以温病治法辨证论治系统性红斑狼疮

系统性红斑狼疮（SLE）是一种多脏器、多系统损害,呈多种免疫异常的自身免疫疾病。一般认为因遗传、感染、内分泌、环境因素等综合作用引起。中医将该病归属为阴阳毒、阳毒发斑、蝴蝶斑、肉痹、脏腑痹、面游风等辨治范围,多数学者认为由内外两方面的因素所致,现代中医温病学将现代医学中具有温病临床特征的一些疾病也归入温病范围,利用中西医结合的方法,分阶段辨治SLE。     

系统性红斑狼疮患者血清铁蛋白水平检测

用酶联免疫吸附试验测定２８例系统性红斑狼疮（ＳＬＥ）患者血清铁蛋白水平，结果表明，与正常对照比较ＳＬＥ患者血清铁蛋白水平增高，但治疗前后血清铁蛋白改变无显著性，与疾病活动指数无显著相关性．这些结果提示ＳＬＥ患者存在有异常铁代谢，本文对此进行了讨论．     

分型治疗红斑狼疮浅探

红斑狼疮是结缔组织疾病之一,是我国医学科研攻关项目以内的疾病。红斑狼疮分为局限性和系统性两种。临床发现系统性高于局限性的发病率,祖国医学对此病早有论述,虽不完全相符,大概属于猫眼疮的范畴,其发病原因,多为火毒内陷,湿热蕴结及肾阴亏虚,外受六淫之邪,内伤于七情,致使脏腑功能失调而发,其发病原因和下面几个方面有关     

系统性红斑狼疮合并弥漫性肺泡出血1例

系统性红斑狼疮是一类累计多器官的常见的风湿免疫系统疾病,该病并发弥漫性肺泡出血死亡率高。本文介绍了一例SLE合并DAH经激素冲击疗法及血浆置换成功救治病例。提示了风湿免疫科医生在对系统性红斑狼疮病人出现血红蛋白、红细胞压积明显下降,及影像学改变,但没有典型的咯血症状时应考虑到DAH的可能,运用激素冲击疗法及血浆置换可提高患者的生存率。     

首例高原大剂量甲基强的松龙短程冲击治疗系统性红斑狼疮合并狼疮肾

甲基强的松龙（ＭＰ）在生理状况下，增加肾小球滤过率，提高血中代稿浓度参与介导肾抗氧化酶活性增高缓解氧自由基对肾组织损害。对于临床表现为急性指数增高的病例，首先使用大剂量ＭＰ静脉冲击，可减轻间质水肿，大剂量短程冲击治疗时，可迅速完全抑制一些酶的活性，而达到最抗炎效果，大剂量ＭＰ短期治疗尤适用于活动性狼疮肾伴肾功能衰竭。     

初发性系统性红斑狼疮患者外周血及T、B淋巴细胞疾病相关基因的筛选及鉴定

目的寻找在SLE分子发病机制中起关键作用的致病基因的候选基因.方法通过高密度基因芯片技术,得到初发性SLE患者外周血单核细胞及T、B淋巴细胞亚群的基因表达谱,在差异表达显著的基因中挑选4个位于SLE易感区段的基因,通过TaqMan实时PCR技术在55例SLE患者中验证基因的差异表达.结果得到初发性SLE患者外周血单核细胞及T、B淋巴细胞亚群的基因表达谱,确定TRIM,KLRC1,IL-4R及EGR-1基因为SLE易感基因的候选基因,实时PCR结果证明SLE患者外周血单核细胞中,TRIM基因△Ct值显著低于正常人对照(P＜0.05),基因表达水平为正常对照的2.43倍,IL-4R基因与EGR1基因的△Ct值显著高于正常人对照(P＜0.05),基因表达水平分别为正常对照的0.33倍、0.26倍,KLRC1基因的△Ct值显著高于正常人对照(P＜0.01),基因表达水平为正常对照的0.56倍,在SLE患者外周血T细胞亚群中,TRIM基因△Ct值显著低于正常人对照(P＜0.01),基因表达水平为正常对照的2.94倍,IL4R基因与EGR1基因的△Ct值显著高于正常人对照(P＜0.01),基因表达水平分别为正常对照的0.32、0.21倍,LRC1基因的△Ct值显著高于正常人对照(P＜0.01),基因表达水平为正常对照的0.56倍.在SLE患者外周血B淋巴细胞亚群中,由于B细胞淋巴亚群所占淋巴细胞比率过低,基因检测数据不稳定,故未作统计学分析.结论在系统性红斑狼疮的发病中,患者外周血单核细胞及T、B淋巴细胞亚群细胞基因表达水平发生了改变,主要集中于一系列免疫相关基因,其中TRIM,KLRC1,IL-4R及EGR-1基因在患者群中变化显著,初步断定为SLE易感基因的候选基因.     

