2型糖尿病患者血浆同型半胱氨酸和D-二聚体相关性研究

[目的]探讨2型糖尿病患者血浆同型半胱氨酸（Hey）和D—D二聚体（DD）水平变化及其之间的相关性。[方法]采用高效液相色谱法和全自动血凝分析透射光免疫浊度法测定2型糖尿病无并发症患者43例、2型糖尿病合并大血管病变患者47例和40例正常对照组的同型半胱氨酸和D—D二聚体含量，同时检测叶酸及维生素B12并进行对比观察。[结果]2型糖尿病患者及2型糖尿病合并大血管病变患者的血浆同型半胱氨酸和D—D二聚体水平均高于正常对照组（P〈0．05）；2型糖尿病无并发症组和伴有大血管病变组患者的Hey、DD也有显著性差异（P〈0．05），但Hey与DD两者之间无直线相关性，血浆中Hey水平与叶酸和维生素B12水平存在负相关。[结论]高Hey、DD水平及低叶酸是2型糖尿病的独立危险因素。     

脑梗死患者超声配合激光治疗前、后血浆GMP-140和vWF水平变化及其临床意义

目的探讨超声治疗脑梗死患者血浆α颗粒膜蛋白-140（GMP-140）和血管性血友病因子（vWF）含量变化及临床意义。方法选用未使用抗血小板药物治疗的脑梗死患者进行超声治疗（常规药物＋超声＋激光），用ELISA双抗体夹心法测定治疗前、后血浆GMP-140和vWF的含量。结果脑梗死患者治疗前血浆GMP-140和vWF水平较正常对照组高（P〈0．05），且患者治疗前血浆GMP-140和vWF呈显著正相关（r=0．47．P〈0．01）；超声治疗组治疗前、后比较，GMP-140和vWF降低，差异有统计学意义（P〈0．05），并接近正常对照组；超声治疗组较药物治疗组治疗后GMP-140和vWF降低更明显，但差异无统计学意义（P〉0．05）；超声治疗对神经功能缺损程度的治疗效果优于单纯药物治疗组（P〈0．05）。结论脑梗死患者体内存在血小板活化，GMP-140和vWF可能共同参与了脑梗死发生发展过程，超声治疗脑梗死的机制可能与GMP-140和vWF等多种因素有关。     

女性绝经后2型糖尿病患者血糖与血浆纤维蛋白原水平的关系

目的探讨糖尿病（DM）患者血浆纤维蛋白原（Fg）水平的变化。方法对73例女性绝经后2型糖尿病患者及80位女性绝经后健康对照者进行空腹血糖（FPG）、Fg、三酰甘油（TG）和高密度脂蛋白胆固醇（HDL）测定。结果2型糖尿病患者和健康对照组间，Fg、TG水平差异有统计学意义（P〈0．05）。病例组按有无并发症分组后，周围神经病并发症组与大血管并发症组Fg水平明显高于无并发症组（P〈0．05）。结论绝经后，女性糖尿病患者血浆纤维蛋白原水平较正常女性人群高，合并并发症组较无并发症组高。因此，纤维蛋白原可能参与糖尿病患者并发症的形成。     

糖尿病患者凝血、抗凝血及纤溶功能的变化

目的 探讨糖尿病患者凝血、抗凝血、纤溶系统的变化及意义。方法 纤维蛋白原（Fg)采用Clauss法，纤维蛋白A肽（FPA）、血管性血友病因子（vWF)、D－二聚体（D－dimer)、抗凝血酶－Ⅲ（AT－Ⅲ）、血浆血小板α－颗粒膜蛋白140（GMP－140）采用酶联免疫吸附试验（ELISA）法，组织型纤溶酶原激活物（t-PA)、纤溶酶原激活剂抑制物（PAI）采用发色底物法。结果 与对照组比较，糖尿病无并发症组Fg、FPA、vWF、GMP-140水平显著增高（P＜0.05),AT-Ⅲ、D-dimer、t-PA、PAI差异无显著性；糖尿病有并发症组Fg、FPA、vWF、D-dimer、PAI、GMP－140水平显著增高（P＜0.01)，AT－Ⅲ、t-PA水平显著降低（P＜0.01)。结论 糖尿病时，凝血、抗凝血、血小板、纤溶等系统发生了显著变化，因此测定上述指标，对指导临床治疗、监测病情、预防血栓形成具有一定价值。     

