老年癫痫患者血清miR-222、miR-21的水平变化及其临床意义

目的:探讨老年癫痫患者血清中miR-222、miR-21水平含量变化及其与炎症因子、T淋巴细胞亚群的关系。方法:选取2015年1月至2016年1月在我院诊断的老年癫痫患者47例(癫痫组)、选取同期健康体检对象47例作为健康组,检测两组血清miR-222、miR-21、肿瘤坏死因子-α(TNF-α)、白细胞介素-2(IL-2)、T淋巴细胞亚群水平,并分析相关性。结果:癫痫组的血清miR-222(1.2941±0.2751)、miR-21(2.1176±0.3382)、血清TNF-α(4.78±0.96)ng/m L、IL-2(4.37±1.12)ng/m L均高于健康组(0.6674±0.129)、(0.7314±0.1162)、(1.33±0.42)ng/m L、(8.96±2.77)ng/ml(P0.05);癫痫组的CD8+(28.92±3.16)%高于健康组(26.60±2.45)%(P0.05),CD4+(39.54±6.81)%、CD3+(57.18±7.44)%、CD4+/CD8+(1.37±0.20)均低于健康组(50.63±7.21)%、(69.25±6.81)%、(1.90±0.27)%(P0.05);癫痫组血清miR-222、miR-21与CD4+、CD3+水平呈显著的负相关性(r=-0.312,r=-0.381,P0.05),与患者的血清TNF-α、IL-2水平呈显著的正相关性(r=0.496,r=0.338,P0.05)。结论:老年癫痫患者血清中miR-222、miR-21水平显著的升高,并且与患者的血清炎症因子、T淋巴细胞水平变化有关,可能参与患者炎症反应及免疫水平的调节。     

血清大分子量肌糖蛋白C剪接变构体水平对卵巢癌的临床意义研究

目的:探讨血清大分子量肌糖蛋白C剪接变构体(L-Tn-CSV)水平对卵巢癌的临床意义,为卵巢癌的临床诊断、治疗和预后判断提供参考依据.方法:选择143例首次发病卵巢癌患者、18例复发卵巢癌患者、40例良性卵巢肿瘤患者及30例健康人为研究对象,采用定量酶联免疫吸附试验(ELISA)检测各组血清中的L-Tn-CSV、HE4和CA125的表达水平并进行比较分析.结果:对一般卵巢癌标志物CA125和HE4与血清L-Tn-CSV诊断卵巢癌的敏感性和特异性比较发现其无统计学差异;首次发病的卵巢癌患者与复发的卵巢癌患者血清中的L-Tn-CSV水平分别为4924.1±3145.6pg/ml和4217.5± 2349.3pg/ml,显著高于健康女性(2259.3±723.2pg/ml)及良性卵巢肿瘤组(2435.6± 863.6 pg/ml)(P＜0.01);卵巢良性肿瘤组血清L-Tn-CSV含量与正常对照组比较无统计学差异(P=0.42),卵巢癌Ⅱ期、Ⅲ期、Ⅳ期患者血清L-Tn-CSV水平较Ⅰ期显著增高(P＜0.01);复发组的血清L-Tn-CSV水平明显高于卵巢良性肿瘤组和正常对照组(P＜0.01),而Ⅲ期、Ⅳ期血清L-Tn-CSV水平无统计学差异(P＞0.01);Spearman等级相关分析显示血清L-Tn-CSV水平与卵巢癌临床分期(r=0.573,P＜0.01)及复发(r=0.627,P＜0.01)呈正相关;术后血清L-Tn-CSV水平呈阴性与切除手术后治愈可能性显著相关(P＜0.01).结论:血清L-Tn-CSV水平对卵巢癌肿瘤诊断、分期及预后评估有一定的参考价值.     

