重组人促红细胞生成素治疗血液透析患者的贫血对血液流变学的影响

目的：研究重组人促红细胞生成素 （ｒ Ｈｕ Ｅ Ｐ Ｏ）治疗血液透析患 者的贫血对血液流 变学的影响。方法 ： 观 察了 １６ 例维 持 血透 （ Ｈ Ｄ） 患者 ｒ Ｈｕ Ｅ Ｐ Ｏ 治 疗 前后 血 红蛋 白 （ Ｈｂ ）、红 细 胞（ Ｒ Ｂ Ｃ） 计数、红 细 胞压 积（ Ｈ Ｃ Ｔ）及血液流变学指标等项变化,并进行数据分析。结果：显示 ｒ Ｈｕ Ｅ Ｐ Ｏ 治疗后 其 Ｈｂ 、 Ｒ Ｂ Ｃ 计数、 Ｈ Ｃ Ｔ 及全 血粘度明显升高,与治疗前相比有显著性差异（ Ｐ＜ ０．０５～０．００１）,全血 粘度与 Ｈ Ｃ Ｔ 呈显著 正相关,与血浆纤 维蛋白原、血糖、血浆甘油三酯及血清白蛋白相关不显著。结论：ｒ Ｈｕ Ｅ Ｐ Ｏ 治疗后全血粘度的 增高主要是由 Ｒ Ｂ Ｃ 计数和 Ｈ Ｃ Ｔ 的增高决定的,维持性 Ｈ Ｄ 患者在使用 ｒ Ｈｕ Ｅ Ｐ Ｏ 纠正贫血过程中,必须定期监测 Ｈｂ 水平和 Ｈ Ｃ Ｔ,以求取得最好治疗效果。     

重组人红细胞生成素治疗慢性肾衰贫血18例疗效观察

贫血是慢性肾衰的常见并发症，近年来重组人红细胞生成素（ｒ－ＨｕＥＰＯ）应用于临床，使慢性肾衰贫血的治疗发生了根本性的改变。本文观察１８例应用国产ｒ－ＨｕＥＰＯ治疗慢性肾衰贫血的患者，获得较好疗效，现报道如下。１　材料与方法１８例患者均符合慢性肾衰诊断标准，其原发病为慢性肾小球肾炎１１例，慢性肾盂肾炎２例，多囊肾２例，糖尿病肾病１例，高血压病２例。本组患者均有中、重度贫血，其中血红细胞（ＲＢＣ）最高为２．９９×１０１２／Ｌ，最低为１．７５×１０１２／Ｌ，平均２．２７×１０１２／Ｌ；血红蛋白（Ｈｂ）…     

国产和进口rHuEPO治疗长期血透慢性肾衰竭贫血患者的疗效比较

研究和比较国产与进口基因重组人红细胞生成素（ｒＨｕＥＰＯ）对长期血液透析（ＨＤ）慢性肾衰竭（ＣＲＦ）贫血患者的影响。将６０例长期血透慢性肾衰竭贫血病人随机分成２组,分别应用国产ｒＨｕＥＰＯ（益比奥）、进口ｒＨｕＥＰＯ（生血素）１００μｇ／（ｋｇ·周）,均分３次治疗。２组患者在治疗第２周网织红细胞（ＲＲＢＣ）均显著上升,治疗１２周内血细胞比容（ＨＣＴ）均达到０．３０以上,且生活质量均有所改善。表明国产、进口ｒＨｕＥＰＯ疗效无显著性差异,均可安全、有效地改善ＣＲＦ患者贫血状态。     

妊娠期贫血诊断标准选择初探

本文探讨１５５例中晚期孕妇七项红细胞系统的参数，并与未孕健康育龄妇女比较。结果表明，Ｈｂ１００～１０９ｇ／Ｌ孕妇组与Ｈｂ９０～９９ｇ／Ｌ孕妇组的ＲＢＣ、ＭＣＶ、ＭＣＨ、ＭＣＨＣ、ＲＤＷ－ＣＶ间无显著性差异（Ｐ＞０．０５）。每组部有近半孕妇属于小细胞不均一性贫血，与Ｈｂ１１０～１１９ｇ／Ｌ组及未孕组比较差异非常显著（Ｐ＜０．０１）。孕妇的ＨＣＴ与Ｈｂ呈高度显著正相关（ｒ＝０．９９２），但贫血较轻时ＲＢＣ可正常。因此，妊娠期贫血诊断参数宜选用Ｈｂ或ＨＣＴ，不宜选用ＲＢＣ。诊断标准选用Ｈｂ＜１１０ｇ／Ｌ较理想。     

