化学修饰低密度脂蛋白与颈动脉粥样硬化相关性的研究

目的观察各类型化学修饰低密度脂蛋白(LDL)与颈动脉粥样硬化(AS)的关系。方法使用复式超声确诊颈AS病人78例,其中伴有糖尿病者30例,不伴糖尿病者48例。氧化修饰低密度脂蛋白(Ox-LDL)测定采用化学法。糖化修饰低密度脂蛋白(Gly-LDL)测定采用微柱亲和层析法。糖氧化修饰低密度脂蛋白(Gly-ox-LDL)测定采用微柱亲和层析加荧光分光光度法。结果血浆Ox-LDL、Gly-LDL和Gly-ox-LDL含量在伴有糖尿病组分别为(1.49±0.48)nmol/ml、(8.66±2.42)%和(0.118±0.083)nmol/ml;在不伴糖尿病组分别为(1.43±0.45)nmol/ml、(6.38±3.03)%和(0.088±0.034)nmol/ml。两病例亚组各修饰型LDL含量与对照组间差异有显著性意义(P均<0.05)。伴有糖尿病组Gly-LDL和Gly-ox-LDL含量与不伴糖尿病组间差异均有显著性意义(P<0.05)。结论化学修饰LDL在颈AS形成中起重要作用,其中Ox-LDL起的作用最重要。     

冠心病患者血清TBIL与OX-LDL水平的变化与相关性研究

目的探讨冠心病(CHD)血清总胆红素(TBIL)与氧化修饰低密度脂蛋白(OX-LDL)水平的变化及其相互之间的关系。方法采用日立7600-20型全自动生化分析仪氧化酶法检测血清TBIL含量。用酶联免疫吸附试验双抗体夹心法检测OX-LDL水平。结果冠心病组血清TBIL明显低于健康对照组[(8.85±2.97)μmol/Lvs(15.51±3.92)μmol/L,P<0.01],而血浆OX-LDL明显高于健康对照组[(85.63±32.45)mmol/Lvs(29.21±11.36)mmol/L,P<0.01]。冠心病患者血清TBIL与血浆OX-LDL的变化呈显著负相关(r=-0.61,P<0.01),而健康对照组中两者间的相关性则不明显(r=-0.15,P>0.05)。结论冠心病时血清TBIL显著降低而OX-LDL显著升高。冠心病患者血清TBIL抗LDL氧化能力的减弱可能是导致OX-LDL升高的重要原因之一。     

紫外分光光度法测定血浆中过氧化脂质含量及其临床意义的探讨

本文介绍一种测定血浆中过氧化脂质含量的紫外吸收法。共测定了103例正常人和31例冠心病患者血浆中脂酰过氧化物(Acyl hydroperoxide,简称AHP)的含量,同时与血浆总脂质(TL)和血浆总胆固醇(TC)含量进行比较。结果发现冠心病患者血浆AHP水平(2.52±0.68)显著高于同年龄组正常人(1.51±0.31)(P<0.01);而且AHP水平的增高比TL和TC增高更为明显。临床上测定AHP水平可作为冠心病辅助诊断和判断其防治效果的一个重要生化指标。     

家族性高胆固醇血症的调脂治疗

家族性高胆固醇血症(FH)是一种由于低密度脂蛋白受体基因突变所致的常染色体现行遗传性疾病,其特征为患者血浆中低密度脂蛋白胆固醇(LDL-C)水平明显升高,伴有肌腱黄色瘤和早发冠心病。FH患者因肝脏表面特异性的LDL受体数目减少或缺乏,导致肝脏对血循环中LDL-C的     

肝硬化患者血浆抗坏血酸和维生素E的测定

目的 :探讨肝硬化患者血浆抗坏血酸和维生素 E的水平及其意义。方法 :测定 6 3例肝硬化患者和 6 3例年龄及性别配对的正常人血浆抗坏血酸 ,维生素 E和过氧化脂质的含量。结果 :肝硬化组血浆抗坏血酸含量为( 42 .94± 6 .99)μm ol/ L ,明显低于对照组 ( 53.30± 9.4 5)μm ol/ L ( t=9.50 ,P =0 .0 0 0 ) ;肝硬化组血浆维生素 E含量为 ( 17.99± 3.51) μm ol/ L,明显低于对照组 ( 2 4 .59± 7.2 2 ) μm ol/ L( t=7.94 ,P=0 .0 0 0 ) ;肝硬化组血浆过氧化脂质含量为 ( 14 .0 9± 1.2 8) μm ol/ L,明显高于对照组 ( 12 .11± 1.2 0 ) μmol/ L( t=17.2 1,P=0 .0 0 0 )。而且肝硬化患者的三个指标之间均有良好的相关性 ( P=0 .0 0 0 )。结论 :肝硬化患者血浆抗坏血酸和维生素 E水平显著下降 ,体内氧化和抗氧化系统失衡。     

