C1q抗体在狼疮性肾炎诊断中的意义

目的检测系统性红斑狼疮(SLE)患者及非狼疮性肾病综合征患者的C1q抗体(C1qAb)的水平,探讨C1qAb在狼疮性肾炎诊断中的意义,并作C1qAb与抗核抗体(ANA)、抗ds鄄DNA和SLEDAI的相关性分析。方法用ELISA对106例SLE、30例非狼疮性肾病综合征患者和30名健康对照者外周血血清中C1qAb进行检测。同时将SLE患者分为狼疮性肾炎(LN)活动期组(A组,76例)和肾外全身症状组(B组,30例),比较各组C1qAb和其他免疫学指标的阳性率差异。分析C1qAb与ANA、抗ds鄄DNA和SLE病活动指数(SLEDAI)的相关性。结果A组C1qAb滴度为(218.4±179.3)IU/ml,明显高于B组(56±61)IU/ml(P<0.01),与肾病综合征组(33±29)IU/ml及对照组(25±21)IU/ml相比P<0.001。A组的C1qAb阳性率为67.1%,而B组阳性率仅为26.6%;肾病综合征组阳性率为6%。以上结果显示C1qAb与LN关系密切。LN活动期C1qAb水平升高,缓解期可恢复至正常。C1qAb的升高与抗ds鄄DNA的升高可同时出现(r=0.28),C1qAb与SLEDAI呈正相关(r=0.72)。结论C1qAb可作为诊断LN的一个重要实验室指标,与临床活动密切相关。     

Increased Complications for Schizophrenia and Bipolar Disorder Patients Undergoing Total Joint Arthroplasty

Background

Although it has been shown that anxiety and depression are associated with increased complications after total joint arthroplasty (TJA), the outcomes of TJA in patients with a history of psychosis are unknown. This study evaluated the influence of bipolar and schizophrenic disorders on complications after TJA, particularly aseptic and septic revisions.

Modulation of the nuclear factor kappa B pathway by Shp-2 tyrosine phosphatase in mediating the induction of interleukin (IL)-6 by IL-1 or tumor necrosis factor

Shp-2, a src homology (SH)2-containing phosphotyrosine phosphatase, appears to be involved in cytoplasmic signaling downstream of a variety of cell surface receptors, although the mechanism is unclear. Here, we have determined a role of Shp-2 in the cytokine circuit for inflammatory and immune responses. Production of interleukin (IL)-6 in response to IL-1 alpha or tumor necrosis factor (TNF)-alpha was nearly abolished in homozygous mutant (Shp-2(-/)-) fibroblast cells. The targeted Shp-2 mutation has no significant effect on the activation of the three types of mitogen-activated protein (MAP) kinases, extracellular signal-regulated kinase (Erk), c-Jun NH(2)-terminal kinase (Jnk), and p38, by IL-1/TNF, indicating that Shp-2 does not work through MAP kinase pathways in mediating IL-1/TNF-induced IL-6 synthesis. In contrast, IL-1/TNF-stimulated nuclear factor (NF)-kappa B DNA binding activity and inhibitor of kappa B (I kappa B) phosphorylation was dramatically decreased in Shp-2(-/)- cells, while the expression and activity of NF-kappa B-inducing kinase (NIK), Akt, and I kappa B kinase (IKK) were not changed. Reintroduction of a wild-type Shp-2 protein into Shp-2(-/)- cells rescued NF-kappa B activation and IL-6 production in response to IL-1/TNF stimulation. Furthermore, Shp-2 tyrosine phosphatase was detected in complexes with IKK as well as with IL-1 receptor. Thus, this SH2-containing enzyme is an important cytoplasmic factor required for efficient NF-kappa B activation. These results elucidate a novel mechanism of Shp-2 in cytokine signaling by specifically modulating the NF-kappa B pathway in a MAP kinase-independent fashion.     

阻塞性睡眠呼吸暂停低通气综合征合并高血压、高同型半胱氨酸血症的研究进展

阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome, OSAHS)、高同型半胱氨酸血症(hyperhomocysteinemia,HHcy)及高血压病均为脑血管病的危险因素。目前对于同时存在OSAHS、HHcy及高血压病的情况研究仍较少,本文就OSAHS患者合并HHcy、高血压病的研究现状进行综述。     

缺血性结肠炎的临床及内镜特点研究

目的 总结缺血性结肠炎的临床及内镜特点，探讨其诊断方法。方法 分析26例经结肠镜发现、病理确诊的缺血性结肠炎的相关资料。结果 50岁以上老年人多见(80．8％)，22例(84．6％)伴有高血压、冠心病、糖尿病、便秘及高脂血症等基础疾病或诱因。临床主要表现为腹痛、血便及腹泻等，病变多位于左半结肠。早期内镜表现主要为结肠黏膜水肿、充血、糜烂及溃疡。病变大多为一过型(76．9％)，如能早期诊断与治疗，多数预后良好。结论 48h内行结肠镜检查是诊断缺血性结肠炎的主要方法。     

Roles of 5-hydroxytryptamine (5-HT) receptor subtypes in the inhibitory effects of 5-HT on C-fiber responses of spinal wide dynamic range neurons in rats

