原发性高血压合并冠心病患者血浆同型半胱氨酸水平测定及临床意义

目的:分析血浆同型半胱氨酸水平对原发性高血压患者发生冠心病的临床预测价值。方法:根据冠状动脉造影检查结果将入选的123例患者分为单纯高血压组(A组)64例和高血压合并冠心病组(B组)59例,测定两组患者血浆同型半胱氨酸水平、血脂、超敏C反应蛋白水平,并通过Logistic回归分析观察原发性高血压患者发生冠心病的危险因素。结果:B组与A组患者血浆同型半胱氨酸[(19.52±9.44)μmol/L vs(12.65±6.09)μmol/L]、超敏C反应蛋白[(20.23±9.79)mg/L vs(12.44±5.78)mg/L]、高密度脂蛋白[(1.06±0.33)mmol/L vs(1.31±0.37)mmol/L]水平比较差异均有统计学意义(P=0.000),Logistic回归分析结果显示,血浆同型半胱氨酸是高血压发生冠心病的独立危险因素[OR=1.116,95%CI(1.060,1.176),P=0.000]。结论:血浆同型半胱氨酸对原发性高血压发生冠心病有预测价值。     

老年高血压人群同型半胱氨酸与高尿酸血症的相关性

目的 探讨老年高血压人群血浆同型半胱氨酸(Hcy)水平与高尿酸血症(HUA)之间的相关性。方法 选取2018年3至8月在江西省婺源县筛查出的9902例年龄≥60岁的高血压患者，进行体格检查及常规血生化指标检测，根据尿酸水平将研究对象分为HUA组和尿酸正常组，采用多因素Logistic回归分析Hcy水平与HUA发生风险的关系。结果 与尿酸正常组相比，HUA组的高同型半胱氨酸血症发生率(99.9%比98.7%,P<0.001)及Hcy水平[16.8(13.8～21.5)μmol/L比14.4(12.3～17.7)μmol/L,P<0.001]均较高。多因素Logistic回归分析显示，校正影响因素后，高同型半胱氨酸血症组患HUA的风险是Hcy正常组的2.92倍。阈值饱和效应分析显示，Hcy<20μmol/L时，Hcy水平与HUA的发生呈正相关(OR=1.05,95%CI=1.04～1.07,P<0.001);当Hcy≥20μmol/L时，Hcy水平与HUA无相关性(OR=1.00,95%CI=0.99～1.00,P=0.055),对数似然比检验有统计学意义(P<...     

无症状高尿酸血症的研究进展

尿酸 (uricacid, UA)是嘌呤代谢终末产物,正常血清尿酸浓度 (serumuricacid, SUA)男性为 210~416μmol/L( 35 ~ 70 mg/L); 女性为 150 ~357μmol/L( 25 ~60mg/L),绝经后接近男性。血液中 98%的尿酸以钠盐形式存在,在 37℃、pH 7. 4的生理条件下,尿酸盐溶解度约为 64mg/L,加之尿酸盐与血浆蛋白结合约为 4mg/L,血液中尿酸盐饱和度约为 70mg/L。SUA≥416μmol/L( 70mg/L)称为高尿酸血症 (hyperuricemia)〔1〕。但也有认为SUA男性≥ 420μmol/L( 70mg/L),女性≥360μmol/L(60mg/L)即为高尿酸血症。绝大多数高尿酸血症者不出现任何…     

高尿酸血症和痛风的流行病学及危险因素

痛风（gout）为嘌呤代谢紊乱和／或尿酸排泄障碍所致血尿酸增高的一组异质性疾病。其临床特点是高尿酸血症、痛风性急性关节炎反复发作、痛风石沉积、特征性慢性关节炎和关节畸形，常累及肾脏引起间质性肾炎和肾尿酸结石形成。高尿酸血症（hyperuricemia，HUM）是痛风的重要生化基础，一般男性〉420μmol／L（7mg／d1），女性〉350μmol／L（6mg／d1）可确定为高尿酸血症，但痛风的患病率远低于高尿酸血症，高尿酸血症者仅一部分发展成临床痛风，其转变的确切机制未明。     

冠心病患者C反应蛋白、血同型半胱氨酸检测的临床意义

目的探讨冠心病患者血清C反应蛋白、血同型半胱氨酸水平与冠心病之间的关系。方法对2010年1月-2012年12月台州市中心医院152例冠心病（稳定型心绞痛、不稳定型心绞痛、急性心肌梗死）患者和50例健康体检者的血清C反应蛋白、血同型半胱氨酸水平进行测定,运用SPSS 17.0软件进行统计分析。结果冠心病组血清C反应蛋白[（12.97±4.87）mg/L]和血同型半胱氨酸[（22.22±9.44）μmol/L]含量明显高于正常对照组[（4.36±1.52）mg/L、（8.78±1.67）μmol/L],差异有统计学意义（P〈0.05）。冠心病组中心肌梗死亚组C反应蛋白、血同型半胱氨酸含量[（17.42±2.86）mg/L、（31.38±7.15）μmol/L]明显高于不稳定型心绞痛亚组[（13.71±5.94）mg/L、（21.50±5.48）μmol/L];不稳定型心绞痛亚组C反应蛋白、血同型半胱氨酸含量明显高于稳定型心绞痛亚组[（7.79±5.38）mg/L、（13.77±4.23）μmol/L）],差异均有统计学意义（均P〈0.05）。结论血清C反应蛋白、血同型半胱氨酸在冠心病患者中高表达,其表达水平的高低可以提示冠心病严重程度及类型。     

