大黄对尿毒症非透析患者微炎症和氧化应激状态的影响

目的:观察大黄对尿毒症非透析患者微炎症和氧化应激状态的疗效。方法:尿毒症非透析病人47例,随机分为观察组和治疗组,治疗组给予大黄泡服2月。并设健康对照组。治疗前及治疗2月后检测血清高敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)以及血浆丙二醛(MDA)、谷胱甘肽过氧化物酶(GSH-Px)水平。结果:与对照组相比,观察组和治疗组hs-CRP、TNF-α、IL-6和MDA水平均明显升高(P<0.01);GSHPx水平下降(P<0.01)。治疗2月后治疗组hs-CRP、TNF-α、IL-6和MDA水平均明显下降,GSHPx水平增高,与观察组相比有显著性差异。结论:大黄可以改善尿毒症非透析患者微炎症和氧化应激状态。     

厄贝沙坦对维持性血液透析患者氧化应激和微炎症状态的影响

目的 探讨厄贝沙坦对维持性血液透析（MHD）患者氧化应激和微炎症状态的影响.方法 选择MHD＞半年以上的患者46例,随机分为常规透析组和透析加厄贝沙坦组,同时以20例健康成人作为正常对照组.测定各组治疗前及治疗3月后血浆晚期蛋白质氧化产物（AOPP）、丙二醛（MDA）、超氧化物歧化酶（SOD）和血清C-反应蛋白（CRP）、白细胞介素-6（IL-6）和肿瘤坏死因子-a（TNF-α）的水平,并监测血压及血钾变化.结果 与正常对照组相比较,常规透析组和透析加厄贝沙坦组血浆MDA、AOPP、CRP、IL-6、TNF-α水平均明显升高（P＜0.05）,SOD则明显降低（P＜0.05）.透析加厄贝沙坦组在治疗3月后所测得MDA、AOPP、CRP、IL-6明显低于服药前以及3月后常规透析组（P＜0.05）,而SOD则显著增高（P＜0.05）.常规透析组治疗前后相比,血浆AOPP、MDA、SOD水平有明显差异性（P＜0.05）;常规透析组治疗前后比较,血浆CRP、IL-6、TNF-α水平增加但差异无显著性（P＞0.05）.在整个治疗期间透析加厄贝沙坦组患者血钾正常.结论 血液透析患者存在氧化应激和微炎症状态,厄贝沙坦能有效地改善MHD患者的氧化应激和微炎症状态.     

银杏叶提取物对ARDS氧化应激及炎症的影响

目的观察ARDS患者炎症反应与氧化应激损伤的关系,探讨银杏叶提取物(舒血宁注射液)对ARDS患者的保护作用。方法本研究为前瞻、对照性研究,选择62例2006～2008年广州市第一人民医院ICU住院ARDS患者随机分为对照组(n=32)和治疗组(n=30)。其中治疗组予舒血宁注射液20 ml/d,静脉输注,疗程7 d。治疗前后分别记录和测定两组患者血浆丙二醛(MDA)、还原型谷胱甘肽(GSH)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)水平以及肿瘤坏死因子(TNF-α)、白细胞介素6(IL-6)水平,并进行相关性分析。结果与对照组相比,治疗7 d后治疗组患者血浆MDA水平显著下降,GSH、SOD、GSH-Px明显升高,血清中TNF-α、IL-6水平亦较对照组更低(P<0.05)。此外,血清TNF-α、IL-6浓度与血浆GSH、SOD、GSH-Px水平呈显著负相关,与MDA水平呈明显正相关(P<0.05)。结论银杏叶提取物可有效改善ARDS患者氧化应激损伤及抑制炎性因子释放,有利于ARDS患者的治疗。     

还原型谷胱甘肽对慢性阻塞性肺疾病炎性因子影响

目的探讨还原型谷胱甘肽对慢性阻塞性肺疾病急性加重期（AECOPD）炎性细胞因子的影响。方法慢性阻塞性肺疾病急性加重患者随机分为两组,治疗组在综合治疗基础上加用应用还原型谷胱甘肽,对照组为综合治疗,治疗前后观察血清细胞因子（IL-8、TNF-α、IL-6）变化。结果两组治疗后均能降低血清TNF-α、IL-8、IL-6的表达,且治疗组优于对照组。结论还原型谷胱甘肽能降低AECOPD患者血清中IL-8、TNF-α、IL-6表达。     

