3,6-[二甲氨基]-二苯骈碘杂六环枸橼酸盐对家兔血液流变学的影响

作者在乌拉坦麻醉家兔上用3.6-〔二甲氨基〕-二苯骈碘杂六环枸橼酸盐4mg/kgiv 10 min后,能使血液高切粘度(9.04±9.34vs 8.23±0.59mPa·s)低切粘度(18.17±4.12vs 19.39±3.64mPa·s,P<0.05),血浆粘度下降(1.39±0.06 vs 1.36±0.O6 mPa·s,P<0.05),电泳时间缩短(41.98±7.03 vs 30.33±2.89s,P<0.05);40min后,仍有高切粘度及低切粘度的降低(P<0.05)。     

体外血栓与血液流变学的关系研究

目的探讨体外血栓与血液流变学之间的关系。方法采用体外血栓形成仪、血液粘度仪、血小板聚集仪分别测定全血粘度、血小板聚集率和体外血栓。结果56例体外血栓形成亢进患者的血液流变学指标,全血粘度低切为(4．54±1．101)mPa·s,中切为(3．92±0．853)mPa·8,高切为(3．15±0．634)mPa·s;血小板聚集率2min0．47±0．21;体外血栓长度为(51．5±19．82)mm,湿重为(112．5±2．76)mg,干重为(43．6±21．7)mg。以上指标与对照组相比,除低切P<0．05外,余均P<0．01,差异有显著性意义。结论体外血栓形成与全血粘度和血小板聚集率显著相关。     

妊娠期高血压综合征孕妇骨代谢变化的临床意义

目的:探讨妊娠期高血压综合征(简称妊高症)孕妇骨代谢变化的临床意义.方法:回顾性分析于我院妇产科建档的62例妊高症孕妇(妊高症组,n=62)和62例正常妊娠孕妇(正常妊娠组,n=62)临床资料.对比两组孕妇骨代谢指标[血清钙(Ca)、磷(P)、降钙素(CT)、骨钙素(BGP)]、血小板参数[血小板计数(PLT)、血小板平均体积(MPV)、血小板分布宽度(PDW)]及血液流变学指标(全血黏度、血浆黏度)差异.结果:正常妊娠组孕妇血清Ca[(2.41±0.23)mmol/L]、CT[(62.34±15.34)ng/L]、BGP[(5.23±0.78)μg/L]等骨代谢指标检测结果及PLT[(172.96±33.63)×109/L]水平均显著高于妊高症组孕妇[(2.19±0.25)mmol/L、(43.52±12.55)ng/L、(3.63±0.91)μg/L和(147.92±26.35)×109/L],MPV[(9.23±1.20)fl]、PDW[(19.25±1.02)%]等血小板参数检测结果,全血粘度[(8.82±1.29)η/mPa·s、(5.20±0.51)η/mPa·s、(4.23±0.59)η/mPa·s]、血浆粘度[(1.62±0.28)η/mPa·s]等血液流变学指标检测结果及血清P[(1.21±0.08)mmol/L]水平则显著低于妊高症组,差异均有统计学意义.结论:妊高症孕妇相较于正常孕妇存在骨代谢、血小板参数及血液流变学状态异常情况,需引起临床重视.     

新生儿脐血血液流变学观察

目的 :观察新生儿脐血的血液粘度、血浆粘度、红细胞压积、血沉、红细胞电泳情况。方法 :新生儿分娩断脐后立即抽取脐血 4ml+肝素抗凝 ,并立即送检 ,采用北京普利生 L BY- N6 A自清洗旋转式粘度计检验。结果 :母体为正常生理妊娠的新生儿组 :全血低切粘度 8.91± 6 .79m pa· s,全血高切粘度 5 .6 6± 2 .0 mpa· s,血浆粘度 1 .46± 0 .2 4m pa· s,红细胞压积 5 0 .1±1 8.4% ,血沉 2 .1 4± 1 .36 mm/ h,红细胞电泳 1 5 .82± 3.79s;母体为妊高征的新生儿组 :全血低切粘度 1 1 .96± 7.38m pa· s,全血高切粘度 6 .48± 1 .5 7mpa· s,血浆粘度 2 .5 3± 1 6 .4mpa· s,红细胞压积 31 .47± 0 .35 % ,血沉 1 .6 8± 1 .43mm/ h,红细胞电泳1 5 .6 8± 3.43s;正常妇女组 :全血低切粘度 2 2 .33± 6 .88mpa· s,全血高切粘度 4.5 0± 0 .5 4mpa· s,血浆粘度 1 .73± 0 .0 9mpa· s,红细胞压积 41 .0 9± 2 .6 0 % ,血沉 1 7.0 9± 6 .35 mm/ h,红细胞电泳 2 1 .0 4± 1 .44 s。结论 :孕期母体血液流变学变化对新生儿影响较小     

