血脂代谢与心血管的发生关系

目的 探讨各项血脂指标与心血管疾病发生发展的关系,及其疾病的临床预测价值,为心血管疾病的一、二级预防提供一定的依据.方法 选取某大学附属医院门诊诊治的血脂异常患者100例及进行体检的健康人40例作为研究对象,其中血脂异常组患者根据血脂异常的程度分为极高危、高危、中危及低危组,通过各组比较,探讨各项血脂指标及其相应比值与心血管疾病的相关性.结果 经过统计学分析,血脂异常组患者的总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、非高密度脂蛋白胆固醇（n-HDL-C）、载脂蛋白B（apoB）、TC/HDL-C、apoB/apoA1、LDL-C/HDL-C的值均较健康人群显著升高,且在血脂异常极高危组中apoB/apoA1比值显著高于低中高危组患者;在血脂异常患者中与心血管疾病相关的指标主要有三酰甘油（TG）、TC、LDL-C、n-HDL-C、apoB、TC/HDL-C、LDL-C/HDL-C、apoB/apoA1均呈现正相关关系.结论 血脂异常患者,其单项血脂及相关的血脂比值均明显高于健康人群,在极高危的血脂异常组apoB、TC/HDL-C、LDL-C/HDL-C、apoB/apoA1均高于低中高危组患者,结果表明通过检查血脂比值的大小对预测心血管事件有着重要的临床意义,可以作为预测心血管事件的重要指标.     

血脂检测对肝脏疾病诊断的意义

目的观察血脂检测在肝脏疾病诊断中的临床应用价值。方法对肝病患者血浆进行血脂甘油三脂TG、总胆固醇TC、高密度脂蛋白HDL-C、低密度脂蛋白LDL-C、载脂蛋白apoAl、载脂蛋白apoB检测,并与健康体检者对比分析。结果各种肝病患者TC、TG、HDL-C、LDL-C、apoA1、apoB水平与正常对照组相比均有下降,其中肝硬化、肝癌组的以上6项指标均较正常对照组有显著性下降,差异有统计学意义。结论对肝脏病人进行血脂检测可了解体内脂质代谢状况和肝实质的受损程度。     

肝病患者血脂检测的临床意义

目的 探讨肝病患者血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白(apoA1、apoB)的变化情况及其临床意义.方法 测定228例肝病患者(其中急性肝炎60例,慢性肝炎53例,肝硬化55例,肝癌60例)TC、TG、HDL-C、LDL-C、apoA1、apoB的水平,与60例健康人进行对照.结果 各种肝病患者的以上各项指标水平较均正常对照组有所下降,其中肝硬化和肝癌患者以上各项指标与正常对照组相比具有极显著性差异(P＜0.01).结论 对肝病患者进行定期的血脂测定,能及时反映体内脂质代谢状况,了解肝脏损害程度,观察病情,估计预后都有重要价值.     

肥胖儿童血浆胆固醇酯转运蛋白与血脂相关性

目的探讨单纯性肥胖儿童血浆胆固醇酯转运蛋白（CETP）与血脂的相关性及其与动脉粥样硬化(AS)的关系。方法用本室建立的酶联免疫测定法（ELISA）检测49例单纯性肥胖儿童血浆CETP水平。结果肥胖儿童与健康儿童相比,其血浆胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）、载脂蛋白B（apoB）的浓度均显著升高（P<0.05）,存在较明显的脂质代谢紊乱;高密度脂蛋白胆固醇（HDL-C）、载脂蛋白A1（apoA1）水平与健康儿童差异不显著（P>0.05）;CETP水平显著高于正常儿童（P<0.05）,且与LDL-C、apoB、TC/HDL-C、LDL-C/HDL-C、apoB/apoA1显著相关,而与HDL-C、apoA1则不相关。结论肥胖儿童存在脂蛋白代谢紊乱,且可能与其CETP水平增高有密切关系;过量脂肪摄入和缺乏体育锻炼也是其CETP水平增高的重要因素。     

血脂异常对脑梗死的影响

目的 考察血脂异常对老年人脑梗死的影响.方法 筛选100例脑梗死患者,年龄45-81岁,与100例健康受试者作对照,抽取受试者清晨空腹静脉血3mL,离心后将分离的血清置-25℃冰箱备用.采用双抗夹心ElISA法检测血清脂蛋白(a),氧化本科法检测血清总胆固醇(TC)和甘油三酯(TG),磷钨酸镁沉淀检测高密度脂蛋白(HDL-C);低密度脂蛋白(LDL-C)采用计算公式:LDL-C=TC(TG/2.2+HDL-C);免疫比浊法检测载脂蛋白A.B(apoA、apoB).结果 脑梗死患者血清LPa、TC、TG、LDL-C、apoB水平显著高于对照组患者,血清HDI-C、apoA水平显著低于对照组,且患者组血清中各项脂质浓度异常发生率与对照组比较差异具有显著性,P＜0.05.结论 血脂异常与老年人脑梗死密不可分,调解血脂水平至正常对于预防和治疗老年人脑梗死具有重要义. (TC)和甘油三酯(TG),磷钨酸镁沉淀检测高密度脂蛋白(HDL-C);低密度脂蛋白(LDL-C)采用计算公式:LDL-C=TC(TG/2.2+HDL-C);免疫比浊法检测载脂蛋白A.B(apoA、apoB).结果 脑梗死患者血清LPa、TC、TG、LD -C、apoB水平王著高于对照组患者,血清HDI-C、apoA水平显著低于对照组,且患者组血清中各项脂质浓度异常发生率与对照组比较差异具有显著性,P＜0.05.结论 血脂异常与老年人脑梗死密不可分,调解血脂水平至正常对于预防和治疗老年人脑梗死     

