协和内科大查房

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3 Basic & Clinical Medicine January 2005 Vol. 25 No. 1, 2005, : ( 2005) (1), (, ) 1,,48, 2, 9 5 7,, L % 101 g/ L, 910 mg/ dl ( 796 mol/ L ) 6411 mg/ dl (2219 mmol/ L) 319 mmol/ L, ph Pa2 111 CO mmhg ( 1 mmhg = Pa ) PaO ,3 4 / 8515 mmhg HCO mmol/ L, 0 2/, ml/, HP 6 10/ HP ( + ),,,,,,, (ARF), 2 15 kg, , 117 mmol/ L, ( 112 ),, 3716, 64 /, 20 /,, 210 mmol/ L, 100/ 60 mmhg, ,7 12 /, ml/,,, 4 mm, 119 mmol/ L, 66 mol/ L, 24 h 1 500, ml, ml/,,,, 410 mmol/ L 134 mmol/ L 111 mmol/ L,,, ( + ) CT, 3 1, 5 /,200 ml/ ;3 2, mL/ d, 20 mg/ d ;, 1 000mL/ d ; (VIP ) 100 mg 1 / 8 h, (3 11 ) 100 ml/ d, mL,,3 6,,, 180 mg/ d,,,,3 640 mol/ L, mmol/ L, ph HCO mL/ d, mmol/ L 3 : : China Academic Journal Electronic Publishing House. All rights reserved.

4 (1) Basic & Clinical Medicine 87, C %, %,, C,ANA dsdna 3 15,, ENA ANCA ( - ) CA19-9 CEA,, CA50 CA242 ; CA U/ ml B 1, B mmhg,,,, 116, 2 L/ min ph 714, PaCO mmhg, PaO mmhg, HCO mmol/ L D2 ( D2dimer ) 015 g/ L V/ Q,,V/ Q, : : ( ) 10 9 L - 1, 8711 %, 101,T2, 82 g/ L, ( ) 10 9 L - 1 : MRI, g/ L,, : 10 15/ HP, 100 %, CT 10 15/ HP, : CT, 40 g/ L, 3134 mmol/ L, 9142 mg/ dl ( 833 mol/ L ), 26 mg/ dl ( 913 mmol/ L ), 4 cm CT, 1011 mg/ dl (2153 mmol/ L) : (1) :, (2) : : 50 %, ( - ) (ACTH), 3214 ng/ L 25 ng/ L 219 mu/ L, (PTH) 1115 g/ L, MRI,MRI B CT, CT (3) :,,, MRI 212 ( ), 612 cm 310 cm, :, B CT CT,,,, (ATN) ATN :3, :, ; ATN : ; CT, ;,,, : 57 mm/ 1h CH U/ ml,c3 ; ; ; Adie s? ; ; ; ; ( ) MRI T1,, 515 cm ATN China Academic Journal Electronic Publishing House. All rights reserved.

5 88 Basic & Clinical Medicine (1) 213 ( ), VIP 1958 Vern2 (1) :ARF, ATN, er Morrison, : ; (2) : 2 ( /,, 7 000mL/ d), ph 210,, achlorhydria syndrome, WDHA) 50 ; (3) :,,,80 % 90 %,V/ Q ; (4),50 % 70 % :,10 % VIP ; (5) : :, :, (1) : 7 400mL/ d ; (2) : 15 kg ; (3),, ;, (4) : 612 cm 310 cm ARF,,CT, ARF,,,,, (1) VIP : ; (2) : Whip2 ple, ; (3) :,, ( ACTH ; CT ), MRI, 214 ( ),,,,,MEN2 MEN,, : (1) < 100 ml/ d, : > ml/ d, g, 2 ( 48 h, > 500 ml/ d) 3 (1) 20 (2), (2) (3) 52Fu, (4),,CT, (5) : VIP VIP, ;,, ;,,40 % 50 %, 3, VIP 14,,,, ph 210,,, 30 %,,, 216 ( ), : ;, 215 ( ) ) ( watery diarrhea hypokelamia, PTH, ; ;,,, ; VIP, PHM( ; China Academic Journal Electronic Publishing House. All rights reserved.

6 (1) Basic & Clinical Medicine 89, F MRI,,, 219 ( ) ( + ), (, ), PaCO mmhg,, CT,,,,UCG : (1),, V/ Q, SLE (2), 40 %, V/ (3) (4) Q 50 %,UCG (,, ),, : (1) (2) :, (3), 217 ( ), 2110 ( ),,,,, - CT 218 ( ),, (CCK ),CCK,,,,,, : 90 db, 55 db ; 100 db, 55 db : B, 2111 ( ) CT:,, ATN,,, :, B CT, ;, :, ;, ( ), , 1, ;,,, ;,, 300, ml/ d, China Academic Journal Electronic Publishing House. All rights reserved.

7 Basic & Clinical Medicine February 2005 Vol. 25 No. 2 : (2005) (2) 1, 2 2, ( 11 ; 21, ) 1,,18, 1, ( 3), ,, 1, 3,,,, CT MRI 10 ANA ( + ) 1 : 160 ( ), dsdna : ( + ) % ( Farr ), ( - ) ( IF ), 65 mm/ h, C HIV2Ab ANCA ENA ( - ) 2, 70 %, : PaO mmhg ( 1mmHg = Pa ), PaCO 2 61 mmhg, 100 % : ( 59 mmhg), EF 70 % CT :, 5 cm 7 cm, ;, 300 mg/ d, 15 kg 112 T 3711, P 120 /, R 26 /, BP 90/ 60 mmhg,, ( 1) ( 2) ( + ),, 1 2,, 3 :

8 186 Basic & Clinical Medicine (2) 113,, :,, : (PNP), :, ; PNP ;, (BO),, PaCO mmhg, IVIG 20 g/ 300 mg/ BiPAP,, 4 CT,,,, ; ; CT,, ;,, :WBC ( ) 10 9 L - 1, PNP %, %, g/ L, L - 1 ( - ), ( PaCO mmhg ) : 30 mm/ 1h ANA : ( + ) 211 ( ) dsdna : ( + ) % ( Farr ), ( - ) ( IF ) C3 C4 CH50, ScL270 Jo21 1, ; 3, ( - ), ;, ( - ) CT:, 1, ; CT, ( 4) CT + ; : ( ) : ( + ) ( IIF, / / AIDS (SLE ) : ),,, PNP, PNP, PNP, : (1) : ; PNP : ; ( IP) ; (2) IgG IgM IgA C3 2 BO : ; : ( IIF) ;

9 (2) Basic & Clinical Medicine 187 (DIF) IgG C3 ;, ; (3), : , IIF PNP PNP PNP, :desmoplakin I BP Ag1 desmoplakin envoplakin Castleman, periplakin HD1/ Plectin PNP, PNP 5 PNP,,, IVIG,, 212 ( ) CT: ;,,, ;,, CT,,, ; Castleman,, Castle2 man,,,, PNP,,, : (1) : Castleman 213 ( ),, ( ) PNP, Anhalt ; (2) :, , PNP : PNP : (1) ;, : (90 %),,,, ; (2) : 214 ( ) : (1) (1) : ; (2), ( PaCO 2 ; (2),PaO 2 ) ; (3) ; (4) ; (3) ; (4), (1) : IgG C3 Castleman,Castleman PNP ; (2) : IgG BO BO, PNP ; Dsg3 IgG Dsg3, Plakin Plakin IgG, (DP I&,ENV,PER,BP230 ) 5 PNP, 1 2

10 188 Basic & Clinical Medicine (2) ;, ;, (,, ), ; BO, mm, Castleman (60 % 90 %), 217 ( ),,, ; 1 6 mm, Sm, 10 %,,, 3 % 5 %, BO, SLE dsdna,,,20 %PNP 60 % 80 %, SS MCTD AIH,, SSA SSB Takahashi 1, SLE PNP,, ANA, BO, ANA PNP BO dsdna ssdna,, B BO,,,,, - 1, (Dsg - 1) 23 (Dsg23), 215 ( ) PNP,, ANA, Castle2, : man Castleman (1), ; (2) ANA,, SLE,, ; (3) dsdna Farr, IF, T, IF SLE ; (4) B Ig,, ; (5) (CTD) SLE 216 ( ) 218 ( ), Castleman,, CTD,,, Castleman, CTD, dsdna,,

11 Basic & Clinical Medicine March 2005 Vol. 25 No. 3 : (2005) (3), ( ) 1 B :, 3 19, CEA CA199 ; 111 : (,,27 ), : cm ,,,, ;, CT B Castleman 5173 cm 5143 cm,,, 3147 cm 2197 cm, 1175 cm, 3 25 kg 117 cm,, 112, MRI, 110/ 60 mmhg(1 mmhg = Pa), ,, 1 cm, 1 cm,,,,, 3 cm 3 cm, ;, 3 cm, ; ( - ),, 113, , ; Hb Castleman 54 g/ L , 2 10,, 2 h,,, B,, 400 ml,, 115, : : RBC ( ) L - 1,Hb g/ L, WBC ( ) 10 9 CT,, L - 1,PLT( ) 10 9 L - 1, 2102 %,,, :BIL 1 + PRO UBG 66 mol/ L LEU : China Academic Journal Electronic Publishing House. All rights reserved.

12 286 Basic & Clinical Medicine (3) + OB ( - ) 40 mm/ h (5, 26 ) : ALT 45 U/ L AST 45 U/ L TP 619 g/ dl ALB 310 g/ dl A/ G 018 TBIL 2131 mg/ dl DBIL 1117 mg/ dl GGT 177 U/ L ALP 479 U/ L TBA 1317 mol/ L, Cr 0183 mg/ dl BUN 1411 mg/ dl, ( 5 31 ) : ALT 41 U/ L AST 41 U/ L TP 612 g/ dl ALB 218 g/ dl TBIL 1170 mg/ dl DBIL 0196 mg/ dl GGT 163 U/ L ALP 437 U/ L TBA 3714 mol/ L : HbsAb ( + ), ( - ) HIV HCV( - ) CRP AFP, : : 18 g/ dl,, 392 g/ dl 5 %, WBC 4 ng/ ml :517 ng/ ml B12 :253 pg/ ml ESR CRP ; :, ;CT,,, : (1) : ( : ANA ds2dna ENA ANCA 70 % 90 % ), ( - ), : AMA 1 : 80, ; ;CT ( - ) Ig : IgA 4111 g/ L IgM IgG ;, : CT ;,, 7, : 4 3 CT 4,, 5 (B ) (2) :, 116 : Castleman, (3) : ( ) Weber2Christian,,,,,, (4) : (5) : AMA 1 80, (6) :, :,,, Castleman ( ) ; Castleman : Hb 52 g/ L, ESR,, 40 mm/ h ;, ;, ;, B :,,,,, Castleman, ; CT:,,, :,,,, ( 30 %), : : (1) ; China Academic Journal Electronic Publishing House. All rights reserved.

13 (3) Basic & Clinical Medicine 287 (2),,, ; (3), TCR IgH, Castleman,90 % ; (4) ; (5),,,,, ;10 % 212 ( ) : ;,,, ; CT, Castleman :, CT,,,,,, ; 2 % 20 % ; Ig M,, ESR,ANA RF Coombs ;,, (CT, Castleman ),, Castleman,, ; ( ) AIDS Castleman Castleman ;, Caseleman ;,, + ;, ASCT,,,,, ;,,,, ;,, Castleman 213 ( ), 214 ( ), ;,,,,,,,, :Castleman,, :,,, Castleman, 2 : (1) ( 80 % 90 %),,, 215 ( ), ;, (2) ( 10 % 20 %),,,, SS TTP ; POEMS,,,,,, ;, China Academic Journal Electronic Publishing House. All rights reserved.

14 288 Basic & Clinical Medicine (3) Castleman,,,,, 216 La wrence ( ),, ; 3 ;,, 200 mg, ; 1, 012 mg 2,,, 10, 217 ( ) 014 mg,, 10 mg 2,, (, ) 2004,, 2 : ( RNA ) /,, 90 %,, :,,,, ( ),,, : ( ),,,,,, ( ) China Academic Journal Electronic Publishing House. All rights reserved.

15 Basic & Clinical Medicine April 2005 Vol. 25 No. 4 : (2005) (4),, (, ) : R5 :A 1 : WBC 25/ L RBC 25/ L : 103mm/ 1h ANA ( - ) : ANCA 1 : 40 Ig ( - ) :, C ,, C , 5 kg / :, , 130/ 75 mmhg,,,, 68,, 1 111, ( ) ( - ), ,,, CT MRI, III, ( ), ,,, ( Gaint Cell Arteritis, GCA)?, 114 ( ), ( : WBC ( ) 10 9 L - 1, N ( ) %, RBC ( ) ),, 3 20 ( ) g/ L, Plt ( ), L - 1, Hb 10 9 L - 1 ;, ; : RBC (2 4) / HP, WBC (2, 4) / HP ;, + : ; g/ dl,,, ; : ; PT + A : PT 1211 s, 015g, 2 / PT % 8715 %, INR 1105, Fbg 812 mg/ dl, APTT 2818 s ; ENA ANA dsd2,, : Hb 100g/ L, Plt NA ACL / L ; ( - ) ; ANCA 1 : 40 ( ) ; RPR HIV2Ab HCV2Ab ( - ) ; B :

16 (4) Basic & Clinical Medicine ( GCA), 68, 1 ;? ;,, ; 21 GCA? 31,? 41? ( ),, ;,,,,, 10 GCA! 1 1, :? 2, ( - ),? 31,, ( - ),? 41 (50 %, -,, )? 51, : 103 mm/ 1 h, CRP 5193 mg/ dl, ANA ENA dsdna ( - ), AN2 CA 1 40 : ( GCA)? 81 : (PMN) 3 : 11? 91 ; 21 ;? 101 : 31, : 11GCA,? 21 GCA DMARDs,,? 31GCA ANCA? 41 Narvaez,? 51 GCA10 : PMR 23, GCA? mg/ d 1 2,, ( Johns Hopkins http : / / MTX) 2002, INSSV ( vasculitis1med1jhu1edu/ index1html, ) ( ), MRA +, + MTX ), GCA 213 ( ) ACR GCA : 11 > 50 ; 9112 % WBC Plt CRP 21 ; 31, ; 41ESR 50 mm/ h ; 51 : 214 ( ) ; 103 mm/ 1 h GCA, : ( ) ; CTD : RA SLE ; : ; : NHL MM ; GCA :? 61,? 71 : TIA,,, 56 : 98 GCA, 2 (,,,, 3, :, GCA 9315 %, 2 :

17 378 Basic & Clinical Medicine (4),,, ; :, ;, (1) :, Babinski ( + ) : : (1) > 50 (2), (3),, (4) :, (5),, (6) :,,, (2) : 3, (, :,, ),, :,, (1) : ; (2), : GCA, ; 10 % 15 %,, ;,,,,, (10 % 80 %) (30 %, 50 %), : ; (3) :,,, (4) : Wegener :,?,,, (5)? (80 %) :,,, (6) :, GCA (7) :, 215 ( ),, GCA, (8) mg/ d, (3) : GCA,,,, GCA 33 % 50 %, 1 2,, 40 % 50 %, 10 % 60 %

