2型糖尿病与超敏C-反应蛋白和血脂的关系

目的 观察2型糖尿病与超敏C-反应蛋白(hs-CRP)和血脂的关系.方法 选取40例2型糖尿病患者(观察组),同时选取40例健康志愿者(对照组),均于清晨空腹采集静脉血,分离血清,利用全自动生化分析仪检测血清中hs-CRP、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)的含量,比较两组各生化指标的差别.结果 观察组hs-CRP、TG、TC、LDL-C均明显高于对照组,差异有统计学意义(P＜0.05);观察组HDL-C明显低于对照组,差异亦有统计学意义(P＜0.05).结论 hs-CRP和血脂与2型糖尿病有密切的关系,糖尿病患者应定期检测血脂,有效地控制血脂水平,以对糖尿病及并发心血管等疾病的诊断、治疗和预防提供依据.     

复方芪藤通络汤联合依帕司他治疗老年2型糖尿病周围神经病变临床研究

目的:观察复方芪藤通络汤联合依帕司他对老年2型糖尿病周围神经病变(diabetic peripheral neuropathy,DPN)患者临床体征及症状、神经传导速度及糖代谢水平等的影响。方法:102例DPN患者按照随机数字表法分为观察组和对照组,各51例。对照组给予常规控制血压、血糖、血脂治疗,并每次口服依帕司他50 mg,3次·d-1。观察组对照组基础上加用复方芪藤通络汤。两组均治疗3个疗程。比较两组患者临床疗效及治疗前后中医证候评分、多伦多临床评分、血液流变学、神经传导速度和糖代谢水平变化情况。结果:治疗3个疗程后观察组有效率86.27%,显著高于对照组68.63%,差异有统计学意义(P0.05);两组中医证候积分较治疗前明显降低,差异有统计学意义(P0.05),且观察组明显优于对照组,差异有统计学意义(P0.05);治疗前,两组多伦多临床评分、血液流变学各指标、神经传导速度各项指标及糖代谢水平对比,差异无统计学意义(P0.05),经治疗,两组各项指标均有所改善,且观察组显著优于对照组,差异有统计学意义(P0.05)。结论:复方芪藤通络汤联合依帕司他治疗老年2型DPN患者可有效改善其临床体征与症状,提高临床疗效,同时可提高神经传导速度,改善血液流变学及糖代谢各项指标水平。     

糖尿病并发短暂性脑缺血发作患者血脂及高敏C反应蛋白水平与预后的关系

目的 探讨糖尿病并发短暂性脑缺血发作(TIA)患者血脂、血清高敏C反应蛋白(hs-CRP)与预后的关系.方法 选择80例糖尿病并发TIA首次发作患者,对其随访1年,其中31例糖尿病并发2～4次TIA(B组),6例发生缺血性卒中(C组),余43例随访中未再发生TIA及缺血性卒中(A组);另选择40例糖尿病无TIA者作为对照组.检测各组患者血脂及血清hs-CRP水平.结果 A、B、C组患者血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、hs-CRP水平均显著高于对照组,差异有统计学意义(P＜0.01);B、C组患者血清TC、LDL-C、hs-CRP水平显著高于A组,差异有统计学意义(P＜0.05);C组患者血清TC、LDL-C、hs-CRP水平又显著高于B组,差异有统计学意义(P＜0.05).结论 血脂及hs-CRP水平可作为判断糖尿病并发TIA患者预后的指标;血脂、血清hs-CRP水平升高,提示糖尿病并发TIA患者预后较差.     

不同糖耐量冠心病患者炎症因子与胰岛素抵抗的相关性分析

目的探讨不同糖耐量冠心病(CHD)患者的炎症因子与胰岛素抵抗(IR)的关系及意义。方法经冠状动脉造影确诊的CHD患者104例,均在入院后进行葡萄糖耐量实验(OGTT),根据OGTT结果分为糖耐量正常(NGT)组38例、糖耐量异常(IGT)组32例、2型糖尿病(T2DM)组34例,测定空腹血糖(FPG)、空腹胰岛素(FINS)、血脂、肿瘤坏死因子-α(TNF-α)及高敏C-反应蛋白(hs-CRP)等指标,采用自我平衡模型分析法(HOMA)计算胰岛素抵抗指数(IRI)。结果 T2DM组TNF-α、hs-CRP水平及IRI明显高于IGT组及NGT组,IGT组亦明显高于NGT组,差异有统计学意义(P<0.01),相关性分析显示IRI与TNF-α、hs-CRP水平呈正相关(r分别为0.342、0.425,P<0.05)。结论随着CHD患者糖代谢进展,TNF-α、hs-CRP水平及IRI逐步升高,二者呈正相关,共同参与了CHD并发IGT和T2DM。     

普伐他汀对T2DM并发高血压患者血清中炎症因子和血脂的影响

目的 探讨普伐他汀对2型糖尿病(T2DM)并发高血压患者血清中炎症因子和血脂水平的影响.方法 将112例T2DM并发高血压患者分为对照组和观察组,每组56例.对照组患者给予控制饮食、降血糖、控血压等治疗;观察组患者在对照组治疗的基础上加用普伐他汀进行治疗,比较治疗前后两组患者血清白细胞介素6(IL-6)、高敏C反应蛋白(hs-CRP)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)及高密度脂蛋白胆固醇(HDL-C)的水平.结果 与治疗前比较,治疗后观察组患者血清中IL-6、TC、hs-CRP、TG及LDL-C水平均明显降低,HDL-C水平明显升高,差异有统计学意义(P＜0.05);对照组患者的各项检测指标虽有改善,但与治疗前比较差异无统计学意义(P＞0.05).与对照组比较,观察组患者治疗后IL-6、hs-CRP、TC、TG及LDL-C水平明显降低(P＜0.05),HDL-C水平明显升高(P＜0.05).结论 普伐他汀能有效地控制T2DM并发高血压患者血中炎症因子和血脂水平.     

