老年NIDDM患者微量白蛋白尿与脂质代谢的关系及临床意义

为了研究老年非胰岛素依赖型糖尿病（ＮＩＤＤＭ）患者尿微量白蛋白与血脂、脂蛋白的关系，测定了老年ＮＩＤＤＭ伴微量白蛋白尿（ＵＡＥ）患者和ＮＩＤＤＭ不伴ＵＡＥ患者及正常对照组的甘油三酯（ＴＧ）、胆固醇（ＴＣ）、低密度脂蛋白胆固醇（ＬＤＬ Ｃ）、高密度脂蛋白胆固醇（ＨＤＬ Ｃ）、载脂蛋白Ａ（ａｐｏＡ）、载脂蛋白Ｂ（ａｐｏＢ）、脂蛋白（ａ）〔ＬＰ（ａ）〕。结果：老年ＮＩＤＤＭ伴有微量蛋白尿患者的ＴＧ、Ｌｐ（ａ）显著高于不伴ＵＡＥ的ＮＩＤＤＭ患者及对照组，而ａｐｏＡ及ＨＤＬ Ｃ明显低于不伴ＵＡＥ的ＮＩＤＤＭ患者及对照组。结果提示：老年ＮＩＤＤＭ伴有微量白蛋白尿患者的心血管病的发病率及死亡率的增加可能与血脂及脂蛋白代谢异常有关。     

Ⅱ型糖尿病患者血浆胰岛素水平与血脂的关系

分析７６例Ⅱ例糖尿病（ＮＩＤＤＭ）患者空腹血浆胰岛素水平与血脂的关系，了解胰岛素对血脂的影响结果：ＮＩＤＤＭ患者血清胆固醇（ＴＣ）、甘油三酯（ＴＧ）、低密度脂蛋白胆固醇（ＬＤＬ－ｃ）较对照组升高，而高密度脂蛋白胆固醇（ＨＤＬ－ｃ），ＨＤＬ－ｃ／ＴＣ，ＨＤＬ－ｃ／ＬＤＬ－ｃ降低；ＮＩＤＤＭ患者各组间ＴＣ差异无显著性与正常胰岛素水平组比较，低胰岛素水平组ＴＧ有显著意义的升高，低和高胰岛素水平组ＨＤＬ－ｃ，ＨＤＬ－ｃ／ＴＣ，ＨＤＬ－ｃ／ＬＤＬ－ｃ有显著意义的降低，低胰岛素水平组与高胰岛素水平组血脂差异无显著性结果表明，血浆胰岛素水平正常和其功能的正常发挥是使ＮＩＤＤＭ患者血脂保持在正常水平的条件之一     

山楂精降脂片治疗原发性高脂蛋白血症的临床观察

观察口服山楂精降脂片对高脂蛋白血症患者血清总胆固醇（ＴＣＨ）、甘油三脂（ＴＧ），高密度脂蛋白胆固醇（ＨＤＬ－Ｃ），低密度脂蛋白胆固醇（ＬＤＬ－Ｃ）的影响，结果表明：山楂精降脂片可明显降低血清ＴＣＨ、ＴＧ，升高ＨＤＬ—Ｃ及ＡＰｏＡ，对Ａ／Ｂ比值具有良好的调节作用。说明山楂精降脂片能降低血脂，调节体内脂质代谢，是一种安全有效的血脂调节剂     

影响糖尿病患者胆固醇水平的多因素分析(附80例临床分析)

