Luminex液态芯片技术在克罗恩病诊断与病情监测中的应用

目的探讨Luminex液态芯片技术检测血清中细胞因子的表达在克罗恩病患者中的临床意义。方法选取不同严重程度克罗恩病(CD)患者76例作为研究对象,选取同期健康人群50例作为对照组。按照MILLIPLEX MAP Kit试剂盒的要求,利用Luminex技术检测血清中细胞因子白细胞介素2(IL-2)、γ干扰素(IFN-γ)、肿瘤坏死因子(TNF-α)、白细胞介素4(IL-4)、白细胞介素6(IL-6)、白细胞介素10(IL-10)以及白细胞介素17A(IL-17A)的表达水平,采用酶联免疫吸附试验(ELISA)测定血清中抗酿酒酵母抗体(ASCA),分析CD组与健康对照组之间的差异。结果细胞因子表达水平除IL-17A外,CD组IL-2、IFN-γ、TNF-α、IL-4、IL-6、IL-10水平均高于健康对照组,差异有统计学意义(P0.05);活动期CD患者血清IFN-γ、TNF-α、IL-6水平明显高于缓解期和健康对照组,差异有统计学意义(P0.05);中、重度活动期CD患者血清TNF-α、IL-6水平高于轻度活动期CD患者,差异有统计学意义(P0.05);血清ASCA水平在CD组与健康对照组比较,差异有统计学意义(P0.05),ASCA阳性患者TNF-α、IL-6水平显著高于ASCA阴性患者,差异有统计学意义(P0.05)。结论 TNF-α、IL-6在CD患者的炎症发生和病情发展中起着重要作用,测定血清TNF-α、IL-6的水平可反映克罗恩病的病情程度。细胞因子水平动态变化与CD病情进展相关,对CD疾病检测和病情监测具有重要意义。     

血清EB病毒抗体水平与鼻咽癌患者预后的关系

目的 探讨血清EB病毒VCA/IgA、EA/IgA、NA1/IgA及Rta/IgG抗体水平与鼻咽癌患者预后的关系.方法 140例初治无远处转移的鼻咽癌患者分别在治疗前和治疗结束后采用免疫酶法检测血清VCA/IgA和EA/IgA,ELISA法检测NA1/IgA和Rta/IgG.随访进行远期疗效和生存的评价.结果 治疗后患者血清VCA/IgA、EA/IgA、NA1/IgA及Rta/IgG抗体水平较治疗前有明显下降,但仍显著高于正常对照组(P＜0.05).治疗后持续缓解的鼻咽癌患者其治疗前VCA/IgA、EA/IgA抗体水平显著低于疾病进展患者(P＜0.05).血清VCA/IgA、EA/IgA、NA1/IgA及Rta/IgG抗体水平与患者的3年总生存率无关(P＞0.05).治疗前VCA/IgA抗体高水平组(≥1∶320)及EA/IgA抗体高水平组(≥1∶80)患者的无进展生存期(61.8％,61.3％)低于抗体低水平组患者(86.5％,86.5％;P＜0.001).Cox回归分析显示治疗前VCA/IgA抗体水平是影响无进展生存的独立危险因素(HR=3.80,P=0.001).结论 VCA/IgA、EA/IgA可为鼻咽癌患者预后判断提供帮助.     

糖尿病代谢紊乱引致高凝状态的实验分析

目的　对 12 4例Ⅱ型糖尿病患者作血流变学检查和血小板聚集试验以了解糖尿病病人的凝血状态。方法　用毛细管粘度计和血小板聚集仪对 12 4例确诊Ⅱ型糖尿病的中老年患者进行多参数的检测。结果　糖尿病患者血小板聚集指数明显高于对照组 (P <0 0 5 ) ;糖尿病伴视网膜病变 (DR)患者与非视网膜病变者 (NDR)比较 ,全血比粘度和血小板聚集试验均有显著增高 (P <0 0 5 ) ;而糖尿病伴酮症酸中毒者血小板聚集也明显高于对照组 (P <0 0 5 )。结论　Ⅱ型糖尿病患者血小板聚集功能略高于正常对照组 ,但如糖尿病同时伴有视网膜病变 ,酮症酸中毒者血小板的聚集功能则显著提高 ,提示对糖尿病患者应早期发现和及时解除病人血液粘度的增高和血小板聚集功能的改变 ,以防止糖尿病高凝状态所造成的微循环的损害。     

