以慢性疲劳为主诉的患者血清叶酸、维生素B12测定

目的了解慢性疲劳与血清叶酸、维生素B12的关系.方法我们收集了就诊于慢性疲劳门诊的患者共67人,均以不明原因的疲劳为主诉,病程至少在半年以上;将他们按年龄段分成青壮年组(年龄＜50岁)和中老年组(年龄≥50岁),并相应的配以健康对照组.结果青壮年组和中老年组叶酸缺乏的发生率和血清叶酸浓度与对照组相比均无统计学显著差异(P＞0.05).青壮年组维生素B12的发生率及血清维生素B12浓度与对照组相比无统计学显著差异(P＞0.05),中老年组血清维生素B12的发生率明显高于对照组,血清维生素B12浓度明显低于对照组,有统计学非常显著差异(P＜0.01).结论本文研究发现,血清维生素B12缺乏很可能是中老年人慢性疲劳的原因之一,而青壮年慢性疲劳与此关系不大.     

叶酸、维生素B12与2型糖尿病尿白蛋白排泄率的相关性研究

目的探讨叶酸、维生素B12水平与2型糖尿病尿微量白蛋白排泄率（UAER）的关系，从而探求新的经济、有效早期防治糖尿病肾病（DN）的方法。方法93例T2DM患者分为3组：正常白蛋白尿组（NAU，UAER〈20μg／min，n=35），微量白蛋白尿组（MAU，UAER20-200μg／min，n=31）和临床白蛋白尿组（CAU，UAER〉200μg／min，n=27）。35例健康人做正常对照组（NC）。放免法检测各组对象的血清叶酸、维生素B12水平。结果MAU组和CAU组UAER显著高于NC组（P〈0．01）。2型糖尿病各组患者血清叶酸水平显著低于NC组（P〈0．01），维生素B12水平亦低于NC组（P〈0．05），叶酸和维生索B12水平在NAU组和MAU组间有显著性差异（P〈0．01）。随UAER的增高，血清叶酸和维生素B12水平下降。UAER与叶酸（r=-0．321，P〈0．01）及维生素B12水平（r=-0．210，P〈0．01）呈负相关。结论T2DM患者UAER与血清叶酸、维生素B12水平呈负相关。NAU期血清叶酸和维生素B12开始下降，且随UAER的增高，血清叶酸、维生素B12水平进行性下降，叶酸和维生素B12水平可间接反映糖尿病肾病（DN）的病情轻重。糖尿病肾病早期补充叶酸、维生素B12可能是延缓DN进展的经济、有效的方法。     

肝炎肝硬化合并缺铁性贫血患者的血液指标分析

目的：分析肝炎肝硬化合并缺铁性贫血（ IDA）患者的血液指标。方法选取失代偿期肝炎肝硬化合并有IDA（观察组）与肝炎肝硬化合并非IDA（对照组）患者各30例,分别测定血清铁蛋白、叶酸、维生素B12、凝血功能、血细胞分析、肝功能,并对各项结果进行比较。结果观察组血清铁蛋白低于对照组（ P＜0．05）、叶酸高于对照组（P＜0．05）、维生素B12与对照组比较差异无统计学意义（P＞0．05）;观察组丙氨酸氨基转移酶、γ－谷氨酰转肽酶均高于对照组（P＜0．05）,而门冬氨酸基转移酶、白蛋白、胆红素、碱性磷酸酶、胆汁酸与对照组比较差异无统计学意义（ P＞0．05）;观察组凝血酶原时间、凝血酶原活动度、凝血酶时间与对照组比较差异无统计学意义（P＞0．05）;观察组血红蛋白、平均红细胞体积、平均血红蛋白、平均血红蛋白浓度均低于对照组（P＜0．05）,红细胞压积、红细胞计数、白细胞计数、血小板计数与对照组比较差异无统计学意义（ P＞0．05）。结论血清铁蛋白、叶酸、血红蛋白、平均红细胞体积、平均血红蛋白、平均血红蛋白浓度的测定有助于诊断肝炎肝硬化患者合并IDA,肝炎肝硬化合并IDA患者的血液学异常与肝功能损害有密切关系。     

