胰岛素抵抗与冠心病关系的初步探讨

本文测定了２０例冠心病患者和１９例正常人葡萄糖耐量（ＯＧＴＴ）时胰岛素和血糖水平。冠心病组ＯＧＴＴ的１、２、３ｈ血清胰岛素为４９．１±１８．９ｍＩＵ／Ｌ、４６．３±１６．４ｍＩＵ／Ｌ３９．６±１５．９ｍＩＵ／Ｌ胰岛素／血糖（ｍＩＵ／ｍｍｏｌ）比值分别为５．１±１．３、５．８±１．１、７．３±１．４，结果均明显高于正常对照组（Ｐ＜０．０１）。表明冠心病组病人存在高胰岛素血症和胰岛素抵抗（ＩＲ）。同时，冠心病组总胆固醇、甘油三酯分别为６．１２±１．８２ｍｍｏｌ／Ｌ、２．４４±１．０６ｍｍｏｌ／Ｌ，均显著高于对照组（Ｐ＜０．０１、Ｐ＜０．０５），提示胰岛素抵抗可能导致脂质代谢紊乱，进而引起冠心病。     

M－促甲状腺激素检测对甲亢、甲减诊断的价值

采用国产磁分离法药盒测定正常人６９例、甲亢１７６例、甲减２６例血清Ｍ－促甲状腺激素（Ｍ－ＴＳＨ）。结果血清Ｍ－ＴＳＨ正常值为１．７１±０．８５ｍＩＵ／Ｌ。甲亢患者为０．２２±０．１６ｍＩＵ／Ｌ，其中＜０．５ｍＩＵ／Ｌ１７２例，占９７．７％。中减患者为５１．１５±３２／５ｍＩＵ／Ｌ，全部＞５ｍＩＵ／Ｌ。与正常组对照比较均有显著性差别（Ｐ＜０．０１）。     

石楠藤提取物对急性出血坏死性胰腺炎大鼠治疗作用的实验研究

作者报道中药石楠藤提取物对急性出血坏死性胰腺炎（ＡＨＮＰ）大鼠治疗作用的实验研究。将１００只ＳＤ大鼠随机分为三组：①假手术组（ＳＯ组）；②ＡＨＮＰ组（ＡＰ组），该组动物在ＡＨＮＰ诱发后，不做特殊治疗；③石楠藤提取物治疗组（ＳＮ组）。该组动物在ＡＨＮＰ诱发后１０分钟经腹腔内注射石楠藤提取物（１％石楠藤提取物５ｍｌ／ｋｇ体重）。结果表明：ＳＮ组血清淀粉酶值明显下降（ＳＮ组１６１３０±５０３０Ｕ／Ｌ６ｈ、１９２９０±５３８０Ｕ／Ｌ１２ｈｖｓＡＰ组２３７８０±３９６０Ｕ／Ｌ、２８４７０±４１５０Ｕ／Ｌ，Ｐ＜０．０１）。血中ＰＡＦ含量明显降低（ＳＮ组１．３±０．３０ｎｇ／ｍｌ１ｈ、２．０±０．３４ｎｇ／ｍｌ６ｈ、２．１±０．３２ｎｇ／ｍｌ１２ｈｖｓＡＰ组２．２±０．２５ｎｇ／ｍｌ、６．１±０．４２ｎｇ／ｍｌ、１０．１±０．５３ｎｇ／ｍｌ，ｐ＜０．０１）。血浆内毒素含量明显下降（ＳＮ组６９．９±７．２ＥＵ／Ｌ、６ｈ、９１．１±８．４ＥＵ／Ｌ、１２ｈｖｓＡＰ组９８．４±６．９ＥＵ／Ｌ、１５１．７±９．１ＥＵ／Ｌ，Ｐ＜０．０１）。石楠藤提取物治疗组术后平均存活时间明显长于ＡＰ组（ＳＮ组：４３．５ｈ，ＡＰ组１１．５ｈ，ｐ＜０     