系统性红斑狼疮患者血清中CD83 与自身抗体的表达及其相互关系

目的:检测系统性红斑狼疮(systemic lupus erythematosus,SLE)患者血清中 CD83(soluble CD 83,sCD 83)和多种自身抗体的表达水平,并探讨其相互关系.方法:ELISA 检测患者可溶性 CD 83 和AnuA的表达,应用间接免疫荧光的方法检测抗cmDNA 抗体,应用乳凝法检测血清中的DNP,采用胶体金标记和快速膜渗滤技术测定血清中的抗 dsDNA 抗体.结果:对照组患者血清中可溶性 CD83 的表达为(0.26±0.10)ng/ml,实验组患者血清中可溶性 CD83 的表达为(5.56±0.72)ng/mI.与对照组相比,实验组患者血清中可溶性CD 83的平均浓度明显升高.在抗dsDNA抗体阴性的 51 例系统性红斑狼疮患者中 AnuA 的阳性率明显高于抗DNP 抗体和抗 cmDNA 抗体,同样在抗 DNP 抗体阴性的 58 例系统性红斑狼疮患者中 AnuA 的阳性率明显高于 dsDNA 抗体和抗 cmDNA 抗体.系统性红斑狼疮患者中可溶性 CD83 的水平(<2.68 ng/ml)与各种自身抗体(抗 dsDNA 抗体、AnuA、抗DNP抗体和抗 cmDNA 抗体) 水平的相关系数分别为(r＝0.542,0.613,0.489和0.367).具有高水平可溶性CD83的系统性红斑狼疮患者( ≥2.68 ng/ml),与各种自身抗体(抗dsDNA抗体,AnuA,抗 DNP 抗体和抗cmDNA 抗体)水平的相关系数分别为(r＝0.711,P<0.05)、(r＝0.845,P<0.01)、(r=0.862,P<0.01)和(r=0.724,P<0.051).结论:可溶性CD83通过活化DC细胞并激活补体系统,参与系统性红斑狼疮的发生发展,联合可溶性 CD83 和多种自身抗体的检测,能更明确系统性红斑狼疮患者病情的严重程度,有利于 SLE 的诊断和治疗.     

系统性红斑狼疮患者血清中CD83与自身抗体的表达及其相互关系

目的：检测系统性红斑狼疮（systemic lupus erythematosus,SLE）患者血清中CD83（soluble CD 83,sCD 83）和多种自身抗体的表达水平,并探讨其相互关系。方法：ELISA检测患者可溶性CD 83和AnuA的表达,应用间接免疫荧光的方法检测抗cmDNA抗体,应用乳凝法检测血清中的DNP,采用胶体金标记和快速膜渗滤技术测定血清中的抗dsDNA抗体。结果：对照组患者血清中可溶性CD 83的表达为（0.26±0.10）ng/ml,实验组患者血清中可溶性CD 83的表达为（5.56±0.72）ng/ml。与对照组相比,实验组患者血清中可溶性CD 83的平均浓度明显升高。在抗dsDNA抗体阴性的51例系统性红斑狼疮患者中AnuA的阳性率明显高于抗DNP抗体和抗cmDNA抗体,同样在抗DNP抗体阴性的58例系统性红斑狼疮患者中AnuA的阳性率明显高于dsDNA抗体和抗cmDNA抗体。系统性红斑狼疮患者中可溶性CD83的水平（〈2.68 ng/ml）与各种自身抗体（抗dsDNA抗体、AnuA、抗DNP抗体和抗cmDNA抗体）水平的相关系数分别为（r=0.542,0.613,0.489和0.367）。具有高水平可溶性CD83的系统性红斑狼疮患者（≥2.68 ng/ml）,与各种自身抗体（抗dsDNA抗体,AnuA,抗DNP抗体和抗cmDNA抗体）水平的相关系数分别为（r=0.711,P〈0.05）、（r=0.845,P〈0.01）、（r=0.862,P〈0.01）和（r=0.724,P〈0.051）。结论：可溶性CD83通过活化DC细胞并激活补体系统,参与系统性红斑狼疮的发生发展,联合可溶性CD83和多种自身抗体的检测,能更明确系统性红斑狼疮患者病情的严重程度,有利于SLE的诊断和治疗。     

