血栓前状态实验室诊断指标探讨

目的　探讨心、脑血管损伤前血栓前状态实验室检测指标 ,为早期发现、早期治疗此类危害生命的疾病寻找实验依据。方法　选择 60例心绞痛、冠心病、脑血管病变患者 ,采用ELISA法测定血浆中vWF、P 选择素 (GMP 1 40 )、组织型纤溶酶原激活物 (t PA)、纤溶酶原激活物抑制物 (PAI)、凝血酶 -抗凝血酶复合物 (TAT)、纤溶酶 -抗纤溶酶复合物 (PAP)、D D二聚体 (D Dimer)、血栓前体蛋白 (TpP)、同型半胱氨酸 (tHcy) ,全自动血凝仪检测血浆凝血酶原时间 (PT)、活化部分凝血活酶时间 (APTT)和血浆纤维蛋白原 (Fg)。 结果　vWF、GMP 1 40、t PA、PAI、TAT、TpP、tHcy均显著高于对组照 (P <0 0 0 1 )。TpP、tHcy异常升高的患者更易发展成为心肌梗死和脑梗死。各检测指标之间也有差异 ,TpP和tHcy两指标与其他指标相比具有很高的敏感性与特异性。PT、APTT在心、脑血栓形成前后变化无统计学意义(P >0 0 5 )。结论　vWF、t PA、PAI、GMP 1 40、TAT、PAP、D Dimer、Fg、TpP、tHcy均可以作为心、脑血管疾病血栓前状态的诊断指标。TpP、tHcy在灵敏度和特异性方面高于其他项 ,在判断血栓前状态中具有较高临床价值     

2型糖尿病患者血栓通治疗前后血栓状态变化

目的观察血栓通治疗2型糖尿病患者血栓状态的变化.方法将86例2型糖尿病患者随机分成两组,A组:血栓通组,B组:对照组,采用酶免法及显色法测定血小板α颗粒膜糖蛋白质-140(GMP-140)、组织纤溶酶原激活物(t-PA)、纤溶酶原激活物抑制物(PAI)、血管性假血友病因子(vWF)四项标志物变化.结果血栓通组患者治疗后GMP-140、PAI、vWF明显降低,而t-PA活性升高,与治疗前对比差异有显著意义(P＜0.01);B组治疗前后无差异(P＞0.05);A组治疗后各标志物变化与B组对比有显著差异(P＜0.01).结论血栓通能显著降低GMP-140、PAI、vWF,而且还能升高t-PA活性,具有调节纤溶系统功能及抗凝作用.     

围生期血栓前状态分子标志物的检测

目的　研究具有高危因素的孕产妇血栓前状态相关分子标志物的变化。方法　选取具有高危因素的孕产妇 2 5 8例、正常晚期妊娠妇女 2 0例及门诊体检健康非妊娠妇女 2 0例 ,分别测定各组血浆中血管性血友病因子 (vWF)、血小板α -颗粒膜蛋白 (GMP - 14 0 )、抗凝血酶 -Ⅲ (AT -Ⅲ )、蛋白C系统筛选 (PCATProCGlobal)、纤维蛋白原 (Fbg)、纤溶酶原 (PLG)、组织纤溶酶原激活物 (t-PA)及其抑制物 (PAI)、D -二聚体 (D -Dimer)的含量。结果　正常妊娠时血浆内vWF ,PLG ,PAI,D -Dimer,Fbg含量升高 (P <0 0 1) ,AT -Ⅲ降低 (P <0 0 1) ,而GMP - 14 0 ,PCAT ,t-PA则无显著性变化 (P >0 0 5 ) ;具有高危因素的孕产妇较同龄孕产妇血浆内vWF ,GMP - 14 0 ,PLG ,PAI,D-Dimer,Fbg含量明显升高 (P <0 0 1) ,PCAT ,AT -Ⅲ显著降低 (P <0 0 1) ,而t -PA则无显著性变化 (P >0 0 5 )。结论　妊娠期妇女尤其是具有高危因素的孕产妇血液处于明显的血栓前状态 ;对孕产妇 ,尤其是具有高危因素的孕产妇应采取预防为主的措施     

