目的 分析银屑病患者外周血T淋巴细胞亚群分布与中医辨证分型的关系.方法 选定本院2019年12月至2020年12月住院治疗的76例银屑病患者作为观察组,以及同期门诊体检的76例健康人员作为对照组,均进行外周血T淋巴细胞检测,比较中医辨证分型组、对照组T淋巴细胞因子水平,比较不同临床分期组、对照组T淋巴细胞因子水平,比较不同病情严重程度组、对照组T淋巴细胞因子水平.结果 CD4+水平血燥证组比血瘀证组、血热证组、对照组高,P<0.05.CD8+水平血热证组比血瘀证组、血燥证组、对照组高,P<0.05.CD4+/CD8+水平血燥证组比血热证组、血瘀证组、对照组高,P<0.05,4组CD3+水平比较,P>0.05.进行期组CD4+、CD4+/CD8+水平均高于静止期组、恢复期组、对照组,P<0.05.进行期组CD8+水平低于静止期组、恢复期组、对照组,P<0.05.4组CD3+水平比较,P>0.05.CD4+水平、CD4+/CD8+水平轻度组、中度组、对照组均低于重度组,P<0.05.重度组CD8+水平低于轻度组、中度组、对照组,P<0.05.4组CD3+含量比较,P>0.05.结论 银屑病患者CD4+、CD8+、CD4+/CD8+水平与中医辨证分型有一定的联系,通过检查免疫细胞因子水平,对疾病的诊治具有重要作用.

目的 分析轻度胃肠炎伴良性婴幼儿惊厥(BICE)和患儿肠道内微生物的变化间的相关性.方法 回顾分析2017年1月至2018年12月在我院诊治的BICE患儿40例,作为研究组,将2019年1月至12月我院诊治的40例单纯轻度胃肠炎患儿作为对照组,两组均行粪便轮状病毒抗原检测、相关病菌检测及肠黏膜屏障功能检测,记录试验数据,并进行比对分析.结果 研究组及对照组轮状病毒感染率分别为47.5％、15.0％;粪便内大肠杆菌、肠球菌、乳酸杆菌、双歧杆菌数量及DAO、D-乳酸、NO水平,研究组均高于对照组(P＜0.05)差异有统计学意义.结论 肠道微生物改变可影响BICE发生及发展,轮状病毒及肠内益生菌减少可促使BICE病情发展,损坏肠黏膜屏障功能.

目的 研究银屑病各中医证型患者辅助性T细胞17(T helper cells 17,Th17)/调节性T细胞(Regu-latory T cells,Treg)和相关细胞因子的表达特点及与病情的相关性.方法 选取2019年6月—2020年6月就诊的银屑病患者90例,根据其中医证型分为血热、血燥、血瘀组,每组30例,另选健康志愿者30例为对照组.同时根据银屑病面积与严重程度评分法(Psoriasis area and severity index,PASI)将所有患者分为轻中度组和重度组.比较各组间Th17/Treg细胞和相关细胞因子的表达水平.采用Pearson相关分析分析银屑病患者Th17、Treg细胞比例及Th17/Treg比值与PASI评分的相关性.结果 血热、血燥、血瘀组Th17细胞比例、Th17/Treg比值均高于对照组,差异有统计学意义(P<0.05),血热组Th17细胞比例和Th17/Treg比值均高于血燥、血瘀组,差异有统计学意义(P<0.05),Treg细胞比例均低于血燥组、对照组,差异有统计学意义(P<0.05);血热、血燥、血瘀组白介素-6(Interleukin-6,IL-6)、白介素-17(Interleukin-17,IL-17)、白介素-22(Interleukin-22,IL-22)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)表达水平均高于对照组(P<0.05),血热组IL-6、IL-17、IL-22、TNF-α表达水平均高于血燥、血瘀组,白介素-10(Interleukin-10,IL-10)、转化生长因子-β(Transforming growth fac-tor-β,TGF-β)表达水平均低于血燥组、对照组,差异有统计学意义(P<0.05);重度组患者Th17细胞比例、Th17/Treg比值均高于轻中度组,差异有统计学意义(P<0.05),Treg细胞比例低于轻中度组,差异有统计学意义(P<0.05);Pearson相关分析显示,Th17细胞比例、Th17/Treg比值与PASI评分呈均正相关(r=0.807,r=0.828,P<0.001),Treg细胞比例与PASI评分呈负相关(r=-0.608,P<0.001).结论 外周血Th17/Treg细胞和相关细胞因子在银屑病患者血热、血燥、血瘀三证型之间存在表达差异,且以血热型最为显著,此可为银屑病的中医辨证治疗提供初步量化参考指标.此外,Th17细胞比例、Th17/Treg失衡程度越高,Treg细胞比例越低,银屑病患者病情越重.