芬氟拉明对磺脲类失效的非胰岛素依赖型糖尿病的疗效

３１例经磺脲类（ＳＵ）口服降糖药治疗继发失效的非胰岛素依赖型糖尿病（ＮＩＤＤＭ） 患者，在足量ＳＵ药物的基础上联合应用芬氟拉明治疗。疗程为６周。结果显示：联合治疗前 后空腹血糖（ＦＢＧ）分别为：１２．０５±２．３８ｍｍｏｌ／Ｌ与８．３５±９．４３ ｍｍｏｌ／Ｌ，Ｐ＜０．００１；餐后血 糖（ＰＢＧ）分别为：１９．０６±５．４５ｍｍｏｌＬ与１３．１８±５．３７ｍｍｏｌ／Ｌ，Ｐ＜０．００１；糖基化血红蛋白 （ＨｂＡ１Ｃ）分别为：９．５１±２．４２％与６．６８±１．３１％。Ｐ＜０．００１。体块指数（ＢＭＩ）、空腹血浆胰 岛素（ＦＰＩ）及餐后血浆胰岛素（ＰＰＩ）均无明显改变。胰岛素敏感试验结果显示于治疗后各点 血糖水平均有不同程度下降。     

肾病综合征病人抗氧化功能的研究

为研究肾病综合征（ＮＳ）时抗氧化功能状况，我们测定３６例患者血超氧化物歧化酶（ＳＯＤ）、丙二醛（ＭＤＡ）及维生素Ｅ，以及尿ＳＯＤ、ＭＤＡ。结果表明：ＮＳ患者血总ＳＯＤ、Ｃｕ－Ｚｎ－ＳＯＤ及维生素Ｅ水平明显低于正常对照组（分别为７６．２２±２７．４８μＵ／Ｌ比１０４．２０±１８．８０μＵ／Ｌ，Ｐ＜０．００１；２０．４０±２２．６３μＵ／Ｌ比６２．９９±１５．６０μＵ／Ｌ，Ｐ＜０．００１；６．６８±３．５２ｍｇ／Ｌ比１６．３８±１．０５ｍｇ／Ｌ，Ｐ＜０．００１）；尿ＳＯＤ及ＭＤＡ明显高于对照组（分别为：１１４．９８±３１．７３μＵ／Ｌ比８２．３４±２６．５０μＵ／Ｌ，Ｐ＜０．００１；３．９９±１．９８μｍｏｌ／Ｌ比２．６４±０．７８μｍｏｌ／Ｌ，Ｐ＜０．００１）．研究提示，ＮＳ时抗氧化功能减退，肾脏易遭受氧自由基损害。     

血清sIL—2R检测在儿童血液病中的变化及意义

应用双抗体夹心酶联免疫吸附法测定３９例血清液病患儿血清可溶性白介素２受体（ｓＩＬ－２Ｒ）水平。结果发现，急性淋巴细胞性白血病（ＡＬＬ）组血清ｓＩＬ－２Ｒ水平为（２１８．８８±７６．９８）ｋＵ／Ｌ，急性非淋巴细胞性白血病（ＡＮＬＬ）组（４１１．６７±２２８．４５）ｋＵ／Ｌ，骨髓增生异常综合征（ＭＤＳ）组为（３３９．５０±９２．０３）ｋＵ／Ｌ，非何杰金淋巴瘤（ＮＨＤ）组为（４２５．５０±１３７．０５）     

脐血必需元素含量与胎儿畸形的相关性研究

应用偏振塞曼原子吸收法测试１５５例脐血必需元素的含量。结果畸表儿组脐血锰（２４．５５±７．３４）μｇ／Ｌ；铁（３２８．５８±１１８．５０）ｍｇ／Ｌ；铜（０．６９±０．２９）ｍｇ／Ｌ；镁（３３．８９±８．８６）ｍｇ／Ｌ，正常体重儿组脐血锰（３１．１２±１１．６７）μｇ／Ｌ；铁（３７３．６８±９７．８０）ｍｇ／Ｌ；铜（０．５７±０．２０）ｍｇ／Ｌ；镁（３０．９２±６．５９）ｍｇ／Ｌ．畸形儿组脐血锰、铁含量明显低于正常体重儿组（Ｐ＜０．０１及Ｐ＜０．０５），而铜、镁含量高于正常体重儿组（Ｐ＜０．０１及Ｐ＜０．０５）。提示低锰、低铁与胎儿畸形关系非常密切，多种人体必需元素平衡失调与胎儿畸形有关。     

