糖尿病视网膜病变患者血清VEGF和Ang-2的测定及意义

目的 探讨糖尿病视网膜病变患者血清血管内皮细胞生长因子(VEGF)和血管生成素-2(Ang-2)的变化及其临床意义.方法 99例2型糖尿病患者分为无糖尿病视网膜病变组(NDR组)35例,单纯型糖尿病视网膜病变组(BDR组)40例,增生性糖尿病视网膜病变组(PDR组)24例,以及正常对照纽30例.用酶联免疫吸附法(ELISA法)检测各组血清VEGF和Ang-2水平.结果 NDR组、BDR组和PDR组患者血清VEGF和Ang-2水平均显著高于健康对照组(均P＜0.05).BDR组患者血清VEGF和Ang-2水平明显高于NDR组患者,且PDR患者血清VEGF和Ang-2水平又明显高于BDR组患者(P＜0.05).血清VEGF与Ang-2水平呈正相关.结论 VEGF和Ang-2均参与了糖尿病视网膜病变的发生、发展,其水平异常与病情严重程度有密切关系.     

2型糖尿病患者急性相蛋白的变化

目的探讨2型糖尿病患者急性相蛋白的变化.方法选择了临床上较敏感的、属于保护人体蛋白功能组的急性相蛋白中的C反应蛋白(CRP)和纤维蛋白原(Fib),对2型糖尿病患者及有血管并发症者进行了测定.结果糖尿病患者Fib、CRP水平明显高于对照组(P＜0.01、0.05);而糖尿病并发微血管病变者Fib水平明显高于未并发血管病变者和对照组(P＜0.01),血浆CRP水平差别无显著性意义(P＞0.05).结论血浆CRP水平升高可能与2型糖尿病患者血小板的激活有关;血浆Fib水平升高可能与并发症的发生有关.     

糖尿病性视网膜病变患者血清抵抗素与血管内皮生长因子的相关性研究

目的 探讨糖尿病性视网膜病变患者血清抵抗素与血管内皮生长因子（VEGF）的关系.方法 选取107例Ⅱ型糖尿病性视网膜病变患者包括Ⅰ期、Ⅱ期、Ⅲ期、Ⅳ期、Ⅴ期和Ⅵ期为实验组,另取20例无视网膜病变的Ⅱ型糖尿病患者为糖尿病组及20例健康志愿者为对照组.采用酶联免疫吸附（ELISA）法检测血清VEGF与抵抗素的水平.结果 实验组血清抵抗素与血清VEGF水平显著高于糖尿病组和对照组（P＜0.05）,糖尿病组高于对照组（P＜0.05）.随着视网膜病变的发展,Ⅰ期、Ⅱ期、Ⅲ期、Ⅳ期、Ⅴ期和Ⅵ期血清抵抗素与血清VEGF水平逐渐升高,在各期两两之间有显著差异（P＜0.05）,血清抵抗素与血清VEGF水平具有正相关性（P＜0.05）.结论 血清抵抗素与血清VEGF随着糖尿病性视网膜病变程度加重而升高,血清抵抗素与血清VEGF水平具有正相关性,血清抵抗素可能通过参与新生血管形成而促进糖尿病性视网膜病变的进展.     

2型糖尿病患者血清抵抗素水平与血管内皮功能紊乱的关系

目的:探讨2型糖尿病(T2DM)患者血清抵抗素水平与血管内皮功能紊乱的关系.方法:测定60例T2DM患者及30例健康人(正常对照组)血清中抵抗素、血管性血友病因子(vWF)、C反应蛋白(CRP)及一氧化氮(NO)的水平,分别将以上检测结果进行比较.结果:T2DM组血清抵抗素、vWF、CRP水平均高于正常对照组(P＜0.05),而NO低于正常对照组(P＜0.05);其中抵抗素与vWF、CRP呈正相关(r分别为0.32、0.42,均P＜0.05),与NO呈负相关(r为-0.47,P＜0.01);多元逐步回归分析显示血清NO、vWF、CRP分别与抵抗素存在显著的相关性(均P＜0.05).结论:血清抵抗素水平可能与T2DM患者血管内皮功能紊乱有关,是预测T2DM血管并发症有价值的指标.     

糖尿病肾病患者血清C反应蛋白、肿瘤坏死因子-α和血管内皮生长因子水平变化

目的探讨糖尿病肾病(DN)患者血清C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)和血管内皮生长因子(VEGF)水平的变化。方法将63例2型糖尿病(T2DM)患者根据是否并发肾脏损害分为T2DM组35例和DN组28例,另选同期体检健康者30人为正常对照组,检测3组血清CRP、TNF-α和VEGF水平,并进行比较。结果 T2DM组和DN组患者血清CRP、TNF-α和VEGF水平显著高于正常对照组,差异有统计学意义(P<0.05);DN组患者血清CRP、TNF-α和VEGF水平显著高于T2DM组,差异有统计学意义(P<0.05)。结论 CRP、TNF-α和VEGF可能与DN的发生和发展有关。     

血清高敏C反应蛋白与2型糖尿病大血管病变的相关性研究

目的 探讨血清高敏C反应蛋白与2型糖尿病大血管病变的关系.方法 选取2型糖尿病患者62例,其中2型糖尿病并发大血管病变组(A组)32例,无大血管病变组(B组)30例,另选30例健康者为对照组(C组).分别测定三组患者血清高敏C反应蛋白水平.结果 2型糖尿病组高敏C反应蛋白水平与健康对照组比较明显升高(P＜0.05);并发大血管病变患者高敏C反应蛋白水平高于非大血管病变患者(P＜0.05).结论 血清高敏C反应蛋白水平的检测对预测2型糖尿病患者发生大血管病变的发生有重要的临床意义.     

