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find Author "李立新" 9 results
  • 滤泡辅助性T细胞及其与系统性红斑狼疮关系的研究进展

    滤泡辅助性 T 细胞(Tfh)是近年来发现的辅助 B 细胞发生体液免疫的一类新的 CD4+T 细胞亚群,其具有特异的细胞识别表位(CD4+CXCR5+)和主要的信号传导分子(BCL-6、诱导性协同共刺激分子、程序性细胞死亡蛋白-1),并能分泌一系列细胞因子 [白细胞介素(IL)-21、IL-6、IL-27 等 ]。Tfh 在 B 细胞的发育、分化,抗体的产生和类型转换以及生发中心的形成中发挥重要作用。Tfh 细胞数量及其效应分子的异常与多种自身免疫性疾病密切相关,系统性红斑狼疮(SLE)是一种发病率较高的典型的自身免疫性疾病。该文主要综述了 Tfh 细胞的特征、功能、分化发育及其与 SLE 的关系,深入研究 Tfh 细胞可能为治疗 SLE 发现新的治疗靶点和方向。

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  • Detection and Correlation Analysis between Anti-cell Membrane DNA Antibody and Other Autoantibodies

    ObjectiveTo analyze the correlation between anti-cell membrane DNA (mDNA) antibodies and other autoantibodies and estimate its diagnosing significance for systemic lupus erythematosus (SLE). MethodsFrom January to August 2015, the sera samples from 254 patients with various autoimmune diseases, including 106 SLE, 80 rheumatoid arthritis (RA), 32 mixed connective tissue disease (MCTD), 29 Sjogren's syndrome (SS), 7 polymyositis/dermatomyositis (PM/DM) and 20 healthy controls, were collected. The anti-mDNA antibody, anti-dsDNA antibody, antinuclear antibody (ANA) and anti-keratin antibody (AKA) were detected by indirect immunofluorescent assay; anti-cyclic citrylinated peptide antibody (CCP) antibody was detected by enzyme-linked immuno sorbent assay; rheumatoid factor (RF) was detected by rat scatter turbidimetry assay; and anti-Sm antibody was detected by Western blotting method. ResultsAnti-mDNA antibody was found in 77 of 106 SLE (72.6%), 4 of 80 RA (5.0%), 6 of 32 MCTD (18.7%), 4 of 29 SS (14.7%), 0 of 7 PM/DM (0.0%) and 0 of 20 healthy controls (0.0%), respectively. It's notable higher in SLE than that in the others (P < 0.001). The sensitivity, specificity and diagnosis efficiency of anti-mDNA antibody for SLE were 72.6%, 91.7% and 84.3%, respectively. Anti-mDNA antibody was significantly correlated with ANA, anti-dsDNA antibody and anti-Sm antibody (P < 0.001), while it had no significant correlation with anti-CCP antibody, AKA and RF (P > 0.05). ConclusionAnti-mDNA antibody is closely related with other SLE associated antibodies and with high sensitivity and specificity for SLE diagnosis.

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  • The Effectiveness of NT-proBNP in Diagnosing Heart Failure

    Objective To evaluate the diagnostic value of N terminal pro-brain natriuretic peptide (NT-proBNP) for heart failure (HF) and the relationship between NT-proBNP and HF. Methods Applying electrochemiluminescence immunoassay on Elecsys 2 010 quantitatively detects NT-proBNP in HF patients with varing heart damage. Results ① Using 155 pg/ml as the cutoff for diagnosis of HF, the sensitivity and specificity are both 80 %, positive likelihood ratio (PLR) is more than 4.0; when NT-proBNP is more than 350 pg/ml, PLR is more than 14. ② NT-proBNP significantly increases in HF patients,and has significant difference compared with disease control group, Plt;0.05. In dilated cardiomyopathy (DCMP) and acute myocardial infarction (AMI) NT-proBNP is the highest, in coronary heart disease (CHD) and hypertension it’s the smallest. With rising NYHA classes, NT-proBNP increases exponentially. The correlation between NT-proBNP and heart function is good, rs=0.859 (Plt;0.01). Conclusions NT-proBNP for diagnosing HF has a high sensitivity and specificity and can effectively evaluate heart function. With worsening of heart damage, NT-proBNP shows exponential or linear increase.