血栓前体蛋白在诊断血栓前状态中的临床价值

目的:探讨心、脑血管疾病患者血浆中血栓前体蛋白(TpP)在早期诊断血栓前状态中的价值。方法:采用ELISA法测定160例患者及210例正常人血浆中凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)和血浆纤维蛋白原(Fg)、血管性血友病因子(vWF)、纤溶酶原激活物抑制物(PAI)、组织型纤溶酶原激活物(tPA)、DD-二聚体(DDimer)、血栓前体蛋白(TpP),对各项指标在诊断血栓前状态时的阳性率、准确率和敏感度进行比较。结果:160例患者血浆中vWF、TAT、TpP、tPA、PAI均显著高于正常对照(P0.05);PT、APTT在心、脑血栓形成前后无显著变化(P0.05);TpP与其他指标相比,具有很高的敏感性与特异性。结论:vWF、tPA、PAI、DDimer、Fg、TpP均可以作为早期诊断心、脑血管血栓形成前状态的分子标志物,而TpP灵敏度、特异性高于其他各项,在早期判断血栓前状态时具有较高临床价值。     

妇科恶性肿瘤患者术后血液血栓前状态的检测

目的：探讨妇科恶性肿瘤患者血栓前状态生物指标的变化。方法：检测38例妇科恶性肿瘤患者手术前后及20例正常非孕妇女的血管性血友病因子（vWF)、血小板α－颗粒膜蛋白（GMP－140）、抗凝血酶（AT－Ⅲ）、蛋白C依赖的活化部分凝血酶原时间（PCAT）、纤溶酶原（PLG）、纤溶酶原激活物抑制物（PAI）、D－二聚体和组织纤溶酶原激活物（t-PA)等指标。结果：妇科恶性肿瘤患者术前vWF含量、GMP－140、AT－Ⅲ、PLG、PAI、D－二聚体均比对照组高（P＜0．01），而术后升高更明显；PCAT手术前、后均明显低于正常非孕妇女；而组织纤溶酶原激活物（t-PA) 则无显著性改变（P＞0．05）。结论：提示妇科恶性肿瘤患者术前血液呈血栓前状态，术后呈更明显的血栓前状态。     

冠心病血瘀证与血小板颗粒膜蛋白和纤溶功能关系的探讨

目的探讨血小板颗粒膜蛋白 (GMP—1 4 0 )、组织型纤溶酶原激活物 (t—PA)、纤溶酶原激活物抑制物 (PAI—1 )与冠心病血瘀证的关系。方法选择 48例血瘀型、5 2例非血瘀型冠心病 (CHD)患者和 5 4例健康人 ,对其血浆GMP—1 4 0含量、t—PA、PAI—1活性进行检测。结果CHD血瘀证患者血浆GMP—1 4 0明显高于非血瘀证和健康对照组 (P <0 .0 5或P <0 .0 1 ) ,CHD患者血瘀证PAI—1活性明显升高 ,t—PA活性明显降低 ,与非血瘀组和健康组相比差异有显著性意义 (P <0 .0 5或P <0 .0 1 ) ,进一步分析表明 ,t—PA/PAI—1比值各组相比均具有显著差异 (均P <0 .0 1 ) ,以血瘀证组最低。结论GMP—1 4 0、t—PA、PAI—1可作为冠心病血瘀证的微观辨证参考指标。     

高血压病患者血栓前状态的研究

目的 :探讨高血压病易并发血栓性疾病的机制。方法 :分别采用放射免疫法、发色底物显色法、ELISA法等检测 16例健康人 (对照组 )、5 3例高血压病 1、2、3级患者血浆中的分子标志物—血栓素B2 (TXB2 )、6 -酮前列腺素F1α(6 -K -PGF1α)、组织型纤溶酶原激活物 (t-PA)、组织型纤溶酶原激活物抑制物 (PAI- 1)及血液流变学指标。结果 :1～ 2级高血压组及 3级高血压组病人 ,血浆TXB2 、t-PA含量、PAI- 1含量及活性、血粘度、纤维蛋白原水平均明显高于对照组 (P <0 .0 5 ) ;而t-PA活性、6 -K -PGF1α含量均显著下降 (P <0 .0 5 )。结论 :高血压病患者存在血栓前状态 ,血压升高可能是直接原因。这为解释及防治高血压病血栓性并发症提供了依据。     

