狼疮性肾炎患者淋巴细胞亚群的变化与免疫球蛋白的关系

目的　探讨狼疮性肾炎 (L N)患者外周血淋巴细胞亚群、活化状态和免疫球蛋白的变化及其相互关系 .方法　采用流式细胞仪和酶联检测仪对 2 1例 L N进行了研究 .结果　 1L N患者 CD3+ +CD4 + (0 .2 4± 0 .10 ) ,CD4 5 RA+ (0 .2 9± 0 .0 6 ) ,CD4 5 RO+ (0 .0 2± 0 .0 2 ) ,CD4 + +CD4 5 RA+ (0 .11± 0 .0 6 ) ,CD4 + CD4 5 RO+ (0 .0 5± 0 .0 4 )细胞比例明显减少 ,与对照组 (0 .4 1± 0 .0 9,0 .4 5± 0 .11,0 .0 5± 0 .0 5 ,0 .2 1±0 .0 7,0 .0 8± 0 .0 2 )比较 P<0 .0 5 ,P<0 .0 1;2 L N患者 HL A-DR+ (0 .13± 0 .0 4 ) ,CD19+ +HL A- DR+ (0 .0 8± 0 .0 3) ,CD19+ +CD4 3+ (0 .0 3± 0 .0 2 ) ,CD19+ +CD5 + (0 .0 5± 0 .0 2 )细胞比例明显增高 ,与对照组 (0 .0 6± 0 .0 4 ,0 .0 4± 0 .0 4 ,0 .0 1± 0 .0 0 4 ,0 .0 1± 0 .0 1)比较 P<0 .0 5 ,P<0 .0 1;3L N患者 Ig E水平明显升高 ,与对照组 (81± 4 0 ) k U· L- 1 相比 ,NS组 (46 7± 2 99) k U· L- 1 P<0 .0 1,非 NS组 (2 2 4± 15 1) k U·L- 1 P<0 .0 5 ,两组比较 P<0 .0 5 ;Ig M,NS组 (3.7± 2 .0 )g· L- 1 ,非 NS组 (3.6± 2 .9) g· L- 1 ;Ig A,NS组 (4.7±1.1) g· L- 1 ,非 NS组 (4.1± 2 .0 ) g· L- 1 水平也升高 (P<0     

奈达铂治疗恶性肿瘤的Ⅱ期临床观察

目的 :观察抗肿瘤新药奈达铂 (Nedaplatin,NDP)治疗晚期非小细胞肺癌 (NSCL C)、鼻咽癌 (NPC)和食管癌的疗效及毒性反应。方法 :初治 (未接受过化疗 )的 NSCL C、NPC和食管癌病人按数字随机法分成试验组和对照组 ,NSCL C病例试验组接受 NDP10 0 mg/m2 ,静注 ,第 1天 ;长春地辛 (VDS) 3mg/m2 ,静注 ,第 1、5天 ;对照组接受顺铂 (DDP) 10 0 mg/m2 ,平均分在连续 3d静注 ,第 1天 ;VDS3m g/m2 ,静注 ,第 1、5天 ;NPC和食管癌病例的试验组接受 NDP10 0 mg/m2 ,静注 ,第 1天 ;5 - Fu5 0 0mg/m2 ,静注 ,第 1～ 5天 ;对照组接受 DDP10 0 mg/m2 ,平均分在连续 3d静注 ;5 - Fu5 0 0 m g/m2 ,静注 ,第 1～ 5天。复治 (DDP方案化疗失败后 )的 NSCL C和 NPC病例进入单药组 :奈达铂 10 0 mg/m2 ,静注 ,第 1天。所有方案均为每 3周为 1个疗程。结果 :共计 6 1例病例入组 ,均可评价疗效和毒性反应。总计试验组的有效率 (RR)为 33.3% (8/2 4 ) ,稍高于对照组的 2 6 .9% (7/2 6 ) (P >0 .0 5 )。其中 ,NSCL C试验组与对照组的 RR各为 18.8% (3/16 )和 2 0 % (4 /2 0 ) ;NPC试验组与对照组的 RR各为5 7.1(4 /7)和 80 % (4 /5 ) ,(P >0 .0 5 ) ;食管癌试验组 PR1例与对照组 SD1例。单药组 (11例 )的 RR为 4 5 .5 %。 3个组的     

胸腺肽α1对老年晚期恶性肿瘤患者细胞免疫功能的影响

目的 :观察胸腺肽α1对老年恶性肿瘤患者细胞免疫功能的影响。方法 :30例老年恶性肿瘤患者 ,用胸腺肽α1治疗 2个月 ,第 1个月每日 1.6 mg,第 2个月隔日 1.6 mg,均为皮下注射 ,观察治疗前后 T细胞亚群及 NK细胞、患者生活质量、血常规及肝肾功能变化。结果 :30例患者用胸腺肽α1前 ,CD4、CD4 /CD8、NK细胞分别为 (32 .33± 6 .2 5 ) %、(0 .77± 0 .2 3) %、(16 .0 5± 6 .79) % ,治疗后为 (39.4 2± 9.2 6 ) %、(1.19± 0 .5 3) %、(2 4 .37± 8.2 3) %。治疗前后比较均有显著意义 (P<0 .0 5 ) ,患者生活质量分值治疗后比治疗前显著提高 (P<0 .0 5 )。结论 :胸腺肽α1能提高老年晚期恶性肿瘤患者的细胞免疫功能 ,是较理想的免疫增强剂。     