    Release date:2016-09-07 02:25 Export PDF Favorites Scan
  • Clinical Significance of Serum Ferritin Level in the Determination of Liver Damage in Patients with Chronic Hepatitis B

    Objective To explore the relationship between the level of serum ferritin (SF) and liver damage in patients with chronic hepatitis B (CHB). Methods The concentration of serum ferritin of 98 patients with CHB from July to October 2014 was measured, and then correlation analysis was performed to analyze the correlation between SF and such indexes as serum tumor marker α-fetoprotein, biochemical markers [alanine amino transferase (ALT), aspartate amino transferase (AST), total protein (TP), albumin and total bilirubin (TBIL)], and hepatitis B serum markers (hepatitis B surface antigen, hepatitis B surface antibody, hepatitis B e antigen, hepatitis B e antibody, and hepatitis B core antigen). Serum hepatitis B virus DNA (HBV-DNA) viral load was also tested, and then the discrepancy of SF levels in the high and low viral load groups was analyzed. Results The average concentration of the abnormally elevated SF was (878.69±837.98) ng/mL. The SF mean difference between low-load HBV-DNA and high-load HBV-DNA was statistically significant (P < 0.05). Serum ferritin levels were independently and positively correlated with ALT, AST, and TBIL (P < 0.01) and inversely correlated with TP and albumin (P < 0.01). Conclusion The rise of SF is associated with liver damage, which can reflect the state of inflammation of patients with CHB.

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  • Antinuclear Antibodies Assay: A Comparative Study between HELIOS and Artificial Interpretation

    ObjectiveTo verify the consistency between artificial interpretation and automatic interpretation by HELIOS automatic immunofluorescence system by comparing their results on the same antinuclear antibodies (ANA) fluorescent slides, and analyze the application of automatic interpretation clinically. MethodA total of 281 ANA fluorescent slides of 281 impatients or outpatients in February 2015 were analyzed by HELIOS automatic immunofluorescence system and artificial interpretation respectively. As HELIOS could only determine the titer not the fluorescence type, only the negative or positive results qualitatively and the titer of ANA positive slides were analyzed. ResultsThere was no statistically significant difference between HELIOS automatic immunofluorescence system and artificial interpretation in negative or positive rate qualitatively (P>0.05) . The total coincidence rate was 98.9%, the positive coincidence rate was 99.5%, and the negative coincidence rate was 97.4%, and the kappa coefficient was 0.973. The difference of titer between the two groups had no statistical significance (P>0.05) . ConclusionsThe results of HELIOS automatic Immunofluorescence system and artificial interpretation are in good consistency. HELIOS automatic immunofluorescence system is suitable for clinical use as its high degree of automation, simple operation and result reliability.

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  • The Study of Laboratory Tests and Clinical Characteristics of Systemic Lupus Erythematosus Subtype Based on a SLE Family

    ObjectiveSystemic lupus erythematosus (SLE) patients from a SLE family with homogeneity can provide experimental basis for individualized diagnosis and treatment by studying the characteristics of laboratory tests and symptoms. MethodsLaboratory tests were analyzed for three SLE patients in the family, and set up the screen model by three laboratory tests (anitnuclear antibody positive, rheumatoid factor positive and IgE positive, ANA+RF+IgE+). All SLE cases were screened from latest four years as SLE subtype patients (named "similar family SLE patients"), then the family laboratory tests and clinical characteristics were analyzed. ResultsA total of 55 patients (6.27%) were screened as similar family SLE patients from individual SLE patients according to model from 877 cases. The laboratory tests of similar family SLE patients including creatinine, WBC, CRP were significant lower than other SLE patients (P < 0.05), but significant higher for the IgG, positive rate of anti-SSA and anti-SSB (P < 0.05), and the alopecia and skin rashes were more common in similar family SLE patients than other SLE patients. ConclusionsThe ANA+RF+IgE+ SLE patients are of lower inflammatory state and kidney involvement; Clinical symptom is priority to alopecia and skin rashes.

    Release date:2016-10-02 04:54 Export PDF Favorites Scan
  • 1 例 IgG4 相关性硬化性胆管炎误诊为胆管癌的病例分析并文献复习

    目的 探讨 IgG4 相关性硬化性胆管炎的临床表现、诊断、鉴别诊断及治疗。 方法 对 2014 年在四川大学华西医院就诊的 1 例误诊为胆管癌的 IgG4 相关性硬化性胆管炎患者的临床资料进行回顾性分析,包括既往误诊为胆管癌的病史、实验室及辅助检查等,结合相关文献分析误诊的原因并总结经验,以指导日后的临床工作。 结果 该病例术前高度怀疑为肿瘤,行手术治疗后病理报告未查见确切癌细胞,后因黄疸多次安置、更换胆管支架,最终诊断为 IgG4 相关性硬化性胆管炎,予以激素治疗后好转。 结论 IgG4 相关性硬化性胆管炎是较为少见的胆管系统疾病,其诊断较困难,与胆管癌的鉴别十分重要。

