联合检测血清透明质酸、Ⅳ型胶原及层黏蛋白对肝纤维化的诊断价值

目的 :探讨血清透明质酸 (HA)、Ⅳ型胶原 (CIV)及层黏蛋白 (LN)联合检测对肝纤维化的诊断价值。方法 :采用酶联免疫法对健康人组 2 2例、急性肝炎组 10例、慢性肝炎组 10例、肝硬化组 2 5例及慢性重症肝炎组 10例 ,分别检测血清HA ,CIV及LN的水平 ;对肝硬化组三项指标分别检测和联合检测所得的敏感性、特异性及准确性进行比较。结果 :血清中HA ,CIV及LN的水平以肝硬化组和慢性重症肝炎组最高 ,均明显高于其它组 (P <0 0 1)。肝硬化组联合检测的敏感性高于单项检测的敏感性 ,但其特异性降低。结论 :联合检测HA ,CIV及LN可提高诊断肝纤维化敏感性 ,但特异性降低 ;其中HA +CIV的敏感性和特异性较高 ,为最优联合     

科素亚与洛汀新治疗Ⅳ期糖尿病肾病蛋白尿的疗效比较

目的比较ARB类与ACEI类减少Ⅳ期糖尿病肾病尿蛋白的疗效。方法100例糖尿病肾病Ⅳ期患者随机分为2组,分别应用科素亚、洛汀新治疗8周,检测并对比实验前后24 h尿蛋白总量。结果科素亚与洛汀新对降低Ⅳ期糖尿病肾病患者尿蛋白量的效果相似。结论ARB与ACEI类药物减少Ⅳ期糖尿病肾病患者尿蛋白量的疗效无差异。     

Elevated serotonin transporter binding in major depressive disorder assessed using positron emission tomography and [11C]DASB; comparison with bipolar disorder.

BACKGROUND: Altered serotonergic function is thought to play a role in the pathophysiology of major depressive episodes based upon evidence from neuroimaging, pharmacological, postmortem and genetic studies. It remains unclear, however, whether depressed samples that differ with respect to having shown a unipolar versus a bipolar illness course also would show distinct patterns of abnormalities within the serotonergic system. The current study compared serotonin transporter (5-HTT) binding between unipolar-depressives (MDD), bipolar-depressives (BD) and healthy-controls (HC) to assess whether the abnormalities in 5-HTT binding recently found in depressed subjects with BD extend to depressed subjects with MDD. METHODS: The 5-HTT binding-potential (BP) measured using positron emission tomography (PET) and [(11)C]DASB was compared between unmedicated, depressed subjects with MDD (n = 18) or BD (n = 18) and HC (n = 34). RESULTS: Relative to the healthy group both MDD and BD groups showed significantly increased 5-HTT BP in the thalamus (24%, 14%, respectively), insula (15%) and striatum (12%). The unipolar-depressives had elevated 5-HTT BP relative to both BD and HC groups in the vicinity of the periaqueductal gray (PAG, 20%, 22%, respectively). The bipolar-depressives had reduced 5-HTT BP relative to both HC and MDD groups in the vicinity of the pontine raphe nuclei. Depression-severity correlated negatively with 5-HTT BP in the thalamus in MDD-subjects. CONCLUSIONS: The depressed phases of MDD and BD both were associated with elevated 5-HTT binding in the insula, thalamus and striatum, but showed distinct abnormalities in the brainstem. The latter findings conceivably could underlie differences in the patterns of illness symptoms and pharmacological sensitivity observed between MDD and BD.     

慢性乙肝肝组织病理、肝内Ⅳ型胶原免疫组化与血清肝纤维化指标联合检测对肝纤维化诊断的相关研究

目的探讨慢性乙型肝炎（CHB）肝组织病理学、肝内Ⅳ型胶原（CIV）免疫组化与血清肝纤维化指标联合检测对肝纤维化诊断的相关性。方法对104例CHB患者进行了肝组织病理学，肝内CIV免疫组化检测及病理图像定量分析和血清肝纤维化指标（CIV、PC Ⅲ及HA）的同步检测。结果慢性乙肝肝内CIV及血清CIV、PC Ⅲ和HA检测值均随肝病理损害及肝纤维化程度的加重而升高，经相关分析，其r值分别为0．995、0．985、0．980，P均〈0．01。结论①肝内CIV与血清CIV、PCⅢ、HA检测可作为肝纤维化诊断的重要指标：②CHB患者肝窦内CIV的检出，为血清CIV的检测提供了病理学的证据；③CHB患者肝纤维化的程度，随肝损害程度的加重而逐渐增强。     