血清标志物联合检测在急性冠状动脉综合征诊断中的应用

目的:探讨血清cTnⅠ、CK-MB、MYO及BNP联合检测在急性冠状动脉综合征诊断中的临床价值。方法:选择临床及冠状动脉造影明确诊断的ACS患者76例,稳定性心绞痛患者32例,同期选择35例健康体检者作实验对照组;应用免疫化学发光法分别检测患者血清中cTnⅠ、CK-MB、MYO及BNP水平,采用受试者工作特征曲线(ROC)评价各指标的敏感度、特异度,并分析4项指标联合检测的诊断价值。结果:ACS组血清cTnⅠ、CK-MB、MYO及BNP水平分别为(9.27±7.25)μg/L、(239.50±213.27)ng/ml、(37.06±21.60)ng/ml、(632.11±293.20)pg/ml;AS组分别为(1.32±0.57)μg/L、(63.34±31.02)ng/ml、(19.48±8.04)ng/ml、(125.20±6.57)pg/ml;对照组为(0.17±0.06)μg/L、(30.02±15.23)ng/ml、(14.06±3.19)ng/ml、(47.52±21.30)pg/ml;ACS组患者血清cTnⅠ、CK-MB、MYO及BNP水平及阳性率均高于SA组和健康对照组,组间差异有统计学意义(P0.05);cTnⅠ的ROC曲线下面积(AUC)为(0.917±0.025),高于BNP曲线下面积(0.823±0.031)(P=0.037);4项指标联合检测ACS患者的敏感度(92.3%),高于单项检测86.0%(P0.05)。结论:检测血清cTnⅠ、CK-MB、MYO及BNP对于判定心肌缺血和损伤程度有重要价值,各项指标之间有互补作用,联合检测可为ACS早期诊断提供参考依据。     

慢性肾脏病患者血清GDF-15的水平及临床意义

目的:探讨慢性肾脏病(Chronic Kidney Disease,CKD)患者血清生长分化因子-15(Growth Differentiation Factor-15,GDF-15)的表达及与其他肾功能相关临床指标的相关性。方法:选取西南医科大学附属医院2017年3月至2017年7月健康体检中心30例健康体检者对照组及肾病内科、内分泌科、心内科住院病房各期CKD患者150例,采用ELISA法测试验检其血清GDF-15水平。结果:除去CKD1期外,各期CKD患者eGFR及血清SCr、BUN、GDF-15水平均明显高于健康对照组,差异具有统计学意义(P0.05);随着CKD分期的增加,患者血清SCr、BUN、GDF-15浓度逐渐增加,且各组之间差异具有统计学意义(P0.05)。CKD3组患者血清UA浓度明显高于健康对照组、CKD1组(P0.05),CKD4组、CKD5组血清UA浓度明显高于健康对照组、CKD1组及CKD2组(P0.05)。GDF-15水平与eGFR水平呈负相关(r=-0.768,P0.01),与SCr水平呈正相关(r=0.751,P0.01),与BUN水平呈正相关(r=0.764,P0.01),与UA水平呈正相关(r=0.470,P0.01)。结论:GDF-15与慢性肾脏病的发生与发展密切相关。     

肾癌患者血清VEGF的水平及其与临床病理分期的关系

目的:探讨肾癌患者血清血管内皮生长因子(VEGF)的水平及其与临床病理分期的关系。方法:选择2013年1月至2015年1月在我院行手术治疗的肾癌患者56例为观察组,选择同期在我院进行健康体检的正常成人50例作为对照,所有患者的诊断均经病理切片证实,对所有研究对象,采集其清晨空腹静脉血,用酶联免疫吸附法(ELISA)检测血清中的VEGF和VEGF受体-1(VEGFR-1)。结果:观察组血清中VEGF和VEGFR-1的浓度分别为(132.75±68.31)ng/mL和(33.76±15.39)ng/mL,均显著高于对照组,差异有统计学差异(均P0.05);不同分期患者血清中VEGF和VEGFR-1浓度差异有统计学意义(均P0.05),病理分期增加,VEGF与VEGFR-1的浓度增加,VEGF与VEGFR-1呈正相关(r=0.625,P0.05)。结论:血清VEGF水平可用于诊断RCC,且对于预判RCC的病例分期具有重要价值。     

