浅析急性肺栓塞治疗中溶栓率的变化趋势

目的 比较急性肺栓塞溶栓与抗凝治疗的疗效,分析溶栓率的变化趋势.方法 对2001年1月至2009年12月间我院收治的190例肺栓塞患者的临床资料进行回顾性分析,分为溶栓组与抗凝组,进行同期资料之间溶栓率的比较,并分别观察两组的有效率、出血率及复发率.结果 2001-2003年(A)、2004-2006年(B)、2007...     

转化生长因子-β对人Th17细胞增殖的影响

目的探讨转化生长因子（TGF）-β对人Th17细胞的免疫调节作用。方法应用免疫磁珠分离正常人CD4^＋T细胞并随机分为观察组和对照组,均置于含5μg/ml植物凝集素和5 ng/ml人重组IL-2的IMDM培养基中,在此基础上观察组加入100 IU/ml TGF-β,均于37℃、5%CO2孵箱中培养4 d。采用ELISA法检测两组细胞上清中IL-17蛋白水平,流式细胞术检测CD4^＋T细胞内IL-17比例（Th17细胞数量）。结果观察组和对照组CD4^＋T细胞上清中IL-17蛋白水平分别为（6.11±9.20）、（15.07±12.70）pg/ml,观察组低于对照组（P=0.07）;观察组和对照组Th17细胞数量分别为2.45%±0.62%、2.81%±0.44%,观察组明显低于对照组（P〈0.05）。结论 TGF-β在体外能通过抑制人Th17细胞增殖而调节其免疫作用。     

类风湿关节炎患者血清巨噬细胞移动抑制因子白细胞介素-17及-23表达与合并动脉粥样硬化的相关性研究

目的 通过颈部彩色多普勒超声检测类风湿关节炎(RA)患者合并动脉粥样硬化情况,检测血清巨噬细胞移动抑制因子(MIF)及白细胞介素(IL)-17、IL-23水平,分析它们之间的相关性及在RA致动脉粥样硬化中的作用.方法 收集69例RA患者,根据颈部血管彩色多普勒超声结果,分为合并动脉粥样硬化组36例及无动脉粥样硬化组33例,并设64名健康者为健康对照组.采用酶联免疫吸附试 验(ELISA)法检测3组血清MIF、IL-17及IL-23水平.采用t检验、方差分析进行统计分析,相关性分析采用Pearson相关分析和Logistic回归分析.结果 合并动脉粥样硬化组MIF水平明显高于无动脉粥样硬化组及健康对照组(3组分别为15.2±1.7,13.8±2.2,8.0±2.9,P<0.05),且与颈动脉内膜中层厚度(IMT)值(r=0.271,P=0.036)、斑块大小(r=0.291,P=0.024)、IL-17(r=0.328,P=0.007)及IL-23(r=0.316,P=0.010)水平呈正相关;合并动脉粥样硬化组IL-17和IL-23水平高于健康对照组(2.8±2.0和2.0±0.8,449±174和341±113),但与无动脉粥样硬化组比较差异无统计学意义.Logistic回归分析显示RA患者MIF水平与动脉粥样硬化的发生呈正相关.结论 RA合并动脉粥样硬化患者血清MIF水平显著升高,且与IL-17、IL-23表达密切相关,血清MIF水平升高可作为RA患者发生动脉粥样硬化的预测指标.

Abstract：

objective To detect the serum macrophage migration inhibitory factor(MIF)and interlbukin (IL)-17,IL-23 levels in rheumatoid arthritis patients with atherosclerosis and to analyze the association between them and their role in the pathogenesis of atherosclerosis in rheumatoid arthritis patients.Methods Total of 69 patients with RA were divided into atherosclerosis group(AS group)and those without atherosclerosis group(NAS group)according to neck vascular ultrasonography.Sixty-four healthy controls(the control group)were also enrolled into this study.MIF and IL-17,IL-23 levels were determined bv ELISA assay.The t test of two independent-samples and One-way ANOVA were used to compare the levels of MIF.IL-17 and IL-23 in different groups of patients and healthy individuals.The correlation between diffrent paramenters was assesed by Pearson's coefficient of correlation and Logistic regression.Results The serum MIF level in the AS group was significantly higher than that in the NAS group and healthy controls(15.2±1.7,13.8±2.2,8.0±2.9,P<0.05),and there were significant correlations between the serum MIF concentration,carotid intima-media thickness(IMT)(r=0.271,P=0.036).the size of atherosclerotic plaques(r=0.291,P=0.024),the serum level of IL-17(r=0.328,P=0.007)and IL-23(r=0.316,p=0.010).The serum IL-17 and IL-23 level in the AS group was higher than healthy controls(2.8±2.0 vs 2.0±0.8,449±174 vs 341±113),while there were no significant differences between AS group and NAS group.The serum MIF level in RA patients was positively correlated with atherosclerosis according to Logistic regression analysis.Conclusion The serum MIF level in RA patients with AS is significantly higher than that in NAS group and healthy controls,and it may be related with the serum level of IL-17 and IL-23.The elevated serum MIF level may be a predictor for atherosclerosis in patients with rheumatoid arthritis.     

