冠心病患者糖耐量减低与颈动脉粥样硬化的相关分析

目的 探讨糖耐量减低的冠心病患者颈血管超声的特点。方法 将104例冠心病患者经口服葡萄糖耐量试验（OGTr）筛选为糖耐量减低（IGT）组和糖耐量正常（NGT）组，用B型超声检查2组患者双侧颈总动脉，观察内膜连续性、内膜中层厚度（IMT）、斑块等指标。结果 IGT组的相对胰岛素敏感性指数（RI—SI）明显低于NGT组，差异有显著性（P〈0．05）。IGT组的内膜连续性比NGT组明显差（P〈0．05），IGT组双侧平均IMT、动脉粥样硬化（AS）积分及平均IMT异常增高发病率均显著高于NGT组（P〈0．05）。但以上指标IGT组与糖尿病（DM）组差异无显著性。结论 与NGT人群比较，IGT人群已经存在胰岛素抵抗及明显的颈动脉粥样硬化病变，其程度与糖尿病类似。     

脑梗死患者糖代谢异常与颈动脉粥样硬化的相关性

目的探讨糖代谢异常的脑梗死患者颈动脉粥样硬化的程度及其相关危险因素。方法选择脑梗死患者96例,通过口服葡萄糖耐量试验(OGTT)将患者分为正常组(n=26例)、糖耐量异常组(IGT,n=36例)、2型糖尿病组(DM,n=36例)。行颈部血管彩色超声,并分析三组间与颈总动脉内中膜厚度(IMT)及颈动脉斑块积分、颈动脉斑块个数的相关性。结果 IGT组及DM组的双侧颈动脉IMT平均值、斑块积分和斑块个数与正常组相比差异均有统计学意义(P<0.05),IGT组和DM相比无统计学意义。Logistics回归显示,收缩压(P=0.008)、年龄(P=0.021)、餐后血糖(P=0.002)是颈动脉粥样硬化的危险因素。结论餐后高血糖是动脉粥样硬化的独立危险因素。     

不同糖耐量状态下黏附分子水平变化及其与颈动脉内膜中层厚度的关系

目的 研究从糖耐量正常、糖耐量减低至糖尿病发展过程中可溶性血管细胞黏附分子-1(sVCAM-1)和可溶性细胞间黏附分子-1(sICAM-1)的变化,探讨二者与糖尿病早期动脉硬化颈动脉内膜中层厚度(IMT)的关系.方法 选取糖耐量正常者30例(NGT组)、糖耐量减低者50例(IGT组)、2型糖尿病(T2DM)患者55例(T2DM组),检测3组受试者血生化指标及sVCAM-1、sICAM-1水平,用超声检测颈动脉IMT.结果 NGT组、IGT组、T2DM组受试者血sVCAM-1、sICAM-1水平及颈动脉IMT逐渐增高,组间两两比较差异有统计学意义(P＜0.05).相关研究显示,颈动脉IMT与血清sVCAM-1、sICAM-1成正相关,sICAM-1和sVCAM-1与体质指数、餐后2 h血糖、三酰甘油及胰岛素抵抗指数均呈正相关(P＜0.05).结论 糖代谢异常早期即有炎症反应发生,并导致了血管内皮损伤,参与了糖尿病动脉硬化的整个进程.血清sVCAM-1和sICAM-1水平升高与肥胖、糖脂代谢异常及胰岛素抵抗有关.     

不同血糖水平患者血Hcy与颈动脉硬化关系探讨

目的 探讨不同血糖水平患者血浆同型半胱氨酸(homocysteine,Hcy)水平与颈动脉硬化关系.方法 通过对29例糖耐量正常者(normal glucose tolerance,NGT)、43例糖耐量异常(impaired glucose tolerance,IGT)者和37例糖尿病(diabetes mellitus,DM)患者的血浆Hcy、血脂、颈动脉内膜-中层厚度(intima-media thickness,IMT)、糖化血红蛋白(glycolated hemoglobin,HbA1c)和餐后2h血糖(2h postprandial plasma glucose,2hPG)进行检测,比较不同血糖水平患者血浆Hcy水平与颈动脉硬化的关系.结果 NGT组、IGT组和DM组患者间的血浆Hcy、颈动脉IMT、三酰甘油、2hPG比较差异有统计学意义(P<0.05).血浆Hcy水平与HbA1c、2hPG、颈总动脉IMT具有相关性(r=0.467、0.509、0.637,P均<0 05).结论 血浆Hcy水平升高是糖尿病患者合并颈动脉硬化的独立危险因素.     

Correlation analysis on carotid artery disease and glucose metabolism in patients with ischemic cerebrovascular disease

目的 探讨缺血性脑血管病患者颈动脉病变与糖代谢的相关性危险因素.方法 从我院神经内科就诊经颈动脉彩超发现颈动脉斑块的缺血性脑血管病患者中选择血胆固醇及甘油三酯稳定在无明显差异范围内的187例患者进行观察.按检查结果及病史分为糖耐量正常组(NGT组,n=47),合并糖耐量减低进行比较组(IGT组,n=68)及合并糖尿病组(T2DM组,n=72).收集患者性别、年龄、合并症及检查结果等各项资料并对比.结果 T2DM组、IGT组的病例数明显高于NGT组,差异有统计学意义.IGT组及T2DM组中的吸烟人数比例、高血压人数比例及BMI、WHR均高于NGT组,差异有统计学意义,空腹血糖、餐后血糖、C反应蛋白方面组间差异有统计学意义,IGT组的上述指标明显高于NGT组且明显低于T2DM组,且上述指标与颈动脉粥样斑块积分呈正相关.结论 糖代谢异常为颈动脉病变的独立危险因素,高血压、吸烟、CRP、BMI、WHR同样为颈动脉病变的危险因素.     