血清Irisin水平与心衰的相关性研究

目的:观察心衰患者血清IRISIN水平变化规律,研究Irisin对心衰诊疗的临床价值。方法:连续收集西京医院心内科住院的心衰患者132例,根据NYHA心功能分级将患者分为三组,其中心功能Ⅱ级48例,Ⅲ级44例,Ⅳ级40例,同时选取心功能正常(左室射血分数LVEF50%)的30例健康体检者为对照组。采用酶联免疫吸附试验(ELISA)检测患者血清中Irisin水平,根据Irisin水平分为低Irisin组和高Irisin组,比较两组间心衰的发生率,分析Irisin水平与心衰的关系。结果:①心衰组Irisin水平显著低于心功能正常组(6790±3628 ng/mL vs 12691±2272 ng/mL,P0.01),且从Ⅱ级到Ⅳ级,逐渐降低;②心衰组LVEF值显著低于心功能正常组(45.7±8 vs 59.7±4.3,P0.01),且从Ⅱ级到Ⅳ级,逐渐降低;③心衰组N末端B型利钠肽原(ProBNP)水平显著高于心功能正常组(2938±2795 pg/mL vs 184±151 pg/mL,P0.01),且从Ⅱ级到Ⅳ级,逐渐升高;④低Irisin组心衰发生率明显高于高Irisin组(92.6%vs47.5%,P0.01);⑤单因素相关分析显示:血清Irisin水平与左室射血分数呈正相关(r=0.694,P0.05),与proBNP呈负相关(r=-0.45,P0.05);结论:心衰患者血清Irisin水平降低,而且随着心功能的恶化显著降低,心衰患者血清Irisin水平与心衰程度有一定的相关性。     

子宫内膜异位症患者血清可溶性B7-H4的水平及意义

目的:探讨子宫内膜异位症患者血清可溶性B7-H4(sB7-H4)的水平及其临床意义。方法:用ELISA夹心法检测43例子宫内膜异位症患者术前血清sB7-H4的水平及40例子宫内膜异位症患者术后血清sB7-H4的水平,同时选取30例体检健康妇女血清sB7-H4水平作为对照。结果:子宫内膜异位症患者血清sB7-H4水平为(36.23±5.67)μg/L,体检健康者血清sB7-H4水平为(31.24±4.56)μg/L,两者比较差异有统计学意义(P0.01)。手术前,子宫内膜异位症患者血清sB7-H4水平为(36.23±5.67)μg/L,明显高于术后(32.54±4.27)μg/L(P0.05)。子宫内膜异位症患者血清sB7-H4水平与CA125水平呈显著正相关(r=0.531,P0.01)。结论:血清可溶性B7-H4可能与子宫内膜异位症的发病有关,检测血清中可溶性B7-H4水平对内异症的辅助诊断和疗效观察可能具有一定的临床意义。     

