纤维蛋白原和红细胞比积在2型糖尿病微血管病变中的临床意义分析

目的探讨血浆纤维蛋白原和红细胞比积在糖尿病微血管病变的发生和发展过程中的作用。方法按统一要求测定124例糖尿病患者及30例正常人的血浆纤维蛋白原和红细胞比积。结果糖尿病患者血浆纤维蛋白原和红细胞比积均明显升高（P〈0．01）。在伴有微血管病变中变化更明显（P〈0．01）。结论两者共同参与了糖尿病微血管病变的发生和发展。     

59例糖尿病患者血浆纤维蛋白原和红细胞比积的测定

目的探讨血浆纤维蛋白和红细胞比积在糖尿病微血管病变的发生和发展过程中的作用。方法测定5例Ⅱ型糖尿病患者及60例正常人的血浆纤维蛋白原和红细胞比积。结果糖尿病患者血浆纤维蛋白原和红细胞比积均高于正常对照组（P〈0．01）。结论两者共同参与了糖尿病血管病变的发生和发展。     

糖肾康治疗2型糖尿病合并血脂异常的临床观察

目的探讨糖肾康治疗2型糖尿病并血脂异常的临床疗效。方法2型糖尿病并血脂异常患者120例，随机分为治疗组及对照组，每组60例，分别测定两组患者服药前及服药后3个月的FG、2hPG、TC、TG、LDL-C、HDL-C、空腹胰岛素水平和血液流变学，并进行比较。结果两组患者的TC、TG、LDL-C、血浆比粘度、纤维蛋白原和红细胞压积都较服药前降低，HDL-C水平较服药前升高，差异有显著意义（P〈0．05）。治疗组FG、2hPG明显较服药前降低，差异有显著意义（P〈0．05），对照组FG、2hPG和服药前差异无显著意义（P〈0．05）。治疗组IAI较服药前明显提高（P〈0．05），对照组改变不明显（P〈0．05）。结论糖肾康与辛伐他汀都有明显的调节血脂作用，且糖肾康还有协助降糖及提高胰岛素敏感性的作用。     

降粘、抗凝药物治疗2型糖尿病血液流变学指标的变化

目的：探讨降粘、抗凝药物蚓激酶、血塞通对2型糖尿病患者血糖及各项血液流变学指标的影响。方法：180例2型糖尿病患者随机分为对照组及蚓激酶、血塞通、蚓激酶＋血塞通3个治疗组，测定各组的空腹及3餐后2h血糖，并测定3个治疗组治疗前后的高切、低切全血粘度及血浆粘度、红细胞压积、纤维蛋白原5项血液流变学指标。结果：蚓激酶、血塞通、蚓激酶＋血塞通3个治疗组空腹及3餐后2h血糖均明显低于对照组（P〈0．05-0．01），3个治疗组治疗后高切、低切全血粘度及血浆粘度、红细胞压积、纤维蛋白原均明显低于治疗前（P〈0．05-0．01）。结论：降粘、抗凝药物蚓激酶、血塞通单独或联合应用均可改善2型糖尿病患者血液流变学障碍，促进血糖控制。     

妊娠期糖尿病患者的血小板参数变化

目的：探讨单纯妊娠期糖尿病患者及妊娠期糖尿病并发子痫前期患者血小板参数变化的意义。方法：检测28例妊娠期糖尿病并发子痫前期患者、86例单纯妊娠期糖尿病患者及92例正常对照组孕妇的血小板参数，并做对比分析。结果：妊娠期糖尿病并发子痫前期组与单纯妊娠期糖尿病组的血小板平均体积、血小板压积比较，两组差异有统计学意义（P〈0．05）；与正常对照组孕妇的血小板平均体积、血小板压积比较两组差异有统计学意义（P〈0．05），单纯妊娠期糖尿病患者与正常对照组孕妇的血小板平均体积、血小板压积的比较，两纽差异有统计学意义（P〈0.05）。结论：检测血小板平均体积、血小板压积可以作为了解单纯妊娠期糖尿病患者及妊娠期糖尿病合并子痫前期的患者血小板活化状态的参考指标。     

