恙虫病并发心脏损害136例的临床分析

目的探讨恙虫病并发心脏损害的,临床特点。方法回顾性分析136例合并心脏损害的恙虫病患者的临床表现、心电图、心肌酶谱、超声心动图检查及转归情况。结果136例合并心脏损害的恙虫病患者中58．8％患者有心脏症状或体征：61.8％的患者有一项或多项心肌酶学异常,76．5％的患者有心电图异常;超声心动图检查无心内结构异常改变。结论恙虫病患者可伴有不同程度的心脏损害。大多数损害较轻,预后良好。     

108例狼疮性心脏病患者的病变分析

目的：分析狼疮性心脏病患的病变特征，为早期发现病变提供依据。方法：从住院确诊的136例系统性红斑狼疮(SLE)患中，筛选出108例心脏损害病例进行分析。结果：108例患中，心悸和气促等临床症状只占51．8％和37．0％；心电图、超声心动图和胸部X线表现异常，分别占79．6％(86例)、87．0％(94例)和16．7％(18例)。结论：SLE患的心脏损害较突出，发生率可高达79．4％，症状轻微时易被忽视，应对患做常规心电图、X线及超声心动图检查，以提高其心脏损害检出率。     

急性胰腺炎伴心脏损害78例临床护理观察

目的：探讨急性胰腺炎合并心脏损害的临床护理要点,方法：回顾分析223例急性胰腺炎患者心脏检查、治疗及护理的临床资料。结果：223例急性胰腺炎患者中出现心脏损害78例（35．0％）,老年患者心脏损害47例。结论：对急性胰腺炎患者应常规进行心电图、心肌酶、心脏彩色多普勒等检查,以便早期发现心脏受损情况,加之及时有效的护理,可提高临床疗效。     

系统性硬皮病的心脏损害

目的 研究系统性硬皮病(SSc)患者的心脏损害。方法对28例SSc患者临床和实验室资料进行回顾性分析。结果28例SSc患者中，临床有心脏损害6例(21．4％)，心脏可能受损8例(28．6％)。X线胸片、心电图、超声心动图检查发现心脏异常者分别为9例(32．1％)、12例(42．9％)、18例(64．3％)。结论SSc心脏受累并不少见，实验室检查对SSc心脏早期损害诊断具有一定的价值。     

系统性红斑狼疮心脏损害67例临床分析

目的探讨系统性红斑狼疮(SLE)心脏损害的特点,并分析年龄、性别、病程及疾病活动与SLE心脏损害的关系。方法收集我院2006年6月至2010年5月SLE住院患者117例的临床资料,根据检查结果分为心脏损害组和无心脏损害组。结果 117例SLE患者中67例(57.2%)出现心脏损害。心脏损害以心电图ST-T缺血性改变最多见,占44.8%(30/67),超声心动图可见心脏损害累及心包、心肌、瓣膜。心脏损害组与无心脏损害组之间年龄、性别差异无统计学意义,病程、疾病活动性指数差异有统计学意义(P<0.05)。结论 SLE可累及心脏各个部位,其中以心电图ST-T缺血性改变最多见,SLE心脏损害大多数患者症状轻微或无症状。SLE心脏损害与病程、疾病活动性相关。     

系统性红斑狼疮的心脏损害(附69例X线分析)

本文报告经临床证实的系统性红斑狼疮108例中69例(67.60%)有不同程度的心脏损害。女性62例(89.96%),21～40岁50例(72.46%)。心脏损害的主要临床表现有心悸、心脏杂音、高血压和心电图、超声心动图异常。81.20%的患者X线表现心脏增大,心脏外形大多呈主动脉型及普大型,69.65%的患者有肺瘀血,部分患者有胸腔积液、间质性肺炎等改变。所有的心肺X线表现并不具特征性,诊断必须结合临床表现、心电图检查及X线表现这三项资料,而X线检查对观察心包炎,肺循环、胸、肺改变较其他检查为优。因此,重视X线表现,对提高系统性红斑狼疮心脏损害的检出率,具有较大意义。     