18 (4) Basic & Clinical Medicine %, 64 (51 75 ) : 8/ 9 ; 50 % 2/ 9 ; > 50 mm/ 1 h 9/ 9 ; AION (anterior ischemic optic neuropathy), 5/ 9 ; 3/ 9 : 20, ; 70 mg/ d ; ( CTX/ MTX) ;, ) Takayasuπs GCA, 217 ( ) 7/ 9 ; 3/ 9 ; 5/ 9 ;, GCA,, 30,, 7, 4, GCA, ESR mm/ h :, > 50, GCA,,, AION, GCA,, GCA,?, 218 ( ) : 1 GCA,, GCA 2 mg/ (kg d) ( mg/ d)? ( 1 2,, 2004, 27 (2) : ) ( ) : GCA,,,,? 2110 ( ), GCA GCA :, 70 % 80 %, 90 %,,,, GCA,! 2! AION PION, 2111 ( ) CRAO GCA!,,,,,,!,,, GCA, 2112 ( ) 216 ( ) 1, GCA, GCA, 6 mm, GCA,,, ( ) ( 2113 ( ),, GCA, 9, : (3 6 ) ;, GCA 1

19 380 Basic & Clinical Medicine (4),??,,? :,,, GCA?, 2114 ( ) GCA ( ),,, GCA 30/ 10, 80 Kelly (2002 ) GCA 300/ 10 50,,, 2 GCA 80,,, GCA 13, 28, 48,,, GCA GCA,,,, PMN, GCA, (Sandra L. Dabora) 3 ( Genes Chromosomes Cancer, 2005 ;42 : ), (TSC) (Ramona O. Hopkins) 2 15 (Am J Respir Crit Care Med,2005 ;171 : ), (ARDS), NCI BIOCOMPARE (2005/ 3/ 7),, ( ) Genome Research http :/ / home. ccr. cancer. gov/ oncology/ oncogenomics 18,927 (Hashem El2Serag) 4 ( Gut,2005 ;54 : ), (HCC) 3 X (Am J Roentgen,2005 ;184 : ),, 8, (Jonathan S. T. Sham) 2 20 (J Clin Oncol,2005 ;23 : ), (NPC)

20 Basic & Clinical Medicine May 2005 Vol. 25 No. 5 : (2005) ( 5),, (, ) 1 30 mgπd,5 6,,15 6, 4, L - 1,WBC L (8 ) B,, ( PLT) cm, ;, ( - ) ΠL, ( WBC) (, 2004 Hb), ( + ) 2 6, 800 ml ;B, ; 1, C, 150 ml, 2000,,,,, ml,,,, PLT , 2 8, Hb 18 L - 1,Hb gπl,wbc L gπl,plt 8 14, 10 9 L - 1,WBC L - 1, (Ret) 112 % 5 %,, ( PT) 1616 s, ( PT %) ; (ALT) 84 UΠL, (AST) 6214 %,, 78 UΠL, ( GGT ) 91 UΠL, 5 ( - ) : 6 7, 3 ;, 6 B,, 019 cm ; ; CT,,1,,, ; , 20, MDS, : 60 mgπd ( ), 112 C PLT L Πmin, 105Π55 mmhg ( 1 mmhg = ml, Pa),,,,,,, 2001,,,, 30 mgπd, ( - ), , ml, Πmin,, 2 3Π6, ,,,,,, : : ( 50 ), PLT L L - 1, , 16,Hb 18 gπl, PLT China Academic Journal Electronic Publishing House. All rights reserved.

21 476 Basic & Clinical Medicine (5) 4 cm,, 3 cm, ( + ),, 113 : gπl : 819 gπl ; B12 : PT + A :PT s, PT % 6214 % 77 %, (APTT) s :25 42 mmπ1h C ( CRP) : 8189 mgπl ( ) :HBsAb, HBcAb ;, CT : ( - ) ; IV :175 ngπml ( < 140), : 0124 ( ) B :, ; 1017 cm, ;,, 519 cm, 215 cm ;, 310 cm CT + + :,,,,,,,,, ;, : 111 cm, 212 ( ) 280 mπs, 114 cm, 015 cm,, :,, : :16183 molπl, : molπl, : 34 % 812 gπl Rouπs, Coomb s, Ham, : ( - ) :,,,?,, 114 3, ; MDS - RA :,, 2 19,, , MDS, ( - ) 3, 500 ml,, :,,,,, : ANA ds DNA ENA ( - ) 115 : s IgG:34 ngπ10 7 PA : WBC L - 1, Hb 18 ( < 128 ngπ10 7 PA) : ; : 69 gπl,plt L - 1 Ret :114 % 212 %, : K2F ( - ) L - 1 : 2Π , 25Π50, 18Π50, 5Π50 ; : ( - ) : ( - ) : ( + ) : ( TP) gπl, (ALB) gπl, 102 mgπl ; IgG 1118 gπl, IgA 4189 gπl, IgM 0198 gπl ; : ALB 5617 %, 1 4 %, %, 1014 %, 1914 %? 2,, :,,, :, China Academic Journal Electronic Publishing House. All rights reserved.

22 (5) Basic & Clinical Medicine 477, ( - ) ; ;,,, ( ITP),, (5) :,, 3, :,,,,,,,,, 12 %,, 10 %,,,24 %,, ;, Budd2Chiari, 12 %,,8 %,,,,, (6) :,,,, : (1), : MDS,10, ;, : (1), ;,,,,,,, ;,, (2), (2) :,,,,,,, 2, 2, (3), 2, : (1), 2,? (2), (3),? : (1) 7 8 : Π, 10 9 L - 1, 3 % 5 %, ; (2) MDS, 20 %,? (3),20 %,,?, 213 ( ),,, 6, (4) (VOD) : ( ),,,, China Academic Journal Electronic Publishing House. All rights reserved.

23 478 Basic & Clinical Medicine (5),,,,,,, HCT,, MCV ; ; (6), ; (DC) :85 % X,,, ;,,,,,,, Π,,DC 50 %,70, 10 % (1) ITP : ITP,60 % 80 % 20 % 10,, IVIG, MDS AML HD DC,,, ITP MDS,, DC VW, 2002, 146 MDS2RA 9 % PLT,8Π 11, ITP, DC MDS (2), :,,,,, : (1), + Π +, ( + ),,,,,,, PLT ( - ), (3) : L - 1,,, VII,,,, 20,, MDS (2) ;90 %, MDS, A, ; > 500 gπl, > 80 %, 214 ( ) ;, ml, VWF (3) DC,, > 200 gπl, (4), 2 : ( IPH) ( ), ( ) ( ),,,, VOD IPH,,,,, (5) MDS :, ; IPH ;,,,,,,,MDS China Academic Journal Electronic Publishing House. All rights reserved.

24 (5) Basic & Clinical Medicine 479, ;,, ;, (5) ( ) :,, ;,, ; ;,,,, 216 ( ), (DC) DC, :,CTA,, 215 ( ) ;,, :15,,, ;,,,, MDS ; ( + ), IgA Fanconi ( ) DC : : (1) IPH :,,,:,, DC, IPH SLE, IPH ;DC, 1 MDS ( 2) DC, (DC) :,, DC,,, 217 ( ), : (1),,,, ; IPH,, DC (3) : IPH,IPH,,, (2),MDS, ( 4) Wiskott2,, Aldrich : X,,,,,,,, IVIG,5 %, +, IVIG,,, MDS,,,, ;, China Academic Journal Electronic Publishing House. All rights reserved.

25 480 Basic & Clinical Medicine (5), 2111 ( ) ; gπl, 1 2, ;, + +,, MDS,,, 2112 ( ), 3 : (1) MDS DC? (2) CTA,, +,? (3),? 218 ( ) ;, 2114 ( ),? 219 ( ), 10 %, 3,, 2110 ( ), 2113 ( ), 30 %, 3 IVIG 1 2 IVIG, 100 g,, , 1 2 Phemister, 3 4,,,,, 1 10 % 20 %,3 70 % : ; :,,,, ; 2 3, CD15 +, CD20 +, CD3 +, CD68 +, PC +,,2 SMA +, ( ) WBC L - 1, NEU % 6215 %, Hb,, 74 gπl,plt L - 1 : 80 gπl, China Academic Journal Electronic Publishing House. All rights reserved.

26 Basic & Clinical Medicine June 2005 Vol. 25 No. 6 : (2005) ( 6) 1, 1, 1 2, ( 11 ; 21, ) 1,, :,,54 18 ( ) 20, 1 112, 6 T 3616, R 19 Π,BP 105Π80 mmhg ,,,,, ( - ), 4,, 82 Π,, Π6, P2 > A2,, 3,,, 3 5 ( - ), 1 cm,, ( - ) ( ) 113, 95 mmhg, ( )?,,, MRI,,, 114, :, 122Π50 mmhg,,, 15 mg :O 2 CP mmhg,co 2 CP 2618 mmhg, Tid, 1125 mg Qd 115, 11511, OB, ( - ) 24 h :01310 g,, ALT,TBil gπl,dbil 1117, B 1172 gπl,alb 39 gπl, K Na Cl Cr BUN,,,,UA gπl, :ANA + dsdna Jo21 1, RF ANCA ESR CRP 5 kg : D2Dimer AcL ENA LA( - ), :

27 (6) Basic & Clinical Medicine : X :,, CT:, ;, CT VΠQ, CTPA CTV :, ;,, ; ; : (1) :, ; (2), ;, COPD, - : FEV1 FVC (, FEV1ΠFVC : ) ; (3),, :, HIV, ,, ( 44, 44, ) ( ),, B :,,, B :, 1814 % 116 BP Π70 85 mmhg,,,, 3 kg,, 82 CT 92 bpm,, VIΠ6, VΠQ, P2 > A2,,, : (1) 90,,,, 1 cm,,? (2) ; (3) CT 119 mmhg 85 mmhg,ct ( ),,, -,,,,,? :, 1,,,,,, 3 : ;,,, ;4 5,?,, 3,,, ;,,,,

28 574 Basic & Clinical Medicine (6),,,, ACEI,,,,, ( ) 1, 119 mmhg ( ) 2003, ;, ;,,, ( ) CT ( COPD -, ),CT 14, FEV1 FVC FEV1ΠFVC CT (,, ),, COPD, MRI T1,CT T1, T2,,, ; VΠQ? CT?, CT,,,, CTPA,,,, ( 80 mmhg, ),,, 50 mmhg,, CT MRI, 1 %, VΠQ CTA,, VΠQ, ; CT,,,, ;, 213 ( ),, ;, HIV 3 VΠQ : 30,,,,,,, : ;,,,,, Q :

29 (6) Basic & Clinical Medicine %,, ( 25 % 217 ( ) ),,?,?,,,?, 215 ( )? 218 ( ),, COPD,,,, < 85 %,,,, :, 219 ( ) : VΠQ, COPD,, VΠQ, ; 2110 ( ), 1 ( ), ;SLE, ( 100 mmhg ),,, :, (10 CT,VΠQ ) ;,, ;, ;, 40 mmhg,,, 2,, C2,, 216 La wrence ( ),,, TNF, oxldl ( 1, ), HIV,,,, statin ACEI,,, ;,,,

30 576 Basic & Clinical Medicine (6) 2111 ( ),,?,?,,Lawrence?, :,,,,?, T, T 4 (Diabetes,2005,54 : ),, T :, (Robert I. Lechler), CTLA42Ig :,,,, BNP CHF CHF, (Robert P. Frantz) 3 (Am Heart J,2005,149 : ), (CHF) (BNP) BNP BNP, BNP CHF,,, BNP, DNA BIOCOMPARE (2005Π4Π20), DNA Ecole Normale Superieure Sloan2Kettering Natrue Nature TopIB DNA DNA, IB2 (TopIB) DNA,, TopIB,, DNA, DNA DNA, DNA CT 4 27 (JAMA,2005,293 : ), CT CT,, CT

31 BBaassiicc && CClliinniiccaall MMeeddiicciinnee JJUULLYY VVooll.2255 NNoo ~~ 66 // 22 WWBBCC ~~ LL ~~ LL HHbb 8822 ~~ 9922 gg // LL PPLLTT ~~ LL AALLTT UU // LL AASSTT UU // LL TTBBIILL mmgg // LL DDBBIILL mmgg // LL AALLBB 2255 gg // LL EESSRR 7777 mmmm // hh BB 55 ccmm HHIIVV--AAbb -- HHCCVV--AAbb HHCCVV--RRNNAA -- TTOORRCCHH RRVV--IIggGG 11 :: HHSSVV--IIggGG 11 :: HHSSVV-- IIggMM CCMMVV--IIggGG 11 :: EESSRR 2222 ~~ ~~ LL mmmm // hh PPPPDD -- AAllbb %% ~~ -- CCEEAA CCAA CCAA CCTT 3366 %% 5500 mmgg // VVPP %% γ %% ~~ %% IIgg IIggGG ~~ GG // LL 77 ~~ 1177 IIggEE IIUU // mmll 00 ~~ TT BB NNKK TT CCDD88 ++ TT AANNAA ++ ddssddnnaa EENNAA -- SSMMAA 11 :: CCHH UU // mmll 2266 ~~ 5555 CC 33 << mmgg // LL 6600 ~~ CCssAA CCTTXX MMTTXX 2255 kkgg TT BBPP // 9900 mmmmhhgg 11 ccmm ccmm 1122 ccmm WWBBCC ~~ LL ~~ LL HHbb 9988 ~~ gg // LL PPLLTT ~~ LL AALLBB 2200 ~~ 2277 gg // LL %% 6611 %% 2222 %% 44 %% 66 %% 11 %% 11 %% CCMMVV--PPPP6655 BBCCRR // AABBLL -- UUCCGG EEFF 6622 %% CCTT CCTT

32 BBaassiicc && CClliinniiccaall MMeediicciinnee %% ~~ 1177 %% CCssAA mmgg // 2200 mmgg // ~~ ~~ 3300 mmll // 55 ccmm CCTT CCTT CCTT VVCCRR CCTTXX MMTTXX CCMMLL HHDD NNHHLL CCMMLL IIHHEESS IIHHEESS LL >> 55 %% << 1199 %% HHSSVV--IIggMM HHCCVV--AAbb HHCCVV--RRNNAA -- HHCCVV--AAbb 33 TTBB--AAbb PPPPDD

33 BBaassiicc & CClliinniiccaall MMeeddiicciinnee CChhuurrgg--SSttrraauussss ssyynnddrroommee CCSSSS CCSSSS 33 CCSSSS PP--AANNCCAA ++ AANNCCAA CCSSSS gg CCDD CCDD NNKK CCDD2200 CCDD7799 ±± CCDD11 CCDD2233 CCDD TT TT TT ppllaassmmaaccyyttooiidd TT--cceellll llyymmpphhoommaa << 1100 %% TT LL ~~ LL ~~ LL LL CCMMLL -- // TT IILL--22 IILL--44 IILL--55 γ IIFFNN IILL PPeetteerr SSttrraanngg 44 JJ PPaaiinn SSyymmppttoomm MMaannaaggee

34 BBaassiicc && CClliinniiccaall MMeeddiicciinnee AAuugguusstt VVooll Noo CCTT 3388 PPPPDD ++ EESSRR CCTT 1100 CCTT BB LL BB mmll 66 kkgg PPCCOOSS dd 4400 ~~ 6600 dd CCTT TT ~~ ccmm ccmm Ⅱ SSMM 33 ccmm ccmm gg // LL PPTT ++ AAPPTTTT HHbbssAAbb HHbbccAAbb ++ CC AAFFPP CCAA CCAA CCEEAA PPPPDD 2255 mmmm 7722 hh // mmmm // mmmm %% 2222 %% gg // LL 5522 uu // LL 1188 uu // mmll