痛风的临床诊断与治疗

高尿酸血症与痛风 概述 高尿酸血症是指体温37℃时血清中尿酸含量男性超过416 μmol/L(7.0mg/d1),女性超过357 μ mol/L(6.0mg/d1).这个浓度为尿酸在血液中的饱和浓度,超过此浓度时尿酸盐即可沉积在各种组织中,造成痛风组织学改变.     

同型半胱氨酸和超敏C反应蛋白水平在脑梗死中的临床意义

目的探讨脑梗死患者同型半胱氨酸和超敏C反应蛋白水平变化及临床意义。方法海口市第三人民医院神经内科确诊为脑梗死患者(共200例)为实验组,其中高血压患者100例,非高血压患者100例。同期在该院体检中心的健康体检者(共200例)为对照组。采用循环酶法测定各组的同型半胱氨酸(Hcy)含量,用比浊法测定各组的超敏C反应蛋白(hsCRP)含量,并进行差别分析。结果实验组的Hcy、hsCRP分别是(27.0±7.6)μmol/L、(10.5±2.4)mg/L,均高于对照组的(11.2±2.3)μmol/L、(2.2±0.9)μmol/L(P0.01),高血压组的Hcy、hsCRP分别是(33.5±9.8)μmol/L、(13.5±5.2)mg/L,均高于非高血压组的(24.5±4.9)μmol/L、(10.9±4.2)μmol/L(P0.01)。结论高水平同型半胱氨酸和超敏C反应蛋白与脑梗死的发生、发展显示有密切相关,提示联合该二项检测具有重要的临床价值。     

同型半胱氨酸、超敏C反应蛋白、胱抑素C和纤维蛋白原与急性脑梗死患者关系的研究

目的 对同型半胱氨酸、超敏C反应蛋白、胱抑素C、纤维蛋白原和急性脑梗死的关系进行研究.方法 分析本院2016年3月~2017年3月就诊的急性脑梗死77例患者资料,将其设为观察组,另选取同时间本院健康体检者77例为对照组,对两组同型半胱氨酸、超敏C反应蛋白、胱抑素C及纤维蛋白原水平加以检测,研究其和疾病的关系.结果 观察组同型半胱氨酸、超敏C反应蛋白、胱抑素C及纤维蛋白原水平(14.20±4.80)μmmol/L、(9.75±8.30)mg/L、(1.35±0.30)mg/L、(3.89±1.40)g/L均比对照组高(P<0.05);观察组四项指标联合测定阳性概率93.51%均比每项单独测定概率高(P<0.05);观察组同型半胱氨酸和超敏C反应蛋白、胱抑素C呈现正相关性,胱抑素C与纤维蛋白原呈正相关性,且超敏C反应蛋白和胱抑素C、纤维蛋白原均呈现正相关性(P<0.05).结论 同型半胱氨酸、超敏C反应蛋白、胱抑素C、纤维蛋白原和急性脑梗死间存在一定关系,共同参与疾病发生和发展全过程,且临床对此四项指标联合测定有利于为疾病尽早采取有效防治措施提供参考,值得临床推广.     

药用炭片治疗高尿酸血症20例临床分析

随着人们生活水平的提高,饮食结构的改变,高尿酸血症及痛风的发病率呈逐年上升趋势。高尿酸血症是嘌呤代谢障碍引起的血中尿酸水平持续升高(>420μmol/L),尿酸盐沉着于关节及其他结缔组织,而引起痛风,若尿酸盐沉着在肾小管间质中则可引起尿酸性肾病,使肾功能受损。我院近两年利用药用炭片强大的物理吸附作用治疗     

高尿酸血症的中医临床及实验研究进展

高尿酸血症(hyperuricacidemia)系嘌呤代谢紊乱或尿酸排泄减少所引起的一组疾病,一般以男性血尿酸水平>417μmol/L(7mg/dL),女性>357μmol/L(6mg/dL),诊断为高尿酸血症[1].过去一直认为高尿酸血症对人体的影响主要是尿酸盐结晶沉积在关节及肾脏而引起相应的病变,而近年许多研究表明,高尿酸血症与高血压、糖耐量异常、中心性肥胖、脂代谢紊乱、动脉粥样硬化等发生相关,已成为代谢综合征的一部分.     

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…