血尿酸与颈动脉粥样硬化的关系探讨

目的探讨血尿酸水平与颈动脉粥样硬化的关系,以阐明血尿酸在颈动脉粥样硬化发生中的作用。方法检测40例患者晨起空腹血清尿酸水平,依尿酸水平分组：A组：尿酸〈350μmol／L,20例;B组：尿酸≥350μmol／L,20例。2组在血糖、血脂、年龄、性别等方面相匹配。采用高分辨率彩色多普勒超声仪检测2组颈动脉IMT及颈动脉窦部斑块发生率。结果A组平均颈动脉IMT=（0．92±0．21）mm,颈动脉窦部斑块发生率15％;B组平均颈动脉IMT=（1．18±0．27）mm,颈动脉窦部斑块发生率30％。2组比较P〈0．05,有显著性差异。结论血尿酸水平与颈动脉粥样硬化有关,血尿酸在颈动脉粥样硬化及斑块发生中起一定作用。     

血尿酸水平与老年高血压患者颈动脉硬化关系探讨

目的:探讨血尿酸(UA)与老年高血压患者颈动脉粥样硬化病变的关系.方法:将90例老年高血压患者按血UA水平分为A组(血UA<300 μmol/L)23例,B组(血UA300～399 μmol/L) 25例,C组(血UA400～499 μmol/L)23例, D组(血UA>500 μmol/L) 19例,20例血UA<300 μmol/L的正常老年人为对照(对照组),应用彩色多普勒超声检测其颈动脉内中膜厚度(IMT)、粥样硬化斑块,同时检测血脂、UA及C反应蛋白(CRP).结果:高血压组的IMT较对照组明显增厚,P<0.01;动脉粥样斑块的检出率明显增高,P<0.05;且血UA高的高血压患者的IMT较血UA正常的高血压者明显增厚(P<0.05).结论:高UA高血压、及脂质代谢紊乱均是颈动脉粥样硬化的危险因素.     

老年2型糖尿病患者颈动脉斑块与同型半胱氨酸的关系

目的:探讨老年2型糖尿病患者颈动脉斑块与同型半胱氨酸的关系。方法:将67例老年2型糖尿病患者按照血同型半胱氨酸水平的不同,分为两组:A组37例(血Hcy≤10.5μmol/L,男29例,女8例),B组30例(血Hcy>10.5μmol/L,男23例,女7例),分别测定颈动脉粥样硬化斑块程度。结果:A组Hcy水平(7.29±1.84)μmol/L显著低于B组(14.74±8.40)μmol/L,A组颈动脉粥样硬化斑块分级程度(2.38±1.06)显著低于B组2.93±1.01),差异有统计学意义(P<0.05)。结论:老年2型糖尿病患者动脉粥样硬化发展与高血同型半胱氨酸血症关系密切。     

脑梗塞伴颈动脉粥样硬化与血尿酸水平的相关性

目的研究血尿酸(UA)水平与脑梗塞及颈动脉粥样硬化之间的关系。方法采用彩色多普勒超声分别对79例脑梗塞患者和30例健康对照者进行颈动脉检测,同时测定他们的血UA及空腹血糖、总胆固醇、甘油三脂、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、脂蛋白(a)水平,并进行相关性分析。结果脑梗塞患者血UA平均水平(349.55±88.28μmol/L)显著高于对照组(221.53±88.20μmol/L),两组比较有统计学差异(P<0.01)。脑梗塞组中伴有颈动脉粥样硬化者血UA水平(376.31±86.70μmol/L)高于未伴有颈动脉粥样硬化者(312.24±77.22μmol/L)(P<0.05)。Logistic回归分析结果表明血UA水平与年龄、空腹血糖、总胆固醇、甘油三脂、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、脂蛋白(a)无显著相关性(P>0.05)。结论血UA水平与脑梗塞、颈动脉粥样硬化有一定相关关系,血UA是独立的致脑梗塞危险因素。     

高血压病患者颈动脉粥样硬化程度与血尿酸浓度水平的相关性研究

目的探讨高血压病患者颈动脉粥样硬化程度与血尿酸(UA)水平的关系.方法128例高血压病患者行双侧颈动脉超声多普勒检查,依据颈动脉粥样硬化(狭窄)程度分为5组,同时检查血UA值.结果5组间血UA值分别为:内膜增厚组(267±52)μmol/L;内膜斑块形成组(325±50)μmol/L;管腔轻度狭窄组(347±50)μmol/L;管腔中度狭窄组(389±48)μmol/L;管腔重度狭窄组(17±48)μmol/L.5组间比较差异均有统计学意义(P＜0.05或P＜0.001).结论高血压病患者颈动脉粥样硬化(狭窄)程度与血尿酸浓度水平呈正相关.     

合并2型糖尿病的高血压患者颈动脉粥样硬化改变及阿托伐他汀干预研究

目的 探讨合并2型糖尿病的高血压患者颈动脉粥样硬化程度、与高敏C-反应蛋白(hs-CRP)的关系及阿托伐他汀的干预作用.方法 62例合并2型糖尿病的高血压患者(A组)和42例单纯性高血压患者(B组)入院后常规降压、降糖、抗血小板治疗,A组加用阿托伐他汀10 mg,每晚1次.分别于入院后及6个月时测定血浆hs-CRP、脂蛋白(a)[LP(a)]、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、糖化血红蛋白(HbA 1c),高频超声检测颈动脉,记录颈动脉内膜中层厚度(IMT)、颈动脉斑块积分、斑块发生率.结果 入院时A组hs-CRP明显高于B组,分别为(8.78±1.59)mg/L和(6.34±1.43)mg/L,P＜0.01,IMT、颈动脉斑块积分、斑块发生率A组也明显高于B组;阿托伐他汀治疗后hs-CRP、IMT、颈动脉斑块积分、斑块发生率分别由(8.78±1.59)mg//L、(1.24±0.13)mm、82.3%、(6.23±0.57)mm下降为(6.19±1.30)mg/L、(0.98±0.19)mm、69.5%、(5.07±0.42)m,P＜0.01.相关分析表明hs-CRP、LP(a)与IMT、颈动脉斑块积分、斑块发生率成正相关;hsCRP与HbA1c、TG、LDL-c呈正相关(P＜0.005～0.01);结论 合并2型糖尿病的高血压患者颈动脉粥样硬化程度较重;阿托伐他汀治疗可改善颈动脉粥样硬化程度及炎症反应程度,具有稳定斑块作用;③hs-CRP有致动脉硬化作用.     