35 BBaassiicc & CClliinniiccaall MMeeddiicciinnee // mmmm IIggAA gg // LL IIggGG IIggMM IIggDD IIggEE IIggAA γγ %% MM kk λ ~~ mmgg // ddll 2244 hh ccmm 22 // %% EEKKGG UUCCGG EEFF 7722 %% 1188 ccmm HH 22 OO ccmm HH 22 OO AANNAA ddssddnnaa EENNAA AANNCCAA -- AAMMAA 11 :: ppoollyynneeuurrooppaatthhyy oorrggaannoommeeggaallyy eennddooccrriinnooppaatthhyy MM pprroo-- TTSSHH UU // mmll ~~ tteeiinn sskkiinn cchhaannggeess hh CCTT ppgg // mmll << PPOOEEMMSS ppmmooll // LL PPOOEEMMSS gg // LL nnmmooll // LL mmiiuu // mmll 99 mmiiuu // ddll 2244 hh NNaa KK CCll CCaa PP BB mmmm HH 22 OO 66 // mmmm // mmmm gg // LL CCTT CCTT CCTT MMRRAA 4400 // mmmm gg // LL 3300 UU // LL SSAAAAGG MMRRII UU // mmll -- BB mmll QQ88hh MM IIggAAλ 55 AACCTTHH FF PPOOEEMMSS PPOOEEMMSS PPOOEEMMSS CCTT CCTT MMRRAA 22..3

36 BBaassiicc & CClliinniiccaall MMeeddiicciinnee PPCCOOSS BB 33 TT LLHH // FFSSHH >> PPCCOOSS PPCCOOSS PPCCOOSS PPCCOOSS PPCCOOSS cchhrroonniicc iinnffllaammmmaattoorryy ddeemmyyeelliinnaattiinngg ppoollyynneeuurrooppaatthhyy CCIIDDPP HHMMSSNN 8899 PPOOEEMMSS PPOOEEMMSS PPOOEEMMSS PPOOEEMMSS ~~ mmmmhh 22 OO PPOOEEMMSS 11CCIIDDPP CCIIDDPP BB11 BB66 BB1122 AA AATTPP 33 ~~ AAddddiissoonn FF TTSSHH AACCTTHH TTSSHH FF AACCTTHH ⅠⅠ Ⅱ// ⅠⅠ PPOOEEMMSS ~~ %% ~~ 3322 %% 9900 %% SSAAAAGG ++

37 BBaassiicc && CClliinniiccaall MMeediicciinnee PPOOEEMMSS PPOOEEMMSS VVEEGGFF ++ // DDiissppeennzziieerrii PPOOEEMMSS 11 2 CCaassttlleemmaann PPOOEEMMSS MM IIggAA PPOOEEMMSS PPOOEEMMSS PPOOEEMMSS 2200 %% CCPPAAPP PPOOEEMMSS PPOOEEMMSS PPOOEEMMSS PPOOEEMMSS PPPPDD 1100 PPOOEEMMSS PPPPDD 1188 ccmmhh 22 OO PPPPDD PPOOEEMMSS PPOOEEMMSS PPPPDD 1177 mmmm

38 BBaassiicc && CClliinniiccaall MMeeddiicciinnee ccmmhh 22 OO Ⅳ nngg // mmll -- XX >> 3300 ccmmhh 22 OO >> 22 ccmm 22 << 2200 ccmmhh 22 OO PPOOEEMMSS PPOOEEMMSS PPOOEEMMSS mmgg qqdd ++ 22mmgg qqdd MMPP ccmm MMPP BB DDiissppeennzziieerrii AA KKyyllee RRAA LLaaccyy MMQQ eett aal.. PPOOEEMMSS ssyynnddrroommee ddeeffiinniittiioonnss aanndd lloonngg--tteerrmm oouuttccoommee JJ.. BBlloooodd DDiissppeennzziieerrii AA GGeerrttzz MMAA.. TTrreeaattmmeenntt ooff PPOOEEMMSS ssyynnddrroommee JJ.. CCuurrrr TTrreeaatt OOppttiioonnss OOnnccooll DDaann TThheeooddoorreessccuu 66 UUrroollooggyy AALLLLHHAATT PPaauull KK.. WWhheellttoonn AArrcchh IInntteerrnn MMeedd AACCEE 33 AALLLLHHAATT NN EEnnggll JJ MMeedd GGMM--CCSSFF JJoosshhuuaa RR.. KKoorrzzeenniikk

39 BBaassiicc && CClliinniiccaall MMeeddiicciinnee SSeepptteemmbbeerr VVooll.2255 NNoo mmgg // dd mmgg ttiidd mmgg bbiidd ~~ ccmm 11 PPIIPP MMCCPP EESSRR 5522 mmmm // hh CCRRPP mmgg // ddll AANNAA :: 8800 EENNAA RRFF AAPPFF AAKKAA ~~ mmgg mmgg mmgg mmgg // dd mmgg // mmgg // 11 ~~ qqdd kkgg 1155 mmgg qqww 1100mmgg qqdd 2200mmgg ttiidd CCuusshhiinngg TTmmaaxx 3399 WWBBCC GG // LL GGRR %% HHGGBB gg // LL PPLLTT GG // LL JJoo mmgg qqdd 11 TTmmaaxx 3388 ~~ ccmm 55 mmgg // dd 2200 mmgg // dd VV Ⅳ BBaabbiinnsskkii ~~ mmgg mmgg // dd

40 BBaassiicc && CClliinniiccaall MMeddiicciinne RRAA CCTTXX // MMTTXX 1155 mmgg // SSCCLLEE BB CCTT TTmmaaxx NNSSAAIIDDss PPPPDD ~~ mmgg qqdd WWBBCC ~~ LL NNEEUUTT %% ~~ %% EEOOSS %% ~~ %% LLYYMMPP %% ~~ %% RRBBCC ~~ LL HHGGBB 7788 ~~ gg // LL PPLLTT 8822 ~~ LL ~~ gg // LL hh gg AALLTT 1111 ~~ 5500 uu // LL AALLBB ~~ gg // ddll AASSTT 88 ~~ 6699 UU // LL CCKK 99 ~~ 2222 UU // LL LLDD ~~ UU // LL HHBBDD ~~ UU // LL GGGGTT 3355 ~~ UU // LL AALLPP 6600 ~~ UU // LL KK ~~ mmmmooll // LL BBUUNN ~~ mmgg // ddll CCRR ~~ mmgg // ddll 2233 ~~ mmmm // hh CCRRPP ~~ mmgg // ddll nngg // ddll >> PPTT ss IINNRR AAPPTTTT ss FFbbgg mmgg // ddll AANNAA -- --ddssddnnaa -- EENNAA -- AANNCCAA -- RRFF -- AAKKAA AAKKFF AALLBB %% γγ %% αα %% %% IIggGG gg // LL IIggAA gg // LL β IIggMM gg // LL IIggEE IIUU // mmll 00 ~~ CCHH UU // mmll ~~ CC mmgg // ddll CC mmgg // ddll HHBBssAAbb ++ HHbbccAAbb HHCCVV--AAbb -- HHIIVV--AAbb -- RRPPRR -- EEBBVV IIggGG // VVCCAA :: 4400 IIggAA // VVCCAA -- IIggAA // EEAA -- IIggMM // VVCCAA PPPPDD :: :: 8800 BB NNKK TT TTOORRCCHH RRVV--IIggGG :: 4400 CCMMVV--IIggGG :: HHSSVV--IIggGG :: AAFFPP nngg // mmll CCAA UU // mmll CCAA TTSSHH UU // mmll ~~ TTPPOO AAbb UU // mmll 00 ~~ MM == 7744 %% EE == 2233 %% MM :: EE == :: ccmmhh 22 OO CCSSFF CCSSFF mmgg // ddll 6611 mmgg // ddll 9922 mmmmooll // LL CCSSFF CCSSFF XX--rraayy RRAA CCTT CCTT CCTT BB

41 CCTT CCTT EEFF %% 1100 BB ccmm ccmm ccmm BBaassiicc && CClliinniiccaall MMeeddiicciinnee CCTTDD RRAA PPMMRR TTBB XX--rraayy CCTT CCTT CCTT CCTT CCTTDD CCTTDD SSCCLLEE CCTTDD SSCCLLEE CCTTDD 11 CCuusshhiinngg Ⅲ EESSRR CCRRPP CCTTDD RRAA PPPPDD XX--rraayy XX--rraayy

42 BBaassiicc && CClliinniiccaall MMeediicciinnee RRAA RRFF AAKKAA AAPPFF RRAA RRSS33PPEE HHLLAA--BB77 RRFF -- EESSRR PPMMRR 11 CCKK 22 PPMMRR EESSRR PPMMRR Ⅱ 55 EESSRR CCRRPP EESSRR CCRRPP SSSS 44 CCTTXX MMTTXX MMRRII QQ 44 EESSRR CCRRPP PPPPDD CCTT CCTT TT CCTT

43 BBaassiicc && CClliinniiccaall MMeeddiicciinnee XX--rraayy CCTT PPPPDD XX--rraayy RRAA DDNNAA HHIIVV 1133%% AAIIDDSS 1122 DDoouuggllaass LLoowwrriiee PPoohhaanngg UUnniivveerrssiittyy ooff SScciieennccee aanndd TTeecchhnnoollooggyy YYoouunnggcchhuull SSuunngg GGeennee TThheerraappyy SSuunngg DDNNAA LLoowwrriiee LLoowwrriiee TTuubbeerrccuulloossiiss ccaann bbee ttaacckklleedd wwiitthh aa ccoocckkttaaiill ooff aannttiibbiioottiiccss bbuutt uupp ttoo 1122 mmoonntthhss ooff ttrreeaattmmeenntt aarree nneeeeddeedd ttaacckkllee hhttttpp // // wwwwww.. nnaattuurree.. ccoomm // nneewwss // // // ffuullll // hhttmmll

44 Basic & Clinical Medicine October 2005 Vol. 25 No. 10 : (2005) ( 10),,,,, (, ) 1,,,28 2,, 1, d : ph 71467, PO 2 64 mmhg, PCO 2 3, 4 d 3815 mmhg, SO 2 93 % ; WBC L - 1, GR, T 3815,, 93 %,,, RCU,, 1, Raynaud, (WBC) L - 1,, 1 Πd, ; ( GR) 7719 %, ;, 3 d, WBC L - 1, GR 84 %,, 2 d,, ;,,, WBC L - 1, GR 90 %,, , , 100 Π, 34 Π,, 120Π80 mmhg,, 38 39,,,,,,, 5 d, CT,, 100 Π,,, ; ( HIV),, ( ESR) 42 mmπhr, (ALT),,4 Π 47 UΠL, (AST) 4018 UΠL, (TBIL) ( ), 3313 molπl, (ALB) 2318 gπl, 113, :ph 71517,PO 2 47 mmhg,pco mmhg,so 2 88 % 12 30pm?, 10, ;3 00pm,,, : 120Π60 mmhg, Π min, 35 Πmin,, :

45 (10) Basic & Clinical Medicine , 2 10 g 4 d ; 40,, 211 ( ) 10 LΠmin, PO mmhg CT, ;, ;, 1 B, 3, 1600 ml, 1400 ml,, CT 38 39, 2, 3 LΠmin,,WBC,, HRCT 3,,, 400 mg qd,, 250 mg qd po, 3 HRCT, ;,,, ;, ( - ), ,, 2 18, CT,,,, L - 1,, ALT 61 UΠL 115 : WBC L - 1, HB 10 9 gπl, Plt L : RBC 2 4,, ; ΠHPF, WBC 1 3 ΠHPF 24 h : ;, ; g ( ml), ESR mmπh C 9712mgΠL, HIV2 ( - ),CMV2IgG( + ) , HSV2 IgG( + ) , 6 d,, ( - ), 6 d, ( - ), ( - ),, : :ALT UΠL,, WBC : ; :,, ; T :,, ( ALT 380 UΠL, ) : ,1 400, 116,,, 212 ( ), ;,, 3 d, 2 d, 5 d 39, 400 mg qd 250 mg qd, 37,

46 962 Basic & Clinical Medicine (10), CT,,,ALT, ALT, ALT ;WBC L ( ),,,2,,,,,,,,,,,,, CMV2IgG( + ) 216 ( ) ,4,,,, CMV ( - ),,, ( ) ( - ), IgM CMVpp65 ( - ), - ( - ),,,, 6 ;,,, 1,,,,,,,, 2,,,,,,,, IFA,,, Lp8, 1 100, 1 400,4 214 ( ), Lp8, CMV, CMV2Ig 4, CMV, CMV,, HIV, Still,,,,, CMV 215 ( ), ;,,, 217 ( ),,

47 (10) Basic & Clinical Medicine 963,,, 1 d,, 6,, 1 d, CMV,,,, CMV,,CMV,,, 219 ( ), 218 ( ),,,,?, BCYE,,, CMV, ( - ),,,,,,,, WBC, CMV, ESR 125 mmπh,crp, CMV 2110 ( ), CMV,, CMV2IgG 4, CMV, CMV,, CMV,, CMV, IPF Lp8, 4, IFA,,,,, BIOCOMPARE (2005Π8Π30),, 1 (SCA1), Purkinje Ataxin21 1,,, (Cell), Purkinje Ataxin21,

48 Basic & Clinical Medicine November 2005 Vol. 25 No. 11 : ( ) (11),, (, ) 1 (DB IL ) 1512 mol/ L, ( K) 3129 mmol/ L,, 70 /,,,,,,,54 3, : WBC / L, N 3016 %, L %, RBC / L, Hb 117 g/ L, PL T / L : AL T 66U/ L, ALB 216 g/ dl, 3, TBiL 1165 mg/ dl, DBil 0166 mg/ dl, AL P 49 U/ L,,, Cr 0169 mg/ dl, Ca 718 mg/ dl, 9 ( PT + A) : PT 1515 S,APTT,, S, INR 1129 : ALB 4213 %,,, (1211 %, 41 %, IgA 5184 g/ L, Ig G 3112 g/ L, IgE ;, ;, : U/ ml : T ng/ ml, T4,, 5137 g/ dl, TSH U/ ml, FT3,, 0173 pg/ ml, Fr T ng/ dl TG2Ab >,,, IU/ ml ( < 115), TPO2Ab 6716 U/ ml, : ( AL T) ( < 34) 108 U/ L, ( TB IL) 3215 mol/ L, 420 ng/ ml, ESR 30 mm/ h ANA + dsdna: ANA1 : 640 ( ), ( ) ( T3) 1112 pmol/ L, : SMA 1 160, AMA 1 160, AMA2M2 : ( T4) 5144 pmol/ L : 203 RU/ ml RF 413 IU/ ml, LA 2416 S, ACL :, ( - ),ANCA ( - ), ENA ( - ),APF ( - ),A KA ( - ), 0154 CT :, ( - ),HCV ( - ) :1984, :, :, AL T PO mmhg, PCO mmhg,p H 71504, SO , %, A2aDO mmhg : PO 2, 3414 mmhg, PCO mmhg, p H 71518, SO %,A2aDO mmhg : BP 100/ 70 mmhg,, PO mmhg,pco mmhg,p H 71477,SO 2,, 9918 %,A2aDO mmhg : :

