糖化血红蛋白检测在2型糖尿病诊断中的临床价值及其影响因素

目的:探讨糖化血红蛋白(Hb A1c)检测在2型糖尿病诊断中的临床价值及其影响因素。方法:选取2015年5月~2016年2月我院收治的120例2型糖尿病患者作为糖尿病组,同期健康体检者60例作为健康对照组进行观察。两组均空腹采集EDTA-2K抗凝静脉血2 m L进行糖化血红蛋白检测,同时生化管采集静脉血3 m L检测空腹血糖,采样和检测过程严格按照标准操作。对两组患者检测结果加以分析。结果:糖尿病组糖化血红蛋白平均值为(8.30±2.25)%,健康对照组糖化血红蛋白平均值为(4.70±0.90)%。糖尿病组空腹血糖测定平均值为(8.50±3.60)mmol/L,健康对照组空腹血糖测定平均值为(4.80±0.80)mmol/L。两组数据差异均具有统计学意义。结论:糖尿病组患者的空腹血糖和糖化血红蛋白值均比健康对照组高,进行糖化血红蛋白监测对糖尿病的诊断和控制有着重要临床意义。糖化血红蛋白检测值正常或偏低的标本要结合患者血常规血红蛋白值进行综合判断。     

即时检验糖化血红蛋白在妊娠糖尿病筛查中的应用

目的:分析即时检验糖化血红蛋白的效果,分析其在妊娠糖尿病筛查中的应用价值。方法:收集确诊的妊娠糖尿病孕妇32例,将其作为试验组,另选择68例身体健康孕妇作为对照组,测定并比较两组孕妇的空腹血糖(FPG)、糖化血红蛋白(Hb Alc)、葡萄糖50g口服筛查测定值(GCT),统计FPG,Hb Alc,GCT在妊娠糖尿病筛查中的敏感性、特异性、准确性。结果:试验组孕妇的FPG,Hb Alc,GCT水平分别为(8.19±1.26)mmol/L、(9.8±1.1)%、(10.12±1.46)mmol/L,,以上指标均高于对照组,差异均存在统计意义(P<0.05),Hb Alc在妊娠糖尿病筛查中的特异性、准确性高于FPG,GCT。结论:即时检验糖化血红蛋白,采血量小,实用性强,在妊娠糖尿病筛查中的应用价值较高。     

COPD病人血红蛋白组成成分及其功能的研究

目的　研究慢性阻塞性肺气肿 (COPD)病人的血红蛋白 (Hb)组成成分 ,了解其与正常人之间有无量和质的差异 ,组成成分的变化对氧的运输有无影响。方法　用AVLOMNI 6型仪器测定动脉血中的Hb。结果　COPD病人Hb平均值 x =12 4.7g/L ,s =3 1.3g/L ,对照组病人Hb平均值 x =119.8g/L ,s =15 .3g/L ,t =1.10 79,P双侧 >0 .0 5。结论　COPD病人的Hb含量与正常人的Hb含量没有差异 ,但个体间组成成分差别大 ,血红蛋白衍生物的含量与正常对照组相比有明显差异 ,成分的变化对氧的运输有影响     

空腹血糖测定联合糖化血红蛋白在糖尿病诊断中的临床应用

目的:研究探讨空腹血糖测定联合糖化血红蛋白在糖尿病临床诊断中的作用及价值。方法:选取该院收治的糖尿病患者60例作为研究对象,分别对患者的空腹血糖值和糖化血红蛋白等指标进行检测,以同期在我院接受体检的健康志愿者60例作为对照,比较其检测结果。结果:观察组和对照组受检者的空腹血糖值平均水平分别为(9.01±1.22)mmol/L和(4.74±1.08)mmol/L,观察组患者显著高于对照组,比较有统计学差异(P0.05)。观察组糖尿病患者的糖化血红蛋白水平检查结果显示,HbAlc≥6.5%的有47例,占78.3%,HbAlc6.5%的有13例,占21.7%,分析FPG和Hb Alc的相关性可见(r=0.701 1,P0.05),有显著相关性。结论:空腹血糖值与糖化血红蛋白的水平都与糖尿病的病变呈显著相关性,是诊断糖尿病、评估治疗效果的重要指标。     

