急性心肌梗塞患者血脂的测定和分析

目的分析急性心肌梗塞(AMI)患者发病24小时之内的血脂与年龄、性别、高血压病、糖尿病的关系。方法对120例AMI患者入院时的总胆固醇(TC)、低密度脂蛋白-胆固醇(LDL-C)、高密度脂蛋白-胆固醇(HDL-C)、血清甘油三酯(TG)进行测定,并根据患者年龄、性别,有无合并糖尿病、高血压病进行分组,比较各组间的血脂。结果急性心肌梗塞发病24小时之内TC≥6.24mmol/L者占12.5％,TC在4.68～6.24mmol/L的患者占44.17％,LDL-C≥2.6mmol/L者占63.33％,HDL-C≤0.91mmol/L占13.33％,TG≥2.2mmol/L者占20％,TG在1.70～2.2mmol/L者占13.33％;所有血脂异常者总计为78.67％。结论在急性心肌梗塞发病24小时之内,可以发现血脂异常。在男性和女性、高血压病和非高血压病、糖尿病和非糖尿病患者之间,血脂存在显著性差异。     

老年进展性脑梗死与血脂、纤维蛋白原关系的探讨

选取神经内科收治的老年急性脑梗死患者87例分组后进行血脂、纤维蛋白原(Fib)测定、头CT或MRI检查及SSS评分,并进行比较分析.进展组合并高血压、糖尿病病史及TC、LDL-C、Fib值明显高于非进展组(P<0.05).早期进展组TC、LDL-C值高于后期进展组(P<0.05).认为TC、LDL-C和Fib的升高以及高血压、糖尿病是脑梗死进展的危险因素,TC和LDL-C的升高可能是不同进展时期的危险因素.     

急性心肌梗死患者血脂改变及其影响因素分析

目的了解急性心肌梗死（AM）I患者急性期血脂指标：甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（LDL-C）、低密度脂蛋白胆固醇（HDL-C）的改变情况及其影响因素.方法采用随机抽样调查住院病历资料的方式,对206例曾住院治疗的AMI患者（AMI组）和240例未发生AMI的冠心病患者（对照组）的部分血生化指标以及病史,是否发生不良事件等进行研究.结果 （1）AMI组TG,TC,LDL-C水平均低于对照组（P〈0.05）,而HDL-C在两组之间的水平差异无统计学意义（P〉0.05）;（2）除年龄外,TC、血尿酸水平以及既往有高血压病史与TG水平呈正相关关系;TG、LDL-C水平及有糖尿病病史与TC水平呈正相关关系;TC与LDL-C水平呈正相关关系.结论 AMI患者急性期血脂水平较CHD未发生AMI时低;影响各血脂指标的因素是多方面的,也是相互作用的.     

2型糖尿病合并非酒精性脂肪性肝病与胰岛素抵抗及血脂代谢紊乱的关系

目的 观察2型糖尿病合并非酒精性脂肪性肝病患者体内胰岛素抵抗、血脂代谢情况,比较两者之间的内在联系.方法 选取单纯2型糖尿病患者60例作为对照组,并以合并非酒精性脂肪肝的2型糖尿病患者60例作为观察组,对两组的血糖、血脂水平进行比较研究.结果 观察组FCP和1hCP检测指标均高于对照组,两组间比较差异有统计学意义(P＜0.05);两组患者TC、HDL-C、TG、LDL-C等值比较,观察组较对照组有增高趋势,组间比较差异有统计学意义(P＜0.05).结论 对2型糖尿病合并非酒精性脂肪性肝病患者胰岛素抵抗状态明显,且存在血脂代谢异常,需早期诊断治疗以降低不良后果的发生.     

超敏C反应蛋白与血脂检测对冠心病诊断的价值分析

目的：探讨超敏C反应蛋白与血脂检测在冠心病诊断中的价值。方法整群选取医院2015年1月—2016年1月收治的159例CHD患者和103例健康体检者进行进行hs-CRP和血脂检测并对比。结果健康体检组hs-CRP (1.62±0.53)mg/L、TC (4.34±0.91)mmol/L、TG (0.93±0.22)mmol/L、LDL-C (2.59±0.3)mmol/L明显低于CHD各组(P<0.05);HDL-C(1.51±0.13)mmol/L明显高于CHD各组(P<0.05)。 CHD各组比较,AMI 组hs-CRP、TC、TG、LDL-C水平明显升高,HDL-C水平明显降低(P<0.05)。结论hs-CRP和血脂检测对CHD的诊断和发展具有重要意义。     

2型糖尿病合并高血压病患者的临床危险因素分析

目的观察和探讨2型糖尿病合并高血压病的临床危险影响因素。方法选取65例2型糖尿病合并高血压病患者作为观察组,同期选取60例单纯2型糖尿病患者作为对照组,详细测量并记录两组患者一般情况,包括身高、体质量、BMI、颈围、腰围、臀围、腰臀比,同时测定两组患者血脂水平及尿酸(UA)水平并进行比较。并对观察组患者不同级别高血压组其一般情况、血脂及UA水平进行分析比较。结果观察组患者BMI、腰臀比均明显高于对照组(P0.05),观察组患者TG、TC、LDL-C、UA均明显高于对照组,HDL-C明显低于对照组,两组差异具有统计学意义(P0.05)。结论 2型糖尿病合并高血压病的临床危险因素包括BMI、TG、TC、LDL-C及UA等,因此,对于2型糖尿病患者,在积极控制血糖的同时,积极控制患者的BMI,并重视生化指标的监测,对2型糖尿病合并高血压病患者具有重要意义。     