血清同型半胱氨酸、维生素B 12和叶酸水平与妊娠期亚临床甲状腺功能减退的相关性

目的：分析血清同型半胱氨酸、维生素B12和叶酸水平与妊娠期亚临床甲状腺功能减退的相关性。方法选择2014年1月至2015年11月在河南省南阳市中心医院产科诊断为妊娠期亚临床甲状腺功能减退孕妇150例作为观察组,选择同期妊娠期甲状腺功能正常孕妇150例作为对照组。比较两组孕妇的血清促甲状腺激素、游离甲状腺激素、游离三碘甲状腺原氨酸、同型半胱氨酸、血清维生素B12、叶酸水平,分析血清促甲状腺激素以及同型半胱氨酸的相关血清指标。结果观察组的同型半胱氨酸水平、促甲状腺激素水平高于对照组（P＜0．05）,维生素B12和叶酸水平低于对照组（P＜0．05）。血清促甲状腺激素与同型半胱氨酸水平呈正相关（ P＜0．05）,血清促甲状腺激素与维生素B12和叶酸无明显相关性（ P＞0．05）。血清同型半胱氨酸水平与促甲状腺激素水平呈正相关（P＜0．05）,血清同型半胱氨酸水平与叶酸水平呈负相关（P＜0．05）,血清同型半胱氨酸水平与维生素B12无明显相关性（ P＞0．05）。结论妊娠期亚临床甲状腺功能减退和同型半胱氨酸、维生素B12和叶酸水平有一定的相关性。     

叶酸、维生素B12对高同型半胱氨酸血症患者心率变异性的影响

目的：探讨叶酸、维生素B12对高同型半胱氨酸患者的血清同型半胱氨酸（Hcy）、一氧化氮（No）水平及心率变异性（HRv）的影响。方法：63例血清Hcy水平增高患者随机分为2组：（1）对照组（30例）：不服用叶酸等影响Hcy的药物；（2）干预组（33例）：每天口服叶酸、维生素B嗡治疗前及治疗后4周，测定患者空腹血清Hcy、NO水平，同时行动态心电图检查。所有数据以SPSS10．0软件包进行统计学处理。结果：干预组Hcy水平与服药前相比降低（P〈0．01）；干预组NO水平与服药前相比升高（P〈0．01）：对照组Hcy及N0水平亦有变化但无统计学差异（P〉0．05）。干预组患者经治疗后正常窦性RR间期总体标准差（SDNN），每5min窦性RR间期均值标准差（SDANN），正常连续窦性RR间期差值均方根（rMSSD）均较治疗前升高，统计学有显著性差异（P〈0．01）。结论：口服叶酸、维生素B12显著降低了高Hcy血症患者的空腹Hcy水平，升高NO水平，使内皮功能得到改善；同时提高HRV，改善患者的自主神经功能，对于预防心脑血管病的发生有一定价值。     

血浆同型半胱氨酸与临床孤立综合征的相关性研究

目的探讨多发性硬化（MS）的早期表现一临床孤立综合征（clinically isolated syndromes,CIS）患者血浆同型半胱氨酸（hornocysteine,Hcy）水平及其临床意义。方法采用荧光偏振免疫法检测CIS患者40例（CIS组）血浆中Hcy的浓度,并用放免方法检测叶酸、维生素B12,其结果与30例健康体检者（NC组）进行比较。结果CIS组血浆中Hcy水平高于NC组,差异有显著性（P〈0．05）,而两组叶酸、维生素B12浓度差异无统计学意义（P〉0．05）aCIS组中脊髓型和脑干型Hcy水平相比较,差异无统计学意义（P〉0．05）。结论血浆Hcy水平与CIS有关,CIS患者Hcy水平升高,可能在CIS向MS发展的病理过程中发挥作用。     

