原发性高血压与高胰岛素血症的关系探讨

目的 :探讨原发性高血压与高胰岛素血症的关系。方法 :采用酶联免疫分析法测定 2 1例原发性高血压患者和 2 3例血压正常者空腹C肽 ,采用毛细血管法测定空腹血糖及糖负荷后 2h血糖。结果 :原发性高血压患者空腹C肽及糖负荷后 2h血糖均显著高于正常血压组 (P <0 .0 1) ,空腹血糖差异无显著性 (P >0 .0 5 )。结论 :原发性高血压患者存在高胰岛素血症及糖代谢异常。     

胰高血糖素与2型糖尿病的相关性研究

目的探讨2型糖尿病患者空腹及餐后血浆胰高血糖素、血糖、胰岛素的变化及意义,并分析2型糖尿病患者胰岛素抵抗指数、血脂、体重指数、瘦素的变化。方法110例2型糖尿病患者与56例健康对照组,测量空腹血浆胰高血糖素、血糖、胰岛素、血脂、瘦素及餐后血浆胰高血糖素、血糖、胰岛素的水平,并进行比较。结果（1）糖尿病患者空腹及餐后血浆胰高血糖素水平均高于正常人（P〈0．05）。（2）糖尿病患者餐后胰岛素峰值较正常对照组延后。（3）糖尿病组胰岛素抵抗指数水平比对照组明显升高（P〈0．05）。（4）糖尿病组总胆固醇、低密度脂蛋白、甘油三酯明显高于正常对照组（P〈0．05）,高密度脂蛋白明显低于正常对照组（P〈0．05）。（5）糖尿病组体重指数比对照组高（P〉0．05）。（6）糖尿病组瘦素值比对照组低（P〉0．05）。结论胰高血糖素的绝对或相对过多,是造成2型糖尿病患者高血糖症的因素之一。     

2型糖尿病病人胰高血糖素和胰岛素水平的变化及临床意义

①目的　探讨 2型糖尿病病人空腹及馒头餐后血浆胰高血糖素、血清胰岛素含量的变化及意义。②方法　采用放射免疫法分别检测了 6 5例 2型糖尿病病人空腹及馒头餐后血浆胰高血糖素、胰岛素的水平变化 ,并与 34例健康人进行比较。③结果　糖尿病病人空腹及餐后各时相胰高血糖素水平均高于正常人 (t =16 .79～2 0 .37,P <0 .0 1)。糖尿病病人馒头餐后胰高血糖素水平明显升高 ,6 0min显著高于其空腹水平 (F =15 .4 5 ,q =5 .6 2 ,P <0 .0 1) ,180min时基本恢复到空腹水平。正常人餐后 30min胰高血糖素水平略有升高 ,后各时相逐渐下降 ,180min稍低于空腹水平 ,各时相变化均无显著性差异 (F =2 .38,P >0 .0 5 )。糖尿病病人胰岛素 /胰高血糖素比值馒头餐后上升迟缓 ,6 0min才高于其空腹水平 (F =2 .6 7,q =4 .11,P <0 .0 5 ) ;12 0、180min比值仍上升 ,亦明显高于其空腹水平 (q =4 .78、5 .4 3,P <0 .0 1)。正常对照组胰岛素 /胰高血糖素比值于馒头餐后上升快 ,6 0min达高峰(F =12 .6 7,q =5 .5 2 ,P <0 .0 1) ;180min与空腹相比无显著差异 (q =1.77,P >0 .0 5 )。④结论　 2型糖尿病病人存在较严重的胰岛A细胞功能异常 ;餐后胰岛素 /胰高血糖素比值是一项能敏感、准确判断糖尿病病情的可靠的指标。     

阿卡波糖对2型糖尿病患者胰高血糖素的影响

目的探讨阿卡波糖对新诊断2型糖尿病患者胰高血糖素水平的影响。方法正常对照组12例和糖尿病组13例进食混合餐,分别于空腹和餐后15、30、60、90和120分钟测量血糖、胰岛素及胰高血糖素。1周后,糖尿病组进食混合餐＋阿卡波糖（100mg）,再次测量以上指标进行比较。结果干预前糖尿病组与正常对照组相比,餐后30分钟和90分钟胰高血糖素明显升高,胰高血糖素曲线下面积升高显著（P〈0．05）。干预后糖尿病组胰高血糖素15分钟有明显下降,胰高血糖素曲线下面积下降显著（P〈0．05）。结论阿卡波糖干预可降低2型糖尿病患者混合餐餐后血糖,同时降低胰高血糖素分泌。     

肝硬化患者糖代谢、血清胰岛素及胰高血糖素的变化

目的观察肝硬化患者糖代谢变化,探讨其可能机制与肝储备功能的关系。方法 46例肝硬化患者进行口服糖耐量试验、胰岛素释放试验及胰高血糖素的测定,并与同期住院36例非肝病患者进行比较。结果肝硬化组和对照组空腹血糖均正常,分别为（5.0±2.8）mmol/L和（4.9±1.9）mmol/L（P〉0.05）;餐后2h,肝硬化组血糖为（10.4±5.2）mmol/L,对照组血糖为（7.8±2.2）mmol/L,肝硬化组血糖升高更为明显（P〈0.05）。两组空腹血清胰岛素均正常,分别为（17.2±6.3）Um/L和（10.2±7.0）Um/L（P〉0.05）;餐后2h,肝硬化组胰岛素为（55.9±11.2）Um/L,对照组胰岛素为（35.7±12.2）Um/L,肝硬化组胰岛素升高更为明显（P〈0.05）。肝硬化患者胰高血糖素较对照组明显增高,分别为（256.14±76.1）ng/L和（67.9±26.6）ng/L（P〈0.05）。结论肝硬化患者糖代谢异常,且随肝功损害加重,胰高血糖素增高,提示胰岛素抵抗参与其发生过程。     

