中青年心肌梗死患者的危险因素分析及冠状动脉病变特点分析

目的评价中青年心肌梗死的危险因素及其冠状动脉病变特点。方法入选我院2001年1月至2003年12月初发急性ST段抬高型心肌梗死患者124例,按照患者年龄分为中青年组(30~45岁,42例),老年组(60~70岁,82例),将两组临床特点(性别、年龄、吸烟、并发疾病、化验指标)危险因素分布、冠状动脉造影特点进行比较。结果男性97.7%比76.6%,P<0.1,无显著性统计学差异,吸烟(52.4%比24.3%,P<0.001)、高胆固醇血症(P<0.01)在中青年与老年患者有显著性统计学差异,高血压、2型糖尿病、三酰甘油在中青年及老年组患者中没有明显差异(P>0.05)。冠状动脉造影显示,中青年组与老年组冠状动脉病变比较,青年组单支血管病变比例(78.6%)比老年组(25.6%)高,P<0.05。双支以上病变比例(21.4%)比老年组(74.4%)低,P<0.05有显著性统计学差异。结论吸烟、肥胖和高胆固醇血症是中青年心肌梗死患者最常见的危险因素,中青年心肌梗死患者冠状动脉病变较轻,短期预后较好。     

老年与中青年急性心肌梗死患者临床特点对比观察

目的对比中青年人和老年人急性心肌梗死(AMI)的临床特点。方法将118例AMI患者分为中青年组(<45岁)26例和老年组(≥45岁)92例,对2组患者进行回顾性分析。结果 2组男性发病率均高于女性(P<0.05或P<0.01),且老年组女性患病率显著增加(P<0.05)。中青年组吸烟、酗酒、家族史、肥胖及精神压力为发病主要危险因素的比例显著高于老年组,差异均有统计学意义(P<0.05)。中青年组血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)值低于老年组,差异有统计学意义(P<0.05);2组三酰甘油(TG)值比较差异无统计学意义(P>0.05)。结论不同年龄组AMI患者的危险因素及冠状动脉病变有不同的特点,既要对多种危险因素进行综合干预,亦应有针对性的进行。     

不同年龄急性心肌梗死患者血脂 血清脂蛋白(a)水平及其相关性分析

目的探讨本地区不同年龄急性心肌梗死(AMI)患者血脂、脂蛋白(a)[Lp(a)]水平状况及二者的相关性。方法将108例急性心肌梗死患者分为三组青年组(<45岁)29例,中年组(45~59岁)37例,老年组(≥60岁)42例,分别测出三组总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(HDL-C)、高密度脂蛋白胆固醇(LDL-C)、血清Lp(a)的值,对三组间常规血脂、Lp(a)的测定值以及它们之间有无相关性进行统计学分析。结果①血清TC、LDL-C、HDL-C、Lp(a)的测定值水平中、老年组高于青年组,但三组间差异无统计学意义(P>0.05)。TG测定值水平青年组明显高于老年组,两组之间的差异具有统计学意义(P<0.05);青年组与中年组、中年组与老年组之间差异无统计学意义(P>0.05)。②Lp(a)与LDL-C、TC具有相关性(P<0.05),且为正相关,与TG、HDL-C无相关性。结论血脂异常、高Lp(a)作为冠心病、急性心肌梗死发生发展的重要危险因素,对其应进行积极预防、控制。同时对青年人的高TG血症、低HDL血症应特别重视。     

青年冠心病危险因素分析

目的 探讨冠心病(CHD)的临床特点在青年与老年患者间的差异,以提高防治水平.方法 回顾性分析54例青年CHD患者与136 例老年CHD患者的临床资料,着重分析比较两组的危险因素.结果 青年组CHD患者女性比例、合并原发性高血压、糖尿病的比例均明显低于老年组(P<0.01),体重指数、大量吸烟的比例、血浆总胆固醇,高密度脂蛋白胆固醇,低密度脂蛋白胆固醇、甘油三酯浓度均明显高于老年组(P<0.01),具有统计学意义.结论 男性、肥胖、大量吸烟为青年CHD主要发病危险因素,血浆总胆固醇,高密度脂蛋白胆固醇,低密度脂蛋白胆固醇、甘油三酯浓度也可能为青年CHD的危险因素.     

