血清胆红素、尿酸、血脂与冠心病关系的研究

目的探讨血清胆红素、尿酸、血脂与冠心病（CHD）之间的关系。方法通过冠状动脉造影检查选取71例CHD患者及50例对照组，CHD组又分为单支、双支、多支病变亚组，分别测定CHD患者与对照组血清总胆红素（TBIL）、直接胆红素（DBIL）、间接胆红素（IBIL）、尿酸（UA）、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）浓度。结果与正常对照组相比，CHD患者血清TBIL、DBIL、IBIL浓度低于对照组（P〈0．01）；CHD组血清UA、TC、TG、LDL—C高于对照组（P〈0．01）；HDL—C低于对照组（P〈0．01）；随着冠状动脉病变支数的增加血清UA、TC、TG、LDL—C明显增加（P〈0．05）；HDL—C明显降低（P〈0．01）；双支、多支病变组血清TBIL均低于单支亚组（P〈0．05），而多支组血清TBIL低于双支病变组（P〈0．01）。结论血清胆红素浓度降低、UA升高、血脂异常与CHD相关，是CHD的独立危险因素。     

冠心病患者血脂、血清胆红素及尿酸检测的临床意义

目的：探讨冠心病（CHD）患者血清胆红素、尿酸（UA）、血脂检测的临床应用价值。方法：采用全自动生化分析仪检测75例CHD患者（CHD组）血清总胆红素（TB）、直接胆红素（DB）、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）、载脂蛋白A（apoA）、载脂蛋白B（apoB）和UA,同时检测68例健康者（对照组）上述指标,并对结果进行统计分析。结果：CHD组血清TB、DB、HDL—C、apoA水平明显低于对照组,两组比较差异有统计学意义（P〈0．05）;CHD组血清UA、TC、TG、LDL—C、apoB明显高于对照组,两组比较差异有统计学意义（P〈0．05）。结论：高脂血症、高尿酸血症和低水平血清TB是CHD的危险因素,检测患者血清胆红素尿酸血脂水平,可能为临床冠心病的诊断、治疗和预后提供依据。     

胆红素水平与冠心病发病、血脂水平相关关系的研究

目的　就胆红素水平与冠心病 (CHD)发病及血脂水平是否相关进行对照研究。方法　设定CHD组(10 0例 )与对照组 (6 0例 ) ,测定血清总胆红素 (TBIL)、甘油三酯 (TG)、总胆固醇 (CHO)、高密度脂蛋白 (HDL)、低密度脂蛋白胆固醇 (LDL -C) ,采用FRIEDWALD公式计算 (组间比较采用 t检验 )。结果　CHD组TBIL浓度明显低于对照组 (P <0 .0 5 ) ,CHD组TBIL浓度与LDL -C、TG呈一定的负相关。结论　CHD的发生与TBIL的降低有一定的相关性。TBIL具有防止脂质氧化的作用 ,从而防止CHD的发生     

血清胆红素与冠心病及其血脂的关系探讨

目的 探讨血清胆红素与冠心病(CHD)及其血脂的关系. 方法 采用钒酸氧化法、氧化酶法、抗体阻碍均相法和免疫透射比浊法分别对115例CHD患者及77例对照组进行了血清总胆红素(TB)、直接胆红素(DB)、胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL)、载脂蛋白A1(ApoAl)、载脂蛋白B(ApoB)检测;间接胆红素(IB)和低密度脂蛋白胆固醇(LDL)则通过计算得出,并对结果进行了统计学分析. 结果 与对照组比较,CDH患者血清TB、HDL、ApoA1明显降低(p＜0.05),LDL、TG、ApoB明显增高(p＜0.05,p＜0.01).CDH组TB与TG呈负相关(p＜0.01),与ApoAl呈正相关(p＜0.05).DB与TC、TG、LDL呈负相关(p＜0.01,p＜0.05).IB与TG呈负相关(p＜0.01),与ApoA1呈正相关(p＜0.05). 结论 低水平胆红素可能是冠心病的危险因素之一,其可能通过对血脂代谢的影响,从而影响CHD的发生、发展.     

