子痫前期患者血清胱抑素C和尿酸检测的临床意义

目的 评估血清胱抑素C （CysC）、尿酸（UA）在子痫前期患者早期肾脏功能损害中的价值.方法 对58例轻度子痫前期患者、68例重度子痫前期患者及62例正常晚期妊娠妇女（对照组）血清中CysC、UA、Scr、Urea水平进行检测.结果 轻、重度子痫前期组的CysC、UA值与正常妊娠组比较,差异均有统计学意义（P＜0.05）,且轻、重度子痫前期组间的差异亦有统计学意义（P＜0.05）.虽然Scr、Urea在重度子痫前期组与正常妊娠组间差异有统计学意义（P＜0.05）,但是各组的值均在正常参考值范围内.结论 CysC、UA可作为评估子痫前期肾功能损害的敏感指标,对其进行动态监测,有利于肾功能损害的早发现、早治疗,改善孕产妇及围生儿结局.     

孕中期子宫动脉血流多普勒检查预测妊娠期高血压临床研究

目的探讨孕中期子宫动脉血流多普勒检查预测妊娠期高血压病的临床意义。方法对2010年2月-2012年11月在我院接受彩色多普勒超声检查的孕24~28周HDCP患者进行分析,研究子宫动脉血流阻力指数与HDCP患者围生儿预后的关系。结果重度子痫前期患者子宫动脉血流PI、RI值明显高于对照组、妊娠期高血压组和轻度子痫前期组（P〈0.01）;重度子痫前期患者围生儿预后明显较正常对照组、妊娠期高血压组和轻度子痫前期组差（P〈0.01）。结论利用多普勒超声检测子宫动脉血流阻力,可以很好的检测HDCP患者的病情程度,还可以为改善新生儿的预后提供方法。     

血清尿酸在妊娠期高血压疾病子痫前期预后评价中的临床意义

目的 探讨血清尿酸预测妊娠高血压疾病子痫前期的临床意义。方法 检测80例子痫前期孕妇血清尿酸值。结果 子痫前期患者血清尿酸值显著高于正常孕妇（P〈0．001），重度子痫前期组血清尿酸值显著高于轻度子痫前期组（P〈0．001），血清尿酸值越高，围产儿预后越差。结论 血清尿酸值可预测子痫前期患者及围生儿的预后。     

妊娠期高血压疾病患者血清瘦素、胰岛素水平变化及相关性研究

目的:测定妊娠期高血压疾病(HDCP)患者和正常孕妇血清瘦素(Leptin)及胰岛素(INS)水平,探讨Leptin、INS与妊娠期高血压疾病发病的关系.方法:采用放射免疫法测定40例HDCP患者和40例正常晚期妊娠妇女的空腹血清Leptin和INS水平,分析两者相关性,同时测量体重指数和血压.结果:(1)HDCP组血清Leptin、INS水平高于正常妊娠组,P＜0.05;(2)HDCP患者中轻度子痫前期组Leptin水平高于妊娠期高血压组,P＜0.05;重度子痫前期及子痫组高于轻度子痫前期组,P＜0.05;(3)HDCP孕妇血清Leptin与INS水平呈明显正相关,相关系数r=0.767,P＜0.01.结论:HDCP患者血清Leptin水平明显升高,且随病情的加重有逐渐升高趋势,HDCP血清Leptin与INS呈正相关关系,高瘦素、高胰岛素血症可能共同参与了HDCP的发生和发展.     