本文观察８０例非胰岛素依赖型糖尿病（ＮＩＤＤＭ）患者的病程、糖化血红蛋白（ＧＨｂ）、甘油三脂（ＴＧ）、高密度脂蛋白－胆固醇（ＨＤＬ－Ｃ）、低密度脂蛋白－胆固醇（ＬＤＬ－Ｃ）、ＨＤＬ－Ｃ／ＬＤＬ－Ｃ、载脂蛋白Ａ１（ａｐｏＡ１）、载脂蛋白Ｂ１００（ａｐｏＢ１００）、ａｐｏＡ１／ａｐｏＢ１００、雌二醇（Ｅ２）、睾酮（Ｔ）、Ｅ２／Ｔ、尿白蛋白排泄率（ｕＡＥＲ）等因素对总胆固醇（ＴＣ）的影响，应用ＳＡＳ统计软件进行逐步回归分析。结果显示：ＴＣ与ＬＤＬ－Ｃ、ｕＡＥＲ显著正相关，与Ｅ２或Ｅ２／Ｔ显著负相关；而ｕＡＥＲ又与ＴＣ、ＧＨｂ、病程均显著正相关，提示ＮＩＤＤＭ患者胆固醇异常与脂蛋白代谢、性激素代谢、肾功能以及糖代谢等紊乱有关。     

非胰岛素依赖型糖尿病患者红细胞膜ATPase活性改变及其影 …

目的 搪塞非胰岛素依赖型糖尿病（ＮＩＤＤＭ）患者红细胞膜Ｎａ－Ｋ－ＡＴＰａｓｅ及Ｃａ＾２＋－ＡＴＰａｓｅ活性改变的影响因素。方法 测定７７例ＮＩＤＤＭ患者和５０例正常人血糖、总胆固醇（ＴＣ）、甘油三酯（ＴＧ）高密度脂蛋白胆固醇（ＨＤＬＣ）脂质过氧化物（ＬＰＯ）、谷胱甘肽（ＧＳＨ）、糖化血红蛋白、超氧化物歧化酶ＳＯＤ、谷胱甘肽过氧化物酶（ＧＳＨＰＸ）、红细胞膜Ｎａ－Ｋ－ＡＴＰａｓｅ和Ｃａ＾２＋－ＡＴ     

非胰岛素依赖型糖尿病患者红细胞膜ATPase活性改变及其影响因素

目的探讨非胰岛素依赖型糖尿病（ＮＩＤＤＭ）患者红细胞膜Ｎａ＋－Ｋ＋－ＡＴＰａｓｅ及Ｃａ２＋－ＡＴ－Ｐａｓｅ活性改变的影响因素。方法测定７７例ＮＩＤＤＭ患者和５０例正常人血糖、总胆固醇（ＴＣ）、甘油三酯（ＴＧ）、高密度脂蛋白胆固醇（ＨＤＬＣ）、脂质过氧化物（ＬＰＯ）、谷胱甘肽（ＧＳＨ）、糖化血红蛋白（ＨｂＡｌｃ）、超氧化物歧化酶（ＳＯＤ）、谷胱甘肽过氧化物酶（ＧＳＨＰＸ）、红细胞膜Ｎａ＋－Ｋ＋－ＡＴ－Ｐａｓｅ和Ｃａ２＋－ＡＴＰａｓｅ活性。ｔ检验、直线相关分析和多元逐步回归分析。结果ＮＩＤＤＭ组血糖、ＨｂＡｌｃ、ＴＣ、ＴＧ、ＴＣ／ＨＤＬＣ、ＬＰＯ显著高于对照组（Ｐ＜０．０１），ＨＤＬＣ、ＧＳＨ、ＳＯＤ、ＧＳＨＰＸ、红细胞膜Ｎａ＋－Ｋ＋－ＡＴＰａｓｅ和Ｃａ２＋－ＡＴＰａｓｅ活性低于对照组（除ＧＳＨ的Ｐ＜０．０５外，其他Ｐ＜０．０１）；不同ＨｂＡｌｃ、ＴＣ／ＨＤＬＣ、ＧＳＨ、ＬＰＯ、ＴＣ组的红细胞膜Ｎａ＋－Ｋ＋－ＡＴＰａｓｅ活性有显著性差别。红细胞膜Ｎａ＋－Ｋ＋－ＡＴＰａｓｅ活性＝１２．８０＋０．２７（ＧＳＨ）－０．１２（ＬＰＯ）－０．０９（ＴＣ／ＨＤＬＣ），红细胞胞膜Ｃａ２＋－ＡＴＰａｓｅ活性＝１０８．２０＋１．     

