2型糖尿病肾病患者同型半胱氨酸和叶酸及维生素B（12）水平变化

目的探讨同型半胱氨酸（HCY）和叶酸（FA）及维生素B12（VB12）在2型糖尿病肾病（T2DN）中的变化。方法根据24小时尿白蛋白排泄率（urinary albumin excretion rate,UAER）将122例2型糖尿病（T2DM）患者分为单纯糖尿病（SDM）组、早期糖尿病肾病（EDN）组和临床糖尿病肾病（CDN）组,50例体检健康者作为健康对照组分别检测同型半胱氨酸和叶酸及维生素B12水平。结果与健康对照组比较,T2DM3组患者HCY水平升高（P〈0.05）而叶酸和维生素维生素B12水平降低（P〈0.05）,HCY与FA和VB12均呈负相关,r分别为-0.61和-0.43（P〈0.01）。结论2型糖尿病肾病患者血清HCY水平随着UAER的增加而升高,FA和VB12水平随着UAER的增加而下降,这些指标可能与T2DN的病情进展有关。     

血清脂蛋白（a）检测对早期糖尿病肾病诊断价值的探讨

目的探讨血清脂蛋白（a）[Lipoprotein（a）,LP（a）]测定对临床早期糖尿病肾病（DiabeticBe．phropathy,DN）的意义。方法根据24h尿白蛋白排泄率（UAER）将118例糖尿病患者分为糖尿病无肾病组（A组,4l例,UAER〈30mg／24h）、临床早期DN组（B组,39例,30mg／24h≤UAER〈300mg／24h）及临床DN组（c组,38例,UAER≥300mg／24h）。从同期门诊健康体检者中随机选择40例为对照组（D组）。分别测定各组UAER及血清Lp（a）。各组均数的比较用方差分析,各组分别比较UAER和Lp（a）间的直线相关性。结果糖尿病各组与对照组比较血清Lp（a）升高（A组与D组比P〈0．05,B、C组与D组比P〈0．01）,且随DN之肾脏病变进展（UAER增加）而递增（B组与A组比P〈0．01,C组与B组比P〈0．05）。A组与B组血清Lp（a）水平与UAER呈直线正相关（A组r=0．356,P〈0．05;B组r=0．438,P〈0．01）。结论血清Lp（a）水平与DN肾损害程度相关,可以作为诊断早期DN的辅助方法之一。     

早期糖尿病肾病患者血清抵抗素与血糖及血脂代谢的相关性分析

目的探讨血清抵抗素(Resistin)与糖尿病肾病(DN)患者血糖、血脂代谢、尿微量白蛋白之间的关系。方法选取糖尿病患者72例,根据尿微量白蛋白排泄率分为正常白蛋白尿(NAU)组、微量白蛋白尿(MAU)组和临床蛋白尿(CAU)组,另选22例健康体检者作为对照组(NC)组。检测各组血清Resistin、糖化血红蛋白(HbA_(1c))、血脂指标(TC、TG、LDL-C、HDL-C)、微量白蛋白排泄率(UAER)、内生肌酐清除率(Ccr)。结果 DN组血清Resistin、HbA_(1c)、TG、TC、LDL-C、UAER水平均显著高于NC组(P<0.05),而HDL-C、Ccr显著低于NC组(P<0.05)。CAU组、MAU组与NAU组比较,HbA_(1c)、TG、TC、LDL-C、UAER的水平均显著升高(P<0.05),而HDL-C、Ccr显著降低(P<0.05)。相关性分析显示:在DM组中,血清Resistin与TG(r=0.66,P=0.01)、TC(r=0.56,P=0.01)、LDL-C(r=0.51,P=0.01)、HbA_(1c)(r=0.50,P=0.03)、UAER(r=0.66,P=0.01)均呈显著正相关,与Ccr(r=-0.64,P=0.01)、HDL-C(r=-0.55,P=0.01)呈负相关。结论血清抵抗素与血糖控制水平、HbA_(1c)、高脂血症及糖尿病肾病尿微量白蛋白关系密切。     