肠道菌群失衡与腹膜透析患者血清炎性因子的相关性及对患者预后的影响CSCD

目的 探讨肠道菌群失衡与腹膜透析患者血清炎性因子的相关性并监测患者的预后。方法 选择2017年12月至2020年12月来我院治疗的140例腹膜透析患者为腹膜透析组;另纳入140例健康体检者作为健康体检组。比较两组对象血清炎性因子[白介素(IL)-6、IL-8、IL-13、IL-18]水平和肠道菌群(双歧杆菌、乳杆菌、肠杆菌、肠球菌)数量,分析肠道菌群与血清炎性因子和预后的相关性。结果 腹膜透析组患者血清IL-6、IL-8、IL-18水平分别为(30.21±1.22)ng/mL、(69.12±10.22)ng/mL、(138.47±19.28)ng/mL,均高于健康体检组;而IL-13的水平为(16.47±1.24)ng/mL,显著低于健康体检组,差异有统计学意义(均P<0.05)。腹膜透析组患者粪便标本中双歧杆菌和乳杆菌数量为(6.67±1.24)lg CFU/g、(6.41±1.04)lg CFU/g,均显著低于健康体检组;而肠杆菌和肠球菌数量为(9.15±0.32)lg CFU/g、(7.63±1.54)lg CFU/g,均高于健康体检组,差异有统计学意义(均P<0.05)。腹膜透析患者血清IL-6、IL-8、IL-18与双歧杆菌、乳杆菌数量呈负相关,与肠杆菌和肠球菌呈正相关;血清IL-13与双歧杆菌和乳杆菌数量呈正相关,与肠球菌和肠杆菌呈负相关,差异均有统计学意义(均P<0.05)。随访半年,140例腹膜透析患者中28例复发腹膜炎,复发者血清IL-6、IL-8、IL-18水平显著高于未复发者,IL-13水平显著低于未复发者,差异均有统计学意义(均P<0.05)。腹膜炎复发者肠道肠杆菌和肠球菌水平显著高于未复发者(均P<0.05),而乳杆菌和双歧杆菌无显著区别(均P>0.05)。结论 腹膜透析患者血清炎性因子水平较高,肠道益生菌减少,致病菌增加;肠道菌群数量与血清炎性因子水平密切相关,二者水平的变化能提示疾病的进展,为腹膜透析患者预后监测提供依据。     

血β2微球蛋白水平在系统性红斑狼疮中的临床意义

目的：探讨系统性红斑狼疮（systemic lupus erythematosus,SLE）患者血β2-MG水平与疾病活动的相关性及其临床意义。方法：随机抽取2012年2月-2012年7月我科收治的62例SLE患者（SLE组）和同期在我院门诊体检的健康体检者40例（对照组）,检测和比较两组血清β2-MG、自身抗体、补体水平,并对SLE患者进行SLEDAI评分,分析SLE患者血清β2-MG水平与自身抗体、补体水平和SLEDAI评分的相关性。结果：SLE组血β2-MG水平（3．11±0．40μg／mL）显著高于对照组（2．23±0．23μg/mL）,差异有统计学意义（P〈0．05）;其中发生口腔溃疡、浆膜炎及蛋白尿的SLE患者的血β2-MG水平与无此三种表现的患者相比显著升高,差异有统计学意义（P〈0．05）。SLE患者的血β2-MG水平与抗ds—DAN抗体、SLEDAI均呈显著正相关（分别为r=0．289,r=0．361,P〈0．01）,与C3呈负相关（r=-0．271,P〈0．05）。结论：SLE患者血β2-MG水平高于正常,可作为SLE疾病活动指标用于监测疾病活动。     

类风湿关节炎患者血清维生素D水平与疾病活动度相关

目的:探讨类风湿关节炎(Rheumatoid arthritis,RA)患者血清维生素D(25(OH)D)水平与疾病活动度的关系。方法:总共纳入180例RA患者,同时纳入60例年龄、性别相匹配的健康对照。检测所有参与者的血清25(OH)D水平及所有RA患者C反应蛋白和血沉。同时获取RA患者晨僵时间、疼痛视觉模拟表评分、乏力视觉模拟表评分、压痛关节数、肿胀关节数、健康评估量表得分、情绪变化量表得分等。利用RA患者28个关节疾病活动评分(Disease activity score in 28 joints,DAS28)评估RA疾病活动度。结果:相对于健康对照组(43.89±16.28 ng/m L),RA患者的血清25(OH)D明显降低(28.52±8.95 ng/m L)(P=0.000)。RA患者的血清25(OH)D水平越低,压痛关节数、肿胀关节数越多(P=0.043,r=-0.132;P=0.017,r=-0.177),血沉、C反应蛋白越高(P=0.018,r=-0.177;P=0.007,r=-0.200),同时DAS28评分越高(P=0.007,r=-0.201);患者的晨僵时间、疼痛评分、乏力评分、健康评估量表得分及情绪量表得分与血清维生素D水平负相关(P=0.043,r=-0.151;P=0.019,r=-0.175;P=0.006,r=-0.205;P=0.048,r=-0.147;P=0.017,r=-0.178)。结论:RA患者血清维生素D普遍缺乏,并且与RA患者疾病活动度负相关。     