HBV相关肝细胞癌患者核因子-κB异常情况及其临床意义

核因子-κB(NF-κB)是与免疫球蛋白κ轻链增强子B区结合,具有和某些基因上启动子区固定核苷酸序列结合而启动该基因转录的蛋白质,激活的NF-κB,在炎症相关性肝癌(HCC)中高表达,在肝细胞慢性炎症和癌变之间起桥梁作用[1].我们用酶联免疫吸附法(ELISA)及实时定量PCR法分析了人肝癌组织及肝病患者外周血中NF-κ B的表达,以探讨其在肝癌诊断、转移预测和鉴别诊断中的临床价值.     

普萘洛尔对肾上腺素促大鼠动脉粥样硬化斑块进展的保护作用及其机制的研究

目的:探讨普萘洛尔对肾上腺素促大鼠动脉粥样硬化斑块进展的预防作用及其机制。方法:50只Wistar雄性大鼠经高脂喂养17周,制成动脉粥样硬化模型。随机分为对照组、肾上腺素组、普萘洛尔小剂量组、普萘洛尔中剂量组、普萘洛尔大剂量组,每组10只。所有大鼠在继续高脂喂养基础上,对照组皮下注射生理盐水0.5ml/d;肾上腺素组予肾上腺素0.5mg.kg-1.d-1皮下注射;普萘洛尔小、中、大剂量组分别予普萘洛尔2.5mg.kg-1.d-1、5mg.kg-1.d-1、7.5mg.kg-1.d-1灌胃,0.5h后皮下注射肾上腺素0.5mg.kg-1.d-1。分组处理1周,处死全部大鼠,取主动脉粥样斑块用免疫组织化学方法检测巨噬细胞(CD68)浸润及MMP-9表达。结果:肾上腺素组,CD68阳性细胞浸润及MMP-9的表达显著高于对照组;普萘洛尔小、中、大剂量组,CD68阳性细胞浸润程度及MMP-9的表达较肾上腺素组显著减少,且减少程度与普萘洛尔剂量呈正相关。结论:普萘洛尔可以减轻肾上腺素刺激后大鼠动脉粥样硬化斑块内巨噬细胞的浸润及其MMP-9表达,有延缓肾上腺素促大鼠动脉粥样硬化斑块进展的作用。     

聚乙二醇化干扰素治疗乙型肝炎病毒e抗原阳性慢性乙型肝炎患者乙型肝炎病毒表面抗原消失的相关因素

目的 探讨聚乙二醇化干扰素（PEG-IFN α-2a）治疗HBeAg阳性慢性乙型肝炎(CHB)患者过程中预测HBsAg消失的相关因素。方法 对72例HBeAg阳性CHB患者,应用PEG-IFN α-2a 180 μg,每周1次,共48周。每3个月检测ALT、AST及HBV DNA、HBeAg和H BsAg定量,对48周治疗结束时HBsAg消失与基线、12周、24周的HBV DNA、HBeAg和HBsAg定量的相关关系进行分析。计数资料行Fisher精确检验及受试者工作特征(ROC)曲线分析。结果65例HBeAg阳性CHB患者完成本研究,其中7例HBsAg消失。48周时HBsAg的消失与治疗12周时H BeAg水平有关（Fisher确切概率法,P=0.023）,与治疗24周时HBeAg水平高度相关 （Fisher确切概率法,P=0.004）,与12周或24周时HBsAg＜250 IU/mL相关(Fisher确切概率法,P=0.001,P=0.002)。与12周时HBV DNA阴转相关（Fisher确切概率法,P=0.039）,而与24周时HBV DNA是否阴转无关（Fisher确切概率法,P= 0.130）。经ROC曲线分析显示,12周、24周HBsAg及24周HBeAg曲线下面积(AUC)分别为0.8584(P=0.0021)、0.9606(P=0.001)及0.8350(P=0.040)。结论 联合应用24周HBeAg和HBsAg定量水平可能是预测48周疗程结束时是否发生HBsAg消失的有效指标。     

