阿托伐他汀对不稳定型心绞痛病人血管内皮功能及血小板活化的影响

目的探讨阿托伐他汀对不稳定型心绞痛病人血管内皮功能及血小板活化的影响。方法 68例不稳定型心绞痛病人随机分成常规组(34例)和阿托伐他汀组(34例)。所有病人分别于入院时及用药4周后取血,行血清一氧化氮(NO)、血浆内皮素-1(ET-1)及血小板胞质内α-颗粒膜糖蛋白(CD62p)测定。另选本院同期健康体检者30名作为对照组,要求采血前两周内未服用任何药物。结果不稳定型心绞痛病人血NO水平显著低于对照组(P<0.01),ET-1、CD62p水平明显高于对照组(P<0.01)。治疗4周后两组病人血清NO水平显著升高,血浆ET-1、血小板CD62水平明显降低(P<0.01),且治疗后两组之间有统计学意义(P<0.01),但治疗4周后两组患者血NO水平仍低于对照组(P<0.01),ET-1、CD62p水平仍高于对照组(P<0.01)。结论阿托伐他汀有改善不稳定型心绞痛病人内皮功能,抑制血小板活性作用,阿托伐他汀10mg/d治疗4周后不稳定型心绞痛病人仍然存在内皮功能障碍及血小板活化的问题。     

心脏活动平板运动试验参数对冠心病的诊断价值

目的 总结平板运动试验对冠心病的诊断价值.方法 2006年1月至2011年3月在我院住院接受心脏活动平板运动试验（TET）及冠状动脉造影（CAG）检查的患者445例,回顾性总结分析其平板运动试验中不同参数变化对冠心病的诊断价值.结果 ①进行平板运动试验的445例患者中,TET阳性200例,其中CAG阳性150例、CAG阴性50例;TET阴性245例,其中CAG阴性206例、CAG阳性39例.TET检出冠心病的敏感性为79.36%（150/189）,特异性为80.47%（206/256）,预测准确性为80.00%（356/445）.②CAG阳性组（189例）与CAG 阴性组（256例）比较,CAG阳性组的总运动时间、峰值心率、ST段下移出现时间明显小于CAG阴性组（P＜0.05）,其ST段下移幅度及持续时间显著大于CAG阴性组（P＜0.05）.③CAG阳性的189例中,单支病变87例、多支病变102例,多支病变组总运动时间、峰值心率、ST段下移出现时间明显小于单支病变组（P＜0.05）,ST段下移幅度及持续时间显著大于单支病变组（P＜0.05）.④在平板运动试验阳性组中,性别在冠心病的诊断价值中差异有统计学意义,男性对冠心病的诊断率明显高于女性（P＜0.05）;在平板运动试验阴性组中,性别在冠心病的诊断率方面差异无统计学意义（P＞0.05）.⑤平板运动试验Bruce方案级别与冠心病也有明显的相关性：1级的阳性预测值、阴性预测值和准确率均较其他级高,分别为85.71%、94.44%和88.33%.随着级别的递增,到4级时,其阴性预测值达100%,准确率也为100%.结论 平板运动试验是一项诊断冠心病较理想的非创伤性的检查方法,综合多项参数分析可初步估测其病变程度.     

品管圈活动在降低血液透析相关性低血压发生率中的作用

目的探讨应用品管圈（quality control circle,QCC）方法降低血液透析相关性低血压发生率的效果。方法选择2011年10月在航空总医院血液透析中心发生透析相关性低血压患者21例为研究对象,成立品管圈活动小组、确立活动课题,进行现状调查、分析发生血液透析相关性低血压的原因、设定目标值、制订对策并实施,比较实施品管圈活动前后低血压的发生率。结果开展品管圈活动后血液透析相关性低血压发生率从15．00％下降到5．38％,活动前后比较,差异具有统计学意义（P〈0．05）。结论品管圈活动可降低血液透析相关性低血压发生率。     

The Cellular Toxicity of PM2.5 Emitted from Coal Combustion in Human Umbilical Vein Endothelial Cells