2型糖尿病患者血清氧化型低密度脂蛋白和血液抗氧化能力分析

目的　通过对 5 0例 2型糖尿病患者血清甘油三酯 (TG)、胆固醇 (Chol)、高密度脂蛋白胆固醇 (HDL c)、低密度脂蛋白胆固醇 (LDL c)、氧化型低密度脂蛋白 (OX LDL)、载脂蛋白 (ApoA1、ApoB10 0 )及血液抗氧化能力 (AOC)分析 ,探讨2型糖尿病患者OX LDL与血液抗氧化状态的关系 ,寻找评价 2型糖尿病患者发生冠心病危险性的有效血液生化指标。方法　收集 5 0例经临床确诊的 2型糖尿病患者及 5 0例无心血管疾病、无糖尿病及无肾病人群的空腹血清 ,对血脂和血液AOC进行分析。结果　TG、Chol、HDL c、LDL c、ApoA1、ApoB10 0 两组比较无差异 (P >0 0 5 ) ;OX LDL 2型糖尿病组明显高于对照组 (P <0 0 1) ,血液AOC 2型糖尿病组明显低于对照组 (P <0 0 1)。结论　血清OX LDL及血液AOC分析有望成为评价 2型糖尿病患者发生冠心病危险性更灵敏、更有效的血液生化指标。     

冠心病患者血清高敏C-反应蛋白、血脂水平研究

目的　探讨血清中高敏C 反应蛋白、血脂浓度与冠心病 (CoronaryHeartDisease,CHD)的关系及临床意义。方法　测定CHD患者共 1 1 9例 ,其中不稳定型心绞痛 (UA)患者 5 3例 ,稳定型心绞痛 (SA)患者 6 6例及正常对照组 30例 ,血清高敏C 反应蛋白 (High SensitivityC ReactiveProtein ,Hs CRP)、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)、载脂蛋白A1 (apoA1 )、载脂蛋白B(apoB)浓度。结果　UA、SA患者的血清Hs CRP含量显著高于正常对照组 (P<0 .0 1 ) ,其中UA组患者血清Hs CRP水平又明显高于SA组患者 (P <0 .0 1 ) ;UA患者apoA1 浓度明显低于正常对照组 (P <0 .0 1 ) ,SA患者apoA1 浓度较正常对照组低 (P <0 .0 5 ) ,其余结果无差别。结论　血清Hs CRP、apoA1 水平与冠心病 ,尤其是冠心病不稳定型心绞痛密切相关     

透析膜对维持性血液透析患者脂质代谢的影响

目的 :探讨不同的透析膜对维持性血液透析患者脂质代谢的影响及其意义。方法 :分别检测 2 0例长期应用铜仿膜透析与 2 5例聚砜膜透析患者血清总胆固醇 (TC)、甘油三脂 (TG)、高密度脂蛋白 (HDL)、低密度脂蛋白 (LDL)、极低密度脂蛋白 (VLDL)、载脂蛋白A1(ApoA1)、载脂蛋白B(ApoB)及脂蛋白A[Lp(a) ]水平。结果 :与对照组相比 ,铜仿膜透析组和聚砜膜透析组血清TG、TC、ApoB、Lp(a)及TG/HDL水平均明显增加 (P <0 0 1) ,HDL水平明显降低 (P <0 0 5 ) ;与铜仿膜透析组相比 ,聚砜膜透析组血清HDL及ApoAl水平明显增加 (P <0 0 5 ) ,其余指标则没有明显改变 (P>0 0 5 )。另外 ,聚砜膜透析组HDL水平及TC/HDL比值达到动脉硬化水平的百分比较铜仿膜透析组明显降低 (P <0 0 5 )。结论 :长期应用聚砜膜透析可改善透析患者部分脂质代谢指标 ,其确切机制尚有待于进一步研究。     

