检测糖尿病患者血清微量元素的临床意义

【摘要】目的通过检测糖尿病患者血清中微量元素的含量,探讨微量元素对糖尿病的影响。方法使用等离子体发射光谱仪测定154例糖尿病患者血清中微量元素锌、铜、硒、铬含量,并与健康体检者（对照组）比较。结果糖尿病患者血清中微量元素锌、硒、铬的含量低于对照组,铜的含量明显高于对照组,差异均具有统计学意义（P〈0．01）。并且糖尿病肾病及血糖控制差的患者锌、硒、铬水平更低,而血铜含量则更高,差异具有统计学意义（P〈0．0l,P〈0．05）。结论糖尿病患者体内微量元素的含量与糖尿病具有密切关系。适当调整患者体内微量元素的含量将有助于糖尿病病情的控制。     

持续非卧床腹膜透析对尿毒症患者微量元素的影响

目的 探讨持续非卧床腹膜透析（CAPD）对尿毒症患者微量元素的影响。方法 用火焰及无火焰原子吸收法检测30例尿毒症患者行持续非卧床腹膜透析前及透析1月后血清铜、锌、铁的含量及腹膜透析透出液中铜、锌、铁、钙、镁、磷、钾元素的含量，分析腹膜透析前后尿毒症患者血清及透出液中微量元素的变化。结果 尿毒症患者透析后血清铁及锌的浓度均明显高于透析前（P〈0．05），而血清铜透析前后无明显差异（P〉0．05）。腹膜透析透出液中铜、锌、镁、钾、钙、磷含量透析前后有显著性差异（P〈0．05），而腹膜透析透出液中铁浓度透析前后无明显差异（P〉0．05）。结论 经CAPD治疗后尿毒症患者铜、锌、铁、磷、钾的异常代谢可得到部分纠正。     

妊娠期糖尿病与微量元素铜铁锌的相关性78例分析

目的：检测妊娠期糖尿病（GDM）患者血清中微量元素铜、铁、锌的含量,探讨其与GDM的关系。方法：采用电感耦合等离子体质谱法分别检测78例GDM孕妇和78例正常的孕妇血清中铜、铁、锌的含量。结果：GDM组孕妇血清中微量元素铁、锌的含量低于正常对照组（P〈0．01）,而铜的含量GDM组与正常对照组比较差异无统计学意义（P〉0．05）。结论：微量元素锌、铁在GDM的发生和发展过程中具有重要的作用。GDM孕妇体内存在微量元素的代谢紊乱,应加强孕妇的饮食指导,适时补充铁、锌等。     

加味补阳还五汤对易卒中自发性高血压大鼠血清微量元素的影响

目的观察加味补阳还五汤对易卒中自发性高血压大鼠(SHR／SP)血清微量元素锌、铜、铁、硒、锰的影响,进一步证实加味补阳还五汤对SHR／SP的智力改善具有一定的功能性作用。方法将20只8周龄雄性SHR／SP均分为对照组和用药组,对照组常规饲养,用药组喂含补阳还五汤的饲料。同时以同龄10只WKY大鼠作为空白组。实验周期为3个月,观察大鼠血清微量元素锌、铜、铁、硒、锰含量。结果空白组锌、锰、硒含量明显高于用药组(p值均<0．01),用药组又明显高于对照组(p值均<0．01)。空白组铜含量明显低于用药组(P<0．05),用药组又明显低于对照组(P<0．05)。3组血清铁含量的差异均无统计学意义(P值均>0．05)。结论加味补阳还五汤对SHR／SP血清锌、铜、硒、锰具有一定的调控作用,这些微量元素在一定程度上影响了学习记忆行为能力。     