还原型谷胱甘肽及贝那普利对糖尿病肾病氧化应激的影响

目的 观察还原型谷胱甘肽及贝那普利对Ⅲ期糖尿病肾病(DN)氧化应激的影响.方法 通过对健康者(对照组)、糖尿病者(DM组)、贝那普利治疗组(A组)、还原型谷胱甘肽治疗组(B组)、及联合治疗组(C组),治疗前、治疗3周后检测各组血清超氧化物歧化酶(SOD)、丙二醛(MDA)、晚期蛋白氧化产物(AOPP),尿微量白蛋白排泄率(UEAR),观察还原型谷胱甘肽及贝那普利对氧化应激指标及UEAR的影响.结果 与对照组比较,治疗前DM组、DN组血清MDA、AOPP及UAER均明显升高,SOD均明显降低(P均＜0.05),以DN组变化明显;治疗后DN组血清MDA、AOPP及UAER均明显降低,SOD均明显升高(P均＜0.05).结论 还原型谷胱甘肽及贝那普利均可显著降低Ⅲ期糖尿病肾病患者的血清MDA、AOPP及UAER,提高SOD,具有一定肾脏保护作用.     

腺苷蛋氨酸联合还原型谷胱甘肽治疗病毒性肝炎患者的效果

目的：探讨腺苷蛋氨酸联合还原型谷胱甘肽治疗病毒性肝炎患者的效果及对肝功能指标的影响。方法：选取鹰潭市人民医院2018年1月—2022年6月收治的病毒性肝炎患者100例,按照简单随机化法分为对比组与联合组,各50例。所有患者均采取对症治疗,同时对比组予以还原型谷胱甘肽治疗,联合组予以腺苷蛋氨酸联合还原型谷胱甘肽治疗,所有患者均连续治疗4周。比较治疗后两组患者临床效果,比较治疗前后两组患者肝功能指标[谷丙转氨酶（ALT）、总胆红素（TBIL）、谷草转氨酶（AST）]、炎症指标[C反应蛋白（CRP）、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]、氧化应激指标[谷胱甘肽过氧化物酶（GSH-Px）、超氧化物歧化酶（SOD）、丙二醛（MDA）]变化。结果：治疗后,联合组临床效果优于对比组,总有效率高于对比组（P<0.05）;两组治疗后ALT、TBIL、AST、CRP、IL-6、TNF-α、MDA水平较治疗前均降低（P<0.05）,且联合组均低于对比组（P<0.05）;两组治疗后GSH-Px、SOD水平较治疗前均上升（P<0.05）,且联合组均高于对比组（P&...     

类风湿关节炎患者血清炎症因子和氧化应激指标治疗前后水平的变化

目的 探讨类风湿关节炎(RA)患者血清炎症因子和氧化应激指标治疗前后水平的变化。方法 选择2016年4月～2019年3月我院门诊就诊的RA患者50例(病例组),予以口服芬必得胶囊0.3 g/次,2次/d,连用2周。观察治疗前后血清炎症因子[超敏C反应蛋白(hs-CRP)、白介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)]和氧化应激[丙二醛(MDA)、超氧化物歧化酶(SOD)和过氧化氢酶(CAT)]指标的变化。另选择同期的健康体检者30例作为健康组。结果 病例组治疗前血清hs-CRP、IL-6和TNF-α水平较健康组更高(P0.01);治疗2周后,病例组血清hs-CRP、IL-6和TNF-α水平均较前显著下降(P0.05或P0.01)。同时病例组治疗前血清MDA水平明显高于健康组,血清SOD和CAT水平明显低于健康组(P0.01);治疗2周后,病例组血清MDA水平均较前明显下降,血清SOD和CAT水平较前明显上升(P0.05或P0.01)。结论 RA患者体内存在炎症因子hs-CRP、IL-6、TNF-α水平紊乱和氧化应激指标MDA、SOD和CAT水平异常,血清hs-CRP、IL-6、TNF-α、MDA、SOD和CAT水平的变化可作为评估RA患者治疗疗效的敏感血清学指标。     

