大剂量缬沙坦对糖尿病肾病患者尿蛋白排泄量和肾功能的影响

目的对大剂量缬沙坦在治疗糖尿病肾病中对患者尿蛋白排泄量和肾功能的影响进行评价。方法选取2011—2012年我院收治的60例糖尿病肾病患者作为研究对象,在糖尿病治疗措施的基础上,加用口服大剂量缬沙坦f162mg／d）,对治疗前、后患者的血压、24h尿蛋白、24h尿清蛋白、24h尿β2微球蛋白、24h尿IgG、血尿素氮、血肌酐、血β2微球蛋白、血钾、空腹血糖进行观察。结果患者24h尿总蛋白、24h尿清蛋白、24h尿β2微球蛋白和24h尿IgG与治疗前相比均显著降低（P〈0．05）,收缩压、舒张压与治疗前相比也显著降低（P〈0．05）;血β2微球蛋白、血尿素氮、血肌酐、血钾及空腹血糖与治疗前差异均无统计学意义（P〉0．05）。结论应用大剂量缬沙坦治疗糖尿病肾病,可明显改善患者的蛋白尿症状和血压,对患者的肾脏有保护作用。     

替米沙坦治疗早期2型糖尿病肾病患者临床观察

目的 探讨血管紧张素Ⅱ受体拮抗剂替米沙坦治疗早期2型糖尿病肾病的疗效.方法 将64例血压正常、尿微量清蛋白排泄率(UAER)为20～200μg/min的2型糖尿病患者随机分为治疗组和对照组,治疗组在控制血糖基础上加用替米沙坦(80mg/d),对照组加用安慰剂.观察治疗前后尿蛋白、血压、肾功能、血清K 、糖化血红蛋白(HbAlc)变化.结果 治疗组24h尿蛋白定量、β2-微球蛋白治疗前后相比下降明显,与对照组比较差异有统计学意义(P＜0.05).血压、肾功能、血清K 、HbAlc两组治疗前后差异无统计学意义(P＞0.0 5).结论 替米沙坦能降低血压正常的早期2型糖尿病肾病患者尿微量清蛋白排泄率和β2-微球蛋白,有独立于降压之外的肾脏保护作用.     

来氟米特联合奥美沙坦治疗糖尿病肾病的疗效观察

目的：观察来氟米特联合奥美沙坦治疗糖尿病肾病的疗效。方法选取56例糖尿病肾病患者,按照随机数字法均分为对照组和观察组（n=28）。2组均常规给予降糖治疗,对照组给予奥美沙坦20 mg/d口服,观察组给予来氟米特20 mg/d口服,奥美沙坦用量同对照组。疗程均为12周。比较2组患者治疗前后24 h尿蛋白、血肌酐、尿β2微球蛋白、尿视黄醇结合蛋白水平。结果2组治疗后24 h尿蛋白、血肌酐、尿β2-微球蛋白、尿视黄醇结合蛋白均较治疗前显著下降（P＜0.05）,观察组下降较对照组更加显著（P＜0.05）。结论来氟米特联合奥美沙坦可降低糖尿病肾病患者24 h尿蛋白、尿β2-微球蛋白、尿视黄醇结合蛋白水平,保护肾功能。     

百令胶囊联合缬沙坦治疗糖尿病肾病疗效观察

目的观察百令胶囊联合缬沙坦胶囊治疗糖尿病肾病的疗效。方法将80例糖尿病肾病患者随机分为对照组40例和治疗组40例,两组患者在良好控制血糖、血压基础上,治疗组给予百令胶囊5糊次,3次／d,口服,缬沙坦胶囊80～160mg/d,口服;对照组单用缬沙坦胶囊,80～160mg/d,口服,共12周;治疗前后观察24h尿蛋白定量、血浆白蛋白（ALB）、尿β2微球蛋白（β2-MG）指标。结果治疗组与对照组比较,24h尿蛋白定量降低（P〈0．01）,血浆白蛋白明显升高（P〈0．05）,尿（β2-MG）明显降低（P〈0．05）。结论百令胶囊联合缬沙坦胶囊治疗糖尿病肾病能明显的减少蛋白尿,升高血浆白蛋白。     

缬沙坦联合黄芪注射液治疗早期糖尿病肾病的效果观察

目的探讨缬沙坦联合黄芪注射液应用在糖尿病肾病患者中的临床治疗效果及应用价值。方法将该院治疗的早期糖尿病肾病患者144例采取随机数字表法分为观察组和对照组,对照组给予缬沙坦治疗,观察组联合黄芪注射液治疗,记录两组治疗情况。结果观察组治疗后24 h尿蛋白定量(95.27±8.79)mg/d,尿β2微球蛋白(0.04±0.01)mg/L,尿素氮(5.68±0.38)mmol/L,肌酐(86.03±4.61)μmol/L;对照组治疗后24 h尿蛋白定量(143.76±14.33)mg/d,尿β2微球蛋白(0.11±0.09)mg/L,尿素氮(6.26±1.01)mmol/L,肌酐(92.89±10.24)μmol/L,组间对比差异有统计学意义(t=24.4750、6.5593、4.5606、5.1834,P0.05)。结论缬沙坦联合黄芪注射液应用在糖尿病肾病患者中可以缓解肾小球高滤过与高内压,减少尿蛋白漏出,缓解早期糖尿病肾病进展,值得在临床上推广使用。     