5-Hydroxytryptamine (5-HT; serotonin) plays an important role in the descending control of nociception. 5-HT and its receptors have been extensively studied in the modulation of nociceptive transmission at the spinal level using behavioral tests that may be affected by the effects of 5-HT on motor performance and skin temperature. Using electrophysiological methods, the present study aimed to systematically investigate the roles of 5-HT receptor subtypes on the inhibitory effects of 5-HT on responses of the spinal wide dynamic range (WDR) neurons to C-fiber inputs in rats. Under basal conditions, topical application of 5-HT to the spinal cord inhibited the C-fiber responses of WDR neurons dose-dependently, whereas antagonists of 5-HT(1A) [WAY 100635 [N-[2-[4-(2-methoxyphenyl)-1-piperazinyl]ethyl]-N-2-pyridinyl-cyclohexanecarboxamide maleate salt]], 5-HT(1B) [GR 55562 [3-[3-(dimethylamino)propyl]-4-hydroxy-N-[4-(4-pyrid-dinyl)phenyl]benzamide dihydrochloride]], 5-HT(2A) [ketanserin [3-[2-[4-(fluorobenzoyl)-1-piperidinyl]ethyl]-2,4[1H,3H]-quinazolinedione tartrate]], 5-HT(2C) [RS 102221 [8-[5-(2,4-dimethoxy-5-(4-trifluoromethylphenylsulfonamido)phenyl-5-oxopentyl]-1,3,8-triazaspiro[4.5]decane-2,4-dione hydrochloride]], 5-HT(3) [MDL 72222 [3-tropanyl-3,5-dichlorobenzoate]], and 5-HT(4) [GR 113808 ([1-[2-[(methylsulfonyl)-amino]ethyl]-4-piperidinyl]methyl 1-methyl-1H-indole-3-carboxylate)] had no effect on their own. The inhibitory effects of 5-HT were reversed by antagonists of 5-HT(1B) (GR 55562), 5-HT(2A) (ketanserin), 5-HT(2C) (RS 102221), 5-HT(3) (MDL 72222), and 5-HT(4) (GR 113808) but not by 5-HT(1A) (WAY 100635) receptor antagonists. Topical administration of agonists of 5-HT(1A) [(2R)-(+)-8-hydroxy-2-(di-n-propylamino)tetralin hydrobromide], 5-HT(1B) [CGS 12066 [7-trifluoromethyl-4-(4-methyl-1-piperazinyl)pyrrolo-[1,2-a]quinoxaline maleate salt]], 5-HT(2A) (alpha-methyl-5-hydroxytryptamine maleate), 5-HT(2C) [MK 212 [6-chloro-2-(1-piperazinyl)pyrazine hydrochloride]], 5-HT(3) [1-(3-chlorophenyl)biguanide hydrochloride], and 5-HT(4) [2-[1-(4-piperonyl)piperazinyl]benzothiazole] also inhibited the C-responses. These results suggest that, under basal conditions, there is no tonic serotonergic inhibition on the C-responses of dorsal horn neurons, and multiple 5-HT receptor subtypes including 1B, 2A, 2C, 3, and 4 may be involved in mediating the inhibitory effects of 5-HT.     

食管超声多普勒对二尖瓣狭窄患者肺静脉前向性血流的研究

本文应用双平面食管超声多普勒对４７例二尖瓣狭窄（二窄）患者和４０例正常人肺静脉前向性血流进行了对照研究。结果表明，二窄组肺静脉收缩期和舒张期血流峰速、流速积分以及收缩期分数均较对照组显著降低，而且以收缩期血流降低更为明显。二窄组瓣口面积与收缩期肺静脉的回流呈正相关。二窄合并房颤时，肺静脉在缩、舒期的回流均更趋减慢。     

The Effect of Thermal Biofeedback and Progressive Muscle Relaxation Training in Reducing Blood Pressure of Patients with Essential Hypertension

In order to assess the effectiveness of the thermal biofeedback training combined with the progressive muscle relaxation therapy in the treatment of patients with essential hypertension, blood pressure decline was measured on the treatment group who had the combined thermal biofeedback and progressive muscle relaxation training (N=11), and on the control group who had only the progressive muscle relaxation training (N=8). Baseline blood pressure was measured four times for two weeks on both groups. For the treatment group, blood pressure was measured twice before and after each of eight sessions of thermal biofeedback training for four weeks. For the control group, blood pressure was measured every two visits to a clinic for progressive muscle relaxation self-training twice before and after the self-training. A significant decline of the systolic blood pressure by 20.6 mmHg and of the diastolic blood pressure by 14.4 mmhg was observed in the treatment group. There was a tendency for both blood pressures to increase in the control group.     

全髋关节置换84例早期并发症分析

选择2006-01／2008-04赣州市人民医院骨科进行全髋关节置换84例患者，男48例，女36例，年龄25-82岁。所用羟基磷灰石喷涂非骨水泥柄金属臼全髋由台湾联合公司提供。12例患者出现置换后早期并发症，平均年龄62岁。其中包括：呼吸衰竭1例，肺部感染4例，伤口感染1例，电解质紊乱2例，应激性溃疡1例，发生后脱位1例，坐骨神经损伤1例，肺栓塞1例。除肺栓塞患者因急性呼吸衰竭死亡外，其余经对症处理均恢复正常。无假体松动、断裂和下沉等并发症发生。经分析表明术前准各充分，术中操作仔细、规范，术后针对不同情况采取积极预防措施是避免置换后早期并发症发生的关键。