超纯水对维持性血液透析患者氧化应激和炎症水平的影响

目的 研究超纯水对维持性血液透析患者氧化应激和炎症水平的影响.方法 对36例符合条件的患者采用重复测量自身对照的方法,测定在使用超纯水前、后6个月及12个月时血清晚期氧化蛋白产物(AOPP)、丙二醛(MDA)、谷胱甘肽过氧化物酶(GSH-Px)、髓过氧化物酶(MPO)、白蛋白(AIb)、C-反应蛋白(CRP)、新喋呤、肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)水平.结果 改进水处理系统后,透析用水的细菌和内毒素含量明显下降(P＜0.01).随访一年中,各项检测指标在不同时间点的差异均有统计学意义(P＜0.05);6个月时血清AOPP、MDA、GSH.Px、Alb、CRP、新喋呤、TNF-α水平较使用超纯水前明显改善(P＜0.05),且MPO有非常显著的差异(P＜0.01);12个月时IL-6(P＜0.05)、MDA(P＜0.01)水平进一步下降.相关分析显示血清MPO活性与AOPP及CRP水平在改用超纯水前后均呈正相关关系.结论 改用超纯水后患者的氧化应激和炎症水平显著降低,且MPO也许可以同时提示氧化应激和炎症水平.     

依达拉奉联合还原型谷胱甘肽对急性脑梗死的干预及影响

目的：探讨依达拉奉联合还原型谷胱甘肽对急性脑梗死患者氧化应激指标及炎症介质水平的影响,并作临床预后评估。方法：选择急性脑梗死患者120例,随机分为联合组和对照组各60例,分别测定人院时、治疗后血清丙二醛（MDA）、超氧化物歧化酶（s0D）、白细胞介素-6（IL-6）和肿瘤坏死因子-α（TNF-α）的水平,并进行临床神经功能缺损程度评分;并以60例健康体检者作为正常组。结果：急性脑梗死患者血清MDA、IL-6和TNF-α水平较正常组升高（P均〈o．05）而SOD水平较正常组降低（P〈．05）;治疗后联合组较对照组血清MDA、IL-6和TNF-α水平及神经功能缺损程度评分下降更为明显（P均〈O．05）而SOD水平较正常组上升明显（P〈O．05）。结论：MDA、SOD、IL-6和TNF-α可能参与了脑梗死的一系列病理、生理变化;联合应用依达拉奉和还原型谷胱甘肽可明显降低血清氧化应激指标及炎症介质水平,并有助于脑梗死后神经功能的恢复。     

局部枸橼酸抗凝对急性重症胰腺炎合并急性肾损伤患者炎症及氧化应激的作用

目的研究连续性静脉-静脉血液滤过采用局部枸橼酸抗凝对急性重症胰腺炎合并急性肾损伤患者炎症及氧化应激的作用。方法选取雅安市人民医院/重庆市九龙坡区第二人民医院重症监护室急性重症胰腺炎合并急性肾损伤需行连续性血液净化患者50例,分为低分子肝素抗凝组(22例);局部枸橼酸抗凝组(28例)。检查患者血常规、肝肾功、电解质、血脂、血淀粉酶、脂肪酶、凝血、C反应蛋白、白介素-6(IL-6)、肿瘤坏死因子α(TNF-α)、MDA(丙二醛)、AOPP(超氧化蛋白产物)、SOD(过氧化氢酶)。结果局部枸橼酸抗凝组患者血清CRP、IL-6、TNF-α、MDA、AOPP均较低分子肝素组降低(P0.05)。血清SOD较低分子肝素组增高(P0.05)。结论连续性静脉-静脉血液滤过采用局部枸橼酸抗凝较采用低分子肝素抗凝可以改善急性重症胰腺炎合并急性肾损伤患者炎症及氧化应激水平。     

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.