颈动脉粥样硬化患者不同中医证型的血脂水平及血清RLP-C、sICAM-1、sVCAM-1含量差异分析研究

目的 研究颈动脉粥样硬化患者不同中医证型的血脂水平及血清脂蛋白残粒(RLP-C)、 细胞间黏附分子1(sICAM-1)和血管细胞黏附分子1(sVCAM-1)含量差异.方法 筛选2015年1月至2015年12月就诊于航天中心医院的颈动脉粥样硬化的患者90例设为中医组,同时筛选健康体检者90例设为正常组,取患者晨起空腹静脉血进行检测.观察颈动脉粥样硬化患者痰浊阻遏证、脾肾阳虚证、肝肾阴虚证、阴虚阳亢证以及气滞血瘀证情况,比较不同中医证候类型患者与正常组的血脂水平及其血清RLP-C、sICAM-1及sVCAM-1含量.结果 90例颈动脉粥样硬化患者中,54例为痰浊阻遏证,占总患病人数的60.00%,显著高于脾肾阳虚证、肝肾阴虚证、阴虚阳亢证以及气滞血瘀证患者,差异具有统计学意义(P<0.05);不同中医证候类型患者的血清TG、TC和LDL-C水平要高于正常组,而HDL-C含量要低于正常组,差异均具有统计学意义(P<0.05);此外,痰浊阻遏证患者的TG、TC、LDL-C含量高于其他中医证候型患者,而HDL-C含量低于其他中医证候型患者,差异均具有统计学意义(P<0.05);不同中医证候类型患者的血清RLP-C、sICAM-1及sVCAM-1水平要高于正常组,且痰浊阻遏证患者血清RLP-C、sICAM-1及sVCAM-1水平要高于其他中医证候型患者,差异均具有统计学意义(P<0.05).结论 颈动脉粥样硬化患者主要为痰浊阻遏证候,且颈动脉粥样硬化患者与健康体检者的RLP-C及其相关指标差异显著,其中痰浊阻遏证患者最为明显.     

老年前期及老年人血脂代谢紊乱与中医证候的相关性研究

目的探讨老年前期及老年人血脂代谢紊乱与中医证候的相关性,且探讨中医证候与总胆固醇(TC)、甘油三酯(TG)、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A1(ApoA1)、载脂蛋白B(ApoB)之间的关系.方法调查100例高脂血症患者,记录一般情况(性别、年龄、身高、体重),调查中医证候,记录TC、TG、LDL-C、HDL-C、ApoA1、ApoB值.结果100例高脂血证患者中,痰浊阻遏证23例,脾肾阳虚证22例,肝肾阴虚证21例,阴虚阳亢证18例,气滞络瘀证9例,无证候7例;在各组中,痰浊阻遏证组TC、HDL-C最低,且与肝肾阴虚证组、阴虚阳亢证组有显著性差异.结论在各证型构成比中,以痰浊阻遏证组最多,占23%;气滞络瘀证组最少,占9%;痰浊阻遏证组主要表现为TG单项增高;肝肾阴虚证组、脾肾阳虚证组、阴虚阳亢证组、气滞络瘀证组表现为TC、TG双项升高.     

不同中医证候血脂异常患者凝血功能差异研究

目的:本研究观察60例不同中医证型血脂异常患者的凝血酶原时间(PT)、凝血酶原国际标准化比值(INR),比较其凝血功能的差异,评估血栓风险的不同,为中医辨证用药提供一定的临床思路。方法:根据2007年中国成人血脂异常防治指南及根据《中药新药临床研究指导原则(试行)》中的血脂异常证候诊断标准制作诊断量表,收集临床病例,判定中医证型,对符合证候的患者入院后第1天早晨空腹,取外周静脉血,血生化检测,记录血凝结果,采用ANOVA单因素方差分析。结果:凝血酶原时间(PT)的结果比较,阴虚阳亢证脾肾阳虚证肝肾阴虚证痰浊阻遏证气滞血瘀证,凝血酶原国际标准化比值(INR):阴虚阳亢证脾肾阳虚证痰浊阻遏证肝肾阴虚证气滞血瘀证。结论:气滞血瘀、痰浊阻遏患者的血脂异常患者血液处于高凝状态,具有更高的血栓风险,在临床中治疗血脂异常时注意活血化瘀、化痰去浊。     

