血清总胆汁酸、丙氨酸氨基转移酶和血清天门冬氨酸氨基转移酶在肝硬化疾病中的应用

目的:探讨肝硬化患者血清总胆汁酸(TBA),血清丙氨酸氨基转移酶(ALT)和血清天门冬氨酸氨基转移酶(AST)的变化和临床意义。方法:用全自动生化分析仪测定67例肝硬化患者(代偿期30例,失代偿期37例)的血清TBA,AST和ALT的活性。同时设立正常对照组,TBA测定采用酶比色法,AST和ALT测定采用速率法。结果:肝硬化失代偿期患者血清TBA,AST和ALT分别为(109.8±80.6)μmol/L,(215.5±106.9)U/L,(196.8±103.7)U/L。肝硬化代偿病期人血清TBA,AST和ALT分别为(37.6±23.9)μmol/L,(43.7±23.9)U/L,(50.9±26.6)U/L,正常对照组TBA,AST和ALT分别为(11.9±7.3)μmol/L,(19.3±10.9)U/L,(23.3±11.6)U/L。肝硬化失代偿期组TBA,AST和ALT明显比正常对照组高(P<0.01),肝硬化代偿期组TBA明显高于对照组(P<0.01)。结论:在肝硬化患者的诊断中,TBA灵敏性高于AST和ALT,肝硬化失代偿期患者血清AST高于ALT,可能因为肝硬化失代偿期患者肝脏损伤重。     

胃癌患者血清维生素A、视黄醇结合蛋白测定的临床意义

目的探讨胃癌患者血清维生素A和视黄醇结合蛋白(RBP)测定的临床意义。方法对26例胃癌患者和28例健康体检者(对照组)采用荧光分析法测定血清维生素A水平,微量快速免疫比浊法测定血清RBP水平。然后对两组测定结果进行比较和分析。结果胃癌组血清维生素A水平为(1.103±0.311)μML、RBP为(1.717±0.538)μML;对照组血清维生素A为(1.406±0.292)μML、RBP为(1.634±0.546)μML。胃癌组血清维生素A水平较对照组明显降低(P<0.01),而RBP水平与对照组的差异无统计学意义(P>0.05)。结论血清维生素A缺乏与胃癌的发生有一定关系。联合测定血清维生素A和RBP水平有利于评价体内维生素A水平的真实状况。     

佝偻病患儿血清锌含量测定分析

对西安市及咸阳市8个托儿所中确诊为佝倭病的130例不同病期患儿作血清锌测定,并与同龄健康儿进行比较,结果表明,佝偻病组血清锌(9.71±1.82μmol/L)非常显著地低于健康组(11.06±1.73μmol/L),P<0.01,佝偻病活动期血清锌含量(6.10±1.73μmol/L)明显低于恢复期(10.97±1.36μmol/L)和后遗症期(11.38±1.42μmol/L),P<0.01;血清锌含量越低,佝偻病的发病率越高。     

冠心病患者血清铜锌含量测定的临床意义

应用火焰原子吸收分光光度法对98例冠心病患者及41例健康人血清中铜、锌的含量进行了测定,其中冠心病高胆固醇患者51例;冠心病高甘油三酯患者44例,结果冠心病高胆固醇组血清铜含量为13.10±1.93μmol/L;血清锌含量为19.66±4.07μmol/L;铜锌比值为0.68±0.14。冠心病高甘油三酯组血清铜含量为12.83±2.67μmol/L;血清锌含量为18.22±5.29μmol/L;铜锌比值为0.73±0.15。与对照组相比,冠心病两组血清铜、铜锌比值显著降低(P<0.01);血清锌含量明显升高(P<0.01),提示血清铜、锌含量,尤其是铜锌比值测定是诊断冠心病的一项客观指标,同时也是冠心病易患因素之一。     

冠心病患者血清锌、铜含量的测定及其临床意义

应用火焰原子吸收分光光度法对53例冠心病患者及50例健康人血清中锌、铜的含量进行了测定。结果冠心病组血清铜含量X=15.99±2.64μmol/L;血清锌含量X=19.62±3.78μmol/L。铜/锌比值X=0.83±0.22。与健康人对照组相比,血清铜、铜/锌比值明显降低,血清锌含量显著升高(P均<0.001)。提示血清锌、铜含量测定是诊断冠心病的一项指标。     

