胰岛素抵抗与冠心病关系的初步探讨

本文测定了２０例冠心病患者和１９例正常人葡萄糖耐量（ＯＧＴＴ）时胰岛素和血糖水平。冠心病组ＯＧＴＴ的１、２、３ｈ血清胰岛素为４９．１±１８．９ｍＩＵ／Ｌ、４６．３±１６．４ｍＩＵ／Ｌ３９．６±１５．９ｍＩＵ／Ｌ胰岛素／血糖（ｍＩＵ／ｍｍｏｌ）比值分别为５．１±１．３、５．８±１．１、７．３±１．４，结果均明显高于正常对照组（Ｐ＜０．０１）。表明冠心病组病人存在高胰岛素血症和胰岛素抵抗（ＩＲ）。同时，冠心病组总胆固醇、甘油三酯分别为６．１２±１．８２ｍｍｏｌ／Ｌ、２．４４±１．０６ｍｍｏｌ／Ｌ，均显著高于对照组（Ｐ＜０．０１、Ｐ＜０．０５），提示胰岛素抵抗可能导致脂质代谢紊乱，进而引起冠心病。     

高血压病患者胰岛素抵抗与血浆纤溶酶原激活物抑制物-1的关系

目的：研究高血压病（ｅｓｅｎｔｉａｌｈｙｐｅｒｔｅｎｓｉｏｎ,ＥＨ）病人胰岛素抵抗（ｉｎｓｕｌｉｎｒｅｓｉｓｔａｎｃｅ,ＩＳＲ）与纤溶酶原激活物抑制物１（ＰＡＩ１）的关系。方法：ＥＨ病人５９例,正常对照４６例。测定血浆ＰＡＩ１、ｔＰＡ（组织型纤溶酶原激活物）、空腹血糖（ＧＬＵ）、胰岛素（ＩＮＳ）、低密度脂蛋白胆固醇（ＬＤＬＣ）、高密度脂蛋白胆固醇（ＨＤＬＣ）、甘油三酯（ＴＧ）、胰岛素敏感指数（ＩＳＩ）、血尿酸（ＵＡ）、体重指数（ＢＭＩ）、腹围／臀围比（ＷＨＲ）等指标。结果：ＥＨ病人ＩＳＩ（用空腹血糖与胰岛素乘积的倒数表示）较正常对照组下降（－５．４±０．５ｖｓ－３９±０．８,Ｐ＜０．０１）。血浆ＰＡＩ１较对照组升高［（２９±８）ｍｇ·Ｌ－１ｖｓ（２４±５）ｍｇ·Ｌ－１,Ｐ＜０．０１］。在高血压组中单相关分析表明ＰＡＩ１与ＷＨＲ（ｒ＝０．３６９,Ｐ＜０．０１）、ＧＬＵ（ｒ＝０．５６３,Ｐ＜０．００１）正相关,与ＩＳＩ（ｒ＝－０．３０１,Ｐ＜０．０５）,ＨＤＬＣ（ｒ＝－０．４１７,Ｐ＜０．０１）、ｔＰＡ（ｒ＝－０．４９９,Ｐ＜０．００１）负相关。以ＢＭＩ、ＷＨＲ、ＩＳＩ、ＨＤＬＣ、ＬＤＬ     

肾病综合征病人抗氧化功能的研究

为研究肾病综合征（ＮＳ）时抗氧化功能状况，我们测定３６例患者血超氧化物歧化酶（ＳＯＤ）、丙二醛（ＭＤＡ）及维生素Ｅ，以及尿ＳＯＤ、ＭＤＡ。结果表明：ＮＳ患者血总ＳＯＤ、Ｃｕ－Ｚｎ－ＳＯＤ及维生素Ｅ水平明显低于正常对照组（分别为７６．２２±２７．４８μＵ／Ｌ比１０４．２０±１８．８０μＵ／Ｌ，Ｐ＜０．００１；２０．４０±２２．６３μＵ／Ｌ比６２．９９±１５．６０μＵ／Ｌ，Ｐ＜０．００１；６．６８±３．５２ｍｇ／Ｌ比１６．３８±１．０５ｍｇ／Ｌ，Ｐ＜０．００１）；尿ＳＯＤ及ＭＤＡ明显高于对照组（分别为：１１４．９８±３１．７３μＵ／Ｌ比８２．３４±２６．５０μＵ／Ｌ，Ｐ＜０．００１；３．９９±１．９８μｍｏｌ／Ｌ比２．６４±０．７８μｍｏｌ／Ｌ，Ｐ＜０．００１）．研究提示，ＮＳ时抗氧化功能减退，肾脏易遭受氧自由基损害。     

