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。     

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。     

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。     

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。     

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。     

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。     

丹参注射液对糖尿病患者血液流变学的影响

[目的]观察丹参注射液对糖尿病患者液流变学的影响。[方法]65例糖尿病患者随机分为两组,治疗组33例在对照组基础上给予丹参注射液40ml／d,治疗前后分别检测两组患者血液流变学参数。[结果]对照组治疗后血浆黏度、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]丹参注射液能有效改善糖尿病患者血液流变学异常的作用。     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

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.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

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.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.