鼻咽癌患者放疗前后血清一氧化氮浓度变化的研究

目的 :研究一氧化氮 (NO)在鼻咽癌血清中的浓度及其临床意义。方法 :用硝酸还原酶法测定健康人和鼻咽癌患者的血清NO3-和NO2-之和以反映体内一氧化氮水平。检测了不同临床分期的鼻咽癌患者4 0例 (原发于鼻咽顶壁区 18例 ,鼻咽侧壁区 2 2例。T119例 ,T2 11例 ,T3 7例 ,T43例 ;N0 2 7例 ,N19例 ,N2 4例 ;M0 34例 ,M16例 )放疗前后及 30例健康体检者血清一氧化氮含量。结果 :鼻咽癌患者血清一氧化氮含量显著高于健康人 ,前者为 111.16± 39.4 1μmol L ,后者仅为 6 8.6 4± 17.36 μmol L (P <0 .0 0 1) ,鼻咽癌患者放疗结束后 2周的血清一氧化氮含量为 87.81± 30 .5 4μmol L ,比放疗前明显降低 (P <0 .0 0 1) ,淋巴结转移组为 10 5 .31± 2 5 .18μmol L ,显著低于无淋巴结转移组的 12 1.74± 2 9.4 5 μmol L(P <0 .0 5 ) ,3年内死亡组为97.72± 2 9.4 5 μmol L ,显著低于存活组的 10 5 .31± 2 5 .18μmol L(P <0 .0 5 )。 结论 :鼻咽癌患者血清一氧化氮含量显著高于健康人 ,它可能在分子水平参与了鼻咽癌的发生、发展。     

胃蛋白酶原联合同型半胱氨酸检测对胃组织良恶性病变的诊断价值

目的 探讨胃蛋白酶原(PG)联合同型半胱氨酸(Hcy)检测对胃组织良恶性病变的诊断价值.方法 收集2014年1月至2016年8月我院收治的100例胃癌患者为胃癌组,100例胃良性病变患者(41例胃炎、25例胃息肉、34例胃溃疡)为胃良性病变组,选取同期我院健康体检者200例为对照组.采用酶联免疫吸附法(ELISA)测定三组受检者的血清PG(PGⅠ、PGⅡ)水平并计算胃蛋白酶原率(PGR),循环酶法测定三组受检者的血清Hcy水平,并计算血清PG联合Hcy对胃良性病变及胃癌的诊断价值.结果 胃癌组、胃良性病变组血清PGⅠ水平分别为(59.37±14.16)μg/L、(93.85±14.23)μg/L,PGR分别为(3.27±1.52)、(7.65±2.04),均低于对照组的(149.92±13.34)μg/L、(11.40±1.95),差异均有统计学意义(P<0.05);胃癌组、胃良性病变组血清PGⅡ水平分别为(20.18±4.59)μg/L、(16.06±5.87)μg/L,Hcy水平分别为(26.37±3.85)μmol/L、(12.16±3.91)μmol/L,均高于对照组的(10.71±5.15)μg/L、(9.83±3.24)μmol/L,差异均有统计学意义(P<0.05);胃癌组血清PGⅠ水平、PGR低于胃良性病变组,血清PGⅡ、Hcy水平高于胃良性病变组,差异均有统计学意义(P<0.05).在TNM分期Ⅰ、Ⅱ、Ⅲ、Ⅳ时,血清Hcy水平分别为(19.64±4.98)μmol/L、(22.00±5.14)μmol/L、(24.38±5.97)μmol/L、(27.07±4.52)μmol/L,呈递增趋势,整体比较差异有统计学意义(P<0.05),PG I水平分别为(67.63±15.91)μg/L、(55.39±15.18)μg/L、(46.18±14.97)μg/L、(39.72±15.50)μg/L,PGⅡ水平分别为(18.02±3.97)μg/L、(17.25±4.25)μg/L、(16.34±4.50)μg/L、(15.38±4.12)μg/L,PGR分别为(3.87±2.28)、(3.38±2.56)、(2.76±3.31)、(2.02±3.54),均呈递减趋势,整体比较差异均有统计学意义(P<0.05).PGⅠ+PGR+Hcy对胃癌诊断的灵敏度、特异性、阳性预测值、阴性预测值及准确率分别为89.00%、95.00%、94.68%、89.62%、92.00%,均高于PG I+PGR的76.00%、83.00%、81.72%、77.57%、79.50%以及Hcy的71.00%、86.00%、83.53%、74.78%、78.50%,差异均有统计学意义(P<0.05).结论 血清PG、Hcy可有效评估胃黏膜的疾病状态,两指标联合有助于早期鉴别诊断胃良性病变和胃癌,提高对胃癌的诊断价值.     

