、中度炎症(10/HP≤WBC<30/HP)、重度炎症(WBC≥30/HP)3组,并比较3组之间PSA水平的变化,其中180例 行。EPS细菌培养。结果:血清PSA升高比例为46.7％,其中轻度炎症组10％、中度炎症组10％、重度炎症组26.7％。3组血清PSA 平均值分别为(2.3830±0.8350)ng/ml、(3.1571±0.6432)ng/ml及(7.1557±0.9110)ng/ml。轻、中度炎症组间PSA改变无明显差 异(P>0.05),而轻、中度炎症组与重度炎症组阃PSA变化均有显著差异(P<0.001和P<0.005)。非细菌性前列腺炎血清PSA升 高比细菌性前列腺炎更明显,两者有显著差异(P<0.05)。结论:慢性前列腺炎血清PSA浓度升高比例在50％左右,PSA可作为衡 量该疾病严重程度及判断治疗效果好坏的一个重要指标。     

前列腺特异性抗原水平变化在ⅢA型慢性前列腺炎诊治中的意义

目的：探讨血清前列腺特异性抗原水平在ⅢA慢性前列腺炎发生、发展中的变化,提高对慢性前列腺炎的临床诊治水平。方法选择确诊为ⅢA慢性前列腺炎患者66例,根据前列腺按摩液(EPS)中白细胞(WBC)计数,分为轻度(10≤WBC＜20/HP)、中度(20≤WBC＜30/HP)和重度(WBC≥30/HP),探讨各组患者血清fPSA、tPSA 和fPSA/tPSA 与疾病轻重程度的相关性,同时比较以上指标在患者治疗过程中的变化情况。结果血清fPSA和tPSA与疾病严重程度呈正相关(P＜0.01);fPSA/tPSA与疾病严重程度呈负相关(P＜0.05);经治疗后血清fPSA和tPSA水平逐渐降低,fPSA/tPSA值逐渐增加,就诊时与治疗8周后相比,差异均具有统计学意义(P＜0.01,P＜0.05)。结论在ⅢA慢性前列腺炎的治疗过程中,应动态检查血清fPSA、tPSA和fP-SA/tPSA,可提示疾病的严重程度及临床治疗情况。     

血清PSA值及直肠指检指导前列腺穿刺活检的临床意义

目的 探讨血清PSA浓度及直肠指检在指导前列腺穿刺活检中的价值.方法 对59例血清PSA＞4 ng/ml和(或)直肠指检前列腺有结节的患者,行经直肠B超引导下前列腺穿刺活检.结果 59例患者中前列腺活检阳性者32例(54%),PSA浓度＞10 ng/ml组活检阳性率较PSA＜10 ng/ml组高(P＜0.05).直肠指检发现有结节的患者,前列腺活检阳性率较无结节明显增高(P＜0.05).结论 随着血清PSA浓度升高,前列腺活检阳性率升高;对于直肠指检发现有结节患者,即使PSA＜4 ng/ml,也应行前列腺穿刺活检排除前列腺癌.     

联合用药治疗慢性前列腺炎伴血清前列腺特异性抗原升高的疗效观察

目的:探讨热淋清颗粒与左氧氟沙星联合用药治疗慢性前列腺炎伴血清前列腺特异性抗原(PSA)升高患者的疗效。方法:27例慢性细菌性前列腺炎及45例慢性炎症性前列腺炎患者经检查同时伴有血清PSA≥4μg.L-1,给予热淋清颗粒4g口服3次.d-1及左氧氟沙星0.2g口服2次.d-1,共28天。观察治疗前后患者临床症状改善情况及血清PSA水平的变化。结果:治疗后慢性细菌性前列腺炎组症状总体评分由治疗前(18.4±6.2)降至(12.1±5.5),血清PSA由(7.34±3.12)μg.L-1降至(4.81±2.71)μg.L-1;慢性炎症性前列腺炎组症状总体评分由治疗前(16.7±4.28)降至(11.3±6.4),血清PSA由(8.13±4.22)μg.L-1降至(5.81±3.32)μg.L-1。结论:热淋清颗粒与左氧氟沙星联合用药可明显改善慢性细菌性前列腺炎和慢性炎症性前列腺炎伴血清PSA升高患者的临床症状,并能显著降低血清PSA水平。     