营养支持治疗在结核病患者外科手术后的应用

目的探讨肠外营养支持对结核病患者外科手术后患者营养状况的影响。方法48例结核病大中手术后的患者随机分成研究组(25例)和对照组(23例),研究组在术后连续7d予肠外营养支持,提供非蛋白热卡(NPC)25~30kcal/(kg·d),氮供给量为0·15~0·2g/(kg·d),对照组仅在术后予静脉补充葡萄糖溶液,两组均予普通饮食,观察两组手术前、手术后8d和14d营养指标和代谢指标的变化,并进行统计分析。结果治疗前两组的各项营养和代谢指标均无明显差异。术后8d与术前比较,对照组的各项营养指标均降低,均P<0·01,代谢指标ALT,BUN升高,均P<0·05,而研究组ALB和BUN也较术前分别降低和升高,均P<0·05。组内比较:TLC和ALB研究组均高于对照组,分别P<0·05和P<0·01,GLU研究组低于对照组(P<0·05)。术后2周与术前比较,对照组的Hb,ALB仍低于术前,均P<0·01;研究组的营养指标和代谢指标,以及对照组的代谢指标均基本降至术前。组内比较:研究组的各项营养指标高于对照组,分别P<0·05,P<0·05和P<0·01,BUN研究组低于对照组(P<0·05)。结论结核病患者术后早期即存在营养障碍,营养支持能明显改善结核病大中手术后患者的营养状况,降低术后的代谢反应,促进术后尽早康复。     

复方苦参注射液治疗胃肠道恶性肿瘤临床观察

目的探讨复方苦参注射液联合化疗治疗胃肠道恶性肿瘤的临床疗效。方法选取61例不能手术的中晚期胃肠道恶性肿瘤患者,随机分为治疗组和对照组,两组患者均按亚叶酸钙方案化疗,200mg/(m2·d),静脉注入后续用5-氟尿嘧啶400mg/(m2·d),连用5d为1周期,间隔21d重复使用,连用2个周期。治疗组患者化疗同时和间歇期应用复方苦参注射液20mL加入生理盐水250mL静脉滴入,每天1次,26d为1疗程,连用2个疗程。结果应用复方苦参注射液联合化疗治疗有效率为51.61%,单用化疗有效率26.66%,二者比较有统计学意义P<0.05。结论复方苦参注射液是一种治疗中晚期胃肠道恶性肿瘤有效的药物。     

参芪扶正注射液对晚期非小细胞肺癌化疗患者免疫功能的影响

目的应用参芪扶正注射液配合化疗治疗晚期非小细胞肺癌(NSCLC),观察其对肺癌患者细胞免疫功能的影响。方法将56例老年肺癌患者随机分成两组,单纯化疗组(对照组)28例采用多西他赛75 mg/m2第1 d,顺铂60 mg/m2第1～3 d;联合化疗组(观察组)28例采用化疗方案及剂量同对照组,化疗开始即联合应用参芪扶正注射液250 ml,静脉滴注,连续7 d,21 d为1周期,至少治疗3周期。结果实验组白细胞介素-2(IL-2)、淋巴细胞转化率、总T淋巴细胞(CD3+)、辅助T淋巴细胞(CD4+)和自然杀伤细胞(NK)升高程度明显高于对照组(P<0.01);抑制/细胞毒T淋巴细胞(CD8+)、肿瘤坏死因子-α(TNF-α)降低程度明显低于对照组(P<0.01)。结论参芪扶正注射液对中晚期NSCLC化疗患者免疫功能有较好的调节作用。     

参麦注射液对非小细胞肺癌化疗减毒作用的观察

进一步探讨参麦注射液对化疗的减毒作用。方法 :对肺癌患者 2 0 3例进行回顾性分析。结果 :化疗后 OKT1值参麦组略上升 ,对照组下降 ( P<0 .0 5) ;OKT4 / OKT8比值治疗后参麦组明显高于对照组 ( P<0 .0 5)。参麦组 s IL - 2受体水平下降 ( P<0 .0 5) ,LAK细胞、NK细胞略上升( P<0 .0 5) ,对照组 s IL - 2受体水平下降不明显 ( P<0 .0 5) ,L AK细胞、NK细胞均下降 ( P <0 .0 5) ;化疗后参麦组外周血白细胞和血小板降低程度明显小于对照组 ( P<0 .0 5) ,全身体力状况也优于对照组。结论 :参麦液对化疗有一定的减毒作用 ,使化疗计划更易于完成。     