目的 探讨孕早期子痫前期(PE)患者血清脂蛋白相关磷脂酶A2(Lp-PLA2)、对氧磷酶1(PON-1)、脂联素(APN)及甲胎蛋白(AFP)水平,并检测分析血清Lp-PLA2、PON-1、APN联合AFP水平对PE的临床意义.方法 选取2016年6月-2019年9月于医院进行产检的孕早期孕妇556例为研究对象,其中正常孕妇449例并设为对照组,PE患者107例设为研究组,包括轻度PE患者63例,重度PE患者44例.分别检测血清Lp-PLA2、PON-1、APN及AFP水平.采用Logistic回归分析血清Lp-PLA2、PON-1、APN及AFP水平与PE的关联性.以ROC曲线下面积(AUC)评价血清Lp-PLA2、PON-1、APN及AFP水平对PE患者诊断价值.结果 研究组血清Lp-PLA2及AFP水平均高于对照组,血清PON-1及APN水平均低于对照组(P＜0.05).重度PE患者血清Lp-PLA2及AFP水平均高于轻度PE患者,血清PON-1及APN水平均低于轻度PE患者(P＜0.05).Logistic回归分析结果显示,血清Lp-PLA2、PON-1、APN及AFP水平均与PE发生有关.血清Lp-PLA2及AFP水平均与PE发生呈正相关,血清PON-1及APN水平均与PE发生呈负相关.ROC曲线结果显示,血清Lp-PLA2、PON-1、APN及AFP诊断PE的AUC分别为0.768、0.765、0.771、0.786,四者联合诊断PE的AUC为0.806.结论 孕早期PE患者血清中Lp-PLA2、AFP水平升高,血清PON-1、APN水平降低.血清Lp-PLA2、PON-1、APN及AFP水平均与PE病情发展相关,对孕早期PE均具有诊断价值,四者联合诊断效果更佳,可为临床在孕早期诊断PE提供理论参考依据.

OBJECTIVE:To investigate the effects of berberine on learning and memory ability in vascular cognitive impairment rats.METHODS:Sixty-eight Wistar rats were randomly divided into control group (n=10), sham operated group (n=10) and the modeling group of vascular cognitive impairment rat (n=48), then the rats in modeling group were randomly divided into four groups (n=10): vehicle group, berberine low dose group (20 mg/kg), medium dose group (40 mg/kg) and high dose group (60 mg/kg). Bilateral common carotid arteries were occluded in rats to establish vascular cognitive impairment (VCI) model. Different doses of berberine were intraperitoneally injected into the treatment group and normal saline was intraperitoneally injected into the other groups once a day for a total of 34 days. After 28 days of administration, Morris water maze was used to test the learning and memory ability of rats. After the water maze experiment, the levels of superoxide dismutase (SOD) activity, glutathione (GSH), malondialdehyde (MDA), tumor necrosis factor alpha(TNF-α), interleukin-1 beta (IL-1β), 5-hydroxytryptamine (5-HT) and monoamine oxidase (MAO) in the forebrain cortex were detected.RESULTS:Compared to sham group, the escape latency in VCI group was significantly extended (P＜0.01) and the times of passing through the platform were decreased remarkably (P＜0.01). The levels of SOD, GSH and 5-HT in the hippocampus or anterior cortex were decreased significantly (P＜0.01), while the contents of MDA, TNF-α, IL-1β and MAO were increased remarkably (P＜0.01). Compared with VCI group, the escape latency in berberine-treated groups was shortened significantly (P＜0.01, P＜0.05) and the times of passing through the platform were increased remarkably (P＜0.01, P＜0.05), the levels of SOD, GSH and 5-HT were increased significantly (P＜0.01), while the contents of TNF-α, IL-1β and MAO were decreased remarkably (P＜0.01).CONCLUSION:Berberine could significantly improve the spatial learning and memory abilities of rats with vascular cognitive impairment. The mechanism may be related to the effects of berberine on the hippocampal antioxidant stress, anti-inflammatory response and the monoamine neurotransmitter system in the forebrain cortex. Berberine 60 mg/kg dose group had better effect.

