高血压患者血尿酸检测临床意义分析

目的：探讨高血压患者血尿酸检测临床意义。方法：比较150例高血压患者及150例健康体检人群血尿酸水平差异,不同高血压分级患者血尿酸水平及高尿酸血症发生率,并观察血尿酸与肌酐、总胆固醇、甘油三酯相关性及血尿酸对高血压事件的影响。结果：高血压患者血尿酸（440．22±60．11）μmol／L,高尿酸血症32．86％高于健康体检者（365．12±44．79）μmol／L（P＜0．05）;高血压合并高尿酸血症组患者总胆固醇（6．37±1．19）mmol／L、甘油三酯（3．84±0．72）mmol／L、肌酐（135．70±16．43）μmol／L高于正常血尿酸组（4．62±0．87）mmol／L、（2．51±0．54）mmol／L、（101．59±14．45）μmol／L（P＜0．05）。结论：高血压患者高血尿酸发生率较高,高尿酸血症增加高血压事件的风险,因此对高血压患者常击I已进行血尿酸监测,积极干预高尿酸血症具有重要临床意义。     

高尿酸血症与 IgA 肾病患者预后的相关性研究

目的：探讨高尿酸血症与 IgA 肾病患者预后的关系,以及通过干预血尿酸水平能否达到改善肾小球滤过率的效果。方法将确诊为 IgA 肾病且随访>1年的患者156例,根据血尿酸水平分为血尿酸升高组51例和血尿酸正常组105例。分析血尿酸水平与临床特征的相关性,以及对不良预后发生率的预测能力;观察干预治疗的高尿酸血症和未干预治疗的eGFR 水平。结果2组患者在血尿酸、肾小球滤过率、高脂血症、肾小球球性硬化比例、毛细血管内增生、节段肾小球硬化等方面具有明显差异（P<0.05）;随访过程中将高尿酸血症组分成干预组和非干预组,经过干预治疗后可有效提高肾小球滤过率。结论血尿酸影响 IgA 肾病的预后,降低尿酸可使肾脏受益。     

原发性高血压患者血尿酸水平临床研究

目的：探讨血尿酸水平变化与原发性高血压发生、发展的相关性。方法收集2011年7月～2013年12月在新余市人民医院就诊及体检的原发性高血压500例患者相关资料,同时选择健康体检的血压正常者500例作为对照组,对比分析2组血压、血尿酸及血脂的检测结果。结果高血压组患者血尿酸水平显著高于对照组（P＜0.01）;高血压组发生高尿酸血症200例,占40.0%;对照组发生高尿酸血症5例,占1.0%;2组高尿酸血症发生率的差异具有统计学意义（P＜0.01）;单纯性高血压,中、重度高血压与轻度高血压患者血尿酸水平相比,差异具有统计学意义（P＜0.05）。结论原发性高血压与血尿酸水平变化互为因果,随着血压的升高血尿酸水平也呈增高趋势,降低血尿酸利于血压的控制。     

健康检查后督导对高尿酸血症人群的影响

目的探讨对高尿酸血症人群生活方式干预对血尿酸的影响。方法将健康体检查出有高尿酸血症的108例分为观察组、对照组,观察组进行生活方式干预,对照组不进行任何干预。1年后观察这些人群的血尿酸情况。结果 1年后观察组血尿酸水平有明显下降(P<0.05);观察组血尿酸持续升高人数明显低于对照组(P<0.05)。结论提倡健康的生活方式对改善高尿酸血症以及预防高尿酸血症有明显积极作用。     

慢性胃炎运用健康教育干预的效果观察

目的：探讨针对慢性胃炎患者，观察临床给予健康教育干预后获得的临床效果。方法：选取我院2013年02月－2015年02月慢性胃炎患者102例。通过随机数表法完成慢性胃炎患者的随机分组。A2组（对照组51例）：临床选择常规护理的方法；A1组（观察组51例）：临床在常规护理基础上，给予健康教育干预。对比两组患者在护理满意度评分、焦虑程度以及睡眠质量几方面存在的差异。结果：两组慢性胃炎患者分别完成临床干预后，在护理满意度评分方面，A1组明显高于 A2组慢性胃炎患者（P ＜0．05）；在生活满意度以及睡眠质量两方面，A1组明显优于 A2组慢性胃炎患者（P ＜0．05）。结论：针对慢性胃炎患者，临床在护理过程中给予健康教育，能够将患者的焦虑状态进行有效缓解，最终将患者的睡眠质量有效提高，凸显健康教育干预的临床价值。     