骨折患者凝血四项与D-二聚体、FDP检测分析

目的通过检测骨折患者与健康体检者血浆凝血四项（PT、APTT、TT、Fg）与DD、FDP的变化情况,分析两者差异,探讨其临床意义。方法采集骨折患者与健康对照组空腹血于血凝管,分离血浆,用Rayto RAC-100型全自动血凝仪检测凝血四项与DD、FDP。结果骨折患者PT、APTT、TT与健康对照组无显著性差异（P〉0.05）,而Fg、DD、FDP与健康对照组差异显著（P〈0.01）。结论同时检测凝血四项与DD、FDP能更灵敏地反映骨折患者的凝血功能,指导临床医生采取更合理的处理措施。     

同型半胱氨酸、超敏C反应蛋白、纤维蛋白原与2型糖尿病大血管病变的相关性研究

【目的】探讨2型糖尿病合并大血管病变与血浆中的同型半胱氨酸、超敏C反应蛋白（hs—CRP）及纤维蛋白原的关系,并分析2型糖尿病大血管病变的相关危险因素。【方法】将2型糖尿病患者分为合并大血管病变组（n=75）与非血管病变组（n=138）,设健康对照组20例,检测三组的血浆同型半胱氨酸、hs—CRP、纤维蛋白原水平。将相关因素进行logistic多因素回归分析。【结果】2型糖尿病合并大血管病变组患者血浆同型半胱氨酸、hs—CRP及纤维蛋白原水平显著高于无大血管病变组及对照组（均P〈0．01）。Logistic回归发现同型半胱氨酸、hs-CRP、纤维蛋白原等均是2型糖尿病合并大血管病变的独立危险因素（均P〈0．05）。【结论】血浆同型半胱氨酸、hs-CRP、纤维蛋白原水平与2型糖尿病大血管病变相关,炎症可能参与了糖尿病大血管病变过程。     

2型糖尿病合并大血管病变患者血流变检测结果分析

目的 观察2型糖尿病及其合并大血管病变患者血流变学指标的变化。方法 应用YDA2Ⅳ血液粘度仪测定全血粘度及血浆粘度（mPa.s）,应用全自动血细胞分析仪测定红细胞压积（L/L）。结果 正常对照组全血粘度、血浆粘度及红细胞压积显著低于2型糖尿病无大血管病变组（P〈0.05）和2型糖尿病合并大血管病变组（P〈0.01）;2型糖尿病合并大血管病变组全血粘度、血浆粘度及红细胞压积显著高于2型糖尿病无大血管病变组（P〈0.05）。结论 长期、反复跟踪检测患者血流变学指标的变化,有助于提前预测2型糖尿病患者合并大血管病变的发生。     

血栓前状态与原发性高血压关系的临床研究

目的通过观察原发性高血压患者血栓前状态（PTS）分子标志物的变化，探讨其易并发血栓性疾病的机制，为临床早期诊治提供客观依据。方法检测1000例原发性高血压患者及100例健康对照者血浆PTS分子标志物[血管性血友病因子（vWF）、血浆α-颗粒膜蛋白（GMP-140）、11-去氢血栓烷B2（11-DH-TXB：）、纤维蛋白原（FiB）、抗凝血酶（AT）]的含量，组织型纤溶酶原激活剂（t-PA）、纤溶酶原激活剂抑制物-1（PAI-1）的活性水平及血流动力学指标，并进行分析与评价。结果与正常对照组相比，高血压组患者的血浆vWF、GMP-140、11-DH-TXB，、nB含量及PAI-1活性和血粘度均明显升高，而AT含量、t-PA活性均明显下降（均为P〈0．01）。随着血压水平升高，PTS标志物水平变化越显著（P〈0．05）。结论原发性高血压燕者存在PTS，PTS与其病情进展及血栓性疾病的发生密切相关。     

