孕早中期C反应蛋白水平及其与妊娠期糖尿病的关系

目的观察孕早中期C反应蛋白（CRP）水平及其与妊娠期糖尿病（GDM）的关系。方法31例GDM患者、33例糖耐量减低（IGT）患者与44例无糖耐量减低正常妊娠妇女,分别于孕10～14周和孕24～28周行CRP检测,比较三组的CRP水平。结果三组孕妇的孕早、中期血清CRP水平差异均有统计学意义（P〈0.05）,GDM组高于IGT组,IGT组高于NGT组。各组孕中期的CRP水平高于孕早期,差异均有统计学意义（P〈0.01）。结论GDM的发展过程中伴随有慢性炎症反应,且这种炎症反应随着妊娠进展和糖耐量异常的加重更为明显。孕早期血清CRP监测有利于GDM的早期发现和预防。     

C-反应蛋白与妊娠期糖尿病相关性的临床研究

目的：探讨C-反应蛋（CRP）与妊娠期糖尿病（GDU）之间的关系。方法随机选取在自治区人民医院及新疆生产建设兵团医院就诊的孕妇共392名为研究对象,将研究对象分为妊娠期糖尿病组（GDM）、妊娠期糖耐量异常组（IGT）、葡萄糖耐量正常组（NGT）、对照组,比较各组在妊娠不同阶段的血清CRP水平,采用方差分析进行数据统计处理。结果GDM纽的CRP水平显著高于NGT组、IGT纽和对照组,差异有统计学意义（P〈0．05）。结论CRP与GDM的发生有相关性,对GDM有一定的预测价值。     

妊娠期糖尿病患者胰高血糖素样肽1与肿瘤坏死因子α的相关性分析

目的 探讨妊娠期糖尿病(GDM)患者血清胰高血糖素样肽1 (GLP-1)、肿瘤坏死因子α(TNFα)的变化.方法 观察正常葡萄糖耐量妊娠组(NGT)、葡萄糖耐量受损组( IGT)及GDM组血清TNF-α、GLP-1以及口服葡萄糖耐量试验(OGTT)结果. 结果 与NGT、IGT组比较,GDM组妊娠中期血清TNF-α明显升高而GLP-1值明显降低,差异有显著性(P<0.01). 结论 TNF-α、GLP-1等炎症因子是妊娠期糖尿病发生、发展的重要影响因素.     

肥胖与非肥胖糖耐量受损患者血清C反应蛋白表达水平的研究

目的：探讨肥胖和非肥胖糖耐量受损（IGT）患者血清CRP表达的差异和临床意义。方法：117例IGT患者和68例正常糖耐量（NGT）对照组按BMI≥25kg／m^2和BMI〈23kg／m^2分为肥胖组与非肥胖组，以免疫散射比浊法测定CRP并加以比较。结果：CRP水平IGT组和NGT组各自组内比较，肥胖者均较非肥胖者高（P〈0．05）；组间比较，IGT组较NGT组CRP水平在肥胖者和非肥胖者均增高，差异显著（P〈0．01）。结论：IGT患者较NGT患者，肥胖较非肥胖者的炎症因子表达更显著。     

C反应蛋白值对妊娠期糖尿病预测价值的探讨分析

目的通过追踪监测238例妊娠期妇女血清CPR水平,对不同妊娠阶段孕妇血清C-反应蛋白（CRP）的变化规律进行比较,从而了解CRP对预测妊娠期糖尿病（GDM）的临床意义及价值。方法根据血糖水平将研究对象分为妊娠期糖尿病组（GDM）,妊娠期糖耐量受损组（GIGR）,葡萄糖耐量正常组（NGT）,比较各组在不同妊娠阶段的血清cRP水平,采用方差分析进行数据统计处理。结果所有的研究对象中NGT组183例（1．86mg／L）和IGR组29例（3．61rag／L）、GDM组26例（4．37mg／L）的血清CRP均值比较差异有统计学意义（P〈0．05）;组内对照,各组在妊娠不同阶段的CPR的均值比较差异无统计学意义。结论CRP与GDM的发生有相关性,CRP对GDM有一定的预测价值。     

妊娠期糖尿病患者血清白介素-6，肿瘤坏死因子-a和高敏-C反应蛋白的意义

目的观察妊娠期糖尿病（GDM）患者血清白介素-6（IL-6）、肿瘤坏死因子-a（TNF-Ot）和高敏一C反应蛋白（hs-CRP）的意义。方法选择2010年1月～2012年6月在上海市奉贤区中心医院妇产科产检的单胎孕妇436例,根据葡萄糖筛选试验和葡萄糖耐量试验,分为GDM组,糖耐量受损（IGT）组和正常对照组（NGT组）,并观察IL-6、TNF-d、hs-CRP和糖化血红蛋白（HbAlc）的变化。结果与IGM组和NGT组比较,GDM组的IL-6、TNF-a、hs-CRP和HbA。水平出现明显升高,差异有高度统计学意义（P〈0．01）。根据患者HbA。的水平,分为〈6．5％组为33例,6．5％～8．5％组为41例和〉8．5％组为81例。孕妇血清IL-6、TNF-a和hs-CRP水平随着HbA。的升高,而逐渐升高．差异有高度统计学意义（P〈0．01）。结论GDM孕妇的血清IL-6、TNF-a和hs-CRP水平出现明显升高,IL-6、TNF-a和hs-CRP可能参与了GDM的发病过程。     