前列腺炎患者血清TPSA、FPSA及FPSA／TPSA比值与前列腺液WBC含量的比较分析

目的探讨前列腺炎患者血清总前列腺特异抗原（TPSA）、游离型前列腺特异性抗原（FPSA）及游离型前列腺特异性抗原／总前列腺特异抗原（FPSA／TPSA）比值与前列腺液门细胞（WBC）的相关性。方法通过化学发光法测定205例前列腺炎患者血清TPSA、FPSA、FPSA/PSA比值,再与前列腺液（EPS）镜检WBC含量作比较,分析不同EPS中WBC含量与血清TPSA、FPSA、FPSA／TPSA比值的关系,以及前列腺炎治疗前后血清TPSA、FPSA、FPSA／TPSA比值的变化,来确定两者的相关性,试验同时设对照组40例。结果前列腺炎较严重组（WBC＋＋＋～＋＋＋＋）血清FPSA、TPSA及FPSA/PSA比值与前列腺炎较轻组（WBC＋～＋＋）及正常对照组差异均有显著性（P〈0．05）,前列腺炎治疗好转前后血清TPSA、FPSA、FPSA/PSA比值对比有显著性差异（P〈0．05）。结论前列腺炎可以导致血清TPSA、FPSA及FPSA-PSA升高,这种升高与EPS中WBC的含量呈正相关,血清TPSA、FPSA及FPSA-PSA升高也可以作为前列腺炎疗效判断的一项指标。     

前列腺液白细胞介素8与肿瘤坏死因子α检测在Ⅲ型前列腺炎诊断与分型中的意义

目的 探讨前列腺液中细胞因子白细胞介素8（IL-8）和肿瘤坏死因子α（TNF-α）在Ⅲ型前列腺炎（慢性非细菌性前列腺炎/慢性盆底疼痛综合征）诊断和分型中的意义. 方法 酶联免疫吸附法检测60例临床诊断的Ⅲ型前列腺炎患者（其中ⅢA型组34例,ⅢB型组26例）和20名健康体检者（对照组）前列腺液（EPS）中IL-8和TNF-α浓度.分析各组EPS中IL-8和TNF-α浓度差异. 结果 ⅢA型组EPS中IL-8及TNF-α水平分别为（61±2432）ng/L、（259±165）ng/L,与ⅢB型组[（2257±1237）ng/L、（104±39）ng/L]和对照组[（1675±685）ng/L、（67±27）ng/L]比较,差异有统计学意义（P＜0.01）;ⅢB型组EPS中IL-8及TNF-α水平高于对照组,差异有统计学意义（P＜0.05）. 结论 检测EPS中IL-8及TNF-α水平可能有助于Ⅲ型前列腺炎的诊断和分型.     

组织学前列腺炎与良性BPH临床进展的关系

目的 探讨组织学前列腺炎与良性前列腺增生(BPH)临床进展的关系.方法 回顾性分析90例BPH患者临床资料.结果 90例BPH患者中,58例(64.4%)被诊断为组织学前列腺炎,年龄(70.5±6.4)岁,前列腺体积(45.8±17.4)ml,术前血清前列腺特异性抗原(PSA)(7.0±4.2)ng/ml.32例单纯BPH患者年龄(67.9±7.6)岁,前列腺体积(37.8±15.4)ml,术前PSA(4.0±3.2)ng/ml,均明显低于合并组织学前列腺炎者(P<0.05).结论 组织学前列腺炎是BPH临床进展的重要因素之一;合并前列腺炎的患者临床检测指标明显高于单纯BPH患者.     

血清PSA、PAP联合检测对前列腺癌的诊断价值及雌激素对其的影响

目的 研究血清PSA、PAP联合检测对前列腺癌诊断的价值及雌激素对其的影响.方法 选取本院泌尿外科收治的前列腺癌患者60例,给予己烯雌酚3 mg,每日一次口服,同时给予阿司匹林肠溶缓释片100 mg,每日一次口服,连续2个月.同时选取前列腺增生患者60例,正常对照组为同时期体检健康者60例.采用放射免疫分析法,分别观察前列腺增生组、正常对照组、前列腺癌组治疗前、前列腺癌组治疗后血清PSA、PAP水平,以及前列腺癌组患者治疗前后IPSS评分指标.结果 ①前列腺癌组的血清PSA、PAP水平为(80.64±64.72)、(45.86±55.73) ng/ml,明显高于前列腺增生组的(5.82±5.96)、(1.35±0.92) ng/ml和正常对照组的(0.75±0.24)、(0.79±0.61) ng/ml,差异有统计学意义(P＜0.05);前列腺增生组和正常对照组比较差异无统计学意义(P＞0.05).②PSA对前列腺癌的阳性检出率及检测的灵敏性为78.33％,指标特异性达70.00％,而PAP对前列腺癌的阳性检出率及检测的灵敏性为53.33％,指标特异性达93.33％;PSA对前列腺癌检出的阳性率和灵敏性均高于PAP,而特异性却不及PAP,差异有统计学意义(P＜0.05);③治疗后,前列腺癌组血清PSA、PAP水平为(9.71±10.38)、(7.82±11.77) ng/ml,与治疗前比较,血清PSA、PAP水平明显下降,差异有统计学意义(P＜0.05);④治疗后,前列腺癌组前列腺症状有所改善,IPSS评分为(7.68±1.12),与治疗前的(21.66±4.61)比较,IPSS评分明显降低,差异有统计学意义(P＜0.05).结论 血清PSA、PAP联合检测能够提高对前列腺癌诊断的灵敏性和特异性,可用于前列腺癌的早期诊断;雌激素能够降低其水平,改善前列腺癌症状,抑制病情进展.     

