慢性吸烟与男性2型糖尿病踝肱指数的关系

目的 探讨吸烟与2型糖尿病男性患者的踝肱指数关系.方法 测定172例男性2犁糖尿病的踝肱指数(ABI),根据ABI分组,ABI<0.9为A组(外周血管病变组)共38例,ABI≥0.9为B组共134例,比较两组的临床指标、慢性吸烟率.结果 男性2型糖尿病中外周血管病变发生率为22.1%,A组体重指数(BMI)、HOMA-IR、吸烟率高于B组(P<0.05).结论 男性2型糖尿病合并下肢动脉病变患者存在肥胖、胰岛素抵抗、高吸烟率.     

原发性高血压肥胖患者体脂分布与胰岛素抵抗的关系

目的 研究原发性高血压肥胖患者不同体脂分布对胰岛素抵抗的影响.方法 对100例原发性高血压肥胖患者的体质量指数(BMI)、腰臀比(WHR)、胰岛素抵抗指数进行调查,检测身高、体重、腰围、腹围、臀围,并测定空腹血糖、餐后2h血糖、空腹胰岛素、餐后2h胰岛素、血清总胆固醇、血清三酰甘油、低密度脂蛋白胆固醇,计算胰岛素抵抗指数.采集相应数据对体脂分布与胰岛素抵抗的关系进行研究.结果 腹型肥胖组患者的胰岛素抵抗指数、血脂明显高于非肥胖组(P＜0.05).结论 原发性高血压肥胖患者中腹型肥胖组的体重指数、血脂水平、胰岛素抵抗指数均高于非腹型肥胖组,说明原发性高血压腹型肥胖患者更易发生脂质代谢、糖代谢的改变.     

男性腹型肥胖者血浆网膜素水平的研究

目的 研究男性腹型肥胖人群的血浆网膜素水平.方法 入选男性85例,根据腰臀比(WHR)分为A、B两组.A组(腹型肥胖组)腰臀比≥0.90,共37例;B组(对照组)腰臀比＜0.90,共48例.入选者均空腹经肘静脉抽血,使用酶联免疫吸附测定法(ELISA法)测定血浆网膜素水平.并测量身高、体质量、腰围、臀围、血压、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、三酰甘油、超敏C-反应蛋白、空腹血糖及胰岛素水平.结果 A组血浆网膜素水平较B组降低,差异有统计学意义(P=0.004).血浆网膜素水平下降是男性腹型肥胖的独立相关因素(P=0.048).结论 男性腹型肥胖人群较对照人群血浆网膜素水平下降,血浆网膜素水平下降是男性腹型肥胖的独立相关因素.     

踝肱指数异常率及相关因素分析

目的：通过踝肱指数（ABI）检查,了解ABI异常率及分析影响ABI的相关因素。方法：选我院内分泌病房2007年3月～2007年12月住院的60例2型糖尿病患者测定ABI,并对ABI与病程、年龄、糖化血红蛋白、胆固醇、三酰甘油、高密度脂蛋白、低密度脂蛋白、体重指数进行相关性分析。结果：60例患者中,ABI〈0.910例,0.9≤ABI〈1.350例,ABI与年龄、病程、糖化血红蛋白、胆固醇、三酰甘油及低密度脂蛋白有关。结论：ABI是一项花费少、简单、无创的诊断糖尿病下肢外周动脉病变的可靠指数;合并糖尿病下肢外周动脉病变的患者存在更严重的代谢紊乱,故对糖尿患者应更好地控制血糖、血脂。     

2型糖尿病胆囊结石的危险因素分析

目的初步探讨2型糖尿病合并胆囊结石的危险因素.方法采用病例对照方法,观察64例2型糖尿病伴胆囊结石(DG)与75例糖尿病不伴胆囊结石(NDG)患者,检测两组对象的身高、体重、腰围、臀围、血压、血脂、尿酸、血糖、空腹胰岛素,计算出体重指数、腰臀比、胰岛素抵抗指数、胰岛素敏感指数.结果两组比较,年龄、血压、甘油三酯、胆固醇、低密度脂蛋白、尿酸、空腹血糖差异无统计学意义(p>0.05);DG组比NDG组体重指数、腰臀比、空腹胰岛素、胰岛素抵抗指数明显升高(p<0.05),高密度脂蛋白、胰岛素敏感指数明显下降(p<0.05);多元逐步回归分析显示空腹胰岛素、高密度脂蛋白降低有增加胆囊结石发病危险的趋势.结论低高密度脂蛋白、高胰岛素血症和肥胖是2型糖尿病并发胆囊结石的危险因素.     