NIDDM患者血脂异常与胰岛素抵抗关系的探讨

测定了４０例非胰岛素依赖型糖尿病（ＮＩＤＤＭ）患者血脂水平，结果发现，总胆固醇（ＴＣ），甘油三酯（ＴＧ）显著增高，而高密度脂蛋白胆固醇（ＨＤＬ－Ｃ）显著降低；伴有大血管病变的患者脂代谢紊乱更为显著，且存在高胰岛素血症和明显的胰岛素抵抗，ＴＧ与空腹胰岛素（ＦＩＮＳ）呈明显正相关，ＴＣ，ＴＧ与胰岛素敏感性指数（ＩＳ）呈明显负相关。     

非胰岛素依赖型糖尿病与冠心病间血脂变化比较的临床研究

作者观察了男性、年龄在５５岁以上的非胰岛素赖型糖尿病（ＮＩＤＤＭ）而不伴有冠心病表现者１２７例，不伴糖尿病的冠心病（ＣＨＤ）患者６５例。观察了两组的血清总胆固醇（ＴＣ）、甘油三酯（ＴＧ）、高密度脂蛋白（ＨＤＬ）、低密度脂蛋白（ＬＤＬ）及动脉硬化指数（ＡＩ，即ＴＣ－ＨＤＬ／ＨＤＬ），结果发现ＮＩＤＤＭ组ＴＣ明显高于ＣＨＤ组（Ｐ＜０．０００５），ＴＧ也高于ＣＨＤ组（Ｐ＜０．０５），而ＨＤＬ、ＬＤＬ及ＡＩ间无统计学差别。本研究提示ＮＩＤＤＭ组ＴＣ显著高于ＣＨＤ组，ＴＧ也高于ＣＨＤ组。     

48例Ⅱ型糖尿病人血脂分析

本文对非胰岛素依赖型糖尿病（ＮＩＤＤＭ）病人４８例与年龄，ＢＭＩ相当的１８例对照就血脂ＴＧ、ＴＣ，脂蛋白ＨＤＬ─Ｃ、ＬＤＬ─Ｃ，ＶＬＤＬ─Ｃ，载脂蛋白ＡＰＯＡＩ，ＡＰＯＢ水平进行比较。ＮＩＤＤＭ组ＴＧ、ＴＣ比对照组高，两组之间差异显著；脂蛋白和载脂蛋白检查ＨＤＬ─Ｃ和ＡＭＡＩ水平较对照组低，ＬＤＬ─Ｃ，ＶＬＤＬ─Ｃ和ＡＰＯＢ是ＮＩＤＤＭ较对照组高。由于ＨＤＬ─Ｃ降低，抗动脉硬化因素下降，ＬＤＬ─Ｃ升高是动脉粥样硬化危险因素升高，这是ＮＩＤＤＭ病人脂代谢不正常，动脉粥样硬化危险性大的原因。用ＡＰＯＡＩ／ＡＰＯＢ和ＬＤＬ─Ｃ／ＨＤＬ─Ｃ比值较单项测定结果的差别更显著，是判别ＮＩＤＤＭ病人动脉粥样硬化更良好的指标。     

糖复康对NIDDM脂代谢紊乱患者血脂及载脂蛋白水平影响

在临床上收集了１５１例Ⅱ型糖尿病脂代谢紊乱患者，随机分为两组，观察组用糖复康治疗，对照组用达美康治疗，结果表明：ＮＩＤＤＭ脂代谢紊乱患者的甘油三脂、胆固醇、低密度脂蛋白、极低密度脂蛋白（ＶＬＤＬ－Ｃ）、载脂蛋白Ｂ１００及动脉硬化指数（ＡＩ）水平显著高于正常组，高密度脂蛋白（ＨＤＬ－Ｃ）及载脂蛋白Ａ１（ＡｐｏＡ１）水平显著低于正常组；糖复康可显著降低ＮＩＤＤＭ脂代谢紊乱患者的ＴＧ，ＴＣ，ＬＤＬ－Ｖ、     

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.