结核菌素试验复强反应免疫机理的探讨

为探讨结核菌素试验复强反应免疫机理，我们在对河南省禹州市神地区常住人口３８９７人作了结核菌素（ＰＰＤ人型）皮试调查。试验分四组，即试验前组、皮试阴性组、皮试阳性组及复强反应组。随机抽样作外周血免疫学检测，结果显示：复强反应组与其他组相比，ＣＤ－３、ＣＤ－４阳性率均有所升高（Ｐ＜０．０５），但ＣＤ－４／ＣＤ－８比值无显著性差异（Ｐ＞０．０５）：血清免疫球蛋白及Ｃ－３测定，复强反应组ＩｇＭ高于皮试前及阴性组，但无统计学意义（Ｐ＞０．０５）；血清ＳＩＬ－２Ｒ检测，各组均比皮试前组升高，尤以复强反应组与皮试前组或阴性组比较为甚（Ｐ＜０．００１）；结核特异抗体测定复强反应组虽有升高，但与皮试前或阴性组相比差异不显著（Ｐ＜０．０５）；特异性结核循环免疫复合物测定，复强反应组与皮试前组及阴性组相比有显著性差异（Ｐ＜０．００１）。揭示复强反应的免疫机理很可能是ＰＰＤ刺激机体使Ｔ细胞免疫反应为主的特异性回忆应答。     

富丁汤治疗肾虚湿热型慢性前列腺炎的临床研究

慢性前列腺炎肾虚湿热型居多。通过临床观察,民族药方富丁汤的有效率为86．25％,优于对照组氧氟沙星和前列康。对于细菌性慢性前列腺炎,富丁汤与氧氟沙星无差异;对于非细菌性慢性前列腺炎,其疗效则明显优于氧氟沙星。此外,富丁汤在改善临床症状、提高前列腺液中锌的含量以及降低前列腺液中免疫球蛋白IgA的含量等方面均有较好效果。     

通脉络胶囊的抗血栓形成作用的研究

目的：研究通脉络胶囊对实验动物的血栓形成作用，为临床用药提供依据。方法：建立兔颈总动脉－颈外静脉体外循环旁路，形成血小板血栓，来研究通脉络胶囊抗兔体内血栓形成的作用；用直流电连续刺激大鼠一侧颈动脉，制备老年血瘀模型，来研究通脉络胶囊抗老年大鼠体内血栓形成的作用。各实验均设四组动物：通脉络胶囊高、低剂量组、复方丹参片组、水对照组。结果：各实验中通脉络胶囊高、低剂量组与水对照组比较均有极显著性差异（Ｐ＜０．０１）；与复方丹参片组比较有极显著性差异（Ｐ＜０．０１）。结论：通脉络胶囊有显著的抗血栓形成作用，其作用远较复方丹参片强；第二种方法操作简单、可靠，对于药物的抗栓作用的研究更具有推广应用价值。     

Bronchoscopy and Tuberculostearic Acid Assay in the Diagnosis of Sputum Smear-negative Pulmonary Tuberculosis: A Prospective Study with the Addition of Transbronchial Biopsy

A prospective study of the efficacy of bronchoscopy and tuberculostearicacid assay in the diagnosis of sputum smear-negative pulmonarytuberculosis (TB) was carried out in 39 patients with symptomsand radiographic changes suggestive of active pulmonary TB.The diagnosis of TB was confirmed in 15 patients, probable TBwas diagnosed in eight and 16 patients did not have TB. An earlydiagnosis of TB was made by bronchoscopy in six patients (40per cent). Culture of sputum obtained before bronchoscopy waspositive in nine patients (60 per cent) while combined withbronchoscopy specimens, a positive mycobacterial culture wasobtained in 12 patients (80 per cent). Mycobacteria were culturedfrom transbronchial biopsy specimens from five patients (33per cent) but none of these was exclusively positive. Histologicalexamination of transbronchial biopsy tissue was diagnostic ofTB in four patients and it was the exclusive means of earlydiagnosis in two. Transbronchial biopsy also provided an alternativediagnosis in four other patients. Tuberculostearic acid assayhad a sensitivity of 0.40 in bronchial aspirate, 0.80 in bronchoalveolarlavage fluid, and 0.27 in transbronchial biopsy specimens: thecombined result was 0.87. In nine patients with pulmonary TBin whom an early diagnosis could not be made, the tuberculostearicacid assay was positive in seven (78 per cent). We concludethat bronchoscopy with bronchoalveolar lavage and transbronchialbiopsy is helpful in providing early diagnosis and positiveculture results. Assay of tuberculostearic acid in bronchoalveolarlavage fluid is a useful adjunct to early diagnosis. However,mycobacterial culture and assay of tuberculostearic acid intransbronchial biopsy specimens have little diagnostic value.     

心肌梗死大鼠心肌细胞凋亡及磷酸肌酸的干预

目的:缺血引起的心肌能量供应不足是心肌细胞凋亡主要的因素之一,观察补充外源性能量磷酸肌酸对缺血心肌细胞凋亡和心功能的影响。方法:实验于2003-04/06在解放军总医院老年心血管病研究所实验室完成。选用SD大鼠50只,按随机数字表法分为3组:①磷酸肌酸组19只,结扎左冠状动脉制作心肌梗死模型,结扎前30min按200mg/kg的剂量腹腔注射磷酸肌酸1次。②缺血对照组21只,心肌缺血方法同磷酸肌酸组,结扎前30min腹腔注射相同体积的50g/L葡萄糖注射液1次。③正常对照组10只,仅在冠状动脉下穿线,不结扎冠状动脉,其余同缺血对照组。结扎冠状动脉6h后,取各组大鼠心脏标本做石蜡切片,缺口末端标记法染色,高倍镜下计数心肌细胞凋亡指数,凋亡指数=凋亡心肌细胞数/心肌细胞总数;取心脏标本前,测左心室收缩压、舒张末压和压力变化速度,并进行组间比较。结果:磷酸肌酸组大鼠造模时死亡9只;缺血对照组造模时死亡10只,造模成功后6h内死亡1只,进入结果分析共30只大鼠,每组10只。①缺血对照组大鼠的左心室舒张末压显著高于正常对照组[(13.9±5.3vs.2.8±3.2)mmHg(P<0.01)],左心室压力变化速度显著低于正常对照组[(705.8±111.7vs.1141.7±94.5)mmHg/s(P<0.01)];磷酸肌酸组大鼠的左心室舒张末压显著低于缺血对照组[(8.9±3.5)mmHg(P<0.05)];左心室压力变化速度显著高于缺血对照组[(841.5±76.1)mmHg/s(P<0.01)];左心室收缩压与缺血对照组差异无显著性意义(P>0.05)。②磷酸肌酸组大鼠的心肌细胞凋亡指数显著低于缺血对照组(0.203±0.054vs.0.278±0.052,P=0.006)。结论:补充外源性能量磷酸肌酸可以减少缺血后心肌细胞凋亡,并改善心功能,磷酸肌酸抑制缺血心肌细胞凋亡可能是改善心肌梗死后心功能的主要作用途径之一。