肝硬化患考精氨酸负荷试验下血浆胰高糖素、胰岛素、C肽的观察

肝硬化患者存在糖代谢及糖调节激素代谢的紊乱,常伴有肝源性糖尿病。精氨酸负荷试验是研究肝硬化患者葡萄糖代谢异常和糖调节激素代谢紊乱机制的一个重要手段。本文对23例肝炎后肝硬化患者进行精氨酸负荷试验,观察血浆胰高糖素、胰岛素、C肽及血糖的变化。结果表明,肝硬化临床血糖升高的患者存在高胰高糖素血症和高胰岛素血症。并初步探讨了其发生机理。     

高血压合并高甘油三酯血症患者餐后血糖异常的相关性分析

目的分析空腹血糖正常的高血压及高血压合并高甘油三酯血症患者餐后血糖异常的发病情况及特点,尽早发现隐匿性糖代谢异常。方法选择167例无糖代谢异常病史,空腹血糖正常的原发性高血压病人进行空腹血糖、甘油三酯及餐后2小时血糖检测。结果167例患者中确诊为IGT者65例(38.92%),DM23例(13.78%),高血压合并高甘油三酯血症患者餐后糖代谢异常者63例(38.33%)。结论推荐空腹血糖正常的高血压患者特别是合并高甘油三酯血症患者常规进行餐后2小时血糖检测。     

肝硬化糖代谢异常的临床研究

目的　探讨肝硬化失代偿期患者血糖及胰岛素代谢变化及其机理。方法　对 1 6例肝硬化失代偿期患者 ,2 0例 2型糖尿病患者及 1 0例正常健康者进行口服葡萄糖耐量试验 (OGTT) ,检测其血糖、胰岛素及C肽水平 ,同时查糖化血红蛋白 ,计算胰岛素释放指数和胰岛素敏感性指数 ,对各组检查结果进行比较分析。结果　肝硬化组空腹血糖水平显著低于 2型糖尿病组 (P <0 0 1 ) ,空腹胰岛素、C肽和胰岛素释放指数显著高于 2型糖尿病组 (P <0 0 1 ) ,但胰岛素敏感性指数两组之间无明显差异 (P >0 0 5 )。与正常对照组比较 ,肝硬化组空腹血糖、餐后血糖、糖化血红蛋白、空腹胰岛素、空腹C肽及胰岛素释放指数多种指标显著高于正常对照组 (P <0 0 1 ) ,胰岛素敏感性指数显著低于正常对照组 (P <0 0 1 )。结论　肝硬化患者存在糖代谢异常 ,且主要与胰岛素抵抗有关     

冠心病心衰患者胰岛糖代谢调节激素变化

目的 :了解胰岛糖代谢调节激素的变化与冠心病心力衰竭 (HFCHD)发生、发展的关系。方法 :分别测定47例HFCHD患者治疗前、后及正常对照组空腹血糖 (Glu)、胰岛素 (In)、胰高血糖素 (Gc)、C肽 (Cp)水平。结果 :(1)各组间Glu均无显著差异 (P >0 0 5 ) ;(2 )HFCHD患者In、Gc均高于正常对照组 (P <0 0 5 ) ;HFCHD患者心功能越差 ,血浆In、Gc水平越高 ,治疗后均有所改善 ,尤以心功能Ⅲ、Ⅳ级组差异显著 (P <0 0 5 ) ;(3)HFCHD患者Cp水平亦显著高于正常对照组 (P <0 0 5 ) ,但不同心功能各组间无显著性差异 (P >0 0 5 )。结论 :(1)HFCHD患者存在高In血症和高Gc血症。 (2 )HFCHD患者存在对In敏感性降低的同时也存在对Gc敏感性的降低     

糖尿病患者治疗前后血胰岛素C肽和胰高血糖素变化

本文观察20例正常人和38例非胰岛素依赖型糖尿病（NIDDM）患者（轻型30例，重型8例）治疗前后血糖、胰岛素、C肽和胰高血糖素的变化。发现两组病人血胰高血糖素显著高于正常人（P＜0．05），轻型组治疗前空腹、餐后两小时血糖显著升高、血胰岛素、c肽分别高于正常（P＜0．05）；治疗后空腹和餐后两小时血糖显著下降，胰岛素和C肽稍有升高；胰高血糖素有下降趋势，但无统计学意义。重型组治疗前组C肽显著低于正常（P＜0．05），胰高血糖素明显升高，与轻型组比较P＜0．05；治疗后胰高血糖素明显下降，其值与正常人相比P＜0．05，与轻型组比较无显著性差异。     

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.