2型糖尿病合并脑梗塞与脂蛋白（a）的关系

目的 :探讨血清脂蛋白 (a) [Lp(a) ]水平与 2型糖尿病合并脑梗塞关系。方法 :测定 5 4例 2型糖尿病合并脑梗塞患者血清Lp(a)及总胆固醇 (TC)、甘油三脂 (TG)、高密度脂蛋白胆固醇 (HDL C)水平 ,计算低密度脂蛋白胆固醇(LDL C)水平 ,并与 5 2例正常对照者及 48例单纯糖尿病病人作比较。结果 :2型糖尿病合并脑梗塞组血清Lp(a)明显高于正常对照组 [(0 3 3± 0 2 1) g/Lvs (0 .19± 0 .11)g/L ,P <0 .0 1]及单纯糖尿病组 [(0 .3 3± 0 .2 1) g/Lvs (0 .2 2± 0 .13 )g/L ,P <0 .0 1]。 2型糖尿病合并脑梗塞患者血清Lp(a)水平与LDL C呈正相关关系 (r =0 .2 98,P <0 0 5 )。结论 :2型糖尿病患者Lp(a)水平增高可能与脑梗塞发病有密切关系。     

普法他汀对高脂血症患者载脂蛋白E的影响

目的 :探讨普法他汀对高脂血症患者血清总载脂蛋白E(apoE)水平的影响。方法 :40例高脂血症患者每晚顿服普法他汀 2 0mg 4周 ,比较服药前后血清甘油三酯 (TG)、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)、apoA、apoB、apoE及脂蛋白 (a) [Lp(a) ]水平的变化。结果 :用药后血清TC及TG分别下降 2 0 .3%及 8.7% (P <0 .0 0 1,<0 .0 5 ) ,LDL C下降 2 3.1% (P <0 .0 1) ,apoB及apoE分别下降 12 .9%及 32 .5 % (P<0 .0 5 ,<0 .0 0 1) ,apoA1增加 7 3% (P <0 .0 5 )。apoE下降幅值分别与其自身基础和TG及LDL C基础值呈正相关(P <0 .0 1,<0 .0 1,<0 .0 5 )。HDL C呈增高趋势 ,Lp(a)改变无统计学差异。结论 :普法他汀能导致血清apoE水平显著下降其可能参与了抗动脉粥样硬化过程。     

氟伐他汀对高脂血症患者载脂蛋白E的影响

目的 :探讨氟伐他汀对高脂血症患者血清总载脂蛋白E(ApoE)水平的影响。方法 :4 0例高脂血症患者每晚顿服氟伐他汀 2 0mg 4周 ,比较服药前后血清甘油三酯 (TG)、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)ApoA1 、ApoB、ApoE及脂蛋白 (a) [Lp(a) ]水平的变化。结果 :用药后血清TC和TG分别下降 2 0 3%和 8 7% (P <0 0 0 1,P <0 0 5 ) ,LDL C下降 2 3 1% (P <0 0 1) ,ApoB和ApoE下降 12 9%和 32 5 % (P <0 0 5 ,<0 0 0 1) ,ApoA1 增加 7 3% (P <0 0 5 )。ApoE下降峰值分别与其自身基础和TG及LDL C基础值呈正相关 (P <0 0 1,<0 0 1,<0 0 5 )。HDL C呈增高趋势 ,Lp(a)改变无统计学差异。结论 :氟伐他汀能导致血清ApoE水平显著下降其可能参与了抗动脉粥样硬化过程     

红细胞膜脂蛋白(a)含量检测及相关因素研究

目的 :对 2 3例老年冠心病 (CHD)红细胞膜 (RBCm)脂蛋白 (a)〔Lp(a)〕及胆固醇 (TC)含量进行测定 ,并与正常对照组进行比较。方法 :RBCm制备采用Dodge法 ,膜蛋白测定采用酚试剂法 ,Lp(a)测定用ELISA法、TC测定用胆固醇酶法。结果 :CHD组RBCmLp(a)及血浆Lp(a)含量明显高于对照组 (P <0 0 5 ,P <0 0 1) ,CHD组RBCm及血浆TC与对照组无显著性差异 (P >0 0 5 )。相关分析显示 :膜上Lp(a)含量与血浆Lp(a)含量呈明显正相关 (r =0 5 6 3,P <0 0 5 ) ,与血浆TC相关性不显著 (r =0 12 6 ,P >0 0 5 )。结论 :高Lp(a)是CHD的独立危险因素 ,脂质代谢紊乱与CHD有密切关系。     