2型糖尿病肾病患者血清同型半胱氨酸和脂联素检测的临床意义

目的：探讨血清同型半胱氨酸（HCY）和脂联素（ADPN）在2型糖尿病肾病（T2DN）发生发展中的作用。方法：根据24h尿微量白蛋白排泄率（UAER／24h）将169例2型糖尿病（T2DM）患者分为单纯糖尿病N（SDM组）,早期糖尿病肾病组（EDN组）和临床糖尿病肾病组（CDN组）;51名健康者作为对照组（NC组）,分别测定血清HCY及ADPN水平。结果：SDM、EDN和CDN3组血清HCY、ADPN水平高于NC组（P〈0．05）;EDN和CDN组血清HCY、ADPN水平高于SDM组（P〈0．05）;CDN组血清HCY、ADPN水平高于EDN组（P〈0．05）;NC、SDM、EDN和CDN4组受试者血清HCY、ADPN与UAER水平呈正相关（rHCY=0．49,PHCY〈0．05;rADPN=0．56,PADPN〈0．05）。结论：血清HCY、ADPN与T2DN的发生、发展有关,检测二者水平可能对评估糖尿病肾病有作用。     

血清C反应蛋白水平与糖尿病患者肾小球功能损害的关系

目的探讨血清C反应蛋白（CRP）与糖尿病患者肾小球功能之间的关系。方法对100例2型糖尿病（T2DM）患者检测血清CRP,并按尿白蛋白排泄率（UAER）分组进行组间比较及相关性分析。结果临床白蛋白尿组（CAU）的CRP水平明显高于微量白蛋白尿组（MAU）与正常白蛋白尿组（NAU）,差异有高度统计学意义（t值分别为5.0607、12.3700,P均〈0.01）;MAU组的CRP水平亦明显高于NAU组,差异有统计学意义（t=8.6886,P〈0.01）。CAU组和MAU组的血清CRP水平均与UAER呈正相关关系,相关系数经t检验,P均〈0.05,相关系数有统计学意义。结论 T2DM患者CRP水平的升高与肾小球功能损害程度之间呈正相关关系,CRP与UAER的联合检测对T2DM患者预测DKD的风险有一定的临床意义,可以作为DKD的早期监控指标予以重视。     

糖尿病肾病患者血清sCD40L与HbA1c分析的临床意义

目的：探讨糖尿病肾病（diabetes nephropathy,DN）患者血清可溶性CD40配体（soluble CD40 ligand,sCD40L）水平变化及其临床意义。方法：根据尿微量清蛋白排泄（UAER）将92例2型糖尿病患者分为单纯糖尿病（A）组、早期糖尿病肾病（B）组和临床糖尿病肾病（C）组,别选30例健康体检者作为对照（D）组,分别测定各组血清sCIMOL和HbAlc水平。结果：4组之间血清sCD40L和HbAle水平有明显的差异（P〈0．05）且血清sCD40L和HbAle水平呈正相关（r=0．89,P〈0．01）、HbA1c与UAER相关（r=0．56,P〈0．05）。结论：DN患者血清sCD40L水平升高,且与HbAle水平呈正相关,sCD40L、HbA1c与糖尿病肾病密切相关。     

尿白蛋白排泄率和肾小球滤过率在早期糖尿病肾病的诊断价值

目的 探讨尿白蛋白排泄率（UAER）和肾小球滤过率（GFR）在早期糖尿病肾病的诊断价值。方法 29例糖尿病肾病（DN）病人、36例无肾脏疾病的糖尿病（DM）病人，采用终点法检测UAER．酶法来检测GFR。结果 DN组UAER显著高于DM无肾病组（P〈0．01）。GFR显著低于DM无肾病组（P〈0．01）。DN组UAER和GFR之间呈负相关（r=-0．76），DM无肾病组UAER厦GFR（r=0．59）亦呈负相关。结论 UAER和GFR是早期DN敏感的监测指标。     