糖尿病酮症酸中毒的临床预防及护理体会

目的对应用综合护理模式是对患有糖尿病酮症酸中毒疾病的患者实施护理的临床效果进行研究。方法抽取我院收治的糖尿病酮症酸中毒患者共计84例,利用随机双盲法将84例患者随机分为对照组及观察组各42例,对照组给予常规护理,观察组给予综合护理,对两组护理效果进行分析。结果观察组患者糖尿病酮症酸中毒症状消失时间和临床治疗计划实施总时间均较对照组发生明显缩短(P<0.05);观察组患者对护理服务的满意度明显高于对照组(P<0.05)。结论应用综合护理模式是对患有糖尿病酮症酸中毒疾病的患者实施护理的临床效果非常明显。     

长期住院精神分裂症男性患者合并糖尿病现况

目的:了解长期住院精神分裂症男性患者合并糖尿病现况并分析相关因素。方法:以我院持续住院时间12个月及以上的207例男性精神分裂症患者为研究对象,以国际疾病和相关健康问题统计分类第十版(ICD-10)标准对患者进行诊断,以自编的调查问卷进行调查。结果:在207例男性精神分裂症患者中,合并糖尿病者33例(15.9%),以是否合并糖尿病为自变量进行二元Logistic回归分析显示,年龄大及服用氯氮平是患者合并糖尿病的危险因素(P=0.038,0.013)。结论:长期住院精神分裂症男性患者中糖尿病的发生率远高于普通人群,年龄偏大及服用氯氮平增加了糖尿病的发生率。     

炎症性肠病患者中四种自身抗体联合检测的临床意义

为探讨联合测定血清抗中性粒细胞胞浆抗体(ANCA)、抗酿酒酵母菌抗体(ASCA)、抗小肠杯状细胞抗体(IGA)、抗胰腺腺泡抗体(PAB)对溃疡性结肠炎(UC组)和克罗恩病(CD组)的诊断和鉴别诊断价值.用间接免疫荧光法测定20例UC组和20例CD组以及10例肠道疾病组患者和5名健康对照组血清ANCA、ASCA、IGA、PAB水平.在四个组中ANCA的阳性率分别为70%、25%、10%和0%,UC组显著高于后三组(P<0.05);而ASCA的阳性率分别为15%、60%、10%和0%,CD组显著高于其他三组(P<0.05).IGA阳性率分别为30%、65%、10%和0%,CD组亦显著高于二个对照组(P<0.05),但与uc组比较,无显著性差异(P>0.05).ANCA /ASCA-诊断UC的敏感性、特异性和阳性、阴性预测值分别是55%、90%、84.6%和66.7%,而ASCA /ANCA-的诊断CD分别是35%、95%、87.5%和59.4%.IGA /ANCA-的诊断cD分别是45%、95%、90%和63.3%;AN-CA、ASCA和IGA阳性有利于炎症性肠病(IBD)的诊断却不能敏感地筛选;ANCA、ASCA和IGA联合检测可作为UC和CD鉴别诊断,是IBD非创伤性鉴别诊断方法之一.     