初发性系统性红斑狼疮患者外周血及T、B淋巴细胞疾病相关基因的筛选及鉴定

目的寻找在SLE分子发病机制中起关键作用的致病基因的候选基因。方法通过高密度基因芯片技术，得到初发性SLE患者外周血单核细胞及T、B淋巴细胞亚群的基因表达谱，在差异表达显著的基因中挑选4个位于SLE易感区段的基因，通过TaqMan实时PCR技术在55例SLE患者中验证基因的差异表达。结果得到初发性SLE患者外周血单核细胞及T、B淋巴细胞亚群的基因表达谱，确定TRIM，KLRCl，IL-4R及EGR-1基因为SLE易感基因的候选基因，实时PCR结果证明：SLE患者外周血单核细胞中，TRIM基因△Ct值显著低于正常人对照（P〈0．05），基因表达水平为正常对照的2．43倍，IL-4R基因与EGRl基因的△Ct值显著高于正常人对照（P〈0．05），基因表达水平分别为正常对照的0．33倍、0.26倍，KLRCl基因的△Ct值显著高于正常人对照（P〈0．01），基因表达水平为正常对照的0.56倍，在SLE患者外周血T细胞亚群中，TRIM基因△Ct值显著低于正常人对照（P〈0．01），基因表达水平为正常对照的2．94倍，IL4R基因与EGRl基因的△Ct值显著高于正常人对照（P〈0．01），基因表达水平分别为正常对照的0.32、0.21倍，LRCl基因的△Ct值显著高于正常人对照（P〈0．01），基因表达水平为正常对照的0.56倍。在SLE患者外周血B淋巴细胞亚群中，由于B细胞淋巴亚群所占淋巴细胞比率过低，基因检测数据不稳定，故未作统计学分析。结论在系统性红斑狼疮的发病中，患者外周血单核细胞及T、B淋巴细胞亚群细胞基因表达水平发生了改变，主要集中于-系列免疫相关基因，其中TRIM，KLRC1，IL-4R及EGR-1基因在患者群中变化显著，初步断定为SLE易感基因的候选基因。     

科研人员发现系统性红斑狼疮的新易感基因miR-146a

中科院上海生命科学院／上海交大医学院健康研究所分子风湿病学研究组罗晓兵博士在沈南教授的指导下,找到了miR-146a参与狼疮发病的分子遗传学证据,这一研究成果发表在PloS Genetics上。系统性红斑狼疮（Systemic lupus erythematosus,SLE）是一种具有极强遗传倾向的系统性自身免疫病,Ⅰ型干扰素通路过度活化是其重要的分子表型。     

以温病治法辨证论治系统性红斑狼疮

系统性红斑狼疮(SLE)是一种多脏器、多系统损害,呈多种免疫异常的自身免疫疾病.一般认为因遗传、感染、内分泌、环境因素等综合作用引起.中医将该病归属为阴阳毒、阳毒发斑、蝴蝶斑、肉痹、脏腑痹、面游风等辨治范围,多数学者认为由内外两方面的因素所致,现代中医温病学将现代医学中具有温病临床特征的一些疾病也归入温病范围,利用中西医结合的方法,分阶段辨治SLE.     

千言万语,尽在一尿

<正>几乎所有的动物都有领地意识,就如同人类有"居者有其屋"的观念一样,动物们认为自己占据的领地越大,越有安全感,在群组中就占有更大的优势。但动物们不用手机,无法通过短信、电话、QQ、微信等方式给同类留言,或是评论、点赞,它们如何才能告诉同伴或敌人"这是我的家"呢?我的地盘尿做主在街头的电线杆或大树下,我们常常看到狗狗旁若无人似的,抬起后腿便开始尿尿。其实,尿尿并不仅仅是狗狗的生理需求,更是狗狗的一种标记行为。狗狗借尿液来覆盖新环     

Hepcidin and Ferritin: Important Mediators in Inflammation Associated Anemia in Systemic Lupus Erythematosus Patients

