维吾尔族、汉族冠状动脉斑块64排螺旋CT特征与危险因素对照分析

目的:比较新疆维吾尔族(维族)与汉族冠心病患者冠状动脉粥样硬化斑块的64排螺旋CT特征与冠心病危险因素,探讨2个民族冠心病发病可能原因。方法:同期64排螺旋CT冠状动脉造影确诊为冠心病的维族患者152例及汉族患者304例,分析其斑块成分、部位、血管狭窄程度及梗阻性斑块(狭窄≥50%的斑块)累及冠状动脉的分支数,并采集患者性别、年龄、身高、体质量及高血压病史、糖尿病病史、吸烟史、家族史,三酰甘油、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇水平进行比较。结果:维族冠心病患者斑块发生率高于汉族(P<0.05),斑块发生在回旋支的比例高于汉族(P<0.05),斑块引起管腔中、重度狭窄比例高于汉族(P<0.05),梗阻性斑块累及多支比例高于汉族(P<0.05);2个民族斑块成分差异无统计学意义(P>0.05)。维族冠心病患者体质量指数高于汉族(P<0.05),2个民族高血压、糖尿病、吸烟史、三酰甘油、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇比较差异无统计学意义(P>0.05)。结论:2个民族冠状动脉粥样硬化斑块特征存在差异,维族冠状动脉粥样硬化斑块发生率高、病变程度较汉族重,可能与维族体质量指数高于汉族有关。     

维、汉民族血清胆红素水平与早发冠心病对比研究

目的:探讨新疆地区维、汉2个民族血清胆红素水平与早发冠心病的关系.方法:将766例冠状动脉造影患者(男性≤55岁,女性≤65岁)分为早发冠心痛组372例,其中维族112例,汉族260例;正常对照组394例,其中维族136例,汉族258例.冠状动脉病变从是否患有冠心痛、病变支数及冠状动脉Gensini总积分3个方面分析.结果:汉族早发冠心痛组总胆红素、间接胆红素低于对照组,维族早发冠心病组总胆红素、直接胆红素低于对照组,差异均有统计学意义(P<0.05).早发冠心痛组维族总胆红素及直接胆红素低于汉族,差异有统计学意义(P<0.05).维族多支病变总胆红素水平低于单支病变,双支、多支病变直接胆红素水平低于单支病变,汉族双支、多支病变总胆红素、直接胆红素、间接胆红素水平低于单支病变,差异均有统计学意义(P<0.05).多元逐步回归分析显示,引入其他危险因素后,汉族间接胆红素、维族直接胆红素均与冠状动脉病变程度呈负相关(P<0.05).结论:血清胆红素可能是早发冠心痛的独立危险因素.维族直接胆红素、汉族间接胆红素对预测冠状动脉粥样硬化严重程度有一定意义.     

颈动脉斑块与缺血性脑血管病及其危险因素的关系

目的探讨缺血性脑血管病患者颈动脉粥样硬化斑块特点及其与缺血性脑血管病之间的关系,寻找颈动脉斑块危险因素。方法对115例颈内动脉粥样硬化缺血性脑血管病患者进行颈动脉超声检查,并检查血清甘油三酯、总胆固醇、高密度脂蛋白、低密度脂蛋白,分析引起颈动脉粥样硬化的危险因素。结果超声检查颈动脉粥样硬化斑块检出率为81.7%(94例),颈动脉中重度狭窄发生率为7.8%(9例)。缺血侧颈动脉斑块发生率(67.7%),其中软斑发生率(33.1%),均高于非缺血侧(48.5%,其中软斑20.4%,P<0.05)。斑块组发生高血压病的比例(85.1%)明显高于无斑块组(57.1%,P<0.05);且在软斑组长期烟酒史及男性比例高于稳定性斑块组(P<0.05)。结论缺血性脑血管病患者颈动脉粥样硬化以斑块居多,软斑为重要危险因素,高血压病在斑块发生发展中起重要作用。多因素分析表明,年龄、甘油三酯、总胆固醇和低密度脂蛋白影响颈动脉斑块的形成,而性别、烟酒史可能会影响斑块的稳定性。     

血尿酸与脑梗死患者颈动脉粥样硬化关系研究

目的 探讨脑梗死患者颈动脉粥样硬化程度与血尿酸的关系.方法 122例脑梗死患者按颈动脉硬化程度分为内膜-中膜增厚组、斑块形成组和管腔狭窄组,并设56例正常对照组;测定4组总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、血尿酸及C-反应蛋白的浓度,进行比较分析.结果 内膜中膜增厚组、斑块形成组和管腔狭窄组的甘油三酯、低密度脂蛋白胆固醇、血尿酸及C-反应蛋白的浓度显著高于对照组(P<0.05).Logistic多元回归分析发现颈动脉粥样硬化程度与低密度脂蛋白胆固醇、血尿酸呈显著正相关(P<0.05).结论 甘油三酯、低密度脂蛋白胆固醇、血尿酸及C-反应蛋白与脑梗死患者的颈动脉粥样硬化程度正相关.低密度脂蛋白胆固醇、血尿酸是颈动脉粥样硬化的独立危险因素.     