原发性肾病综合征患儿血脂代谢紊乱与肾功能损害的关系探讨

目的探讨原发性肾病综合征患儿（PNS）血脂代谢紊乱与肾功能改变的关系。方法2004—04-2007—04，黑龙江省医院道外分院和哈尔滨市第二医院收治的57例PNS患儿，根据肾功能检查结果分成无肾功能损害组（34例）与肾功能损害组（23例），检测高密度脂蛋白（HDL）、非-高密度脂蛋白（non—HDL）、低密度脂蛋白（LDL）、载脂蛋白A1（ApoAl）、载脂蛋白B（ApoB）、血浆总胆固醇（TC）、甘油三酯（TG）、ApoAl／B、血浆尿素氮（BUN）、肌酐清除率（Ccr）和尿酸（ua）等指标。结果（1）肾功能损害组TG、BUN、Ccr和UA均明显高于无肾功能损害组；（2）57例PNS患儿TG与Ccr及UA呈高度正相关（P〈0．01），ApoAl与Ccr呈中度正相关（P〈0．05），ApoB与uA呈中度正相关（P〈0．05）；（3）57例PNS患儿non—HI）L与LDL呈高度正相关（P〈0．01）。结论PNS合并肾功能损害的血脂代谢紊乱以TG显著增高为特征：TG和non—HDL变化可以作为临床判断PNS患儿肾功能损害程度及调脂措施有效性的指标。     

载脂蛋白的检测及其临床应用

用Diasys公司生产的试剂盒对正常人群及冠心病 (CHD)人群进行 (TC、TG、HDL -C、ApoA1和ApoB的测定。结果显示 :CHD组TC、TG、HDL -C与对照组相比P <0 .0 1,而ApoA1、ApoB及ApoB/ApoA1值与对照组相比 ,差异有高度显著性 (P <0 .0 1)。认为载脂蛋白检测作为冠心病的诊断指标明显优于总胆固醇、甘油三酯、高密度脂蛋白胆固醇三项     

1型和2型糖尿病患者血脂和血清酶检验的临床意义

目的　探讨 1、 2型糖尿病患者血脂和血清酶的变化特点。方法　对 2 2例 1型糖尿病患者、 1 34例2型糖尿病患者和 5 2例非糖尿病患者对照进行了空腹 1 2小时后血糖 (GLU)、血清尿素氮 (BUN)、肌酐 (CR)、尿酸 (UA)、谷丙转氨酶 (ALT)、谷草转氨酶 (AST)、乳酸脱氢酶 (LDH)、磷酸肌酸激酶 (CK)、α 羟丁酸脱氢酶(HBDH)、总胆固醇 (CH)、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)、载脂蛋白A (ApoA)、载脂蛋白B (ApoB)等指标的测定。 结果　 1型糖尿病组与对照组比较 ,GLU、BUN、CR、ALT、HBDH、CH、ApoB高于对照组 (P <0 0 5或 0 0 1 ) ,HDL C、ApoA低于对照组 (P <0 0 5 )。 2型糖尿病组与对照组比较 ,GLU、BUN、CR、ALT、AST、LDH、CK、HBDH、LDL C、ApoB高于对照组 (P <0 0 5或 <0 0 1 ) ,HDL C、ApoA低于对照组 (P <0 0 1 )。 1型糖尿病组与 2型糖尿病组比较 ,GLU、BUN、HDL C等指标 1型糖尿病组高于 2型糖尿病组 (P <0 0 1 )。结论　 1型糖尿病的血糖水平高于 2型糖尿病。 1、 2型糖尿病人群均存在脂代谢的异常 ,血清心肌酶谱的变化和心、肝、肾等主要脏器受损 ,但其程度有差异 ,2型糖尿病伴发冠心病的危险性高于 1型糖尿病。对糖尿病患者的治疗关注脂代谢紊     

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.     

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.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.