自身抗体检测在自身免疫性疾病中的价值

目的:探讨ENA(抗可提取性核抗原抗体)、ANA(抗核抗体)和抗ds-DNA抗体(双链DNA抗体)在AID患者中的相关性及敏感性。方法:分析2013年2月至2014年4月在我院接受治疗的AID患者的临床资料。检测入组患者的ENA、ANA、抗ds-DNA抗体表达情况。比较男性、女性的自身抗体阳性情况差异,并探讨不同荧光模式的ANA对应的ENA各项阳性情况以及ANA表达与ENA、抗ds-DNA表达相关性。结果:本研究共纳入研究对象180例,其中男性患者67例,女性患者113例。女性患者的ANA(χ2=12.23,P0.01)、抗ds-DNA阳性率(χ2=5.906,P=0.015)均显著高于男性。nRNP、ss-A阳性标本中的颗粒型ANA比例最高,而Scl-70阳性标本中均质型ANA比例最高;ANA阳性标本的ENA阳性率(χ2=6.406,P=0.011)、抗ds-DNA阳性率(χ2=43.49,P0.01)显著高于ANA阴性的标本。结论:男性自身抗体阳性率明显低于女性,颗粒型在ANA核型中占据比较高的比率,抗ds-DNA和ENA的阳性检出率与ANA阳性率有着一定的关系。     

老年糖尿病酮症酸中毒患者IL-6和氧化应激的变化

目的: 探讨老年糖尿病酮症酸中毒(DKA)患者白细胞介素6(IL-6)和氧化应激的变化.方法:检测老年糖尿病酮症酸中毒患者治疗前后血IL6、 8异前列腺素F-2α(8-isoprostaglandinF2α,8isoPGF2α)水平、超氧化物歧化酶(SOD）活性、总抗氧化能力(TAC)和丙二醛(MDA）含量.结果:在DKA患者SOD、 TAC显著低于对照组(P<0.05), 而IL6、 MDA和8isoPGF2α显著高于对照组(P<0.05); DKA患者治疗后的SOD和TAC显著高于治疗前患者(P<0.05), 而IL-6、 MDA和8isoPGF2α显著低于治疗前患者(P<0.05).DKA患者治疗前IL6与8isoPGF2α呈显著性正相关(r=0.33, P<0.05）, 治疗后IL-6与SOD呈显著性负相关(r=-0.36, P<0.05）.DKA患者治疗前后IL-6与MDA均呈显著性正相关(r=0.38, 0.41, P<0.05）.结论: DKA患者血清IL-6水平明显升高, 且与氧化应激有关.     

在沪学龄儿童注意缺陷多动障碍(ADHD)的现况调查

目的:了解上海市某区5~15岁儿童有注意缺陷多动障碍(ADHD)倾向的现况,为ADHD患儿的确诊提供相应的科学依据。方法:整群分层随机抽样,抽取了上海市某区5所小学2320名儿童进行注意缺陷及多动症状调查表(SNAP-Ⅳ)进行施测,以SPSS 17.0进行统计分析。结果:1父母版、教师版的结果均显示,男童注意力障碍、多动冲动显著多于女童(χ2=50.149,44.672,56.321,54.962;P0.05),对立违抗在11岁的儿童中较明显(χ2=4.165,9.059;P0.05);2父母版多动冲动≤11岁的儿童较多(χ2=5.568,P0.05);3教师版对立违抗男童显著多于女童(χ2=25.442,P0.05)。结论:儿童注意力障碍、多动冲动等行为问题男性显著高于女性,学龄儿童行为问题中以注意力障碍最为突出。     

维生素D受体Fok Ⅰ基因多态性对SLE患者维生素D受体表达的影响

目的:检测维生素D受体(VDR)FokⅠ基因多态性与系统性红斑狼疮(SLE)的相关性,以及对SLE患者VDR mRNA表达的影响。方法:应用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)分析技术检测VDRFokI基因位点及基因型在271例SLE患者和130例健康人中的分布情况;并应用实时定量聚合酶链反应(RT-PCR)技术检测VDR mRNA在48例SLE患者和38例健康对照组的表达。结果:VDRFokⅠ多态性等位基因F和f频率在SLE组和健康对照组有统计学差异(P=0.001),携带F等位基因个体发生SLE的相对危险度(OR)为1.630(95%CI=1.210-2.196,P=0.001);FF纯合子基因型频率在SLE组也明显高于健康对照组(42.8%vs25.4%,χ2=11.417,P=0.001)。同时,携带F等位基因的SLE患者(FF基因型和Ff基因型患者),浆膜炎发生率(P=0.001)及抗ds-DNA抗体(P=0.001)、抗Sm抗体(P=0.047)和抗组蛋白抗体(P=0.001)阳性率较F等位基因阴性SLE患者(ff基因型患者)明显升高。VDR mRNA在48例SLE患者表达下调,其?Ct值(?Ct值越大,表达量越小)为9.26±2.37,高于健康对照组的7.82±3.05(P=0.026)。而在SLE患者,携带F等位基因患者的VDR mRNA的?Ct值明显高于F等位基因阴性患者(10.54±1.88vs7.15±3.78,P=0.019)。结论:VDRFokⅠ多态性与SLE发病易感性有关,而且携带F等位基因的患者更容易发生浆膜炎和产生抗ds-DNA抗体和抗Sm抗体等自身抗体,此可能与F等位基因下调SLE患者的VDR mRNA表达有关。     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

