血清转铁蛋白受体与血清铁鉴别缺铁性贫血和慢性病贫血的意义

目的 :探讨血清可溶性转铁蛋白受体 (sTfR)与血清铁 (SI)鉴别缺铁性贫血和慢性病贫血的意义。方法 :分别应用免疫比浊法和比色法测定缺铁性贫血和慢性病贫血的转铁蛋白受体和血清铁。结果 :缺铁性贫血组sTfR的值为 ( 6 .93± 2 .14 )mg/L ,明显高于慢性病贫血组 ( 2 .2 4± 0 .73)mg/L ,(P <0 .0 1) ,和正常对照组 ( 1.18± 0 .2 1)mg/L(P <0 .0 1)。结论 :联合检测sTfR和SI ,尤其是计算比值对于鉴别缺铁性贫血和慢性病贫血具有重要的临床意义和经济价值。     

小儿缺铁性贫血与两种铁参数相关性研究

目的:探讨血清转铁蛋白受体(sTfR)、血清铁蛋白(SF)在儿童缺铁性贫血(IDA)诊断中的意义。方法:6月~12岁缺铁性贫血儿童50例及正常儿童20例均进行血红蛋白(Hb)、血清转铁蛋白受体(sTfR)、血清铁蛋白(SF)、血清铁(SI)、总铁结合力(TIBC)测定,并将受测对象分为正常对照组(C组)、轻度缺铁性贫血组(IDA1组)、中~重度缺铁性贫血组(IDA2组),计算正常组(C组)、轻度缺铁性贫血组(IDA1组)、中~重度缺铁性贫血组(IDA2组)三组间血清转铁蛋白受体(sTfR)均数并将其进行统计学分析比较。并应用相关分析法将血清转铁蛋白受体(sTfR)、血清铁蛋白(SF)与血红蛋白(Hb)三者相互之间进行相关分析。结果:正常对照组、轻度缺铁性贫血组、中~重度缺铁性贫血组血清转铁蛋白受体浓度(nmol.L-1)分别为27.6±9.3,44.3±8.5,63.4±12.6,将其三者间进行方差分析及两两比较,均有显著差异(P<0.01)。sTfR与Hb呈负相关(r=-0.912 9,P<0.05),SF与Hb呈正相关(r=0.712 7,P<0.05)。sTfR与SF呈负相关(r=-0.643 4,P<0.05)。结论:sTfR是最接近Hb的参数,对IDA诊断价值优于SF     

血清转铁蛋白受体检测在诊断妊娠及新生儿缺铁性贫血的应用

目的　研究血清可溶性转铁蛋白受体 (serumtransferrinreceptor ,sTfR)检测在妊娠合并缺铁性贫血的诊断价值 ,探讨妊娠缺铁性贫血对新生儿的影响。方法　采用美国R&Dsystem公司生产的试剂盒 ,检测 3 0例正常妊娠妇女(正常组 )及 3 0例妊娠合并贫血妇女 (贫血组 )的血清及两组妇女所分娩的新生儿脐血血清sTfR水平。结果　贫血组sTfR平均值为 ( 3 1 3 9± 6 80 )nmol/L ,高于临界参考值 2 8 1nmol/L(P <0 0 5 ) ,提示缺铁性贫血。正常组sTfR平均值为( 2 5 2 1± 6 90 )nmol/L低于临界值 (P <0 0 5 ) ,属正常范围。两组sTfR平均值比较差异有显著性 (P <0 0 1) ;贫血组新生儿脐血的sTfR平均值为 ( 3 2 2 4± 8 0 8)nmol/L ,显著高于临界值 (P <0 0 1) ,正常组脐血的sTfR平均值为 ( 2 8 68±10 13 )nmol/L ,接近临界参考值 (P >0 0 5 ) ,属正常范围 ;两组新生儿脐血sTfR平均值比较 ,差异无显著性 (P >0 0 5 )。结论　sTfR可作为妊娠合并缺铁性贫血的一个敏感指标。新生儿脐血sTfR测定可作为最早期提示新生儿缺铁性贫血的参考指标。     