冠心病患者血浆同型半胱氨酸水平与血清叶酸、维生素B12浓度的相关性研究

目的观察高同型半胱氨酸血症（HHCY）是否是人群发生冠心病（CHD）的独立危险因素，同时探讨CHD患者血中同型半胱氨酸（HCY）、叶酸、VitB12浓度的变化及其相关性。方法选择CHD患者123例，正常对照101例。采用荧光偏振免疫分析法测定血浆HCY水平，化学发光免疫分析法测定血清叶酸、VitB12浓度。结果（1）CHD组患者血浆HCY平均浓度（15．04±7．58）μmol／L显著高于正常对照组（10．08±3．11）μmol／L，P〈0．01，CHD组患者血清叶酸平均浓度（4．02±2．27）ng/ml显著低于对照组（5．93±2．76）ng／ml，P〈0．01，CHD组患者血清VitBt2平均浓度（303．63±130．51）pg／ml与正常对照组（292．17±94．05）pg/ml比较差异无显著性（P〉0．05）。CHD组HHCY的发生率（36．59％）亦明显高于对照组（9．90％，P〈0．01）。CHD病因的多元Logistic回归分析显示HCY是CHD发病的独立危险因素。HCY对于CHD的相对危险度（RR）为1．238。相关分析显示：CHD组血浆HCY水平与血清叶酸、与VitB12浓度呈显著负相关（P=0．000）。结论HHCY是CHD的独立危险因素。CHD组血浆HCY水平与血清叶酸、与VitB12浓度呈线性负相关。血浆HCY、叶酸浓度检测有助CHD的诊断。     

抑郁症患者的血清叶酸和维生素B12浓度测定及其临床意义

目的：探讨抑郁症患者与血清叶酸和维生素B12浓度的关系。方法：采用放射免疫法对29例抑郁症患者（老年期抑郁症患者11例、青年抑郁症患者18例）和42例正常人（正常老年人20例、正常青年人22例）的血清叶酸和维生素B12浓度进行测定。结果：老年期抑郁症患者的血清叶酸浓度[（13.55±3.80）ng/ml]显著低于正常老年人[（18.86±7.99）ng/ml]（P〈0.05）,血清维生素B12浓度与正常老年人差异无显著性（P〉0.05）;青年抑郁症患者的血清叶酸[（12.20±4.17）ng/ml]和维生素B12浓度[（309.02±101.57）pg/ml]显著低于正常青年人[（20.11±10.59）ng/ml]和[（428.66±145.13）pg/ml]（P均〈0.05）。抑郁症患者的HAMD评分与血清叶酸和维生素B12浓度均无显著相关性（P均〉0.05）。结论：抑郁症患者存在叶酸和维生素B12缺乏。     

抑郁症患者血清维生素B12和叶酸水平研究

检测抑郁症患者血清维生素B12、叶酸的水平并探讨其与健康人群的差异。方法 采用电化学发光免疫分析方法对148例抑郁症患者（抑郁症组）和160例健康人群（健康对照组）进行血清维生素B12和叶酸的测定,比较抑郁症组与健康对照组血清维生素B12和叶酸水平。结果 抑郁症组血清维生素B12和叶酸的质量浓度分别为（527.28±173.74）pg·mL-1和（7.03±3.52）ng·mL-1,健康对照组血清维生素B12和叶酸的质量浓度分别为（669.67±336.89）pg·mL-1和（7.93±4.00）ng·mL-1,抑郁症组血清维生素B12和叶酸水平均低于健康对照组（P=0.000,P=0.038）。结论 抑郁症患者的血清维生素B12和叶酸水平低于健康人群。 更多还原     

宫外孕三种保守治疗方法的疗效比较

目的：探讨3种保守治疗方法在宫外孕治疗中的临床疗效。方法：A组：米非司酮组25例。B组：米非司酮配伍甲氨蝶呤组25例；C组：甲酰四氢叶酸配伍甲氨蝶呤组20例；结果：A组与B组2者保守治疗宫外孕成功率有显著差异（P〈0．05）。C组与A组2者保守治疗宫外孕成功率有显著差异（P〈0．05），而B组与C组无显著性差异（P〉0．05），3者毒副作用无显著性差异（P〉0．05）。结论：使用米非司酮配伍甲氨蝶呤进行宫外孕保守治疗疗效确切，而甲酰四氢叶酸配伍甲氨蝶呤值得在临床上推广。     

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.     

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.