溃疡性结肠炎患者血浆凝血及纤溶指标测定及疗效预测价值分析

目的分析溃疡性结肠炎(UC)患者血浆凝血及纤溶指标表达及疗效预测价值。方法选取2016年9月～2018年8月我院收治的60例UC患者作为UC组,选取同期健康体检者60例作为对照组,比较两组、不同疾病活动度、治疗前后患者血浆凝血及纤溶指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(Fg)、D-二聚体(DD)]水平,采用Pearson分析UC活动度与PT、APTT、TT、Fg、DD相关性,以Logistic分析影响UC Mayo疾病活动指数评分的因素,并采用接收者操作特征(ROC)及曲线下面积(AUC)分析各指标预测总有效的价值。结果 UC组PT、APTT短于对照组,TT、Fg、DD高于对照组(P0.05);缓解期、轻度、中度及重度活动患者PT、APTT依次降低,TT、Fg、DD依次升高(P0.05);PT、APTT与UC活动度无关(P0.05);TT、Fg、DD与UC活动度呈正相关(P0.05);低PT、低APTT与UC Mayo疾病活动指数评分无关(P0.05);高TT、高Fg、高DD是影响UC Mayo疾病活动指数评分的危险因素(P0.05);总有效者TT、Fg、DD均低于无效者(P0.05);预测总有效的AUC TTFgDD。结论 UC患者血浆凝血及纤溶指标异常变化明显,TT、Fg、DD与UC活动度有关,治疗UC应兼顾炎症、凝血、纤溶指标调控,检测TT、Fg、DD水平可为临床提供一种简单、快速的疗效评估方法。     

纤溶和凝血功能变化与2型糖尿病微血管病变的关系

目的探讨凝血与纤溶功能变化在糖尿病微血管病变中的临床意义。方法纤溶酶原激活物抑制物-1（PAI-1）活性采用发色底物法,纤维蛋白原（Fg）采用免疫浊度法测定。结果糖尿病无微血管病变组血浆PAI-1和Fg水平高于小常对照组（P〈0．05）,糖尿病微血管病变组血浆PAI-1和Fg水平明显高于无微血管病变组及正常对照组（P〈0．01）。结论2型糖尿病患者存在血液的高凝及低纤溶状态,在发生2型糖尿病微血管病变后更为明显,检测2型糖尿病患者血浆中PAI-1和Fg水平,对糖尿病微血管病变的预防和治疗具有一定的临床意义。     

1，5-脱水山梨醇的性质及其临床应用

1，5-脱水山梨醇（1，5-anhydro-D-glncitol；1，5-AC）是一种存在于人类血液中的正常化合物，由于其代谢稳定，在血液中波动范围小，可反映血糖短期的变化．具有空腹血糖、果糖胺和糖化血红蛋白所不具有的优点，在糖尿病诊断与治疗中具有很高的价值和意义。     

颞浅动脉旁注射护理服务项目的成本核算

目的探讨颞浅动脉旁注射(以下简称颞浅注射)护理成本核算方法。方法根据项目成本核算有关公式完成颞浅注射护理成本核算,并与当前收费作比较。结果根据实际情况核算出颞浅注射护理成本。结论提供了较为科学的核算方法,为更合理地制定价格提供了依据。     

Differentiation of CD3-4-8- human fetal thymocytes in vivo: characterization of a CD3-4+8- intermediate