小儿感染性疾病血清纤维结合蛋白测定的临床价值

本文测定了４５例感染儿和２０例健康儿血清纤维结合蛋白（Ｆｎ）、转铁蛋白（Ｔｆ）、免疫球蛋白（Ｉｇ）含量。结果：①感染儿Ｆｎ（０．０３８±０．０３５ｇ／Ｌ）明显低于健康儿（０．１８８±０．０３７ｇ／Ｌ）（Ｐ＜０．００１），②４５例感染儿中２５例肺炎与２０例非呼吸道疾病儿Ｆｎ均低于健康组（分别为０．０３３±０．０２９ｇ／Ｌ和０．０４４±０．０３ｇ／Ｌ），Ｐ均＜０．００１）。２５例肺炎儿中１２例重型Ｆｎ（０．０１９０±０．０１５６ｇ／Ｌ）较普通型（０．０３８±０．０３１ｇ／Ｌ）降低（Ｐ＜０．０５）③感染儿Ｔｆ（１．２４７±０．８５４ｇ／Ｌ）明显低于健康儿（１．９９９±０．２５１ｇ／Ｌ）（Ｐ＜０．００１），感染儿ＩｇＧ（９．５９３±３．０４１ｇ／Ｌ）也明显低于健康儿（１３．０１０±０．４７４ｇ／Ｌ）（Ｐ＜０．００１）；ＩｇＡ、ＩｇＭ无显著差异。表明：①Ｆｎ含量可作为揭示感染及判定感染严重程度的客观指标。②Ｔｆ值具有提示感染及评估铁营养状况的双重价值。③本实验在临床上对感染性疾病患儿评价病情及指导治疗均有实用意义     

经皮二尖瓣球囊扩张术对血浆降钙素基因相关肽、内皮素失衡的影响

为探讨经皮二尖瓣球囊扩张术（ＰＢＭＶ）对血浆降钙素基因相关肽（ＣＧＲＰ）及内皮素（ＥＴ）的影响，采用放射免疫分析法（ＲＩＡ）测定了３０例二尖瓣狭窄（ＭＳ）患者经皮二尖瓣球囊扩张术前后血浆降钙素基因相关肽、内皮素水平。结果显示：１、ＰＢＭＶ前后血浆ＣＧＲＰ水平分别为３５．６０１±１７．２９４ｎｇ／Ｌ，３９．２４６±１８．５２８ｎｇ／Ｌ（Ｐ＞０．０５）；血浆ＥＴ分别为１１７．５２４±４０．６３１ｎｇ／Ｌ，９４．９４９±３１．７９９ｎｇ／Ｌ（Ｐ＜０．０５）；ＣＧＲＰ／ＥＴ分别为０．３０２±０．１４１、０．４５２±０．１６１。２、血浆ＣＧＲＰ水平与平均肺动脉压呈负相关（ｒ＝－０．４３５，Ｐ＜０．０５），而与血浆ＥＴ呈显著正相关（ｒ＝０．７３５，Ｐ＜０．００１）。研究表明，ＭＳ患者血浆ＣＧＲＰ／ＥＴ严重失衡，ＰＢＭＶ对恢复ＣＧＲＰ／ＥＴ间平衡有积极作用，测定其血浆含量可做为判定病情程度及ＰＢＭＶ疗效的一项指标     

空腹甘油三酯正常者脂肪负荷试验的动态观察

目的：探讨空腹ＴＧ正常的人在脂肪餐后的血脂水平的动态变化。方法：采用６３．９ｇ／ｍ２体表面积的脂肪餐，对５８名ＴＧ　≤１．７０　ｍｍｏｌ／Ｌ的人进行脂肪代谢的研究，根据年龄分为老年组、中年组和青年组，又依据餐后４ｈ、８ｈＴＧ浓度和ＴＧ－ＡＵＣ分为餐后ＴＧ正常组和异常组。结果：脂肪餐后的ＴＧ水平明显较空腹增高（Ｐ　＜０．００１），餐后各时间点之间的ＴＧ无显著性差异（Ｐ　＞０．０５），平均达峰时间为３．９８ｈ，８ｈ未能完全恢复至空腹水平。青、中、老年组达峰时间和ＴＧ－ＡＵＣ依次递增，仅青年组和老年组达峰时间的差异有显著性意义（Ｐ　＜０．０５）。餐后ＴＧ异常组各时间点的ＴＧ水平均明显高于正常组（Ｐ　＜０．００１）。餐后ＴＣ、ＨＤＬ－Ｃ和ＬＤＬ－Ｃ在２　ｈ时都有一个低谷期，８　ｈ时基本恢复正常。结论：空腹ＴＧ正常者中有一些人，在高脂餐后可出现ＴＧ代谢异常；ＴＧ廓清速率随着年龄的增加而减慢。     

