血清C-反应蛋白测定对判断术后感染的意义

连续测定57例外科患者手术前后血清C-反应蛋白(CRP)的变化,如抗感染治疗满意,术后CRP会迅速下降至10μg/ml以下;如感染未得到很好控制,或先控制尔后又复发,则CRP下降迟缓且维持于20μg/ml以上。研究表明监测患者血清CRP水平有助于早期发现感染和观察疗效。     

妊妇、产妇、产褥期妇女及脐带血的血清C—反应蛋白(C—Reactive Protein)(CRP)的微量测定及其临床意义

概要: 用改进的单相免疫扩散法(modified single radial immunodiffusion)微量测定了正常妇女、妊妇、产妇、产褥期妇女和脐带血共计261个样本的血清CRP值,获得以下结果。 1.31例正常妇女的血清CRP值:0.5μg/ml以下者21例(68％)、0.5μg/ml～2μg/ml者8例(26％),2μg/ml以上者2例(6％)。     

血清CRP用于院内感染监测的探讨

对住院病人血清C-反应蛋白(CRP)连续临测发现患住院期间无继发感染时血清CRP均值小于10μg/ml．发生院内继发感染时手术组及非手术组血清CRP均值大于20μg／ml，经抗生素治疗有效时CRP均值下降．直至小于10μg／ml，血清CRP动态观察可作为院内感染监测与控制的有鼓指标。     

肝癌患者血清铜和锌浓度的变化

用原子吸收分光光度计测定了66例健康成年人及17例肝癌惠者血清铜和锌浓度。健康人血清铜平均浓度126.40±23.44μg/100ml((?)±SD),锌116.12±25.60μg/100ml.17例肝癌患者血清铜明显增高,平均浓度为155.83±37.08μg/100ml(P<0.001),血清锌降低为86.72±31.89μg/100ml(P<0.001)。血清Cu/Zn 比值明显的增加(正常值为1.12±0.32;肝癌时为2.15±0.31,P<0.001)。结果提示血清铜锌浓度及比值测定对诊断肝癌有一定意义。     

不稳定型心绞痛患者C-反应蛋白基因多态性与其血清水平的相关性

目的:探讨中国苏南地区汉族人群不稳定型心绞痛(unstable angina pectoris,UAP)患者C-反应蛋白(C-reactive protein,CRP)基因+1444C/T多态性与其血清CRP水平的相关性?方法:本研究包括172例不稳定型心绞痛患者(UAP组)和230例非冠心病者(对照组),分别应用酶联免疫吸附法和聚合酶链反应-限制性片段长度多态性法检测血清CRP水平及CRP基因+1444C/T多态性?结果:①本研究人群存在CRP基因+1444C/T多态性;②UAP患者血清CRP水平(8.269/9.179 μg/ml)显著高于非冠心病者(3.578/2.236 μg/ml)(P < 0.001),且经多因素Logistic回归校正各影响因素后,仍提示血清CRP水平与UAP发病风险相关;③血清CRP水平在UAP组与对照组各基因型之间无显著差异(P > 0.05),进一步按性别和年龄分组后,仍未发现该基因多态性不同基因型间的血清CRP水平有任何差异(P > 0.05)?结论:中国苏南地区汉族人群CRP+1444C/T基因多态性与血清CRP水平无相关性?     

降钙素原、C-反应蛋白在慢性阻塞性肺病合并细菌感染中的诊断价值

目的：探讨降钙素原、C-反应蛋白在慢性阻塞性肺病合并细菌感染中的诊断价值。方法随机选取该院2014年6月—2015年9月收治的慢性阻塞性肺病患120例,通过肺CT检查结果分为感染组60例,未感染组60例,另选取60名体检健康者作为正常对照组,分别测定其血清降钙素原(PCT)、C-反应蛋白(CRP)浓度,对感染组和未感染组患者使用抗菌药物一段时间后,再次测定PCT、CRP,并记录结果。结果感染组治疗前PCT为(2.49±2.87)μg/L、CRP浓度为(73.79±18.29)μg/L,与未感染组、正常对照组相比,差异有统计学意义(P﹤0.01);治疗后感染组PCT为(1.98±0.11)μg/L、CRP浓度为(7.32±2.63)μg/L,较治疗前后差异有统计学意义(P﹤0.05),治疗前后,未感染组PCT、CRP浓度差异无统计学意义(P﹥0.05);治疗后感染组PCT浓度为(1.98±0.11)μg/L,明显高于未感染组(P﹤0.05),CRP浓度与未感染组差异无统计学意义(P﹥0.05)。结论血清PCT联合CRP检测是诊断慢性阻塞性肺病患者是否合并细菌感染的较敏感的特异性指标,具有一定的临床指导意义。     