老年2型糖尿病患者尿白蛋白排泄率与高敏C反应蛋白的相关性研究

目的探讨老年2型糖尿病患者尿白蛋白排泄率(UAER)与高敏C反应蛋白(hs-CRP)的关系。方法将210例老年2型糖尿病患者根据UAER分为正常白蛋白尿(NAU)组、微量白蛋白尿(MAU)组和临床白蛋白尿(CAU)组,以100名健康老年人作为对照(NC)组,检测各组的hs-CRP,并对UAER与有关因素进行单因素线性相关分析。结果NAU、MAU和CAU组的hs-CRP分别为(1.5±0.2)、(3.0±0.9)和(4.4±1.9)mg/L,均明显高于NC组的(0.2±0.1)mg/L(P值均<0.01),MAU和CAU组均明显高于NAU组(P值均<0.01)。进一步线性相关分析表明,老年2型糖尿病患者的UAER水平与稳态模型评估胰岛素抵抗指数(HOMA-IR)、hs-CRP和糖化血红蛋白(HbA_1c)呈正相关(r=0.368、0.376和0.289,P值分别<0.01、0.05)。结论hs-CRP与2型糖尿病及糖尿病肾病的发生明显相关,在2型糖尿病肾病危险因素预测中具有重要意义。     

尿白蛋白排泄率与代谢综合征相关组分的关系

目的研究尿白蛋白排避率（UAER）与代谢综合征相关组分的关系。方法2型糖尿病（T2DM）患者258例,按照UAER分为正常白蛋白尿组（NAU）（〈30ms／24h）、微量白蛋白尿组（MAU）（30-299ms／24h）和临床白蛋白尿组（CAU）（≥300ms／24h）,比较三组的体质量指数（BMI）、血压、血生化指标、24h尿尿酸（UUA）、胰岛素分泌指数（HOMA—IS）、胰岛素抵抗指数（HOMA—IR）和胰岛素敏感指数（ISI）,并行Pearson相关分析和多元逐步回归分析。结果与NAU组比较,MAu组收缩压（SBP）、BMI、血尿酸（UA）、UUA、in（HOMA—IR）和In（HOMA—IS）升高,In（ISI）降低（P〈0．05）;而CAU组SBP、舒张压（DBP）、BMI、甘油三酯（TG）、极低密度脂蛋白（VLDL）、UA、UUA和1n（HOMA—IR）升高,In（ISI）降低（P〈0．05）;CAU组较MAu组TG升高（P〈0．05）。UAER与SBP、TG、VLDL、UA呈正相关（P〈0．01）。多元逐步回归显示TG、SBP、UA是UAER的主要影响因素。结论,12DM患者TG、SBP、uA是UAER的主要影响因素,提示对这些危险因素的控制有助于预防和控制糖尿病肾病。     

糖尿病肾病患者血清结缔组织生长因子和肿瘤坏死因子表达及其临床意义

[目的]探讨结缔组织生长因子（CTGF）、肿瘤坏死因子-α（TNF-α）在糖尿病肾病（DN）患者不同阶段的表达水平及相关性。[方法]根据24 h尿白蛋白排泄率率（UAER）将94例DN 患者分为无蛋白尿（NRU组）、微量蛋白尿（MIU组）及大量蛋白尿（MAU组）三组,同时以89例健康体检者作为对照组（CON组）,检测各组血清中CTGF、TNF-α水平并比较分析。[结果]NRU 组、MIU 组及MAU 组血清CTGF和TNF-α水平显著高于 CON 组,其差异有统计学意义（ P ＜0．01）。 NRU 组、MIU 组及 MAU 组患者中UAER与CTGF（ r ＝0．924,P ＜0．01）和TNF-α（ r ＝0．861,P ＜0．01）呈正相关;血清中CTGF与 TNF-α水平呈正相关（ r ＝0．432,P ＜0．05）。[结论]血清中CTGF和TNF-α水平在DN患者中均有不同程度的增高,与UAER呈正相关,有可能成为监测DN病情变化的有效指标。     

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…     

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.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

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.     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

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.     

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.