小剂量G—CSF对化疗引起的粒细胞减少症的治疗作用

应用小剂量（２μｇ／ｋｇ）粒细胞集落刺激因子（Ｇ－ＣＳＦ）于１８例肺癌患者化疗中，以观察预防发生中性粒细胞减少症的疗效。其中小细胞肺癌５例，非小细胞肺癌１３例，随机分成Ｇ－ＣＳＦ组及对照组各９例，化疗方案为ＣＥ（卡铂－ＶＰ１６）。结果Ｇ－ＣＳＦ组粒细胞绝对计数（ＡＮＣ）＜２．０×１０９／Ｌ，发生例数５例，持续天数为３．６±３．５天；对照组持续天数１６．８±７．１天，Ｐ＜０．０５。ＡＮＣ最低值至恢复正常（ＡＮＣ＞２．０×１０９／Ｌ）的天数Ｇ－ＣＳＦ组及对照组分别为２．６±１．３天，８．９±５．３天（Ｐ＜０．０５）。Ｇ－ＣＳＦ组化疗后的第２０天ＡＮＣ均已恢复正常，ＡＮＣ为（９．７±６．８）×１０９／Ｌ故可在第２２天顺利接受第二周期化疗。对照组ＡＮＣ（１．６６±０．８）×１０９／Ｌ（Ｐ＜０．０１）。由此可见，小剂量Ｇ－ＣＳＦ能有效地防治肺癌化疗引起的粒细胞减少症     

输精管结扎16月大鼠睾丸雄激素受体mRNA表达与血浆睾酮

为在分子水平上探讨输精管结扎对雄激素受体的影响，取１４只Ｗｉｓｔａｒ雄性大鼠分为输精管结扎组（ＶＧ）和假手术组（ＳＯＧ），采用Ｎｏｒｔｈｅｒｎｂｌｏｔ，Ｄｏｔｂｌｏｔ方法对术后１６个月大鼠睾丸组织做雄激素受体ｍＲＮＡ表达及血中ＬＨ和睾酮水平检测。结果表明，（１）应用Ｎｏｒｔｈｅｒｎｂｌｏｔ分析发现，ＶＧ和ＳＯＧ在２８Ｓ后相同的位置上均有一杂交带，ＶＧ表达强度明显地强于ＳＯＧ；斑点印迹杂交结果同样显示ＶＧ的ＡＲｍＲＮＡ表达强于ＳＯＧ。（２）血浆睾酮含量，ＶＧ（８．５９±３．０９ｎｍｏｌ／Ｌ）略低于ＳＯＧ（９．７６±２．５６ｎｍｏｌ／Ｌ），Ｐ＞０．０５。血清ＬＨ，ＶＧ（２．８０±０．８３ｍｇ／Ｌ）略高于ＳＯＧ（２．６４±０．８７ｍｇ／Ｌ），Ｐ＞０．０５。提示ＶＧ睾丸ＡＲｍＲＮＡ表达增强可能与血浆睾酮含量的下降有关，是一种代偿适应性变化。     

磁性分离酶联免疫测定技术在糖尿病的临床应用

目的引进磁性分离酶联免疫测定（ＭＡＩＡ）新技术,应用于糖尿病的临床实践。方法初诊１型糖尿病（ＩＤＤＭ）１０例,轻症２型糖尿病（ＮＩＤＤＭ）４１例,及健康正常对照１５例,作口服葡萄糖耐量试验（ＯＧＴＴ）,使用瑞士ＳｅｒｏｚｙｍｅⅠ系统和ＭＡＩＡ进口试剂测定胰岛素（Ｉｎｓ）和Ｃ肽（Ｃ－Ｐ）。结果ＭＡＩＡ批内变异系数（ＣＶ）为３．８３％,批间ＣＶ为７．３８％;灵敏度分别为０．５２ｍＩＵ／Ｌ和０．４２ｐｍｏｌ／Ｌ。ＭＡＩＡ结果与放射免疫法（ＲＩＡ）之间有显著直线相关（Ｐ＜０．０１）。健康人ＯＧＴＴ试验时,空腹Ｉｎｓ和Ｃ－Ｐ分别为（１６．１９±６．７６）ｍＩＵ／Ｌ和（５０４．２０±１７７．２４）ｐｍｏｌ／Ｌ,在３０～６０ｍｉｎ达到峰值,平均为（６３．５３±７．９８）ｍＩＵ／Ｌ和（２１８８．７５±２７９．０８）ｐｍｏｌ／Ｌ。ＩＤＤＭ患者Ｉｎｓ和Ｃ－Ｐ空腹水平低,ＯＧＴＴ试验无峰值出现;而ＮＩＤＤＭ患者峰值则延迟。结论ＭＡＩＡ稳定可靠,特异性高,无放射性污染,优于ＲＩＡ,在糖尿病临床实践中有较大应用价值。     

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.