352例不育症患者精浆中微量元素的含量分析

目的探讨精浆微量元素含量与不育症的关系。方法用罗氏P800全自动系列化分析仪检测352例男性不育症患者精浆锌、铁、铜、钙、镁五种微量元素。结果不育症患者精浆中Zn、Fe、Ca元素的含量明显低于健康生育组（P〈0．01或P〈0．05）;Cu元素含量高于健康生育组（P〈0．05）;Mg元素的含量与健康生育组无明显差别（P〉0．05）。结论精浆锌、铁、铜、钙等微量元素含量改变是引起男性不育的重要原因之一;精浆镁含量变化与不育无关。     

2型糖尿病患者微量元素的观察

目的：观察2型糖尿病与微量元素的关系。方法：对82例2型糖尿病患者与70例正常对照组的血清锌、铜、钙、铁、镁五种元素及血糖进行测定比较。全部数据均采用SPSS11．0统计分析处理。结果：2型糖尿病患者血清铜、铜／锌比值显著高于对照组（P〈0．01），且与血糖呈正相关；血清锌明显低于对照组（P〈0．01）且与血糖呈负相关，血清钙、铁、镁两组无差异。结论：血清微量元素，与糖尿病有着密切的关系，适当的补充微量元素对糖尿病患者纠正糖代谢紊乱有着重要的临床意义。     

急性心肌梗死患者血清微量元素的变化

测定了25例心肌梗死患者急性期血清微量元素（钙、铜、铁、镁、锌）的含量，并与心肌梗死恢复期及正常人比较，发现急性期血清铜、铁含量明显增高（P＜0．01），锌、镁含量明显减低（P＜0．01），而钙的含量无差异（P＞0．05）。提示心肌梗死急性期，心肌细胞大量破坏，使血清铜、铁、锌。镁含量发生显著变化。临床上可测定其血清含量来作为评价心肌缺血程度的指标，治疗上适当补充锌、镁对心肌细胞的修复有益。     

脑瘫患儿血清微量元素分析

目的：探讨脑瘫的病因及合并症与其体内微量元素之间的关系。方法：将131例脑瘫患儿作为研究组，另选130例非脑瘫患儿作为对照组，测量其血清五种微量元素的含量。结果 研究组患儿血清锌、铁、钙的含量均明显低于对照组患儿，尤其是锌和钙的含量，二者具有非常显著性差异（P〈0．01），而血清镁、铜的含量虽低于对照组，但二者无显著性差异（P〉0．05）。结论：微量元素的缺乏与脑瘫患儿运动功能及智能发育障碍有关。     

心绞痛发作时血清锌、铜含量的临床意义

目的 探讨心绞痛发作时血清锌、铜含量变化的临床意义。方法 心绞痛病人发作时和缓解后分别采静脉血4ml,用高频等离子发射光谱法测定血清中微量元素锌、铜浓度。结果 心绞痛发作时血清中锌浓度较对照组明显降低（P＜0．01）,而血清铜浓度明显增高（P＜0．01）;心绞痛缓解后血清锌、铜浓度较对照组均有差异（P＜0．01,P＜0．001）;心绞痛缓解后锌浓度较发作时明显回升（P＜0．01）,而血清铜浓度明显降低（P＜0．001）;心绞痛发作时血清铜锌比值明显升高（P＜0．01）,而缓解后血清铜锌比值较对照组无差异（P＞0．05）,心绞痛发作时血清铜锌比值较心绞痛缓解后有明显差异（P＜0．01）。结论 血清中微量元素锌铜水平与心绞痛发作和缓解存在明显相关性,揭示微量元素锌、铜在心绞痛发生机理上起重要作用。     

贫血儿童血清铁锌铜水平的研究

目的：研究贫血儿童血清铁、锌、铜等微量元素的水平。方法：对437名5－7岁儿童进行了血红蛋白、血清微量元素水平的测定。结果：该组儿童中贫血的发生率为23．79％；贫血组儿童血清铁、锌、铜浓度低于或显著低于对照组（P＜0．05，P＜0．01），血清铁、锌、铜缺乏的发生率显著高于对照组（P＜0．01）。结论：微量元素缺乏在贫血儿童中较为严重，应积极采取措施，纠正学龄前儿童的贫血及微量元素的缺乏。     

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.