脑梗死患者血脂水平与载脂蛋白B基因多态性和性别关系的研究

目的研究动脉粥样硬化性脑梗死（ＡＣＩ）患者血脂水平与载脂蛋白Ｂ（ＡｐｏＢ）基因多态性及性别之间的相关性。方法运用聚合酶链反应－限制性片段长度多态性（ＰＣＲ－ＲＦＬＰ）对８６例ＡＣＩ患者和５５例正常对照（ＮＣ）进行ＡｐｏＢ的基因分析。结果①两组间等位基因频率分布无差异（Ｐ＞０．０５）;②两组间存在总胆固醇（ＴＣ）、甘油三酯（ＴＧ）、低密度脂蛋白（ＬＤＬ）、载脂蛋白Ａ（ＡｐｏＡ）、载脂蛋白Ｂ（ＡｐｏＢ）、脂蛋白（ａ）［Ｌｐ（ａ）］水平的差异（Ｐ＜０．０５）;③ＡＣＩ组血脂水平异常与性别有关（Ｐ＜０．０５）。结论ＡｐｏＢ基因多态性对ＡＣＩ患者血脂水平无明显影响;性别对脂质代谢有一定影响。     

脑梗塞合并糖耐量异常患者血脂水平变化的临床意义

目的：观察脑梗塞合并糖耐量异常患者血脂水平变化。方法：将１４７例脑梗塞患者分为糖尿病组、糖耐量异常（ＩＧＴ）组及血糖正常组，用酶法测总脂（ＴＬ）、甘油三酯（ＴＧ）和高密度脂蛋白（ＨＤＬＣ）；用免疫比浊法检测载脂蛋白（ＡｐｏＡＩ、ＡｐｏＢ１００），并与４０例健康对照组比较。结果：ＩＧＴ组除ＡｐｏＢ１００外，余与对照组差异均有显著性（Ｐ＜０．０５～Ｐ＜０．０１）。结论：脑梗塞并ＩＧＴ者，有明显脂质代谢异常，提示ＩＧＴ为脑梗塞发病不容忽视的危险因素     

糖尿病合并胆囊结石高危因素研究

目的：明确糖尿病并发胆囊结石的高危因素，探讨预防方案。方法：研究对象１９７例分成四组。糖尿病合并胆囊结石组（Ａ组，ｎ＝３２），糖尿病无胆囊结石组（Ｂ组，ｎ＝３６），胆囊结石无糖尿病组（Ｃ组，ｎ＝６２）和对照组（无糖尿病无胆囊结石，Ｄ组，ｎ＝６７）。对比研究各组血脂、载脂蛋白（Ａｐｏ）、磷脂（ＰＬ）、脂蛋白（ａ）（ＬＰ（ａ））及糖尿病患者的糖化血红蛋白（ＧＨｂＡ１Ｃ）、空腹及餐后血糖、胰岛素、Ｃ肽水平。结果：Ａ组、Ｂ组与Ｄ组比较，甘油三酯、ＡｐｏＢ、ＡｐｏＣ２、ＡｐｏＣ３、ＡｐｏＥ水平均明显升高，Ｐ＜０．０５或０．０１，具有胆囊结石血脂的特点。更存在ＡｐｏＡ１、ＡｐｏＡ２、ＡｐｏＡ１／ＡｐｏＢ、ＨＤＬｃ／ＴＣ比值（Ａ组）等反映保护因子水平的显著下降，Ｐ均＜０．０１。Ａ组与Ｂ组比较，空腹胰岛素浓度有升高倾向（Ｐ＝０．０７６），餐后胰岛素浓度均显著升高（Ｐ＜０．０５或０．０１），除ＨＤＬｃ／ＴＣ比值下降（Ｐ＜０．０１）外，所有血脂、载脂蛋白、ＰＬ、ＬＰ（ａ）、ＧＨｂＡ１Ｃ、空腹及餐后血糖、Ｃ肽水平两组差异均无显著性（Ｐ＞０．０５）。两组病程差异亦无显著性（Ｐ＞０．０５）。结论：（１）糖尿病并发胆囊结石的高危因     