LDL氧化易感性与体内氧化LDL水平相关性分析

目的 :探讨体内氧化低密度脂蛋白 (Ox LDL)水平与LDL亚组分氧化易感性之间的关系。　方法 :采用序列超速离心分离 2 2例冠心病 (CHD)患者及 2 0例对照组血浆LDL ,体外Cu2 + 介导的LDL氧化分析其氧化易感性的变化 ;ELISA法检测体内Ox LDL水平。　结果 :CHD患者LDL氧化的延滞时间及总氧化值显著升高 ,氧化速率无变化 ;致密LDL氧化的延滞时间及总氧化值亦不同于轻的LDL。CHD患者Ox LDL水平显著升高 (5 39.1± 15 5 .6vs(318.0± 15 9.6 ) μg/L(P <0 .0 1)。Ox LDL水平同致密LDL氧化的延滞时间呈负相关 (r =- 0 .4 8,P <0 .0 5 ) ,同轻的LDL氧化的延滞时间不相关。Ox LDL水平同致密LDL的蛋白质浓度有相关趋势 (r=- 0 .4 2 ,P =0 .0 5 3)。　结论 :高浓度的小而密的B型LDL ,因易于氧化导致体内Ox LDL水平升高 ,促进了动脉粥样硬化 (As)的发生、发展     

糖尿病患者低密度脂蛋白亚组分颗粒大小及氧化易感性的分析

目的研究糖尿病(DM)患者低密度脂蛋白(LDL)亚组分颗粒直径及氧化易感性的异常特征,探讨其动脉粥样硬化(AS)高发生率的机制。方法超速离心分离30例DM患者及26例对照组的血浆LDL,采用2%～16%聚丙烯酰胺凝胶梯度电泳法分析LDL颗粒直径及图形,并分析其抗氧化能力。结果①DM患者LDL颗粒直径为(26.31±0.72)nm同对照组(26.41±0.95)nm之间无差异,两组间A型、B型LDL图形亦相同。②LDL颗粒直径同血浆TG水平呈负相关(r=-0.32,P<0.05)。③DM患者LDL抗氧化能力下降。结论DM患者AS的高发生率与其LDL易于氧化的特性相关联。     

缺血性脑血管病病人血浆氧化修饰低密度脂蛋白的检测

①目的　探讨氧化修饰低密度脂蛋白 (OX LDL)与缺血性脑血管病的关系。②方法　应用酶联免疫吸附试验测定了 10 6例缺血性脑血管病病人血浆OX LDL含量。③结果　短暂性脑缺血发作 (TIA)组和脑梗死组血浆OX LDL水平均高于对照组 (F =14.6 7,q =5 .339.85 ,P <0 .0 1) ,且脑梗死急性期较恢复期明显升高(q =4.0 7,P <0 .0 5 )。④结论　血浆OX LDL水平增高可能与缺血性脑血管病的发生发展有密切关系。     

吲哒帕胺、洛丁新对高血压患者血浆氧化修饰低密度脂蛋白的影响

目的 :探讨吲哒帕胺、洛丁新对高血压患者血浆氧化修饰低密度脂蛋白 (OX LDL)水平的影响。方法 :采取随机原则将 98例高血压患者分为吲哒帕胺与洛丁新 2组进行为期 8周的观察治疗 ,治疗期间监测血压、OX LDL、血清总胆固醇 (TC)、甘油三酯 (TG)、低密度脂蛋白 (LDL)、高密度脂蛋白 (HDL)等指标。结果 :两种药物均可使血浆OX LDL水平明显降低 (P <0 .0 1) ,而对TC、TG、LDL水平无明显影响 (P >0 .0 5 ) ,洛丁新治疗后可使LDH水平升高 (P <0 .0 5 )。结论 :吲哒帕胺、洛丁新在降低血压的同时 ,可使OX LDL水平明显降低 ,均具有抑制LDL氧化的作用。     

糖尿病患者血清超敏C反应蛋白和低密度脂蛋白含量变化研究

目的:研究血清超敏C反应蛋白(hs -CRP)和血清低密度脂蛋白胆固醇(LDL -C)对糖尿病并发动脉粥样硬化的预示作用。方法:用胶乳增强免疫比浊法检测血清hs-CRP ,一步法检测LDL -C。结果:糖尿病患者LDL -C正常组血清hs-CRP浓度为(1 0.63±6.2 1 )mg/L ,LDL -C为(2.74±0.31 )mmol/L ;LDL -C升高组hs-CRP为(1 7.39±1 2. 31 )mg/L ,LDL -C为(3.91±0.58)mmol/L。正常对照组血清hs-CRP为(2.83±1 .35)mg/L ,LDL -C为(2.57±0.30 )mmol/L。LDL -C正常组和LDL -C升高组hs-CRP明显高于正常对照组(P <0.0 1 )。hs-CRP在LDL -C正常组和LDL -C升高组之间也存在明显差异(P <0.0 1 )。糖尿病组hs-CRP浓度与LDL -C浓度呈正相关(r =0.46 ,P <0.0 1 )。结论:hs-CRP参与糖尿病并发动脉粥样硬化过程,对其发病机制有一定的预示作用     

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.     

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.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.