寻常型银屑病不同证型蛋白组学表达的比较研究

目的 对寻常型银屑病(血热证、血瘀证、血虚证)患者与正常人差异蛋白进行分析,探求三证之间差异性表达蛋白,从蛋白质组学角度揭示三证之间的差异.方法 取寻常型银屑病血瘀证、血虚证、血热证患者的血清,应用蛋白提取、定量、双向电泳技术、质谱鉴定和数据库检索,寻找出三证之间的差异蛋白和共有蛋白,并将这些蛋白进行组间比较.结果 发现了15种显著性差异蛋白(P<0.05),其中补体C3、凝聚素、血清转铁蛋白、间-α-胰蛋白酶抑制剂H4重链(片段)、载脂蛋白E、 补体C4-B、 甘露糖结合蛋白C及富亮氨酸-α-2-糖蛋白在血虚型银屑病患者血清表达水平高于血热型和血瘀型(P<0.05).纤维蛋白原β链、血液接合素、纤维蛋白原γ链、HPX蛋白、α-抗胰蛋白酶、甲状腺素转运蛋白及载脂蛋白Ⅳ在血热型银屑病患者血清中的表达水平高于血瘀型患者(P<0.05).共同蛋白有5种(P<0.05),分别为血液结合素、纤维蛋白原γ链、HPX蛋白、α-抗胰蛋白酶、载脂蛋白A-Ⅳ.结论 寻常型银屑病(血热证、血瘀证、血虚证)血清中存在表达差异性蛋白质,可能与寻常型银屑病的发病机制和银屑病不同证型的物质基础有关.     

脾胃虚损型重症肌无力患者骨骼肌的蛋白质组研究

【目的】研究脾胃虚损型重症肌无力(myasthenia gravis,MG)患者与正常人骨骼肌蛋白的差异性表达情况,以探讨MG的发病机制。【方法】采用双向电泳技术对脾胃虚损型MG患者与正常人的骨骼肌蛋白进行分离,采用Image Master 2D platinum 5.0软件对所得的图像进行分析,寻找差异性蛋白。对比值≥1.5的差异蛋白点运用基质辅助激光解吸电离—飞行时间质谱法进行鉴定,在IPI数据库进行搜索,寻找匹配的相关蛋白质。【结果】通过双向电泳技术分析,在实验组脾胃虚损型MG患者与正常对照组骨骼肌中共找到27个表达差异的蛋白质斑点,其中实验组呈低表达,对照组呈高表达的有14个蛋白质点;实验组呈高表达,对照组呈低表达的有13个蛋白质点。对27个表达差异的蛋白质点中选择比值较大的15个蛋白质点进行质谱鉴定,共鉴定出10个蛋白。【结论】MG的发病和(或)病理过程可能是多种机制参与的结果,与骨骼肌收缩有关的肌细胞结构蛋白表达变化、线粒体能量代谢障碍、钙通道以及氧自由基等均可能与此相关,MG与纤维蛋白原及其肽链,MG并发胸腺增生或胸腺瘤与ADP-Ribosylarginine Hydrolase是否存在关系,尚不明确。     

IL-15在寻常型银屑病患者皮损中的表达

目的从mRNA及蛋白质水平研究白介素15（IL-15）在寻常型银屑病患者皮损及非皮损皮肤中的表达,探讨其在银屑病发病中的作用。方法采用RT-PCR和免疫组化法对28例寻常型银屑病患者皮损及非皮损皮肤中IL-15的表达情况进行了检测,同时以10例正常人皮肤作为对照。结果2种IL-15前体蛋白的mRNA在所有皮肤标本中都有表达,银屑病皮损中IL-15 mRNA的表达明显高于非皮损处皮肤（P〈0．001）和正常人皮肤（P〈0．001）,非皮损皮肤的表达与正常人皮肤相比差异无显著性（P〉0．05）。免疫组化结果显示：IL-15低表达于非皮损和正常皮肤的基底细胞层,而在银屑病皮损处高表达,且表达范围可达表皮全层及真皮乳头层。皮损处IL-15的表达明显高于非皮损（P〈0．001）和正常皮肤（P〈0．001）,非皮损与正常皮肤之间的表达无显著性差异（P〉0．05）。结论寻常型银屑病的皮损中高表达IL-15,在疾病的发生中可能起一定的作用。     

