老年血液透析患者的心血管疾病

目的：探讨老年血液透析（血透）患者心血管疾病发病率有关因素。方法：统计３３例老年ＣＤ发病率，测定伴有ＣＤ（＋ＣＤ）和不伴有ＣＤ（－ＣＤ）二组血胆固醇（ＣＨ）、血甘油三酯（ＴＧ）、透析前后血钼（Ｃａ）、血磷（Ｐ）以及透析前血压（ＢＰ），并比较年龄和透析时间与ＣＤ的关系。结果：二组之间钙、磷及舒张压有差异，年龄及透析时间与ＣＤ发病率关系不大。结论：老年血患者ＣＤ发病率与舒张压升高、钙磷代谢紊乱有关，老     

血液透析患者心血管疾病49例临床分析

目的:探讨老年血液透析(血透)患者心血管疾病(Cardiovascular drsease,CD)发病率有关因素。方法:统计49例老年(年龄≥60岁)血透患者CD发病率,测定伴有CD(+CD)和不伴有CD(-CD)两组患者血白蛋白(ALB)、血β2-微球蛋白(血β2-MG)、透析前后血钙(Ca2+)、血磷(P3-)以及透析前血压(Bp),并比较年龄和透析时间与CD的关系。结果:两组之间血白蛋白、血β2-MG、钙磷及舒张压有差异,年龄及透析时间与CD发病率关系不大。结论:老年血透患者CD发病率与舒张压、β2-MG升高、血白蛋白降低、钙磷代谢紊乱有关,老年血透患者年龄增长和血透时间的延长不增加CD的发病率。     

血透患者甲状旁腺素和骨钙素的变化及其关系的探讨

目的：探讨血透患者血清甲状旁腺素（ｉＰＴＨ）和骨钙素（ＢＣＰ）透析前后的变化及其互相关系。方法：用放射免疫法测定３２例慢性肾衰血透嘲笑爱析前后ｉＰＴＨ和ＢＧＰ的水平变化，并分配民其它生化指标的关系。结果：血透患者ｉＰＴＨ和ＢＧＰ显著较下沉正常组升高，透析后ｉＰＴＨ较血透前显著降低，ＢＧＰ则变化不明显；ｉＰＴＨ和ＢＧＰ、Ｓｅｒ呈明显正相关，与透析时间、血钙、血磷不相关，结论：单次血透能使ＩＰＴＨ降低     

老年血透患者生活质量有关因素分析

目的：通过老年血透患者有关资料分析,寻找影响其生活质量的相关因素,为改善和提高老年血透患者生活质量和生存率而提供临床参考。方法：采用生化方法测定Ａ、Ｂ二组血ＲＢＣ计数,Ｈｂ,血清Ｋ＾＋、ｐ＾３－,Ｃａ＾＋＋;测量透析前血压及ＣＴＲ值。结果：Ａ组血压较Ｂ组显著升高（Ｐ〈０．０１）;ＲＢＣ及Ｈｂ较Ｂ组低（Ｐ〈０．０５）;而Ｂ组血Ｋ＾＋、Ｐ＾３－,Ｃａ＾＋＋均较Ａ组升高（均Ｐ〈０．０１）;两组ＣＴＲ无显     

Graves病患者骨密度与血AKP、尿羟脯氨酸的变化

测定２３８例Ｇｒａｖｅｓ病患者和１２８例正常人的骨密度（ＢＭＤ）以及血三碘甲腺原氢酸（Ｔ＿３）、血清钙（Ｃａ）、磷（Ｐ）、碱性磷酸酶（ＡＫＰ）、尿羟脯氨酸（ＨＹＰ）。结果：Ｇｒａｖｅｓ组ＢＭＤ明显低于正常组（Ｐ＜０．０１），６０．２％患者有ＢＭＤ降低表现，＞４０岁组与正常组比有明显差异（Ｐ＜０．０１）；Ｇｒａｖｅｓ组尿ＨＹＰ与正常组比有非常显著差异（Ｐ＜０．０１）；Ｇｒａｖｅｓ患者中ＢＭＤ降低者，桡、尺骨Ｘ线摄片均正常。     

18例老年尿毒症患者持续性不卧床腹膜透析疗效分析

１８例老年尿毒症患者持续性不卧床腹膜透析疗效分析广西区人民医院闭闵老年尿毒症患者多伴有心脏血管疾病，血透的危险性增加，腹透是最接近生理状态的治疗方法，成为老年患者首选的治疗方式（１）。笔者统计１８例老年患者持续性不卧床腹膜透析（ＣＡＰＤ）治疗的资料，...     

