严重高血糖2型糖尿病患者血糖控制前后C肽水平的变化

目的 :观察严重高血糖 2型糖尿病患者血糖控制前后血浆C肽水平的变化 ,了解其对胰岛B细胞功能的影响。方法 :选择 30例新诊断的严重高血糖 2型糖尿病患者 ,其空腹血糖 (FBG) >1 5 .0 0mmol·L-1 ,馒头餐后 2h血糖 (2hPBG) >2 0 .0 0mmol·L-1 ,糖化血红蛋白 (HBA1C) >1 0 %。测定其治疗前后FBG、2hPBG、HBA1C水平和评价胰岛B细胞功能的空腹C肽 (FCP)水平、馒头餐后 2hC肽 (2hPCP)水平。结果 :治疗前后FBG(1 6 .78± 1 .5 8)mmol·L-1 vs (6 .78± 0 .89)mmol·L-1 、2hPBG(2 2 .7± 1 .97)mmol·L-1 vs (8.82± 0 .94 )mmol·L-1 、HBA1C(1 1 .5 6± 1 .4 2 ) %vs(7.82± 1 .0 1 ) %及FCP(0 .6 2± 0 .1 6 ) μg·L-1 vs(1 .6 7± 0 .4 6 ) μg·L-1 ,2hPCP(1 .86± 0 .1 2 ) μg·L-1 vs(3.84± 0 .84 ) μg·L-1 ,差异均具有统计学意义 (P <0 .0 5 )。结论 :严重高血糖可抑制胰岛B细胞功能 ,血糖控制后胰岛B细胞功能可得以改善     

Graves病患者治疗前后细胞因子的变化

目的　测定 Graves病 (GD)患者血清肿瘤坏死因子(TNF- α)、白细胞介素 1(IL- 1)、白细胞介素 2 (IL- 2 )、白细胞介素 6 (IL - 6 )的水平及在抗甲状腺药物治疗过程中的变化 .方法　 32例 GD患者在确诊时、治疗约 6周和 6月时用放射免疫法测定血清 TNF- α,IL- 1,IL- 2 ,IL- 6 ,TSH,TT3,TT4的水平 . 2 5例年龄与性别相匹配的健康志愿者作为正常对照 .结果　 1与正常对照组相比 ,TNF- α在缓解前明显降低 (1.0 1± 0 .18)μg· L- 1 (P<0 .0 0 1) ,缓解中开始升高(1.2 7± 0 .19)μg· L- 1 ,缓解后继续升高 (1.42± 0 .17)μg·L- 1 ,但仍低于正常对照组 (1.6 9± 0 .15 ) μg· L- 1 ;IL- 1,IL-6在缓解前明显升高 (0 .39± 0 .0 9)μg· L- 1 ,(1.79± 0 .2 1)μg· L- 1 (P<0 .0 1) ,缓解中即降低 (0 .2 8± 0 .0 7) μg· L- 1 ,(1.5 1± 0 .19) μg· L- 1 ,缓解后 (0 . 2 1± 0 . 0 7) μg· L- 1 ,(1.40± 0 .2 1)μg· L- 1 与正常对照组 (0 .2 0± 0 .0 6 )μg· L- 1 ,(1.41± 0 .16 )μg· L- 1 无显著差异 ;IL - 2在缓解前明显降低(4 .2± 1.2 ) μg· L- 1 (P<0 .0 1) ,缓解中即升高 (5 .0± 1.7)μg· L - 1 ,缓解后 (6 .1± 2 .7) μg· L- 1与正常对照组 (6 .3± 2 .3)μg· L- 1无显著     

新生儿窒息脐血一氧化氮和血糖水平与其预后关系

目的　探讨新生儿窒息脐血一氧化氮 (NO)及血糖的变化。方法　对 30例窒息新生儿脐血NO和血糖水平进行检测 ,并与 32例正常新生儿比较。结果　窒息组的脐血NO-2 (43.74± 13.2 0 μmol·L-1)、血糖 (5 .6 3± 1.2 0mmol·L-1)明显高于对照组脐血NO-2 (2 7.2 8± 9.5 2 μmol·L-1)和血糖 (3.6 5± 0 .79mmol·L-1) (P <0 .0 1) ;重度窒息组脐血NO-2 (6 0 .17± 9.93μmol·L-1)和血糖 (7.2 5± 0 .5 4mmol·L-1)显著高于轻度窒息组 (36 .72± 6 .33μmol·L-1和 4.93± 0 .5 3mmol·L-1) (P <0 .0 1) ;NO和血糖水平呈显著正相关 ,而且脐血NO水平与新生儿缺氧缺血性脑病密切相关。结论　新生儿窒息脐血NO和血糖水平的测定具有重要临床意义     

