冠心病及脑梗塞与组织型纤溶酶原激活物及其抑制物关系的探讨

目的：探讨冠心病及脑梗塞与组织型纤溶酶原激活物及其抑制物关系。方法：对31例健康人，20例稳定型心绞痛，15例不稳定型心绞痛，13例急性心肌梗死和17例脑梗塞患者，进行组织型纤溶酶原激活物和组织型纤溶酶原激活物抑制物的测定。结果：与健康人相比，不稳定型心绞痛，急性心肌梗死及脑梗塞急性期患者的组织型纤溶酶原激活物活性和组织型纤溶酶原激活物与组织型纤溶酶原激活物抑制物比值均明显降低（与对照组相比P＜0．05），而稳定型心绞痛患者则未见组织型纤溶酶原激活物与组织型纤溶酶原激活物抑制物活性的明显变化。结论：动物粥样硬化性及血栓栓塞性疾病的形成与发展和机体内纤溶系统的活性改变密切相关。     

蛇毒溶栓治疗急性脑梗塞的血浆纤溶活性变化研究

动态观察 2 0例急性脑梗塞患者早期蛇毒静脉溶栓期间血浆纤溶活性的变化。结果显示用药前及用药后 2 4小时血浆纤溶酶原激活物 (t PA)活性、纤溶酶原激活物抑制物 (PAI)活性的变化无显著性差异 (P >0 .0 5 )。认为急性脑梗塞早期蛇毒静脉溶栓无确切临床疗效。     

组织型纤溶酶原激活物对冠状动脉内斑块稳定性的预测价值

目的采用血管内超声研究急性冠脉综合征患者斑块和组织型纤溶酶原激活物的定量关系以及临床意义。方法 56例急性冠脉综合征患者,常规冠状动脉造影并用血管内超声检测事件相关病变处斑块形态学及特征,应用液相蛋白芯片结合流式细胞分析方法测定组织型纤溶酶原激活物,以及同型半胱氨酸和血脂。结果组织型纤溶酶原激活物浓度在急性心肌梗死组与不稳定性心绞痛组之间未见显著性差异(P=0.304),血管内超声识别的斑块破裂与非斑块破裂者两组比较,组织型先溶酶原复合物浓度差异均未见显著性(P=0.09);易损斑块与稳定斑块两组纤维酶原激活物浓度比较结果未见显著性差异(P=0,90)。组织型纤溶酶原复合物浓度与斑块形态学指标存在显著地相关性;其他因子与各斑块形态学指标结果均无统计学意义。结论斑块损伤和形态特点刺激机体凝血和抗凝血因子的产生,包括组织型先溶酶原复合物的分泌,组织型纤溶酶原激活物是独立与急性冠状动脉综合征炎症反应以外反映斑块形态特点的标志,也提示自身抗血栓保护系统的改变。     

乙型肝炎患者血浆纤溶活性的研究

文献报告,病毒性肝炎患者凝血因子减少,纤溶活性增高,是肝功能受损的重要标志之一。纤溶系统的主要成分是纤溶酶原、纤溶酶、纤溶酶原激活物及其抑制物。本文通过测定组织纤溶酶原激活物(tPA)、纤溶酶原激活抑制物(PAI)、纤溶酶原(PLG)、D-二聚体(D-Dimer),以了解乙肝患者的纤溶状态,现报道如下。     

糖尿病肾病纤溶酶原激活物抑制因子-1检测分析

目的:探讨糖尿病肾病患者血浆纤溶酶原激活物抑制物的变化。方法:检测33例糖尿病肾病患者及30例健康体检对照组血浆纤溶酶原激活物抑制物-1(PAI-1),观察检测结果。结果:33例糖尿病肾病患者纤溶酶原激活物抑制物-1(PAI-1)检测值(51.7±12.5)ng/ml,明显高于对照组检测值(27.1±11.2)ng/ml(P<0.01)。结论:糖尿病肾病患者存在血浆纤溶酶原激活物及其抑制物系统失衡。     

尿激酶型纤溶酶原激活物系统与肿瘤关系的研究进展

尿激酶型纤溶酶原激活物系统中的某些成分可作为人类肿瘤的预后标志,其中尿激酶型纤溶酶原激活物、其受体和抑制因子尤为重要。学者们对许多肿瘤的浸润、转移和预后与尿激酶型纤溶酶原激活物、其受体和抑制因子的含量之间的相关性进行了研究,结果显示,尿激酶型纤溶酶原激活物、其受体和抑制因子与肿瘤的浸润、转移有明显相关性,可作为预测患者生存情况的指标。     

suPAR与多发性骨髓瘤预后关系的研究进展

尿激酶型纤溶酶原激活物与尿激酶型纤溶酶原激活物受体(uPAR)组成的纤溶系统调节纤溶酶原的活化过程,可参与细胞的黏附、转移及血管新生,可溶性尿激酶型纤溶酶原激活物受体是uPAR的可溶形式,缺乏糖基磷脂酰肌醇锚链结构,在肿瘤患者中高表达,有助于判断肿瘤患者的恶性程度及预后,为探讨肿瘤的治疗提供新途径。在多发性骨髓瘤中,其可通过参与骨基质的降解,刺激破骨细胞的增殖等发挥作用。     

缺血性脑血管病血清t-PA和PAI检测及意义

缺血性脑血管病包括短暂性脑缺血发作（Transient Ischemic Attack，TIA）和脑血栓形成，其与机体血浆纤溶系统活性状况有关。人机体凝血-纤溶功能平衡是维持正常血液流通的基础，任何一方面的功能紊乱都可能与血栓性疾病有关。本研究对TIA和急性脑梗死患者进行了组织型纤溶酶原激活物（t—PA）和纤溶酶原激活物抑制物（PAI）的检测。报告如下。     

原发性高血压伴糖尿病患者凝血和纤溶活性的改变

原发性高血压易并发心、脑血管等血栓性疾病 ,其原因可能是高血压患者多存在胰岛素抵抗、脂蛋白代谢紊乱和凝血、纤溶系统功能的改变。其中凝血和纤溶活性的改变在血栓性疾病的发生中起着非常重要的作用。纤溶系统由纤溶酶 (纤溶酶原 )、纤溶酶原激活物及其抑制物组成。本研究观察了原发性高血压伴糖尿病的患者血浆纤溶酶原激活物抑制物 (ＰＡＩ)活性、组织型纤溶酶原激活物 (ｔＰＡ)和血管性假血友病因子 (ｖＷＦ)的改变 ,分析ＰＡＩ和ｔＰＡ与哪些代谢因素有关。探讨高血压病伴糖尿病患者凝血纤溶功能失衡的原因。１．一般资料选择我院１…     

凝血和纤溶与缺血性心脏病的关系

纤维蛋白原为重要的凝血因子,越来越多的研究表明高纤维蛋白原水平导致高凝状态,诱发血管疾病造成缺血性损伤。纤溶酶原激活物抑制物1是血浆纤溶活性的主要决定因素。异常升高纤溶酶原激活物抑制物1阻碍纤维蛋白分解,从而增加血浆纤维蛋白原。高纤维蛋白原水平导致高凝状态促进血栓形成。纤溶酶原激活物抑制物参与多种代谢性疾病血栓前状态的形成,造成动脉血栓形成的危险性增加。纤溶酶原激活物抑制物1、纤维蛋白原不仅在冠心病的发病机制中发挥着重要作用,而且与冠心病患者的不良预后有关。     

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.