促红细胞生成素对血液透析患者脂质代谢的影响

目的　探讨促红细胞生成素 (EPO)在血液透析患者治疗过程中对脂质代谢的影响。方法　 76例维持性血透患者随机分为两组 ,3 6例接受EPO治疗 ,另外 40例为对照组 ,都进行常规透析 ,治疗 6个月后 ,观察两组患者血红蛋白、血清铁及血脂变化。结果　EPO治疗组Hb ,Hct明显上升 (P <0 0 5 ) ,血清铁、TC、TG、LDL、LP(a)明显下降 (P <0 0 5 )。Hct与血清铁、LP(a)呈负相关关系 (相关系数分别为r =-0 42 ,r =-0 3 6,P <0 0 5 ) ,血清铁与LDL、LP(a)呈正相关关系 (相关系数分别为r=0 40 ,r=0 3 5 ,P <0 0 5 )。两组透析前比较差异无显著性 ,透析后治疗组Hb、Hct上升 ,血清铁、TC、TG、LDL和LP(a)下降 ,差异有显著性 (P <0 0 5 )。结论　EPO治疗能有效改善维持性血透患者的脂质代谢紊乱 ,减少动脉硬化、心脑血管疾病发生的危险性     

冠心病患者OX-LDL、Lp(a)及脂质、载脂蛋白的临床分析

目的　观察冠心病 (CHD)患者血浆氧化修饰低密度脂蛋白 (OX LDL)、脂蛋白 (a)〔Lp(a)〕的水平在动脉粥样硬化(AS)的发生发展中所起的作用。方法　采用酶联免疫吸附实验 (ELISA)及双抗体夹心法测定血浆OX LDL和Lp(a)的水平。结果　CHD患者血浆OX LDL、Lp(a)的水平明显高于对照组 (P <0 .0 1) ,且水平的高低与CHD的严重程度呈正相关。结论　OX LDL、Lp(a)与AS的发生发展有密切联系 ,是血脂诊断中特异性强、灵敏度高的检测指标 ,动态检测其变化对CHD的辅助诊断具有一定的价值 ,同时也为CHD患者的抗氧化治疗提供了依据     

混合型高脂血症患者血小板活性和纤溶活性的变化

目的 :探讨高脂血症患者血小板活化标志物 GMP- 14 0及纤溶活性的改变。方法 :选择 30例混合型高脂血症患者和 2 0例正常对照组 ,测定血浆α-颗粒膜蛋白 14 0 (GMP- 14 0 )含量及血浆组织型酶原激活物 (t- PA)、t- PA抑制物 (PAI)活性。结果 :高脂血症组较正常对照组血浆 TC、TG、L DL - C明显增高 (P均 <0 .0 1) ,HDL - C下降 (P<0 .0 1)。GMP- 14 0含量、PAI活性明显升高 (P均 <0 .0 1) ,t- PA活性降低 (P<0 .0 1)。PAI- 1活性与 TG呈正相关 (r=0 .4 6 ,P<0 .0 5 )。结论 :高脂血症患者血小板活性明显增加 ,GMP- 14 0水平升高 ;纤溶活性明显降低。     