高脂血症中医辨证分型与过氧化脂质、超氧化物歧化酶的相关性

目的:探讨高脂血症中医辨证分型与过氧化脂质(LPO)、超氧化物歧化酶(SOD)的相关性。方法:对172例高脂血症患者进行中医辨证分型,其中痰浊阻遏型75例,脾肾阳虚型15例,肝肾阴虚型20例,阴虚阳亢型38例,气滞血瘀型24例。检测LPO及SOD,将5种证型的各项指标进行组间对照分析,探讨其相关性。结果:各证型的LPO均高于正常范围,其中以脾肾阳虚型最高,其他依次为肝肾阴虚、气滞血瘀、阴虚阳亢、痰浊阻遏,各证型的SOD均低于正常范围,以肝肾阴虚型最低,其他4型由低到高依次为阴虚阳亢、痰浊阻遏、脾肾阳虚、气滞血瘀。脾肾阳虚型LPO与其他4型比较,经过统计学检验有显著性差异(P<0.05);肝肾阴虚型SOD与其他4型有显著差异(P<0.05),气滞血瘀型与阴虚阳亢、痰浊阻遏、脾肾阳虚有显著差异(P<0.05)。结果表明高脂血症中医辨证分型与LPO、SOD存在一定的相关性。结论:LPO及SOD可以考虑作为中医辨证分型客观化的现代化检测指标。     

2型糖尿病血脂异常的中医证候研究

目的 探讨2型糖尿病血脂代谢紊乱的中医证候分布规律,中医证候与血脂变化之间的相关性.方法 调查60例2型糖尿病血脂代谢紊乱患者,记录一般情况,调查中医证候,记录总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)含量.结果 60例患者中,痰浊阻遏证21例,脾肾阳虚证2例,气阴两虚证17例,阴虚阳亢证8例,气滞血瘀证5例,无证可辨7例.各证型患者TC、LDL-C、TG、HDL-C值无显著性差异,气阴两虚组与痰浊阻遏组间体重指数有显著性差异,HDL-C减低的男女患者人数有显著性差异.结论 在各证型构成比中,以痰浊阻遏证最多(35.0%),脾肾阳虚证最少(3.3%);体重指数在各组间以痰浊阻遏证组最高,气阴两虚证组最低;男性HDL-C减低人数较女性为多.     

丹参通络解毒汤对冠心病不稳定型心绞痛患者黏附分子的影响

目的观察丹参通络解毒汤对瘀热壅毒、毒损心营证不稳定型心绞痛(unstanble angina,UA)患者的血脂以及血清细胞间黏附分子-1(ICAM-1)、血管细胞黏附分子-1(VCAM-1)的影响。方法选择瘀热壅毒、毒损心营型冠心病不稳定型心绞痛患者60例。将60例患者随机分为两组,对照组30例给予常规西药治疗,观察组30例在对照组治疗基础上加服丹参通络解毒汤治疗,观察两组治疗2个月后的中医证候积分、心电图疗效、心绞痛疗效以及治疗前后血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、ICAM-1和VCAM-1的水平变化。结果观察后,观察组中医证候积分心电图疗效,心绞痛疗效均较对照组高,差异有统计学意义(P0.05)。治疗后两组TC、TG、LDL-C、ICAM-1和VCAM-1水平较治疗前降低,HDL-C水平较治疗前增加,且观察组血脂、黏附因子水平改善程度优于对照组,差异有统计学意义(P0.05)。结论丹参通络解毒汤治疗瘀热壅毒,毒损心营型冠心病不稳定型心绞痛疗效确切,其作用机制可能与调节血脂代谢、降低ICAM-1和VCAM-1水平有关。     