2型糖尿病肾病患者血清脂联素、血管内皮生长因子水平与氧化应激的相关性

目的:探讨2型糖尿病肾病(DN)不同阶段血清脂联素(APN)、血管内皮生长因子(VEGF)变化及其与氧化应激的关系.方法:将符合1999年WHO诊断标准的2型糖尿病患者根据24 h尿蛋白排泄率分为3组,即正常白蛋白尿组(SDM)、微量白蛋白尿组(NA)、大量蛋白尿组(MA).另设正常对照组(NC).采用双抗夹心ELISA法检测DN患者血清APN、VEGF水平,采用比色法测定超氧化物歧化酶(SOD)活性及丙二醛(MDA)、谷胱甘肽过氧化物酶(GSH-Px)含量.结果:①DN患者血清APN水平低于正常对照组;DN患者各组间比较,大量蛋白尿组的血清APN水平最低,差异有统计学意义(P＜0.05);血清VEGF水平在NA、MA组明显高于SDM组和NC组,差异有统计学意义(P＜0.05).②与NC组比较,SOD活性及GSH-Px水平在糖尿病各组明显下降(P＜0.01),MDA水平在NA组、MA组明显升高(P＜0.01).③糖尿病患者血清APN与UAER、MDA、VEGF浓度呈负相关(P＜0.05),与SOD、GSH-Px呈显著正相关(P＜0.01);血清VEGF浓度与病程、HbAlc、UAER、MDA的升高呈正相关(P＜0.05),与SOD、GSH-Px呈显著负相关(P＜0.01).结论:DN患者血清APN、VEGF水平与氧化应激密切相关,低APN血症是2型糖尿病及DN发生的危险因素,VEGF升高可能是DN的危险因素.     

2型糖尿病患者血清血管内皮生长因子和白介素-6水平检测

目的 探讨血管内皮生长因子(VEGF)和白介素-6(IL-6)在2型糖尿病(T2DM)患者发生发展中的作用.方法 采用ELISA技术检测50例2型糖尿病患者和50例健康对照者血清VEGF、IL-6水平.结果 与正常对照组相比,T2DM患者血清VEGF水平显著增高(P ＜0.001),合并肾病较未合并肾病患者血清VEGF水平显著增高(P ＜0.001);IL-6水平在两组间无显著性差异;受检者空腹血糖水平与血清VEGF水平之间呈高度正相关(P＜0.01),与IL-6水平无明显相关关系.结论 T2DM患者中血清VEGF生成增高,尤以并发糖尿病肾病患者为甚,提示高水平的VEGF可能在T2DM及其肾病并发症的发生、发展过程中起着一定作用.     

CRP与2型糖尿病视网膜病变的关系

目的 探讨血清C-反应蛋白(CRP)与2型糖尿病视网膜病变的关系.方法 将132例2型糖尿病根据眼底结果分糖尿病组、单纯型DR组、增殖型DR组测定血清CRP水平,并与糖脂代谢指标作相关分析.结果 CRP水平糖尿病组与糖尿病DR有显著差异(P＜0.05),且随病程延长而升高,CRP水平与血糖、HbA1c、BMI、TC、TG、LDL-C呈正相关(P＜0.05).结论 提示CRP可能与2型糖尿病应网膜病变的发生、发展有一定相关性.     

2型糖尿病及非糖尿病大血管病变患者血清C-反应蛋白水平分析

目的　观察 2型糖尿病及非糖尿病大血管病变患者血清中C -反应蛋白 (CRP)浓度的变化。方法　选择 2型糖尿病患者 1 5 0例 ,其中伴大血管病变组 78例 ,无大血管病变组 72例 ;非糖尿病大血管病变组 74例 ,正常人群组 76例。采用数率散射比浊法测定 4组患者的血清CRP浓度。结果　 2型糖尿病两组 (包括糖尿病合并大血管病变组及无大血管病变组 ) ,以及非糖尿病大血管病变组血清CRP水平均高于正常人群组 ,差异有显著性(P <0 0 1或P <0 0 0 1 ) ,2型糖尿病两组与非糖尿病大血管病变组间CRP水平差异无显著性 (P >0 0 5 ) ,2型糖尿病合并大血管病变组与无大血管病变组间CRP水平差异也无显著性 (P >0 0 5 )。结论　 2型糖尿病患者及非糖尿病大血管病变患者体内可能存在慢性低水平炎症反应 ,CRP可能是 2型糖尿病以及动脉粥样硬化发生发展的一个良好预测因子。     

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.