ObjectiveTo explore the relationship between different components offineparticulate matter (PM2.5) emitted from coal combustion and their cytotoxic effect in the vascular endothelial cells. MethodsCoal-fired PM2.5was sampled using a fixed-source dilution channel and flow sampler. The sample components were analyzed by ion chromatography and inductively coupled plasma atomic emission spectroscopy(ICP-AES). The PM2.5suspension was extracted using an ultrasonic water-bath method and thenhuman umbilical vein endothelial cells (EA.hy926) were treated withvarious concentrations of the PM2.5 suspension. Cell proliferation,oxidativeDNA damage, and global DNA methylation levelswere used to measurethe cellulartoxicity of PM2.5emitted fromcoalcombustion. ResultsComparedtoothertypesof coal-fired PM2.5preparations,thePM2.5 suspension from Yinchuan coal had the highest cytotoxicity.PM2.5 suspension from Datong coal hadthe highest toxic effectwhile that fromYinchuan coal had the lowest.Exposure to coal-fired PM2.5 from Jingxi coalresulted inlower 8-hydroxy-2'-deoxyguanosine (8-OHdG) levels. At the same dose, PM2.5 emitted from coal combustion could produce more severeDNAimpairmentcompared to that produced by carbon black.Cell survival rate was negatively correlated with chloride and potassiumionscontent.The5-methylcytosine(5-mC) level waspositively correlated withMnandnegatively correlated withZn levels.The 8-OHdG% level was positively correlated withboth MnandFe. ConclusionPM2.5 emitted from coal combustion can decrease cell viability, increase global DNA methylation, and causeoxidativeDNA damage inEA.hy926 cells. Metalcomponentsmay be important factors that influence cellular toxicity.     

GDM患者血清25-羟维生素D3变化及其与炎症因子、血脂指标的相关性研究

目的检测妊娠期糖尿病(GDM)患者血清25-羟维生素D3[25-(OH)2-VitD3]水平,评估其水平与机体炎症因子、血脂的相关关系。方法选取2018年2~9月在中国医科大学航空总医院产检并确诊为GDM的孕妇178例作为GDM组,同期在本院进行产检且糖耐量检查正常的孕妇100例作为正常对照组。对比两组孕妇血清中25-(OH)2-VitD3、炎症因子及血脂指标水平的差异,采用Pearson检验评估GDM患者血清25-(OH)2-VitD3水平与机体炎症因子、血脂指标的相关关系。结果GDM组血清中25-(OH)2-VitD3的含量显著低于正常对照组(P<0.05)。GDM组血清中炎症因子白介素-1β(IL-1β)、IL-6、IL-18和肿瘤坏死因子α(TNF-α)水平显著高于正常对照组(P均<0.05);血脂指标总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白B(Apo-B)和载脂蛋白CⅢ(Apo-CⅢ)的水平显著高于正常对照组,高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A1(Apo-A1)的水平显著低于正常对照组(P均<0.05)。相关性分析发现,GDM孕妇血清中25-(OH)2-VitD3水平与炎症因子、血脂指标均相关(P均<0.05)。结论GDM患者血清25-(OH)2-VitD3水平明显降低,且其水平与机体炎症因子、血脂指标相关,这在GDM发生及病情评估中具有重要意义。     

抗肿瘤雷公藤内酯醇半合成衍生物理化性质及其有关物质的研究

目的研究雷公藤内酯醇半合成衍生物(MC002)的理化性质和有关物质,为剂型设计提供依据。方法采用紫外分光光度法测定MC002在甲醇中的吸收系数;采用红外光谱仪测定MC002的红外吸收光谱;按中国药典2010版二部中溶解度的测定方法测定在不同溶剂中的近似溶解度;采用摇瓶法测定MC002在正辛醇-水、正辛醇-pH=7.4磷酸盐缓冲液中的油水分配系数;用Thiele管测定熔点;采用X-射线粉末衍射法测定其晶型。结果 MC002在甲醇中的吸收系数(E1%)为226.23±29.18;样品红外吸收光谱图与标准品谱图基本一致,易溶于水、甲醇、乙醇、丙酮,微溶于氯仿和乙酸乙酯,在乙醚中极微溶解;在正辛醇-水和正辛醇-pH=7.4磷酸盐缓冲液中的分配系数分别为0.074 0和1.080;熔点为50⁵2℃;X-射线粉末衍射说明MC002为非结晶型粉末。3批有关物质测定均<1%,样品纯度>99%。结论 MC002是一个亲水性很强的盐类药物,本实验确定的MC002部分理化性质和有关物质分析,可为其生物药剂学的研究及剂型设计提供依据。     