49 (11) Basic & Clinical Medicine 1075 PO mmhg, PCO mmhg, p H 71484, SO %,A2aDO mmhg Qs/ Qt = % : ( ) : 212 ( ),LV EF 70 % ( ) ( TIPS), 99m Tc2 : CT : ( 99m Tc2macroaggregated albumin, MAA),, CTPA :, CT :,,,, : = ( - :, ) / 100 % : -, 1913 %,, : 1913 %,,, 21/ 18 mmhg, 114,,,, 10 L/ min,, 98 % 100 % :,,,, 213 ( ),,,,, 1984, AL T 9, CT :,,,, : :,,,, : - :, : CT :,,, : ( ), CT (V/ Q) : :AMA 1 160,M2,SMA 1 160,ANA1 :, 1913 % 640 ( ),1 160 ( ), Ig G + + : ( ) CT Krowka, : 2 : ( ) ;, ( ) ; / (, ( ),, ) ; ( ) ; (,,,

50 1076 Basic & Clinical Medicine (11), ) 215 ( ),,V/ Q,,,,,,,, : ,,,7 1, , 16 75, 40 %, 15 % , 1 :,, 1 1 4,,,, ;, ;,,A2aPO 2, : (100 %), 15 mmhg ; UCG ( ) V/ Q (8416 %), (1412 %) ; ( ) (1412 %), ( 8416 %), ;, (8416 %), (7014 %) : ( 1111 %), + : (1) (1111 %),CT (3313 %),, ; ( 6617 %), (2) 214 ( ),,,2, 216 ( ), : (1), (AIH) : ANA ( ) SMA Ig G 3112 g/ L, 41 % ; (2) ( PBC) : AMA AMA2M2 203 RU/ ml IgM 4164 g/ L, AL P GGT, ; (3) (AIH + PBC) : M - 2,, 90 % 95 %,,,, ; ;, 50 %,,,, PaO 2 < 50 mmhg,,, > 30 %,,UCG (100 %), (7718 %), (1617 %) 100 %, 22 % 57 % 3,1,,

51 (11) Basic & Clinical Medicine 1077 GP210,, PBC 25 % ; SP100, 218 ( ) PBC 20 % 30 %, +, PBC, PBC?, PBC 50 %,, PBC 80 %,,,,, 219 ( ), 1,, 20,, 5, 5, +, 80,,,,,,,, ANCA,,,,,,, 2110 ( ),, B,,,, SSA SSB, Ig G,,,, Ig G 2111 ( ), 20,,,, 217 ( ), 60 mmhg,, 15 h,,

52 1078 Basic & Clinical Medicine (11) 2112 ( ),,,, 5 %, 500 mmhg,, 459 mmhg,, V/ Q 5 6,, ;,,, V/ Q,,,,,,, ACE ( Alzheimer disease) ( ), (ACE) (captopril) (perindopril) Takashi Ohrui Ohrui 162 ACE (MMSE),, ACE ( 3715 mg/ d 2 mg/ d) MMSE, 016 ACE ( enalapril 5 mg/ d imidapril 5 mg/ d ; 416 ) ( nifedipine 20 mg/ d nil2 vadipine 4 mg/ d ; 419 ) MMSE, ACE, Ohrui, MMSE ACE Ohrui ACE Neurology, 2004 ;63 :1145,

53 Basic & Clinical Medicine December 2005 Vol. 25 No. 12 : ( ) ( 12),, (, ) 1, ( + ),,10 20 Πmin, 113,, ,,,,, ;,, 0 2 Πd,,3 7 Πd,,,,, 4 6 Πd (,, ),, 1 h,, 1 Πd, ;; ( ) : WBC L - 1,N 5318 %, 6518 % ; Hb gπl ;PLT L - 1,, ; + ;, : ANCA ASCA ENA ; : ALT UΠL, AST50, 115 UΠL ; ;AKP GGT BIL TP ALB :TG mgπdl (40 150),CHO mgπdl,, ( ),HDL2C mgπdl (36 70),LDL2C 76,, 113 mgπdl (80 140),APOA mgπdl,, ( ),APOB,, Lp (a) Ig :, 1 CRP ESR ; PT + A ; 347 ngπml ( < 140 ngπml) ;ANA AMA ENA ASCA (AGA) ( EMA) 112 (ARA) OGTT BP 110Π60 mmhg,,bmi HBA1C ; 1612, K2F HIV HCV HEV EBV CMVIgM, 1 cm, (, ( - ) - ), 4 cm, ; ( 313 cm), :

54 1180 Basic & Clinical Medicine (12),, 414 cm, 212 cm,,, CT +,,, :, CT,,, ;,PR > 1, ; D2 :1106 g( > 112 gπ5 h) ; PABA :41 %( > 60 %Π6 h) :12 h, 0 % ;24 h 10 %( 75 % ( IBS),15 % ) ;48 h 75 %(, ) 5 h :0 % : 212 ( ), 2 h MMC :, 3 ; 1, 8 min, 53 min, :, 40 min 4611 ; mmhg, s,, 55 min, 6813 ; ( mmhg, s ), ( : (1) : ) : 112 cm 75 %,,,, Mallory, (2) :, ALTΠAST, > 1 ; ;,, (NASH) : (NASH) ; (3) :, : ( TG),, : :CD68 ( + ) :PAS, ( - ) 116, ( ) ; ( ) 3,,? MEDLINE,?, 3,, 4 ; VIP,,,,, ;,,, ;

55 (12) Basic & Clinical Medicine 1181,,,NASH :,,,,,,,, Gaucher Niemann2Pick, ;, ; (, ) (,,, ) ( ), 213 ( ) ;SLE,,, ( TG),, ds2dna, ENA SM, A B C E,, ApoA1 ApoB100 ApoE TG,,,,,,, : : PABA, ;, ; :, (LPL), (LCAT), TG,, 4, ;,, ; TG,, CM VLDL ApoC2,, LPL ; LPL HL,, 214 ( ) (nonalcoholic steatohepatitis,nash) NASH LDL HDL VLDL, (1),75 %,25 % : TG, NASH B48 NASH, (CM),,, HDL ApoE B2 C3, CM NASH LPL, CM TG, NASH,, TG,,, CM

56 1182 Basic & Clinical Medicine (12), TG LPL, CM,,,, ApoE, :, (2) 3, ( : ),,, ; TG, TG ; ApoB100 VLDL, VLDL 3, VLDL TG ( mgπdl), LDL TG :,, ; htg ( Type ) ( Type ), LPL ApoC2 TG ( Type ) TG, TG 3 : TG, TG, ; TG, LPL ApoC2 LPL LPL,, LPL TG < 1Π LPL,, TG, mgπdl, LPL,,,, : TG TG, TG, TG,, LPL, LPL LPL, LPL, 215 ( ) TG NASH, TG, TG NASH? TG LPL,,, ApoC2, ApoC2 LPL, LPL, ApoC2,TG > mgπdl,,,, HDL, TG LPL, ApoC2 LPL, VLDL (htg), TG, (VLDL) (CM),,,, TG, TG,,, TG : :,, SLE,

57 (12) Basic & Clinical Medicine 1183 :,, TG TG, TG, ; ; 218 ( ), TG LPL,, mg tid HL, VLDL HL 216 ( ),,, TG,, 219 ( ), Gaucher Niemann2Pick,, 2110 ( ), TG,,, ApoC2 ;,, LPL, LPL, TG,, mgπdl, LPL,, TG ; LPL ApoC2 LPL TG, 217 ( ) ApoA5 TG,,, 75 %, 2111 ( ),,, TG, TG,, TG? Mallory Mallory,,,,,,, 3, LPL (, 1) (, ) NASH :,,,,, LPL :,, >, TG, TG? LPL, LPL, LPL mgπdl, : 013 cm LPL,,,, LPL TG NASH LPL TG

58 1184 Basic & Clinical Medicine (12) 1 LPL HL LPL ( ) ( :muπml ) :,,,,,, Paris25 Xavier Jouven 10 ( Eur Heart J,2005 ;26 : ),,,, Terje R. Pedersen (JAMA,2005 ;294 : , ) LDL, BIOCOMPARE (2005Π11Π16),Laurence Livermore Molecular Cell, (FERT) RNA DNA RNA BIOCOMPARE (2005Π11Π18), (American Journal of Respiratory and Critical Care Medicine,),, (COPD) Stamford Tracy Shevell 11 (Obstet Gynecol,2005 ;106 : ), (ART), ( IVF), ART,, ART

59 Basic & Clinical Medicine January 2006 Vol. 26 No. 1 : ( ) (13) 1 2, ( 11 ; 21, ) 1,73 2, 111,, 90, 3918, /,,,,,,,,Mur2,, phy,, 12 d, 3712, d, 38 39,, 3815, 40 d : WBC L - 1, 6913 %, Hb 102 g/ L, PLT L - 1 ; ASO 400IU/ ml ; ; ; 114 B, ; :, 38, ; CT:, 3816,, ; CT:,,,,1 d 1,,, 3918,,,, 20,,, 40, : 6 6,, L - 1, 1 U, 200 mg/, / L :, 112, cm,,, ; T 36, BP 105/ 70 mmhg,, 2, :

60 (1) Basic & Clinical Medicine 107, : : HBcAb, ANA, 1 : ,AMA 1 : 320, AMA2M2 166 RU/ ml,aca 1 640, 1 64 HSV2Ab : IgM, IgG :, CTD, 2 1 HIV2Ab HCV2, 40 mg Qd Ab TB2Ab PPD RPR 1 mg/, 2,, :AFP CA CA125, 6,, : :,, CT:, CT:,,,,,,, CT ;,, CT ;, ; : : WBC, Hb g/ L,pH L - 1, : 116 % : 013 g/ L,RBC 1 3/ HPF, 116 : WBC 6 8/ HPF, RBC / HPF ( ) 2,PT +? A : PT 1212 s, FBG mg/ dl,aptt 3419 s ESR : mm/ h ; CRP : mg/ L :Alb 4317 %, %, %, 2818 %,A/ G 0178 Ig : IgG 1917 g/ L, IgA 4171 g/ L, IgM 315 g/ L > 500 g/ L : LAM 11 g/ L, KAP 1611 g/ L : ; 260/ mm 3, 1/ mm 3, 1/ mm 3, 0/ mm 3, ; TP 2019 g/ L, ALB 814 g/ L, LD 48 U/ L, Cl mmol/ L, GLU mg/ L ; ADA 715 U/ ml ; ; CT Kwart, ; DIC : FDP 5 10 g/ L,D2dimer 0155 mg/ L, IgG: 766 ng/, 10 7 PA : :ANA : 1 : ;AMA ; AMA2M2 166 RU/ ml ; ACA ; : C g/ L, C4 595 g/ L dsdna ENA ANCA RF ACL :,,, : 0, 2 2 < 011 :, 7 7 : Schirmer : R 3 mm,l 4 mm BUT: R 2 s,l 3 s :R,L EBV2Ab : IgM 1 80,IgG 1 20 CMV2Ab : IgM,IgG, ; B :,, B : UCG ECG? ( ), CT, CT,, CT:, 8 25 :,, 8

61 108 Basic & Clinical Medicine (1) 29 :, 6,,, 9 19, ( :, PLT ) ( ) 7 21 CT( ) : ( ),,,,,,, 9 9, CT( + ) :,, ;,, ;,,,, ;,,, ;,,,,,, CT, ;,, 10 15, ;,, PPH,, (2) :? : :,, ; :,,, ; :, :,,,,?,,, 212 ( ),,, : (1) :,,,, 2? 4, 5 10mL,,,,,,, :, 6, ; :,,, B,,,,, (3) : CT,,,,

62 (1) Basic & Clinical Medicine 109,, ACA,,,, ACA SSA SSB,,, SSA SSB,,,,, AMA2M2, CT : ( PBC),,,, GGT ALP, B,, PBC,,,,,,,, 213 ( ),,, 4, SLE,,,,, CT, PBC,,,,,,,,,,,,,,, CT,,,,,,,,,,, CT,, 2 PPD,,,, : ANA ( ) 640,ACA 1 640,AMA2M2, PBC,,,,,, PBC,

63 110 Basic & Clinical Medicine (1) PBC, PBC, PLT AMA2M2, 40 %, PBC, 5 % 10 %,,, : :, B, T ; :,,, PT APTT,, 40 mg,,,,, B, MTX, IVIG,,,, ACL 2GP1,,,,,, 215 ( ), PBC,,,, 40,,,,ANA 500 mg 3 d,,,,,, SS, ( ), CT, SSA SSB,,,,, 6,,, AMA2M2,, PBC,AMA M2, 2 3,, IgM,, CT,,,,,,, PBC,,,,,, PBC CT,, GP210 AMA,

64 (1) Basic & Clinical Medicine 111,,,,,,,, CT,,, CT,, 217 ( ), :, ;,,,,,,,,,, EDTA,,,,,,,,,,,,,, ;,, : 218 ( ),,, PBC, ;, 3 : DIC :,, : 20 2 CT,,,,,, ; ; TTP :,, :, TTP, :,, 2147 g/ dl,,,, ;, :

65 112 Basic & Clinical Medicine (1), ; :, CREST,, 80 % 98 %,, 1/ 4, PBC,, ;,PBC,20 %, M2,ANA, SSA,,,,,,, PBC, PBC, 2110 ( ) 219 ( ) (AMA), ; (ACA),, ;M2,AMA PBC, 90 % 95 %,, 73,,

66 Basic & Clinical Medicine February 2006 Vol. 26 No. 2 : ( ) (14),,, (, ) 1,74 2, 220 RU/ ml,iif2anca( , :,,, 2, (70 %) HRCT( CT) :, ;,,, d Scr mol/ L, BUN 21120mmol/ L,ESR 140 mm/ hr,crp 794 mg/ L 20 mg Qd),11 2, : 140/ 70mmHg, CTX( ) 200 mg Qod( 2 ),, :,24 h 0156 g, Scr mol/ L,BUN 2115 mol/ L,MPO2ANCA ( + ) 7 d ACS( ),,10 ml, ; 5 10 / 30, 112 : 130/ 90 mmhg, ; 115, ;, 72 min - 1,, ; ( - ), ; ;,,,? 113 : WBC L - 1, HgB 84 g/ L, Plt L - 1, : ( - ) ( + ),, ;24 h 0169 g Scr mol/ L, BUN mol/ L, K mmol/ L, Ccr ( ) 13 ml/ min ; hs2crp > 100 mg/ L ; MPO2ANCA( 2 ) ) > 1 80 : :, mg Qd 7 d ( : (SV2PDA, SV2OM3, LIMA2LAD), mol/ L, CRRT,6 d,?? : China Academic Journal Electronic Publishing House. All rights reserved.

67 216 Basic & Clinical Medicine (2) 116 ;,Scr mol/ L,? : ( ) (1) (CABG),, CT (RPGN),,, mol/ L,,,, 60 mg/ d 1, (2), CTX 012 g/ (2 ), : 3 ml/ kg,,,,,, h, >, 4412 mol/ L 25 %, 10 ;, 2 % 2 3 ;,,, ; 2 3, 90 : 120 ml, (Scr < mol/ L), 80 %,Scr 48 h,4 5 d 212 ( ),,,,, ;, 2,, ;,,CRP ),MPO2ANCA( + ),IIF2ANCA( + ) > 1 2,,,,CRP,MPO2ANCA ( + ), ANCA,,,2 3, 80,2004 8,,, 018 % 110 % ; 412 %, 515 % ; 0106 %, 0118 % : % (n = 57), 77 % (n, Scr 9712 mol/ L, = 22), 27 % (n = 71), : > China Academic Journal Electronic Publishing House. All rights reserved.