颅内动脉瘤患者血清蛋白组变化的研究

【目的】寻找颅内动脉瘤患者血清中表达差异的蛋白。【方法】采集12例血清蛋白样本（颅内动脉瘤患者4例、脑挫裂伤患者4例及正常成人本4例）用不同的CyDye染料交叉标记后依次进行双向胶内差异凝胶电泳（2-DDIGE）、图像分析及基质辅助激光解析离子化飞行时间质谱（MALDI—TOF—MS）鉴定。【结果】发现胶号为1119的蛋白质点，在颅内动脉瘤患者血清中比正常成人组表达升高1．82倍（P〈0．05），而在脑挫裂伤患者血清中与正常成人的表达差异没有统计学意义（P〉0．05）。该蛋白点经质谱鉴定为结合珠蛋白。【结论】结合珠蛋白在颅内动脉瘤患者血清中表达升高，可能参与了颅内动脉瘤的形成及扩张。     

慢性盆腔炎性不孕患者的免疫内分泌特点及其与中医证候的关系

初步探讨慢性盆腔炎性不孕患者中医证型与免疫内分泌的关系。【方法】将75例患者辨证分为气滞血瘀、湿热瘀阻、肾虚血瘀和痰瘀互结4型,观察不同证型患者的IgG、IgA、IgM、IgE等体液免疫指标和雌二醇(E2)、孕激素(P) 等内分泌指标的变化情况,并与20例正常对照组比较。【结果】各证型的慢性盆腔炎性不孕患者的各项免疫指标以及血清 E2水平与正常组比较,差异均无显著性意义(P>0．05),而血清孕激素(P)水平比正常组下降(P<0．05),其中湿热瘀阻型组的血清孕激素水平比其他3种证型下降得更低(均P<0．05),而痰瘀互结型组则比其他3种证型稍高(均P< 0．05),气滞血瘀型和肾虚血瘀型之间差异无显著性(P>0．05)。【结论】慢性盆腔炎性不孕患者的血清孕激素水平比正常人降低,而不同证型患者的血清孕激素水平也存在一定的规律性。     

Jagged1 Notch1与NF κB蛋白在寻常型银屑病中的表达

【摘要】 目的 检测寻常型银屑病患者皮肤组织中Jagged1、Notch1与NF κB蛋白的表达,探讨Notch信号通路的异常激活与银屑病发病机制的关系。方法 收集2012年7月~2014年7月年西南医科大学附属医院皮肤科寻常型银屑病40例患者的病理标本（病例组）及40例正常人的皮肤标本（对照组）,采用免疫组织化学法分别检测银屑病患者皮损区、非皮损区及对照组皮肤标本的Jagged1、Notch1与NF κB表达。结果 Jagged1、Notch1与NF κB在银屑病皮损区组比其他两组表达明显升高,差异有统计学意义（P＜005）;非皮损区组与对照组表达相似,差异无统计学意义（P＞005）。且银屑病皮损区组Jagged1、Notch1和NF κB三者间阳性表达呈正相关（P＜001）。结论 Jagged1、Notchl、NF κB蛋白在寻常型银屑病患者中均呈现高表达,且银屑病皮损区Jagged1、Notch1和NF κB三者阳性表达呈正相关,因此Jagged1、Notchl、NF κB蛋白可能在银屑病的发病机制中占有重要地位。     

人类巨细胞病毒感染的特异性血清蛋白差异表达

目的应用同位素标记相对和绝对定量(iTRAQ)技术结合液相色谱-串联质谱(LC-MS/MS)技术,筛选在人类巨细胞病毒(HCMV)血清差异表达蛋白。方法收集HCMV感染者与正常人的血清各10例,去除高丰度蛋白,iTRAQ试剂标记后采用液相色谱-串联质谱技术鉴定特异性蛋白,并比较蛋白的表达差异。结果共鉴定出362种蛋白质。对比发现有49种血清蛋白的表达差异超过两倍,其中蛋白表达显著上调的有19种,显著下调的有30种;这些差异蛋白中有6种与HCMV感染具有较高的相关性,分别是:脂联素、α-1抗胰蛋白酶、载脂蛋白E、C反应蛋白、结合珠蛋白和血清淀粉样蛋白A1。结论定量的血清蛋白质组学分析,可有效地获得HCMV感染者与正常人的血清蛋白质组差异表达图谱,筛选出与HCMV感染相关的特异性蛋白,为HCMV的早期诊断与治疗提供依据。     