弹烧复合伤合并海水浸泡对血管内皮细胞止血功能的影响

目的　探讨弹烧复合伤合并海水浸泡对血管内皮细胞止血功能影响的原因和机制。方法　建立弹烧复合伤的犬实验模型 ,致伤后将犬随机分为非浸泡组和浸泡组 ,将浸泡组犬在海水中浸泡 4h后捞出 ,然后于伤后 4、7、10、2 0、2 8h分别取血检测循环内皮细胞 (circulatingendothelialcells ,CEC)、以及组织型纤溶酶原激活剂 (tissue typeplasminogenacti vator ,t PA)、纤溶酶原激活剂抑制物 (plasminogenactivatorinhibitor 1,PAI 1)、血栓素B2 (thromboxaneB2 ,TXB2 )和 6 酮 前列腺素1α( 6 keto prostaglandinF1α,6 K PGF1α)比值的变化 ,并且于伤后 2 8h活杀犬 ,取肺组织行病理检查。非浸泡组除不浸泡海水外 ,余检测时相及指标同浸泡组。结果　非浸泡组于伤后 4h和 7hCEC、PAI 1、TXB2 6 K PGF1α均升高 (P <0 0 5 ) ,t PA降低 (P <0 0 5 ) ,而浸泡组于伤后 4、7、10、2 0、2 8hCEC、PAI 1和TXB2 6 K PGF1α均持续增高 (P <0 0 5或P <0 0 1) ,t PA持续降低 (P <0 0 1) ;组间比较 :浸泡组从伤后 4h至伤后 2 8h ,各指标均与非浸泡组有显著差异 (P <0 0 5或P <0 0 1)。光镜下可见肺血管中血栓形成。结论　弹烧复合伤合并海水浸泡后可引起全身EC急性损伤以及造成EC止血功能紊乱 ,从而导致血栓形成 ,     

缺血性脑血管病与血栓标志物的关系探讨

目的　通过检测缺血性脑血管病 (ICVD)患者的有关血液学指标 ,研究ICVD病人的发病因素 ,以利于ICVD的治疗及一级、二级预防。方法　检测 13 8例ICVD患者的血管性血友病因子抗原 (vWF :Ag)、P -选择素 (P -Selectin)、抗凝血酶含量 (AT -Ⅲ :Ag)、抗凝血酶活性 (AT -Ⅲ :A)、组织型纤溶酶原激活物活性 (t -PA :A)、纤溶酶原激活剂抑制剂活性 (PAI :A) ,纤溶酶原 (PLG)水平并与对照组比较。结果　与对照组相比 ,ICVD组的vWF :Ag、P -Selectin、PLG、PAI :A升高 ,而AT -Ⅲ :A、AT -Ⅲ :Ag、t -PA :A降低 (P <0 .0 1或P <0 .0 5 )。ICVD组组间比较 :腔隙性脑梗死组、短暂性脑缺血组与急性脑梗死组AT -Ⅲ :A、AT -Ⅲ :Ag、PLG水平差异有显著性 (P <0 .0 1或P <0 .0 5 )。结论　ICVD患者存在血管内皮损伤、血小板活性增加、高凝状态及纤溶活性降低。血栓标志物的检测对ICVD的诊断及治疗过程监测有着重要的意义     

急性心肌梗死患者血栓前状态指标变化的观察与护理

目的 探讨急性心肌梗死(AMI)患者血清与血栓前状态(PTS)的观察指标水平变化及护理对策.方法 采用ELISA方法测定45例急性心肌梗死(AMI)患者和40例健康对照组患者的血清P选择素(Ps)、组织型纤溶酶原激活物(tPA)、纤溶酶原激活物抑制物(PAI)和血管性血友病因子(vWF).结果 AMI组血清Ps、PAI和vWF均值高于正常对照组(P<0.01),AMI组血清tPA均值低于正常对照组(P<0.01).结论 急性心肌梗死患者存在明显的血管内皮损伤,抗凝作用减弱,血小板黏附与聚集及纤溶活性下降,在护理上,注意观察患者血栓前状态各项指标变化情况,做到早期发现,早期治疗.在选用药物治疗时,应当努力保护其内皮功能,适当采用抗血小板活化,抗凝,减少血液黏稠度等综合治疗措施,以提高疗效,降低并发症的发生.     

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…     

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.     

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     

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.     

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.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.