复方丹参滴丸联合酒石酸美托洛尔缓释片治疗冠心病心绞痛的效果及对心电图变化和血液流变学的影响

目的：观察复方丹参滴丸联合酒石酸美托洛尔缓释片治疗冠心病心绞痛效果。方法：冠心病心绞痛患者124例,随机分为对照组和观察组各62例。对照组采用酒石酸美托洛尔缓释片治疗,观察组采用复方丹参滴丸联合酒石酸美托洛尔缓释片治疗。比较两组临床疗效、治疗前后心绞痛发作次数和持续时间、心电图变化 ［ST段下降导联数（NST）、ST段压低总和（ΣST）］及血液流变学指标（高切全血黏度、低切全血黏度、血浆黏度）。结果：观察组总有效率为96.77%,高于对照组的75.81%,差异有统计学意义（P＜0.05）。治疗2个月后观察组心绞痛发作次数5.14±1.20次/周,持续时间1.02±0.35 min/次,少于对照组的9.58±2.15次/周和2.45±0.74 min/次,差异均有统计学意义（P＜0.05）。治疗2个月后观察组NST、ΣST分别为3.98±1.03个和4.14±0.85 mv,低于对照组的4.52±1.35个和5.41±1.05 mv,差异均有统计学意义（P＜0.05）。治疗2个月后观察组高切全血黏度、低切全血黏度、血浆黏度分别为4.15±0.62 mPa·s,11.26±1.95 mPa·s和1.45±0.21 mPa·s,低于对照组的4.85±0.95 mPa·s,12.31±2.01 mPa·s和1.57±0.24 mPa·s,差异均有统计学意义（P＜0.05）。结论：复方丹参滴丸联合酒石酸美托洛尔缓释片治疗冠心病心绞痛疗效显著,能减少心绞痛发作次数,缩短发作时间,改善心电图及血液流变学。     

筋骨通脉汤联合刺络放血对颈肩疼痛患者慢性炎症及血液流变学的影响

目的 探讨筋骨通脉汤联合刺络放血对颈肩疼痛患者慢性炎症及血液流变学的影响.方法 选取2016年1~5月张家口市崇礼县中医院收治的颈肩疼痛患者120例,采用数字表法将患者随机分为观察组(n=60)和对照组(n=60),观察组采用中药筋骨通脉汤联合刺络放血治疗,对照组采用口服维生素B1、B12片及吲哚美辛肠溶片治疗,两周为一个疗程,两组均治疗两个疗程.比较两组治疗前后血清炎性因子及血液流变学指标变化,采用日常生活能力量表(BI指数)进行评分并统计疗效.结果 治疗后观察组C反应蛋白(CRP)、白细胞介素-1β(IL-1β)、前列腺素E2(PGE2)、5-羟色胺(5-HT)分别为(8.96±2.62)mg/dL、(68.67±8.23)ng/dL、(30.94±3.39)ng/L、(111.05±25.42)ng/mL,均显著低于治疗前及对照组,白细胞介素-10(IL-10)[(24.82±3.24)pg/mL]高于治疗前及对照组,差异有统计学意义(P<0.05);治疗后两组全血高/低切黏度、血浆黏度、纤维蛋白原和红细胞压积等血流变指标分别为(5.03±2.74)mPa·s、(8.69±1.25)mPa·s、(2.13±0.16)mPa·s、(3.59±1.25)g/L、(40.23±4.74)%,均较治疗前有所降低,而观察组明显低于对照组,差异均有统计学意义(P<0.05或P<0.01);治疗后两组BI指数均有所升高,且观察组(89.68±7.12)明显高于对照组(75.27±6.14),差异均有显著统计学意义(P<0.01);观察组治疗总有效率(91.67%)高于对照组(78.33%),差异有统计学意义(P<0.05).结论 筋骨通脉汤联合刺络放血治疗颈肩疼痛,改善了机体慢性炎症状态和血液流变学,疗效确切,副作用少,值得临床推广.     