不同年龄急性心肌梗死患者血脂水平分析

目的 :研究本地区不同年龄急性心肌梗死 (AMI)患者血脂水平状况及冠心病 (CHD)二级预防中的调脂治疗。方法 :将 170例AMI患者分为中青年组 (35～ 5 9岁 ,49例 )、老年组 (6 0～ 79岁 ,10 9例 )、高龄老年组(80～ 90岁 ,12例 ) ,分析各年龄组总胆固醇 (TC)、甘油三脂 (TG)水平 ,血脂增高检出率 ,强调了高胆固醇血症的治疗策略。结果 :TC ,TG水平随AMI发病年龄增加而降低 ,TG水平与AMI发病年龄呈负相关 (γ =- 0 2 0 3,P <0 0 1) ,中青年组及老年组TC均值极显著高于高龄老年组 (P <0 0 1) ,中青年组TG均值显著高于其他两组(P <0 0 5 ) ,39%的AMI患者因TC增高需开始饮食疗法 ,2 7%的需开始药物疗法。结论 :重视CHD ,特别是中青年组病人的调脂治疗 ,调脂治疗为CHD二级预防的重要措施。     

冠心病患者血脂水平变化特点的研究

目的了解冠心病(CHD)患者血脂水平的变化特点。方法对70例CHD患者和70例正常对照组血清血脂水平进行测定,并对其结果进行分析。结果CHD患者血清中的总胆固醇(TC)和极低密度脂蛋白胆固醇(vLDL-C)均较正常对照组高(P<0.01);高密度脂蛋白胆固醇(HDL-C)较正常对照组低(P<0.01);甘油三酯(TG)和低密度脂蛋白胆固醇(LDL-C)与对照组比较差异无显著性(P>0.05)。经多因素方差分析结果表明,血脂水平紊乱与CHD组有关(P<0.05或0.01),与患者的性别、年龄无关(P>0.05)。图形资料提示,CHD患者青壮年时期已存在血脂紊乱现象。结论血脂中TC、HDL-C、vLDL-C的异常改变与CHD的发病有关系。年少的血脂紊乱可能是CHD发病的重要因素。     

高血压和冠心病患者血脂及载脂蛋白检测结果分析

目的探讨高血压、冠心病(CHD)患者脂代谢的变化规律.方法对本院30例正常人群、53例高血压及67例CHD患者的血脂、载脂蛋白用HITACHI 7060全自动生化分析仪检测并进行对比分析.结果与正常对照组相比较,高血压病患者TC、TG、ApoB100均显著性升高(P＜0.01),LDL、Lp(a)升高显著(P＜0.05);CHD患者TC、TG、LDL、ApoB100、Lp(a)均显著性升高(P＜0.01),ApoA1、HDL呈显著性降低(P＜0.05).高血压病组与CHD组相比较,CHD患者TG、Lp(a)升高及HDL降低在两组间的差异有显著性(P＜0.05),而ApoA1显著性降低(P＜0.01).结论通过监测血脂、载脂蛋白水平,对于高血压病、CDH的早期诊治或预防具有重要的临床价值.     

糖化血红蛋白与血脂血糖及肾功能各项生化指标联合检测的临床价值

目的 探讨糖尿病及非糖尿病心血管疾病患者实施糖化血红蛋白与血脂血糖及肾功能各项生化指标联合检测的临床运用价值.方法 取90例糖尿病患者(糖尿病组)、90例非糖尿病心血管疾病患者(非糖尿病组)及90例健康体检者(参照组)进行研究,对所有的人员均进行糖化血红蛋白(HbA1c)、血脂(三酰甘油TG、胆固醇TC、低密度脂蛋白胆固醇LDL-C)、空腹血糖(FPG)及肾功能各项生化指标(肌酐Cr、尿素Urea)检测,统计分析不同人员的检测结果.结果 糖尿病微血管未病变组患者HbA1c、TG、TC、LDL-C、FPG、Cr、Urea检测水平与参照组人员相比明显较高,糖尿病组微血管病变患者HbA1c、TG、TC、LDL-C、FPG、Cr、Urea检测水平与未病变患者相比明显较高,差异有计学意义(P<0.05).90例非糖尿病组患者中HbAlc水平≥6.0%患者52例,HbAlc水平<6.0%患者共38例.非糖尿病组HbAlc水平≥6.0%患者TG、TC、LDL-C、FPG、Cr、Urea水平与HbAlc水平<6.0%患者相比明显较高,差异有统计学意义(P<0.05).结论 糖尿病及非糖尿病心血管疾病患者实施糖化血红蛋白与血脂血糖及肾功能各项生化指标联合检测的运用价值显著.     

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.