早产儿微量元素、维生素水平与其生长指标的相关性分析及其临床意义

目的：分析早产儿微量元素、维生素水平与其生长指标的相关性,并探讨其临床意义。方法：将2018年1月至2019年6月入住于我院的230例早产儿作为研究对象,并选择230例同期于我院出生的足月新生儿作为对照,对比两组新生儿静脉血微量元素钙(Ca)、镁(Mg)、锌(Zn)、铁(Fe)、铜(Cu)水平和维生素A、25羟基维生素D[25-(OH)D]、维生素E水平,并比较两组新生儿头围、出生体重、身长等生长参数,分析早产儿微量元素、维生素水平与生长参数相关性。结果：早产儿Ca、Mg、Zn、Fe、Cu水平均低于足月新生儿(P<0.05);早产儿维生素A、25-(OH)D和维生素E水平均低于足月新生儿(P<0.05);早产儿头围、出生体重和身长均小于足月新生儿(P<0.05);早产儿Ca、Mg、Zn、Fe水平与其出生体重均呈正相关(P<0.05),Ca、Zn均与身长呈正相关(P<0.05),25-(OH) D水平与其头围和出生体重均呈正相关(P<0.05)。结论：早产儿微量元素Ca、Mg、Zn、Fe水平出生体重具有相关性,维生素D与头围和出生体重也有密切关系,早期补充这些微量元素和维生素对促进早产儿生长发育具有重要意义。     

妊娠中期不良结局与微量元素含量的相关性研究

目的:探讨微量元素含量与妊娠中期不良妊娠结局的相关性。方法:选取124例处于妊娠中期不良妊娠结局的孕妇,分为A组(先兆流产)61例、B组(胎膜早破)48例、C组(死胎)15例,再选取80例同期产检健康的孕妇作为对照组,比较4组孕妇及新生儿的微量元素锰(Mn)、硒(Se)、锌(Zn)、铜(Cu)、铁(Fe)的含量。结果:孕妇静脉血Fe含量A、C组明显低于对照组(P<0.05),B组和对照组比较无显著差异(P>0.05)。Cu、Zn含量A、B、C组的均明显低于对照组(P<0.05)。Se含量A、B、C组与对照组比较无明显差异(P>0.05)。Mn含量A、C组明显低于对照组(P<0.05),B组和对照组比较无显著差异(P>0.05)。A组新生儿的静脉血Fe、Zn、Se含量明显低于对照组(P<0.05)。Cu含量与对照组比较无明显差异(P>0.05)。B组新生儿的静脉血Zn、Se含量明显低于对照组(P<0.05)。C组新生儿的静脉血Zn、Se、Fe含量明显低于对照组(P<0.05)。结论:微量元素异常与妊娠中期不良妊娠结局有明显的相关性,可引起妊娠中期发生先兆流产、胎膜早破甚至死胎,同时母体内的Cu、Fe、Mn微量元素的含量异常能对新生儿体内的相应元素含量产生影响;孕期合理摄入含Cu、Fe、Mn、Zn等微量元素,对预防妊娠中期发生流产、胎膜早破及死胎有重要的意义。     

透射免疫分析检测腹膜透析患者纤维结合蛋白的临床意义

目的探讨腹膜透析患者血清纤维结合蛋白含量变化及其临床意义。方法应用透射免疫分析法测定70例尿毒症患者进行腹膜透析前后的血清纤维结合蛋白(Fn)含量,同时检测血清肌酐(Crea)、血清尿素氮(BUN)含量,并进行相关性统计分析。结果与正常对照组(223.7±11.7)mg/L比较,腹透前组(168.07±16.06)mg/L、腹透后组(191.77±17.01)mg/L Fn含量降低,差异有统计学意义(P<0.05);腹透后组与腹透前组比较,Fn水平升高,差异有统计学意义(P<0.05);透析前、后Fn升高水平与Crea、BUN降低水平的变化趋势均不完全一致。结论对进行腹膜透析治疗的尿毒症期患者进行Fn水平检测,有助于监测透析患者腹膜纤维化的情况及判断患者腹膜透析的效果,可作为评估腹膜透析效果辅助指标之一。     