高血脂患者血液流变学指标及对肝功能生化检测的临床分析

目的 探讨高血脂患者血液流变学指标及对肝功能生化检测的影响.方法 以68例高血脂患者为研究组,以同期到本院进行体检的68名健康人为对照组.对比分析两组研究对象的血液流变学指标(全血粘度低切10/s、全血粘度中切60/s、全血粘度高切150/s、血浆黏度120/s)以及肝功能生化指标(谷丙转氨酶、谷草转氨酶、γ-谷胺酰转肽酶).结果 研究组患者血液流变学各指标与对照组相比,差异有统计学意义(P<0.05);研究组患者谷丙转氨酶、谷草转氨酶及γ-谷胺酰转肽酶水平分别为(55.3±6.4)mmol/L、(38.7±5.6)mmol/L、(37.5±4.0)mmol/L,均高于对照组的(23.2±3.5)mmol/L、(24.2±4.4)mmol/L、(15.5±3.9)mmol/L,差异有统计学意义(P<0.05).结论 高血脂患者肝功能存在异常,对其实施血液流变学各指标检测与肝功能生化检测,有助于预防早期脂肪肝.     

直肠癌术后血凝状态变化及预防

目的　对比研究直肠癌患者术后血液高凝状态的发生、发展及相应的临床检测和有效的临床干预。方法　直肠癌患者 60例 ,随机分为对照组和低分子肝素 (LMWH )组。LMWH组术后第 1天开始预防性应用LMWH 5 0 0 0u/d ,共 7d。各组均于术前、术后 2周测定血液流变学指标及观察血凝状态。结果　 60例直肠癌患者术前全血还原黏度 (BRV)低切、高切偏高 ,术后直肠癌对照组BRV低切 (2 0 5 1± 5 38)mPa·s ,高切 (5 70± 3 2 4)mPa·s ,5例出现静脉血栓 ,占 17% ,直肠癌LMWH组BRV低切 (13 30± 5 2 5 )mPa·s ,高切 (4 98± 3 43)mPa·s ,无一例出现血栓。两组间差异有显著性 (P <0 0 5 )。直肠癌LMWH组无一例有出血等副作用。结论　直肠癌患者术前、术后均呈现血液高凝状态 ,术后血液高凝状态更加明显 ,静脉血栓发病率较高 ,术后及时进行LMWH的干预 ,可缓和血液高凝状态 ,减少和避免静脉血栓的形成。     

中药复方降脂片对血脂及血液流变学的影响

作者对118例高脂血症患者服用中药复方降脂片前、后进行了血清胆固醇(TC)、甘油三酯(TG)和高密度脂蛋白(HDL)及血液流变学的检测观察。结果表明,该药对降低血脂疗效显著,TC,TG分别由治疗前的5.94±1.10和2.69±1.39mmol/L降为5.24±0.91和1.87±0.87mmol/L,P<0.01。血液流变学6项指标均有较好的降低作用,全血粘度高切、低切和红细胞压积均P<0.01,血浆粘度、红细胞电泳时间和纤维蛋白原均P<0.05。     

丹参川穹嗪辅助治疗急性脑梗死对血液流变学及炎性细胞因子的影响

目的 探讨丹参川穹嗪辅助治疗急性脑梗死对血液流变学及炎性细胞因子的影响.方法 将118例急性脑梗死患者随机分成观察组与对照组,每组59例,对照组给予常规对症治疗,观察组在常规对症治疗基础上联合丹参川穹嗪治疗,两组疗程均为2周.观察两组患者治疗前后血液流变学及炎性细胞因子变化.结果 观察组治疗后血浆高切黏度、红细胞压积、纤维蛋白原水平分别为(2.53±0.26)mPa?s、(0.45±0.03)、(3.41±0.91)g/L,均较本组治疗前显著降低(t=7.340,2.635,3.954,P<0.01);对照组治疗后血浆高切黏度、纤维蛋白原水平分别为(2.82±0.35)mPa?s、(3.76±0.98)g/L,较本组治疗前明显降低(t=2.111,2.068,P<0.05),红细胞压积水平治疗前后无统计学差异;观察组治疗后血浆高切黏度、红细胞压积及纤维蛋白原水平均明显低于对照组(t=5.109,2.207,2.010,P<0.05).两组患者治疗后IL-6、IL-8、IL-1β水平分别为(5.61±2.20)ng/L、(69.81±20.32)ng/L、(16.32±8.17)pg/mL、(9.46±3.18)ng/L、(183.15±58.67)ng/L、(23.76±9.82)pg/mL,均较本组治疗前水平显著降低(t=15.052,36.189,10.994,8.455,17.106,8.269,P<0.01),观察组IL-6、IL-8、IL-1β水平均显著低于对照组(t=7.647,14.021,4.473,P<0.01).结论 丹参川穹嗪辅助治疗急性脑梗死可明显改善血液流变学,有效减轻炎症反应,对提高临床疗效具有重要作用.     

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.