糖尿病并脂肪肝的超声诊断及其与血脂含量相关性分析

测定了６２例Ⅱ型糖尿病患者的血脂含量并观察了肝脏超声的显像。结果发现,肥胖型糖尿病患者存在明显脂代谢障碍,血胆固醇（ＴＣ）、甘油三酯（ＴＧ）、高密度脂蛋白（ＨＤＬ－Ｃ）与对照组相比差异显著（Ｐ〈０．０１）;与非肥胖型糖尿病相比,血ＴＧ明显增高（Ｐ〈０．０１）。３８例肥胖型糖尿病患者中３６例并有脂肪肝。说明脂肪肝除与高血糖因素有关外,还与肥胖、高ＴＧ血症密切相关。观察还发现,肥胖型糖尿病患者大血管病     

男女两性老年人体质量指数与血脂相关关系的比较

为探讨男女两性老年人肥胖与血脂相关关系的差异,对北京９７６例（男６０７例,女３６９例）６０～９３岁老年人进行抽测。男女两性老年人的年龄、体质量指数、收缩压无显著差异,女性老人ＴＣ、ＴＧ、空腹血糖明显高于男性（Ｐ均＜０．０１）,糖尿病及高脂血症发病率明显高于男性（Ｐ＜０．０５,Ｐ＜０．０１）,肥胖发病率高于男性,但无显著性差异;男女体质量指数（ＢＭＩ）与ＴＣ、ＴＧ均有明显相关关系,男性稍强于女性,多元逐步回归分析显示ＢＭＩ为老年男女预测血脂水平的独立因素。     

单纯性肥胖儿童血清脂类测定及其临床意义

目的：研究单纯性肥胖儿童血脂的变化，方法：应用日本岛津７０００型生化自动分析仪（酶法）测定２８例单纯性肥胖儿童和２０例正常体检儿童的血脂，并对血脂各项指标进行组间比较，结果：肥胖线血总胆固醇（ＴＣ），甘油三脂（ＴＧ），载脂蛋白Ｂ（Ａｐｏ－Ｂ）低密度脂蛋白胆固醇（ＬＤＬ－Ｃ）均明显高于对照组（Ｐ〈０．０１）。结论：单纯性肥胖儿童存在明显的脂代谢紊乱，防治小儿单纯性肥胖症对预防成人期动脉粥样硬化和冠心     

高脂血症和游离脂肪酸与脂肪肝的相关性调查

目的 探讨高脂血症及游离脂肪酸与脂肪肝发生的关系。方法 测定2386名健康体检者的血脂、游离脂肪酸（FFA）水平，并做腹部B超。结果 2386名体检者检出脂肪肝351例，男性脂肪肝患病率明显高于女性（P〈0．01）；脂肪肝组三酰甘油（TG）、总胆固醇（TC）和FFA明显高于非脂肪肝组（P〈0．01）；混合型高脂血症（高TG和高TC）组和高TG血症组脂肪肝的患病率及FFA水平明显高于血脂正常组（P〈0．01），混合型高脂血症组脂肪肝发生率及FFA水平高于高TG血症组（P〈0．05）。结论 脂肪肝发病率与高脂血症尤其是高TG血症和游离脂肪酸密切相关。     

老年人脂肪肝与代谢综合征相关性分析

目的：探讨老年人脂肪肝的发生与肥胖、血脂、血尿酸（uA）等代谢指标的相关性。方法：对我院2007年9月～2012年5月住院患者213例,分别比较脂肪肝与非脂肪肝组的体重指数、血脂、血糖、和血尿酸水平。结果：脂肪肝组的体重指数、总胆固醇、三酰甘油、低密度脂蛋白、血糖、血尿酸水平明显高于非脂肪肝组,而高密度脂蛋白水平明显低于非脂肪肝组（P〈0．01）。结论：老年脂肪肝发生率较高,脂肪肝的发生与代谢综合征密切相关。     

导致脂肪肝相关因素临床分析及预防对策

目的：探讨脂肪肝相关因素,为早期干预对策的选择提供依据。方法：选取2010年1月-2013年12月我院诊治的脂肪肝患者100例,再在同一人群中选择年龄、性别相匹配的非脂肪肝者100例作为对照,对两组的体重、血糖、血脂等指标进行分析。结果：脂肪肝组和非脂肪肝组年龄、性别构成无统计学差异;脂肪肝组超重及肥胖的比例显著高于非脂肪肝组（P＝0．000）;脂肪肝组的血清甘油三酯水平显著高于非脂肪肝组（P＜0．01）,血清总胆固醇水平也显著高于非脂肪肝组（P＜0．01）,两组的血糖水平没有统计学差异（P＝0．245）。脂肪肝组高血糖患病率没有统计学差异（ P＝0．258）。结论：体重、甘油三酯和胆固醇是影响脂肪肝的相关因素,应采取针对性的营养干预措施以避免脂肪肝的发生。     

