2型糖尿病患者血脂、脂蛋白及载脂蛋白水平的变化分析

目的 探讨血脂、脂蛋白及载脂蛋白在2型糖尿病患者中的变化及意义.方法 检测124例2型糖尿病患者和60例健康对照者血清中胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇酯(HDL-C)、低密度脂蛋白胆固醇酯(LDL-C)、载脂蛋白A,(ApoA1)、载脂蛋白B(ApoB)和脂蛋白a[LP(a)]的水平变化.结果 糖尿病组的TC、TG、LDL-C和Lp(a)水平明显高于对照组,而HDL-C和ApoA1/ApoB水平明显低于对照组,差异有显著性.有血管病变组的TC、TG、LDL-C和Lp(a)水平明显高于无血管病变组,而HDL-C和ApoA1/ApoB水平明显低于无血管病变组,两组比较差异有显著性.结论 糖尿病患者体内存在着血脂、脂蛋白及载脂蛋白水平的变化,并在糖尿病发生血管病变中发挥着重要作用.     

536例精神病人的血脂水平分析

目的 :对精神病人的血脂进行测定和分析 ,了解其血脂与健康人是否存在差异。方法 :对 5 36例精神病病例样本、2 2 4例正常对照 ,测定总胆固醇 (TC)、甘油三脂 (TG)、高密度脂蛋白胆固醇 (HDL -C)、低密度脂蛋白胆固醇 (LDL-C)、载脂蛋白A1(ApoA1)及载脂蛋白B(ApoB)等六项血脂指标 ,并将病例样本根据病种分为四组进行比较研究。它们是精神分裂症 4 18例、抑郁症 30例、酒精所致精神障碍 2 6例 ,其它精神病 6 2例。结果 :5 36例病例样本与 2 2 4例正常对照比较 ,TC、HDL -C、LDL -C及ApoA1无显著性差异 (P >0 .0 5 ) ,而TG及ApoB有显著性差异 (P <0 .0 5 ) ,其中TG升高、ApoB降低。与正常对照比较 ,精神分裂症组的TC、HDL -C、LDL -C及ApoA1无显著性差异 (P >0 .0 5 ) ,TG及ApoB显著升高 (P <0 .0 5 ) ;抑郁症组的HDL -C及ApoA1无显著性差异 (P >0 .0 5 ) ,TC、TG、LDL -C及ApoB有显著性差异 (P <0 .0 5 ) ,其中TC、LDL -C及ApoB下降 ,TG升高 ;酒精所致精神障碍组的TC无显著性差异 (P >0 .0 5 ) ,HDL -C及ApoA1显著降低 (P <0 .0 5 ) ,而LDL -C、TG及ApoB显著升高 (P <0 .0 5 ) ;其它精神病例组的TC、HDL -C、LDL -C及ApoA1无显著性差异 (P >0 .0 5 ) ,TG及ApoB显著升高 (P <0 .0 5 )。结论 :精神病人与健     

原发性NS患者血脂的检测及临床意义

目的:探讨肾病综合征(NS);患者血脂的变化情况。方法:采用终点法及免疫比浊法测定了38例尚无合并症的NS患者和28例健康人的血清甘油三酯(TG),总胆固醇(TC),高密度脂蛋白(HDLC),低密度脂蛋白(LDLC),载脂蛋白AlB(ApoA1B);脂蛋白(a)[Lp(a)]水平。结果:NS组TC、TG、LDLC,ApoB,lp(a)的水平均明显高于对照组(P<0.01)。而HDLC.apoAl水平与对照组无明显差异(P>0.05)。结论:NS患者有脂质及载脂蛋白代谢紊乱。在出现动脉硬化性心血管合并症之前,体内已经具备了诱发合并症的生化基础。     

心肌梗塞患者血脂水平分析

目的　比较心肌梗死 (MI)患者与健康者血脂水平。方法　测定 16 8例MI患者 (A组 )和 16 5例健康者 (B组 )空腹血清总胆固醇 (TC)、甘油三酯 (TG)、载脂蛋白A -I(ApoA1)、载脂蛋白B10 0 (ApoB10 0 )、高密度脂蛋白—胆固醇 (HDL—C)及低密度脂蛋白一胆固醇 (LDL—C)水平。结果　A组与B组比较 :TC、TG、ApoA、ApoB10 0 、HDL—C及LDL—C均有显著统计学差异 (P <0 .0 5 )。结论　心肌梗死与血脂水平密切相关     

2型糖尿病患者血脂和载脂蛋白测定的临床意义

目的:探讨2型糖尿病患者血脂和载脂蛋白的变化及其在疾病发生发展中的临床意义。方法:应用日立7170全自动生化分析仪检测16 7例2型糖尿病患者与16 0例正常对照者血糖(GLU)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、载脂蛋白A1(ApoA1)、载脂蛋白B(ApoB)、脂蛋白a[LP(a) ],对组间进行分析比较。结果:糖尿病患者组与对照组之间血脂和载脂蛋白差异有显著性。结论:2型糖尿病患者存在血脂和载脂蛋白的改变,并在糖尿病并发动脉粥样硬化(AS)、冠心病(CHD)中发挥重要作用。     