石楠藤提取物对急性出血坏死性胰腺炎大鼠治疗作用的实验研究

作者报道中药石楠藤提取物对急性出血坏死性胰腺炎（ＡＨＮＰ）大鼠治疗作用的实验研究。将１００只ＳＤ大鼠随机分为三组：①假手术组（ＳＯ组）；②ＡＨＮＰ组（ＡＰ组），该组动物在ＡＨＮＰ诱发后，不做特殊治疗；③石楠藤提取物治疗组（ＳＮ组）。该组动物在ＡＨＮＰ诱发后１０分钟经腹腔内注射石楠藤提取物（１％石楠藤提取物５ｍｌ／ｋｇ体重）。结果表明：ＳＮ组血清淀粉酶值明显下降（ＳＮ组１６１３０±５０３０Ｕ／Ｌ６ｈ、１９２９０±５３８０Ｕ／Ｌ１２ｈｖｓＡＰ组２３７８０±３９６０Ｕ／Ｌ、２８４７０±４１５０Ｕ／Ｌ，Ｐ＜０．０１）。血中ＰＡＦ含量明显降低（ＳＮ组１．３±０．３０ｎｇ／ｍｌ１ｈ、２．０±０．３４ｎｇ／ｍｌ６ｈ、２．１±０．３２ｎｇ／ｍｌ１２ｈｖｓＡＰ组２．２±０．２５ｎｇ／ｍｌ、６．１±０．４２ｎｇ／ｍｌ、１０．１±０．５３ｎｇ／ｍｌ，ｐ＜０．０１）。血浆内毒素含量明显下降（ＳＮ组６９．９±７．２ＥＵ／Ｌ、６ｈ、９１．１±８．４ＥＵ／Ｌ、１２ｈｖｓＡＰ组９８．４±６．９ＥＵ／Ｌ、１５１．７±９．１ＥＵ／Ｌ，Ｐ＜０．０１）。石楠藤提取物治疗组术后平均存活时间明显长于ＡＰ组（ＳＮ组：４３．５ｈ，ＡＰ组１１．５ｈ，ｐ＜０     

中老年男性血SOD,FBG,TG,TC及免疫球蛋白含量分析

目的 探讨衰老过程中机体内酶，血糖，血脂及免疫球蛋白含量变化，而进一步研究诱发性疾病的一些相关因素。方法 邻苯三酚自氧法，终点法速率散射浊度法。结果 ＳＯＤ老年组２７５０±５２０ｕ／ｇＨｂ，对照组２８７０±５０３Ｕ／ｇＨｂ（Ｐ〈０．０１）。ＦＢＧ老年组６．１１±２．１４ｍｍｏｌ／Ｌ，对照组５．０２±０．５７ｍｍｏｌ／Ｌ（Ｐ〈０．０１），ＴＧ老年组５．３９±１．１２ｍｍｏｌ／Ｌ对照组４．６７±０．７     

测定肺泡灌洗液心钠素在肺良恶性病变鉴别中的价值

目的：探讨支气管肺泡灌洗液（ＢＡＬＦ）心钠素（ＡＮＰ）水平在肺部良、恶性病变鉴别中的价值。方法：采用放射免疫直接测定法,测定４０例肺部良性病变和３５例肺癌患者ＢＡＬＦ中ＡＮＰ水平分别为（７０±６）ｎｇ／Ｌ、（１５３±３５）ｎｇ／Ｌ,两者有极显著差异（Ｐ＜０．００１）;肺良性病变ＢＡＬＦ中ＡＮＰ水平［（７０±６）ｎｇ／Ｌ］明显低于血清ＡＮＰ水平［（１６５±３０）ｎｇ／Ｌ］,差异有极显著性意义（Ｐ＜０．００１）;肺良性病变和肺癌ＢＡＬＦ与血清ＡＮＰ水平之比值分别为０．４２、０．９,两者差异有极显著性意义（Ｐ＜０．００１）;其对肺癌的敏感性及特异性分别为８０％和１００％。结论：测定ＢＡＬＦ中ＡＮＰ水平是肺部良、恶性病变鉴别的重要方法之一。     

重组人类促红细胞生成素治疗慢性肾功能衰竭贫血

应用重组人类促红细胞生成素（ｒＨｕＥＰＯ）治疗１６例慢性肾功能衰竭（ＣＲＦ）维持血液透析（ＨＤ）患者的贫血，８周后，贫血明显改善，生活质量提高。共观察１２周。血红蛋白（Ｈｂ）由５１．４±９．３ｇ／Ｌ增至８８．４±４．７ｇ／Ｌ（Ｐ＜０．００１），红细胞比积（Ｈｃｔ）由１７．５±２．８％增至３１．７±４．２％（Ｐ＜０．００１）。     

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.