基于iTRAQ标记结合生物信息学技术的风湿性疾病湿热证血清蛋白组学研究

目的 应用iTRAQ标记结合生物信息学分析技术,开展风湿性疾病湿热证的血清蛋白组学研究。方法 对强直性脊柱炎湿热证、痛风湿热证、正常对照共3组各20例血清,进行iTRAQ标记结合液相串联质谱蛋白组学分析,应用DAVID、UniProtKB/Swiss-Prot、IPA等网络数据库平台对风湿性疾病湿热证的差异蛋白进行生物信息学分析,并对显著差异蛋白进行验证。结果 获得15个湿热证差异蛋白,其中表达上调的蛋白12种,下调蛋白3种。通过分析得到差异表达蛋白所涉及的5个最有意义的典型生物信号通路。这些差异蛋白功能及生物信息学分析提示与疾病急性期反应和疾病活动度有关。验证实验结果与iTRAQ检测结果一致。结论 为风湿性疾病湿热证的分子机制以及候选诊断治疗标志物的进一步研究提供了依据。      

乙腈预处理血清寻找肝细胞癌发病相关的蛋白质

【目的】 应用乙腈(ACN)预处理血清的方法,对肝细胞癌(HCC)患者的血清进行蛋白质组分析,寻找与HCC发病相关的蛋白质&#65377; 【方法】 收集原发性HCC患者和健康人的血清各12例,首先使用乙腈预处理,然后去除白蛋白和免疫球蛋白等高丰度蛋白质,再进行双向电泳(2-DE)分析,筛选HCC与健康对照血清中有显著性差异的蛋白质斑点,并进行MALDI-TOF/TOF质谱鉴定&#65377; 【结果】 血清经0%&#65380;20%和30%浓度的乙腈预处理后,进行2-DE分析发现蛋白质斑点的检出数量分别为532 ± 96&#65380;623 ± 102和674 ± 123;对预处理后HCC患者和正常人的血清进行差异分析,发现甲状腺素(Tetraiodo-L-Thyronine)和Proapolipoprotein的表达上调,而维生素D结合蛋白(Vitamin D-binding Protein)和铁传递蛋白(Transferrin)的表达下调&#65377; 【结论】 对血清样本的蛋白质组分析,应用乙腈预处理会增加与白蛋白非特异性结合的蛋白质的检出;HCC患者血清中甲状腺素等4个蛋白的表达异常与HCC相关&#65377;     

Chemerin、ADP、LEP与寻常型银屑病证候的相关性

目的探讨昆明地区寻常型银屑病患者常见证型脂肪细胞因子趋化素(Chemerin)、脂联素(ADP)、瘦素(LEP)与中医证候的相关性。方法对昆明地区寻常型银屑病患者常见证型进行分型,采用酶联免疫法(ELISA)检测163例寻常性银屑病患者Chemerin、ADP、LEP的浓度,用SPSS软件对昆明地区寻常型银屑病患者的证型与患者Chemerin、ADP、LEP的含量进行回归分析。结果寻常银屑病三种中医证型PASI评分和Chemerin由高到低依次是湿热证、血热证、血燥证,三种证型的Chemerin、ADP和LEP与PASI评分之间存在正相关:Chemerin和LEP两个因素影响三个证型的PASI评分;寻常银屑病三种中医证型的LEP,湿热证最高,还不能确认血热证和血燥证的LEP的高低;寻常银屑病三种中医证型ADP差异有统计学意义(P <0.05),血热证与血燥证、血热证与湿热证比较,二者的ADP没有差异;血燥证与湿热证比较,二者的ADP有差异(P <0.05)。结论昆明地区寻常性银屑病最常见的证型为湿热型,银屑病患者的PASI评分与Chemerin、ADP和LEP有密切相关性,... 更多     

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…     

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.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

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.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.