68 (2) Basic & Clinical Medicine 217 CABG 1, (Scr > mol/ L), :, ;, 150, > 70 Scr > 200 m,, mol/ L, ;,, : ;, 41 %, 22 % : 50 %, :,28 % 61 %,30 %,, 54 % :,,,,,,,ANCA( - ), 1/ 3, > 60, :,,, ;,, ; CABG,,, ;, 1, 64 % 87 %,,1 79 % :, 2, 2, 214 ( ),, ;,,,,, ;,, ; MPO2ANCA, 220 RU/ ml, MPO2ANCA, ;, 65 mg, qd 1 ; 4, 213 ( ),, p2anca, ANCA : 717 %, 114 %, 019 %, 19 %,, 63 % CABG :, China Academic Journal Electronic Publishing House. All rights reserved.

69 218 Basic & Clinical Medicine (2), ( ),, 216 ( ),, avf V5 V6 ST,,,,,,,,, 70 %,,,,,,, IVIg,,,,,, 215 ( ), 217 ( ),CT,,,,, ;, ;, ARDS,,, ANCA MPN Wegener, Churg2Strause Wegener,, ;, ; MPA,,, Churg2Strause,,,,, CT,,, 218 ( ),, China Academic Journal Electronic Publishing House. All rights reserved.

70 (2) Basic & Clinical Medicine 219,,, 2110 ( ),,,, ANCA,MPA,,,,,,,,, MPA RPGN,,, 2111 ( ),, 219 ( )? 2112 ( ),,MPA,,,,,,,,, 25 %,, 2113 ( ),,,,, 2,,,,, 60 mg qd,,, BIOCOMPARE (2005/ 12/ 27), tetrahydrocannabinol,, CB1 rimonabant ( AcompliaTM) (Neuron), CB1 (leptin) (LH),,CB1, (DSI), leptin DSI,leptin CB1,leptin,, leptin China Academic Journal Electronic Publishing House. All rights reserved.

71 Basic & Clinical Medicine March 2006 Vol. 26 No. 3 : ( ) (15),,, ( ) 1, ; ( 1 7) : :WBC( ) 10,25 5, 9 L - 1, EO 7018 % 8313 %,Hgb g/ L,PLT( ) 10 9 L :ALB g/ dl 5 ( - ), ( - ), ( - ), : 29 mm/ h ANA dsdna ANCA ENA,, ( - ) IgE 590 IU/ ml :,, 2 ( EO),, ( + ) CT:, 10 cm 10 cm 1 : (WBC) CT:,, L - 1,EO 6413 %, (Hb) 128 g/ L, : ; M E = (PLT) L % ; : : : : HLA ( - ), DR CD11b CD15 CD10 CD13 40 % ( + ), 10 mg Qd 200 mg Qod NAP : 26 %, 38 2,, EO : bcr/ abl ( - ) :,, 12 %, 4414 %,,, 45 mg Qd,,,,, 20 cm 10 cm,, :,,,, :,,,, 3 cm 1 cm,, ; ( - ) Bid ; 110 / ; 2 cm, 2 cm,,, ; 014 Qd,, : Bid,, 10 cm 20 cm 8 cm 75 mg Qd cm 3 5 cm,, ;,, :

72 334 Basic & Clinical Medicine (3) 1 ( ) 5 ( ) 2 ( ) 6 ( ) 3 ( ) 7 ( ) 4 ( ) 43 % ; :, : > 7 %, > L - 1 ; : < 15 %, < L - 1 ; 15 % 50 %, ( ) 10 9 L - 1 ; 50 % 90 %, > L - 1, > L - 1, : (HES) / (CEL) : ,, 211 ( ), :, 5, ; CEL, HES, EO, HES,Ph CEL 2/ 3, ; > L - 1, 60 % ( - ), bcr/ abl : 85 % BM 2 % 20 %,

73 (3) Basic & Clinical Medicine 335 : >,, : L - 1, 6 ;,,, ;,,, ;,, IL25, IgE ;, ;, < 5 % ;, ;,, ; IgE ;, > 70 %,,,, (HD) :,,, 213 ( ),,, Churg2Strauss (CSS) :, T,,,,,,, ; :,,, ANCA,, :, :, ( ), ( CML) 2M4EO (AML2, M4EO) (ALL) Wegener : :,,C2ANCA, : :,,,,, :, :, Churg2Strauss (CSS), CSS, ;, :,,,,, :,,, 214 ( ), : 212 ( ),, T :CD3 ( + ),CD20, ( - ),MPO ( + ),CD30 ( - ),granzymeb

74 336 Basic & Clinical Medicine (3) ( - ) : abl, CML,, T, Langer2, : han s T AE1/ AE3 ( - ),S2100 ( + ), CD34 ( + ),CD3 ( + ) T,, Langerhan s,, Langerhan s, ; 215 ( ),,,,,,,,, HES,, 3, Sezary,,,,, CML WHO, CHOP HES CEL, > 20 %, (CTX 112 D1, EPI 110 mg D1, VCR 2 mg D1, Pred ; 2 % 20 %, 40 mg D1 5), CEL,, bcr/ BIOCOMPARE (2006/ 1/ 23), Neuron, strychnine BIOCOMPARE (2006/ 1/ 23),, 1 19 (Nature), 2 5 2AMP, 5π2AMP, 5π2AMP,,5π2AMP 2 1 Insubria Anne M. Grandi 1 (Am J Cardiol,2006 ;97 :71-76), 1,,

75 Basic & Clinical Medicine April 2006 Vol. 26 No. 4 : ( ) ( 16) 1, 2 3, ( 11 ; 21 ; 31, ) 1 ( 1,2),,51 43, 3, 3 8 mm, cm, 7,,,,, 2 5 mm,, 10, ; :,, ;, 16, :,,,3, ; 1,, ;,,,, 2 3 Π 5 6 Π,, ;, 1 2 Π,,, 3 ; 15 kg : ;1961,2001 ; 15, 180Π 90 mmhg, ; 1963 ; , 1 2 :

76 (4) Basic & Clinical Medicine 445, ; : ;, : 3 5 cm,, : ( ) ( - ),, ( - ), :, ; Murphy ( - ), AE1ΠAE3 ( + ),AFP( + ),CgA ( + ),Syn ( + + ), EMA :, 3 5 mm, ( + ),SMA( - ),CEA( - ),Ki267 ( - ), 113 ; OB + III( - ) ; D2 :115 gπ5 h ( 260 ml) ; ANA dsdna ( - ) ; ESR 15 mmπh ; CRP 3164 mgπl ; : ; CEA 4 ugπl, CA 50 1 UΠmL, CA UΠmL, CA UΠmL ; ECG ; :, ; : B :, ; :, 114, B : ;,, ;,, 1 2 Π, CT :,,,, ; 2, ; ;?? 211 ( ) ; :, ; : ( 3) : ( ) :, ; ( ) ;,, ; ( ) : ( :, 4) :, ; :,,:, ; 3, 3 4, ;,, : Gardner Peutz2Jeghers Cronkhite2Canada Cowden, :Cowden Cowden, 2 8 mm,,,

77 446 Basic & Clinical Medicine (4), ;33 % 45 % ; ( HER22Πneu ras PS22 ), PTEN (10q23), Cowden,, : Cowden : 5 Cowden??? 212 ( ) 213 ( ) : 3 1, : ; 2,, : ; ;, Gardner Turcot,,,,Cowden Peutz2Jeghers,, ( 5), Cronkhite2Canada,, : Peutz2Jeghers, :, (FAP) :, Gardner : 3 : Cowden Corn2 (FAP) khite2 Canada, Turcot : (20 30,, < 100 ), > cm, 3 B : 10,,,,,, Peutz2Jeghers :,,, Ki67 ( ), Cowden,,1963 :,, AE1ΠAE3 EMA ( + ), ( PTENΠMMAC1 ; CgA ( + ) Syn ( + + ), ), ;,,,AFP ( + ), AFP,,,

78 (4) Basic & Clinical Medicine 447, Cowden, Cronkhite2Canada (CCS),,,, 2 2 ( ), CCS,,, 31 86,80 % > 50, : ; : ; den, ; ; ; 1Π3 ( 92 %) ( 80 %),, Π PTENΠ ( 100 %) MMAC1 ( ), 216 ( ) 91 % 90 % 87 %, ( ), CCS CCS, 1715 %,, Cowden,,, ;, ;,,,,,,, : ;, ;,,, :,, Cronkhite2Canada ; Cowden Cowden ;, : : ( 11 ;21 ), ;, (B ) ( ) (B ), (CT), 214 ( ),, ; Cow2,, den,,,? PTEN,, 215 ( ) Cowden, Cow2 Cowden ( ) : Cowden,,, 2 PTEN, Cowden,, Lhermitte2Duclos (LD) (, Π ) Bannayan2Riley2Ruvalcaba,, (BRR) (, 1 ),

79 448 Basic & Clinical Medicine (4) CT 217 ( ) Cowden :,, (, ) ; ; Cowden + ( %) ( ),,, (50 67 %) ( 3, 10 %) ; Π (76 %, Π ) (25 50 %) ; (40 %),, ; (38 %) ; 2, ; (44 % ) (, AFP? ), :,, 80 % PTEN,10q23,2Π , 40 % 5,, 3, 1973,,,,, Π? Cowden, %,,, 7 8 cm ; 50 %,, ;, 3 cm, Cowden,,,,, Peutz2Jeghers 40 cm, : Crnkhite2Canada, 218 ( ) ;, :CgA NSE Syn AE1ΠAE3 ( + ), 1,, Vikram Patel Martin Prince 3 (Br J Psychiatry,2006 ;188 : ),, 3, John D1 Fernstrom 3 (Arch Surg,2006 ;141 : ),,

80 Basic & C linical M edicine May 2006 Vol. 26 No. 5 : ( ) (17) 1, 2, 1 ( 11 ; 21, ) 1, 14 3, 2, , 38, L - 1,, 5 mg/ 3,, Tmax 39, 5 7 pm, ANA (1 80),, 24 h g, (ACL ) ; PLT L - 1, L - 1, 60 mg/qd 8 /qd,,,, ( 7 ), A ( 12 ), 1,, : : 112,, ( + ),,, 120 /,,,,,, ; 2 cm,,,, ( + ) ; ( + ), 9 /, 113 : :, ITP,,, 300 mg/qd 2, CT ; 192 mm H 2 O, 9115 mg/l; MR I,, 10 d,, ICP > 340 mm H 2 O, 6511 mg/l,, 2 4 h ;,,,,,,,,,, ; 1,,,, 200 mg/, 800 mg/,,, 2 MTX 10 mg : China Academic Journal Electronic Publishing House. All rights reserved.

81 (5) Basic & ClinicalMedicine ,,,, ;,, , CT, ACL ( ),,, 2 3 m in, m in,, : CT, MRV MRA,,,, CT MR I ( 1) ; MRV,, kpa,,, ; PET 1 M R I : H IV ( - ), TB 2Ab ( - ) ; ESR 36 mm /h; CRP 1217 mg/dl :DNA (ANA + ds2dna ) ( - ) ENA,, 550 ng/10 7 /L, ( ANCA ) ( - ), ( ), ;, SMA 1 80; CH ku /L, C g/l, C4 < g/l : CT,,, ; : ( + ), 1150 /mm 3, 110 /mm 3, 2%, 98% ; : TP 31 g/l, ALB 113 g/l, LDH 211 U /L, GLU 0114 g/l; : ( - ), 280 /mm 3, 190 /mm 3, 60%, 40% ; : TP 217 g/l, ALB 11 g/l, LDH 95 U /L, GLU mg/l ( ), 8, :, ; : ; :,, ; :,, ; : ; : ; ANA, ACL, : ( SLE) :,, ACR ( 1982 ) SLE ACR SLE, ANA SLE99% ANA, SLE : :,,, : ; 8,, ; PET,, : NP2SLE; ; ; ( ) ( reversible pos2 terior leukoencephalopathy syndrome, RPLE ) H inchey 1996, 15:,, (1 17 ) CSF China Academic Journal Electronic Publishing House. All rights reserved.

82 558 Basic & ClinicalMedicine (5), ;,,,,, : ; ; ; RPLE A FK506, IV IG, CHOP RPLE RPLE, A, A 5, A RPLECTX MTX, CTX MTX RPLE? : SLE? SLE?????,? 212 ( ) : ; ( ), ;,, ;,, 213 ( ), ( ),, :,,, ; ;,,, ;,,, 214 ( ) : ; ( ) ; ( ),,,, ;,, ( ) 215 ( ),, :,, ; ;, PET, ACL, ;, 216 ( ),, SLE, Sm ds2dna, ANA, ANA SLE ANA SLE,, SLE ANA SLE ANA 97%, 90% ANA SLE 4% 13%, : SSA ; SLE ANA ; ; China Academic Journal Electronic Publishing House. All rights reserved.

83 (5) Basic & ClinicalMedicine 559 ANA ANA SLE: ; ANA : a ; b ; c,, ANA SLE ( 10% 3% ), 1 /3 ACL, 1 /3, 1 /3 ANA, 1 /3 ANAITP, SLE ITP, ( ) ( ), ANA, SSA, SLE ( ) (NPSLE), SLE, 24% 51%, SLE, SLE NPSLE, : : ; : ; : NPSLE, ACL ( ), NPSLE, ( - ), 217 ( ) : ; ; NPSLE,, : ( ) MRV, CTX,,, (DSA), A,,, ( ),,, PET,, 218 ( ),,, SLE SLE SLE, ANA Sm ANA, ACL, ACL, ANA, SSA ANA, SSA SLE ANA, ACL,, ANA, SLE, SLE ANA,,, 219 ( ),,,,,?? 2110 ( ) NPSLE, rrnp CTX, CTX, CTX, ( 200 mg/ ),, 2111 ( ) China Academic Journal Electronic Publishing House. All rights reserved.

84 560 Basic & ClinicalMedicine (5),, RPLE MRV,, DSA, DSA 2112 ( ) SLE,,?? 2113 ( ),, 2114 ( ) SLE,, ;, PET,,,,,, DSA 3, 10% 715%, MDS2RAEB : 3%, 5%, 19%, RBC, RBC, 46, XX; MDS : ;,, ;,, MDS, rrnp, ;, 24 h 1111 g,, MR I ( 2) : RPLE, CTX,,, RPLE;, 50 mg/qd 20 mg/ tid,, 4 2 M R I I (MRSA ) China Academic Journal Electronic Publishing House. All rights reserved.

