老年女性心脑血管疾病患者雌激素与血脂测定

目的：研究老年妇性心脑血管疾病患者体内雌激素与血脂的变化。方法；用化学发光法测定68例患才心脑血管疾病（CCVD）的老年女性（病例组）、73例正常老年女性（对照组）的血清雌二醇（E2）、促卵泡刺激素（FSH）和促黄体生成素（LH）；用酶法测定血清总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL－C）、高密度脂蛋白胆固醇（HDL－C）；用免疫比浊法测定脂蛋白（Lp(a))、载脂蛋白A（apo-A）及载脂蛋白B(apo-B）。结果：病例组与对照组相比，E2、HDL－C和apo-A水平显著降低，FSH、HL、TC、TG、LDL－C和apo-B水平则显著升高（P均＜0.01）。2组间Lp(a)差异无显著性（P＞0.5）。E2与TC、TG、LDL－C及apo-B水平呈显著负相关，相关系数分别为－0.52、－0.41、－0.39和－0.37；E2与HLD－C及apo-A水平呈显著正相关，相关系数为0.39和0.43，P均＜0.01。结论：老年女性雌激素失调与脂代谢异常显著相关，可能是老年女性CCVD发病的主要原因之一。     

乐山市五通桥区中老年干部血脂及血尿酸调查及其临床意义

目的：了解乐山市五通桥区30岁以上部分干部的血脂及血尿酸水平随年龄变化规律及其临床意义。方法：用全自动生化分析仪检测752名干部血清甘油三酯（TG）、胆固醇（TC）、高密度脂蛋白一胆固醇（HDL-C）、低密度脂蛋白一胆固醇（U）L—C）及血尿酸（uA）含量。结果：除了老年男性组以外各组的TG、TC及LDL-C随着年龄的增加而增加,进入老年期后,男性TG、TC、LDL--C有回落趋势,女性TC、LDL--C水平显著高于男性。女性HDL—C随年龄下降趋势,男性则无显著性差异,女性的uA水平随年龄升高,与TG呈显著正相关。结论：血脂及血尿酸水平与年龄、性别相关,高血脂与高尿酸血症常常并存,男性血脂水平在45-49岁迭高峰,女性有不断升高的趋势,因而从该阶段特别注意控制膳食,增加体力劳动,以防止和减少心管病密切相关的高脂血症、高尿酸血症的发生。     

绵阳地区中老年人2008--2012年血脂检测结果分析

目的回顾性分析绵阳地区2008～2012年健康体检的中老年人血脂指标,为心血管病的预防提供依据。方法采集体检者空腹血样,测定总胆固醇（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）水平,分析血脂水平在男女之间的差异、随年龄变化的规律及5年血脂异常率及变化趋势。结果绵阳地区中老年人血脂水平表现为,①性别方面：TC、HDL—C水平女性高于男性,TG、LDL—C水平男性高于女性,差异均有统计学意义（均P〈0．05）;②年龄方面：TC、LDL—C水平在50～〈60岁年龄组最高,TG水平在40~〈50岁年龄组最高,HDL—C水平在40～49岁年龄组中最低;③异常率及变化趋势：Tc水平异常率最高,HDL—C水平异常率最低。2008～2012年血脂水平总体先升高后下降,但2012年水平仍高于2008年。结论绵阳地区中老年人血脂水平和异常率较高,血脂异常的早期预防、干预工作很重要。     

女性原发性高血压患者绝经前后脂蛋白（a）及血脂水平变化的临床研究

目的观察女性原发性高血压患者绝经前后脂蛋白（a）[Lp（a）]及血脂水平的变化，探讨其对女性冠心痛发病情况可能存在的影响。方法女性原发性高血压患者121例，测定Lp（a）、总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL—C）和高密度脂蛋白胆固醇（HDL—C）。对比绝经前后Lp（a）及血脂水平的变化，并与女性健康体检者（对照组）进行对比。结果高血压组Lp（a）、TC、TG、LDL—C均显著高于对照组。而HI）L—C及HDL—C／TC则明显低于对照组，在所有原发性高血压患者中，绝经后的患者Lp（a）、TC、TG、LDL—C显著高于绝经前患者，而HDL—C／TC则前者低于后者。结论绝经后原发性高血压患者Lp（a）、TC、LDL-C均明显高于绝经前患者，而HDL—C／TC则低于绝经前患者，提示绝经后女性原发性高血压患者Lp（a）及血脂水平增高与内源性雌激素水平下降有关，是绝经后冠心病发病率明显上升的重要原因。     

Ⅱ型糖尿病患者血脂,脂蛋白及载脂蛋白水平

本文检测了73例Ⅱ型糖尿病（NIDDM）患者血脂、脂蛋白及载脂蛋白水平，并与正常人作了比较。结果表明，Ⅱ型糖尿病患者血清胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL－C）及载脂蛋白B100（APOB100）浓度都显著升高（P＜0．001），高密度脂蛋白胆固醇（HDL－C）、载脂蛋白AI（APOAI）浓度及APOAI／APOB100比值都呈不同程度的降低（P＜0．02～0．001）。糖尿病伴有高脂血症的发生与年龄及病程成正相关。     