2型糖尿病患者血脂水平变化

目的初步评价2型糖尿病(DM)患者血脂代谢异常情况。方法选择2型DM并发冠状动脉疾病(CAD)63例,未并发冠状动脉疾病(CAD)69例及正常对照100例,按常规空腹测定血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A-Ⅰ(apoA-Ⅰ)和载脂蛋白B(apoB)水平,计算非高密度脂蛋白胆固醇(non-HDL-C)水平,比较各组间血清脂质成分的差异。结果2型DM并发CAD组血清TC、TG、LDD-C、apoB、non-HDL-C水平较对照组明显升高(P<0.01),血清HDL-C、apoA-Ⅰ水平较对照组明显降低(P<0.01或P<0.05)。2型DM未并发CAD组血清TC、TG、LDL-C、non-HDL-C水平较对照组明显升高(P<0.01或P<0.05),血清HDL-C水平较对照组明显降低(P<0.05),而血清apoA-Ⅰ及apoB水平与对照组相比虽有升高或降低但差异无显著性(P>0.05)。结论2型DM患者存在不同程度的血脂代谢异常,并发CAD患者尤为明显,故应及早对心血管疾病的危险因素进行干预。     

2型糖尿病患者血脂水平检测分析

目的 探讨2型糖尿病患者血脂水平变化特点及临床意义.方法 分别检测80例2型糖尿病组患者的总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A1(apoA1)和载脂蛋白B(apoB),并与80例健康对照组进行比较.结果与健康对照组相比,2型糖尿病组的TG、LDL-C和apoB水平显著升高(p＜0.01),TC明显升高(p＜0.05),HDL-C和apoA1水平明显降低(p＜0.05,p＜0.01).结论 2型糖尿病患者存在明显的脂代谢紊乱,应积极采取干预措施,减少并发症的发生.     

血脂水平及apoB/apoA1比值与突发性耳聋发生及预后的关系

目的 观察突发性耳聋患者血脂水平和载脂蛋白B/载脂蛋白A1(apoB/apoA1)比值变化，分析其与突发性耳聋发生及预后的关系。方法 回顾性收集2018年7月至2021年7月在浙江省温州市中西医结合医院确诊的60例突发性耳聋患者（突发性耳聋组），根据其预后分为有效组和无效组。另选取同期健康体检者60例作为对照组。比较各组三酰甘油（TG）、总胆固醇（TC）、高密度脂蛋白（HDL-C）、低密度脂蛋白（LDL-C）及apoB/apoA1水平，并采用多因素Logistic回归分析影响突发性耳聋患者治疗预后的因素。结果 突发性耳聋组TG、TC、LDL-C水平和apoB/apoA1比值均高于对照组，HDL-C水平低于对照组（均P<0.05）。经治疗后，60例突发性耳聋患者有31例听力阈值改善15 d B及以上，纳入有效组；有29例听力阈值改善低于15 dB，纳入无效组。采用倾向匹配法，排除混杂因子后，有效组TG、TC、LDL-C水平和apoB/apoA1比值均低于无效组，HDL-C水平高于无效组（均P<0.05）。LDL-C和apoB/apoA1水平是影响突发性耳聋患者临床疗效的独立危...     

老年高血压病患者血脂和脂蛋白变化的研究

目的观察老年高血压痛患者血脂和脂蛋白变化特点及意义。方法随机选取90例高血压痛住院病人，同时以90例血压正常者作为对照，检测血清总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、栽脂蛋白A1及B（apoAl、apoB）、脂蛋白（a）[p（a）]，进行比较分析。结果高血压病人血清TC、TG、LDL-C、apoB、Lp（a）水平明显高于正常对照组，并且观察组的异常检出率指标也多于对照组：结论老年高血压患者容易出现脂质代谢紊乱。     

61例2型糖尿病患者血脂水平分析

目的:了解2型糖尿病患者血脂水平的变化,探索其临床意义.方法:选择2型糖尿病患者61例,健康体检者(正常对照组)60例,采用日立7060全自动生化分析仪检测血清总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A1(apoA1)、载脂蛋白B(apoB).结果:2型糖尿病组TC、TG、LDL-C、apoB水平明显高于正常对照组(P<0.01),HDL-C、apoA1水平明显低于正常对照组(P<0.01,P<0.05).结论:2型糖尿病患者存在明显的脂代谢紊乱,并发心血管疾病的危险性明显增高,应及早对心血管危险凶素进行干预,延缓、减少并发症的发生.     

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…