85 Basic & C linical M edicine June 2006 Vol. 26 No. 6 : ( ) (18),,,,, ( 11 ; 21, ) 1, 19, , 1,,,, 15 m in,, :WBC L - 1, N 83%, Hb 116 g /L, PLT L - 1 CT, Tmax 3911, : WBC L - 1, N 9217%, Hb PLT CRP 4514 mg/l, TB 2Ab ( - ) ANA ( + ) SN 1: 160, PPD ( ), CXR ( - ) CSF, 210 mm H 2 O, : ( + ), 79 / L, WBC 76 / L, 58 / L, 18 / L; GLU 58 m g / dl, PRO 85 m g / dl, C l mmol/l; TORCH ( - ) MR I T1 T2,,,, 3715,,, 1 1,, 4 h, : 1, 6 :, 112 T 3714,,,, ; I,, 2, 1 1 cm 2 cm,, ; 2 3, ( - ), V, ( - ), Babinski ( ), ( - ), , 4 d Tm ax ,, 1 8,,,,,,,, Tm ax B,,, : WBC L - 1, N 7510%, L 1914%, E 015%, Hgb 128 g /L, PLT L - 1 +OB ( - ) : ALT 14 U /L; ALB 44 g /L, TB IL :

86 (6) Basic & ClinicalMedicine m g /dl, Cr 0174 m g / dl, K 3196 mmol/l CSF : 210 mm H 2 O, WBC 76 / L, 58 / L, GLU 58 mg/dl, PRO 58 m g / dl, Cl11619mmol/L, ( - ), ( - ), ( - ), TORCH ( - ), ( - ), 1 512, OB ( - ), MBP 4179 nmol/l, ( - ) : H IV HCV RPR EBV 2Ab CMVpp65 ( - ) TORCH: RV 2IgG ( + ) 1 40, CMV 2IgG ( + ) 1 128, HSV 2IgG ( + ) 1 256, ( - ) ( ) ( - ) : ESR 7 54 mm / h, CRP 1182 m g /dl : A lb 5218%, 1 318%, %, 918%, 2117% Ig : IgG 1615 g /L, IgA 2157 g /L, IgM 110 g /L, IgE IU /ml ANA ( + ) SN ; SMA AMA ( - ) ENA ANCA RF ACL rrnp ( - ) : CH U /ml, C m g / dl, C mg/dl ( - ) HCY mol/l (5 15) T : B T NK, T (CD4 + T 107 /mm 3, CD8 + T 79 /mm 3 ), CD8 + T : EKG T UCG EF 61%, TCD, CXR ( - ) BUS, ; CT, ;, CT, MR I, ; MR I,,,,,, ; : : 015, 016; :, ; : ( ) ; PAS ; ; ( - ) : ( ),,,,,, : PAS TB 116 ( - ) (?) ( ) :,, 1, :,,,,,, 2 /6 SM, : 1, 6,,,,, CSF, WBC,, CSF, CSF TORCH : PAS, ( - ) :,, PAS ( - ),,,,, CSF WBC,, CSF, : ( 1) :,,,, CSF,,,,,,

87 670 B asic & C linicalm edicine (6), T, CD4 + T, CD8 + T, :,, 20% 75%,,,,,,,, CT,,, :,,,, CNS,, CSF,,,,,,,, :,,,, 7 8 9,,,, CSF,, CSF, ( 2) :, 6 4,, CT,, CSF,,, CT, ( 3 ) :,, CSF WBC < 100 / L,,,, ; CSF ( 4) :,, UCG,, IE ( 5) CNS : :,,,,, :,,, CSF :,,, ( 6 ) CNS : ( 7 ) : :,,, CSF,,,, :,,,,, ( + ), ( + ), :,,, CT;, 45 : 2 2,,,,,, :,,,,,,, ;,,,

88 (6) Basic & ClinicalMedicine 671 :,, 7 10 d, 80% 90%: 80%, 2, ph ;,, ; : B, 2 4 g,, B, ( posaconazole), 1983, 2, ( ), CNS, 2, 2,,, M EDL INE : , = 3 2, (32 11) (16 68 ) 34, 22 (6417% ), 12 ( 3513% ) 20 B 12,, 40% ; 8 14 B 13, 9219%, B 2, 34 1 :,,, T CD4 ;, ;, ;,, CNS,,,,, CSF, CNS : SLE:,, 2 2, SLE, :, : CNS,?, : :?? : 4, 200 mg/d B 25 mg/d, 556 m g? 212 ( ), 1 ; CT, CT CT,, CT, CT MR I CT T1 T2, MR I + MRS T1 T2 ;, ( T1, T2 ), ;, ;,, MR I ;,, MR I, ; CT,, : :,,, :,, MR I,, :, :

89 672 B asic & C linicalm edicine (6), 213 ( ), :,, :,,,, CSF,,,,,, CSF,,,,, CSF,,,,, CSF,, CNS :, ; 2 CNS, (1, 1 ), 1, 1,,,, ;, PAS,, CNS 214 ( ) :,,,, ;, ;,,,,, ;,,,,,,,,,,,,,,, 215 ( ) ; PAS; ( ) ( - ),,,,, 6 10 m,,, GM S,,,,,,,, B 216 ( ) MR I,, CT,,,, 217 ( ) CNS,,,, 10,,, T,

90 (6) Basic & ClinicalMedicine 673, CD4 + T CD8 + T, CNS 218 ( ) :, 1 CNS,,, 60%,,,,,,?,,? :,,,,

91 Basic & C linical M edicine July 2006 Vol. 26 No. 7 : ( ) (19),,, (,, ) 1 B 5 d,,, 2,,,, 51, T: 3911 P: 120 /m in R: 22 /m in Bp: 160 / mmhg 1, ( 3814 ),,, < 1, cm,,,, Pro2 + Ery5 +,, CRP, ALT 48 U /L ( - ), 120 /m in,, SM Murphy s ( - ) UCG B ( - ) 113 Still, 114,, 39 ( Tmax 41 ),, WBC, /L, NEUT%, Hb ( g/L ), PLT CRP 195 mg, ESR 112 mm /h ENA ASO RF ( - ) 3 ( + ) PPD ( - ) : Hb 90 g/l, WBC L - 1, N 8812%, E 415%, L 415%, PLT L - 1, RET 1122% :, 76% 84%, 2% 11%, 1% : 0 - TRACE ( - ) ALT U /L, ALB 24 g/l 24 h g 5,, 1 2 /d,, 3 kg : OB ( - ) : ALT 89 U /L, AST 96 U /L, GGT 81 U /L, ALP 177U /L, LDH 933 U /L, ALB 26g/L, Cr 0183 mg/dl, +, PT + A: PT 1316 s, INR 1115R, Fbg , 150 /80 mmhg, mg/dl, APTT 4012 s, TT 3410 s ESR mm /h, CRP mg/dl :

92 (7) Basic & ClinicalMedicine : AST U /L, LD U /L, HBD U /L, CK 100% CK2MM : SI 23 ug/dl, TIBC 391 ug/dl, TS 6%, SF 1000 ng/ml IV 260 ng/ml : ANA dsdna ENA ANCA RF LA ( - ) ACL ( + ) - ( ) : 1 SMA ( + ) 1 80, 1, ( - ) : ALB38%, a1 814%, a2 1612%, 2513% Ig : CH U /ml, C3 165 mg/dl, C4 ( - ) : HBV H IV HCV RPR ( - ) PPD ( - ) TB 2Ab ( - ) EBV: IgG/VCA ( ) CMVpp65 ( - ) TORCH1 RV 2IgG ( + ) , CMV2IgG ( + ) , HSV2IgG ( + ) ( - ) 3 ( - ) 1 MRSE, 2012 h, : CA ( - ) CA U /L : B : UCG: (56 39 mmhg) ECG ; CT ( 6-16) :, ; ; CT ( 7-8) :, : : ( ) ; : : 1, 27%, 2,,, ( - ) : O 95%, I 5% ; + (2 ) :,, / :,,,,,,,, :, : CD3 CD20 CD79 CD68 MPO ( + ) : ( ),,,,,,, : ( + ) : 0106 ml /m in, mg/l /3 q12 q8h,,,,,, 60 g/l, 2u, 10 g 13, 1,,, 5 d,, 15 mg q 12 h, 3912,, 25 mg q 12 h, 116 : :?? ( ) CT,,, CT,,,, 212 ( ), 2,,

93 800 Basic & ClinicalMedicine (7) +,, NSA ID s, Hb,,,, NSA ID s, 11 Still :,WBC,,, 21 : :, ANA, SMA ACL, 31 : WBC,,,, LDH > 1000 U /L,,, 41?,, ; 51 : +,,,? 2,? : 11? 21,?? 31? 41? 213 ( ), 2, :, (,,, ),, Hb, A lb, ACL ( + ), ANCA ( - ), Still 11, Still 30 21, 2, Still,,,,,?,,,, ( ),, 11, 21, V Gotten,,,,,,, Jo - 1,,,, MTX 214 ( ),,,,,,,,, T,, 215 ( ), CT,,,?,,,,?,,,, CT, 216 ( ), 2,,, (CRP ESR SF D - dimer ),

94 (7) Basic & ClinicalMedicine 801 LDH, LDH,,,,,,,,,,,,,,,, 11,,21 PCR - HH? 31, PET 41,,,,,,, 2110 ( ),,,, Hb 8 9 g/dl,, LDH,,,, EPO,, EPO,, EPO 2111 ( ) 217 ( ), ACL ( + ),, CT,,,?,,,, 10 15%,,, MR I,,,, MTX,,, 2112 ( ) DNA,,,,,,,,,,,, 2113 ( ),,, 218 ( ),,,, 219 ( ),,,

95 802 Basic & ClinicalMedicine (7) ( ),,, ( - ),,,, ( ) 2114 ( ),, : ;, ;, ;, ;, ;,,, (,,,,,,,,,,,?,,, Hb PLT WBC Hb,WBC,,,, EPO,,,,,, Hb 2115 ( ),, Still,,,,,,,,,, Still ), 150 Still,, mg Qd 10, CTX 2, WBC L - 1, Hb 93 g/l, PLT L - 1, : ALT 26 U /L, ALB 317 g/dl, GGT 49 U /L, ALP 99 U /L, LDH 256 U /L CTX 110 iv drip, 1 /,, 1 WBC /L, Hb 99 g/l, PLT /L,

96 Basic & C linical M edicine Sep tember 2006 Vol. 26 No. 9 : ( ) (20) 1, 2, 2 ( 11 ; 21, ),, 39 5, , 3 5 d,, 3, 3815, ;, ;,, 3915,,, CT, B,???,,, 41, 1, T,,,,, : UCHL21 ( + ), CD3 ( + ), CD20 ( + ) CHOP ( CTX 800 mg d1, 600 mg d8 + EP I 70 mg d1 + VP mg d12d5 + Pred 60 mg d12d5), 4, CT, ( IFO 2g d123 + DDP 40 mg d123 + VCR 2 mg d1, d8), CT IFO 2 g d123 +DDP 40 mg d123 +VCR 1 mg d1, d8) 3,, CT 2 N IH / NC I,,, 3 CT CT 2 ( IFO 2 g d123 +DDP 40 mg d123 + VCR 1 g d1, d8) 3, TCR: 128 /A ( + ), 10 ( - ), 11 ( - ), ( - ) ; IgH: VH ( - ), R3A ( - ), R2 ( - ) ; IgK ( - ),,, ; ; ;, 9 kg : 1992 EB 1998 : ,, : 112,,,, 80m in - 1,,,, :

97 1042 Basic & ClinicalMedicine (9),,, : ESR 33 mm /h, CRP : ALB 5318%, 2318%, A /G 1116 ANA + S 1 160, SMA , ds2dna ENA ACL LA ANCA RF Ig 24 ( - ) T : CD4 + T, CD8 + T, CD8 + T : CMV2PP65 ( - ), TORCH: RV2IgG ( + ) 1 80, CMV2IgG ( + ) 1 128, HSV2IgG ( + ) 1 64 EBV2IgA /VCA ( < 0129) : WBC /L, N 4813% 5516%, Hb PLT : N 39%, L 44% V itb12 :M E 1182,: Hu Yo R i ( - ) :, PET :, CT :, 3,, CT :,, : ( ),,, ( ),, : UCHL21 ( + + ), CD20 ( + ), CD68 ( + ), EBER ( - ) : CD3 ( + + ), CD20 ( + ), CD79 ( + ), TTF - 1 ( - ), CD34 ( + ) ( ) CT :,,, CT, 212 ( ) CT,,,,,,,,, W egener, W egener,,,, PET 3,, 213 ( PET ) PET: 11, 21, ,,, PET,, 214 ( ) :,,, CT PET 3,, N IH /NC I,, CHOP,,

98 (9) Basic & ClinicalMedicine 1043,,, 3 : 11, ; 21,, ; 31,,,,, ( 5% 8% ),,,,,,, CD4 + T, ( B ), EB,, 4, 38 88% 4,,,,, 3,,, 2,, ,,, ( ) ( ) ( : 1, 615 1) 90% : 9, ( 6 3),, (40 60 ), 30% 70%, (,, 80% ),, (6616% ), 3313% PaO %, 1 67 mmhg( mmhg) 80%,,, (1 8 cm),,,,, 40%, 25% (5, ( 36% 53% ), 3, 1 ) 10% 35%, 41, ,,, CT,,, CT, ( ), CD4 +, CD20 +, CD +, SMA - CTX +VCR + Pred, 21 d 1, 4 CT,, 1, CT L iebow

99 1044 Basic & ClinicalMedicine (9) 1972, 30,,,,,,,, ; 1 /4,, ;,,, (,, ) W egener,,,,,,,, 1982 Fauci, [ 1 mg/ ( kg d), 2, 2 ] ; ; [ 2 mg/ ( kg d), 37 ], 5 ; IgM IgG 46%,, 17, 5 2, 1113, 65% 90%,, 50%,, ( ) 15% 25%, , 1,,, 216 ( ),, CT,, W egener,,,, PET,, ;,, ;,,,,,,,

100 (9) Basic & ClinicalMedicine 1045,,,, :,,,,, PET, ;, 3, ;,,,,,,, N IH /NC I,, B, EB RNA, T B B ; B,, ; B,, B, ;, ;, 5,,,,,,,, 217 ( ), 80,,,,,,, 3-5cm, 3 3,1,,, 10,,, CHOP, 5,,,,, CHOP,,,,,,,, 2,,, :,,,,,,,,, 5,,,,,, 218 ( ), : ;;,,, 3, 1, 2,, 2,

101 1046 Basic & ClinicalMedicine (9) 1,, 2,,,,,,,, 219 ( ) 1,, EBV 2,, 1, EBV, ,,, EBV 2110 ( ),,,, W egener,,ct,, 2110 ( PET ) PET PET,, CT B, 2111 ( ),,, 3, ( ),,, B IOCOMPARE (2006 /8 /3), Scripp s ( an2 ti2obesity vaccine),,, ( yo2yo dieting), 8 4 PNAS, 2ghrelin Janda : ghrelin,, 1999 ghrelin,,,, ghrelin,,, ghrelin,,,, ( Immunopharmacotherapy), Ghr1, Ghr2 Ghr3,, Ghr1 Ghr3 ghrelin, ghrelin Ghr1 Ghr3,, ghrelin ghrelin,,,,

102 Basic & C linical M edicine November 2006 Vol. 26 No. 11 : ( ) (21),,, (, ) , 69 1, B ( - ), 3 2 cm 017 cm,, PT + A, B + 2, 34 /m in, 130 m in - 1,, 86% CT (CTPA ), ICU,,, APTT2R (2 ) d 3 mg Qd 14 d,, PT2INR ( 2 ) d, 3, 112 2, 731, cm, cm; : 2, : 30 ; 5 ; 4 : ( - ) PT + A, UCG:, ; ; ; ; ,,, 10 L /m in, : 89%, BP: 150 /70 mmhg, : 120 m in - 1, 3075 IU 2, 15 m in 47%, 35 m in, ( ) , ICU / 28, / (76251 ) 01037% 28 : % % % % 1 316% 1 316% : China Academic Journal Electronic Publishing House. All rights reserved.