甘地胶囊对糖尿病血瘀证治疗作用的临床观察

目的 观察甘地胶囊对糖尿病血瘀证的治疗作用。方法 2型糖尿病血瘀证患者48例，随机分为对照组和观察组。西药对照组（16例）按西医治疗方案控制血糖；观察组（32例）西药治疗同时，口服甘地胶囊，疗程为2个月。观察临床症状积分、血糖（FBG）、餐后2h血糖（2PBG）、糖基化血红蛋白（HbAlc）、血总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、血液流变学指标（全血黏度、血浆黏度、红细胞压积、纤维蛋白原）。同时进行安全性检查。结果 观察组治疗后中医症状积分下降明显（P〈0．01），与对照组比较，差异有非常显著性（P〈0．01）。观察组总有效率75％，明显优于对照组的18．75％，差异有显著性（P〈0．05）。观察组治疗后FBG、2hPBG、HbAlc均明显下降，差异有非常显著性（P〈0．01），与对照组比较，差异有非常显著性（P〈0．01）。观察组治疗后TC、TG、LDL-C明显下降，HDL-C明显升高，差异有非常显著性（P〈0．01）；两组间比较，TC、TG、LDL-C差异有显著性（P〈0．05～0．01）。HDL-C差异无显著性（P〉0．05）。观察组治疗后血液流变学指标都有明显改善，差异有非常显著性（P〈0．01）；两组间比较，全血黏度低切、血浆黏度、纤维蛋白原，差异有非常显著性（P〈0．05～0．01）；安全性检查无不良事件发生。结论 甘地胶囊能改善中医症状积分，提高中医症状疗效，与西药降糖治疗联合，可使难降血糖指标得到进一步控制，有良好的调节脂类代谢与改善血液流变学指标作用。甘地胶囊对于糖尿病血瘀证患者治疗作用显著。     

2型糖尿病及糖尿病肾病患者C反应蛋白检测的临床价值

目的：探讨C反应蛋白（CRP）在2型糖尿病（T2DM）及其并发肾病患者中的浓度变化及，临床价值。方法：根据尿白蛋白排泄率（UAER）将102例T2DM患者分为单纯糖尿病组（SDM组）、早期糖尿病肾病组（EDN组）和临床糖尿病肾病组（CDN组），30名本院健康体检者作为对照组，应用免疫透射比浊法测定血清CRP，将组间的CRP进行统计学比较，并进行相关分析。结果：各糖尿病组血清C反应蛋白（CRP）水平与对照组比较均具有统计学差异（P〈0．05），EDN、CDN组显著高于SDM组（P〈0．05），CDN组与EDN组相比亦明显升高（P〈0．05）。相关分析显示CRP与UAER呈显著正相关（r=0．485，P〈0．01）。结论：CRP水平在T2DM组和并发DN组中逐渐增高，表明其可能是T2DM和DN发生的危险因素，CRP与糖尿病及其血管慢性并发症有关。     

葛根素治疗老年人2型糖尿病并发脑梗塞35例分析

目的 观察葛根素治疗老年2型糖尿病并发脑梗塞偏瘫肢体肌力恢复的疗效及对血液流变学指标的影响。方法 随机将70例老年人2型糖尿病并发脑梗塞患者分为治疗组和对照组。所有病例在常规治疗基础上，治疗组用葛根素注射液，对照组用复方丹参注射液。14d后观察用药前后病情变化，并测定血液流变学指标。结果 治疗组有效率91．4％，明显高于对照组68．6％（P〈0．05）。治疗组治疗后血液流变学指标差异有统计学意义（P〈0．01）。对照组治疗前、后比较差异无统计学意义（P〉0．05）。结论 葛根素对老年人2型糖尿病并发脑梗塞偏瘫肢体肌力的恢复有效，可改善血液流变学指标。     

银杏达莫注射液对糖尿病患者血液流变学的影响

目的：观察银杏达莫注射液对糖尿病患者血液流变学的影响。方法：将98例2型糖尿病患者随机分为两组,治疗组50例给予银杏达莫注射液50ml／d,对照组48例给予复方丹参注射液20ml／d,治疗前后分别检测两组患者血液流变学参数。结果：对照组治疗后血液黏度、纤维蛋白原、红细胞聚集指数、红细胞变形指数明显改善（P〈0．05）。治疗组治疗后血液流变学各项检测指标较治疗前显著改善（P〈0．01）。两组比较全血高切黏度、低切黏度降低有统计学意义（P〈0．05）,血浆黏度、红细胞变形指数、红细胞聚集指数改善有显著统计学差异（P〈0．01）。结论：银杏达莫注射液具有更好的改善糖尿病患者血液流变学异常的作用。     

脑出血患者急性期血液流变学检测分析

目的 分析脑出血患者急性期血液流变学指标的变化及其临床意义。方法选88例符合标准的病人，检测其血液流变学指标，按出血量、有无合并脑梗塞、有无合并高血压、病情等分组分析。结果纤维蛋白原、全血还原粘度低切高于正常参考值，但红细胞压积明显低于正常值。纤维蛋白原指标在病程长、合并脑梗塞、病情轻时偏高，组间比较差异有统计学意义（P＜0．01～0．05）。全血还原粘度在出血量少组偏高，组间比较差异有统计学意义（P〈0．05）。全血粘度、血浆粘度在合并高血压病组偏高，组间比较差异有统计学意义（P〈0．05）。结论脑出血患者急性期的血液流变学指标与病程、病情、出血量相关。     

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.     

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.