手术室护理干预对心外科术后下呼吸道感染率的影响

目的：探讨心外科手术患者,给予手术室护理干预后对患者下呼吸道感染率产生的影响。方法选取该院心外科手术患者758例。通过随机数表法完成心外科手术患者的随机分组。 A2组（对照组379例）：给予常规护理;A1组（观察组379例）：给予手术室护理干预。结果 A1组心外科手术患者临床护理满意度为96.83%,A2组为64.12%,A1组手术患者高于A2组患者明显（P＜0.05）。结论针对心外科手术患者,临床给予手术室护理干预,能够显著降低完成手术后出现下呼吸道感染的概率。     

非布司他和别嘌呤醇治疗原发性痛风疗效和安全性的比较

目的观察并比较非布司他与别嘌呤醇治疗痛风伴高尿酸血症患者的疗效和安全性。方法将门诊60例痛风伴高尿酸血症的患者按随机数字表法分为3组：A组口服非布司他片40mg/d,B组口服非布司他片80mg/d,C组口服300mg/d别嘌呤醇片。比较3组患者治疗前及治疗后4、12、20周血尿酸水平、肝肾功能及不良反应发生情况。结果治疗后3组患者血尿酸水平均较治疗前下降,差异均有统计学意义（均P＜0.05）,且B组患者血尿酸下降幅度均较A组、C组更显著,差异有统计学意义（P＜0.05）,A组与C组比较,差异无统计学意义（P＞0.05）。出现消化道症状A组2例（10.0%）,B组3例（15.0%）,C组1例（10.0%）,皮肤瘙痒1例（10.0%）,差异无统计学意义（P＞0.05）。结论非布司他、别嘌呤醇是治疗痛风伴高尿酸血症的有效方案,其中B组口服非布司他片80mg/d疗效更佳。     

降尿酸对老年高血压合并糖尿病的高尿酸患者血糖的影响

目的 研究老年高血压合并糖尿病的高尿酸血症患者中降低高尿酸水平对血糖的影响.方法 老年高血压合并糖尿病的高尿酸血症患者100例,分为对照组和干预组.对照组给予常规的饮食控制、降压、降糖药物治疗.干预组在常规治疗的基础上给予苯溴马隆片治疗.对比研究2组治疗前、治疗后3、6、12月血尿酸、糖化血红蛋白、空腹血糖、餐后2h血糖及血糖达标率.结果 干预组患者血尿酸水平明显低于干预前及对照组,差异有统计学意义（P＜0.01）;2组患者的糖化血红蛋白、空腹血糖、餐后2h血糖、血糖达标率无明显改变.结论 降尿酸对老年高血压合并糖尿病的高尿酸血症患者的血糖无影响.     

尼莫地平治疗高血压蛛网膜下腔出血疗效观察

目的：探讨针对高血压蛛网膜下腔出血（ SAH）患者,选择尼莫地平完成治疗后的临床效果。方法：选取我院2012年3月～2014年3月高血压SAH患者100例。通过随机数表法将所有高血压SAH患者分为A1组（观察组50例）与A2组（对照组50例）。针对A2组患者,选择常规治疗的方法。针对A1组患者,选择常规治疗＋尼莫地平持续泵入的方法给予临床治疗。对比A1组与A2组高血压SAH患者完成治疗后的效果表现。结果：在临床出现CVS（脑血管痉挛）概率方面,A1组低于A2组患者非常明显（P＜0．05）;在临床出现再出血概率方面,组间无显著差异（P＜0．05）;在临床治愈率方面,A1组高于A2组患者极为明显（P＜0．05）;在临床患者死亡率方面,A1组低于A2组患者明显（P＜0．05）。结论：针对高血压SAH患者,选择尼莫地平给予临床治疗后,在降低临床出现脑血管痉挛概率以及再出血概率等方面,表现出显著的意义,患者的临床治愈率表现为明显增高,成功凸显临床应用价值。     

伴高尿酸血症的 IgA 肾病临床与病理分析

目的：探究伴高尿酸血症的 IgA 肾病临床与病理特征,分析其相关因素。方法将190例原发性IgA 肾病患者分为血尿酸正常组及高尿酸血症组,对比分析2组临床和病理特征。结果 IgA 肾病患者高尿酸血症的患病率为33.16%。高尿酸血症组与血尿酸正常组在性别、BMI、血压、血脂、血清胱抑素 C（Cys-C）、肌酐（Scr）、尿蛋白量、Lee 分级、肾小球球性硬化、肾小管间质损害、肾小动脉病变程度方面差异存在统计学意义。结论 IgA 肾病患者较易发生高尿酸血症,与血尿酸正常者相比,临床表现和肾脏病理损伤更为严重,提示高尿酸血症与 IgA 肾病预后相关。     

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.     

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.