冠心病患者血清中钙、磷与脂质相关关系探讨

检测１０５ 例冠心病患者和１０５ 例健康人的血钙、血磷与血脂,并行相关性分析。发现冠心病组血钙明显高于对照组;血磷与对照组无差别;血钙与血磷的乘积亦明显高于对照组。相关分析表明,对照组血清总钙（ＴＣａ） 与甘油三脂（ＴＧ） 、总胆固醇（ＣＨＯ） 、低密度脂蛋白（ＬＤＬ） 、载脂蛋白Ａ１（ＡＰＯＡ１） 及载脂蛋白Ｂ（ＡＰＯＢ） 呈正相关;无机磷（ＩＰ） 与各脂质成份无相关;钙磷乘积（ＴＣａ ×ＩＰ） 与ＬＤＬ 正相关。冠心病组ＴＣａ 除高密度脂蛋白胆固醇（ＨＤＬ） 外,与其他血脂成份均存明显正相关;ＩＰ 与ＣＨＯ、ＬＤＬ 及ＡＰＯＢ 呈正相关;ＴＣａ×ＩＰ 则与ＬＤＬ、ＡＰＯＢ 呈正相关。支持钙拮抗剂有助于保护动脉,减缓动脉粥样硬化的形式。     

川芎嗪醋酸盐液透析效果初步观察

通过观察２８２５人次应用川芎嗪醋酸盐透析液血透患者透析前后ＳＣＲ、ＢＵＮ均值，及维持血透半年以上２６例慢性肾衰患者的血ＳＣＲ、ＢＵＮ、Ｎａ、Ｋ、Ｃａ、Ｃｌ、Ｐ均值，并与１９８５人次醋酸盐透析患者血透前后ＳＣＲ、ＢＵＮ均值，及维持透析半年以上１２例慢性肾衰患者的血ＳＣＲ、ＢＵＮ、Ｎａ、Ｋ、Ｃａ、Ｃｌ、Ｐ均值比较，结果：两组透析前血ＳＣＲ、ＢＵＮ均位无显著性差别（Ｐ＞０．０５），但透析后川芎嗪醋酸盐组ＳＣＲ、ＢＵＮ均值明显降低，统计学处理有非常显著性差别（Ｐ＜０．０１）；维持血透半年以上的ＳＣＲ、ＢＵＮ透析前均值亦比醋酸盐组均值低，统计学处理分别有非常显著（Ｐ＜０．０１）和显著性（Ｐ＜０．０５）差别。而血清电解质除Ｐ均值比较有显著性差别外，余均无显著性差别（Ｐ＞０．０５）。认为：应用具有活血祛瘀功用的川芎嗪醋酸盐液透析，与常规醋酸盐透析液比较，有显著提高血透效果的作用，且不会引起电解质紊乱。     

冠心病患者自清中钙,磷与脂质相关关系探讨

检测１０５例冠心病患者和健康人的血钙、血磷与血脂,并行相关性分析。发现冠心病组血钙明显高于对照组;血磷与对照组无差别;血钙与血磷的乘积亦明显高于对照组。相关分析表明,对照组血清总钙（ＴＣａ）与甘油三脂（ＴＧ）、总胆固醇（ＣＨＯ）、低密度脂蛋白（ＬＤＬ）、载脂蛋白Ａ１（ＡＰＯＡ１）及载脂蛋白Ｂ（ＡＰＯＢ）呈正相关;无机磷（ＩＰ）与各脂质成份无相关;钙磷乘积（ＴＣａ×ＩＰ）与ＬＤＬ正相关。冠心病组ＴＣ     

不同的较低血透剂量对维持性血透患者矿物质骨代谢及并发症的影响

目的 采取不同血液透析的剂量为维持性血液透析患者进行治疗,了解不同血透治疗的剂量对维持性血液透析患者钙磷、甲状旁腺激素及并发症的影响。方法 采用回顾性研究,选择2019年1月~2021年1月在四川省人民医院和金牛区人民医院进行维持性血液透析且符合条件的患者共60例。将其分为标准血透剂量组A组（3×4小时/周）,低频率血透剂量组B组（2×4小时/周）,低透析时间血透剂量组C组（3×3小时/周）3个组,研究观察时间1年,分别于治疗前、治疗2月、治疗6月、治疗12月检测各项血生化指标,即血肌酐（Scr）、尿素氮(BUN)、白蛋白（Alb）、血钙、血磷、甲状旁腺激素（PTH)等,并分别于治疗后1、6、12个月时记录并发症发生的例数,最后进行统计学分析得出结论。结果 研究前3组透析患者血清钙磷及PTH水平无明显差异（P＞0.05）,研究结束时标准血透剂量组血清钙磷水平达标率最高（P＜0.05）,低频率血透剂量组血清钙磷水平达标率最低（P＜0.05）,但3组PTH并无明显差异（P＞0.05）。研究前3组各项并发症（消化道症状、神经系统症状、皮肤症状、低血压事件、急性心血管事件）并无明显差异（P＞0.05）,研究结束时,3组消化道症状无明显差异（P＞0.05）,其他症状比较标准血透剂量组均优于其他两组（P＜0.05）,同时低透析时间血透剂量组优于低频率血透剂量组（P＜0.05）。结论 血液透析患者维持标准血透剂量有利于维持正常的钙磷代谢及降低并发症。在无法达到标准血透剂量时,采取标准透析频率减少透析时间的血透剂量优于仅维持每次标准血透时间减少透析频率的血透剂量,但各组对PTH及消化道症状的影响并不明显。     

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.