变应性鼻炎与人体必需元素

本文报告99例变应性鼻炎患者及50例健康人Mg、Mn、Mo、Sr、Cd、Cr、Ni、Ti、Zn、Ca、Fe和Cu等12种人体必需元素含量,经统计学分析表明患者组Mo、Ti、Zn、Fe元素的含量低于对照组(P〈0.01),Mg含量高于对照组(P<0.01),Mn、Sr、Cd、Ni、Ca、Cu元素水平两组无明显差异(P>0.05),Cu/Zn比值明显高于对照组(P<0.01),本文对变应性鼻炎在病因学及综合治疗方面提供了新的线索。     

急性视力降低病人枕发微量元素含量测定及临床意义

笔者应用原子吸收法测定了急性视力降低(实验组)和正常人(对照组)各30例枕发中锌(Zn)、铁(Fe)、铜(Cu)、钙(Ca)、镁(Mg)、镉(Cd)含量的变化。结果表明:实验组Zn、Fe、Ca、Mg含量明显低于对照组,差异非常显著(P<0.01);而 Cu含量明显高于对照组,差异非常显著(P<0.01);实验组Cu含量虽然低于对照组,但无显著性差异(P>0.05),而Cu/Zn比值明显高于对照组,差异显著(P<0.05)。说明视力降低与体内Zn、Fe、Cu、Ca、Mg含量降低有关。     

新疆和田地区60岁以上维吾尔族老人血清微量元素水平调查

目的了解新疆和田地区洛浦县、墨玉县、和田县60岁以上维吾尔族老人血清微量元素水平。方法采集和田地区423名维吾尔族老人外周血,以火焰原子吸收法检测血清铁(Fe)、铜(Cu)、锌(Zn)元素含量,并比较不同性别、不同地区和不同年龄组微量元素含量的差异。结果和田地区老人血清Zn、Fe含量高于成人血清微量元素正常参考值。和田地区3个县老人血清Fe、Cu含量存在地区差别(P<0.05),其中洛浦县老人血清Fe含量高于墨玉县(P<0.05);洛浦县、墨玉县老人血清Cu含量低于和田县(P<0.05);和田地区3个县老人血清Zn含量差别无统计学意义(P>0.05)。不同性别老人血清Fe、Cu、Zn含量无明显差异(P>0.05)。和田地区不同年龄组老人血清Zn、Cu含量存在差别(P<0.05),其中60～69岁组血清Cu、Zn含量低于80～岁组(P<0.05),70～79岁组老人血清Zn含量低于80～89岁组,差异有统计学意义(P<0.05);不同年龄组老人血清Fe含量无明显差异。结论和田地区维吾尔族老人血清Fe、Zn微量元素含量水平较高,可能与该地区老人健康长寿有关。     

广西三江县侗族、南宁市汉族乳母膳食与乳汁中营养素含量调查分析

目的:了解广西三江县侗族、南宁市汉族乳母膳食营养状况及乳汁中各种营养素的含量.方法:收集240名广西三江县侗族和南宁市汉族乳母产后0～6个月的乳汁,测定其蛋白质(PRO)、脂肪(FAT)、碳水化合物(COH)、钙(Ca)、锰(Mn)、铁(Fe)、铜(Cu)、锌(Zn)、维生维A(Vit A)的含量,并对乳母进行膳食调查.结果:①膳食调查结果:侗、汉族乳母膳食结构明显不同.侗族乳母PRO、COH、Fe每日平均摄入量均显著高于DRIS标准(P＜0.05);Ca、Zn及Vit A平均摄入量均低于DRIS标准(P＜0.01).汉族乳母PRO、COH每日平均摄入量高于DRIS标准(P＜0.01);Ca、Zn、Fe及Vit A每日平均摄入量均低于DRIS标准(P＜0.01).侗族乳母膳食PRO、COH、Ca、Mn、Cu摄入量均明显低于汉族乳母(P＜0.01);②母乳各营养素含量分析结果:侗族满月前母乳PRO、FAT、Fe含量高于参考值,满月后Ca、Fe、Zn、Vit A含量低于参考值.汉族满月前后母乳PRO和FAT含量高于参考值,Ca和Vit A低于参考值;满月后Mn和Cu含量高于参考值,Fe、Zn和Vit A含量低于正常值.侗族母乳PRO、FAT、Ca、Mn、Cu、Zn含量均显著低于汉族母乳(P＜0.05).结论:广西三江县侗族、南宁市汉族乳母膳食Ca、Zn、Vit A人均每日摄入量均较DRIS标准明显偏低;侗、汉族母乳Ca、Zn、Vit A含量均较参考值偏低.     