糖尿病患者糖化血红蛋白与空腹血糖水平的相关性分析

目的 探讨糖尿病患者糖化血红蛋白与空腹血糖水平的相关性.方法 选取糖尿病患者122例作为观察组,以同期进行健康体检的成人122例作为对照组.对研究对象进行糖化血红蛋白测定和血糖检测,分析检测结果.结果 观察组糖化血红蛋白和空腹血糖含量[(9.29±1.44)%、(9.19±1.77)mmol/L]均显著高于对照组[(4.88±0.15)%、(4.62±0.18)mmol/L],差异具有统计学意义(P<0.05).糖化血红蛋白与空腹血糖的相关性呈正相关性(r=0.625,P<0.05).结论 糖尿病患者糖化血红蛋白与空腹血糖水平呈正相关性,糖化血红蛋白的检测能够更好地指导糖尿病的筛查和诊治,临床应用价值较高.     

生化检验在糖尿病诊断中的应用价值

目的 探讨空腹血糖、糖化血红蛋白检验在糖尿病诊断中的应用价值.方法 收集初次诊断为糖尿病的人群作为研究对象,定义为研究组,共计100例;对照组为同期来本院进行健康体检的100例正常人群.对所有研究对象进行测定空腹血糖、糖化血红蛋白,比较研究组和对照组空腹血糖、糖化血红蛋白以及研究组空腹血糖、糖化血红蛋白阳性率.结果 研究组和对照组空腹血糖分别为(7.5±0.5)、(6.5±0.4)mmol/L,糖化血红蛋白分别为(5.2±0.6)、(4.3±0.8)mmol/L,2组空腹血糖、糖化血红蛋白比较差异均有统计学意义(P<0.05).研究组空腹血糖、糖化血红蛋白阳性率分别为90%、99%,差异有统计学意义(P<0.05).结论 与空腹血糖相比,糖化血红蛋白诊断糖尿病方法 简单,干扰因素少,阳性率高.     

糖尿病视网膜病变不同分期患者的HbAlc、FPG、FAZ、MVD水平变化及临床意义

目的 探讨糖尿病视网膜病变不同分期患者的糖化血红蛋白(HbAlc)、空腹血糖(FPG)、黄斑中心凹无血管区域(FAZ)、微血管密度(MVD)水平变化及临床意义。方法 选择2018年7月至2020年12月惠州市第三人民医院收治的120例糖尿病患者为研究对象,根据视网膜病变不同分期,将患者分为A组(无视网膜病变,41例)、B组(轻度非增殖性视网膜病变,23例)、C组(中度或重度非增殖性视网膜病变,20例)和D组(增殖性视网膜病变,36例),并选择同期在上述医院体检的50例健康者作为对照组。比较五组受检者的Hb Alc、FPG、FAZ、MVD水平,并采用Spearman秩相关分析法分析HbAlc、FPG、FAZ、MVD水平与糖尿病视网膜病变不同分期的相关性。结果 对照组受检者的Hb Alc、FPG水平分别为(5.48±0.50) mmol/L、(5.77±0.56) mmol/L,均明显低于B组的(10.25±1.01) mmol/L、(10.08±1.00) mmol/L、C组的(10.79±1.06) mmol/L、(10.59±1.04) mmol/L和D组的(11.02±1.09) ...     