103 (11) Basic & ClinicalMedicine 1287 : 26 85, : , 17, , 3517% 1 30, 615 d : 9219% 90% ; 6719% /, / ; 25% / ; 711%,, : 6 D2D immer (D2 ), 4 2 FDP ( ) 13 V /Q, 12,92% 5 CTPA, 4 1, : 5711%; 2510% + ; 711% ; + 316%, 2, : 7510%, 2510% /, 5 /7 (pulmonary embolism, PE),, 90% PE ( pulmonary thromoembolism, PTE) PE ( deep vein thrombosis, DVT) ( venous thromboembolism, VTE) PTE DVT, DVT ) ; DVT 1) : 20% ( 2) : 44% ; 3)(LDUH) : 68% ; 4) (LMWH) : 76%,,, DVT 40% 60%,,, 312 ( ), VTE > 1 /1000, 50% PE 3 15% 25% 75% VTE 1 ( ET PV) ;APC ( FV Leiden ) G20210A ( PC PS AT2III) VTE, DVT 80%, DVT PE, 50% PE DVT, PE PE, 70% DVT, DVT ; DVT PE, VTE PE, W ells ( Thromb Haemost, 2000, 83: 4181) PE, PE,, 3 :, < 4% ; ( PE) :, 5% 10% ; ( PE) :, 30% PE CTPA /, D2 VTE 98%, China Academic Journal Electronic Publishing House. All rights reserved.

104 1288 Basic & ClinicalMedicine (11) 99% VTE, FDA PE r2tpa (LMWH ), LMWHAPTT,,, LMWH 5 d, PT2INR , LMWH, (ACCP),, 3 ;, 6 ;, ( ) / (V /Q) ( PE), ( 7 9 m ),,,,,,, ( 99 Tcm2DTPA 99 Tcm 2GP ), < 110 m,,,,,,,,,, PE V /Q PE PE PE, PE 100% 90% 50% 10% 0% PE PE, ;, CTA,,, ;; PE, CTA PE, CTA V /Q 314 ( ) CT1992,, CT,, 30 m in, 5 mm, CT, CT, CT,,, 16 CT, 1 mm 016 mm 93%, 572%, 1998 CT ( combined multislice CT venography and pulmonary angiography, CTVPA ), 170 s,,,, (multip lanar reconstruction, MPR) (maximum intensity p rojection, M IP) ( volume rendering technique, VRT) ( curve p lanar reconstruction, CPR ),,,, MPR,,,,, 7% 12%, PE,, CTPA,, China Academic Journal Electronic Publishing House. All rights reserved.

105 (11) Basic & ClinicalMedicine 1289,,M IP,,,, 70%, 6215% CTV,, CT,,, X, CTPA, 87%, CT X, 86% 98%, 66%, X CT, CT,, CT,, CTPA, X CTPA,,,, CTPA,, CT CT,, CT DVT,,,,,,,, ACCP,,,,,,, - DVT, 100%, X, CT, PE CTPA CTV, 5% DVT PE, DVT, CTVPA,, X, CT,, CT,, 315 ( ), , 50, 1615%, ( 57 ), 50 14, 28% : 16%, 14%, 12%, 10%, 8%, 4%, 6%,, 8%,,,,, DVT, : 1) China Academic Journal Electronic Publishing House. All rights reserved.

106 1290 Basic & ClinicalMedicine (11) 2),, PO 2 3), 4)1 14, 3 4,,, 50 44, 8 6,, 6 : 1),,,,, 2),, 3), 4),, : 1),, 2), 3) DVT,, 316 ( ICU) ( PE) (DVT),, (VTE) DVT PE Geerts 2001 Chest DVT ( ) 29%, PE 116%, PE 019%, 80% DVT, VTE 11VTE (1) (2), ( GCS) ( ICP) (3), (LDUH ) (ADH) (LMWH) VTE, VTE : ) ( ( > 45 m in) ( > 45 m in) > 72h : : (1 ) > 60 (2 ) DVT/PE (3 ) (1 ) 1 (1 ) (2 ) (1 ) (BM I > 25) (1 ) (1 ), : 20210A Leiden ( C ) S C 3,, VTE GCS ICP GCS ICP GCS ICP LDUH /LMWH LDUH /LMWH LDUH /LMWH, China Academic Journal Electronic Publishing House. All rights reserved.

107 (11) Basic & ClinicalMedicine 1291 VTE, ACCP: :,,,, : VTE < 40,,, 40 60,,, 40, 5000 U, 2, 3400 U, 1 > 60, > 40, 5000 U, 3, 3400 U, 1, ( 5000 U, 3, 3400 U /d),,,, 21VTE (1) : VTE, : 14 d : UK ( ) 2 U / kg, 2 h, rtpa mg 2 h 2 PT APTT, 2,,, 7 ACCP,,, VTE,,,, : 5 d, PE, 10 d 1,, INR 2, ICU 3, 3 5, INR,,, : Xa IIa, ;,,, APTT, (, ), 4 ( PF4 ),, (H IT), (Ccr < 25 ml /m in) ( > 150 kg), (UFH ), (2) VTE,, VTE,,, PE, PE,, 3 ;, 6 12 ; 2,,, 2 2 PE, China Academic Journal Electronic Publishing House. All rights reserved.

108 1292 Basic & ClinicalMedicine (11),,, INR , (3),, INR ,, LMWH UFH UFH VTE 3%, APTT2R ,,, 2( H IT),, 4 d,, /L, 5 d, IgG, /L, 1 /3,,,,,,,,,,, VTE VTE VTE, 317 ( ICU),,,, VTE,,,,,,,,,, adalimumab EvanstonKenneth B. Gordon 10 (J Am Acad Der2 matol, 2006; 55: ),, G1 adalimumab 3 Gideon Koren 9 ( Fertil Steril, 2006; 86: ), 3( PCOS),, 9 (J Clin Psychiatry, 2006; 67: ), Kuop io Tuula H. Heiskanen,, 1 /3 Heiskanen,,, China Academic Journal Electronic Publishing House. All rights reserved.

109 Basic & C linical M edicine December 2006 Vol. 26 No. 12 : ( ) (22),,,, (, ) B MR I ; ( ) ;, 3,,,, 24,,, G 0 P 0 1, 10, BP: 120 /80 mmhg, ( - ) ;, 111 ;, /30, 15 cm;, ( - ), ; 2003,,, , 10 cm, :,, ( ),, ;, ( 1 2 /10HPF) B, : ( ) : ( mm ), ( ) :,,, cm :MR I( ) :,,,,,, ;;,, 5 5 ( 1) CT :, 4 cm 3 : ( ),,, ( 4 5 ; /10HPF), ( ), ( 2) B : ,,, B 319 cm, 014 cm, ; cm,, CDF I B ; cm; 410, 118 cm;, cm, : ; DDP 50 mg + EP I 40 mg, ( ), CDF I,; : China Academic Journal Electronic Publishing House. All rights reserved.

110 (12) Basic & ClinicalMedicine cm, (119 cm), (017 cm ), cm,, : ; ; ; 116? ( ) 2 1 M R I ( ),,,, 14,, ;, CT MR I ;,,,,,, 212 ( ) 1,,,, ;, ;,,, ; 7,,,,,,, : : ; W arm2like,, 48 mmhg, :, ( ), :,,, ;, > 5,, ;, GFR: ml /m in, 2012 ml /m in,, 8812 ml /m in;, 7 2,, 5,, : CA125 CA199 CEA AFP, uncertain low2 CEA grade ( ) ( ), MR I,, CT, China Academic Journal Electronic Publishing House. All rights reserved.

111 1404 Basic & ClinicalMedicine (12), CT,, CT :;,,,,,, 214 ( ),,,,, DJ,, 215 ( ),,,,,,,,,,,,GnRH2a; GnRH2a GnRH2a 216 ( ) 4 200, 7, 2 21, 72,,,,,,,,,, 217 ( ) 1, ;,,,,, 45,,,,,,,,,,,, 218 ( ), ( 48 mmhg),, UCG,, 219 ( ),,,,,, 2110 ( ),,,, 60 70%, CD117 CD34, 2111 ( ), 2,,,, China Academic Journal Electronic Publishing House. All rights reserved.

112 (12) Basic & ClinicalMedicine 1405,, 2112 ( ) :,, 2,,,,,,,,,,,,,, IVP, 5000 ml 3, ( 4), ( 5), cm, 70 /30 mmhg, 20 g/l,, 6 cm,, 13 cm,,, ml, 6000 ml,, 311 :, ; ( 3), IVP:, :, ,,,,, 313 5,, 1 2 /10HPF; ( BV0 /2) ; ; China Academic Journal Electronic Publishing House. All rights reserved.

113 1406 Basic & ClinicalMedicine (12) ;;, : CD34 ( + ), CD117 ( - ), Desm in ( + ), ER ( - ), PR ( + ), Ki267 ( + ) ,, 5 cm 3 cm 250 mg B id , 7 1: 43, 218, , 1, 2 1,,,, 4, 1, 2 : 4, 2, 1, 2 13, 1,,, 1896, 1 / / , TAH + RSO cm 2, IVL /1 6 cm cm TAH + IVL /2 4 cm 4 cm TAH = BSO + IVL / /2,, 16 TAH +BSO IVL cm, TAH +BSO, 18 cm, 13 IVL /1 6 TAH + IVL 9 cm 10 cm / TAH +BSO 5 IVL China Academic Journal Electronic Publishing House. All rights reserved.

114 (12) Basic & ClinicalMedicine 1407, 200, , 45, 90% 24, 30%, 10 30% 8 2,, : ; [ 1 3 ],, [ 4 ], 2,,,, ;,, MR I CT,,, [ 1 ],, [ 5 ],, 4, 1, 2,, 0,, :, /,, ;,,,, 1,,, 1, 3, 1,,,,, CT MR I, 5,,,,,,,, 7, China Academic Journal Electronic Publishing House. All rights reserved.

115 1408 Basic & ClinicalMedicine (12) : [ 1 ] Merchant S, Malp ica A, DeaversMT, et al. Vesselswithin vessels in the myometrium [ J ]. Am J Surg Pathol, 2002, 26 (2) : [ 2 ] Quade BJ, Dal Cin P, Nesky DM, et al. Intravenous leio2 myomatosis: molecular and cytogenetic analysis of a case [ J ]. Mod Pathol, 2002, 15 (3) : [ 3 ] Dal Cin P, Quade BJ, Nesky DM, et al. Intravenous leio2 myomatosis is characterized by a der (14) t (12; 14) ( q15; q24) [ J ]. Genes Chromosomes Cancer, 2003, 36 ( 2) : [ 4 ] Kokawa K, Yamoto M, Yata C, et al. Postmenopausal in2 travenous leiomyomatosis with high levels of estradiol and estrogen recep tor[ J ]. Obstet Gynecol, 2002, 100 ( 5p t2) : [ 5 ] Merchant S, Malp ica A, DeaversM T, et al. Vessels with in vessels in the myometrium [ J ]. Am J Surg Pathol, 2002, 26 (2) : ,, [ 4, 52b ] ( Ph IP),, (BaP), Ph IP,,, Ph IP 137 BaP ( ) Ph IP ,, 868, 520 ( III IV ), 10 g,1. 4 ( 95% : ),,, Ph IP Cancer Res, 2005, 65 (24) In conclusion, very well done meat was positively associated with p rostate cancer risk., China Academic Journal Electronic Publishing House. All rights reserved.

116 Basic & ClinicalMedicine March 2007 Vol. 27 No. 3 : ( ) (23) 1, 2 ( 11 ; 21, ), , 3815,, 10, 1 /, 1,, 112, ( ),,,,,, 2 d, 170 /110 mmhg,, 3 mm,, PaO mmhg (, 1 mmhg = Pa), SaO 2 87%, , : : WBC ( 7146 ( ),, 911) 10 9 L - 1, N 65% 6918%, Hb 120 g/l; ALT 27 U /L, AST 30 U /L, GGT 17 U /L, ALP, 50 U /L, TP 69 g/l, A lb 41 g/l, Cr 141 mol/l, CHO 20 d,, 315 mmol/l, TG 211 mmol/l, LDL 212 mmol/l; (ARDS), ; ; PT +A ( - ) ; PaO, 500 mg/6 h, 75 mg, mg, 40 mg WBC ( mmhg, SaO % ; ESR 14 mm /h; CRP 1011 ) 10 9 L mg/l; HB, Hb g/l, Cr 0192 sab HBcAb ( + ), H IV HCV ( - ) ; RPR ( - ) ; ( - ) ; PPD ( - ) ; Ig 2129 mg/dl, HAV HCV H IV ( - ) ; ( - ) ; ANCA ( - ) ; 2 + ; 2 ( - ) EBV CMV ( IgG + ) :, ESBL ( - ) ; 1 + HB sab HBeAb HBcAb ( + ) ; ( - ), MRSA; : MRSA canca panca ANA dsdna SM ( - ) ; CH50 C3 C4 1,,, 3 d,, 10 d, 30 mg/d 3 5 mg 5 mg, 300 mg/d, 2, CT CRP 16 mg/l; ESR 26 mm /hr; ( - ) ; ANA dsdna ENA Jo1 Scl ( - ) ; ; 1997 : L - 1, 10 3 L - 1, > 100, 4 ( - ), ( - ) : B : ; : China Academic Journal Electronic Publishing House. All rights reserved.

117 354 Basic & ClinicalMedicine (3) ; ECG ; : : :, ; : ( ), 114,, 1, ,,,, :,, : 2, 10 cm 10 cm 5 cm,,,, 1 cm,, : 10 cm 5 cm,??,,, (CTX) 200 mg ( ) 11 d,, 22 d, 1,1 CT,,, 3 CT,, CT, CT, ( 1) 212 ( ) :,,,,,,, 1 CT,,,,,, ( DAH) DAH : ( 1): (APS) Goodpasture ( HSP ) IgA (MPA) ( SLE) (W G) ; (2) : D IC : ( 1) : W G? MPA? (2) Goodpasture? ( 3 ) :? : W G W G : ; ;,, canca DAH W G : Travis 87 W G, DAH 7% (Am J Surg Pathol, 1991, 15) DAH China Academic Journal Electronic Publishing House. All rights reserved.

118 (3) Basic & ClinicalMedicine 355 W G : DAH ; ;;, (CTX) 66% W G, DAH,, canca, W G,, (MPA) : MPA, 50,, DAH,, 80% ; ANCA,, MPA Goodpasture :, DAH,, GBM, : ( IgG) GBM 27%, :, DAH, :, CT, ; ; :,,?,? CTX? 213 ( ),,, 6 5 mg, 214 ( ),,,,,, CT,,,,, 215 ( ),,, S ( ) K ( ) L ( ) E ( ) N ( ),,,,MPA, 18, 216 ( ) : IgA + +, IgG C3 +,,,,,,,,,, IgA, 217 ( ),,,,,, China Academic Journal Electronic Publishing House. All rights reserved.