磷脂酶C-γ1在人胚胎脊髓中的表达变化

为了了解磷脂酶C-γ1(PLC-γ1)的发育表达变化特点,本研究采用免疫组织化学方法检测不同发育时期的人胚胎脊髓中PLC-γ1的表达及变化。结果显示:PLC-γ1在人胚胎脊髓3周到7个月的整个发育过程中均有表达,在发育早期阳性反应可见于神经管内、外界膜,随着套层、边缘层的形成,神经上皮层、套层中均可见到PLC-γ1阳性反应物,且翼板阳性细胞较基板密集;套层阳性细胞在8、9周时达到高峰,随后开始逐渐减少。3个月时边缘层出现散在的阳性细胞,并随着脊髓的发育而逐渐增多。以上结果提示,PLC-γ1及其与PLC-γ1相关的细胞信号通路对人胚胎脊髓的发育可能发挥了重要的生物学作用。     

血清壳多糖酶3样蛋白1、肝纤维化4项及AFP的检测在不同肝脏疾病中的应用价值探讨

目的探讨血清壳多糖酶3样蛋白1(CHI3L1)、肝纤维化4项及甲胎蛋白(AFP)在不同肝脏疾病中的应用价值。方法选取172例符合条件的慢性乙型肝炎病毒感染者,分为慢性乙型肝炎组、肝硬化组和肝癌组。收集同期健康体检者30例作为正常对照组。比较各组间指标的差异,采用受试者工作特征(ROC)曲线分析各指标鉴别诊断效能。采用Spearman秩相关分析各指标与疾病严重程度的相关性。结果血清CHI3L1及肝纤维化4项在肝硬化组和肝癌组明显高于慢性乙型肝炎组和正常对照组(P <0.05)。血清AFP浓度在肝癌组明显高于其他各组,上述差异均有统计学意义(P <0.01),其诊断肝癌的AUC为0.912。ROC曲线分析显示CHI3L1在肝硬化组和慢性乙型肝炎组,慢性乙型肝炎组和正常对照组之间的鉴别诊断效能较好,AUC分别为0.853和0.845。Spearman相关性分析显示肝脏疾病的严重程度与各血清学指标均呈正相关(P <0.05)。结论 CHI3L1、肝纤维化4项及AFP的检测可以辅助诊断慢性肝炎及其肝纤维化导致的肝硬化等不同肝脏疾病,值得在临床推广和进一步的研究。     

The relationship between plasma apolipoprotein A-Ⅳ levels and coronary heart disease

Objective To evaluate the relationship between plasma apoA-Ⅳ levels and coronary atheros clerosis and to explore its relation to other risk factors.Methods Using ELISA techniques, plasma apoA-Ⅳ levels were quantified in 181 patients w ho underwent coronary angiography (CAG).Patients were divided according to the ir coronary status into a coronary heart disease (CHD) group (stenotic lesion on CAG, n=118) and a control group (normal CAG, n=63).The severity of athero sclerosis was assessed by stenosis scoring of the different lesions.Other para meters, including apoA-Ⅰ,apoB, Lp(a), HDL-C, LDL-C, TG, and T C, were measured as well.Univariate, logistic regression analyses were used to define the relationship between coronary atherosclerosis and plasma apoA-Ⅳ levels.Results When compared with the control group, plasma apoA-Ⅳ levels were found to be lo wer in the CHD group.There was a weak negative correlation between plasma apoA -Ⅳ levels and the severity of coronary atherosclerosis.ApoA-Ⅳ was found to be a relatively independent risk factor for CHD.We also found a positive corr elation between apoA-Ⅳ and triglyceride levels.Conclusions ApoA-Ⅳ may be important in the prediction of CHD and coronary atherosclerosis severity.It may also play an important role in the metabolism of triglycerides .     

C—2位硫桥式四环氟喹诺酮抗菌素W1的合成与抗菌活性

合成了一个新的C－2位硫桥式四环氟喹诺酮抗菌素7－氟－8－[(1S,4S)-5－甲基－2,5－二氮杂双环[2.2.1]庚烷-2]-9,1-(环氧亚甲基）－5－氧－5H噻唑并[3,2-a]喹啉－4－羧酸盐酸盐（W1）,未文献报道。W1经元素分析、红外光谱、核磁共振光谱作了结构鉴定,并通过两倍琼脂稀释法对其MICs进行了测定,以氧氟沙星作对照,结果表明：W1显示极好的抗菌活性,其抗G^ 菌（包括耐甲氧西林的金黄色葡萄球菌）的活性比氧氟沙星至少强4倍,抗G^-菌（包括绿脓杆菌）的活性比氧氟沙星至少强两倍。     

检测Ⅳ型胶原蛋白直接双抗夹心法的建立与评价

目的 :建立血清 型胶原蛋白 (COL - )浓度测定的直接双抗夹心法 ,为临床诊断肝纤维化提供一种新的指标。方法 :采用本科室自制的 COL - 单克隆酶标抗体、多克隆抗体建立的直接双抗夹心法 ,同时采用日本试剂盒测定 6 0份正常和肝脏病人血清 COL- 浓度做对照比较。结果 :两种方法无显著性差异 (P>0 .0 5 ,t=0 .16 6 ) ;两法相关分析 ,γ=0 .834,回归方程为 Y=0 .5 9X+ 70 .874。结论 :直接双抗夹心法测定血清 COL- 操作简便、特异、准确 ,可作为辅助诊断肝纤维化的可靠指标 ,并可在临床推广应用