仙人掌提取物对小鼠血糖的影响

目的 :探讨仙人掌水性和酸性提取物对小鼠血糖的影响。方法 :糖尿病小鼠造模成功后分为 5组 :仙人掌酸提物 2个剂量组 (0 .5g·kg-1·d-1和 1.0g·kg-1·d-1) ,水提物 2个剂量组和优降糖组 (2 0 0mg·kg-1·d-1)。正常小鼠灌注等量生理盐水作为正常对照。 6组小鼠均连续给药 2 1d后测血糖。结果 :给药后仙人掌酸提物 2个剂量组血糖均较给药前降低 (P均 <0 .0 5 ) ,2个剂量组间差异无统计学意义 (P >0 .0 5 ) ,但 2组与优降糖组相比 ,P均 <0 .0 5 ;水提物 2个剂量组给药前后血糖无明显变化 (P >0 .0 5 )。结论 :仙人掌酸提物有降血糖作用     

中、晚期慢性肾衰竭患者的蛋白摄入及营养状况

目的　评估非限制饮食的中、晚期慢性肾衰 (CRF)患者饮食蛋白摄入 (DPI)和营养状况。方法　在 36例中、晚期透析前CRF患者和 2 0例正常对照组中 ,测定DPI和营养指标 ,包括血清白蛋白 (Alb)、转铁蛋白 (TF)、前白蛋白 (pre Alb)、胰岛素样生长因子 1(IGF 1)。结果　CRF患者DPI(0 78± 0 2 5 )g·kg-1·d-1低于正常对照组 (1 0 4± 0 31)g·kg-1·d-1,P <0 0 1;Alb、TF亦显著减低 (P均 <0 0 1)。其中 10例CRF患者DPI <0 6 g·kg-1·d-1(2 8% ) ;DPI <0 6g·kg-1·d-1的CRF患者 (n =10 )与DPI≥ 0 6g·kg-1·d-1(n =2 6 )比较 ,Alb为 (2 7 7± 6 1) g·L-1、(35 3± 8 9) g·L-1,TF为 (1 5 8± 0 31) g·L-1、(2 74± 0 5 6 ) g·L-1,pre Alb为 (0 2 3± 0 0 8) g·L-1、(0 33± 0 10 ) g·L-1,P <0 0 1;IGF 1(1 36± 0 30 )nmol·L-1、(2 2 4± 0 6 2 )nmol·L-1,P<0 0 5。结论　大多数中、晚期CRF患者在透析前已发生营养不良 ,而伴有低饮食蛋白摄入患者更为明显。应适时监测并纠正营养不良的发生     

餐后不同时间急性运动负荷对NIDDM患者的降糖作用

【目的】研究餐后不同时间急性运动负荷对非胰岛素依赖型糖尿病 (NIDDM )患者降糖作用的差异。【方法】 18例NIDDM患者 3d中分别于餐后 30、6 0和 90min进行为时 30min最大氧耗量的 6 0 %的运动强度的急性运动负荷 ,观察餐后 30min至 2 10min内血糖变化 ,与试验前 1d不进行运动的同样时间对照。【结果】餐后 90min运动时 ,餐后 30min至 2 10min时间内 ,血糖 时间曲线下面积显著降低 (2 5 4mmol·h·L-1± 5 1mmol·h·L-1降至 2 1 3mmol·h·L-1± 4 4mmol·h·L-1,P <0 0 5 ) ,运动结束时 ,有显著的即时降糖效应 (8 2mmol·L-1± 1 8mmol·L-1降至 5 4mmol·L-1± 1 4mmol·L-1,P <0 0 1) ,而且运动结束后的血糖下降平稳 ;餐后 6 0min运动仅对运动结束时的血糖有显著的即时降糖效应 (8 3mmol·L-1±2 1mmol·L-1降至 6 8mmol·L-1± 1 7mmol·L-1) ,而餐后 30min运动对上述 3项指标无显著改变。【结论】餐后 90min为NIDDM患者进行运动的最佳时间。     