前列腺液中单核细胞趋化蛋白水平与慢性非细菌性前列腺炎的研究

目的研究慢性非细菌性前列腺炎的发病机制并寻求一种简洁的诊断方法。方法筛选门诊慢性非细菌性前列腺炎患者(前列腺炎组)64例和无前列腺炎的健康志愿者(对照组)24例,比较2组前列腺液中单核细胞趋化蛋白(MCP-1)含量。结果前列腺炎组前列腺液中MCP-1含量(73±14)pg/ml,对照组中MCP-1含量(35±11)pg/ml。2组比较差异有统计学意义(P<0.05)。结论慢性非细菌性前列腺炎患者前列腺液中MCP-1含量较对照组明显升高,前列腺液中出现的增多巨噬细胞可能由MCP-1趋化。可以应用检测前列腺液中MCP-1作为一种客观、简洁的诊断方法。     

前列金丹治疗前列腺增生合并Ⅲ型前列腺炎的临床研究

目的 观察前列金丹治疗良性前列腺增生(benign prostatic hyperplasia,BPH)合并Ⅲ型前列腺炎-慢性非细菌性前列腺炎/慢性骨盆疼痛综合征(chronic nonbacterial prostatitis/chronic pelvic pain syndrome,CNBP/CPPS)的临床效果.方法 采用双盲临床研究,将100例BPH合并CNBP/CPPS患者完全随机分为研究组和对照组,各50例.研究组采用前列金丹治疗,对照组采用安慰剂治疗.评价2组治疗3个月后的国际前列腺症状评分(international prostate symptom score,IPSS)、慢性前列腺炎症状评分(the NIH chronic prostatitis symptom index,NIH-CPSI)、最大尿流率、残余尿及前列腺液常规(EPS)中WBC计数.结果 治疗3个月后,研究组和对照组IPSS评分从治疗前的(12.6±2.5)分和(12.4±2.4)分降至(10.3±2.2)分和(12.1±2.5)分,研究组治疗前后比较差异有统计学意义(P＜0.05);CPSI评分从治疗前的(23.0±5.9)分和(23.9±6.0)分降至(16.6±4.5)分和(22.7±5.9)分,研究组治疗后比较差异有统计学意义(P＜0.05).研究组治疗后的最大尿流率增加,残余尿及前列腺液中WBC计数减少,治疗前后差异有统计学意义(P＜0.05).结论 BPH合并CNBP/CPPS患者给予前列金丹治疗能使症状明显改善.     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg.kg) or i.p. (50 mg.kg) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) l.h. kg in the male rat and 10.6 (95% CI: 7.5, 15.0) l.h. kg in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p 0.001) in plasma obtained from the male (8.8 2.0%) compared with the female rat (11.7 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg x kg(-1)) or i.p. (50 mg x kg(-1)) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) 1 x h(-1) x kg(-1) in the male rat and 10.6 (95% CI: 7.5, 15.0) 1 x h(-1) x kg(-1) in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was approximately 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p < 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p < 0.001) in plasma obtained from the male (8.8 +/- 2.0%) compared with the female rat (11.7 +/- 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Interindividual variability in metabolic activation in humans in vivo

In assessing interindividual variability in metabolic activation, the toxic metabolite is often too unstable for conventional analysis. Possible alternatives include a stable product of the reactive metabolite e.g. cysteinyl derivatives of N-acetyl-4-benzoquinoneimine, the toxic metabolite of paracetamol, adducts with DNA or protein, and indirect measurement of the activity of the enzyme(s) producing the active metabolite. An example of the last approach is the use of furafylline, a highly specific inhibitor of human CYP1A2, to determine the extent of the metabolic activation of the cooked food mutagens PhIP and MeIQx. The extent of inhibition, determined from levels of unchanged amine in urine, is an indirect measure of the activity of the activation pathway. Further refinement of this approach, allied to improved measures of the biological process of interest should prove of value in evaluating interindividual variability and its role in the risk assessment process.     

