应用扩展高胰岛素-正葡萄糖钳夹技术检测肥胖伴糖耐量异常个体的胰岛素敏感性

目的应用扩展高胰岛素-正葡萄糖钳夹技术检测肥胖伴糖耐量异常者的胰岛素敏感性。方法按照WHO1998肥胖及WHO1999糖尿病诊断标准,将52例研究对象分为正常体重-正常糖耐量组、超重/肥胖-正常糖耐量组、超重/肥胖糖耐量减退组及超重/肥胖糖尿病组;将超重/肥胖-正常糖耐量者进一步分为3个亚组:超重亚组、轻度肥胖亚组、中度肥胖亚组。应用核磁共振对所有研究对象进行腹内脂肪测量,以腹腔内脂肪面积100cm2为切割点,将正常糖耐量者分为非腹内型肥胖组(non-VA)及腹内型肥胖组(VA)。以扩展高胰岛素-正葡萄糖钳夹技术检测机体胰岛素敏感性。结果单纯超重/肥胖、超重/肥胖伴糖耐量减退或糖尿病者的葡萄糖消失率分别为(3·25±0·13)、(3·06±0·26)和(3·19±0·44)mg·kg-1·min-1,较正常体重正常糖耐量组的(5·86±0·65)mg·kg-1·min-1显著减少(P<0·05,P<0·01);超重、轻度肥胖及中度肥胖但糖耐量正常亚组的葡萄糖消失率分别为:(3·50±0·19)、(3·03±0·13)和(2·75±0·24)mg·kg-1·min-1,较正常体重正常糖耐量组显著降低(P<0·05,P<0·01)。腹型肥胖组的葡萄糖消失率(2·97±0·12)mg·kg-1·min-1、葡萄糖氧化率(1·47±0·19)mg·kg-1·min-1较非腹型肥胖组的(4·55±0·43)mg·kg-1·min-1和(2·24±0·19)mg·kg-1·min-1显著减少(P<0·05,P<0·01)。体重指数、腰臀比、腰围、腹腔内脂肪面积分别与葡萄糖利用率呈负相关(P<0·05,P<0·01)。体重指数、腹腔内脂肪面积及腹部皮下脂肪面积分别是影响葡萄糖利用率的主要因素。结论超重/肥胖无论伴或不伴糖代谢异常,胰岛素敏感性均显著降低,腹内脂肪增多者胰岛素介导的葡萄糖利用率显著减少,总体脂和腹部脂肪与精确胰岛素敏感性指数呈负相关,总体脂和腹部脂肪是影响机体胰岛素敏感性的主要因素。     

中国人葡萄糖兴奋胰岛素分泌的特点

目的 探讨中国人不同糖耐量状态下的葡萄糖兴奋胰岛素分泌的特点。方法 634例受试者分成两类亚组：1、以体块指数（BMI）25为切割点,分为正常体重组（NW）与超重/肥胖组（OW/OB）,并按空腹血糖水平的不同各分为7个亚组。2、根据BMI和糖耐量,把所有受试者分为以下6个亚组;正常体重、正常糖耐量组（NW-NGT）、正常体重-空腹血糖减损/糖耐量减退组（NW-IFG/IGT）、正常体重-糖尿病组（NW-DM）、超重/肥胖-正常糖耐量组（OW/OB-DM）。以口服葡萄糖耐量试验（OGTT）0-120min的平均胰岛素水平评价葡萄糖兴奋的胰岛素分汔功能,采用稳态模式评估法（HOMA）评价胰岛素抵抗（HOMA-IR）。结果 1、中国人空腹血糖与总体胰岛素分泌呈倒U字型曲线,正常体重者中总体胰岛素分泌高峰的空腹血糖值为5.9mmol/L;2、超重/肥胖伴正常糖耐量的个体总体胰岛素分泌最高;3、超重/肥胖个体伴IGT时,总体胰岛素分泌减退及胰岛素抵抗指数的持续升高。结论 1、中国人空腹血糖与总体胰岛同素分泌最高;3、超重/肥胖个体伴IGT时,总体胰岛素分泌减退,并伴胰岛素抵抗指数升高;4、超重/肥胖伴糖尿病时,同时存在进行性的总体胰岛素分泌功能的减退及胰岛素抵抗指数的持续升高。结论 1、中国人空腹血糖与总体胰岛素分泌呈倒U了型曲线,高峰较白种人前移,总体胰岛素分泌达峰值的空腹血糖水平比白种人低;2、中历人超重/肥胖个体中,NGT、IGT及DM三个亚组的总体胰岛同素分泌依次减退并伴有胰岛素抵抗的逐渐增强。     