妊娠高血压患者C反应蛋白与褪黑素的检测及意义

目的通过检测妊娠高血压疾病患者血清C反应蛋白（CRP）和褪黑素（MT）水平,探讨其与妊娠高血压疾病严重程度的相关性。方法选取轻、重度子痫前期患者及正常妊娠晚期孕妇各30例,检测其血清CRP值及MT值。结果重度子痫前期患者血清CRP水平明显高于轻度子痫前期患者,且重度及轻度子痫前期患者血清CRP水平高于正常对照组（P〈0．01）;正常对照组血清MT水平明显高于轻度子痫前期患者,且轻度子痫前期患者血清MT水平明显高于重度子痫前期患者（P〈0．01）。结论妊娠高血压疾病患者血清CRP水平明显增高,且其程度越重,血清CRP水平越高;妊娠高血压疾病患者血清MT水平较正常孕妇明显降低且随病情加重MT水平进一步下降。     

可溶性血管内皮生长因子受体-1在子痫前期的表达及临床意义

目的探讨可溶性血管内皮生长因子受体-1（sFlt-1）在子痫前期患者血清中的表达及临床意义。方法采用ELISA测定74例子痫前期患者血清中的sFlt-1水平,并与正常妊娠妇女相比较,同时常规检测其各项生化指标进行相关性研究。结果子痫前期患者的sFlt-1、24 h尿蛋白定量（Upro）、血尿酸（UA）、血肌酐（Scr）水平均高于正常孕妇,白蛋白（Alb）低于正常孕妇,两者比较差异有统计学意义（P〈0.05）;重度子痫前期组的sFlt-1、Upro、UA、Scr水平均高于轻度子痫前期组,Alb低于轻度子痫前期组,两组比较差异有统计学意义（P〈0.05）。结论血清sFlt-1的水平变化与子痫前期的严重程度密切相关,联合其他检测可以预测和判断子痫前期疾病的严重性,以便早期发现、及时干预,有效改善孕产妇及新生儿的预后。     

重度子痫前期终止妊娠时机与方式对围生儿预后的影响

目的探讨重度子痫前期最佳终止妊娠时机与方式。方法对2006～2009年诊治的358例重度子痫前期患者的临床资料进行回顾性分析,比较不同的终止妊娠时间和方式对围生儿预后的影响。结果终止妊娠时孕周〈34周的低体重儿、FGR、HIE、新生儿窒息及新生儿死亡的发生率明显高于孕周34～37周及孕周≥37周;阴道分娩组的HIE、新生儿窒息及新生儿死亡的发生率明显高于剖宫产组,均有统计学意义（P〈0.05）。结论重度子痫前期围生儿预后与终止妊娠时间及方式密切相关。终止妊娠孕周〈34周,围生儿预后差,所以在病情允许的情况下最好保守治疗至34孕周后终止妊娠;剖宫产是重度子痫前期最佳终止妊娠方式。     

妊娠期高血压疾病病人血CHE、GGT、LDH与病情程度的相关性研究

目的探讨妊娠期高血压疾病（HDCP）病人血清胆碱酯酶（CHE）、γ-谷氨酰转肽酶（GGT）、乳酸脱氢酶（LDH）表达变化及与病情程度的相关性。方法选取80例HDCP病人,依据HDCP进展情况分为伴严重表现子痫前期组21例、不伴严重表现子痫前期组34例、单纯HDCP组25例,另选同期68名正常妊娠孕妇为对照组。比较4组血清CHE、GGT、LDH表达,分析HDCP病人血清各指标表达与血压指标[收缩压（SBP）、舒张压（DBP）]关系及与病人子痫前期发生的关联性,探讨血清各指标预测HDCP病人出现不良妊娠结局的价值。结果SBP、DBP水平为伴严重表现子痫前期组>不伴严重表现子痫前期组>HDCP组>对照组（P < 0.05~P < 0.01）;血清CHE为伴严重表现子痫前期组<不伴严重表现子痫前期组不伴严重表现子痫前期组>HDCP组>对照组（P < 0.05~P < 0.01）;HDCP病人血清CHE表达与SBP、DBP水平均呈负相关关系（P < 0.01）,GGT、LDH表达与SBP、DBP水平均呈正相关关系（P < 0.01）。在控制年龄、孕前体质量、孕周、产妇类型后,血清CHE水平与子痫前期发病呈负相关关系（P < 0.01）,GGT、LDH与子痫前期发病均呈正相关关系（P < 0.01）。随访至分娩,出现不良妊娠结局HDCP病人血清CHE表达低于未出现不良妊娠结局HDCP病人（P < 0.01）,GGT、LDH表达高于未出现不良妊娠结局HDCP病人（P < 0.01）。血清CHE、GGT、LDH预测HDCP病人出现不良妊娠结局的最佳截断值分别≤ 2.83 kU/L、>32.16 U/L、>256.06 IU/L,其曲线下面积均小于联合预测。结论血清CHE、GGT、LDH异常表达是子痫前期发生的重要影响因素,并与HDCP病人病情程度存在一定相关性,三者联合预测HDCP病人出现不良妊娠结局效果更好。     