脑梗死患者颈动脉粥样硬化斑块稳定性与血C-反应蛋白、尿酸水平的关系

目的:探讨脑梗死患者颈动脉粥样硬化斑块的稳定性与血C-反应蛋白(CRP)、尿酸(UA)水平的关系.方法:对90例颈内动脉系统脑梗死患者进行颈动脉超声检查.诊断斑块性质,并测定血CRP及UA水平.结果:17例未检出斑块,43例检出稳定斑块,30例检出不稳定斑块,颈动脉粥样硬化斑块检出率81.1%(73/90).无斑块、不稳定斑块及稳定斑块组间血CRP及UA水平差异有统计学意义(F分别为8.802,61.813,P均＜0.001);不稳定斑块组血CRP、UA水平高于稳定斑块组和无斑块组(P＜0.05),稳定斑块组UA水平高于无斑块组(P＜0.05).脑梗死患者血CRP与血UA水平正相关(r=0.558,P=0.019).结论:血CRP及UA水平可反映颈动脉粥样硬化斑块的稳定性.     

不同剂量阿托伐他汀对颈动脉斑块患者氧化应激指标的影响

目的 探讨不同剂量阿托伐他汀对颈动脉斑块患者氧化应激相关指标的影响.方法 选取2014年3月至2016年2月在南京医科大学附属苏州医院就诊的颈动脉斑块患者120例,采用随机数表法将其分为A、B两组,每组60例.A组患者给予阿托伐他汀20 mg/d持续治疗24周,B组患者则给予阿托伐他汀40 mg/d持续治疗4周,再改为阿托伐他汀20 mg/d治疗20周.分别检测患者入组时、治疗4周后、24周后的血清中氧化低密度脂蛋白(ox-LDL)、丙二醛(MDA)水平及颈动脉斑块Crouse积分.结果 两组患者入院时检测血清中ox-LDL及MDA水平比较差异均无统计学意义(P>0.05);治疗4周、24周后,A组患者中的ox-LDL水平分别为(110.55±17.91)μg/L、(89.91±20.00)μg/L,B组则分别为(101.78±14.53)μg/L、(81.78±13.13)μg/L,差异有显著统计学意义(P<0.01);A组患者中的MDA水平分别为(6.57±1.29)nmol/L、(5.17±1.42)nmol/L,B组中则分别为(5.87±1.34)nmol/L、(4.42±1.31)nmol/L,差异有显著统计学意义(P<0.01).两组患者入院时检测颈动脉粥样硬化斑块Crouse积分比较差异无统计学意义(P>0.05),治疗24周后A、B两组斑块均明显减小,分别为(2.58±1.32)分、(2.07±1.31)分,差异均有统计学意义(P<0.05).结论 阿托伐他汀能够减轻颈动脉粥样斑块患者的氧化应激损伤,还可减缓动脉粥样硬化的发展,减轻动脉内膜增厚,且较大剂量阿托伐他汀效果更佳.     

高血压前期患者颈动脉粥样硬化与血尿酸的关系

目的：探讨高血压前期人群颈动脉粥样硬化（AS）程度与血尿酸（UA）水平的关系。方法选择符合高血压前期诊断者共188例,根据颈动脉超声检查、血压水平和一般资料分为颈动脉内中膜厚度（IMT）正常组（A组）68例,IMT增厚组（B组）64例,IMT斑块组（C组）56例。均检测血UA,分析血uA水平与IMT的关系。结果①血UA水平C组和B组均高于A组（P〈0．01）,且C组高于B组（P〈O．01）。②相关分析显示：IMT与血UA呈正相关（r=0．314,P〈0．05）。结论高血压前期已存在血管损害,颈动脉粥样硬化随血尿酸水平增高而加重。     

老年高血压患者颈动脉粥样硬化病变分析

目的:探讨老年高血压患者的颈动脉粥样硬化病变程度及其与血脂、血尿酸、C-反应蛋白的关系.方法:应用彩色多普勒超声检测22例正常老年人(C组:对照组)、47例老年高血压患者(A组)、43例老年高血压合并冠心病患者(B组)的颈动脉内中膜厚度(IMT)、粥样硬化斑块、血流参数[收缩期峰值流速(Vmax)、阻力指数(RI)];同时检测血脂、血尿酸(UA)及C反应蛋白(CRP).结聚:A组与对照组比较,平均IMT,最大IMT及CRP增高(均为P<0.001),斑块发生率、Vmax、RI、胆固醇(TC)、低密度脂蛋白(LDL-C)、UA增高(均为P<0.05);B组与A组比较,平均IMT、最大IMT、RI及CRP增加更为明显(均为P<0.001),斑块发生率、Vmax、TC、甘油三酯(TG)、LDL-C、UA也有相应变化(均为P<0.05).结论:老年颈动脉粥样硬化病变与许多危险因素有关,防治应采取综合措施.     

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.     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.