What will studies of Fulani individuals naturally exposed to malaria teach us about protective immunity to malaria?

There are an estimated over 200 million yearly cases of malaria worldwide. Despite concerted international effort to combat the disease, it still causes approximately half a million deaths every year, the majority of which are young children with Plasmodium falciparum infection in sub-Saharan Africa. Successes are largely attributed to malaria prevention strategies, such as insecticide-treated mosquito nets and indoor spraying, as well as improved access to existing treatments. One important hurdle to new approaches for the treatment and prevention of malaria is our limited understanding of the biology of Plasmodium infection and its complex interaction with the immune system of its human host. Therefore, the elimination of malaria in Africa not only relies on existing tools to reduce malaria burden, but also requires fundamental research to develop innovative approaches. Here, we summarize our discoveries from investigations of ethnic groups of West Africa who have different susceptibility to malaria.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

The universal muscular chain reaction,muscle spasm,Torsions, ruptures and extravasations. Chameleons of pathology and some manifestations of simple muscular disorders

Most bodily functions require the coordinated actions of complementary and supplementary paired muscle groups. Where this essential muscular cooperation is lacking, hollow organs may burst and others become literally screwed up, giving rise to many similar spastic diseases such as Torticollis, Twisted ovarian cyst, Torsion of the Testis, Volvulus of the intestines, Varicose Veins, Megacolon, Aortamegaly, Scoliosis, Erb's Palsy, Peyronie's Disease, Main-en-Griffe, Undescended Foot (Pes Cavus), Talipes, Strabismus. Spasm is “panenepidemic” and unclassified examples of Torsion Dystonia and Dyskinesia really are as common as debt and taxes.     

Class II HLA in Georgia Caucasus Tbilisi Georgians and their Mediterranean ancestry: The Usko Mediterranean languages

Georgia (or Sakartvelo in its own language) is a South Caucasus Mts. country with its easternmost part is enigmatically named Iberia, like the Iberian Peninsula, which may refer to rivers “Kura” and “Ebro” or their valleys respectively. Most of their inhabitants speak Georgian which is included within Dene-Caucasian group and Usko-Mediterranean subgroup of languages. The latter includes Basque, Berber, ancient Iberian-Tartessian, Etruscan, Hittite, Minoan Lineal A and others. In the present paper, HLA class II -DRB1 and -DQB1 alleles has been studied and extended haplotypes calculated. Most frequent haplotypes are also of Mediterranean origin (i. e.: (A*02-B*51)-DRB1*11:01-DQB1*03:01, (A*02-B*51)-DRB1*13:01-DQB1*06:03, or (A*24-B*35)-DRB1*01:01-DQB1*05:01) and DA genetic distances show that closest world populations to Georgians are Mediterraneans. Georgians also show common extended haplotypes ((A*02-B*51)-DRB1*11:01-DQB1*03:01, (A*02-B*13)-DRB1*07:01-DQB1*02:01 and (A*03-B*35)-DRB1*11:01-DQB1*03:01) with Svan people, a secluded population in North Georgia mountains. We can conclude that Georgians belong to a very old Mediterranean substratum according to both linguistics (Usko Mediterranean languages) and HLA genetics.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.