119 356 Basic & ClinicalMedicine (3), Churg2Strsuss,,,,, IgA, IgA, IgA,,, IgA, IgA, IgA 218 ( ),,,, 219 ( ),,,,,,,,,,,,,, 2110 ( ),,,,,,,,, 2111 ( ),, + CTX,,, 2112 ( ),,, ARDS,,,,,,, 2113 ( ),,,, 2114 ( ),,,, 2115 ( ),,,,,, T, 3 60 mg/d, CTX 600 mg : ( ), ; ( ), : ( - ), ( - ), AB /PAS ( - ) ; CTX,, CTX800 mg, China Academic Journal Electronic Publishing House. All rights reserved.

120 (3) Basic & ClinicalMedicine CTX CT ( mol/l mol/l ), CTX 1 g 2, 20 d CT:( 2),20 mg/d, CTX 514 g, 8814 mol/l,,, ( growth2stimulatory pathway) RT2PCR W estern (NSCLC) 86%, EL ISA, ( anastrozole),,, A549, 21,, Cancer Res, 2005, 65 (24) Treatment of tumor cells in vitro with anastrozole led to significant supp ression of tumor cell groath China Academic Journal Electronic Publishing House. All rights reserved.

121 Basic & C linical M edicine Ap ril 2007 Vol. 27 No. 4 : ( ) (24),,, ( ),, 25, 1, 3, ,,,, 38,,,,,,,, 3715, ; RBC /L /L; Hb 117 g/l 59 g/l; PLT /L /L, ESR 103 mm /h CRP 6122 mg/dl CH u /ml C mg/dl LDH 960 u /L 3 d,,,,, 10 kg : 3 : 112 T: 3710, P: 90 /, R: 21 /, BP: 130 / 60 mmhg,,,, 3 4 cm,, ; ( - ) 3 ; Kernig ( - ) ; ( - ) : : Hb 31 g/l RBC /L WBC /L, PLT /L + OB: : GGT 91 u /L ALP u /L AST u /L LDH u /L OB ( + ) : > 330 mmh 2 O 35 /mm 3 1 /mm mg/dl, ( - ) : :, ; (8% ) (2% ) (1% ) ( ), :, : : CH U /ml, C 3 C 4 ; IgG 6148 g/l IgM g/l; ESR 40 mm /h; ANA dsdna ENA ANCA ACL ( - ) : TORCH: CMV2IgM ( + ) ; H IV EB 2Ab CMVpp65 ( - ) : CA U /ml, AFP CA192 9 CEA : ; CT: B : CT: ; MR I:, :, :,, : China Academic Journal Electronic Publishing House. All rights reserved.

122 (4) Basic & ClinicalMedicine , 38,,, CT,, CNS, ( 5 mg) ( 250 ml Q 4 h ml Q 12 h) ( ) 200 mg Qd,,, WBC, PLT > 5 /mm 3,,, : BP 130 /75 mmhg,, 3, ( + ), ( - ) : Hb 52 g/l, PLT /L ( ),, CT,,,, :,, (MM ), 218 MM 30, MM ( acute myelofibrosis, AMF) : (MF),,,, MF AMF,,,,, 1 AMF ( AML2M7), MF ; AMF, :,, LDH, 212 ( ),,,,,,,, ( ),,, : (1),,, ( 2 ), (3),, ( 4),, : (1),, (2), (3),,,, 213 ( ), 3,, :,,,,,,?? MRA, CT,,,, China Academic Journal Electronic Publishing House. All rights reserved.

123 474 Basic & ClinicalMedicine (4) 214 ( ),, ( 1),, ( 2), AE1 /AE3 ( + ), : 1 F ig 1 Large ma lignan t cells in bone marrow w ith little hem opo ietic tissue and hyperpla stic f ibrous tissue 2 F ig 2 Imm unoh istochem istry of bone marrow AE1 /AE3 ( + ) 215 ( ),, :,,, :,,,, :, KPS,, :, :,,,, :( ), ; 177, 1195: 1, 4617 ( 4 81 ) 8311%, 5519% 4011% 4512%,, 216 ( ),,;,,, ;,,,,,,,,,, 3 : ( 1), ( 2) (3) 217 ( ),, :,, 1 /3, 2 / %, China Academic Journal Electronic Publishing House. All rights reserved.

124 (4) Basic & ClinicalMedicine 475,, : (1) :, (2) : (3), 50%,,, 8, 2 3, 2148,, 2148 : (1) :, ( 2) (3) : 3 9,, 50%,, 218 ( ), : (1), ; (2), ; (3) (MF), MF, MF MR I, ECT,,,,, Anthony R. Green 2 1 (N Engl J Med, 2007; 356: ),, Janus (JAK) 2, JAK2 V617F, V617F,, V617F,, ADHD, Gelderse Vallei Marcel G. Sm its 2 (J Am Acad Child Adolesc Psychiatry2007; 46: ), ( sleep2onset insomnia) (ADHD),, Sm its,, B IOCOMPARE (2007 /2 /6),,,,,, :,,,,,,,, Giovanna Mallucci, (Neuron) China Academic Journal Electronic Publishing House. All rights reserved.

125 Basic & C linical M edicine May 2007 Vol. 27 No. 5 : ( ) (25) 1, 1, 1, 1, 1, 1, 1, 2 ( 11 ; 21, ) 1, mmhg; 4174 mmol/l; ; ; ; CT ; CT ;, 111, 2,, 1 /,, ( ) 2003,,, : 1 2 ( 1),,, 112,,,, BP: 140 /100 mmhg, H t: 130 cm ( 3 3 ( ), W t: 3715 kg ), 14, ( 3 ), BM I: 2212 kg/m 2, 2 B,, ( + ), ( + ), ( + ),,,,,,,, , BP: 160 / ( 2),, ( - ) 1 :

126 594 Basic & ClinicalMedicine (5) : WBC /L, N 8018%, Hb 145 g/l, PLT /L; + OB ( - ) ; ( - ) ; : ALT U /L, ALP U /L, K 4125 mmol/l, Cr 57 mol/l, GLU 412 mmol/l, TG 1168 mmol/l, CHO 6142 mmol/l, LDL2C 3143 mmol/l, HDL2C 2167 mmol/l; 24 h 0109 g; : FT3 FT4 TSH ; PRL 017 nmol/l; : E pmol/l, FSH 417 IU /L, LH 014 IU /L, T 213 nmol/l; GH < 0135 g/l; ng/l; 59 g/l; 3 h OGTT: FBG 411 mmol/l, 2 h PBG 818 mmol/l, 9182 m IU /L, 2 > 300 m IU /L, IGT ; : nmol/l ( 8 am ), nmol/l (4 pm), nmol/l (0 am ) ; ACTH < 212 pmol/l (2 ) ; : 24 h UFC g/d, g/d, 24 h UFC g/d, 24 h UFC g/d; ECG:, ; UCG: ; B :, ; X :, ; : T2score 514 (L224) ; : 16 ; CT: ; B : ; B : ; B : ; MR I: ( 3) ; CT: ( 4),, 4 CT mg q 8 h 120 / 80 mmhg, ( p rimary p igmented nodular adrenal disease, PPNAD ),, Carney ( Car2 ney comp lex, CNC), PPNAD , : ( 5) ; : CgA ( + ), 2inhibin ( + ) 5

127 (5) Basic & ClinicalMedicine Carney ( PPNAD) ( ),, 3,,,,, ; 3, ; : 1 2 : BP 140 /100 mmhg, BM I 2212 kg/m 2,,,,,,,,,?? ( - ) :, ; ; ACTH < 10 ng/ml, ACTH :MR I ; CT, Carney comp lex, PPNAD Carney comp lex, 1985 J1 A idan Carney, ( PPNAD ) 40% 60% camp A ( PRKAR1A ) ( 17q22224) ; 2p16 Carney comp lex : ; : PPNAD ( GH ) ; :, ; : N IH ( 1998 ) Carney comp lex : PPNAD L iddle Sertoli (LCCSCT) B ( ) ; : PRKR1A, + 1 CNC : : IGT, ; : X2ray:, ; : T2score2511 (L224) ; B :, ; : CHO ; ; : PRL ; E2, T ; GH, 120 /80 mmhg ; ; ; Carney,,,, 212 ( ) Carney PPNAD,,?,,,,,,? 213 ( ) PTH, 214 ( ), ACTH < 10 ng/l,,,, PPNAD,

128 596 Basic & ClinicalMedicine (5),,50 mg, 215 ( ) 2001 Carney,,,,,,, Carney,, 216 ( ), ACTH, PPNAD,,,,,,, 217 ( ),,, 3,, 218 ( ),,,,, 2,, 3,,, 115 kg, 110 /70 mmhg,, : 295 nmol/l ( 8 am ), nmol/l (4 pm ), nmol/l ( 0 am ) ; 24 h 2818 g,, 4 4, 7 10,,10,, 24, , 1500 / :38, : : ( suncw@ bjmu. edu. cn, ) (phsiology@ bjmu. edu. cn, ) :,

129 Basic & Clinical Medicine January 2005 Vol. 25 No. 1 : ( 2005) , 1, 1, 2 2, ( 11 ; 21, ) 1 (WBC) ,,39, 31, 9 / L, ( PLT) / L ; B : 510 cm, 5, cm 2 6,, : 1 2 mm, ( - ), : :, 3 4,, : ( ) : K2F B 12,, :7,, 70 cm, :, 1, : (Crohn s disease) 10 mg 1/,2,,,,1 :,,, :,,,,,,,,,, 30, 1 7 1, B,Hb g/ L, PLT / L,WBC 3, 5 20 / d,,,,,b :, B 12,,, 1, : Hb 60 g/ L, ( 2 211, : (Hb) g/ L, : ), 5 mg 2 2,, 10 /, 2003, :Hb 23 g/ L,WBC / L,Plt 14 (1979 ) 1, : : China Academic Journal Electronic Publishing House. All rights reserved.

130 (1) Basic & Clinical Medicine L - 1 : (ALT) (713 % %),Alb 5312 % (5410 % 6517 %), 23 U/ L ( < 40 U/ L ), ( ALB ) 2415 g/ L ( g/ L ), ( TBIL ) 0193 mg/ dl ( mg/ dl ) 1 ( Cr ) 1175 mg/ dl ( < 115 mg/ dl) : FT 4 TSH : 20 g/ dl ( g/ dl), 187 g/ dl ( g/ dl), 1110 % (30 % 5 %) : B 12 :, 0102 ( > 0112) : 1215 umol/ L ( umol/ L) :,WBC 78/ ul, ( + ), ; 018 g/ dl, LDH,, Hb 23 g/ L 47 U/ L, ALB 29 g/ L ( 5 g/ L),, ( - ) ( - ) ( - ), : :HbcAb HBeAb ( + ), ; 212 HIV2Ab HCV2Ab TB2Ab ( - ) ( - ) :,,, : AFP ( - ) CA U/ ml ( <,, 35 U/ ml),ca199 CA242 CA50 CEA ( - ) :,,,,, 0153 ( <,, 0150) :,,HR :80 / min, II, BUS :,,, 117 cm[ (1117,,, ( + ) ( - ) 0113) cm],,, : CT( + ) :,,,,,,,,, :,,Hp ( - ), :, : 10 cm,,, : ( ), :,M : E = 1139 :1, 1, :Hb g/ L,WBC ( ) 10 9 L - 1, PLT (23 49) 10 9 L - 1, ( + ) ; K2F ( - ) % : 3181 % ( 015 % 115 %), ( - ), 5 3 :, : ALT AST, mg/ dl ( mg/ dl), mg/ dl ( mg/ dl), ( TP) g/ dl ( g / dl), ( ALB ) g/ dl ( g/ dl), A/ G, Cr mg/ dl ( < 115 mg/ dl) ( ESR) : 24 mm/ 1 ( < 15) : % (114 % 115 %), % 1812 %(1016 % 2315 %) :320 g/ L ( < 140 g/ L) T3 < 014 mg/ L ( mg/ L), FT pmol/ L ( pmol/ L), T 4 :,, : UCG ECG : K2F (1),,, (2), ALB, CT, A/ G,, China Academic Journal Electronic Publishing House. All rights reserved.

131 92 Basic & Clinical Medicine (1), (wilson disease, WD) 3 (3) WD :WD ;WD 20,, : 39, WD ; (1) :,,, WD K2F :,,, (4) :,, ( (2) : ),,, ( ), (5) : DNA,, WD ;, ( ) ( ) ( ) ( ) : (3) WD : WD,, ( ml) K2F,,,, WD 1 5 cm,,, K2F, 115 cm,, 190 cm,,, WD 7 9 cm, 7 8 cm ( - ), WD 20 cm, K2F,,, WD 112 m, (4) :,, 2,, 39,, 1, , :WBC 1511X10 9 L - 1,Hb 50 g/ L,PLt 214X10 9 L - 1 (5) : : ( ),,,,,, (6) :, ( - ), ;, 4,,, 3,, ( ),,, China Academic Journal Electronic Publishing House. All rights reserved.

132 Basic & Clinical Medicine November 2005 Vol. 25 No. 11 : ( ) ,,, (, ) 1 (1),,, 55 2, 1,,, 2,,,, 2 4, ml/ d, :,,,,, CT, ;,, 1 / 5 ; 6 d,, 1,,,,,,, 1 2 / 10 d, ; :,, B (BUS) ; CT ; 30, %,,,,,, X, AL T 36 U/ L, TP 615 g/ dl, ALB 317 g/ dl, TBil 2171 mg/ dl, DBil 1124 mg/ dl ; (OB) ( - ) ; ; BUS,, ; CT, ;, ; ; ( ) ( 9 00 CT, 9 00 ) : 10, 2 (2) :,, ; : AL P, ( - ),,, ( - ), ( - ), : : :,,, /,,, ( ), ; : 65 U/ L, TB IL 4172 mg/ dl, DB IL 2166 mg/ dl,,,, GGT 108 U/ L, AST 69 U/ L, K 218 mmol/ L, Na : :

133 1072 Basic & Clinical Medicine (11) mmol/ L, CL 7317 mmol/ L ; (CA) ( PSA), ; : BUS 0163 cm, 6 15 ( 25 ( PSV) 3517 cm/ s ( ),, 60 ) ;, 36 ; 2 8 mm ( mm) ; 914 cm 416cm,, < 10 cm ;,,,,,, ( 1), CT :,,, ; ( 2) : 1 2 CT ( superior mesenteric, ; 4 6 h ; ( ) ; X,, SMAS,,,, SMAS, SMAS, : ; ;,, HBV,, 6 cm 515 cm,,, Roux - Y :,,,, SMAS, artery syndrome, SMAS),,, 6 cm,, CT?,,,

134 (11) Basic & Clinical Medicine 1073, ( 2),,,, 1 CT, Diana O. Perkins 10 (Am J Psychiatry, 2005 ; 162 : ),, Perkins,,,,, Certolizumab Christian2Albrechts Stefan Schreiber 9 ( Gastroenterology, 2005 ; 129 : , ), TNF, Certolizumab Certolizumab II, Certolizumab pegol Tufts Brigitte T. Huber 9 (J Rheumatol, 2005 ; 32 : ), (RA) HERV2K18 HERV2K18 HERV2 K18, EB,, T, RA Young Yull Koh 10 (Allergy, 2005 ; 60 : ), BIOCOMPARE (2005/ 10/ 13),, (SIDS),,,,,,, ( Pediatrics)