实验诊断学是衔接基础医学与临床医学的桥梁课程,也是启蒙临床思维方法的核心课程,是医学生的必修课和重点专业课程,所涉及的内容广而繁,在临床医学中占有重要地位.近年来随着检验医学的迅猛发展,实验室检查和实验数据对疾病的诊断、早期诊断、鉴别诊断、病情监测、疗效观察和预后评估都有极其重要的作用,也为疾病预防、健康普查、遗传咨询、科学研究等提供实验依据,同时也广泛应用在健康评价和高危人群的预警等治未病领域中.在精准医疗领域里实验诊断数据为临床医生个体化用药提供参考,辅助医生对药物剂量使用、毒性反应及疗效进行预测.医学生应该精准的掌握实验诊断学,因此做好实验诊断学的教学尤为重要.

Objective To verify the performance of two kinds of portable blood glucose meters(Johnson OneTouch Ultra glucose meter and Abbott FreeStyleOptium Xceed),compare the two meters with automatic biochemistry analyzer on the blood glucose detection,and provide an accurate and reliable method for the rapid detection of clinical blood glucose.Methods Control materials and patients samples with 3 gradual levels were detected continually for 5 days and then the coefficient of variation(CV)was calculated.Capillary blood glucose of 53 diabetes patients were measured by two portable glucose meters,and venous plasma glucose of the same patients were measured by hexokinase method as control.The results were measured by SPSS to determine the accuracy of two meters and the correlation between results of the two meters and automatic biochemical analyzer.Results The results of materials and patients samples with 3 gradual levels detected by the two meters(OneTouch Ultra and Optium Xceed)were 1.9%-3.1% and 5.7%-11.1%.OneTouch Ultra''s performance in the precision was good,but Abbott Optium Xceed was not up to the requirements of quality control of the median level.The correlation coefficients between the two portable blood glucose meters and the total automatic biochemical analyzer were(R)=0.99 and(R)=0.98,respectively,with better correlation.The data of Johnson OneTouch Ultra had 100% accuracy and was in line with the state portable glucose meter accuracy requirements while the acuracy of Abbott Optium Xceed measured results was only 70%(blood glucose concentration was less than 4.2mmol/L)and 79%(blood glucose concentration was more than 4.2mmol/L)to meet the requirements respectively,which were lower than the requirements of the national standard(95%).Conclusion The precision and accuracy of Johnson OneTouch Ultra glucose meter have reached the clinical requirements.The portable glucose meter needs to be compared regularly with laboratory automatic biochemical analyzer to ensure accurate results.

Objective To investigate the effects of ginsenoside-Rg2 on pulmonary arterial hypertension (PAH) induced by monocrotaline (MCT) in rats.Methods Forty-eight male SD rats were randomly divided into the control group,model group,ginsenoside-Rg2 (20,40,80 mg/kg)and bosentan (Bos，200mg/kg)，with 8 rats in each group. PAH model was induced by MCT (50 mg/kg) singly intraperitoneal injection．The animals were administrated intragastrically with ginsenoside-Rg2 according to the above group protocol，once a day，from the day with the monocrotaline injection up to the 28th day. The hemodynamic parameter，including heart rate (HR)， mean artery blood pressure (MBP) and right ventricular systolic pressure (RVSP)，were measured with a polygraph system by catheters placed in carotid or right ventricle; the blood samples were collected for investigating the change of ET-1 and NO in plasma; the right ventricular-weight index was calculated.Results On day 28 after MCT administration, RVSP and RV/LV+S in model group were elevated markedly compared with those in control group, however, HR and MAP were decreased significantly; the concentrations of plasma ET-1 in model group was increased and the concentrations of plasma NO was decreased. Ginsenoside-Rg2 treatment could significantly prevent these effects.Conclusion Ginsenoside-Rg2 can alleviate the pulmonary arterial hypertension induced by monocrotaline in rats.