128例冠心病超敏C反应蛋白及血脂检测结果分析

目的 探讨观察冠心病(CHD)患者血清超敏C反应蛋白(hs-CRP)水平与血脂联合检测的临床应用价值.方法 用全自动生化分析仪及特定蛋白仪分别测定稳定型心绞痛(SAP)患者51例,不稳定型心绞痛(UAP)患者44例,急性心肌梗死(AMI)患者40例和健康者45例的hs-CRP和血脂全套.结果 3个疾病组hs-CRP水平及血脂各项(TC、LDL-C)均比健康对照组高,HDL-C比健康对照组低,差异有统计学意义(P<0,05).UAP、AMI组与健康对照组的hs-CRP值相比差异有统计学意义(P<0.05),但SAP组与健康对照组比较差异无统计学意义(P>0.05).hs-CRP与总胆固醇、低密度脂蛋白胆固醇、载脂蛋白B、脂蛋白a(LPa)呈显著正相关(P<0.05),与高密度脂蛋白胆固醇、载脂蛋白Al呈显著负相关(P< 0.05).结论 hs-CRP可辅助CHD的诊断,与血脂联合检测对CHD的危险性评估及预后判断有重要价值.     

老年人非甾体类抗炎药致上消化道出血的临床特征分析

目的探讨老年人应用非甾体抗炎药(NSAIDs)致上消化道出血的临床特征。方法回顾性分析我院消化内科收治的NSAIDs相关性上消化道出血患者616例,按年龄分为老年组(≥60岁)416例和中青年组(<60岁)200例,分析两组临床特征的差异。结果老年组应用NSAIDs以阿司匹林为主,占55.8%(232/416),高于中青年患组(37.0%,74/200),两组比较差异有统计学意义(P<0.05);其血液常规及凝血常规指标与中青年组相比较差异无统计学意义(P>0.05);老年组服用NSAIDs药物后近期出血率(21.2%)低于中青年组(63.0%),两组比较差异有统计学意义(P<0.05)。老年组及中青年组上消化道出血患者的溃疡病史及Hp感染史比较差异无统计学意义(P>0.05)。结论老年NSAIDs相关上消化道出血的临床特征与青年患者不同,需予以个体化治疗。     

急性心肌梗死并发糖尿病患者糖脂代谢的特点分析

目的探究急性心肌梗死并发糖尿病患者糖脂代谢特点分析。方法选择107例急性心肌梗死患者,按是否患有糖尿病分为糖尿病组(54例)和非糖尿病组(53例),另选取同期健康体检者50例作为对照组,比较三组各血脂和血糖、糖化血红蛋白水平。结果合并糖尿病组和非糖尿病组各血脂指标比较无显著差异(P>0.05),但FPG和HbA1c显著高于非糖尿病组(P<0.05);合并糖尿病组各项指标均高于对照组(P<0.05),非糖尿病组在血脂各指标高于对照组(P<0.05),但两组TG和LDL-C无明显差异(P>0.05)。结论 AMI并发糖尿病患者因血糖增高,存在明显的脂代谢异常特征,临床检测GHbA1c和血脂水平有利于监测病情。     