基因重组促红细胞生成素导致高血压的临床及实验研究

目的：探讨基因重组促红细胞生成素（ｒ－ＨｕＥＰＯ）在治疗慢性肾衰（ＣＲＦ）贫血中导致高血压的机制及防治对策。方法：对ｒ－ＨｕＥＰＯ治疗中出现高血压ＣＲＦ血液透析贫血患者１５例及对照组１５例,ＣＲＦ贫血动物模型,以及透析过程中出现低血压的３４例患者,应用分光光度法及放免法观察用药或透析前后血浆一氧化氮（ＮＯ）代谢产物（ＮＯ２／ＮＯ３）及内皮素－１（ＥＴ－１）的变化。结果： ①ＣＲＦ贫血患者及贫血鼠用ｒ－ＨｕＥＰＯ治疗１６周后,红细胞压积（Ｈｃｔ）升高,血压升高,ＥＴ－１升高（Ｐ＜０．０１）,血浆ＮＯ２／ＮＯ３下降（Ｐ＜０．０１）,而对照组用药前后无明显变化（Ｐ＞０．０５）。②在用药１６周后,ＲＴ－ ＰＣＲ测得实验组大鼠肾皮质及髓质ｉＮＯＳｍＲＮＡ比对照组明显减少（Ｐ＜０．０５）。③透析低血压患者透析后ＮＯ２／ＮＯ３含量增高,ＥＴ－１含量减少（Ｐ＜０．０５）。结论：研究表明ｒ－ＨｕＥＰＯ导致高血压与ｉＮＯＳｍＲＮＡ减少、合成ＮＯ减少和ＥＴ－１增加有重要的关系。     

对青年男性人群缺铁性贫血和核黄素营养状况相互关系的研究

对一青年男性人群的缺铁性贫血和核黄素营养状况的关系进行了观察。发现：其核黄素缺乏率为４２．９％（３０／７０），缺铁性贫血率为３７．５％（２７／７２），游离原卟啉（ＦＥＰ）异常率为１１．０％（８／７３）。核黄素缺乏者平均血红蛋白（Ｈｂ）浓度低于核黄素正常者，缺铁性贫血率（５０％）显著高于核黄素正常者（２５．０％，Ｐ＜０．０５），而两者的ＦＥＰ异常率无差别。对全血谷胱甘肽还原酶活性系数（ＢＧＲＡＣ）与Ｈｂ、ＦＥＰ和红细胞压积（ＨＣＴ）做相关回归分析，发现ＢＧＲＡＣ与Ｈｂ、ＨＣＴ呈显著负相关（Ｐ＜０．０５），而与ＦＥＰ无显著相关关系。结果提示：核黄素缺乏与缺铁性贫血有关系，而与反映铁缺乏的早期指标ＦＥＰ无关     

SPECT测定老年慢性肾衰患者GFR临床评价

ＳＰＥＣＴ测定老年慢性肾衰患者ＧＦＲ临床评价何小钢张权（南京铁路中心医院内科南京２１０００３）单光子发射电子计算机断层扫描（ＳＰＥＣＴ）测定肾小球滤过率（ＧＦＲ）已有报道［１～３］。作者对１９例老年慢性肾衰（ＣＲＦ）患者，应用ＳＰＥＣＴ测定ＧＦＲ，并...     

Rapid detection of cholera toxin gene of Vibrio cholerae O1 by polymerase chain reaction.

ＲＡＰＩＤＤＥＴＥＣＴＩＯＮＯＦＣＨＯＬＥＲＡＴＯＸＩＮＧＥＮＥＯＦＶＩＢＲＩＯＣＨＯＬＥＲＡＥＯ１ＢＹＰＯＬＹＭＥＲＡＳＥＣＨＡＩＮＲＥＡＣＴＩＯＮＲｅｎＳｈａｏｔａｎｇ任少堂，ＱｉｎＹｉｚｈｏｎｇ秦一中，ＺｈａｎｇＸｉａｏｑｉｎ张晓琴，ＬｉｎＤａ...     

贫血

贫血是指各种不同原因或疾病引起的共同症状 ,而不是一个疾病的名称。外周血中单位容积内血红蛋白浓度 (Ｈｂ)、红细胞计数 (ＲＢＣ)和 (或 )血细胞比容 (ＨＣＴ)都低于相同年龄、性别和地区的正常标准 ,即为贫血。一般认为 ,在平原地区成年男性Ｈｂ <12 0 ｇ/Ｌ ,ＲＢＣ <4 .0× 10 12 /Ｌ ,ＨＣＴ <0 .4 0 ,女性Ｈｂ <110 ｇ/Ｌ ,ＲＢＣ <3.5× 10 12 /Ｌ ,ＨＣＴ <0 .35 ,就可诊断为贫血。贫血可以发生于多种疾病 ,如恶性肿瘤可引起贫血 ;心脏手术置换瓣膜可引起溶血性贫血 ;肝、肾的慢性疾病可引起肝性或肾性贫血 ;消化道溃疡慢性失血或…     

Effects of selective head cooling on brain cell membrane activity during postischemic reperfusion.

ＥＦＦＥＣＴＳＯＦＳＥＬＥＣＴＩＶＥＨＥＡＤＣＯＯＬＩＮＧＯＮＢＲＡＩＮＣＥＬＬＭＥＭＢＲＡＮＥＡＣＴＩＶＩＴＹＤＵＲＩＮＧＰＯＳＴＩＳＣＨＥＭＩＣＲＥＰＥＲＦＵＳＩＯＮＤｕａｎＭａｎｌｉｎ段满林，ＬｉＤｅｘｉｎ李德馨ａｎｄＸｕＪｉａｎｇｕｏ徐建国Ｄ...     

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.