糖耐量异常患者超敏C反应蛋白与颈动脉内膜中层厚度的关系

目的探讨糖耐量异常（IGT）患者超敏C反应蛋白（hs—CRP）的变化与颈动脉内膜中层厚度（IMT）的关系。方法检测38例IGT患者和35例糖耐量正常患者（NGT）一般临床资料及血清hs—CRP水平,同时应用高分辨彩色B超测定颈动脉IMT。结果IGT组血清hs—CRP、颈动脉平均IMT、增厚阳性率均显著高于NGT组（P〈0．05）：IGT患者血清hs—CRP与颈动脉平均IMT呈正相关（P〈0．05）。颈动脉平均IMT与OGTY2h血糖、BMI也成正相关（r值为0．42,0．48）,而与FPG无明显相关性。结论IGT患者体内已经存在低度慢性炎症反应,且此阶段动脉粥样硬化性血管病变危险性已明显增加,炎症反应参与了IGT及其动脉粥样硬化的发生与发展。     

糖耐量异常的脑梗死患者血清超敏C反应蛋白与颈动脉硬化的关系

目的 探讨糖耐量异常脑梗死患者血清超敏 C反应蛋白(hs-CRP)的变化与颈动脉硬化的关系.方法 选择脑梗死患者113例,通过口服葡萄糖耐量试验(OGTT)将患者分为糖耐量正常组(NGT,n=60),糖耐量异常组(IGT,n=53),检测血清hs-CRP水平及其他生化指标,采用双功能彩色多普勒超声检测颈动脉内膜中层厚度及斑块.结果 脑梗死患者IGT组血清hs-CRP分布水平、颈动脉内膜中层厚度、颈动脉内膜光滑性分级及不稳定性斑块发生率均显著高于NGT组(P＜0.05);不稳定斑块患者血清hs-CRP分布水平高于稳定斑块(P＜0.05);IGT组血清hs-CRP水平与颈动脉内膜中层厚度呈正相关(r=0.34,P=0.013).结论 脑梗死合并糖耐量异常时血清hs-CRP明显升高,且与动脉硬化的程度密切相关,炎症反应参与了IGT患者动脉粥样硬化的发生与发展.     

缺血性脑血管病患者颈动脉病变与糖代谢的相关性分析

目的探讨缺血性脑血管病患者颈动脉病变与糖代谢的相关性危险因素。方法从我院神经内科就诊经颈动脉彩超发现颈动脉斑块的缺血性脑血管病患者中选择血胆固醇及甘油三酯稳定在无明显差异范围内的187例患者进行观察。按检查结果及病史分为糖耐量正常组(NGT组,n=47),合并糖耐量减低进行比较组(IGT组,n=68)及合并糖尿病组(T2DM组,n=72)。收集患者性别、年龄、合并症及检查结果等各项资料并对比。结果 T2DM组、IGT组的病例数明显高于NGT组,差异有统计学意义。IGT组及T2DM组中的吸烟人数比例、高血压人数比例及BMI、WHR均高于NGT组,差异有统计学意义,空腹血糖、餐后血糖、C反应蛋白方面组间差异有统计学意义,IGT组的上述指标明显高于NGT组且明显低于T2DM组,且上述指标与颈动脉粥样斑块积分呈正相关。结论糖代谢异常为颈动脉病变的独立危险因素,高血压、吸烟、CRP、BMI、WHR同样为颈动脉病变的危险因素。     

不同糖代谢状态与早期动脉粥样硬化相关性研究

目的 探讨不同糖代谢状态与早期动脉粥样硬化(AS)诊断指标--颈股脉搏波速度(cf-PWV)和颈动脉内膜中层厚度(IMT)之间的关系,并进一步研究其影响因素. 方法141例研究对象被分为5组:正常糖耐量组(NGT)、空腹血糖异常组(IFG)、糖耐量异常组(IGT)、IFG+IGT组和初发糖尿病组(PDM),比较各组一般临床资料、各项生化指标、cf-PWV、IMT、空腹胰岛素(FINS)、胰岛素抵抗指数(IRI). 结果IFG、IGT、IFG+IGT和PDM各组研究对象的cf-PWV和IMT较NGT组均有显著升高(Ρ<0.01),IGT组和PDM组的cf-PWV高于IFG组(Ρ<0.05),IGT、IFG+IGT和PDM 3组间的cf-PWV值差异无统计学意义,IFG、IGT、IFG+IGT 3组的IMT值逐渐增加,但3组间两两比较差异无统计学意义.多元逐步回归分析显示:年龄、OGTT2h血糖、收缩压、总胆固醇是cf-PWV的独立危险因素;年龄、空腹血糖、FINS、IRI是IMT独立危险因素. 结论糖耐量异常人群(包括IFG、IGT、IFG+IGT、PDM)cf-PWV和IMT显著增加,表明AS在糖尿病前期就已经开始.     

老年糖代谢异常与踝臂指数?颈动脉粥样硬化的关系

目的:探讨老年糖代谢异常与踝臂指数?颈动脉粥样硬化的关系?方法:将96例老年患者按照糖代谢的不同,分为3组:糖耐量正常组(NGT组)34例,糖耐量减低组(IGT组)28例,2型糖尿病组(T2DM组)34例,分别测定踝臂指数(ABI)?颈动脉粥样硬化斑块程度?结果:随着糖代谢异常的加重,ABI值逐渐降低,NGT组> IGT组>T2DM组(P < 0.05);颈动脉粥样硬化斑块分级程度增高,NGT组相似文献   

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…     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

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.     

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.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…