益气活血方配合拔罐法对老年高脂血症患者血脂水平及体质量指数影响的观察

目的观察益气活血方配合拔罐法对老年高脂血症患者血脂水平及体质量指数的影响。方法将100例老年高脂血症患者随机分为对照组和治疗组,每组50例。对照组给予口服辛伐他汀片,治疗组给予口服益气活血方配合拔罐治疗,疗程为12周。检测两组患者治疗前后的血脂水平及体质量指数,进行统计学分析。结果治疗前两组患者血脂(TC、TG、LDL-C、HDL-C)水平比较,差异无统计学意义(P>0.05);治疗后,治疗组患者TC、LDL-C水平及BMI较治疗前明显降低,差异有统计学意义(P<0.01),TG呈下降趋势,但差异无统计学意义(P>0.05);对照组患者TC、TG、LDL-C较治疗前明显降低,差异有统计学意义(P<0.05或P<0.01);BMI较治疗前呈下降趋势,但差异无统计学意义(P>0.05);两组治疗后比较,治疗组患者LDL-C水平及BMI较对照组明显降低,差异有统计学意义(P<0.05)。结论益气活血方配合拔罐法能明显降低老年高脂血症患者血脂水平及体质量指数。     

2型糖尿病患者甘油三酯与心肌梗死的相关性研究

目的:从心肌梗死危险因素角度探讨与甘油三酯相关的心血管剩留风险。方法:回顾性分析2016年2月—2016年7月收治的符合低密度脂蛋白胆固醇(LDL-C)<2.0 mmol/L的2型糖尿病患者218例,其中合并心肌梗死组112例,无心肌梗死组106例(对照组),研究两组部分生化指标及病史。结果:观察组饮酒史、高血压史、总胆固醇(TC)、甘油三酯(TG)、体质量指数均高于对照组(P<0.05),而高密度脂蛋白胆固醇(HDL-C)低于对照组(P<0.05),差异有统计学意义。对心肌梗死采用多因素逐步Logistic回归分析,结果显示高血压、胆固醇、甘油三酯是心肌梗死的危险因素。结论:甘油三酯为心肌梗死的独立危险因素,在LDL-C正常的2型糖尿病患者中,当合并有高甘油三酯血症时,仍有发生心肌梗死的心血管剩留风险存在。     

血脂水平与出血性脑梗死

目的:探讨出血性脑梗死(HI)与血脂水平的相关性.方法:对出血性脑梗死39例与同期未出血的脑梗死患者89例的血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)和极低密度脂蛋白胆固醇(VLDL-C)水平进行比较分析.结果:HI组血清中TC含量较CI组为低(P<0.05),两组在TG、HDL-C、LDL-C、VLDL-C方面无统计学显著性差异(P>0.05).结论:低胆固醇血症与HI有关.     

Affective and Anxiety Disorders and Alcohol and Drug Dependence:

Depression and anxiety frequently coexist in patients with substance use disorders. This clinically-oriented article examiens the relationship between these conditions and emphasizes data showing that substances of abuse can cause signs and symptoms of both depression and anxiety. These substance-related syndromes appear to have a different course and prognosis than uncomplicated, independent anxiety and major depressive disorders, and clinicians should consider the role of alcohol and other drugs in all patients presenting with these complaints. The authors will also outline an approach for diagnosing and managing patients with the combination of a substance use and depressive or anxiety disorder.     

Modelling and simulation of variability and uncertainty in toxicokinetics and pharmacokinetics

Two important methodological issues within the framework of the variability and uncertainty analysis of toxicokinetic and pharmacokinetic systems are discussed: (i) modelling and simulation of the existing physiologic variability in a population; and (ii) modelling and simulation of variability and uncertainty when there is insufficient or not well defined (e.g. small sample, semiquantitative, qualitative and vague) information available. Physiologically based pharmacokinetic models are especially suited for separating and characterising the physiologic variability from the overall variability and uncertainty in the system. Monte Carlo sampling should draw from multivariate distributions, which reflect all levels of existing dependencies in the intact organism. The population characteristics should be taken into account. A fuzzy simulation approach is proposed to model variability and uncertainty when there is semiquantitative, qualitative and vague information about the model parameters and their statistical distributions cannot be defined reliably.     