Theophylline kinetics in peripheral tissues in vivo in humans

Several biochemical and cellular effects have been described for methylxanthines under in vitro conditions. However, it is unknown, whether threshold concentrations required to exert these effects are attained in target tissues in vivo. We therefore employed the microdialysis technique for measuring theophylline concentrations in peripheral tissues under in vivo conditions.Following in vitro and in vivo calibration, microdialysis probes were inserted into the medial vastus muscle and into the periumbilical subcutaneous adipose layer of healthy volunteers. Following single oral dose administration of 300 mg or i.v. infusion of 240 mg theophylline, in vivo time courses of theophylline concentrations were monitored in tissues and plasma. Major pharmacokinetic parameters (c_max, t_max, AUC) were calculated for plasma and tissue time courses. The mean AUC_tissue /AUC_plasma-ratio was 0.56 (p.o.) and 0.55 (i.v.) for muscle and 0.55 (p.o.) and 0.72 (i.v.) for subcutaneous adipose tissue.We conclude that microdialysis provides important information on the distribution and the tissue pharmacokinetics of theophylline.Abbreviations FPIA Fluorescence polarisation immuno assay - AUC Area under the curve - t_max Time to peak concentration - c_max Peak concentration     

休克时血中氧自由基的变化

本实验测定10名休克患者血浆和红细胞的丙二醛(MDA)、血浆总抗的氧化活性(AOA)的含量。结果表明:休克病人红细胞膜和血浆 MDA 含量(4.298±0.722;5.348±0.834)与对照组(3.235±0.682;4.356±1.081)比较明显增高(P<0.05);血浆 AOA(39.65±7.858)与对照组(48.21±10.81)比较明显降低(P<0.01)。提示:休克时,患者机体内自由基反应增强是引起组织细胞损伤的原因之一。     

Changes in angiopoietin expression in glomeruli involved in glomerulosclerosis in rats with daunorubicin-induced nephrosis

AIM: To study the potential pathological role of endogenous angiopoietins in daunorubicin-induced progressive glomerulosclerosis in rats. METHODS: Seventy male Wistar rats were allocated randomly into a daunorubicin group (DRB; n=40) or a control group (n=30). The rats in the DRB group were injected with DRB (15 mg/kg), in their tails. Subsequently, at intervals of 1, 2, 4, 6, 8, and 12 weeks, 5 male Wistar rats in each group were chosen randomly for 24 h urinary protein quantitative measurements (24 h UPQM), and determination of plasma tumor necrosis factor alpha (TNF-alpha), angiopoietin-1 (Ang1), and angiopoietin-2 (Ang2) levels. Kidney sections were examined by electron microscopy, Periodic Acid Schiff (PAS) staining, immunohistochemical staining and in situ hybridization histochemistry. RESULTS: As glomerulosclerosis progressed in the DRB group, expression of Ang1 mRNA and protein in glomeruli decreased and expression of TNF-alpha protein, Ang2 mRNA and protein in glomeruli increased. Expression of Ang1 mRNA and protein in glomeruli were negatively correlated with 24 h UPQM, Fn protein expression, and mean area of extracellular matrix (MAECM). In comparison, expression of Ang2 mRNA and protein in glomeruli were positively correlated with 24 h UPQM, Fn protein expression and MAECM; furthermore, there was a positive correlation between plasma Ang2 and 24 h UPQM. Plasma TNF-alpha and expression of TNF-alpha in glomeruli were positively correlated with expression of Ang2 mRNA and protein in glomeruli. There was a negative correlation between Ang1 protein expression and Ang2 protein expression in glomeruli. CONCLUSION: During DRB-induced glomerulosclerosis, podocyte injury led to a shift in the balance of Ang1 and Ang2 in glomeruli. Increased TNF-alpha in plasma and glomeruli may upregulate Ang2 expression in glomeruli. Elevated Ang2 in both plasma and glomeruli may mediate protein permeability through the glomerular filtration barrier. Moreover, local expression of Ang2 may facilitate the progress of glomerulosclerosis by upregulating a component expression of extracellular matrix.     

Trichinellosis in immigrants in Switzerland

We describe a case of trichinellosis diagnosed at the Division of Infectious Diseases, Hospital of Lugano, in January 2009. This case was associated with a cluster of cases and was traced to the consumption of contaminated meat after a wild boar hunt in Bosnia.