2型糖尿病患者血浆致动脉硬化指数与踝肱指数的相关性

目的探讨2型糖尿病患者血浆致动脉硬化指数(atherogenic index of plasma,AIP))与踝肱指数(ankle bra-chial index,ABI)的相关性。方法纳入143例2型糖尿病患者,测定双下肢动脉血管压力和肱动脉血管压力,计算踝肱指数,测量身高、体重、血脂、肌酐、尿酸、HbA1c、超敏反应蛋白(sCRP)尿白蛋白/肌酐(ACR)、计算血浆致动脉硬化指数[log(TG/HDL-c)]。依照踝肱指数分为两组:ABI<0.9和0.9≤ABI<1.4组。结果①两组相比,AIP、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-c)、低密度脂蛋白胆固醇(LDL-c)、sCRP、ACR差异均有统计学意义(P<0.05)。②单因素分析表明,ABI与AIP、TG、TC、HDL、LDL、SCRP、ACR相关(P<0.05)。其中ABI与AIP相关系数最大r=0.484。③以ABI为因变量,以其余各因素为自变量作多元回归分析,结果表明血浆致动脉硬化指数(P<0.000)、ACR(P<0.000)、SCRP(P<0.000)进入方程。结论 AIP与2型糖尿病患者ABI具有较好的相关性,可以作为2型糖尿病患者外周血管疾病的有用指标。     

糖尿病下肢血管病变与踝肱指数相关性研究

目的探讨糖尿病下肢血管病变患者的踝肱指数（ABI）水平。方法回顾性分析我院2010年1月-2012年4月收治糖尿病下肢血管病变患者43例的临床资料（A组）,并选取我院同期收治的无下肢血管病变的糖尿病患者45例（B组）及同期行健康体检志愿者43例作为健康对照（C组）,观察三组间生化指标、发病及病程情况,并对三组ABI检测水平进行统计学分析比较。结果 A、B组患者性别、年龄、病程、吸烟、冠心病、脑血管病变、糖尿病视网膜病变、体质量指数、腰臀比、胰岛素抵抗指数、血小板等与C组比较差异无统计学意义（P〉0.05）;而收缩压、舒张压、总胆固醇、三酰甘油、空腹血糖、餐后2 h血糖、糖化血红蛋白等与C组比较,差异均有统计学意义（均P〈0.05）;A组患者ABI低于B组及C组,差异均有统计学意义（均P〈0.05）。结论 ABI的检查对糖尿病患者下肢动脉病变的筛查以及预防坏疽有重要的临床应价值。     

非酒精性单纯脂肪肝患者血浆血管紧张素Ⅱ1型受体相关蛋白内源性配体水平及相关因素分析

目的探讨非酒精性单纯脂肪肝（sNAFLD）患者血浆血管紧张素Ⅱ1型受体相关蛋白内源性配体fapelinl水平的变化。方法采用酶联免疫法测定42例sNAFLD患者和25例正常健康人空腹血浆apelin水平,分析其水平与体重指数、腰围、腰臀比、血压、空腹血糖、空腹血清胰岛素、稳态模型胰岛素抵抗指数、血脂等的关系。结果sNAFLD组的血浆apelin水平高于正常对照组（P〈0．05）;血浆apelin水平与体重指数、空腹血糖、收缩压、低密度脂蛋白、腰围、腰臀比、总胆固醇、空腹血清胰岛素、稳态模型胰岛素抵抗指数呈正相关（r=0．294-0．802,P〈0.05）;多元线性回归分析表明,总胆固醇、胰岛素抵抗指数分别是影响血浆apelin水平的独立相关因素。结论血浆apelin水平与胰岛素抵抗和脂代谢紊乱有关,并可能与sNAFLD的发生、发展具有一定的相关性。     

2型糖尿病患者血浆Visfatin水平与内脏性肥胖和胰岛素抵抗的相关性研究

目的:探讨2型糖尿病(2型DM)患者血浆内脂素(Visfatin)水平及其与胰岛素抵抗的相关性。方法:选择在内分泌科住院的2型DM患者100例(2型DM组),健康正常糖耐量对照组(NGT组)60例,均测定空腹血浆Visfatin水平,计算胰岛素抵抗指数和腰臀比。结果:2型DM组空腹血浆Visfatin水平明显高于NGT组,2型DM患者空腹血浆Visfatin与HOMA-IR,WHR、糖化血红蛋白(Hb A1C)和三酰甘油(TG)呈正相关。结论:2型DM患者空腹血浆Visfatin水平明显升高,且与内脏性肥胖和胰岛素抵抗有关。     

血浆PAI-1与胰岛素抵抗及脂质紊乱的相关性研究

目的探讨PAI-1与胰岛素抵抗、血糖、空腹胰岛素、血脂等的相关性. 方法测定正常人、单纯肥胖、2型糖尿病非肥胖和2型糖尿病肥胖患者的体重指数(BMI)和腰臀比(WHR),PAI-1、血糖、空腹胰岛素及血脂,以稳态模型(Homa Model)公式评估IR(胰岛素抵抗),并计算ISI(胰岛素敏感指数).结果与正常组相比,2型糖尿病(DM)非肥胖组、2型糖尿病肥胖组和单纯肥胖组的血浆PAI-1均显著升高,差异有显著性(P<0.05～P<0.001),后3组中,2型DM非肥胖与2型DM肥胖组PAI-1差异无显著性,2型DM肥胖组PAI-1显著高于单纯肥胖组(P<0.05).多元逐步回归分析提示血浆PAI-1与HOMA-IR、空腹胰岛素、BMI、血甘油三酯、低密度脂蛋白胆固醇具有高度相关性(均P<0.001).结论胰岛素抵抗综合征患者血浆PAI-1水平显著升高,血浆PAI-1与HOMA-IR呈正相关,并与空腹胰岛素、BMI、血甘油三酯、低密度脂蛋白胆固醇密切相关.     

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.     

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.     

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.