阿司匹林肠溶片治疗老年冠心病患者引起上消化道出血的影响因素分析

目的:探讨阿司匹林肠溶片治疗老年冠心病患者引起上消化道出血的影响因素。方法:对2010年10月-2013年10月我院接诊的214例口服阿司匹林肠溶片的老年冠心病患者进行回顾性分析,对51例发生上消化道出血的患者的原因进行分析,内容包括:性别、年龄、服药时间和剂量、既往消化道病史、吸烟史及联用胃黏膜保护剂等情况。结果:随着患者年龄增长,上消化道出血率显著升高(=11.526,P<0.01);服药超过3个月的患者出血发生率显著高于服药低于3个月的患者(=8.530,P<0.01),差异有统计学显著意义;大剂量组出血发生率显著高于小剂量组(=5.127,P<0.01),差异有统计学意义;性别与上消化道出血的发生无相关性(P>0.05),有吸烟史或消化道病史的患者服用阿司匹林肠溶片后更易导致上消化道出血(P均<0.05),而服用阿司匹林肠溶片同时服用胃黏膜保护剂的患者上消化道出血的发生率显著低于未服用胃黏膜保护剂的患者(P<0.05)。结论:有消化道病史、高龄、大剂量、服药时间、有吸烟史、不用胃黏膜保护剂是上消化道出血的独立的危险因素,使用阿司匹林肠溶片治疗的同时,应注意及时给予胃黏膜保护药,以期减少上消化道出血的危害性。     

Major chemical compositions,possible sources,and mass closure analysis of PM2.5 in Jinan,China

The fine particulate matter samples for 24 h were carried out at the Environment Monitoring Station (EMS) and Shandong Jianzhu University (SJU) sites during 2010 in Jinan City, China. Eight water-soluble ion species were analyzed by ion chromatography, while organic carbon (OC) and elemental carbon (EC) were determined with the IMPROVE thermal optical reflectance method, and 20 inorganic elements were measured by inductively coupled plasma-atomic emission spectrometer and inductively coupled plasma-mass spectroscopy. The annual average mass concentration of PM_2.5 was 168.85 μg m^?3 at EMS and 148.67 μg m^?3 at SJU. The coefficient of divergence was 0.14, 0.19, 0.23, and 0.23 in spring, summer, fall, and winter, respectively, indicating that there was no obvious spatial difference at the two sampling sites. The highest PM_2.5, OC, and OC/EC ratio were in winter because of the enhanced emissions from coal combustion for heating and poor atmospheric dispersion. By the method of enrichment factors, the 20 inorganic elements were divided into three types owing to their sources. Al, Si, and Ti were mainly contributed by crustal sources. Na, Mg, P, K, Ca, V, Cr, Mn, Fe, Co, Ni, Ba, and Sr were from both natural emissions and anthropogenic sources. Cu, Zn, Pb, and Sn mainly originated from anthropogenic sources such as vehicular exhaust and industrial emission. Chemical mass closure calculation estimated that SO₄ ^2? was the largest contributor and explained 29.66 % of PM_2.5 mass at EMS, while 31.64 % was at SJU. The organic matter, crustal matter, and NO₃ ^–, respectively, accounted for 15.12, 12.87, and 13.77 % to PM_2.5 at EMS, while it accounted for 13.46, 13.96, and 14.93 % at SJU, respectively. By the positive matrix factorization analysis, the coal combustion and biomass burning, secondary sulfate, soil dust, secondary nitrate, and vehicle emissions were identified as the major emission sources.