番泻叶提取物对豚鼠结肠平滑肌细胞的收缩作用（英文）

目的　研究番泻叶提取物对游离的豚鼠结肠平滑肌细胞收缩的影响 .方法用含 1 g· L-1胶原酶及 0 .1 g· L-1大豆胰蛋白酶抑制剂的消化液消化 ,获得游离的单个豚鼠结肠平滑肌细胞 ;将不同浓度番泻叶提取物加入细胞悬液中 ,用测微尺观察随机遇到的 50个细胞长轴变化情况 ,计算用药前后细胞平均长度 .结果　成功获得了游离的结肠平滑肌细胞 .证实不同浓度的番泻叶提取物 (0 .2 2 ,0 .44,0 .89g· L-1 )与平滑肌细胞共孵育后 ,可使细胞的平均长度缩短为 (93±2 0 ) ,(86± 2 5) ,(85± 1 5)μm,生理盐水对照组为 (1 0 2± 2 3)μm,细胞长度下降的百分数为 8.7% ,1 5.7%和 1 6.6% ,与对照组相比有显著差异 (P<0 .0 5) ;在剂量为 0 .2 2～ 0 .89g·L-1 范围内 ,番泻叶对平滑肌细胞的收缩作用逐渐增强 (P<0 .0 5) ,呈剂量 -效应关系 .结论　番泻叶提取物对豚鼠结肠平滑肌细胞有直接的收缩作用     

纳络酮对硬膜外泵注芬太尼所致阿片类副反应的影响

目的　评估低浓度纳络酮对患者自控硬膜外镇痛(PCEA)引起阿片类药副反应的影响 .方法　选在腰麻和硬膜外联合麻醉下行全子宫切除术后患者 15 0例 ,ASA ～ 级 ,随机分成 3组行 PCEA.A组 :芬太尼 (4 mg· L- 1 ) +布吡卡因 (0 .5 g· L- 1 ) +肾上腺素 (2 mg· L- 1 ) .B组 :A组 + (4mg· L- 1 )纳络酮 .C组 :A组 + (6 m g· L- 1 )纳络酮 .定时记录视觉模拟疼痛评分 (VAS) ,芬太尼用量 ,恶心、呕吐、皮肤瘙痒发生率及评分 .结果　 3组芬太尼用量约为 0 .30 μg· kg- 1· h- 1 ,B,C两组纳络酮用量分别为 (0 .30± 0 .12 ) μg· kg- 1·h- 1 和 (0 .45± 0 .19)μg· kg- 1 · h- 1 ,2 4h内两种剂量纳络酮均可降低阿片类药副反应恶心、呕吐和皮肤瘙痒的发生率及评分 (P<0 .0 1) ,3组 2 4h内 VAS及芬太尼的用量相似 .结论　 PCEA泵注芬太尼与布吡卡因 ,伍用纳络酮 (0 .3～0 .45μg· kg- 1 · h- 1 )既保证镇痛质量 ,又明显降低阿片类副反应发生率及评分     

皮炎湿疹患者外周血单个核细胞分泌Th1/Th2细胞因子水平检测及意义

目的　探讨 Th1 / Th2细胞因子水平变化在皮炎湿疹发病机制中的作用 .方法　收集 48例皮炎、湿疹患者外周血 ,用 Ficoll- Hypaque分离单个核细胞 ,采用夹心 EL ISA方法检测单个核细胞培养上清中的细胞因子 IFN- γ,(γ-干扰素 ) ,IL - 4(白细胞介素 - 4) ,IL - 1 0 (白细胞介素 ) .结果　皮炎、湿疹组患者 IFN- 水平高于正常对照组 (P<0 .0 5 ) ,其浓度(μg· L- 1)分别为 6 7.7± 2 7.3和 6 5 .2± 2 9.9,对照组浓度(μg· L- 1)为 1 5 .9± 8.2 ;IL- 4水平低于正常对照组 (P<0 .0 5 ) ,皮炎湿疹组浓度 (μg· L- 1)分别为 3 5 .6± 8.9和41 .6± 1 1 .8,对照组浓度 (μg· L- 1)为 85 .2± 2 2 .1 ;IL- 1 0水平在两组间无显著差异 ,皮炎湿疹组浓度 (μg· L- 1)分别为76 3 .3± 1 42 .2和 789.9± 1 3 1 .6 ,对照组浓度 (μg· L- 1)为72 9.6± 1 6 8.5 .结论　 Th1型细胞因子在皮炎湿疹的发生发展中起重要的作用     

灵芝多糖对小鼠糖耐量的影响

目的 :探讨灵芝多糖对正常和糖尿病小鼠糖耐量的影响。方法 :采用腹腔注射四氧嘧啶 (2 0 0 mg· kg- 1 )诱导小鼠造成糖尿病模型 ,分别观察单次给予 0 .5 g·kg- 1、1.5 g· kg- 1灵芝多糖后 ,正常和糖尿病小鼠糖耐量的改变。结果 :灵芝多糖 0 .5 g· kg- 1仅能显著降低糖尿病小鼠餐后 1h和 2 h血糖 ,而灵芝多糖 1.5 g·kg- 1对正常和糖尿病小鼠餐后 1h和 2 h血糖均有显著降低作用。结论 :灵芝多糖能改善正常和四氧嘧啶糖尿病小鼠糖耐量。     

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.     

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.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.