脑梗死患者颈动脉粥样硬化的危险因素分析

目的 探讨脑梗死患者颈动脉粥样硬化程度与血脂、纤维蛋白原、血糖、血尿酸及C反应蛋白的关系.方法 将122例脑梗死患者按颈动脉硬化程度分为内膜中膜增厚组、斑块形成组和管腔狭窄组,分别测定其与56例对照组的总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、载脂蛋白A、载脂蛋白B、脂蛋白(a)、纤维蛋白原、血糖、血尿酸及C反应蛋白水平,观察颈动脉粥样硬化程度与血脂、纤维蛋白原、血糖、血尿酸及C反应蛋白的关系.结果 斑块形成组和管腔狭窄组三酰甘油、低密度脂蛋白胆固醇、载脂蛋白B、纤维蛋白原、血糖、血尿酸及C反应蛋白水平显著高于内膜中膜增厚组和对照组(P<0.05).内膜中膜增厚组三酰甘油、低密度脂蛋白胆固醇、载脂蛋白B、纤维蛋白原、血糖、血尿酸及C反应蛋白水平显著高于对照组(P<0.05).Logistic多元回归分析发现,颈动脉粥样硬化程度与低密度脂蛋白胆固醇、脂蛋白(a)、纤维蛋白原、血糖、血尿酸呈显著正相关(P<0.05～0.01).结论 低密度脂蛋白胆固醇、脂蛋白(a)、纤维蛋白原、血糖、血尿酸是颈动脉粥样硬化的独立危险因素.及时检测脑梗死患者血脂、纤维蛋白原、血糖、血尿酸、C反应蛋白和颈动脉粥样硬化情况,评价病变程度,对疾病的早期防治具有重要的价值.     

乌鲁木齐地区维吾尔族与汉族早发冠心病患者危险因素相关研究

目的:探讨维吾尔族(维族)与汉族早发冠心病危险因素的差异及冠状动脉造影的特点.方法:回顾性分析1 094例行冠状动脉造影术患者的临床资料,分析维、汉2个民族早发冠心病危险因素的关系.结果:旱发冠心病患者维族血脂异常比率、脂蛋白a、栽脂蛋白B/栽脂蛋白AI水平均较汉族高.传统危险因素个数较汉族多,差异均有统计学意义(P＜0.05).维、汉2个民族均以非早发冠心痛组为参照行Logistic回归发现冠心病阳性家族史、吸烟是维、汉2个民族早发冠心痛的危险因素;血脂异常及脂蛋白a仅是维族旱发冠心痛的危险因素.结论:血脂异常与脂蛋白a为维族早发冠心痛的危险因素之一;早发冠心病可能存在目前仍未被发现的危险因素.     

血脂与老年冠心病患者颈动脉粥样硬化斑块的相关性

目的 探讨血脂与老年冠心病(CHD)患者颈动脉粥样硬化斑块的相关性.方法 选取276例老年CHD患者,根据有无颈动脉粥样硬化斑块分为斑块组(138例)和无斑块组(138例).收集所有患者的一般资料,并检测其总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白B...     

冠状动脉粥样硬化患者血脂及修饰化脂蛋白水平研究

目的分析冠状动脉粥样硬化患者血脂、修饰化脂蛋白及脂蛋白相关磷脂酶A2水平,探究修饰化脂蛋白及脂蛋白相关磷脂酶A2与冠状动脉粥样硬化发生的关系。方法选取2016年9-12月因急性心肌梗死就诊于华西医院急诊科、最终诊断为冠状动脉粥样硬化性心脏病患者220例作为病例组,以同期在该院体检中心健康体检者200例作为对照组,比较病例组和对照组血脂及修饰化脂蛋白水平的差异。结果病例组空腹血糖、糖化血红蛋白高于对照组,胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇水平低于对照组,差异均有统计学意义(P0.05),三酰甘油水平两组差异无统计学意义(P0.05)。病例组氧化低密度脂蛋白、氧化高密度脂蛋白、糖化低密度脂蛋白、糖化高密度脂蛋白、脂蛋白相关磷脂酶A2水平均高于对照组,差异均有统计学意义(P0.05)。结论血脂不是冠状动脉粥样硬化发生和发展的主要因素,高血糖和高水平修饰化脂蛋白及脂蛋白相关磷脂酶A2与冠状动脉粥样硬化的形成关系密切。     