正常人群Apelin水平与腹型肥胖的关系

目的探讨正常糖调节人群空腹血清Apelin水平与人体脂肪分布之间的关系。方法收集上海地区正常糖调节的20～60岁中国人70名(男40名,女30名),根据1998年世界卫生组织制定的肥胖诊断标准分为正常体重(NW)1组(37名)和超重/肥胖(OW/OB)1组(33名)。采用酶联免疫吸附试验检测空腹血清Apelin水平,测量各体脂参数并检测各项生化指标。另外收集22例正常糖调节行外科择期手术的患者(NW2组,12例;OW/OB2组,10例),术中收集人网膜和腹部皮下脂肪组织,应用实时定量聚合酶链反应检测ApelinmRNA水平。结果 OW/OB1组的血清Apelin水平显著高于NW1组(P<0.05)。偏相关分析校正年龄、性别、血压、血脂后显示,血清Apelin与体质指数(r=0.375)、腰围(r=0.371)、股围(r=0.385)呈正相关(P值均<0.01),与腰臀比(r=0.252)和腹内脂肪面积(r=0.223)呈正相关(P值均<0.05)。进一步以血清Apelin为应变量,以年龄、性别、体质指数、腰围、腰臀比、股围、收缩压、舒张压、胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、腹内脂肪面积、腹部皮下脂肪面积为自变量进行多元逐步回归分析显示,腰围是影响血清Apelin水平的独立相关因素(r2=0.209,P<0.01)。OW/OB2组的大网膜脂肪组织中ApelinmRNA表达为1.25±0.27,显著高于NW2组的0.85±0.20(P<0.05)。结论腹型肥胖可能是引起血清Apelin水平升高的主要因素。     

Influence of abdominal obesity on serum Apelin levels in people with normal glucose regulation

目的 探讨正常糖调节人群空腹血清Apelin水平与人体脂肪分布之间的关系.方法 收集上海地区正常糖调节的20～60岁中国人70名(男40名,女30名),根据1998年世界卫生组织制定的肥胖诊断标准分为正常体重(NW)1组(37名)和超重/肥胖(OW/OB)1组(33名).采用酶联免疫吸附试验检测空腹血清Apelin水平,测量各体脂参数并检测各项生化指标.另外收集22例正常糖调节行外科择期手术的患者(NW2组,12例；OW/OB2组,10例),术中收集入网膜和腹部皮下脂肪组织,应用实时定量聚合酶链反应检测Apelin mRNA水平.结果 OW/OB1组的血清Apelin水平显著高于NW1组(P＜0.05).偏相关分析校正年龄、性别、血压、血脂后显示,血清Apelin与体质指数(r=0.375)、腰围(r=0.371)、股围(r=0.385)呈正相关(P值均＜0.01),与腰臀比(r=0.252)和腹内脂肪面积(r=0.223)呈正相关(P值均＜0.05).进一步以血清Apelin为应变量,以年龄、性别、体质指数、腰围、腰臀比、股围、收缩压、舒张压、胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、腹内脂肪面积、腹部皮下脂肪面积为自变量进行多元逐步回归分析显示,腰围是影响血清Apelin水平的独立相关因素(r2=0.209,P＜0.01).OW/OB2组的大网膜脂肪组织中Apelin mRNA表达为1.25±0.27,显著高于NW2组的0.85±0.20(P＜0.05).结论 腹型肥胖可能是引起血清Apelin水平升高的主要因素.     

应用高葡萄糖钳夹技术检测肥胖伴糖耐量异常者胰岛β细胞的功能变化

目的　应用高葡萄糖钳夹技术探讨糖耐量异常 (IGT)及糖尿病 (DM )个体胰岛素分泌功能的改变 ,以及与超重 /肥胖 (OW /OB)的关系。方法　根据糖耐量情况将上海地区 6 4例受试者分为正常糖耐量 (NGT)组、IGT组及DM组 ;再以体重指数 2 5kg/m2 为切割点 ,把不同糖耐量的受试者分成 6个组 :正常体重 (NW )NGT(NW NGT)组、NW IGT组、NW DM组、OW /OB NGT组、OW /OB IGT组、及OW /OB DM组。应用高葡萄糖钳夹技术研究IGT及DM个体各时相胰岛素分泌指数。结果　 (1)IGT及DM个体胰岛素分泌形态的变化表现 :第一时相胰岛素分泌进行性降低 (IGT 186mU/L± 38mU/L ,DM 71mU/L± 10mU/L ,P <0 0 5 ) ;第二时相胰岛素分泌明显减退 (IGT 70mU/L± 14mU/L ,DM 32mU/L± 4mU/L ,P <0 0 5 )。 (2 )NW IGT及NW DM者 ,第一时相 (NW IGT16 4mU/L± 4 7mU/L ,NW DM 6 1mU/L± 17mU/L)、第二时相 (NW IGT 4 4mU/L± 18mU/L ,NW DM 2 6mU/L± 5mU/L)及最大胰岛素分泌功能 (NW IGT 5 3mU/L± 2 1mU/L ,NW DM 34mU/L± 6mU/L)均显著减退 (P <0 .0 5 )。 (3)单纯OW /OB个体第一、第二时相胰岛素分泌指数及最大胰岛素分泌量显著高于NW NGT者 (分别为 5 4 6mU/L± 6 2mU/L、138mU/L± 18mU/L、16 3mU/L± 2 4mU/L ,P <0 0 5 ) ,OW /O     