人参茎叶中二醇组皂甙对小鼠学习记忆及铜、锌、锰含量的影响

采用跳台法、火焰原子吸收分光光度计法分别研究了人参茎叶中二醇组皂甙(PDS)对小鼠学习记忆和全血铜(Cu)、锌(Zn)、锰(Mn)微量元素含量的影响. 结果表明,不同给药剂量各实验组小鼠跳台错误次数明显低于对照组(P<0.01),潜伏期明显延长(P<0.01);各实验组全血Cu含量均高于对照组(P<0.01),而Zn含量没有变化(P>0.05),Mn含量随给药剂量增加而增高,提示PDS具有提高小鼠学习记忆作用,可能与Cu、Mn含量增高有关.     

新疆乳腺癌患者血清中Mn、Cu、Se、Zn的病例对照研究

目的研究新疆乳腺癌患者血清微量元素锰(Mn)、铜(Cu)、锌(Zn)、硒(Se)的含量变化及其对乳腺癌的意义。方法选择2011年5月-2012年7月入住新疆医科大学附属肿瘤医院的新疆常住各族女性已确诊的原发性乳腺癌患者155例(病例组)及体检健康者155例(对照组),按照1∶1配比的病例对照研究,采用原子吸收分光光度法测定乳腺癌患者和对照组血清中微量元素Mn、Cu、Zn、Se的含量。结果经单因素分析,病例组和对照组Mn、Zn含量和Cu/Zn含量差异有统计学意义(P<0.05)。在不同临床病理分级中血清Cu、Cu/Zn差异有统计学意义(P<0.05),在不同年龄分组中血清Se差异有统计学意义(P<0.05)。PR阴性组PR阳性组血清Mn、Cu、Zn及Cu/Zn差异有统计学意义。Cu/Zn在ER阴性组和阳性组中差异有统计学意义。结论对微量元素的检测可能有助于乳腺癌的早期预防和预后。     

单纯性肥胖青少年血清钙铁锌铜对糖代谢的影响

目的：研究探讨单纯性肥胖青少年血清钙铁锌铜对糖代谢的影响。方法：采取1:1配对的病例对照研究方法,确定单纯性肥胖和正常体重青少年各56名,测定两组血清钙(Ca)、铁(Fe)、锌(Zn)、铜(Cu)、空腹血糖(FBG)和空腹胰岛素(FINS)含量,计算胰岛素抗性（IR）、胰岛素敏感性（ISI）和胰岛素分泌指数(IS),分析Ca、Fe、Zn、Cu与糖代谢指标的相关性。结果：肥胖组青少年血清的FBG、FINS、IR、IS、Ca、Fe、Zn、Cu水平及Zn/ Cu和Zn/ Fe比值均明显高于对照组(P<0.01),而ISI明显低于对照组(P<0.01)。直线相关分析结果显示,肥胖组青少年血清FBG、IR、IS与Cu水平呈显著正相关,与Ca、Zn、Zn/ Cu、Zn/ Fe呈显著负相关（P<0.05）;FINS、ISI与Ca、Zn、Zn/ Cu、Zn/ Fe水平呈显著正相关（P<0.05）,而与Cu呈显著负相关（P<0.05）。结论：单纯性肥胖青少年体内存在明显的糖代谢紊乱及血清Ca、Fe、Zn、Cu平衡失调,两者之间关系密切,表明Ca、Fe、Zn、Cu失调在糖代谢紊乱中起一定作用。     

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.     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.