冠状动脉斑块CT血管造影征象与血清RANTES水平的相关性研究

目的 探讨冠状动脉斑块CT血管造影(CTA)征象与血清活化T细胞趋化因子(RANTES)水平的相关性.方法 选取2017年1-12月于该院收治的冠心病患者226例作为观察组,均经过冠状动脉造影及超声心动图确诊.根据获得的冠状动脉斑块CT值不同将患者分为非钙化斑块组(68例),混合斑块组(73例)及钙化斑块组(85例).另选取同期体检健康者80例作为对照组.收集研究对象一般资料及冠状动脉狭窄程度Gensini积分,采用酶联免疫吸附试验(ELISA)法检测各组血清RANTES水平.采用Pearson相关分析冠心病患者粥样斑块CT值与血清RANTES水平的相关性.结果 观察组收缩压、舒张压、总胆固醇、低密度脂蛋白、三酰甘油、血清RANTES水平高于对照组,差异均有统计学意义(P<0.05).非钙化斑块组、混合斑块组及钙化斑块组CT值依次升高(P<0.05),Gensini积分、血清RANTES水平依次降低(P<0.05).Pearson相关分析结果显示,冠心病患者粥样斑块CT值与血清RANTES水平呈负相关(r=-0.720,P<0.05).经Kaplan-Meier生存分析可知,CT高值组生存率高于CT低值组,血清RANTES高表达组生存率高于血清RANTES低表达组.结论 冠心病患者冠状动脉斑块CTA征象反映的斑块性质与血清RANTES水平密切相关,二者对判断冠状动脉斑块具有较好的辅助诊断价值.     

克拉玛依地区维吾尔族、汉族2型糖尿病患者血脂水平对比分析

目的探讨克拉玛依地区维吾尔族(简称维族)、汉族2型糖尿病患者的血脂异常特点及民族差异。方法收集克拉玛依地区1 015例维族、汉族2型糖尿病患者病历资料,回顾分析其总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)水平并进行比较。结果 2型糖尿病患者血脂异常发病率在不同性别及总体维族高于汉族,差异有统计学意义(男:P=0.025;女:P=0.013;总体:P=0.000)。各类型血脂异常发病率为:高胆固醇血症维族为22.80%,汉族为16.18%;高三酰甘油血症维族为46.50%,汉族为42.57%;混合型高脂血症维族为14.89%,汉族为11.81%;低高密度脂蛋白胆固醇血症维族为66.57%,汉族为52.19%。其中,高胆固醇血症男性及总体(男:P=0.026;总体:P=0.012)、低高密度脂蛋白胆固醇血症男女及总体(男:P=0.015;女:P=0.019;总体:P=0.000)维族高于汉族,差异有统计学意义(P0.05)。TC水平总体(P=0.042)、LDLC水平男性及总体(男:P=0.028;总体:P=0.030)维族高于汉族,差异有统计学意义(P0.05)。HDL-C水平男女及总体(男:P=0.000;女:P=0.010;总体:P=0.001)维族低于汉族,差异有统计学意义(P0.05)。结论克拉玛依地区2型糖尿病患者血脂异常发生率维族明显高于汉族,该地区2型糖尿病患者在部分血脂异常类型及部分血脂水平存在民族差异。     

Measurement of L-carnitine and acylcarnitines in body fluids and tissues in children and in adults

We have developed a reliable and validated radio-enzymatic method for the assay of L-carnitine and acylcarnitines, using a modification of existing methods. The sensitivity of the assay is 10 mumol/l using 10 microliters of plasma or urine. It is also suitable for measurements of carnitine in a 10 mg sample of liver or muscle obtained by percutaneous biopsy. The use of N-ethylmaleimide in the reaction mixture together with an excess of [1-14C]acetyl CoA ensures that the reaction proceeds to completion and a linear response is obtained. Using this method control ranges have been established for plasma and urine carnitine concentrations in healthy children and adults, and for the carnitine content of liver and muscle in adults. No significant difference was found between fasting and post-prandial plasma carnitine levels. An age-related increase was found in urinary total carnitine and acylcarnitine concentration throughout childhood. These data provide a reliable basis for studies of patients with abnormal carnitine and acylcarnitine metabolism, distribution and excretion.     

