特种蛋白检测在老年肺炎中的临床意义

目的 :评价前白蛋白 (PA)、转铁蛋白 (TRF)和C -反应蛋白 (CRP)在区分老年急性肺炎病原体中的作用 ,并探讨其临床应用价值。方法 :采用免疫散射比浊法 ,测定老年肺炎患者治疗前后的血清PA、TRF和CRP水平。结果 :细菌感染组患者治疗前CRP水平明显高于健康对照组 ,而PA和TRF水平明显低于健康对照组 ,两者差异有显著性 (P<0 .0 0 1) ;病毒感染组与对照组比较 ,PA、TRF和CRP差异无显著性 (P >0 .0 5 ) ;细菌性肺炎患者治疗前CRP水平明显高于治疗后 ,而PA、TRF水平明显低于治疗后 ,两者差异有显著性 (P <0 .0 0 1) ;血清PA、TRF和CRP阳性率高于白细胞计数、红细胞沉降率 (ESR)和细菌培养的阳性率 ,两者差异有显著性 (P <0 .0 0 1)。结论 :血清PA、TRF和CRP的定量检测可用于老年肺炎病原体的鉴别及疗效的观察 ,其价值明显高于白细胞计数、ESR和细菌培养 ,是反映老年肺炎感染的敏感且可靠的指标 ,值得临床推广应用     

血清降钙素原、c反应蛋白、白细胞计数对细菌性感染的诊断价值研究

目的探讨血清降钙素原、C反应蛋白、白细胞计数对细菌性感染的诊断价值,为在细菌性感染的诊断、鉴别诊断及指导临床应用抗生素提供指导依据。方法本研究共收集2008年2月～2012年5月期间我院收治的46例细菌性感染性疾病。48例非细菌感染性疾病及40名健康体检者作为本组研究对象,分别检测各组的血清降钙素原、C反应蛋白、白细胞计数水平及比较各组的阳性率。结果细菌性感染组PCT、CRP、WBC计数均明显高于非细菌性感染组、健康对照组,差异有统计学意义（P〈0．05）。细菌性感染组PCT阳性率达95．7％,明显高于非细菌性感染组PCT阳性率（12．5％）,差异有极其显著性（P〈0．01）。细菌性感染组CRP阳性率达100．0％,高于非细菌性感染组PCT阳性率（87．5％）,但差异并不存在显著性（P〉0．05）。细菌性感染组WBC阳性率达93．5％,明显高于非细菌性感染组WBC阳性率（4．2％）,差异有极其显著性（P〈0．01）。结论细菌性感染患者的血清降钙素原、C反应蛋白、白细胞计数均明显高于非细菌感染性疾病患者,对细菌性感染患者进行血清降钙素原、C反应蛋白、白细胞计数检测,可以为临床进行早期准确诊断,尽早进行有效合理治疗,取得良好的预后提供有利的参考依据。     

C反应蛋白在儿童急性呼吸道感染中的应用价值

目的 探讨C-反应蛋白（CRP）在儿童呼吸道感染早期诊断和疗效判断中的价值。方法 检测急性呼吸道细菌感染组75例,病毒感染组70例,健康儿童60例CRP含量和白细胞计数。结果 与病毒感染组、对照组相比较,细菌感染组CRP明显升高（P〈0．01）,细菌感染组治疗前后CRP比较,差异有统计学意义（P〈0．01）。结论 在儿童急性呼吸道感染时,血清中CRP有助于疾病的早期鉴别诊断,动态检测其变化对疗效判断有一定的价值。     

特种蛋白检测在老年肺炎中的临床意义

目的:评价前白蛋白(PA)、转铁蛋白(TRF)和C-反应蛋白(CRP)在区分老年急性肺炎病原体中的作用,并探讨其临床应用价值.方法:采用免疫散射比浊法,测定老年肺炎患者治疗前后的血清PA、TRF和CRP水平.结果:细菌感染组患者治疗前CRP水平明显高于健康对照组,而PA和TRF水平明显低于健康对照组,两者差异有显著性(P<0.001);病毒感染组与对照组比较,PA、TRF和CRP差异无显著性(P>0.05);细菌性肺炎患者治疗前CRP水平明显高于治疗后,而PA、TRF水平明显低于治疗后,两者差异有显著性(P<0.001);血清PA、TRF和CRP阳性率高于白细胞计数、红细胞沉降率(ESR)和细菌培养的阳性率,两者差异有显著性(P<0.001).结论:血清PA、TRF和CRP的定量检测可用于老年肺炎病原体的鉴别及疗效的观察,其价值明显高于白细胞计数、ESR和细菌培养,是反映老年肺炎感染的敏感且可靠的指标,值得临床推广应用.     