一种获得高纯度包涵体蛋白的简便方法

以日本血吸虫SjBMP基因部分编码序列构建SjBMP-pET-28a(+)重组原核表达质粒,并转化至大肠埃希菌(E.coli)BL21(DE3)进行原核表达。将经过鉴定的目的蛋白rSjBMP以包涵体形式表达的诱导菌样通过Ni2+-NTA Agarose亲和纯化和十二烷基硫酸钠-聚丙烯酰胺凝胶电泳(SDS-PAGE)切胶再纯化。用该纯化蛋白制备免疫血清,用蛋白质印迹(Western blotting)检测其免疫反应性。结果显示,经Ni2+-NTA Agarose亲和纯化和SDS-PAGE切胶再纯化,获得高纯度的目的蛋白,回收率>11.0%。用该纯化蛋白免疫家兔制备免疫血清,获得的血清效价高于1∶1 280;Western blotting检测结果表明,用该免疫血清去识别表达的重组蛋白,出现特异的单一条带,表明该纯化蛋白仍保持其抗原性,可用于免疫学相关实验研究。因此,SDS-PAGE切胶纯化后电渗、透析回收是纯化重组包涵体蛋白有效、简便的方法。     

尿激酶延迟溶栓治疗下肢深静脉血栓形成的安全性和有效性

目的：探讨尿激酶延迟溶栓疗法下肢深静脉血栓形成（ＬＥＤＶＴ）的安全性和有效性。方法：在静脉造影确诊后,采用尿激酶延迟溶栓疗法（５０万ｕ１０ｍｉｎ内推入,随后１ｈ内静脉输液１０万ｕ,２－３ｄ每天静脉输液１００万ｕ,４－１４ｄ每天静脉输液２５－５０万ｕ）加每天皮下注射肝素钙５０ｍｇ（每１２ｈ１次）和口服阿司匹林１００ｍｇ（每天１次）治疗ＬＥＤＶＴ患者９例,结果：血栓完全溶解１例（１１．１１％）,部分溶     

The Relationship Between Endocardial Voltage and Regional Volume in Electroanatomical Remodeled Left Atria in Patients with Atrial Fibrillation: Comparison of Three‐Dimensional Computed Tomographic Images and Voltage Mapping

Background: Long‐standing atrial fibrillation (AF) changes left atrial (LA) morphology, and the LA size is related to recurrence after radiofrequency catheter ablation (RFCA). We hypothesize that LA morphology, based on embryological origin, affects the outcome of RFCA. Methods: We analyzed 3D computed tomographic (CT) images of LA in 70 patients with AF (54 males, 55.6 ± 10.5 years old, paroxysmal AF (PAF):persistent AF (PeAF) = 32:38) who underwent RFCA. Each LA image was divided into venous atrium (VA), anterior LA (ALA), LA appendage (LAA), and both antrum. Absolute and relative volumes were calculated, and the lengths of linear ablation sites were measured. Results: (1) In patients with the mean LA voltage ≤ 2.0 mV, LA volume, especially ALA, was larger (P < 0.01) compared to those with LA voltage > 2.0 mV. (2) The total LA volume was significantly larger (P < 0.01) and LAA voltages (P < 0.05) and conduction velocities (P < 0.05) were lower in patients with PeAF than in those with PAF. (3) In patients with recurrence, LA volume was generally larger (P < 0.01) than in those without recurrence. In PAF patients with recurrence, the relative volume of ALA was significantly larger (P < 0.01) than those without recurrence. Conclusions Morphologically remodeled LA has low endocardial voltage, and enlargement of ALA is more significant in electroanatomically remodeled LA. The disproportional enlargement of ALA was observed more often in PAF patients with recurrence after ablation than those without recurrence.     

多媒体训练系统重建弱视儿童双眼视功能的临床观察

目的 观察多媒体训练系统提高弱视患儿视力和重建双眼视功能的临床效果.方法 选择弱视患儿84例（155眼）,随机分为多媒体训练系统治疗组43例（80眼,观察组）、传统弱视训练治疗组41例（75眼,对照组）,观察两组治疗前后视力及三级立体视的改善情况.结果 治疗后观察组轻度弱视的有效率为97.7％,中度弱视的有效率为88.5％,对照组分别为80.0％、54.5％,两组比较差异有统计学意义（P均＜0.05）;观察组远视性弱视治疗后的有效率为95.0％,近视性弱视的有效率为73.3％,对照组分别为74.4％、33.3％,两组比较差异有统计学意义（P均＜0.05）.两组治疗后双眼三级视功能都有明显提高,且观察组与对照组比较差异有统计学意义（P＜0.05）.结论 多媒体训练系统在全面治疗弱视上具有方便、快捷、患儿依从性好、视力恢复快等优点,同时能重建双眼视功能,值得推广应用.