Systemic Lupus Erythematosus is an autoimmune disease with female preponderance. Anemia is found in 50% of Systemic Lupus Erythematosus patients. This is a cross sectional case control study with 30 female Systemic Lupus Erythematosus patients having inflammation associated anemia (Hemoglobin < 10.0 gm/dl) and 30 age matched controls with the aim to measure serum hepcidin and ferritin levels, correlate and study their role as homeostatic regulators of iron metabolism and utility as markers. Serum transferrin, ferritin, iron, total iron binding capacity, hsCRP, liver enzymes and renal parameters were analyzed by using automated analyser. Hepcidin levels were estimated by Sandwich-ELISA method. There was significant decrease in Iron (p < 0.0001), Iron Binding capacity (p < 0.0001), Transferrin (p < 0.0001) in patients, and a significant increase in inflammatory markers: hs-CRP (p < 0.0001), ESR (p < 0.0001) compared to controls. Significant increase in both Hepcidin (p < 0.0001) and Ferritin (p < 0.0001) was observed in patients with significant positive correlation (r = 0.711) with each other. Additionally, ferritin and hepcidin significantly positively correlated with hs-CRP and ESR (r = 0.526, 0.735); (r = 0.427, 0.742) respectively. Negative correlation with hemoglobin, iron, total iron binding capacity and transferrin with hepcidin (r = ? 0.80, ? 0.307, ? 0.553, ? 0.584) and ferritin (r = ?0.722, ? 0.22, ? 0.654, ? 0.728) was observed respectively. On ROC analysis both hepcidin and ferritin has sensitivity of 96.7%, specificity of 100% at cut-off values of 110 and 49 respectively. AUC of hepcidin was 0.993 and ferritin was 0.978. We have established a positive linear correlation between Hepcidin and Ferritin levels in disease activity and the changes correlated with the inflammatory state and anemia in patients, making them important mediators and potential markers of inflammation associated anemia.     

Association of Oxidative Stress with Disease Activity and Damage in Systemic Lupus Erythematosus: A Cross Sectional Study from a Tertiary Care Centre in Southern India

To study oxidative stress in systemic lupus erythematosus (SLE) by estimating serum oxidised LDL (OxLDL), 8-hydroxy-2′-deoxyguanosine (8-OHdG), malondialdehyde (MDA), and total anti-oxidant status and to correlate with SLE disease activity and disease damage. Eighty SLE patients satisfying the Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) 2012 criteria and 80 healthy controls were studied. Exclusion criteria were infections, renal insufficiency, other connective tissue diseases, drug-induced lupus, smoking, alcohol consumption. Disease activity was measured by SLE disease activity index-2 K (SLEDAI), disease damage was quantified by SLICC-Damage Index (SDI). Sera was tested for OxLDL, 8-OHdG, and total antioxidant status (TAS) by double-antibody sandwich ELISA; MDA measured by Colorimetric assay. Oxidative stress markers were compared between group1- controls, group 2-mildly active SLE (SLEDAI ≤ 5), group 3- moderate to highly active SLE (SLEDAI ≥ 6). SLE patients had significantly higher MDA, 8-OHdG and lower TAS when compared to healthy controls, while OxLDL was similar in the three groups. MDA, 8-OHdG were significantly higher, TAS lower in group 3 compared to group 2. MDA had positive correlation with SLEDAI, TAS negatively correlated with SLEDAI. SLE with neuropsychiatric manifestations, vasculitis, anti-sdDNA antibodies had higher MDA, MDA/TAS ratio. SLE patients with thrombocytopenia, and vasculitis had higher OxLDL. Only OxLDL was significantly higher in those patients who have SDI > 1. SLE patients have increased oxidative stress measured by increases in MDA, 8-OHdG, and lower total antioxidant status that was associated with disease activity and some disease manifestations. However only OxLDL was associated with damage.     