利拉鲁肽对2型糖尿病合并脑血栓患者高敏C反应蛋白和血脂及颈动脉粥样硬化斑块的影响探究

目的探讨利拉鲁肽对2型糖尿病合并脑血栓患者高敏C反应蛋白(hs-CRP)和血脂及颈动脉粥样硬化斑块的影响。方法选择2016年1月至2018年9月我院收治的110例2型糖尿病合并脑血栓患者,随机分为两组,各55例。对照组采取二甲双胍治疗,观察组采取二甲双胍联合利拉鲁肽治疗。比较两组高敏C反应蛋白(hs-CRP)、血脂水平、血糖水平及斑块变化情况。结果治疗后,观察组hs-CRP、LDL、TG及TC低于对照组,HDL高于对照组,观察组血糖水平低于对照组,观察组颈动脉粥样硬化斑块面积及动脉内膜中层厚度均小于对照组,差异具有统计学意义(P0.05)。结论 2型糖尿病合并脑血栓患者采取利拉鲁肽治疗,可有效改善患者hs-CRP及血脂水平,降低血糖水平,缩小斑块面积及中层厚度,促进患者康复。     

止嗽散加味治疗慢性支气管炎急性发作合并2型糖尿病临床研究

目的探讨止嗽散加味对慢性支气管炎急性发作合并2型糖尿病患者的临床疗效及炎性因子水平的影响。方法选取2017年9月—2019年2月于辽阳市中医院就诊治疗的慢性支气管炎急性发作合并2型糖尿病患者104例,随机分为观察组与对照组,每组各52例,对照组患者接受常规西医治疗,观察组患者在对照组基础上服用止嗽散加味治疗,并于治疗结束后观测两组患者的治疗有效率、肺功能[用力肺活量(FVC)、第一秒用力呼气容积占预计值百分比(FEV1/Pre)、第一秒用力呼气容积占用力肺活量比值(FEV1/FVC)]、糖代谢指标[空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)]、生活质量评分及血清炎性因子[超敏C反应蛋白(hs-CRP)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]水平。结果治疗后观察组患者有效率显著高于对照组(P0.05)。治疗后观察组患者肺功能指标(FVC、FEV1/Pre、FEV1/FVC)、生活质量评分显著高于对照组(P0.05),且糖代谢指标(FPG、2 h PG、HbA1c)、血清炎性因子(hs-CRP、IL-6、TNF-α)水平显著低于对照组(P0.05)。结论止嗽散加味能够明显提高慢性支气管炎急性发作合并2型糖尿病患者肺功能水平,降低患者糖代谢水平及血清炎性因子IL-6、TNF-α、hs-CRP表达,改善患者生活质量,临床治疗效果显著且安全性高,值得临床推广应用。     

心脑血管疾病诊断中超敏C反应蛋白和血脂联合检测的临床体会

目的:探讨分析心脑血管疾病诊断中超敏C反应蛋白(hs-CRP)和血脂联合检测的临床价值。方法:选取我院2012年10月-2013年11月收治的168例心脑血管疾病患者为观察组,同期进行体检的200例健康者作为对照组,分别测定两组人员的hs-CRP和甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白固醇(HDL-C)以及低密度脂蛋白胆固醇(LDL-C)的水平,并就结果加以对比分析。结果:观察组患者hs-CRP、TG、TC、LDL-C水平均较对照组高,HDL-C较对照组低,且观察组患者hs-CRP和血脂水平会随着患者病情的不同而发生变化,差异均具有统计学意义(p0.05)。结论:hs-CRP和血脂联合检测在心脑血管疾病的诊断中具有重要价值,值得临床应用推广。     

糖尿病合并高血压患者血脂代谢水平的变化及意义分析

目的分析2型糖尿病合并高血压患者血脂代谢水平的变化情况及意义。方法选取郑州市第七人民医院2013年7月至2014年8月就诊的糖尿病患者84例(对照组)及糖尿病合并高血压患者84例(观察组)为研究对象,统计分析两组患者的血脂水平及相关指标。结果观察组总胆固醇(TC)、甘油三脂(TG)、低密度脂蛋白胆固醇(LDL-C)、极低密度脂蛋白胆固醇(VLDL-C)与对照组比较,差异具有统计学意义(P<0.05)。观察组谷丙转氨酶、尿酸、载脂蛋白B水平均较对照组高(P<0.05)。观察组血脂异常率高于对照组(P<0.05)。结论 2型糖尿病合并高血压患者的血脂水平和血脂异常率明显高于非高血压患者。     

妊娠期糖尿病患者凝血功能指标118例分析

目的探讨妊娠期糖尿病患者的凝血功能的状态及其在临床诊疗中的意义。方法调研2016年3月至2017年2月我院妇产科收诊的118例妊娠期糖尿病患者均观察组,同时抽调同期住院的118例糖耐量正常的妊娠后期孕妇视为对照组;均在入院后第二天抽取空腹血,观察两组患者的凝血因子的各项指标水平。结果两组PLT、PT、TT的各项水平差异无统计学意义(P0.05)。观察组的aPTT下调比例及Fbg上调比例明显高于对照组(P0.05)。结论妊娠期糖尿病患者的凝血功能的各项指标中部分指标与正常产妇有明显异常,及时检测凝血功能的指标可有效的预防血栓形成。     

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.