子痫前期孕妇血细胞比容、sVEGFR-1水平与围生儿结局比较

目的 通过对子痫前期患者产前血细胞比容（HCT）、血中sVEGFR-1水平的改变探讨其对围生儿结局的影响.方法 对2011年7月～2012年1月在辽宁朝阳市中心医院入院的41例子痫前期患者和19名正常妊娠者采集一般状况,用电子血细胞自动计数仪测静脉血的血细胞比容;采用酶联免疫测定（ELISA）试剂盒检测血清中sVEGFR-1水平.记录所有胎儿出生体重、Apagar评分,用Pearson检验进行相关性分析.结果 子痫前期组与正常妊娠组比较,孕期明显缩短（P ＜0.001）.无论收缩压还是舒张压均明显高于正常妊娠组（P ＜0.001）,子痫前期组HCT明显增高（P＜0.001）,血清sVEGFR-1水平亦明显升高（P＜0.05）,其中子痫前期早发型升高最显著（P ＜0.001）,23例早发型组中7例采用引产终止妊娠.围生儿出生体重子痫前期组明显低于正常新生儿组（P＜0.05）,其中以早发型组最低,与正常或晚发型组差异明显（P＜0.001）.此外,产后1min的Apagar评分正常新生儿19例全部是满分（10分）,明显高于子痫前期组（P＜0.001）.Pearson检验显示,产前孕妇血清sVEGFR-1水平与围生儿出生体重呈明显的负相关（P＜0.01,r=-0.54）.结论 本研究发现子痫前期HCT明显增高,产前孕妇血中sVEGFR-1水平与围生儿出生体重呈明显负相关,对预测子痫及其母婴预后有重要参考价值.     

重度子痫前期合并胎儿生长受限孕妇妊娠晚期血清氧化蛋白产物和胱抑素C水平表达及其临床意义

目的:探讨重度子痫前期合并胎儿生长受限孕妇妊娠晚期血清氧化蛋白产物(Advanced oxidation protein products,AOPP)和胱抑素C(Cystatin C,Cys-C)水平表达及其临床意义。方法:选取2015年6月-2016年12月就诊本院的重度子痫前期合并胎儿受限的孕妇40例设为研究组,根据预后情况分为预后不良组(28例)和预后良好组(12例),同期选取40例正常晚期妊娠的孕妇为对照组,采用免疫散射浊度法、免疫比浊法检测所有研究对象血清Cys-C和AOPP,比较研究组和对照组血清AOPP和Cys-C表达水平,并分析两者表达水平预测预后情况的临床价值。结果:研究组血清AOPP和Cys-C水平均高于对照组,差异均有统计学意义(P0.05);预后不良组血清AOPP和Cys-C水平均高于预后良好组,差异均有统计学意义(P0.05);经Spearman相关性分析,血清AOPP和Cys-C水平与预后情况呈一定相关性(r=0.721 541,P0.05);ROC曲线分析显示,血清AOPP和Cys-C水平预测重度子痫前期及胎儿生长受限孕妇预后具有良好的评估价值。结论:重度子痫前期及胎儿生长受限孕妇妊娠晚期血清AOPP和Cys-C水平明显升高,且AOPP和Cys-C水平与患者的妊娠结局有着重要的相关性,提示动态监测两者变化趋势有助于评估预后。     

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.