Synergetic Interaction of HLA-DRB1*07 Allele and TNF-Alpha − 863 C/A Single Nucleotide Polymorphism in the Susceptibility to Systemic Lupus Erythematosus

Systemic lupus erythematosus (SLE) is an inflammatory autoimmune disease which is characterized by dysregulation of various cytokines propagating the inflammatory processes that is responsible for tissue damage. Tumor necrosis factor alpha (TNF-α) is one of the most important immunoregulatory cytokines that has been implicated in the different autoimmune diseases including SLE. Two hundred and two patients with SLE and 318 controls were included in the study. The TNF-α gene promoter region (from − 250 to − 1000 base pairs) was analyzed by direct Sanger’s DNA sequencing method to find promoter variants associated with South Indian SLE patients. We have analyzed six TNF-α genetic polymorphisms including, − 863C/A (rs1800630), − 857C/T (rs1799724), − 806C/T (rs4248158), − 646G/A (rs4248160), − 572A/C (rs4248161) and − 308G/A (rs1800629) in both SLE patients and controls. We did not find association of TNF-α gene promoter SNPs with SLE patients. However, the − 863A (rs1800630) allele showed association with lupus nephritis phenotype in patients with SLE (OR: 1.62, 95%CI 1.04–2.53, P = 0.034). We found serum TNF-α level was significantly elevated in SLE cases as compared to control and found no association with any of the polymorphisms. The haplotype analysis revealed a significant protective association between the wild TNF-α alleles at positions − 863C, − 857C, − 806C, − 646G, − 572A and − 308G (CCCGAG) haplotype with lupus nephritis phenotype (OR 0.53, 95% CI 0.35–0.82, P = 0.004). Additionally, the TNF-α − 863 C/A (rs1800630) polymorphism and HLA-DRB1*07 haplotype showed significant differences between SLE patients and controls (OR 4.79, 95% CI 1.73–13.29, P = 0.0009). In conclusion, TNF-α − 863A allele (rs1800630) polymorphism is associated with increased risk of nephritis in South Indian SLE patients. We also found an interaction between HLA-DRB1*07 allele with TNF-α − 863 C/A promoter polymorphism giving supportive evidence for the tight linkage disequilibrium between TNF-α promoter SNPs and MHC class II DRB1 alleles.     

Urinary Retention as a Cause of Hyponatremia in an Elderly Man

Hyponatremia is a common disorder in elderly and can result in changes in cognition, seizures, coma or even respiratory arrest if not recognised and treated. Syndrome of inappropriate anti diuretic hormone secretion (SIADH) is the most common cause of hyponatremia in elderly hospitalised patients and in most cases the etiology cannot be determined on routine investigations. We present a 76 year old male with symptomatic hyponatremia who had chronic urinary retention due to a urethral stricture. His sodium levels improved with catheterisation and worsened again after the catheter was removed. This supports the hypothesis that urinary retention and bladder distension can stimulate ADH release from the posterior pituitary, producing a picture similar to SIADH.     

温州9909热带风暴外围特大暴雨分析

本文运用T106数值预报产品、卫星云冈及天气实况资料等,对1999年9月4日凌晨温州特大暴雨原因进行探讨,发现秋季在厦门以南至广东东部登陆的台风,在浙中南沿海形成台风倒槽,该倒槽内暖湿切变线的中尺度对流云团是引起特大暴雨的重要条件。     

复杂新产品概念开发中的系统耦合识别研究

复杂产品与普通产品的根本区别在于复杂产品内部存在着大量的系统耦舍，这些系统耦舍使得对新产品概念开发活动的管理，如产品规格建立、方案选择等变得非常困难。系统耦舍在多个新产品概念域中具有不同的表现形式，分别为规格耦舍、设计耦舍和任务耦舍。本文对这三种系统耦合的识别活动进行了详细的阐述。指出了设计耦合识别中的关键问题，并提出了相关的解决方案。论文以红外远程检测系统的信号处理电路模块的设计耦舍识别活动为例。说明了设计耦合识别活动的实施方法。     

IIR数字陷波器的设计及FPGA实现

IIR（无限冲激响应）数字滤波器在许多领域得到广泛应用.这里介绍了一种利用Matlab设计一个IIR数字陷波器的方法,接着在硬件实现时将其转化为二阶级联形式,以VerilogHDL语言书写模块,最后利用Altera公司的Quartus Ⅱ软件进行FPGA设计及仿真.     

浅谈微博在尿沉渣形态学教学改革中的作用

伴随医学检验专业改制(五年学制改为四年制),教学学时也相应缩减,在此形势下,如何保持教学质量尤其是尿沉渣形态学教学质量成为目前教改的焦点。利用微博建立尿沉渣形态学线上教学互动平台就可解决这一问题,教改实践证明:这样不仅保持了教学质量,学生对形态学的学习兴趣也提高了。