可溶性血清转铁蛋白受体与血清铁在诊断妊娠妇女缺铁性贫血中的比较

目的　比较可溶性血清转铁蛋白受体 (solubletransferrinreceptor ,sTfR)和血清铁 (serumiron ,SI)两种检测指标 ,在诊断妊娠妇女缺铁性贫血中的灵敏度和特异度。方法　采用免疫分析法和比色法测定 3 0例贫血妊娠妇女和 3 0例健康妊娠妇女的sTfR水平和SI水平 ,并对实验数据进行分析和比较。结果　 3 0例贫血妊娠妇女的sTfR平均值是( 3 1 3 860± 6 7990 )nmol/L ,高于临界值 2 8 1nmol/L(P <0 0 5 ) ,属于贫血范围 ;SI的平均值是 ( 9 5 3± 4 2 62 2 )nmol/L ,与临界值 9nmol/L差异无显著性 ,属于正常范围。 3 0例正常妊娠妇女的sTfR平均值是 ( 2 5 2 0 80± 6 90 3 2 )nmol/L ,小于临界值 2 8 1nmol/L(P <0 0 5 ) ,属于正常范围 ;SI的平均值是 ( 13 3 73 3± 4 83 5 9)nmol/L ,高于临界值属于正常范围 (P <0 0 1)。贫血妊娠妇女的sTfR水平明显高于正常妊娠妇女的sTfR水平 (P <0 0 1) ,SI水平明显低于正常妊娠妇女 (P <0 0 1)。sTfR及SI测定妊娠妇女缺铁性贫血的灵敏度分别是 70 %和 5 3 % ,特异度分别是 84%和 80 %。结论　在诊断妊娠妇女缺铁性贫血中 ,两种指标的特异度都比较高 ,但sTfR测定比SI测定灵敏性高且能对妊娠妇女是否缺铁作出正确判断。     

血清转铁蛋白受体在缺铁性贫血诊断中的意义

目的　探讨血清转铁蛋白受体 (sTfR)在缺铁性贫血诊断中的意义。方法　应用免疫比浊法和比色法测定缺铁性贫血患者和正常对照组的血清转铁蛋白受体 (sTfR)以及血清铁 (SI)。结果　缺铁性贫血组的sTfR值为 6.98± 2 .0 9,高于正常对照组的sTfR水平 ( 1.5 4± 0 .2 7)缺铁性贫血组的SI为 41.98± 2 .87,低于正常对照组 ( 10 4.6±18.9)缺铁性贫血患者与正常对照比较 ,P均 <0 .0 1,两者有显著性差异。结论　sTfR是诊断缺铁性贫血的较敏感的指标     

64例慢性病伴贫血患者血清转铁蛋白受体、血清铁蛋白及其复合参数评价

目的 :探讨血清转铁蛋白受体 (SerumTransferrinReceptor,STFR)、血清铁蛋白 (SerumFerritin ,SF)及其复合参数STFR/logSF和STFR/SF对慢性病贫血 (Anemiaofchronicdisease ,ACD)和慢性病伴缺铁 (chronicdiseasewithirondeficiency ,CDID)的鉴别诊断价值。方法 :酶联免疫法测定 40名健康人、3 0例ACD和 3 4例CDID患者STFR ;放射免疫法测定上述血清样本的SF ,计算出STFR/logSF、STFR/SF ,并进行统计分析。结果 :CDID患者几项铁参数值为 :STFR 3 4 2± 14 8nmol/L ,SF 69 3± 2 3 4μg/L ,STFR/logSF 19 4± 7 3 ,STFR/SF 0 5 3± 0 2 1。ACD患者几项铁参数值为STFR 2 1 8± 11 8nmol/L ,SF187 6± 45 7μg/L ,STFR/logSF 9 7± 3 6,STFR/SF 0 11± 0 0 3。CDID患者 4项铁参数值与ACD相比有显著差异。 结论 :检测血清STFR、SF、STFR/logSF和STFR/SF有助于CDID和ACD的鉴别诊断 ,其中STFR和STFR/logSF更具鉴别价值     

血清可溶性转铁蛋白受体及转铁蛋白在儿童缺铁性贫血合并感染中的诊断价值

目的探讨血清可溶性转铁蛋白受体（sTfR）、转铁蛋白（Tf）在儿童缺铁性贫血合并急性感染（iron deficiency with acute infection，IDAI）中的变化和诊断价值。方法采用速率散射免疫比浊法，测定IDAI组、单纯缺铁性贫血（IDA）组、IDAI组治疗后及健康对照组的血清sTfR、Tf、铁蛋白（SF）水平。常规铁染色观察骨髓储存铁。结果IDAI组和IDA组患儿sTfR、Tf均显著高于对照组（P〈0．01），两组间无显著差异（P〉0．05），IDAI组治疗后血红蛋白（Hb）上升至100g／L以上，但与对照组还有差距时（P〈0．05），sTfR、Tf值降至对照组水平（P〉0．05）。结论sTfR、Tf对诊断缺铁性贫血特异强，测定结果不受感染因素干扰，是临床判断贫血合并感染儿童是否缺铁和监测疗效的可靠指标，临床应用价值优于SF和骨髓储存铁。     