肥胖儿童非酒精性脂肪肝的肝酶检测意义及与血脂的关系

目的：探讨肝酶在儿童肥胖非酒精性脂肪肝病的检测意义及与血脂、体格测量指标的关系。方法：对79例肥胖儿童（伴有非酒精性脂肪肝58例和无非酒精性脂肪肝21例）和93例正常儿童（对照组）进行体格检查;检测血谷丙转氨酶（ALT）、谷草转氨酶（AST）、总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白（LDL）、高密度脂蛋白（HDL）;肥胖儿童行肝脏超声检查。结果：79例肥胖儿童体重、体质量指数（BMI）、腰围、臀围、腰臀比、AIT、TC、TG、LDL高于对照组,HDL低于对照组（P〈0．05）;非酒精性脂肪肝组ALT、AST、ALT/AST〉I的发生率、TG、体重、BMI、腰围高于无非酒精性脂肪肝组（P〈0．05或P〈0．01）;经二分类非条件Logis—tic回归分析。ALT、TG、BMI与儿童非酒精性脂肪肝相关联。结论：ALT、AST的升高是预示非酒精性脂肪肝的敏感指标;TG、肥胖程度和腹型肥胖与非酒精性脂肪肝相关;ALT、TG、BMI的升高可能是肥胖儿童惠非酒精性脂肪肝的独立危险因素。     

脂肪肝与体质量指数、血脂水平的相关性探讨

目的探讨脂肪肝与体质量指数、血脂水平之间的关系。方法对534例参加体检的机关干部测量身高、体质量,并计算体质量指数(BMI);空腹进行腹部B超检查及血脂测定,对不同体质量指数脂肪肝的检出情况以及脂肪肝组和非脂肪肝组的检查结果进行统计分析。结果①534例受检者中共检出脂肪肝126例,检出率为23.6%。②随BMI的增加脂肪肝检出率有增高趋势,其中肥胖组脂肪肝检出率明显高于非肥胖组(P<0.01),约是非肥胖组的4倍;脂肪肝组的BMI水平及肥胖症检出率明显高于非脂肪肝组(P<0.01)。③脂肪肝组的血甘油三酯(TG)水平、高TG血症及混合型高脂血症的检出率明显高于非脂肪肝组(P<0.01)。结论肥胖、以甘油三酯升高为主的高脂血症是脂肪肝发病的重要因素之一,控制体质量、降低血脂对防治脂肪肝具有重要的临床意义。     

北京地区体检人群非酒精性脂肪肝相关危险因素分析

目的探讨非酒精性脂肪肝与体重指数（BMI）、腰围、血脂等的关系,为脂肪肝的防治提供依据。方法对2007年1月至12月我院体检中心13532例北京地区企事业单位体检者的腹部B超检查、血脂、身高、体重、腰围、BMI等结果进行统计分析。结果共检出非酒精性脂肪肝4807例,中位年龄53岁。各年龄组脂肪肝的检出率均随着体型的变化（正常、超重、肥胖）依次增加（X^2=1640．394,P〈0．01）。正常体重组和超重组比较各年龄段脂肪肝检出率差异有统计学意义（x^2=172．618、31．928,P〈0．01）,51～60岁组检出率最高;肥胖组各年龄段脂肪肝检出率差异无统计学意义（X^2=6．194,P=0．402）。脂肪肝组的腰围平均值、BMI、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL—C）高于非脂肪肝组,而高密度脂蛋白胆固醇（HDL—C）水平则低于与非脂肪肝组（均P〈0．05）。脂肪肝组各型血脂异常检出率均高于非脂肪肝组（X^2=112．974～895．500,P〈0．01）,其中高甘油三酯血症最多见（54．36％）。在正常体重和超重患者中,腰围超过界值者脂肪肝检出率明显高于腰围在界值内者（X^2=120．982、45．327,P〈0．01）。logistic回归分析显示,腰围、BMI、TG、LDL—C是脂肪肝的危险因素,女性、HDL—C是保护因素。结论超重、肥胖、血脂异常与脂肪肝的发病关系密切。控制体重、血脂是降低人群脂肪肝患病率的重要措施。     

脂肪肝与肥胖、血脂异常、糖尿病的相关性探讨

目的探讨脂肪肝与肥胖、血脂异常、糖尿病的相关性。方法对参加健康体检的534名机关干部，测量身高、体重，行血脂、血糖、肝肾功能等生化检查，同时行腹部B超、心电图、胸片等检查，并将检查资料录入微机，进行脂肪肝组和非脂肪肝组的对比分析。结果（1）体质指数（BMI）≥28者脂肪肝检出率为65．38％，BMI〈28者脂肪肝检出率为16．45％，肥胖患者脂肪肝检出率明显高于非肥胖者（P〈0．01）；（2）脂肪肝组的BMI、血甘油三酯（TG）、血高密度脂蛋白胆固醇（HDL-C）、空腹血糖（FBG）、餐后2h血糖（PBG2h）水平与非脂肪肝组比较，差异有统计学意义（P〈0．01）；（3）脂肪肝组中并存肥胖症、高TG血症、低HDL-C血症、糖尿病的发生率显著高于非脂肪肝组（P〈0．01）。结论肥胖、高TG血症、低HDL-C血症、糖尿病与脂肪肝的发病密切相关；减轻体重、纠正血脂异常、降低糖尿病患者的血糖对防治脂肪肝具有重要的临床意义。     

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.