深圳市社区健康体检人群血脂水平分析

目的：通过对深圳市社区健康体检人群血脂四项的调查,了解该地区人群血脂水平及血脂异常率的情况与年龄、性别两者之间的关系。方法以参与体检的3351名深圳市社区健康体检人群为研究对象,对所有体检者血脂指标相关资料进行统计分析。结果血脂水平总的趋势是随着年龄的增长,总胆固醇（ TC）、三酰甘油（ TG）及低密度脂蛋白胆固醇（ LDL－C）呈升高状态,男性高于同龄女性;而高密度脂蛋白胆固醇（ HDL－C）在30～50岁年龄段明显下降,且男性下降水平更明显（ P＜0.05）。 TG及HDL－C异常检出率男性明显高于女性（P＜0.05）,TC及LCL－C异常检出率在不同性别间差异无统计学意义;女性在50岁以后TC、TG及LDL－C三项血脂指标异常检出率明显增高,且高于同龄组男性（ P＜0.05）。结论该地区健康人群血脂水平与年龄、性别有关;血脂异常出现年轻化且与性别存在明显相关性,提示该人群应提高健康意识,改变饮食结构和生活方式。     

高龄孕妇血脂和脂蛋白的变化

目的：探讨正常妊娠高龄孕妇孕晚期血脂和脂蛋白的变化。方法：选取2009年12月-2010年4月在我院住院分娩的正常足月孕妇98例,其中,高龄孕妇48例（观察组）,非高龄孕妇50例（对照组）,进行三酰甘油（TG）、胆固醇（TC）、高密度脂蛋白胆固醇（HDL—C）、低密度脂蛋白胆固醇（LDL—C）和脂蛋白α（LP-α）检测。结果：高龄孕妇TG显著高于对照组（P〈0．01）,HDL—C显著低于对照组（P〈0．05）,两组比较,TC、LDL—C和LP—α差异无统计学意义（P〉0．05）。结论：高龄孕妇有较高水平的TG和较低水平的HDL—C。     

心脑血管疾病患者脂蛋白及载脂蛋白观察分析

目的:了解心脑血管疾病患者脂质代谢异常情况。方法:测定患者血清、血脂、脂蛋白及载脂蛋白,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)采用酶法,载脂蛋白A1和载脂蛋白B采用免疫透射比浊法。结果:心脑血管疾病患者的血脂浓度与健康者对比差异有统计学意义。结论:载脂蛋白异常率较其他指标高,是预测脂质代谢紊乱的早期先兆指标。     

深圳市华侨城地区663例健康成人动脉粥样硬化指数水平分析

目的 :探讨本地区健康成人的动脉粥样硬化指数 (AI)水平与年龄、性别、血脂及脂蛋白胆固醇的关系。方法 :采用美国CX5△全自动生化分析仪检测 663例健康成人的血清甘油三酯 (TG)、总胆固醇 (TC)和高密度脂蛋白胆固醇(HDL -C) ,并按文献[1] 计算AI。结果 :663名 2 0～ 70岁健康成人的AI水平为 2 .5 0± 1.0 4,其中男性 ( 362名 )为 2 .74± 1.0 2 ,女性 ( 30 1名 )为 2 .2 1± 1.0 0 ;60岁以下男性AI显著高于女性 (P <0 .0 5 ) ,而 60岁以上则相反 ;男、女性的AI水平都有随年龄增长而升高的趋势 ,特别是男性 40岁以上、女性 5 0岁以上的AI水平都显著升高 (P <0 .0 5 ) ;AI水平与TG、TC和HDL -C的水平都有显著的相关性 ,其中AI与TG和TC水平呈显著的正相关 (P <0 .0 5 ) ,与HDL C水平呈显著的负相关(P <0 .0 1)。结论 :AI是反映人血浆中TG、TC和HDL -C水平的综合性脂质指标 ,建议在作冠心病 (CHD)风险程度的估计时加以应用     

徐州地区健康中老年人群血脂和载脂蛋白分布规律的探讨

目的探讨徐州市区不同年龄段中、老年人群血脂和载脂蛋白水平的差异及意义。方法采用日本Olympus2700全自动生化分析仪检测中、老年健康人群血清中总胆固醇（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AⅠ（APOAⅠ）、载脂蛋白B（APOB）的水平。受检者共计800人，按年龄段分4组，每10岁为一个组段。结果rI℃随年龄增大逐渐增高，70—79岁组达到最高。TG、APOB随年龄增长逐渐增高，到60．69岁组达到最高，以后降低；HDL—C、APOAⅠ随着年龄增长逐渐降低。LDL—C各年龄组间无差别。APOA和HDL—C，APOB和LDL—C、TC之间有显著相关性。结论徐州地区中、老年健康人群血脂和载脂蛋白水平与年龄有关，载脂蛋白与血脂水平密切相关。血脂分析可为中、老年人的健康检查及预防心血管疾病提供重要帮助。     

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.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

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.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.