可溶性转铁蛋白受体和血清铁在妊娠期贫血早期诊断的意义

目的 比较可溶性血清转铁蛋白受体(soluble transferrin receptor,sTfR)和血清铁(serum iron,SI)2种检测指标,在诊断妊娠妇女缺铁性贫血中的灵敏度和特异度.方法 采用可溶性转铁蛋白受体微粒子增强投射免疫分析法测定其sTfR及SI.结果 50例贫血妊娠妇女的sTfR值(3.011±2.026)mg/L明显高于正常妊娠妇女sTfR值(2.047±0.803)mg/L(P＜0.05),贫血妊娠妇女SI值(10.704±3.462)μmol/L明显低于正常妊娠妇女SI值(18.542±4.835)μmol/L(P＜0.05).sTfR及SI测定妊娠妇女缺铁性贫血的灵敏度分别是80%和30%,特异度分别是84%和94%.结论 sTfR及SI均可用于妊娠贫血的早期诊断.但sTfR测定比SI测定灵敏性高且能对妊娠妇女是否缺铁作出正确判断,特别是在亚临床贫血期,sTfR可作为诊断妊娠早期缺铁性贫血的敏感指标.     

静脉补铁和口服补铁对肾性贫血的治疗比较

目的　比较静脉和口服补铁对血液透析患者铁缺乏和贫血的治疗效果。方法　选择 41例维持性血液透析患者 ,平均透析时间 10 .3± 8.8个月 ,每周透析 2～ 3次。试验前检查每位患者的血红蛋白、血球压积、RBC、血清铁(SI)、血清铁蛋白 (SF)、转铁蛋白 (Tf)、转铁蛋白受体 (sTfR)、前白蛋白 (Pro Alb)和C反应蛋白 (CRP)。HCT <3 3 %作为贫血的指标 ,将患者随机分入静脉补铁组和口服补铁组 ,静脉补铁组 19例。给予枸橼酸铁 5 0mg透析后输入 ,共 10次 ,口服补铁组 2 2例 ,给予硫酸亚铁 60 0mg/d。两组病人都给予促红细胞生成素 60 0 0U/周 ,6周后两组重复检查上述指标。结果　试验结束时静脉补铁组各铁参数指标明显高于口服补铁组 ,Tf(2 .2 1± 0 .77vs1.75± 0 .2 5g/L ,P <0 .0 0 1) ;sTfR(1.2 2±0 .68vs 0 .78± 0 .19mg/L ,P <0 .0 1) ;SF(4 96.13± 3 0 6.5 7vs2 79.2± 2 0 6μg/L ,P <0 .0 0 1) ,SI(14 1.6± 5 8.7vs60 .6± 19.1μg/dl,P<0 .0 0 0 1) ;静脉补铁组贫血改善较口服组好 ,HCT上升值 (0 .0 5 4± 0 .0 5 0vs0 .0 3 7± 0 .0 40 )和Hb上升值 (13 .8± 14 .9vs6.9± 9.1P <0 .0 0 1)有明显差异 ;将两组病人治疗前后血红蛋白、血球压积的变化值 ,与治疗前后各铁参数变化值作相关分析 ,发现转     

缺铁性贫血患者sTfR、SF、SI、UIBC、TRF检测的临床意义研究

目的 研究缺铁性贫血患者可溶性转铁蛋白受体(sTfR)、血清铁蛋白(SF)、血清铁(SI)、不饱和铁结合力(UIBC)和转铁蛋白(TRF)检测的临床意义。方法 选择2021年1月至2023年2月济源市人民医院收治的30例单纯缺铁性贫血患者作为缺铁性贫血组,30例单纯慢性病贫血患者作为慢性病贫血组,同期选择30例健康体检人群为健康对照组。对比三组患者的sTfR、SF、SI、UIBC、TRF水平,分析sTfR、SF、SI、UIBC、TRF在不同程度缺铁性贫血中的表达,并采用Pearson相关性分析不同贫血程度与sTfR、SF、SI、UIBC、TRF的相关性;受试者工作特征(ROC)曲线评估sTfR、SF、SI、UIBC、TRF对缺铁性贫血的诊断效能。结果 缺铁性贫血组、慢性病贫血组与健康对照组的sTfR、SF、SI、UIBC和TRF水平差异均有统计学意义(P<0.05)。sTfR、UIBC、TRF:轻度患者低于中度患者,而中度患者低于重度患者(P<0.05);SF、SI:轻度患者高于中度患者,而中度患者高于重度患者(P<0.05)。Pearson相关性显示,缺铁性贫血患者...     

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.