系统性红斑狼疮心脏损害心电图检查的临床意义

目的探讨系统性红斑狼疮（SLE）心脏损害心电图检查的临床意义.方法2004年1月～2009年4刊于我院内科仔院的确诊SLE80例，没有心脏损害症状的患者进行心电图检查，进行回顾性分析。结果80例确诊SLE患者没有心脏受祟的症状和体征，但心电图榆查发现：46例有心电图改变，阳性率占57．5％，进一步做心脏超声检查发现39例有心脏结构或功能改变，阳性率占48．8％。结论SLE患者常规做心电图检查，可以发现无症状的心脏损害患者的心电图改变，进一步做心脏超声等检查，以明确红斑狼疮所致的心脏损害的程度，为治疗提供了重要的早期诊断方法。     

102例系统性红斑狼疮患者心脏损害分析

目的探讨系统性红斑狼疮（systemic lupus erythematosus,SEE）心脏受累表现,并分析年龄、性别、病程及实验室指标与SLE心脏损害的相关性。方法回顾性总结分析2003年5月至2010年3月宁夏医科大学总医院初诊SLE的住院病人102例,其中合并心脏损害59例,无心脏损害43例。结果SEE患者并心脏损害患者中心电图（ECG）ST-T异常23例（39．O％）,窦性心动过速13例（22．0％）,超声心动图（UCG）检查心包积液21例（35．6％）,瓣膜病变20例（33．9％）,肺动脉高压13例（22．0％）。心脏损害组与无心脏损害组之间年龄、性别差异无统计学意义（P〉0．05）,两组之间病程、血沉、C反应蛋白、抗ds-DNA结合率、补体C3、ANA负对数差异有统计学意义（P〈0．05）,经Logistic回归分析SEE心脏损害与血沉及抗ds-DNA结合率存在相关性（r=1．026和1．037）。结论SEE可累及心脏各个部分,对于血沉、抗ds-DNA结合率明显异常的SEE患者,需及时行心电图、超声心动图检查,以提高其心脏损害的检出率,改善患者预后。     

急性胰腺炎并发心脏损害的ICU治疗体会

目的探讨急性胰腺炎并发心脏损害的监护与治疗。方法对我院ICU收治的47例急性胰腺炎并发心脏损害患者心电图、心肌醇学变化及治疗措施、预后进行了回顾性分析，其中轻型组12例，重症组35例。结果于病程的1—3天内出现心电图异常者34例（72．3％）；心肌酶学变化：重症组的肌酸激醇（CK）及其同工酶（CK—MB）较轻型组明显增加，2组比较有显著性差异（P〈0．01），但LDH和AST的增加2组间无显著性差异（P〉0．05）。治疗后42例患者心电图及心肌酶学均恢复正常，平均住院时间为9．6天；5例并发多器官功能衰竭死亡，急性重症胰腺炎并发心脏损害的治愈率为89．4％。结论（1）心脏损害以心电图异常最为多见，对痰病的早期诊断有一定的临床意义。（2）CK和（或）CK—MB升高对于观察病情的危重程度与预后有一定参考价值。（3）监测手段的应用对于急性胰腺炎并发心脏损害的早发现、早治疗、提高治愈率有重要作用。（4）心肌损害的治疗应以保护心肌为主，提高冠状动脉供血，保持氧供需平衡。     

严重急性呼吸综合征合并肝损害的临床及病理研究

目的研究严重急性呼吸综合征(SARS)合并肝损害的临床及病理学特征。方法在病程不同时期,动态观察60例SARS患者肝功能指标变化情况,比较SARS重症组病例与普通组病例的肝损害差异。结果76.7%患者ALT升高(146.3±118.3)u/L、40.0%患者AST升高(81.3±29.8)u/L,30.0%患者Bil升高(35.3±15.6)μmol/L;病程第2周肝损害最多见。SARS重症组ALT,AST和Bil异常升高率高于普通组,但仅AST差异有显著性。激素治疗组与非激素治疗组间肝功能异常发生率的差异并无显著性。约93.5%患者经常规保肝治疗3周后肝功复常。1例尸检显示肝脏广泛轻度非特异炎症反应。结论SARS病人合并肝脏损伤相当普遍,表现为转氨酶的轻中度升高,少部分病例伴有胆红素的轻度异常,适当保肝治疗是必须的,也是有效的。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.