糖尿病伴视网膜病变患者尿液P/Cr比值和血脂变化

糖尿病伴不同程度视网膜病变患者的尿液P/Cr比值及血脂和Apo A_1,B的测定结果表明,增殖型及背景型视网膜病变、无眼底病变与对照组比较尿液P/Cr比值,TG,Apo B水平显著增高(P<0.01);TC轻度升高(P<0.01及P<0.05),HDL-C,H/C比值,Apo A_1水平均显著降低(P<0.01)。     

老年颈动脉硬化患者同型半胱氨酸与血脂血糖尿酸的关系

目的探讨老年颈动脉硬化患者血清同型半胱氨酸(Hcy)与血脂、血糖、血尿酸的相关性。方法测定42例老年颈动脉硬化患者及15例正常老年人的血清三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A1(Apo A1)、载脂蛋白B(Apo B)、载脂蛋白B/载脂蛋白A1(Apo B/Apo A1)、空腹血糖、尿酸及Hcy水平,并进行比较及相关性分析。结果颈动脉硬化组TG、TC、LDL-C、Apo A1、Apo B、Apo B/Apo A1、空腹血糖、Hcy显著高于正常对照组,差异有统计学意义(P<0.05);颈动脉硬化组血清Hcy水平与HDL-C、Apo B、尿酸无明显相关性(P>0.05),而与TG、TC、LDL-C、Apo A1、Apo B/Apo A1、空腹血糖呈显著相关(P<0.05)。结论血清Hcy和血脂、血糖升高都是颈动脉硬化发生的独立危险因素,其中TG、TC、LDL-C、Apo A1、Apo B/Apo A1、空腹血糖水平与血清Hcy水平密切相关。     

急性脑血管病患者血清高密度脂蛋白亚组分与ApoA_1,B含量变化的分析

检测急性脑血管病(ACVD)患者168例血清载脂蛋白(Apo)A_1,B,高密度脂蛋白胆固醇(HDLc)及其亚组分 HDL_(2c),血清总胆同醇(TC)和血清甘油三酯(TG)的含量,与相应年龄健康对照组比较,ACVD 患者血清 ApoA_1明显低于对照组(P<0.01),ApoB 则明显高于对照组(P<0.01),HDLc及其 HDL_(2c)均明显低于对照组(P<0.01和 P<0.001),TC 水平略有降低,与脑出血 TC 水平差异有显著意义(P<0.05),而脑梗塞组与脑出血组比较,ApoB,ApoB/ApoA_1比值有显著差异(P 均<0.01)。     

肾脏病患者血清高密度脂蛋白及其亚组分变化

本文对正常人、未经治疗的肾病综合征和慢性肾功能不全患者血清脂质和高密度脂质白及其亚组分水平进行了研究。检测结果:肾病综合征组血清TC、TG、HDL-3C、LDL-C,TC/HDL-C明显高于正常组,HDL-C,HDL-2C明显低于正常组。慢性肾功能不全组血清TC、HDL-3C虽有升高,但无统计学意义。TG、LDL-C、TC/HDL-C明显高于正常组,HDL-C、HDL-2C明显低于正常组。以上表明,在不同肾功能状态,各组病人均有不同程度脂代谢异常。     

慢性肾功能衰竭患者的外周血大颗粒淋巴细胞计数的变化

为了明确慢性肾功能衰竭患者的自然杀伤细胞(NKC)活性,并进一步反映其非特异性免疫功能状况,我们检测了4 2例慢性肾功能衰竭患者的外周血大颗粒淋巴细胞(LGL)计数,现报告如下。1　材料与方法1.1　病例选择选取我院1998年1月～2 0 0 2年7月间,住院慢性肾功能衰竭患者4 2例,其中男性2 5例,女性17例,年龄2 0～6 0岁,慢性肾炎33例,慢性肾盂肾炎5例,梗阻性肾病2例,痛风性肾病2例。血清肌酐水平平均为830 μmol/L(32 1～12 0 3μmol/L)。根据血清肌酐水平分为A、B两组,A组为终末期肾功能衰竭组,2 4例,血清肌酐水平≥70 7μmol/L ;余下18例为…     

脂联素对终末期肾病患者心血管疾病危险因素影响的研究

目的探讨血清脂联素(ADPN)水平对终末期肾病(ESRD)患者心血管疾病危险因素的影响。方法选择ESRD患者216人(其中合并心血管疾病者135人)作为研究对象。临床分为3组:A组为单纯ESRD组,81例,男45例,女36例。B组为ESRD合并心血管疾病组,135例,男75例,女60例。同时,随机抽取同期健康体检者110例作为对照组(C组),男67例,女43例。测定3组血清ADPN,总胆固醇(TC),甘油三酯(TG),高密度脂蛋白(HDL),低密度脂蛋白(LDL),载脂蛋白(Apo)A1、ApoB、ApoE、脂蛋白(a),hs-CRP及IL-6。计算BMI。结果 B组患者血清ADPN水平显著低于A组,而高于C组(P<0.01)。在脂质代谢中,B组患者血清TG、LDL、脂蛋白(a)显著高于A组和C组(P<0.01)。ADPN与TG、LDL、脂蛋白(a)呈显著负相关,与HDL呈显著正相关。B组患者血管微炎症标志物hs-CRP、IL-6的血清浓度显著高于A组(P<0.01)。ADPN与hs-CRP、IL-6呈负相关。3组的营养学指标相比较,B组的营养状况最差,其体重指数(BMI)、血红蛋白(Hb)、血白蛋白(ALB)、平均每日每公斤体重的能量(DEI)和蛋白质(DPI)显著低于A组及C组(P<0.01)。ADPN与BMI、Hb、ALB、DEI、DPI呈正相关。结论 ESRD患者血清ADPN水平先升高后下降。高浓度的ADPN可以改善患者的脂质代谢紊乱,减少慢性炎症、营养不良的发生。血清ADPN水平下降,可加快ESRD患者心血管疾病的发生发展。     