肺癌患者血清可溶性细胞间粘附分子-1与C-反应蛋白浓度相关性研究

目的 :研究肺癌患者血清可溶性细胞间粘附分子 - 1( s ICAM- 1)与 C-反应蛋白 ( CRP)浓度之间相关性。方法 :分别以 ELISA法和免疫速率散射比浊法 ,测定了 2 2例肺癌患者血清 s ICAM- 1及 CRP水平。结果 :化疗前及化疗后 2周 ,肺癌患者血清 s ICAM- 1>2 4 0μg/ L (正常对照 95%可信区的上限为 2 38.3μg/ L )的百分率分别为 77.3%和 63.6%。治疗有效组 ,化疗后 2周 ,血清s ICAM- 1浓度与化疗前相比显著降低 ( 2 4 8.6± 4 6.7μg/ L vs 377.4± 4 8.7μg/ L ,t检验 ,P<0 .0 1) ;而治疗无效组 ,化疗前后血清 s ICAM- 1浓度无显著变化 ( 32 4 .3± 12 8.1μg/ L vs330 .9±130 .4 μg/ L,t检验 ,P>0 .0 5)。化疗前及化疗后 2周 ,分别有 59.1%和 54.5%的肺癌患者血清CPR浓度增高。治疗有效组 ,化疗后 2周血清 CRP浓度平均值下降了 77.9% ,治疗无效组 ,化疗前后血清 CRP浓度平均值无显著变化。化疗前及化疗后 2周 ,血清 s ICAM- 1与 CRP浓度均呈显著相关性 ,相关系数分别为 0 .660 ( P<0 .0 1)和 0 .794 ( P<0 .0 1)。结论 :肺癌患者血清 s ICAM- 1与CRP浓度呈显著相关性 ,s ICAM- 1与 CRP浓度测定可作为疗效评估及预后的指标。     

HPRPC法结合紫外吸收衍生法测定血清丙戊酸浓度

采用反相高效液相色谱法(下称HPRPC)结合紫外吸收衍生法,测定183例服用丙戊酸钠(每日3次,每次0．2g)的成人癫痫患者的血药浓度。其血清丙戊酸谷浓度为52．7±24．33μg/ml,其中89例(48．6%)在有效范围(50g/ml~100μg/ml),88例(48．63%)<50μg/ml,最低者仅13．67μg/ml,6例(3．28%)高于100μg/ml,最高达127．51μg/ml,提示服常规剂量患者间戊酸血药浓度个体差异颇大。     

血清FKN因子和CRP与2型糖尿病肾病的相关性研究

目的 观察血清Fractalkine（FKN）因子和C反应蛋白（CRP）在2型糖尿病肾病不同时期的变化,并探讨其临床意义。方法 选择2型糖尿病患者130例,根据尿白蛋白排泄率（UAER）分为3组：Ⅰ组45例为无糖尿病肾病组（UAER＜20μg/min）;Ⅱ组43例为早期糖尿病肾病组（UAER 20～200μg/min）;Ⅲ组42例为临床糖尿病肾病组（UAER＞200μg/min）。另选同期健康体检者40例为对照组。测定各组血清FKN和CRP的浓度,分析其在糖尿病肾病不同阶段的变化。结果 ⑴糖尿病肾病组FKN和CRP均明显高于对照组及无糖尿病肾病组和早期糖尿病肾病组（P均＜0.01）;⑵FKN与UAER、CRP、FPG、2hPG、HbA1c呈正相关,CRP与UAER、FKN、2hPG、HbA1c呈正相关。结论 糖尿病肾病患者血清FKN与CRP随着UAER的增加而升高,血清FKN和CRP与DN的发生、发展关系密切,FKN和CRP可作为检测糖尿病肾病预后及治疗效果的指标之一。     

溃疡性结肠炎患者血清P物质、血管活性肠肽及内皮素检测结果分析

目的探讨部分胃肠激素在溃疡性结肠炎患者中的变化及两者的相关性。方法选取武警海南总队医院2002-2011年住院确诊为溃疡性结肠炎患者53例为实验组及同期健康体检者36例为对照组,采用放射免疫法检测其血清SP、VIP和ET水平,分析其与溃疡性结肠炎发病的关系。结果与正常对照组比较,溃疡性结肠炎患者血清SP[(1130.75±109.85)μg/mlvs(426.64±89.62)μg/ml]、VIP[(124.81±17.61)μg/mlvs(83.26±7.65)μg/ml]和ET[(157.73±28.39)μg/mlvs(88.65±13.76)μg/ml]水平均升高,差异有统计学意义(P<0.01)。结论 SP、VIP和ET在溃疡性结肠炎患者中均明显升高,可能与溃疡性结肠炎发生、发展相关。     

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.