胆囊结石及癌变过程中肿瘤坏死因子可溶性受体的变化

目的　探讨可容性肿瘤坏死因子受体 (sTNFR)在胆囊结石及癌变过程中的变化。方法　用双抗体夹心酶联免疫法对 5 3例胆囊结石 ,9例胆囊癌及 11例正常对照者血清及胆法中的sTNFR水平进行检测。结果　血清及胆汁中sTNFR水平胆囊癌组为 (2 .63± 0 .5 6) μg/L、(10 .0 2± 3 .2 3 ) μg/L较胆石症组 (1.2 5± 0 .3 6) μg/L、(2 .81± 0 .93 ) μg/L及对照组 (0 .95± 0 .19)μg/L、(1.83± 0 .5 4) μg/L均显著升高 (P <0 .0 1)。胆囊黏膜从典型增生、非典型增生到胆囊癌的发展过程中sTNFR在血清 (1.11± 0 .2 8、1.5 3± 0 .3 2、2 .63± 0 .5 6)及胆汁中 (2 .5 0± 0 .81、3 .42±0 .87、10 .0 2± 3 .2 3 )逐级增高 (各组间P <0 .0 5 )。胆汁中sTNFR水平在胆囊癌Ⅰ～Ⅲ期 (8.3 6±2 .60 )与Ⅳ～Ⅴ期 (13 .3 3± 4.46)间差异有显著性 (P <0 .0 0 1) ,肿瘤直径≥ 2cm组 (12 .10± 2 .3 2 )与 <2cm组 (7.42± 2 .10 )间差异有显著性 (P <0 .0 5 )。胆汁中TNFR水平明显高于其对应的血清水平 ,两者之间呈正直线相关 (r =0 .875 ,P <0 .0 0 1)。胆囊癌术后血清sTNFR水平显著下降。结论　sTNFR参与胆囊结石致癌的过程 ,与胆囊癌的临床生物学特点密切相关。     

参附注射液对肠缺血-再灌注大鼠肿瘤坏死因子α的影响

目的观察肿瘤坏死因子α(TNF-α)在大鼠肠缺血-再灌注损伤过程中的作用及参附注射液对TNF-α的影响,探讨参附注射液防治肠缺血-再灌注损伤机制。方法 SD大鼠随机分为肠缺血-再灌注组(IR组)、参附注射液预处理组(SF组)和假手术组(C组)。采用阻断肠系膜上动脉(SMA)的方法制造肠缺血-再灌注模型。分别测定各组动物血浆、肠组织TNF-α含量及血液动力学变化;光镜观察肠粘膜损伤情况。结果IR组再灌注后MAP下降,与C组和SF组比有显著性差异(P<0.01);SF组肠粘膜损伤程度减轻,与IR组比有显著性差异(P<0.01);SF组血浆及肠组织TNF-α水平降低,与IR组比有显著性差异(P<0.01)。结论参附注射液可明显防治大鼠肠缺血-再灌注导致的肠粘膜损伤,这种作用可能是通过抑制TNF-α的释放实现的。     

舒利迭加无创通气治疗稳定期慢性阻塞性肺疾病的临床研究

目的探讨舒利迭(吸入型肾上腺皮质激素与长效β2-受体激动剂的预混制剂)联合双水平气道正压通气(B iPAP)对稳定期慢性阻塞性肺疾病(COPD)的治疗作用。方法稳定期COPD病人52例,舒利迭TM50/250,1吸/次,2次/d;B iPAP,吸气压力(IPAP)10~20cm H2O,呼气压力(EPAP,也称PEEP)3~6cm H2O,吸氧浓度(FiO2)3L/m in,每天夜间通气6~8h。观察治疗前、治疗后12周病人临床症状、生活质量、健康状态和肺功能。结果治疗前、治疗后12周病人的临床症状、急性加重次数及严重程度、健康状态和生活质量、肺功能等指标比较差异有统计学意义(P<0.05)。结论舒利迭联合B iPAP治疗稳定期COPD病人能够明显改善其症状,提高生活质量,有一定的临床应用价值,对减缓COPD病人肺功能下降有积极意义。     

Misoprostol in preventing postpartum hemorrhage: a meta-analysis.

OBJECTIVE: To assess misoprostol's ability to prevent postpartum hemorrhage (PPH) where no alternatives exist. Comparison to oxytocics demonstrates how similarly misoprostol achieves a level of effectiveness-obtainable only in hospitals-in remote locations around the world. METHOD: Using the Mantel-Haenszel fixed-effects model and the DerSirmonian and Laird random-effects model, summary statistics indicated that misoprostol's excess risk of PPH was only 4% when compared to oxytocics. RESULT: This risk difference was well within the range of expected results for all uterotonic agents and does not warrant branding misoprostol as an inferior drug. CONCLUSION: Conventional uterotonic drugs should not be used to set the lowest-accepted level of effectiveness in settings where they are entirely unsuitable. Continuing to weigh the benefits of one effective drug against another only delays the distribution of misoprostol in countries where it is the only feasible choice and must be measured against no treatment at all.     