Synthesis and anti-nociceptive and anti-inflammatory effects of gaultherin and its analogs

The synthesis of gaultherin (1) and its analogs was carried out to provide 11 glycosides under phase-transfer catalytic conditions. The activities of all synthesized compounds were evaluated by nitric oxide production inhibitory assay in vitro. Methyl 2-O-(4-O-β-d-galactopyranosyl)-β-d-glucopyranosylbenzoate (5f) showed significantly anti-nociceptive and anti-inflammatory effects by the evaluation in vivo. Structure–activity relationships within these compounds were discussed.     

Antiinfective and encrustation-inhibiting materials--myth and facts

Catheters, urethral and ureteral stents and other urological implants are frequently affected by encrustration and infection due to their permanent contact with urine. Indwelling urinary catheters provide a haven for microorganisms and thus require extensive monitoring. Several surface modification techniques have been proposed to improve the performance of devices including the immobilization of biomolecules, the incorporation of hydrophilic grafts to reduce protein adsorption, the creation of hydrophobic surfaces, the creation of microdomains to regulate cellular and protein adhesion, new polymers and antimicrobial coatings. Physico-chemical explanation to elucidate the mechanism of such encrustation or infection inhibiting materials is still not available. Our series of experiments showed a marked decrease of silver-activity in biological fluids which corresponds with the controversial clinical results obtained with silver coated urinary catheters. Rifampicin/minocycline coated catheters had very low activity against Gram-negative rods, enterococci and Candida spp., the main causing organisms of urinary catheter infection. Surface engineered materials and antimicrobial drug delivery systems will be the next generation of sophisticated urinary catheters and stents, if both efficacy as well as efficiency has been proved clinically.     

成骨细胞的功能与损伤和骨质疏松的防治

骨质疏松是一种全身性骨骼疾病,导致骨折风险增加。成人的骨量通过破骨细胞的骨吸收和成骨细胞的骨形成作用来维持动态平衡,治疗骨质疏松症的理想策略是抑制破骨细胞的骨吸收和/或增强成骨细胞的骨形成功能。目前针对保护成骨细胞及增强其功能的骨质疏松疗法相对较少。因此,本文针对成骨细胞相关功能蛋白、各种细胞损伤机制（内质网应激、氧化应激、机械过载、微小RNA和长链非编码RNA的影响等）及骨质疏松的治疗与预防作一综述,以期为针对增强成骨细胞功能的骨质疏松治疗策略提供新思路。     

益生菌与肿瘤防治

益生菌广泛存在于自然界中,通过维持宿主体内菌群平衡、影响肠屏障功能和调节免疫应答等作用,提高宿主健康水平,被公认为"肠道健康卫士".一些益生菌可以增强机体的免疫功能,抑制致癌物质,影响肿瘤细胞的基因表达,对肿瘤具有拮抗作用.大量研究表明,益生菌在未来的肿瘤防治中有很好的应用和发展前景.     

Self-stimulation and amphetamine: Tolerance to d and l isomers and cross tolerance to cocaine and methylphenidate

The effects of the d and l isomers of amphetamine on self-stimulation responding were tested following acute and chronic administration. Tolerance and post-drug depression of responding occurred in tests with both isomers, indicating no role for p-hydroxynorephedrine (PHN) which is one of the metabolites of d-amphetamine. In the second experiment, d-amphetamine, methylphenidate and cocaine all produced quantitatively and qualitatively similar effects on self-stimulation responding following acute administration. Following chronic administration of d-amphetamine, animals showed tolerance to all three drugs, indicating cross-tolerance among them. These data are consistent with an hypothesis that tolerance and post-drug depression following chronic amphetamine treatment are the result of decreases in postsynaptic receptor sensitivity, which would lead to a decreased effectiveness of all three drugs, regardless of their pre-synaptic mechanisms.     