血清C-反应蛋白与前清蛋白检测对普外感染病人的诊断价值

①目的评价血清C-反应蛋白（CRP）与前清蛋白（PA）在普外感染病人中的变化及其意义。②方法分别对42例普外感染病人进行了术前、术后血清CRP与PA水平的检测,同时与30例健康成人的检测结果进行比较。③结果感染组病人术前血清CRP、PA水平与对照组比较有显著差异（t=3．12、7．28,P〈0．01）;感染组病人术前、术后血清CRP、PA水平比较差异有显著性（t=2．91、6．37,P〈0．01）。④结论CRP、PA的检测对普外感染病人的诊断有一定价值。     

血清C反应蛋白与前白蛋白的测定在新生儿感染性疾病中的应用价值

目的探讨新生儿细菌感染时血清C反应蛋白（CRP）和前白蛋白（PA）的变化对疾病诊断、病情评估及疗效观察的临床意义。方法用免疫比浊法检测59例正常足月新生儿（正常对照组）和78例新生儿（细菌感染组）细菌感染治疗前、治疗后第2天、第7天血清CRP和PA水平。结果与正常对照组相比，细菌感染组血清CRP明显升高，PA则明显降低，均有显著性差异，P〈0．05；感染危重组与非危重组结果比较，血清CRP亦明显升高，PA明显降低，两组间有显著性差异，P〈0．05；感染组治疗前与治疗后第2天、治疗后第2天与第7天比较，血清CRP有明显降低，PA明显升高，其差异均有显著性，P〈0．05，而治疗后第7天检测结果与对照组无显著性差异，P〉0．05。结论血清CRP及PA不仅可以作为诊断新生儿细菌感染的灵敏指标，还可用来评估感染的危重程度，同时，动态观察其血清水平还可用来评价感染性疾病的疗效。     

C-反应蛋白在感染性疾病鉴别诊断中的应用研究

目的：评价C-反应蛋白（CRP）在感染性疾病鉴别诊断中的应用价值。方法：对2010年1月～2011年12月本院急性和慢性细菌感染、病毒感染、寄生虫感染、活动期和稳定期结核感染患者分别检测C-反应蛋白浓度、WBC计数、中性粒细胞计数、ESR,分析C-反应蛋白在急性与慢性感染组间、各不同病原体感染组间的差异和与其他指标的相关性。结果：急性细菌感染组CRP浓度显著高于健康对照组、慢性细菌感染组和急性病毒感染组、急性结核感染组以及急性寄生虫感染组（P〈0.01）;慢性细菌感染组CRP浓度高于其他慢性病原体感染组和健康对照组（P〈0.05）;寄生虫感染组与健康对照组间无明显差异（P〉0.05）;急性结核感染组CRP浓度高于健康对照组和慢性结核感染组（P〈0.05）,但慢性结核感染组和健康对照组间无明显差异（P〉0.05）。结论：检则CRP对指导急性细菌感染的诊断和尽早指导抗细菌感染治疗有重要意义。     

CRP、WBC和ESR联合检测在儿童感染性疾病中应用及意义

目的探讨血清中C-反应蛋白（CRP）、白细胞（WBC）、血沉（ESR）的检测对儿童早期感染鉴别诊断的价值。方法分为细菌感染组35例、病毒感染组28例和对照组20例，分别采用CRP快速分析仪、全自动血球计数仪及ESR测定仪检测。结果细菌感染组CRP、WBC、ESR明显高于对照组，差异非常显著（P〈0．01）；细菌感染组与病毒感染组比较CRP、WBC均有非常显著性差异（砌．01），但ESR无显著差异（P〉0．05）；病毒感染纽CRP、WBC与对照组无显著差异（P〉0．05），ESR明显升高，与对照组有非常显著性差异（P〈0．01）。结论小儿急性感染时，CRP、WBC的检测有助于疾病早期鉴别诊断，对于细菌感染和病毒感染的鉴别诊断有重要价值，而ESR阳性率低，对细菌感染和病毒感染早期鉴别作用不明显。     

110例急性呼吸道感染C反应蛋白检测的分析

目的：C反应蛋白（CRP）的检测对急性呼吸道感染的鉴别诊断和疗效判断的价值。方法：CRP的检测采用免疫透射比浊法，本检测110例急性呼吸道感染患血清CRP水平。结果：（1）110例急性呼吸道感染急性期患血清CRP水平显高于对照组（P＜0．01）；（2）细菌感染组与病毒感染组、对照组相比，CRP水平差异有显性（P＜0．01）。结论：急性呼吸道感染患CRP水平显升高，特别是细菌感染组显高于病毒感染组、血清CRP检测可用于急性呼吸道感染的鉴别诊断，动态检测其变化对疗效判断有一定的价值。     

慢性阻塞性肺疾病急性加重期血清C-反应蛋白测定的临床意义

目的 探讨C-反应蛋白（CRP）在慢性阻塞性肺疾病急性加重期（AECOPD）患者治疗中的意义。方法对比80例AECOPD患者入院前后血清CRP水平、白细胞总数（WBC）、肺功能（FEV1％预计值）和动脉血气分析动态变化情况。结果AECOPD患者血清CRP水平显著高于COPD稳定期患者（P〈0．01）,治疗后CRP在WBC未显著变化时已明显下降,治疗前后的差异有统计学意义（P〈0．01）。CRP的阳性率明显高于白细胞计数、中性粒细胞比率、血沉、体温。结论CRP升高不仅提示COPD的急性加重,极度升高提示COPD患者病情严重并且可能预后不良。CRP作为反映细菌性感染的敏感指标,在疗效上比WBC更迅速、敏感。     

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.