半套式荧光定量聚合酶链反应检测肾移植前后人巨细胞病毒感染状态

目的：研究肾移植受者手术前后人巨细胞病毒（ＨＣＭＶ）的感染率及ＨＣＭＶＤＮＡ含量变化。方法：采用半套式荧光定量聚合酶链反应（ＡｍｐｌｉＳｅｎｓｏｒＰＣＲ）方法定量检测术前肾移植受者６１例，术后３２例，用四格表比较手术前、后的感染率，用ｔ检验比较病毒含量。结果：手术前、后肾移植受者ＨＣＭＶ的感染率分别为７７％和８７５％；ＨＣＭＶＤＮＡ平均含量（拷贝数每升）分别是１０７×１０７Ｌ－１和７４１×１０７Ｌ－１，两者之间感染率无显著差异（χ２＝１６５Ｐ＞００５），但病毒平均含量存在极显著差异（ｔ＝６４６Ｐ＜００１）。结论：研究结果显示：①免疫抑制治疗激活了潜伏性ＨＣＭＶ感染，导致术后ＨＣＭＶ含量显著增加；②决定肾移植受者ＨＣＭＶ感染状态的主要是机体本身的免疫力，减少ＨＣＭＶ感染，术后合理使用免疫抑制剂，避免过度抑制可能更重要     

内源性糖皮质激素浓度测定在肾移植中的意义

对７２例（７５例次）肾移植受者术前、术后内源性糖皮质激素［以氢化考的松（ＨＣ）为代表］进行动态测定。术后肾功能稳定组ＨＣ为０．０３４±０．０２２μｍｏｌ／Ｌ，肾上腺皮质功能残余率（ＲＲ＝术后ＨＣ／术前ＨＣ）为０．０６２±０．０４１，而急性排斥组ＨＣ与ＲＲ分别为０．２０５±０．１５８μｍｏｌ／Ｌ及０．４５８±０．３８２，均高于前者（Ｐ＜０．０５）；感染组ＨＣ与ｎＲ分别为０．０４±０．０３５μｍｏｌ／Ｌ及０．００７５±０．００６８，均低于肾功能稳定组（Ｐ＜０．０５）．ＲＲ对急性排斥反应诊断优于ＨＣ。ＲＲ临界值为０．１０时，对急性排斥诊断的敏感性与特异性分别为０．８３３与０．８９４．ＲＲ与ＨＣ对急性排斥有一定预测性，在排斥反应症状出现２４小时之前，其诊断敏感性为０．７３３。内源性糖皮质激素测定还有助于鉴别急性排斥与急性肾小管坏死。     

初产妇人工流产史与孕期人巨细胞病毒活动性感染的关系

目的探索既往有人工流产史的初产妇与孕期人巨细胞病毒（ＨＣＭＶ）活动性感染的关系。方法用ＥＬＩＳＡ法检测无自然流产及死胎史的初产妇ＨｃＭＶ特异性抗体（ＩｇＭ，ＩｇＡ），共检测１３１７例。其中有人工流产史的３７４例（人流组）和无人工流产史的９４３例〔无人流组）ＨＣＭＶ－ＩｇＭ，ＩｇＡ阳性结果行配对比较；人流组人流的次数与孕期ＨＣＭＶ－ＩｇＭ，ＩｇＡ阳性率的关系比较。结果人流组ＨＣＭＶ活动性感染率２７．５４％，无人流组１８．２４％，差异有显著性（Ｐ＜０．０１）。人流１次，其活动性感染率２４．３５％，２次或２次以上的为３５．８２％，差异有显著性（Ｐ＜０．０５）。结论初产妇孕期ＨＣＭＶ活动性感染与既往人流及反复人流史关系密切     

肾移植患者人巨细胞病毒的检测

采用ＰＣＲ和ＥＬＩＳＡ方法对１１例肾移植者的巨细胞病毒（ＨＣＭＶ）感染情况进行了研究。在术前及术后的４周内，对其外周血及尿中病毒和血清中ＩｇＡ及ＩｇＭ抗体进行了连续检测。结果显示：有６例在移植后出现巨细胞病毒感染，感染率为５４％（６／１１）。血、尿中ＨＣＭＶＤＮＡ或ＨＣＭＶ抗体（ＩｇＡ或ＩｇＭ）阳性。提示：用ＰＣＲ和ＥＬＩＳＡ方法对肾移植病人的ＨＣＭＶ感染情况进行监测，对预防和治疗ＨＣＭＶ感染和提高肾移植的成功率有着重要的意义。     