Interaction of estrone and estradiol with DNA and protein of liver and kidney in rat and hamster in vivo and in vitro

[6,7-³H] Estrone (E) and [6,7-³H]estradiol-17 (E₂) have been synthesized by reduction of 6-dehydroestrone and 6-dehydroestradiol with tritium gas. Tritiated E and E₂ were administered by oral gavage to female rats and to male and female hamsters on a dose level of about 300 g/kg (54 mCi/kg). After 8 h, the liver was excised from the rats; liver and kidneys were taken from the hamsters. DNA was purified either directly from an organ homogenate or via chromatin. The radioactivity in the DNA was expressed in the units of the Covalent Binding Index, CBI = (mol chemical bound per mol DNA-P)/(mmol chemical administered per kg b.w.). Rat liver DNA isolated via chromatin exhibited the very low values of 0.08 and 0.09 for E and E₂, respectively. The respective figures in hamster liver were 0.08 and 0.11 in females and 0.21 and 0.18 in the males. DNA isolated from the kidney revealed a detectable radioactivity only in the female, with values of 0.03 and 0.05 for E and E₂, respectively. The values for male hamster kidney were < 0.01 for both hormones. The minute radioactivity detectable in the DNA samples does not represent covalent binding to DNA, however, as indicated by two sets of control experiments. (A) Analysis by HPLC of the nucleosides prepared by enzyme digest of liver DNA isolated directly or via chromatin did not reveal any consistent peak which could have been attributed to a nucleoside-steroid adduct. (B) All DNA radioactivity could be due to protein contaminations, because the specific activity of chromatin protein was determined to be more than 3,000 times higher than of DNA. The high affinity of the hormone to protein was also demonstrated by in vitro incubations, where it could be shown that the specific activity of DNA and protein was essentially proportional to the concentration of radiolabelled hormone in the organ homogenate, regardless of whether the animal was treated or whether the hormone was added in vitro to the homogenate.Carcinogens acting by covalent DNA binding can be classified according to potency on the basis of the Covalent Binding Index. Values of 10³–10⁴ have been found for potent, 10² for moderate, and 1–10 for weak carcinogens. Since estrone is moderately carcinogenic for the kidney of the male hamster, a CBI of about 100 would be expected. The actually measured limit of detection of 0.01 places covalent DNA binding among the highly unlikely mechanisms of action. Similar considerations can be made for the liver where any true covalent DNA binding must be below a level of 0.01. It is concluded that an observable tumor induction by estrone or estradiol is unlikely to be due to DNA binding.Paper presented at the Satellite Symposium of the European Society of Toxicology, Rome, March 29, 1983     

Isolation and characterization of glycosylated and non-glycosylated prolactins from alligator and crocodile

Two molecular forms of prolactin (PRL). glycosylated and non-glycosylated, were isolated from pituitary glands of two reptiles, alligator and crocodile. The reptilian PRLs were extracted under alkaline conditions from the precipitate obtained after pituitaries were first extracted with 0.25 m sucrose, 1 mM NH₄HCO₃, pH 6.3. Purification was performed by ion exchange chromatography on DE-52, gel filtration on Sephadex G-75 superfine, and reversed phase high performance liquid chromatography. Two forms of both alligator and crocodile PRL, designated PRLI and PRLII, with molecular weights of 26000 and 24000 were isolated. Alligator and crocodile PRLI and PRLII were stained specifically in immunoblots with anti-sea turtle PRL and anti-ostrich PRL. Sequence analysis revealed that both forms of alligator and crocodile PRLs consisted of 199 amino acid residues with a glycosylation consensus sequence (Asn-Ala-Ser) at position 60 in alligator and crocodile PRLs with a molecular weight of 26000 (PRLI). In contrast, Thr was substituted for Asn at position 60 in the PRLs with a molecular weight of 24000 (PRLII). The sequences of alligator PRLs differed from crocodile PRLs only in position 134: Val for alligator PRLs and He for crocodile PRLs. There is a high degree of structural conservation between the reptilian PRLs isolated in this study and avian PRL; each showed 92% sequence identity with chicken PRL and 89% with turkey PRL.