鼻咽癌患者脾区低剂量照射对外周血T-淋巴细胞亚群的影响

目的 :探讨鼻咽癌 (NPC)患者脾区接受低剂量照射后外周血T 淋巴细胞亚群的变化。方法 :比较 5 8例常规放疗(NPC 1)前后和 5 0例放疗加脾区低剂量照射 (NPC 2 )前后淋巴细胞亚群的变化。T 淋巴细胞亚群用抗人T 淋巴细胞单克隆抗体致敏红细胞直接法检测。结果 :①NPC患者外周血T 淋巴细胞各亚群均低于正常人。常规放疗后的T 淋巴细胞较放疗前进一步下降 ,CD3 为 (48 31± 3 75 ) % ,CD4 为 (2 0 76± 4 70 ) % ,CD4 /CD8比值 0 95± 0 2 9,低于放疗前 ,(P <0 0 0 1)。但CD8无变化。② 5 0例NPC患者在放疗同时每周 1次脾区低剂量照射 ,放疗后的CD3 为 (5 2 6 2± 4 2 6 ) % ,CD4 为 (2 7 6 2±3 0 6 ) % ,高于放疗前 (P <0 0 0 1) ,CD8(19 14± 3 10 ) %低于放疗前 ;CD4 /CD8比值 1 48± 0 2 7,高于放疗前 (P <0 0 0 1)。结论 :NPC患者放疗期间接受低剂量的脾区放射 ,可刺激外周血T 淋巴细胞的CD3 和CD4 升高 ,抑制CD8。     

瑞芬太尼与芬太尼复合异丙酚静脉麻醉的临床效果比较

目的　比较瑞芬太尼和芬太尼复合异丙酚静脉麻醉的临床效果。方法　选择ASAⅠ～Ⅱ级腹部手术病例 5 0例 ,随机分成试验组 (瑞芬太尼、异丙酚复合组 )和对照组 (芬太尼、异丙酚组 )各 2 5例。术前均肌注阿托品 0 5mg ,入手术室后静注咪唑安定 0 0 5mg/kg ,诱导后 ,试验组用瑞芬太尼 0 2 5 μg/(kg·min) ,异丙酚 10 0～ 2 0 0 μg/(kg·min) ;对照组用芬太尼 0 2 5 μg/(kg·min) ,观察相关指标。 结果　 2组术中麻醉效果无显著差异 ,术后复苏后 2组均安静。试验组镇痛作用强于对照组 ,术后恢复前者较快。结论　瑞芬太尼比芬太尼更优越、安全。     

人α—干扰素治疗小儿EB病毒感染疗效观察

1目的　观察干扰素治疗小儿 EB感染的疗效。 2方法　对 3 8例传染性单核细胞增多症患儿随机分为两组 ,观察组 18例采用人 α-干扰素 10 0万 U肌注每周 2次 ,治疗 2～ 3周 ,同时给予退热等对症处理 ;对照组 2 0例应用病毒唑治疗 ,剂量按 10～ 15 mg/(kg· d)静滴 1/d,连用 10～ 14 d,对症处理同观察组。3结果　观察组在退热时间 (t=4.2 869,P<0 .0 1) ,淋巴结消退时间 (t=5 .42 4,P<0 .0 1) ,异型淋巴细胞消失时间 (t=2 .5 71,P<0 .0 5 )与对照组相比有显著差异 ;促进 EB-VCA-Ig M转阴率高于对照组。 4结论　干扰素是治疗小儿 EB病毒感染的有效药物     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.     

Possible Spread of adenovirus type 3 from poultry to humans ：indirect evidence from an outbreak in China

Objective:To explore the epidemiology and etiology for an outbreak of acute respiratory tract infection that occurred in one county of Jiangsu Province, China 2004. Methods: Only cases meeting the case definition were included in the study. We reviewed the medical records of the cases who were admitted to the local hospitals, interviewed cases by a standard questionnaire, and then described the epidemiotogic features and analyzed risk factors by means of a case-control study. We collected pharyngeal swab specimens and sent them to different laboratories for isolation and culture. The laboratory used different detection methods such as DIP, PCR, electron microscope examination and microneutralization assay, to identify and then type the positive specimens. Results:A total of 871 cases were reported during the period from April 18 to July 4,2004. The distribution of onset times presented two peaks, one in late May and another in middle June. The epidemic occurred mainly in the elementary and junior high schools in ten townships of one county, and the mean age of the cases was 12 years (range 7 months to 18 years). The course of the disease was acute, and was characterized by fever accompanied with sore throat and tonsillitis. The WBC count of cases was normal or elevated. The mean duration of illness was 5 days (range 2 to 12 days). No fatalities from illness were reported. A case-control study indicated that the possible risk factors were close contact with a case and/or poultry before onset and sharing of towels among members of the family. The typical CPE was observed through inoculating pharyngeal swab specimens into the HEP-2 cell cultures in different laboratories. An infection of adenovirus type 3 was verified by detecting positive specimens in different methods. Conclusion:This investigation demonstrated that the acute respiratory infection in cases was caused by adenovirus type 3. Cases occurred in over 70 schools in ten townships in 2004, and the route of transmission was possibly close contact with cases or droplet transmission.