以真胰岛素水平测定平估2型糖尿病胰岛β细胞功能

目的探讨真胰岛素(TI)水平的测定在分析2型糖尿病(DM)β细胞功能及胰岛素抵抗中的意义.方法将99例研究对象分为3个组新诊断DM组39例,IGT组30例,正常糖耐量组(NGT组)30例,行口服75g葡萄糖耐量试验(OGTT)及TI、胰岛素(Ⅰ)、C肽(CP)试验.对稳态模式(Homa model)胰岛素抵抗指数(IR)、β细胞功能指数(HBCI)及胰岛素敏感性指数(IAI)和葡萄糖负荷后净增胰岛素/净增葡萄糖(即△I 60/△G60)等指标进行比较.结果DM组空腹TI值及负荷后的TI和Ⅰ值均低于IGT组和NGT组,仅空腹Ⅰ值高于IGT组和NGT组,负荷后的TI和Ⅰ各时点值IGT组高于DM及NGT组,DM者与IR呈正相关,与IAI、HBCI、△I 60/△G60呈负相关.用TI值计算△I 60/△G60为IGT组＞NGT组＞DM组;而用Ⅰ计算则为NGT组＞IGT组＞DM组.结论2型糖尿病同时表现显著的胰岛素抵抗及β细胞分泌功能衰退.IGT病人高胰岛素血症更显著,其胰岛素抵抗增强.TI能更准确地反映糖尿病患者胰岛素β细胞分泌功能的变化.     

不同糖耐量人群血浆同型半胱氨酸水平与胰岛素抵抗及胰岛β细胞功能的关系

目的：观察不同糖耐量阶段血浆同型半胱氨酸（homocysteine,Hcy）水平,探讨Hcy与胰岛素抵抗和胰岛β细胞功能的关系。方法：选择在我院健康查体的83名符合入选标准的个体,行标准口服75g葡萄糖耐量试验,留取空腹血标本测定血脂、肝肾功能、Hcy等指标,留取空腹、服糖后2h血标本测定血糖和胰岛素水平、尿微量白蛋白/肌酐水平。Hcy采用免疫荧光偏振法测定。结果：经糖耐量试验将入选者分为糖耐量正常组（NGT）32例,糖耐量减低组（IGT）24例和新诊断糖尿病组（DM）27例。IGT组和DM组空腹Hcy水平明显高于NGT组（P〈0.01）。IGT组和DM组HOMA-IR显著高于NGT组（P〈0.01）,IGT组和DM组ISI显著低于NGT组（P〈0.01）,NGT组和IGT组HBCI显著高于DM组（P〈0.01,P〈0.01）,经HOMA-IR校正之后,NGT组HBCI/IR显著高于IGT组（P〈0.01）。IGT组FBCI显著高于NGT组和DM组（P〈0.05,P〈0.01）,经HOMA-IR校正之后,NGT组FBCI/IR显著高于IGT组和DM组（P〈0.05,P〈0.01）,IGT组FBCI显著高于DM组（P〈0.01）。相关分析显示Hcy与ISI（r=-0.335,P=0.030）呈显著负相关,经HOMA-IR校正后,Hcy与HBCI/IR和FBCI/IR呈显著负相关性。多元逐步回归分析显示,腰围、尿Alb/Cr、FINS、HOMA-IR、FBCI和FBCI/IR对Hcy有显著影响。结论：糖耐量受损者其血浆Hcy水平高于糖耐量正常者,胰岛素抵抗和胰岛β细胞功能受损与糖耐量异常者血浆Hcy水平明显相关。     

糖耐量低减患者血清炎症因子的相关性研究

目的观察糖耐量低减（IGT）患者炎症因子的变化及其意义. 方法检测30 例IGT 患者和30 例正常糖代谢人群（NGT）血清中C-反应蛋白（CRP）和纤维蛋白原（Fg）水平,并测量其身高、体重、腰围、臀围、血压,测定血脂（TG、TC、LDL-C、HDL-C）,计算体重指数（BMI）和腰臀比值（WHR）. 所有受试者均经口服葡萄糖耐量试验（OGTT）. 结果 IGT 组CRP与Fg明显高于NGT组,组间比较差异有统计学意义（P＜0.01）;线性相关分析显示,在IGT 患者中,CRP 、Fg与BMI、WHR、舒张压、收缩压、TG 和LDL-C 呈正相关,与HDL-C 呈负相关;IGT 组BMI、脂代谢异常发生率、高血压发生率显著高于NGT 组. 结论糖耐量低减患者血清炎症因子CRP和Fg水平已经升高.     

不同糖代谢人群炎症因子水平变化及其与胰岛素抵抗的关系

目的:了解不同糖代谢情况下血清中炎症因子白介素-6(IL-6)、白介素-1β(IL-1β)及高敏c-反应蛋白(hs-CRP)的浓度变化,探讨炎症因子与胰岛素抵抗的关系.方法:检测正常对照组(NGT)、糖耐量减低组(IGT)和新发2型糖尿病组(DM)共90例观察对象的空腹血清hs-CRP、IL-6、IL-1β和胰岛素(FINS)、血糖(FBS)浓度及血脂全套;计算各组胰岛素抵抗指数(HOMA-IR).结果:hs-CRP浓度DM组显著高于IGT组和NGT组,IGT组亦明显高于NGT组(P<0.05);IL-6、IL-1β浓度DM组显著高于IGT组和NGT组(P<0.05),IGT组亦较NGT组高,但两者差异无统计学意义(P>0.05).并且炎症因子与HOMA-IR明显相关,其中hs-CRP与HOMA-IR的相关性最强.结论:炎症因子可能是预测2型糖尿病的危险因素,hs-CRP可作为胰岛素抵抗的可信赖标记物.     

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…