Enzyme-linked Immunosorbent Assay of Pro-gastrin-releasing Peptide for Small Cell Lung Cancer Patients in Comparison with Neuron-specific Enolase Measurement

Our previous study demonstrated that pro-gastrin-releasing peptide(31–98), or ProGRP, is a specific tumor marker in patients with small cell lung carcinoma (SCLC). Using a newly developed, highly sensitive enzyme-linked immunosorbent assay (ELISA) for ProGRP, we analyzed 1,446 samples including those obtained from 478 lung cancer patients to evaluate the clinical usefulness of this ELISA. Several properties indicated that ProGRP is a useful tumor marker for SCLC. First, ProGRP was specifically elevated in SCLC patients. In non-SCLC patients and patients with non-tumorous lung diseases, its serum level was very rarely elevated. Secondly, ProGRP was a reliable marker, in terms of the marked elevation of serum ProGRP levels in SCLC patients. Thirdly, serum ProGRP levels were elevated in SCLC patients even at a relatively early stage of this disease. Fourthly, changes in the serum ProGRP level showed an excellent correlation with the therapeutic responses in SCLC patients. Neuron-specific enolase (NSE) is accepted as a tumor marker of SCLC patients. With the aim of comparing ProGRP and NSE as tumor markers for SCLC patients, we measured serum NSE levels in all samples collected in the present study. We found that ProGRP was superior to NSE in terms of sensitivity, specificity and reliability. Therefore, we consider that ProGRP can play a major role as a clinical tumor marker for SCLC patients.     

恶性肿瘤局部淋巴结树突状细胞免疫组化研究

本文采用S-100蛋白为免疫学标记，对34例恶性肿瘤局部淋巴结内树突状细胞进行免疫组化定量研究。结果按S-100蛋白阳性细胞数目多少分为增多（7例）、减少（20例）及正常（7例）3组，统计学分析增多组均值（164.4个/mm^2)明显高于对照组（58.3个/mm^2)；减少组均值（16.5个/mm^2)组显低于对照组；而正常组均值（69.8个/mm^2)与对照组无显著差异。     

Integrated plasma cortisol concentration in children with asthma receiving long-term inhaled corticosteroids.

We assessed the effect of long-term therapy with inhaled beclomethasone dipropionate (BDP) on the pituitary-adrenal axis, by measuring the integrated concentration (IC) of plasma cortisol in eight children with asthma (age, 6-16 years) who regularly used inhaled BDP in doses ranging from 8 to 26.5 micrograms/kg (200-450 micrograms/day) for 6 months to 4 years. The control group included six children (age, 6-16 years) who had the IC of plasma cortisol measured as part of an endocrinological evaluation and were found to be healthy. Cortisol concentration was measured in blood samples collected continuously over a 24-hr period. Mean IC of plasma cortisol in the study group was significantly lower than in the healthy controls (mean +/- SD, 4.9 +/- 3.3 vs 9.1 +/- 1.9 micrograms/mL; P less than 0.02). Cortisol response to 0.25 mg ACTH (iv) was abnormal in one of the eight BDP-treated patients. No correlation was found between IC of plasma cortisol and the BDP dose, severity of asthma, height percentile, or the Tanner stage. We conclude that long-term therapy, even with relatively conventional doses of inhaled BDP may cause reduction in the normal physiological secretion of cortisol. The clinical relevance of low IC of plasma cortisol is not clear, but it may reflect partial suppression of the pituitary-adrenal axis.     

Vascular cell adhesion molecule-1 modulation by tumor necrosis factor in experimental allergic encephalomyelitis

Anti-tumor necrosis factor (TNF) antibodies inhibit passively transferred experimental allergic encephalomyelitis (EAE) in SJL mice. The possibility that this occurs through interference in TNF's upregulation of endothelial cell adhesion molecules was investigated. Expression of both vascular cell adhesion molecule-1 (VCAM-1) and intercellular adhesion molecule-1 (ICAM-1) on spinal cord vessels increased during EAE. The upregulation of VCAM-1 was markedly reduced or prevented by anti-TNF treatment. Leukocytic infiltration was 15-fold lower in anti-TNF-treated than diseased animals. Spinal cord endothelial expression of VCAM-1, though not ICAM-1 or fibronectin, positively correlated with the extent of T cell, B cell or monocyte infiltration in each animal.     

旋毛虫幼虫分泌物抗原在小鼠体内诱生肿瘤细胞毒因子的研究

本文应用Ｌ９２９细胞杀伤法，对注射旋毛虫肌肉期幼虫分泌物（Ｌ１ＥＳ）的小鼠血清进行了检测，发现Ｌ１ＥＳ对已注射卡介苗（ＢＣＧ）或感染旋毛虫的小鼠，均能诱生肿瘤细胞毒因子（ＴＣＦ），而正常对照鼠则不能发生，表明Ｌ１ＥＳ诱生ＴＣＦ需要首先激活巨噬细胞（Ｍφ）这一基本条件。将Ｌ１ＥＳ置３７℃、１ｈ，５６℃、３０ｍｉｎ或１００℃、２ｍｉｎ处理后，其诱生ＴＣＦ的能力均明显高于对照组（Ｐ＜０．０５）。Ｌ１ＥＳ     

血钙水平与肾癌肿瘤大小、分期的相关性分析

目的分析肾细胞癌患者血钙水平和肿瘤大小与分期的相关性，从而进一步发现与病情相关的规律和了解病情。方法按照血钙水平将肿瘤大小／分期相应地分3组，即降低、正常和升高各3组。利用SPSS10．0软件，对3组不同的肿瘤大小／分期病例进行差异性分析和相关性研究。结果3组不同的肿瘤大小差异性分析（Kruskal-wallisH）显示，X^2=4．768，df=2，P=0．092；Spearman相关分析显示相关系数为．0．166，P=0．029。3组不同的肿瘤分期差异性分析（Kruskal-Wallis H）显示，X^2=4、277，df=2，P=0．118；Spearman相关系数为．0．157，P=-0．039。结论3组不同的肿瘤大小之间差异性无统计学意义，血钙水平与肿瘤大小间存在负相关；3组不同的肿瘤分期之间差异性无统计学意义，血钙水平与肿瘤分期间存在负相关。