特异性转移因子对活动性巨细胞病毒感染孕妇的治疗作用

①目的探讨人巨细胞病毒（ＨＣＭＶ）特异性转移因子（ＳＴＦ）对活动性巨细胞病毒感染孕妇的治疗作用。②方法以孕妇血清ＨＣＭＶ特异性ＩｇＭ阳性做为ＨＣＭＶ活动性感染的指标，应用普通转移因子（ＴＦ）、高效价免疫球蛋白（ＨＩＧ）及ＳＴＦ分别对５７例、１８例及４６例感染孕妇进行治疗，以血清ＨＣＭＶ－ＩｇＭ转阴作为有效的指标。③结果ＴＦ组的ＨＣＭＶ－ＩｇＭ转阴率为２８．１％（１６／５７）；ＨＩＧ组的转阴率为５５．５％（１０／１８）；ＳＴＦ组的转阴率为５６．５％（２６／４６）。ＳＴＦ的治疗作用优于ＴＦ（χ２＝９．７８０，Ｐ＜０．０１）；而ＳＴＦ与ＨＩＧ对感染孕妇的治疗作用无显著性差异（χ２＝０．０１，Ｐ＞０．０５）。④结论ＳＴＦ对活动性ＨＣＭＶ感染孕妇具有较好的治疗作用。     

尖锐湿疣患者宫颈人巨细胞病毒感染的研究

目的为分析人巨细胞病毒（ＨＣＭＶ）在尖锐湿疣（ＣＡ）患者宫颈中流行情况。方法采用聚合酶链反应（ＰＣＲ）技术为８５例ＣＡ患者进行宫颈ＨＣＭＶＤＮＡ检测，并对比观察１５６例正常孕妇宫颈ＨＣＭＶ感染情况。结果ＣＡ患者宫颈ＨＣＭＶＤＮＡ阳性２６例，ＨＣＭＶ感染率为３０．５８％；正常孕妇宫颈ＨＣＭＶ阳性１１例，ＨＣＭＶ感染率为７．０５％；二者比较差异非常显著（Ｐ＜０．００１）。结论ＣＡ患者多有非婚性接触史而易发生ＨＣＭＶ感染。     

肾移植患者致敏淋巴细胞检测的临床研究

用四甲基偶氮唑盐（ ＭＴＴ） 法,检测了４１ 例肾移植患者移植前后的致敏淋巴细胞,以探讨致敏淋巴细胞与移植受者的早期排斥的关系。结果表明,急性排斥组（１４ 例） 受者术前致敏淋巴细胞ＯＤ 值平均为０ ．５６ ±０ ．２０ ,感染组（５ 例）ＯＤ 值为０ ．５６ ±０ ．２３ ,肾功能稳定组（２２ 例）ＯＤ 值为０ ．３２ ±０ ．０５ 。肾移植术后以上各组ＯＤ 值为０ ．４６ ±０ ．１９ 、０ ．４６ ±０ ．７０ 、０ ．３８ ±０ ．０８ 。急性排斥期应用胸腺嘧啶（ＡＴＧ） 治疗前后致敏淋巴细胞也有很大的变化。结果提示移植前检测和术后跟踪检测移植受者致敏淋巴细胞状态,有助于预测术后移植肾的早期排斥反应,对ＡＴＧ 治疗也有一定的指导意义。     

肾移植术后巨细胞病毒感染与急性排斥反应

目的：探讨肾移植术后活动性巨细胞病毒（CMV）感染的发生率、原因以及急性排斥反应的影响。方法：检测182例肾移植受者及其供者术前血清抗CMV抗体,受者术后定期PCR法检测体内CMV DNA,对CMV DNA阳性的部分患者给予抗CMV治疗,并比较各组排斥反应的发生率。结果：无论是供者还是受者,术前如血清抗CMV抗体阳性,受者术后发生活动CMV感染者明显增多,且急性排斥反应的发生率亦明显增加;接受抗病毒治疗急性排斥反应明显减少。结论：CMV感染是肾移植术后急性排斥反应的原因之一,预防和治疗CMV感染对肾移植术后急性排斥反应的防治具有重要意义。     

84例不孕妇女与巨细胞病毒感染的关系

对８４例不明原因不孕妇女作了巨细胞病毒ＩｇＭ（ＨＣＭＶ－ＩｇＭ）的检测与临床分析结果表明，不孕妇女组的ＨＣＭＶ－ＩｇＭ感染率（５２．４％），显著高于正常对照组（６．０％，Ｐ〈０．０１）。该研究提示：不明原因不孕患者可提高是ＨＣＭＶ感染作了引起，还发现２４例人工流产后不孕患者与ＨＣＭＶ感染有关。     

人巨细胞病毒感染母婴传播的前瞻性研究

采用抗μ链捕获法和从培养细胞中快速检测人巨细胞病毒（ＨＣＭＶ）早期抗原等方法，对母婴ＨＣＭＶ感染进行了前瞻性研究。结果表明：９４．６％（７０３／７４３）的孕妇既往感染过ＨＣＭＶ；根据ＩｇＧ抗体阳转，孕期原发感染率仅为０．１％，提示孕期活动期ＨＣＭＶ感染主要为复发感染。先天感染率为６．２％，多为隐性感染，且与母亲ＨＣＭＶ－ＩｇＭ抗体阳性密切相关，提示复发感染的母亲体内的抗体对胎儿起了保护作用。宫颈排     

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.     

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     

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.     

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.     

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.