糖皮质激素治疗效果对原发性肾病综合征患者自脂的影响

为了解用糖皮质激素治疗对原发性肾病综合征患者血脂、脂蛋白和载脂蛋白的影响,采用生化方法测定了５２例原发性肾病综合征患者使用糖皮质激素治疗前后的上述指标。结果：对糖皮质激素敏感者（完全缓解组）的ＴＣ,ＴＧ,ＬＤＬ－ｃ和ＡｐｏＢ１００较治疗前明显下降（Ｐ〈０．０１）,ＡｐｏＡ１／ＡｐｏＢ１００较治疗前明显增高（Ｐ〈０．０１）。部分敏感者（部分缓解组）的ＴＣ,ＬＤＬ－ｃ和ＡｐｏＢ１００也较治疗前有明显下     

血脂及载脂蛋白与冠心病关系的临床探讨

对１０４例冠心病病人的血脂、载脂蛋白进行检测，并与对照组进行比较分析。结果表明，胆固醇（ＴＣ）、甘油三酯（ＴＧ）、载脂蛋白Ｂ＿（１００）（ＡｐｏＢ＿（１００））血清含量和胆固醇／高密度脂蛋白胆固醇（ＴＣ／ＨＤＬ－Ｃ）比值明显高于对照组，差异均有显著意义（Ｐ均＜０．０５）。而ＨＤＬ－Ｃ，载脂蛋白ＡＩ（ＡｐｏＡＩ）含量及其ＡＩ／Ｂ＿（１００）比值明显低于对照组，差异均有显著意义（Ｐ均＜０．０５）。提示ＡｐｏＢ＿（１００）及其ＡＩ／Ｂ＿（１００）和ＴＣ／ＨＤＬ－Ｃ比值是对冠心病价值最高、最敏感的判别指标。     

50例急性心肌梗塞患者血脂水平检测报告

目的：对脂质代谢与ＡＭＩ之间的关系进行研究。方法：采用酶法检测血清总胆固醇（ＴＣ）和甘油三酯（ＴＧ）；用磷钨酸钠Ｍｇ２＋一步沉淀法检测高密度脂蛋白（ＨＤＬＣ）及其亚组分（ＨＤＬ２Ｃ和ＨＤＬ３Ｃ）；用单向火箭负度电泳法检测载脂蛋白ＡＩ（ａｐｏＡＩ）和载脂蛋白Ｂ（ａｐｏＢ）对ＡＭＩ患者（５０例）和对照组（６０例）进行取血检测。结果：疾病组血清ＴＧ，ａｐｏＢ水平比对照组明显升高，两组比较差异有显著性（ｔ＝２．１１４，３．３８９，Ｐ均＜０．０５）；而ＨＤＬＣ，ＨＤＬ２Ｃ，ａｐｏＡＩ水平及ＨＤＬ２Ｃ／ＨＤＬ３Ｃ，ａｐｏＡＩ／ａｐｏＢ比值比对照组明显降低，两组间比较差异均有显著意义（ｔ＝１．９９６～２．７６２，Ｐ＜０．０５，０．０１）；结论：血清ａｐｏＢ水平升高可促进冠心病动脉粥样硬化的形成和发展     

老年腔隙性脑梗塞患者血脂水平研究

分析４６例老年腔隙性脑塞（ＬＡＣ）血胆固醇（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Ａ１（ＡｐｏＡ１）、载脂蛋白Ｂ１００（ＡｐｏＢ１００）水平,结果显示,老年ＬＡＣ组ＴＣ、ＴＧ、ＬＤＬ－Ｃ、ＡＰｏＢ１００均显著高于健康对照组（Ｐ〈０．０１）;ＨＤＬ－Ｃ、ＰｐｏＡ１显著低于对照组（Ｐ〈０．０１）。提示血脂异常老年ＬＡＣ发病的危险因素。     