Rosamicin in Urethral and Vaginal Secretions and Tissues in Dogs and Rats

In animal studies we investigated the distribution of rosamicin in plasma and urethral and vaginal tissues in rats as well as in urethral and vaginal secretions in dogs. We found concentration ratios between urethral secretion and plasma of 1.9 and between vaginal secretion and plasma of 2.4. The rosamicin concentrations in urethral and vaginal tissue significantly exceeded the levels of all other tissues investigated. Because rosamicin could be valuable for the treatment of bacterial urethritis and the colonization of the vaginal introitus with fecal bacteria in women, it should be investigated clinically in this respect.     

Similarities and differences in clients treated and in medications prescribed by APRNs and psychiatrists in a CMHC

This study is part of a larger study comparing prescribing practices of psychiatrists and advanced practice psychiatric nurses (APRNs) using the following three groups of patients: patients treated by psychiatrists, those treated by APRNs, and those treated by both APRNs and psychiatrists at different times in 1 year. Demographics for 5507 patients were examined. A subsample of APRNs and psychiatrists prescribed similar total numbers of medications. Psychiatrists prescribed more types of antidepressant medications other than the SSRI antidepressants, and they prescribed more than twice the number of benzodiazepines. APRNs prescribed more SSRIs and spent more time with clients during medication visits.     

Postural strategies and falls in elderly and in parkinsonism]

OBJECTIVE: To use a posture analysis to show the evolution of postural pattern connected with falls.MATERIAL AND METHOD: It is a prospective study on two groups of 16 persons of more than 60 years. A group concerns 16 small disability off drug parkinsonian patients, a group concerns 16 healthy witnesses. All the persons benefited from a posture recording by means of a force platform and were followed during 1 year. RESULTS: Data analysis underlines three groups of persons corresponding to three postural patterns, independently of the presence of Parkinson disease. A group (n = 18) did not contain fallers, the second (n = 10 ) contained 20% of fallers, the third (n = 4) contained 100% of fallers. Differences between the groups were identified on 16 posturographic parameters. DISCUSSION: A group has a good functional value and one does not record any fall. Its characteristics, which correspond to a category of persons who compensate well for the phenomena of ageing, are found in the literature. A group has an intermediate functional value and regrets 20% of fallers. Kinetic profile reveals a tendency to the stiffness of the posture. This group is going to operate rather ankle strategies. A group has an inferior functional value and regrets 100% of fallers. Kinetic profile seems disrupted and not to be able to adapt itself in a satisfactory way to the situation otherwise than by stereotypical reactions. This group is going to operate systematically much less stabilizing hip strategies. CONCLUSION: A close determinism between physiological neuromotor ageing and Parkinson disease does exist. We showed with a prospective follow-up, the arisen of fall and showed the evolution of postural patterns related to fall. It appears as well that evolution mainly follows three stages leading from a small risk of fall gait pattern to a major risk of fall gait pattern.     

Racial differences in oxidative stress and inflammation: in vitro and in vivo

African American race is an independent risk factor for enhanced oxidative stress and inflammation. We sought to examine whether oxidative-stress and inflammatory markers that are typically measured in humans also differ by race in cell culture. We compared levels between African American and Caucasian young adults and then separately in human umbilical vein endothelial cells (HUVECs) from both races. We found heightened oxidative stress and inflammation in the African Americans both in vitro and in vivo. African American HUVECs showed higher nitric oxide (NO) levels (10.8 ± 0.4 vs. 8.8 ± 0.7 μmol/L/mg, p = 0.03), Interleukin-6 (IL-6) levels (61.7 ± 4.2 vs. 23.9 ± 9.0 pg/mg, p = 0.02), and lower superoxide dismutase activity (15.6 ± 3.3 vs. 25.4 ± 2.8 U/mg, p = 0.04), and also higher protein expression (p < 0.05) of NADPH oxidase subunit p47phox, isoforms NOX2 and NOX4, endothelial nitric oxide synthase (NOS), inducible NOS, as well as IL-6. African American adults had higher plasma protein carbonyls (1.1 ± 0.1 vs. 0.8 ± 0.1 nmol/mg, p = 0.01) and antioxidant capacity (2.3 ± 0.2 vs. 1.1 ± 0.3 mM, p = 0.01). These preliminary translational data demonstrate a racial difference in HUVECs much like that in humans, but should be interpreted with caution given its preliminary nature. It is known that racial differences exist in how humans respond to development and progression of disease, therefore these data suggest that ethnicity of cell model may be important to consider with in vitro clinical research.