血清IL-17 与IL-23 在支气管哮喘患者中的表达水平及其相关性

目的:探讨IL-17与IL-23在支气管哮喘患者血清中的表达水平及其相关性。方法:选择2010年2月~2015年9月在我院进行诊治的支气管哮喘患者98例,其中包括56例为缓解期组,42例为急性发作期组,对照组为20例体检健康者,观察三组的血清IL-17、IL-23水平及肺功能指标的差异,并分析其相关性。结果:与对照组相比,缓解期组和急性发作期组血清IL-17、IL-23水平均明显升高(P0.05),急性发作期组血清IL-17、IL-23水平均显著高于缓解期组(P0.05);急性发作期组患者的PEF%、FEV1%、V50%、V25%均明显低于缓解期组,差异有统计学意义(P0.05);哮喘患者血清IL-17水平与IL-23水平呈正相关(r=0.685,P=0.000),血清IL-17与FEV1负相关(r=-0.592,P=0.000)、与PEF负相关(r=-0.515,P=0.000),IL-23与FEV1负相关(r=-0.598,P=0.000),与PEF负相关(r=-0.532,P=0.000)。结论:血清IL-17和IL-23的高表达可能参与了支气管哮喘的形成,并能影响疾病的进程,两者表达水平密切相关。     

Circulating proangiogenic molecules PIGF, SDF-1 and sVCAM-1 in patients with systemic lupus erythematosus

Serum concentrations of three angiogenic cytokines: vascular endothelial growth factor (VEGF), stromal cell-derived factor-1 (SDF-1) and placental growth factor (PIGF) and soluble vascular cell adhesion molecule 1 (sVCAM-1), were investigated in the serum of 61 patients with systemic lupus erythematosus (SLE) and 20 healthy subjects. The possible association between serum levels of these proteins and SLE activity, as well as correlation between the concentrations of cytokines were also analysed. All of these factors were detectable in all SLE patients and the healthy control group. The median concentration of VEGF was higher in active SLE (386 pg/mL) than in inactive disease (327 pg/mL) or in the control group (212 pg/mL, p<0.004). The median serum level of SDF-1 was higher in SLE patients (1,814 pg/mL) than in the control group (1,507 pg/mL, p<0.02). The median concentration of PIGF was higher (14 pg/mL) in SLE patients than in the control group (12 pg/mL, p=0.03), and particularly in active disease (17 pg/mL) as compared to the inactive phase (13 pg/mL, p=0.01). The correlations between the levels of cytokines examined and clinical features, laboratory abnormalities and the type of treatment were also analysed. We found a positive correlation between serum concentrations of PIGF and SLE activity according to SLAM score (p=0.33, p=0.13).     

Pigment epithelium-derived factor in ulcerative colitis: possible relationship with disease activity

OBJECTIVES: Pigment epithelium-derived factor (PEDF) is an endogenous most potential angiogenic inhibitor and increased expression of PEDF in intestinal mucosa specimens was shown in the course of ulcerative colitis (UC). The aim of the present study was to evaluate serum concentration of pigment epithelium-derived growth factor, a potent anti-angiogenic factor and its possible association with vascular endothelial growth factor (VEGF) levels and disease activity. METHODS: Concentrations of PEDF and VEGF were measured in sera of 33 patients (13 females and 20 males) with active UC. RESULTS: There was significant increase of serum PEDF (32.3+/-2.9 vs. 20.6+/-4.7 ng/mL, P<0.05) as well as VEGF (326.4+/-58.1 vs. 110.9+/-15.7 pg/mL, P<0.05) in UC patients compared to healthy controls. Serum PEDF showed strong, positive correlation with endoscopic score (r=0.622, P<0.001), while such association was absent in respect to VEGF (r=0.05, P=0.77). In contrast serum VEGF decreased in severe UC comparing to patients with a mild course of disease, however the difference was not significant (274.9+/-64.9 vs. 360.4+/-103.4 pg/mL, P=0.53). CONCLUSIONS: Increase in serum PEDF during UC, especially in severe forms of disease suggests its involvement in UC pathogenesis.     