    Release date:2017-05-04 02:26 Export PDF Favorites Scan
  • Differentiation Between Transient Intrahepatic Cholestasis and Acute Rejection after Liver Transplantation

    Objective To discuss the differentiation between transient intrahepatic cholestasis (TIHC) and acute rejection (AR) after liver transplantation. Methods Characteristics and the changes (before and within 21 d after transplantation) of alanine aminotransferase (ALT) and direct bilirubin (DBIL) in 30 patients undergone liver transplantation were observed. These patients were divided into TIHC group and AR group following the diagnosis criteria, and the serum levels of ALT and DBIL were compared respectively on day 1 before liver transplantation, day 3, 7 and 21 after liver transplantation. Results Compared with day 3 after transplantation in the TIHC group, DBIL significantly ascended while ALT was changeless on day 7 after transplantation. But in the AR group, DBIL ascended significantly and ALT showed an increasing tendency on day 7 after transplantation. After appropriate therapy, DBIL and ALT of two groups both descended significantly on day 21 after transplantation. Conclusion The changes of DBIL and ALT are available for the differentiation between TIHC and AR after transplantation.

    Release date:2016-09-08 11:07 Export PDF Favorites Scan
  • The significance of prothrombin induced by vitamin K absence-Ⅱ in predicting the biological characteristics of hepatitis B virus-associated hepatocellular carcinoma

    ObjectiveTo explore the predictive value of serum prothrombin induced by vitamin K absence-Ⅱ (PIVKA-Ⅱ) detection for the biological characteristics of hepatitis B virus (HBV)-associated hepatocellular carcinoma (HCC).MethodsThis retrospective study included 394 patients with HBV-related HCC who were newly diagnosed and treated with surgical resection in West China Hospital of Sichuan University between June 2017 and December 2018. Their clinical information such as tumor size, tumor number, tumor cell differentiation, presence of microvascular invasion (MVI), distant metastasis, and portal vein tumor thrombus was collected from the medical record. The laboratory test results of patients during diagnosis and before surgery were collected, including alpha-fetoprotein (AFP), PIVKA-Ⅱ, alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (γ-GGT), etc., and the relationships between PIVKA-Ⅱ levels and tumor biological characteristics were analyzed. Non-normal continuous variables were presented as medium (lower quartile, upper quartile).ResultsCompared with the patients with low HCC serum PIVKA-Ⅱ levels (≤40 mAU/mL), patients with high serum PIVKA-Ⅱ levels (>40 mAU/mL) had larger tumor diameters [5.00 (3.00, 9.00) vs. 2.50 (1.63, 4.95) cm, P<0.001], more severe Barcelona Clinic Liver Cancer (BCLC) stage (P<0.001), and higher AFP [186.05 (6.86, 1 210.00) vs. 17.83 (4.33, 231.95) ng/mL, P<0.001], ALT [38.00 (26.00, 66.25) vs. 32.00 (22.00, 51.00) U/L, P=0.018], AST [42.00 (30.00, 76.00) vs. 34.00 (25.50, 48.25) U/L, P<0.001], and γ-GGT [71.00 (39.00, 165.50) vs. 55.50 (25.00, 93.00) U/L, P=0.005], and were more likely to form portal vein tumor thrombi (16.61% vs. 3.75%, P=0.003) and MVI (43.67% vs. 11.11%, P<0.001). In BCLC stage 0 HCC patients, the positive rate of PIVKA-Ⅱ was only 51.35%. Multivariate logistic regression analysis showed that PIVKA-Ⅱ>40 mAU/mL was an independent predictor of MVI [odds ratio=6.588, 95% confidence interval (CI) (1.645, 26.383), P=0.008]. The area under receiver operating characteristic curve of PIVKA-Ⅱ level predicting MVI was 0.761 [95%CI (0.693, 0.830)], with a sensitivity of 66.22% and a specificity of 79.06%.ConclusionIn HBV-related HCC patients, high PIVKA-Ⅱ is associated with the poor biological characteristics of tumor, and is an independent risk factor for tumor MVI.

    Release date:2021-01-26 04:34 Export PDF Favorites Scan
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