Human thymocyte differentiation was examined by injecting fetal thymic progenitor populations into human thymic xenografts in SCID-hu mice. Thymic progenitors were fluorescently labeled with the lipophilic dye PKH2. The phenotypes of their progeny could be identified by flow cytometric analysis of cells with a very high fluorescent PKH2 signal. Intrathymic injection of purified triple negative (TN) CD3-4-8- thymocytes resulted in the sequential appearance of CD3-4+8-, CD3-4+8+, and CD3+4+8+ cells, with the subsequent appearance of small numbers of phenotypically mature CD3+4+8- and CD3+4-8+ cells over a 4-d period. Sorted CD3-4+8- thymocytes injected intrathymically rapidly differentiated to CD4+8+ cells. CD4+8+ fetal thymocytes in cell cycle differentiated into phenotypically mature CD3+4+8- and CD3+4-8+ populations, whereas nondividing CD4+8+ cells failed to differentiate after intrathymic transfer. The number of cell divisions that occurred between the injection of TN thymocytes and their progeny at different time points was estimated based on the decrease in the intensity of the PKH2 label. The average length of the cell cycle for the TN population was calculated to be 24 h. The SCID-hu model thus provides a useful tool for studying the kinetics of cell division and differentiation of human thymocytes in vivo.     

Pharmacokinetics of (+/-)-, (+)-, and (-)-gossypol in humans and dogs

Pharmacokinetic parameters of (+/-)-, (+)-, and (-)-gossypol were determined in humans and dogs after a single oral or intravenous dose. Mean (+/- SD) oral bioavailability of (+/-)-gossypol in dogs was 30.9% +/- 16.2%. Studies in dogs who received single intravenous injections revealed that the elimination t1/2 and volume of distribution of (+)-gossypol were five and six times those of (-)-gossypol, respectively, whereas total body clearance and the AUC of the two enantiomers were similar. Data from men receiving the compounds orally show that the average peak plasma concentration and the AUC of (+)-gossypol are significantly greater than those of the (-)-isomer. The rate constants of alpha, beta, ka, k21, and k10 for (-)-gossypol are significantly greater than those for (+)-gossypol, indicating higher rates of mass transfer of the (-)-species. In humans the elimination t1/2 of (+)-gossypol was 29 times as that of (-)-gossypol, a difference that is more striking than that found in dogs. The elimination t1/2 of (+/-)-gossypol in humans averages 286 +/- 179 hours.     

健脾益肾方对慢性肾衰患者肾保护的疗效观察

目的 :观察中药健脾益肾方治疗慢性肾衰患者对蛋白尿、肾功能、血清白蛋白的影响。方法 :随机将 4 7例慢性肾衰患者分为两组。治疗组 2 6例 ,予以健脾益肾方每日 1剂 ,每日 2次和对症治疗。对照组 2 1例 ,予以一般对症治疗。疗程 8周 ,治疗前后检测两组 2 4h尿蛋白定量、肾功能、血清白蛋白。结果 :健脾益肾方治疗组能降低慢性肾衰患者蛋白尿及血清肌酐、尿素氮水平 ,明显升高血清白蛋白水平 (P <0 0 5 ,P <0 0 1)。结论 :健脾益肾方对慢性肾衰患者有较好的肾保护作用     

5-4-3-2-1 Go! Standardizing Nutrition and Physical Activity-Related Counseling

Providers at an urban pediatric clinic lacked a standardized protocol for counseling parents and children when addressing the problem of obesity. Providers were trained to implement the 5-4-3-2-1 Go! evidence-based intervention. The electronic medical record was revised for documentation of counseling. Adherence to the protocol was monitored through observation and chart reviews. Providers found the protocol to standardize care and enhance the patient’s ability to set goals and develop plans for change. The rate with which providers recommended follow-up visits for this purpose increased significantly. 5-4-3-2-1 Go! was successfully used to standardize obesity-related follow-up visits.     