脑梗塞血脂载脂蛋白测定及其临床意义

测定６２例脑塞与５０例健康对照者血清胆固醇（ＴＣ）、三酰甘油（ＴＧ）、载脂蛋白ＡＩ（ＡｐｏＡＩ）、脂蛋白Ｂ１００（ＡｐｏＢ１００）,结果表明脑梗塞患者血ＴＧ,ＡｐｏＢ１００水平明显高于对照组（Ｐ〈０．０１）,ＡｐｏＡＩ,ＡｐｏＡＩ／ＡｐｏＢ１００水平明显低于对照组（Ｐ〈０．０１）,ＴＣ恙对照组无显著差异（Ｐ〈０．０５）,提示脑梗塞组在显著的腊代谢紊乱,ＴＧ,ＡｐｏＢ１００升高和ＡｐｏＡＩ,ＡｐｏＡ     

94例冠心病,93例糖尿病患者血脂及载脂蛋白分析

目的：探讨甘油三酯（ＴＧ）、载脂蛋白Ｂ（ＡｐｏＢ）与非胰岛素依赖型糖尿病（ＮＩＤＤＭ）和冠心病（ＣＨＤ）的关系。方法：对９４例ＣＨＤ、９３例ＣＨＤ＋ＮＩＤＤＭ患者及１００例正常人的血脂、脂蛋白及载脂蛋白进行分析对比，并对ＡｐｏＢ与ＣＨＤ的关系进行多因素ｌｏｇｉｓｔｉｃ逐步回归分析。结果：ＣＨＤ组及ＣＨＤ＋ＮＩＤＤＭ组与正常对照组比较，各项血脂均有显著性差异（Ｐ＜００１），ＴＧ、ＡｐｏＢ的异常检出率高于其它项血脂（Ｐ＜００５）；ＣＨＤ＋ＮＩＤＤＭ组与单纯ＣＨＤ组比较，ＴＧ、ＡｐｏＢ有显著性差异（Ｐ＜００１）；ＡｐｏＢ与ＣＨＤ发病危险呈密切正相关（ＯＲ＝１９６１，９５％可信区间１６８３１～２２４２２，Ｐ＝０００５７）。结论：在ＣＨＤ的发病因素中，脂质代谢异常起着极其重要的作用，其中ＴＧ、ＡｐｏＢ对于ＣＨＤ的判别价值优于其它项血脂，且ＮＩＤＤＭ患者ＣＨＤ发展加速的机制与ＴＧ、ＡｐｏＢ也密切相关。因此，应重视对ＣＨＤ、ＮＩＤＤＭ患者ＴＧ、ＡｐｏＢ的监测，并及时纠正脂质代谢紊乱，以降低ＣＨＤ的发病率和病死率。     

老年腔隙性脑梗塞患者血脂水平研究

分析４６ 例老年腔隙性脑梗塞（ Ｌ Ａ Ｃ） 血胆固醇（ Ｔ Ｃ） 、甘油三酯（ Ｔ Ｇ） 、高密度脂蛋白胆固醇（ Ｈ Ｄ Ｌ－ Ｃ） 、低密度脂蛋白胆固醇（ Ｌ Ｄ Ｌ－ Ｃ） 、载脂蛋白 Ａ１（ Ａｐｏ Ａ１） 、载脂蛋白 Ｂ１００（ Ａｐｏ Ｂ１００） 水平,结果显示,老年 Ｌ Ａ Ｃ 组 Ｔ Ｃ、 Ｔ Ｇ、 Ｌ Ｄ Ｌ－ Ｃ、 Ａ Ｐｏ Ｂ１００ 均显著高于健康对照组（ Ｐ＜ ０ ．０１） ; Ｈ Ｄ Ｌ－ Ｃ、 Ａ Ｐｏ Ａ１ 显著低于对照组（ Ｐ＜ ０ ．０１） 。提示血脂异常是老年 Ｌ Ａ Ｃ 发病的危险因素。     

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.