血脂对老年糖尿病患者并发脑梗死的影响

目的:探讨血脂水平对老年糖尿病并发脑梗死的影响。方法:以我院保健所收治的老年糖尿病并发脑梗死35例(脑梗死组)及老年糖尿病无脑梗死35例(非脑梗死组)为研究对象,分析老年糖尿病患者血脂水平与脑梗死发生的关系。结果:总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、脂蛋白(a)[LP(a)]、载脂蛋白A1[ApoA1]、载脂蛋白B[ApoB]各项在两组之间比较均有显著差异。结论:在老年糖尿病患者中血脂升高尤其是LDL和LP(a)升高易发生脑梗死。积极控制老年糖尿病患者的血脂水平对脑梗死有积极预防作用。     

老年2型糠尿病合并高脂血症40例临床分析

对 40例老年 2型糖尿病患者及对照组进行血清总胆固醇 (TC)、甘油三酯 (TG)、高密度脂蛋白胆固醇 (HDL -C)、低密度脂蛋白胆固醇 (LDL -C)、载脂蛋白AⅠ (ApoA 1)、载脂蛋白B(ApoB)测定 ,并给予口服降血脂药物治疗。结果 ,老年 2型糖尿病患者血清TC、TG、HDL -C、ApoB水平明显高于对照组 ,而血清HDL -C和ApoA水平显著低于对照组 ,降脂药物治疗前后血脂水平有显著变化 (P <0 .0 5 )。提示 ,老年 2型糖尿病患者血脂、载脂蛋白和组成成分发生变化及功能异常 ,可促进动脉粥样硬化发生     

成人原发性肾病综合征患者血脂及载脂蛋白水平分析

目的:分析原发性肾病综合征(PNS)患者血脂及载脂蛋白的变化,并分析其与血浆清蛋白和尿蛋白组分的相关性。方法:回顾性分析178例PNS患者,其中120例行肾活检。另选100例健康体检者为对照组。酶法测定总胆固醇(TC)、甘油三酯(TG),直接法测定低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C),免疫透射比浊法测定载脂蛋白A1(ApoA1)、载脂蛋白B(ApoB)、脂蛋白(a)[LP(a)]。聚丙烯酰胺凝胶电泳将尿蛋白分为选择性蛋白尿组和非选择性蛋白尿组。结果:PNS组TC、TG、LDL-C、ApoB、LP(a)测定值较对照组明显升高,HDL-C、ApoA1/ApoB比值明显下降,差异有统计学意义。血脂水平在不同病理类型组之间无显著差别。相关分析显示,TC、TG、LDL-C、ApoB、LP(a)与选择性尿蛋白正相关(P<0.05),与血浆清蛋白水平呈负相关(P<0.05)。结论:PNS患者存在明显的脂质代谢紊乱,与血浆清蛋白及尿蛋白组分有明显相关性。积极控制高脂血症可明显改善PNS患者的预后,减少并发症。     

Ⅱ型糖尿病血管病变与脂代谢及血浆内皮素的关系

对 5 9例Ⅱ型糖尿病患者与 30例正常人的血脂、载脂蛋白及血浆内皮素 (ET)进行测定。结果 :糖尿病组脂代谢紊乱主要表现是TC、TG、LDL、ApoB升高 ,而HDL、ApoA降低 ,有血管病变者的脂代谢紊乱改变更明显 (P <0 .0 5 ) ;糖尿病患者的血浆ET较正常人明显升高 (P <0 .0 5 ) ,有血管病变者较无血管病变者亦明显升高 (P <0 .0 5 ) ,说明脂代谢紊乱在糖尿病血管病变中起重要作用 ,而血浆ET浓度的升高在一定程度上可反映内皮细胞损伤的程度。     

2型糖尿病载脂蛋白ApoA1、ApoB100检测的临床研究

目的:探讨人血清血脂和载脂蛋白ApoA1、ApoB100的水平及ApoA1/ApoB100比值在2型糖尿病并发心血管疾病的意义。方法:选取2型糖尿病患者55例,根据有无并发症分为4组(无并发症组,1种并发症组,2种并发症组,3种并发症组)。同期选取健康人47例对照组。全自动生化分析仪测定各组血清TG、TC、LDL-C、HDL-C、ApoA1、ApoB100水平,并计算ApoA1/ApoB100比值。结果:2型糖尿病组与对照组相比TG、TC、LDL-C、ApoB100水平明显升高(P<0.01),HDL-C、ApoA1/ApoB100比值明显下降(P<0.05),ApoA1水平无明显下降(P>0.05)。2型糖尿病并发心血管病变各组与无并发症组相比,TG、TC、HDL-C、ApoA1水平改变不明显(P>0.05),LDL-C和ApoB100水平明显升高,ApoA1/ApoB100比值显著降低(P<0.05)。结论:定期检查ApoB100和ApoA1/ApoB100,为糖尿病患者预测是否并发心血管病变风险有重要意义。     

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.