Ferroelectric performance of nylons 6-12, 10-12, 11-12, and 12-12

Nylons have great potential for electrical applications requiring high polarizability and low dielectric loss. Recently, the narrow single hysteresis loop with relaxor ferroelectricity and the double hysteresis loop due to antiferroelectricity have been reported in nylon random copolymers, terpolymers, and common even-numbered nylons. Although several studies of ferroelectric nylons have been reported, even–even-numbered and odd–even-numbered nylons have not been sufficiently explored. Here, the ferroelectricity of spin-coated even–even-numbered and odd–even-numbered nylons was investigated. A series of even–even-numbered nylons, including nylons 6-12, 10-12, and 12-12, and an odd–even-numbered nylon, nylon 11-12, were polymerized with 1,10-dodecanedicarboxylic acid (12) and four aliphatic diamines with various methylene units, 1,6-hexanediamine (6), 1,10-decanediamine (10), 1,11-undecanediamine (11), and 1,12-dodecanediamine (12). The obtained nylon polymers were spin coated and then subjected to melt-quenching or thermal annealing followed by quenching. From the X-ray diffraction and the electrical hysteresis loop data, the correlation between the ferroelectricity and the crystal parameters of crystallinity and crystallite size of the γ crystal phase was investigated. Furthermore, the free volume of the nylon samples was estimated to correlate with the ferroelectricity. Temperature-dependent ferroelectricity was investigated for nylon 10-12. At a high temperature, the nylon samples showed a narrow polarization–electric field hysteresis loop and a rhombus-shaped polarization current–electric field hysteresis loop due to the relaxor ferroelectricity. This behaviour was caused by electrically rotating the nanodomains with weakened hydrogen bonds at higher temperatures.

Nylons have great potential for electrical applications requiring high polarizability and low dielectric loss.     

儿童疑似肺炎支原体感染者血清、支气管灌洗液、胸腔积液、脑脊液MP-Ab-IgM检测的结果分析

目的 分析肺炎支原体肺炎(MPP)患儿血清、支气管灌洗液、胸腔积液及脑脊液的肺炎支原体(MP)MP-Ab-IgM检测结果。方法 选取2013年3月～6月在首都医科大学附属北京儿童医院疑似MP感染的278例住院患儿的血清、支气管灌洗液、胸腔积液及脑脊液标本,采用颗粒凝集的方法检测MP-Ab-IgM。结果181例患儿(男孩104例,女孩77例)的不同标本中MP呈阳性反应。278例患儿均进行了血清标本检测,共检出阳性血清标本170例,总检出率为61.2%(170/278),144例同时进行了支气管灌洗液检测,检出阳性62例,检出率为43.1%(62/144); 19例同时进行了胸腔积液标本检测,检出阳性13例,检出率为68.4%(13/19); 15例同时进行了脑脊液标本检测,检出阳性1例,检出率为6.7%(1/15)。各年龄组间检出率分别为:6个月～1岁组29.0%(9/31),～3岁组51.0%(25/49),～5岁组56.1%(23/41),～16岁组79.0%(124/157),6个月～1岁组与其他年龄组比较差异有统计学意义(P<0.05); ～3岁与～5岁组间差异无统计学意义(P>0.05),而与～16岁组间差异有统计学意义(P<0.05)。在6个月～1岁,～3岁,～5岁,～16岁四个年龄组中,同一患儿检测的不同类型MP-Ab-IgM阳性标本,其对应结果为A:血清类(111例)7,21,13和70; B:血清-支气管灌洗液类(45例)0,2,5和38; C:血清+胸腔积液类(7例)0,1,2和4; D:血清+脑脊液(1例)0,0,0和1; E:血清+支气管灌洗液+胸腔积液类(6例)0,0,2和4; F:支气管灌洗液类(11)2,1,1和7。结论 MP感染多种多样,有低龄化趋势,且有逐年增多的趋势。不同年龄组间血清阳性检出率随年龄增长逐渐增加,婴幼儿阳性检出率明显升高,重症患儿多发于年龄较大的患儿。