骨折延迟愈合血清指标及微循环指标的变化研究

目的探讨骨折延迟愈合患者血清可溶性细胞间黏附分子(s ICAM-1)、血管细胞黏附分子(VCAM-1)、骨形态发生蛋白2(BMP-2)及微循环指标的变化情况。方法 50例骨折延迟愈合(A组),50例骨折正常愈合者(B组),50例健康志愿者(C组),检测3组血清s ICAM-1、VCAM-1、BMP-2水平及红细胞聚集、血液流变学指标。结果 A组血清s ICAM-1、VCAM-1均高于B组及C组,而血清BMP-2则低于B组、C组(P<0.05);A组的红细胞聚集程度低于B组及C组(P<0.05);A组的全血低切黏度、血浆黏度、红细胞电泳指数均高于B组及C组(P均<0.05)。结论骨折延迟愈合患者血清s ICAM-1、VCAM-1水平升高,BMP-2水平降低,并且微循环状态较差,积极干预可避免或者降低高危人群发生骨折延迟愈合的风险。     

急性冠脉综合征患者血清炎性标志物测定

目的:探讨急性冠脉综合征(ACS)患者炎性标志物C-反应蛋白(CRP)、可溶性血管内皮细胞黏附分子-1(VCAM-1)和可溶性细胞间黏附分子-1(ICAM-1)水平的变化.方法:检测48例ACS患者、28例稳定性心绞痛(SA)患者和20例正常人血清CRP、VCAM-1、ICAM-1、肌钙蛋白T(cTnT)、总胆固醇(TC)、纤维蛋白原(Fib)水平,并测定冠脉造影积分.结果:ACS组血清CRP与VCAM-1、ICAM-1水平均高于SA组和对照组(P＜0.01);ACS组中血清CTnT阳性者CRP、ICAM-1、VCAM-l浓度均高于阴性者(P＜0.01);ACS组与SA组冠脉狭窄程度差异无统计学意义(P＞0.05);ACS组冠脉狭窄程度和TC水平呈正相关(r=0.550,P＜0.01),与血清CRP、ICAM-1、VCAM-1水平均无相关性(P＞0.05).结论:血清炎性标志物对ACS患者临床危险分层和判断预后有重要价值.     

红曲复方制剂治疗痰浊血瘀型原发性血脂异常的回顾性分析

目的探讨红曲复方制剂治疗痰浊血瘀型原发性血脂异常的临床疗效,为血脂异常的诊治提供依据。方法回顾性分析2013年12月至2015年12月于北京大学第一医院中医、中西医结合科就诊的140例痰浊血瘀型原发性血脂异常患者的病例资料,根据其血脂异常程度进行分层,统计分析服用中药1个月后中医证候积分及血脂水平变化。结果治疗后中医证候积分较前改善;总胆固醇(TC)边缘升高组以及升高组下降幅度分别为(11.59±12.26)%、(22.44±11.05)%,低密度脂蛋白胆固醇(LDL-C)边缘升高组以及升高组下降幅度分别为(18.78±15.26)%、(27.12±15.73)%;甘油三酯(TG)升高组下降幅度为(22.63±27.91)%;高密度脂蛋白胆固醇(HDL-C)降低组治疗后较前上升。结论红曲复方制剂可改善中医证候,降低TC、LDL-C、TG,升高HDL-C。     

血脂康治疗不同中医证型高脂血症的疗效观察

目的：探讨血脂康治疗不同中医证型高脂血症的疗效。方法：有目的性的选择在我院进行治疗的150例高脂血症患者,根据中医原理分为5组,对患者进行血脂康治疗,观察患者在治疗前后阶段中医证候积分和血脂指标的改变情况。结果：气滞血淤、痰浊阻遏、阴虚阳亢3组的中医证候积分降低明显（ P＜0．01,P＜0．05）,其余两组差异不大（P＞0．05）。痰浊阻遏组的总胆固醇/高密度脂蛋白比例明显低于治疗前的比例（P＜0．01）,相比4组也具有更显著的效果（P＜0．05）;肝肾阴虚、阴虚阳亢、气滞血淤3组和治疗前相比,比值明显下降（P＜0．05）;但是治疗前、后观察到脾肾阳虚组的比值无明显变化（P＞0．05）。结论：血脂康降低高脂有显著疗效,这一点不能否认。但是存在证型治疗效果差异问题,其中脾肾阳虚型疗效不明显,痰浊阻遏型疗效最佳。     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

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.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

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.     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.