Objective To evaluate the diagnostic value of anti-mitochondrial antibodies-M2 subtype, anti-gp210, anti-Sp100 by detecting in patients with primary biliary cirrhosis (PBC). Methods Serum samples were detected for AMA-M2, anti-gp210 and anti-Sp100 by immunoblotting assay in 2000 patients with cryptogenic hepatitis, and other 15 healthy individuals were taken as control group. Patients were diagnosed as PBC (129 cases, 6.45%), AIH (205 cases, 10.25%), AIH-PBC overlap syndrome (15 cases, 0.75%), fatty liver (514 cases, 25.70%), drug-induced hepatitis (379 cases, 18.96%), and other unexplained hepatitis (758 cases, 37.90%). Results The positive rates of these three antibodies were 97.67%(126/129), 41.86%(54/129), 27.91%(36/129), respectively. The simultaneous occurrence rate of anti-gp210 and anti-Sp100 was 9.30% (12/129).There were 12 cases with positive anti-gp210 and anti-Sp100 antibody, 3 of whom were diagnosed as PBC through liver puncture. In PBC group, patients with AMA-M2 antibody titer high than 1︰800 accounted for 62.80%(81/129), while the percents of patients with titers ranged from 1︰25 to 1︰100 and from 1︰100 to 1︰200 were 13.95%(18/129) and 30%(12/129), respectively. Conclusions AMA-M2 antibody is still the main marker for PBC diagnosis. The combined detection of AMA-M2 antibody, anti-gp210, anti-Sp100 in PBC have a higher value and play a good supporting role in screening other autoimmune liver diseases.

<正>张玮教授20余年来从事肝病的临床、科研和教学工作,导师严以律己,治学严谨,有幸跟随导师抄方学习获益匪浅,小有心得,与同仁分享。验案一金某,女,42岁,初诊:2005年6月17日。患者反复右胁肋部胀痛1周余,纳可,目涩,腰膝酸软,二便

OBJECTIVE:To investigate the correlation between ER-a in the liver and cytokines of T lymphocytes subsets and serum signatures in PBC patients.METHODS:The research is performed with cross-sectional study. 80 PBC women patients without treatment were enrolled in PBC group, 10 healthy women as baseline-matched in healthy-control group, and 20 patients with non-autoimmune liver disease in non-PBC control group. The expression of IL-6, IL-8, IL-22, TNFa, IFNgamma, AMA-M2, Sp100 and gp210 were analyzed in Peripheral Blood using ELISA in all groups, and ER-a of patients were performed on tissues from liver biopsies in PBC group and non-PBC control group with immunohistochemistry. Spearman correlation test were performed on the indices to identified the association of all Parameters. numerical data were compared with Wilcoxon rank-sum test.RESULTS:Compared with healthy-control group, expression of serum cytokines are significantly higher in PBC and non-PBC groups (P less than 0.01), while no significant difference were observed between PBC and non-PBC groups. The positive rate of ER-a in PBC patients liver tissues in PBC group is higher than that in non-PBC group (Z=4.82, P less than 0.01). Expression of ER-a is positively correlated with positive rates of AMA-M2 antibody, Sp100 and gP210 of tissues of PBC patients ( r=0.898, 0.819, 0.814, P less than 0.01). ER-a is positive correlated with the expression of cytokines, among which the coefficient of correlation of IL-22, TNFa, IFNgamma is more than 0.7 (r=0.71, 0.89, 0.82, P less than 0.01), AMA-M2, Sp100, gp210 is negative in serum of non-PBC control group. No obviously correlations were indicated between the expression of ER-a and cytokines.CONCLUSION:A high level of expression of cytokines in the serum might be one of the factors of etiopathogenesis of PBC.

<正>慢性病毒性肝炎属中医"胁痛"、"黄疸"等范畴。导师张玮主任医师从医20余年,治疗慢性病毒性肝炎积累了丰富的经验,现介绍如下。1从肝治疏肝养肝。肝病初期,邪毒侵滞肝脏,肝气郁

寰枢椎错缝又称寰枢关节半脱位.是临床上较常见的、高发的疾病.临床上多以突然出现头晕眼花、恶心呕吐为主,常在头颈部旋转时加重,颈项部强痛活动受限,可伴有头痛、心慌、耳鸣.其发病率逐年增高,发作时天旋地转,且易反复发作.笔者用推拿结合中药治疗寰枢椎错缝取得了显著疗效,介绍如下.