社区慢病管理对糖尿病前期患者糖代谢指标的改善作用

目的探讨社区慢性病管理对糖尿病前期患者糖代谢指标的改善作用。方法随机选取2016年1月~2017年1月在本社区进行治疗的糖尿病前期患者100例。给予社区慢性病管理模式,最后观察糖尿病前期患者干预前后的空腹血糖、餐后2 h后血糖和Hb Alc以及血脂(TG、TC、HDL-C、LDL-C)等变化情况,并分析转归。结果经过相应的干预措施后,100例患者共有55例患者的血糖值恢复至正常,干预前后的空腹血糖分别为(6.58±0.50)mmol/L、(5.46±0.50)mmol/L,干预前后具有显著性差异(P0.05);干预前后餐后2 h血糖值分别为(8.78±2.50)mmol/L、(7.36±1.89)mmol/L,干预前后具有显著性差异(P0.05)。而干预前后的Hb Alc不存在显著的差异(P0.05)。干预前患者的TG(2.23±0.56)mmol/L、TC(5.86±1.10)mmol/L、HDL-C(0.96±0.27)mmol/L,与干预后TG(1.36±0.36)mmol/L、TC(4.55±1.12)mmol/L、HDL-C(1.12±0.28)mmol/L对比差异有统计学意义(P0.05)。结论采用社区慢性病管理模式可以使糖尿病前期患者的糖代谢指标得到有效的改善,值得广泛推广和应用。     

Billroth Ⅱ式胃肠吻合术后糖尿病患者血糖变化分析

目的 分析Billroth Ⅱ式胃肠吻合术后2型糖尿病患者的血糖变化.方法 将本院近年来30例行Billroth Ⅱ式胃肠吻合术合并2型糖尿病患者的手术前后血糖变化情况做比较分析. 结果行Billroth Ⅱ式胃肠吻合术前患者空腹血糖(9.83±2.29)mmol/L,糖化血红蛋白(7.69±1.83)%;术后6个月空腹血糖(5.53±1.03)mmol/L,糖化血红蛋白(6.07±1.54)%;术后12个月空腹血糖(5.29±1.25)mmol/L,糖化血红蛋白(6.01±1.37)%.手术前后的空腹血糖、糖化血红蛋白和胰岛素用量比较差异有统计学意义(P＜0.05,P＜0.01).结论 Billroth Ⅱ式胃肠吻合术后2型糖尿病患者的血糖水平显著下降,为治疗2型糖尿病提供外科学的新思路和新方法.     

骨钙素β胶原特殊序列对2型糖尿病患者糖脂代谢的影响

目的探讨2型糖尿病(T2DM)患者骨钙素(BGP)和β胶原特殊序列(β-CTX)对糖、脂代谢的影响。方法选取2017年11月至2018年10月在河南省驻马店市中心医院内分泌科住院的T2DM患者376例为研究对象(T2DM组),另选取同期体检健康人群100例作为对照(对照组),比较两组研究对象糖、脂代谢指标及BGP、β-CTX水平差异,分析T2DM患者BGP、β-CTX水平与糖、脂代谢指标的关系。结果 T2DM组空腹血糖(FBG)、糖化血红蛋白(Hb Alc)、三酰甘油(TG)、总胆固醇(TC)和β-CTX水平均高于对照组,BGP水平低于对照组,差异均有统计学意义(P <0. 05); T2DM患者BGP水平与FBG、Hb Alc呈负相关(r=-0. 524、-0. 362,P均<0. 05),与TG和TC无关(r=-0. 125、-0. 056,P均> 0. 05),β-CTX水平与以上指标均无相关性(r=0. 094、0. 164、-0. 031、0. 042,P均>0. 05);高水平和低水平BGP(以7 ng/L界限)的T2DM患者间FBG、Hb Alc比较,差异有统计学意义(P <0. 05)。以Hb Alc为因变量进行多因素分析,结果显示BGP是影响Hb Alc的独立相关因素(P <0. 05),β-CTX与Hb Alc无关(P> 0. 05);以FBG为因变量进行多因素分析,结果显示BGP和β-CTX均不是影响Hb Alc的独立相关因素(P>0. 05)。结论 T2DM患者BGP水平与Hb Alc呈负相关,且是影响Hb Alc水平的独立相关因素。     

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.