脂肪因子Chemerin与肥胖及2型糖尿病的关系

目的 测定正常人群、肥胖及新诊断的2型糖尿病患者血清Chemerin水平,探讨脂肪因子Chemerin与体脂参数、糖脂代谢、胰岛素抵抗的关系.方法 收集正常糖调节(NGR)和新诊断2型糖尿病患者(T2DM)各76例,按体重指数≥25 kg/m2分为正常糖调节正常体重组(NGR-NW)、正常糖调节超重/肥胖组(NGR-OW/OB)、2型糖尿病正常体重组(T2DM-NW)、2型糖尿病超重/肥胖组(T2DM-OW/OB)4个亚组.检测所有研究对象血清Chemerin水平、空腹胰岛素(FINS)、空腹C肽和糖脂代谢参数等,并计算体重指数、腰臀比和胰岛素抵抗指数(HOMA-IR).结果 女性血清Chemerin水平高于男性[(109±28)μg/L比(98±23)μg/L,P<0.05].超重/肥胖者Chemerin水平明显高于正常体重者[(113±27)μg/L比(94±25)μg/L,P<0.01],T2DM与NGR组血清Chemerin水平差异无统计学意义[(105±29)μg/L比(102±27)μg/L,P=0.786].在校正性别和年龄后,血清Chemerin水平与体重指数(r=0.336,P=0.000),腰围(r=0.460,P=0.000),腰臀比(r=0.325,P=0.000),空腹C肽(r=0.377,P=0.000),FINS(r=0.333,P=0.000),HOMA-IR(r=0.182,P=0.027)和甘油三酯(r=0.280,P=0.001)呈正相关;与高密度脂蛋白胆固醇(r=-0.251,P<0.01)呈负相关.多元逐步回归分析显示,空腹C肽、甘油三酯是血清Chemerin水平的独立相关因素(β=0.328、0.280,均P<0.05).结论 女性血清Chemerin水平高于男性,超重/肥胖者血清Chemerin水平显著升高,与胰岛素水平、体脂分布、脂代谢相关,提示Chemerin可能参与肥胖及代谢综合征的病理生理过程.     

正常糖调节人群中基础胰岛素分泌与游离脂肪酸浓度的关系

目的研究糖调节正常者基础胰岛素分泌与游离脂肪酸(FFA)浓度的关系。方法按空腹FFA四分位间距,将308名糖调节正常者(男133名,女175名)分为A组[FFA为(0.41±0.11)mmol/L]、B组[FFA为(0.66±0.05)mmol/L]、C组[FFA为(0.91±0.08)mmol/L]和D组[(1.31±0.28)mmol/L],比较4组的空腹及糖负荷后糖、脂代谢和胰岛素分泌的异同,并分析空腹胰岛素(FINS)与空腹FFA(FFA0’)的相关性。分析正常体重组[NW组,体质指数(BMI)≥18且<25 kg/m~2,131名]、超重组(OW组,BMI≥25且<30 kg/m~2,122名)、肥胖组(OB组,BMI≥30 kg/m~2,55名)中FINS与FFA0’的关系。结果校正年龄、性别、BMI后,B、C、D组的FINS、糖负荷2 h胰岛素(2hINS)均明显升高(P值均<0.01)。偏相关和多元逐步回归分析显示,FINS与FFA0’呈正相关(r=0.278,P<0.01)。NW组和OW组中也发现,FINS与FFA0’呈正相关(r值分别=0.329、0.315,P值均<0.01),OB组中两者不相关(P>0.05)。结论①FFAM度升高与基础胰岛素分泌增加密切相关;②FFA浓度是独立于血糖之外的影响基础胰岛素分泌的重要因素之一;③肥胖群体中,FFA0’与FINS的相关性消失。     