血清B7-H4水平对肝细胞癌的诊断及预后价值

目的:探讨肝细胞癌(HCC)患者血清B7-H4水平及其临床意义。方法:采用ELISA方法检测和比较116例HCC患者和60例健康对照人群的血清B7-H4水平,并分析血清B7-H4水平和HCC患者临床参数和生存情况的关系。结果:(1)HCC患者的血清B7-H4水平显著高于健康对照组(P0.001);(2)血清B7-H4水平与HCC患者血清AFP水平(r=0.653,P=0.012)和TNM分期(r=0.713,P=0.003)相关;(3)高血清B7-H4组HCC患者5年总体生存率较低血清B7-H4组显著降低(P=0.028);(4)血清B7-H4水平是HCC预后的独立预测因子(P=0.034)。结论:HCC患者的血清B7-H4水平显著上调,对于HCC的诊断及预后判断具有重要的参考意义。     

Circulating total and active metalloproteinase-9 and tissue inhibitor of metalloproteinases-1 in patients with systemic lupus erythomatosus

We investigated the serum concentration of total metalloproteinase-9 (tMPP-9), active MMP-9 (aMMP-9), and tissue inhibitor of metalloproteinase-1 (TIMP-1) in a group of 41 patients with SLE and 20 healthy controls. Serum levels of tMMP-9 and TIMP-1 were assessed by an enzyme-linked immunosorbent assay (ELISA) and aMMP-9 by fluorometric assay. The tMMP-9 level was lower in SLE patients (mean 262 ng/mL) than in healthy volunteers (mean 325 ng/mL) (P = .048). Similarly, aMMP-9 level was lower in SLE patients (mean 121 ng/mL) than in control group (mean 169 ng/mL) (P = .0355) and lower in active SLE (mean 54 ng/mL) than in inactive disease (mean 99 ng/mL) (P = .033). TIMP-1 level was also lower in SLE patients (mean 181 ng/mL) than in control group (mean 233 ng/mL) (P = .004). In SLE patients, a positive correlation was found between tMMP-9 and aMMP-9 (rho = 0.568; P = .001). We also found a positive correlation of tMMP-9 and TIMP-1 with VEGF concentrations (rho = 0.450, P = .005 and rho = 0.387; P = .018, resp). tMMP-9, aMMP-9, and TIMP-1 serum levels are lower in SLE patients than in healthy control group.     

脓毒症患者血清炎症因子与SOFA评分的关系研究

目的:探究脓毒症患者血清炎症因子与序贯器官衰竭评估(SOFA)评分的关系,从而有助于评价患者病情严重程度,科学判断预后效果。方法:选择2014年1月至2015年12月期间在本院内接受治疗的脓毒血症患者142例作为研究对象。入院后24 h内患者进行血清炎症因子IL-6、PCT、CRP水平测定,同时进行SOFA评分。按照患者在入院治疗28天内生存结局状况进行分组,分别为死亡组(87例)和存活组(55例),另按照患者合并多器官功能障碍综合症(MODS)与否,分为MODS组(76例)和非MODS组(66例),对比不同组别间IL-6、PCT、CRP及SOFA评分差别;对比不同SOFA评分患者血清IL-6、PCT、CRP水平差异,分析其相关性。结果:IL-6、PCT以及SOFA评分比较,死亡组高于存活组,MODS组高于非MODS组,差异有统计学意义(P0.05);SOFA评分越高,血清IL-6、PCT水平越高,差异有统计学意义(P0.05);SOFA评分升高,患者病死率显著增加,SOFA10分,病死率为78.3%,差异有统计学意义(P0.05);Spearman相关分析结果显示,SOFA评分与血清IL-6水平呈显著正相关关系(r=0.261,P=0.012),与血清PCT水平呈正相关关系(r=0.453,P=0.000),SOFA与CRP水平无相关性(r=0.112,P=0.323)。结论:血清IL-6、PCT水平与SOFA评分具有相关性,可以在脓毒症患者病情严重程度及预后状况判断中作为生物学指标进行常规监测。     