尿微量蛋白联合检测在糖尿病肾病早期诊断中的临床应用

目的:探讨尿微量蛋白联合检测在早期诊断糖尿病肾病(DN)中的临床价值.方法:应用放射免疫分析方法(RIA)检测糖尿病人晨尿中尿微量白蛋白(mALB)、α1-微球蛋白(α1-MG)、β2-微球蛋白(β2-MG)、免疫球蛋白G(IgG)的含量,并将病人按常规尿蛋白定性结果分成:尿蛋白阴性组、尿蛋白±～ 组、尿蛋白2 ～3 组与正常人组进行比较分析.结果:糖尿病人在常规尿蛋白定性阴性时,部分病人尿微量蛋白已显著高于正常人组;当常规尿蛋白定性呈现阳性时,尿微量蛋白随定性阳性程度的增加而逐渐增高;尿蛋白定性阴性组主要呈现mALB、α1-MG、β2-MG等中小分子蛋白增高,而尿蛋白定性阳性组还可出现大分子蛋白IgG的显著增高.结论:尿微量蛋白检测可早期发现糖尿病肾病(DN);而联合检测mALB、α1-MG、β2-MG、IgG等4项尿微量蛋白,还可进一步鉴别诊断肾脏病变部位及其损伤程度,是DN诊断的早期可靠指标.     

缬沙坦治疗老年糖尿病肾病的临床评价

目的 观察血管紧张素Ⅱ1型受体拮抗剂缬沙坦对于伴有蛋白尿的老年糖尿病肾病患者的疗效及肾脏保护作用。方法 测定38例伴有蛋白尿的老年糖尿病肾病合并高血压患者缬沙坦治疗前后的24h尿蛋白定量、尿α -微球蛋白、尿免疫球蛋白G及尿转铁蛋白。 结果 缬沙坦可以显著降低老年糖尿病肾病患者尿中的蛋白含量 (P<0.001) ,同时不影响患者的血脂、血钾、血糖、血尿酸水平。结论 缬沙坦对于肾脏具有明显的保护作用 ,并且耐受性较好     

尿微量蛋白联合检测在糖尿病肾病早期诊断的临床意义

糖尿病患者尿蛋白或尿微量蛋白排泄量增加，常提示肾脏损害的发生。笔者采用放射免疫（RIA）法检测50例糖尿病患者的尿微量白蛋白（mAlb）、β2微球蛋白（β2-MG）、α1微球蛋白（α1-MG）的含量，以探讨微量蛋白在糖尿病肾脏早期损害的诊断价值和临床意义。     

缬沙坦联合阿魏酸钠治疗早期糖尿病肾病的临床研究

目的 探讨缬沙坦联用阿魏酸钠防治早期糖尿病肾病的作用。方法 91例患者随机分成3组，常规组行常规治疗（n=28），缬沙坦组为常规治疗加缬沙坦治疗（n=31），联合组为常规治疗加缬沙坦与阿魏酸钠治疗（n=32）；疗程1个月，并监测尿β2微球蛋白、尿微量白蛋白。结果 缬沙坦组及联合组尿陡微球蛋白、尿微量白蛋白在治疗后明显下降；与常规组比较有显著差异性（P〈0．01）；联合组与缬沙坦组相比较，也有显著性差异（P〈0．05）。结论 缬沙坦联用阿魏酸钠可明显降低糖尿病早期肾病的尿白蛋白，防止其进展。     

尿微量蛋白联合检测在糖尿病肾病早期诊断的临床意义

糖尿病患者尿蛋白或尿微量蛋白排泄量增加,常提示肾脏损害的发生.笔者采用放射免疫(RIA)法检测50例糖尿病患者的尿微量白蛋白(mA1b)、β2微球蛋白(β2-MG)、α1微球蛋白(α1-MG)的含量,以探讨微量蛋白在糖尿病肾脏早期损害的诊断价值和临床意义.     

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     

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.     

Possible Spread of adenovirus type 3 from poultry to humans ：indirect evidence from an outbreak in China

Objective:To explore the epidemiology and etiology for an outbreak of acute respiratory tract infection that occurred in one county of Jiangsu Province, China 2004. Methods: Only cases meeting the case definition were included in the study. We reviewed the medical records of the cases who were admitted to the local hospitals, interviewed cases by a standard questionnaire, and then described the epidemiotogic features and analyzed risk factors by means of a case-control study. We collected pharyngeal swab specimens and sent them to different laboratories for isolation and culture. The laboratory used different detection methods such as DIP, PCR, electron microscope examination and microneutralization assay, to identify and then type the positive specimens. Results:A total of 871 cases were reported during the period from April 18 to July 4,2004. The distribution of onset times presented two peaks, one in late May and another in middle June. The epidemic occurred mainly in the elementary and junior high schools in ten townships of one county, and the mean age of the cases was 12 years (range 7 months to 18 years). The course of the disease was acute, and was characterized by fever accompanied with sore throat and tonsillitis. The WBC count of cases was normal or elevated. The mean duration of illness was 5 days (range 2 to 12 days). No fatalities from illness were reported. A case-control study indicated that the possible risk factors were close contact with a case and/or poultry before onset and sharing of towels among members of the family. The typical CPE was observed through inoculating pharyngeal swab specimens into the HEP-2 cell cultures in different laboratories. An infection of adenovirus type 3 was verified by detecting positive specimens in different methods. Conclusion:This investigation demonstrated that the acute respiratory infection in cases was caused by adenovirus type 3. Cases occurred in over 70 schools in ten townships in 2004, and the route of transmission was possibly close contact with cases or droplet transmission.