慢性肾功能衰竭血清芳香酯酶活性改变的研究

目的研究慢性肾功能衰竭 (CRF)患者血清芳香脂酶 (ArE)活性改变的临床意义。方法 :通过测定CRF早期、晚期与终末期患者血清ArE活性、胆固醇、高密度脂蛋白胆固醇 (HDLc)、氧修饰低密度脂蛋白 (ox -LDL)与脂蛋白 (a) [Lp(a) ]及内生肌酐清除率 (Ccr)等的水平 ,进行分析。结果 :CRF患者血清ArE活性与HDLc水平低于对照组 ,血清ox -LDL、Tc与LP(a)水平高于对照组。三期肾功能衰竭患者血清ArE活性与HDLc水平降低程度自小至大依次为早期、中期与晚期 ,血清ox -LDL、Tc与LP(a)升高程度在三组间有显著性差别 ,其中以终末期最高。血清ArE活性与HDLc、白蛋白、Ccr呈正相关 ,与血清肌酐呈负相关 ,和Lp(a)无相关性。结论 :测定CRF患者血清ArE活性不仅了解其血脂与脂蛋白的代谢异常 ,还可为了解肾功能损害程度提供参考依据。     

TG/HDLc比值及HOMA-IR指数对老年2型糖尿病冠状动脉病变程度的预测价值

目的通过观察TG/HDLc比值及HOMA-IR指数与老年2型糖尿病冠脉病变程度的相关性,探讨其对糖尿病患者冠脉病变的预测价值。方法随机选择住院的老年2型糖尿病和冠心病患者176例,分为3组,单纯糖尿病组(DM,62例)、单纯冠心病组(CAD,46例),糖尿病合并冠心病组(DMCAD,68例);另外40例健康对照者(NC组)来自体检中心。分别测定各组身高、体重,计算BMI;全自动生化仪检测血脂谱(TG、HDLc、TC、LD-Lc、VLDLc)、FBG、Fins水平,计算TG/HDLc比值和HOMA-IR指数;经皮冠脉造影术法检测冠脉病变程度,记录冠脉阻塞积分(CAOS)。结果 DMCHD组患者血浆TC、LDLc、TG、VLDL、FPG、Fins、TG/HDLc、HOMA-IR的水平、CAOS积分均显著高于NC组(P<0.05),HDLc显著低于NC组(P<0.01);DM组及CAD组BMI、FPG、TG/HDLc、HOMA-IR显著高于NC组(P<0.05)。相关分析显示TG/HDLc比值与CAOS积分、HOMA-IR、FPG均呈正相关(r=0.427、0.347、0.273,P<0.05),IR与CAOS积分呈正相关(r=0.490,P=0.000)。结论 TG/HDLc比值及HOMA-IR指数与糖尿病冠脉病变程度呈正相关,是老年2型糖尿病人群冠脉病变程度较好的预测指标。     

脑出血和脑梗塞患者血清高密度脂蛋白及其亚组分胆固醇和其他脂质含量的研究

本文报告46例脑梗塞和38例脑出血患者与同龄对照组(无心、脑血管病和糖尿病)80例的血清高密度脂蛋白胆固醇(HDLc)及其亚组分胆固醇和其他脂质含量的变化.男女脑便塞与脑出血组的甘油三脂(TG)均高于对照组(P<0.001),HDLc、HDL2c/TC、HDLc/TG和HDL2c/TG均显著低于对照组(P<0.0001).     

血液透析对慢性肾功能衰竭患者血清脂质代谢的影响

目的 探讨经血液透析治疗慢性肾功能衰竭（简称慢性肾衰）患者血清脂质水平对心血管及肾脏的影响。方法 测定了98例慢性肾衰患者（53例为非透析组）血清甘油三酯（TG）、总胆固醇（TC）、低密度脂蛋白（LDL）、高密度脂蛋白（HDL）、LDL／HDL、载脂蛋白（Apo)A1、ApoB以及ApoA1/ApoB的含量与40例正常人进行对照研究。结果 慢性肾衰患者脂质代谢异常,表现TG、LDL、LDL／HDL增高,HDL、ApoA1、ApoA1/ApoB降低。慢性肾衰血液透析组同样存在脂代谢异常,与慢性肾衰非透析组相比较,LDL及LDL／HDL增高有明显差异（P＜0．05）,而TG、HDL、ApoA1、ApoB以及ApoA1/ApoB无显著变化。结论 ①慢性肾衰患者可引起继发性脂质代谢紊乱;②慢性肾衰患者行血液透析不能纠正其脂质代谢紊乱,反而使其紊乱加重。     

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.