前列腺素E1对肝硬化患者IL-6, IL-8及ALT的影响

目的研究前列腺素E1（PGE1）对肝硬化患者血清IL-6, IL-8和血清总胆红素（SB）及ALT的影响. 方法应用放射免疫法测定了30例肝硬化患者应用PGE1前后血清IL-6, IL-8, SB和ALT的变化，并与30例应用常规保肝治疗的肝硬化患者对比，同时测定了20名正常人的血清IL-6和IL-8含量. 结果肝硬化组和正常对照组的IL-6含量分别为（436±106）ng*L-1和（255±83）ng*L-1(P<0.01), IL-8含量分别为（429±62）ng*L-1和（277±71）ng*L-1 (P<0.01). 应用PGE1治疗后,IL-6下降为（345±48）ng*L-1(P<0.01)，IL-8下降为（325±50）ng*L-1 (P<0.01)，SB由（32±9）μmol*L-1降为（19±7）μmol*L-1 (P<0.01), ALT由（115±51）U*L-1降为（75±29）U*L-1 (P<0.01), 对照治疗组的IL-6, IL-8, SB及ALT亦显著降低(P<0.05). 结论 PGE1能显著降低肝硬化患者血中IL-6, IL-8, SB及ALT含量，疗效优于常规治疗组，可用于肝硬化患者的治疗.     

老年2型糖尿病患者颈动脉斑块与同型半胱氨酸的关系

目的:探讨老年2型糖尿病患者颈动脉斑块与同型半胱氨酸的关系。方法:将67例老年2型糖尿病患者按照血同型半胱氨酸水平的不同,分为两组:A组37例(血Hcy≤10.5μmol/L,男29例,女8例),B组30例(血Hcy>10.5μmol/L,男23例,女7例),分别测定颈动脉粥样硬化斑块程度。结果:A组Hcy水平(7.29±1.84)μmol/L显著低于B组(14.74±8.40)μmol/L,A组颈动脉粥样硬化斑块分级程度(2.38±1.06)显著低于B组2.93±1.01),差异有统计学意义(P<0.05)。结论:老年2型糖尿病患者动脉粥样硬化发展与高血同型半胱氨酸血症关系密切。     

血清CysC联合RBP检测在诊断早期肾损伤中的应用价值

目的:探讨联合检测血清胱抑素C(CystatinC,CysC)和视黄醇结合蛋白(Retinol-Binding Protein,RBP)在早期诊断肾损伤的应用价值。方法:对照组选择50例,为健康体检无肾脏病史且尿蛋白定性为阴性者;试验组选择36例尿蛋白定性为弱阳性,肾穿刺活检确诊为早期肾损伤的患者。采用免疫透射比浊法分别测定血清CysC和RBP的浓度,并测定血清肌酐(Crea)及尿素(Urea)的浓度,并进行相关的统计学分析。结果:CysC的浓度对照组为(1.12±0.23)mg/L,试验组为(1.78±0.46)mg/L;RBP的浓度对照组为(47.19±14.34),试验组为(85.87±21.64);肌酐的浓度对照组为(60.8±16.17)μmol/L,试验组为(72.5±45.7)μmol/L。尿素的浓度对照组为(5.35±1.46)mmol/L,试验组为(6.21±2.39)mmol/L。结论:联合检测血清CysC和RBP对诊断早期肾损伤具有较高的临床应用价值。     

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.