目的 探讨CD147-shRNA重组质粒对小鼠前列腺癌细胞LNCaP移植瘤的抑制作用.方法 60只SCID小鼠随机分为对照组、空载组和转染组各20只,对照组小鼠接种LNCaP细胞,空载组小鼠接种转染空载质粒LNCaP/pSilencer细胞,转染组小鼠接种转染CD147-shRNA质粒的LNCaP/CD147细胞.比较3组小鼠肿瘤体积、肿瘤质量和抑瘤率,采用PCR法检测肿瘤组织CD147 mRNA的表达情况,采用免疫组织化学法检测肿瘤组织CD147蛋白表达情况.结果 第15、20天时转染组小鼠肿瘤体积[(32.1±6.9)、(40.6±5.8)mm3]明显小于对照组[(60.1±19.8)mm3、(100.6±7.8)mm3]和空载组[(59.8±19.1)mm3、(99.8±6.4)mm3](P＜0.05);第20天转染组小鼠肿瘤质量[(858.7±34.6)mg]明显低于对照组[(2 311.0±25.7)mg]和空载组[(2 233.8±17.9)mg];抑瘤率(63.2％)高于对照组(1.2％)和空载组(0.9％)(P＜0.05);转染组小鼠肿瘤组织CD147 mRNA(1.23±0.98)和蛋白(1.23±0.98)表达水平明显低于对照组(3.67±0.45、2.45±0.35)和空载组(3.68±0.56、2.56±0.98)(P＜0.05);以上指标对照组和空载组比较差异均无统计学意义(P＞0.05).结论 转染CD147-shRNA重组质粒对小鼠前列腺癌细胞LNCaP移植瘤有明显抑制作用.

Objective To explore the variability characteristics of routine blood,serum biochemical and immunological indicators and evaluate the clinical value on diagnosis,classification of disease subtypes and prognostic on psoriasis patient.Methods 292 psoriasis patients(including subtypes of 225 vulgaris,23 erythrodermic,44 arthritis) and 57 healthy controls were enrolled in this study.The routine blood examination,serum biochemical and immunological indicators were detected in 292 cases of psoriasis patients and healthy volunteers and statistical analysis.Results The white bloodcell(WBC),neutrophil(NEUT),eosinophil(EO),platelet(PLT),mean platelet volume(MPV),platelet distribution width(PDW),erythrocyte sedimentation rate(ESR),serum C reactive protein(CRP),uric acid(UA),Triglycerides(TG),Low density lipoprotein(LDL),Apolipoprotein B(ApoB),lipoprotein(a) and Immunoglobulin G(IgG) of the psoriasis patients were significantly higher than that of healthy controls.Meanwhile,the levels of serum high density lipoprotein(HDL),ApolipoproteinA1(ApoA1),calcium(Ca),total protein(TP) and albumin(ALB) of psoriasis patients were obviously lower than that of healthy controls.The WBC,NEUT,monocytes(Mono),PLT,PDW,ESR,CRP,ESR,UA levels of erythrodermic psoriasis group were higher than that of psoriasis vulgaris group,while the red blood cell(RBC),hemoglobin(Hgb),Hematocrit(HCT),serum total cholesterol(TCH),ApoA1,TP and ALB concentrations were significantly lower than that of psoriasis vulgaris group.The PDW,CRP,ESR,serum IgG levels in arthritis psoriasis group were obviously higher and RBC,Hgb,MPV,serum LDL and ALB were significantly lower than that of vulgaris group patients.The NEUT and serum UA were higher and the ESR,serum TP,IgG levels in erythrodermic psoriasis group were lower than that of arthritis psoriasis group.Conclusion The psoriasis patient have obviously abnormal on routine blood,serum biochemical and immunological indicators,the changes of those indicators in different subtypes psoriasis patient have its own features.To understand the abnormalities of these indicators above could be great helpful in the clinical diagnosis,classification,treatment,prognosis and outcome evaluation of the psoriasis.

目的探讨糖尿病患者的糖化血红蛋白(HbA1c)水平与其他生化指标之间的关系。方法选取212例该院确诊的糖尿病患者(患者组)及同期来该院进行体检的健康者122例(对照组),检测两组的HbA1c水平及各类生化指标,比较两组间各项指标的差异,同时将糖尿病患者按照HbA1c水平,分为对照组(HbA1c≤6.5%)和异常组(HbA1c>6.5%),对不同HbA1c水平之间各项生化指标的差异进行分析。结果患者组与对照组相比,TG水平略有升高(P<0.05),BUN、GLU、糖化血清蛋白(GSP)、2D-3羟丁酸(D-3H)明显增高(P<0.01);Mg、K、Na、Cl等指标均明显降低(P<0.01)。糖尿病患者HbA1c与GLU、GSP、D-3H均呈明显的正相关;与Mg、UA、Na、Cl呈明显的负相关。HbA1c异常组与达标组比较,UA及Mg、Na、Cl均明显降低(P<0.01);TG、GLU、GSP明显增高(P<0.01)。结论糖尿病患者的HbA1c、GSP、GLU水平明显增高,且HbA1c水平与GSP、GLU水平高度相关。