Lp(a)的颗粒浓度在评估心血管风险中的应用价值

目的:探究脂蛋白a[Lipoproteins-a,Lp(a)]的颗粒浓度在评估心血管风险中的应用价值。方法:对本院2018年1-6月确诊的心血管疾病患者65例(心血管疾病组)及健康体检者65例(健康对照组)进行回顾性分析,比较两组患者血清Lp(a)、总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)、高密度脂蛋白(high density lipoprotein,HDL)及低密度脂蛋白(low density lipoprotein,LDL)等指标水平,应用受试者工作曲线(receiver operating characteristic curves,ROC)比较不同指标水平在预测/早期诊断心血管疾病中的效能。结果:心血管疾病组患者的血清Lp(a)、TC、TG、LDL均明显高于健康对照组(t=13.665、7.354、6.085、7.454,P=0.000、0.000、0.000、0.000),HDL显著低于健康对照组(t=5.705,P=0.000),两组患者Lp(a)的质量浓度比较,差异无统计学意义(P0.05)。ROC曲线显示,Lp(a)诊断心血管疾病的AUC最高(AUC=0.915,P=0.000),其次为TC、LDL、HDL和TG(AUC=0.830、0.812、0.796、0.787,P=0.000、0.000、0.000、0.000),Lp(a)的AUC高于TC、LDL、HDL和TG(Z=2.005、2.144、2.581、2.507,P=0.045、0.032、0.010、0.012),其最佳截点为Lp(a)132.108 mmol/L。以不同最佳截点鉴诊断心血管疾病的诊断效能,结果显示,Lp(a)的准确率高于TG、HDL和LDL(χ~2=4.389、4.389、5.008,P0.05),敏感性高于TC、TG和LDL(χ~2=11.437、17.727、5.876,P0.05),特异性高于HDL(χ~2=4.311,P0.05),阳性预测值比较差异无统计学意义(P0.05),阴性预测值高于TC、TG和LDL(χ~2=8.220、11.166、5.681,P0.05)。结论:Lp(a)的颗粒浓度在评估心血管风险中具有更好的诊断价值,其中,Lp(a)132.108 mmol/L下的诊断准确率、敏感性及特异性均较高。     

冠心病患者血浆同型半胱氨酸水平的变化及其与血脂的关系

目的　探讨血浆同型半胱氨酸 (HCY)水平变化对冠心病 (CHD)患病的意义以及HCY与血脂的相关性。方法　分别测定 10 5例CHD患者和 32例正常对照组血浆HCY及血脂各参数水平 ,并进行比较及相关性分析。结果　CHD组的HCY、甘油三酯 (TG)、总胆固醇 (TC)水平均明显高于对照组 (P <0 .0 1) ;TC、高密度脂蛋白胆固醇 (HDL -C)、低密度脂蛋白胆固醇 (LDL -C)对HCY均无明显影响 ,而CHD组HCY水平与TG呈正相关(r=0 .0 2 1,P <0 .0 5 )。结论　HCY与CHD具有密切联系 ,HHCY是CHD患病的一个新的危险因素 ,检测血浆HCY对预防和诊治CHD具有一定临床价值。HCY与TG具有一定相关性     

CAPD患者血脂异常与残余肾功能的相关研究

目的 观察连续性不卧床腹膜透析(CAPD)患者血脂异常对残余肾功能(RRF)的影响.方法 根据血脂将72例CAPD患者分为胆固醇(TC)增高组、甘油三酯(TG)增高组及二者均增高组与TC、TG正常组,观察残余肾功能以及CAPD治疗18个月内血脂变化.结果 ①CAPD治疗初期残余肾功能无明显变化(P＞0.05).第12月时,TC增高组RRF较同组透析初月时下降(P＜0.05).TG增高组及TC、TG均增高组的RRF分别与初月时同组RRF比较显著下降(P＜0.001).第18月时3个血脂增高组RRF与TC、TG组比较均有下降(P＜0.05).RRF下降数值与TC(r=0.234,P＜0.05)、TG(r=0.528,P＜0.05)均呈正相关;②低密度脂蛋白(LDL)显著上升,第18个月与初月比较有明显差异(P＜0.05).脂蛋白a[Lp(a)]显著上升,第6月与初月比较有明显差异(P＜0.05),第12、18月分别与初月相比,均继续升高(P＜0.01),并且第18月与第6月相比有明显差异(P＜0.05).结论 ①CAPD患者的RRF随着透析时间的延长而降低.高脂血症与RRF改变值呈正相关,高脂血症对RRF降低有影响;②CAPD患者随着治疗时间的延长出现血脂异常.     

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.