Serum vascular endothelial growth factor and its receptor level in patients with chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) is a disorder which encompasses not only morphological changes in parenchyma, central and peripheral airways but also in structural and functional changes of pulmonary vessels. The role of angiogenic factors leading to abnormal pulmonary vessel remodeling remains unclear. We have investigated a cytokine vascular endothelial growth factor (VEGF) known to be involved in angiogenesis, and its soluble receptors (sVEGF R1, sVEGF R2) in the serum of 20 patients with mild COPD and 10 patients with very severe COPD, using sensitive enzyme-linked immunoassays. The control group consisted of 10 healthy volunteers. We found that the concentration of VEGF in the serum of patients with mild COPD was significantly higher (665.31 +/- 102.20 pg/mL) in comparison to the control group (318.94 +/- 51.40 pg/mL; p < 0.05), and there was a strong negative correlation with FEV1 (r = -0.859; p < 0.001). Additionally, the level of sVEGF R1 in the serum of patients with very severe COPD was also significantly higher (96.60 +/- 26.85 pg/mL) than in the control (36.01 +/- 3.29 pg/mL; p < 0.05) and a positive correlation between the serum level of sVEGF R1 and FEV1 was found (r = 0.748; p < 0.01). Moreover, we observed an insignificant increase of sVEGF R2 in the serum of patients with mild COPD and those with very severe COPD. These results suggest that VEGF and sVEGF R1 receptor are involved in the development of abnormal pulmonary vascular remodelling in patients with COPD.     

白细胞介素33通过促进上皮细胞黏附分子表达参与干燥综合征发病

摘要 目的：探讨白细胞介素（Interleukin-33,IL-33）可能通过调控上皮细胞黏附分子（Epithelial cell adhesion molecule, EpCAM）表达参与干燥综合征（Sj?gren''s syndrome, SS）发病的作用机制。方法：收集因SS诊断需要行唇腺活检术的患者血清和唇腺组织标本及相关临床资料,根据2016年ACR-EULAR SS分类诊断标准将患者分为SS组和非SS组,选取性别、年龄匹配的21例SS患者和21例非SS患者,利用多重检测流式试剂盒（人炎症因子组合1）检测血清中IL-33水平并用t检验比较SS患者组与非SS患者组、抗SSA抗体阳性与阴性组以及唇腺病理阳性与阴性组之间IL-33水平的差异。对唇腺组织石蜡切片进行IL-33免疫组织化学染色,用流式细胞术检测新鲜唇腺组织中上皮细胞EpCAM表达水平并与血清IL-33水平进行相关性分析。结果：SS患者组IL-33水平为（1736±590.1,n=21, pg/mL）,显著高于非SS患者组（306.8±120.3, n=21, pg/mL）（t=2.373,P=0.027）;唇腺病理阳性组即灶性血清IL-33水平（489.8±170, n=27, pg/mL）高于病理阴性组（1978±793.1, n=15, pg/mL）,2组之间有统计学差异（t=2.368,P=0.023）;而抗SSA抗体阳性组与阴性组之间无明显差异（P＞0.05）。免疫组化染色结果提示SS患者唇腺组织上皮细胞IL-33表达相较于非SS患者上升,且血清IL-33水平与唇腺上皮细胞EpCAM的表达呈中等强度正相关（r=0.4915,P=0.0009,95%CI 0.2205-0.692）。结论：IL-33是与SS密切相关的炎症因子,IL-33可能通过促进唾液腺上皮细胞EpCAM的表达参与SS发病。