肥胖对非酒精性脂肪肝患者糖脂代谢的影响

目的探讨不同肥胖类型对非酒精性脂肪肝(NAFLD)患者代谢指标的影响。方法将351例NAFLD患者分为糖尿病组和非糖尿病组,再根据腰围、体质量指数分别分为腹型肥胖、非腹型肥胖亚组、体质量正常、超体质量、肥胖亚组,比较不同亚组间血糖、血脂谱、胰岛素抵抗指数和肝酶谱的差别。结果在非糖尿病组,腹型肥胖者2 h血糖、丙氨酸氨基转移酶(ALT)显著高于非腹型肥胖者(P<0.05);肥胖和超体质量者2 h血糖、空腹胰岛素、三酰甘油、ALT显著高于体质量正常者(P<0.05)。在糖尿病组,腹型肥胖者糖化血红蛋白显著高于非腹型肥胖者(P<0.05),肥胖者空腹血糖2、h血糖、糖化血红蛋白、胰岛素抵抗指数显著高于超体质量者和体质量正常者(P<0.05)。结论不同肥胖类型对NAFLD患者糖脂代谢、胰岛素抵抗有显著影响。     

老年初发2型糖尿病胰岛素抵抗与血清游离脂肪酸相关性研究

目的通过检测糖尿病（DM）组和糖耐量异常（IGT）组及正常对照组血游离脂肪酸、血脂、胰岛素、糖化血红蛋白,计算Homa-IR,以探讨老年初发2型糖尿病胰岛素抵抗与游离脂肪酸与的相关性。方法选择老年初发T2DM组60例,IGT组40例和正常对照组40例,其中老年初发T2DM组分有MS亚组和无MS亚组,IGT组分肥胖及超重亚组和体重正常亚组,正常对照组分肥胖及超重亚组和体重正常亚组,各组年龄、性别具有可比性,检测各组游离脂肪酸（FFA）、胆固醇（TC）、甘油三酯（TG）、空腹、餐后2 h血糖、空腹、餐后2 h胰岛素、糖化血红蛋白（HbA1c）,用稳态模式（Homa Model）公式评估胰岛素抵抗。分别测各组体重Kg、身高m,计算体重指数BMI=Kg/M2,测腰围（W）、臀围（H）,计算腰臀比值（WHR）。结果老年初发T2DM和IGT组的TC、TG、FINS、INS2 h、Ho-ma-IR水平明显高于正常对照组（P〈0.01）,老年初发T2DM组和IGT组FFA水平高于正常对照组,其中DM有MS亚组FFA、Homa-IR、TG、INS2 h高于无MS亚组,IGT组肥胖及超重亚组FFA、Homa-IR、TG、INS2 h高于体重正常亚组,正常对照组肥胖及超重亚组FFA、Homa-IR、TG、INS2 h高于体重正常亚组。多元逐步回归分析显示：FBG、FINS、TG、HbA1C、BMI、FFA是影响Homa-IR水平独立危险因素（标准回归系数分别为0.863、0.458、-0.115、-0.132、0.381、0.127）,P值分别为0.000、0.001、0.000、0.008、0.001、0.000）。结论T2型DM病患者游离脂肪酸水平、Homa-IR明显升高,其中T2DM有并MS亚组水平高于无MS亚组,FFA是导致胰岛素抵抗的重要因素。     

“5+2”间歇性断食联合中链三酰甘油对超重/肥胖患者体脂及糖脂代谢的影响

目的探讨"5+2"间歇性断食(IF)模式联合中链三酰甘油(MCT)对超重/肥胖患者体脂及糖脂代谢的影响。方法将68例超重/肥胖患者随机分为IF+MCT组和IF组,各34例。IF+MCT组采用"5+2"IF联合MCT方案进行干预,IF组采用"5+2"IF方案干预。比较2组患者干预前及干预12周后体格测量、体成分分析、血液实验室检测指标的变化情况。结果干预后,两组患者的体质指数、体重、肥胖度、腰围、臀围、身体总脂肪、体脂率、内脏脂肪面积、内脏脂肪等级、空腹血糖、空腹胰岛素、胰岛素抵抗指数、总胆固醇、三酰甘油、LDL-C水平均下降(均P<0.05),HDL-C水平升高(P<0.05);IF+MCT组患者腰臀比、总胆固醇、三酰甘油、LDL-C均低于IF组,HDL-C高于IF组(均P<0.05)。结论 "5+2"IF联合MCT与单纯"5+2"IF干预均可降低超重/肥胖患者的体脂,改善糖脂代谢,但联合干预对腰臀比及血脂改善的效果更好。     

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.