视黄醇结合蛋白在肾脏疾病中的诊断意义

目的：探讨视黄醇结合蛋白（RBP）检测在肾脏疾病中的诊断意义。方法检测167例肾病患者和57例健康体检者的血清RBP、尿素氮、肌酐、血白蛋白、甲状旁腺素（PTH）、β2微球蛋白,计算肌酐清除率,探讨RBP与传统肾功能指标的关系以及其在诊断肾脏疾病中的临床意义。结果随肾小球滤过率（GFR）降低,尿素氮、肌酐、RBP、PTH、β2微球蛋白水平逐渐增高,当GFR＜60ml/（min·1.73m2）时,肌酐、RBP、β2微球蛋白水平较对照组明显增高（P＜0.05）;RBP与肌酐、尿素氮、PTH、β2微球蛋白呈正相关（P＜0.05）,与内生肌酐清除率呈负相关（P＜0.05）。随着肾功能逐渐下降,血RBP检测阳性率逐渐增高。结论 RBP是可作为早期诊断肾脏疾病的重要指标。     

血液灌流/透析治疗尿毒症顽固性皮肤瘙痒10例临床报告

目的:探讨血液灌流联合血液透析对尿毒症皮肤瘙痒的临床应用价值。方法:对10例维持性血液透析合并重度皮肤瘙痒患者进行血液灌流联合血液透析,同时检测血尿素氮、肌酐、β2-微球蛋白、甲状旁腺激素(PTH)水平。结果:所有患者皮肤瘙痒即明显减轻,血尿素氮、肌酐和β2-微球蛋白、血PTH水平均保持在较低水平。结论:血液灌流联合血液透析对尿毒症皮肤瘙痒患者疗效显著。     

妊娠期高血压疾病患者血清β-痕迹蛋白和尿β2-微球蛋白水平与早期肾损伤的相关性

目的探讨妊娠期高血压疾病患者血清β-痕迹蛋白和尿β2-微球蛋白水平与早期肾损伤的关系及临床意义。方法选择2016年1月至2017年12月郑州市第一人民医院收治的80例妊娠期高血压疾病患者为研究对象,根据是否存在肾损伤将患者分为肾损伤组(n=17)和无肾损伤组(n=63),另选择同期孕检的50例健康孕妇为对照组。于孕35～37周采集所有受试者空腹肘静脉血,采用酶联免疫吸附试验法检测血清β-痕迹蛋白、肌酐、尿素氮、胱抑素C、肾损伤分子-1(KIM-1)及尿β2-微球蛋白水平。对3组孕妇血清β-痕迹蛋白、肌酐、尿素氮、胱抑素C、KIM-1及尿β2-微球蛋白水平进行比较;采用Pearson相关分析血清β-痕迹蛋白和尿β2-微球蛋白水平与血清肌酐、尿素氮及KIM-1水平的相关性,采用受试者工作特征曲线(ROC)评估各个指标对肾损伤的诊断价值。结果肾损伤组和无肾损伤组孕妇血清β-痕迹蛋白、肌酐、尿素氮、胱抑素C、KIM-1及尿β2-微球蛋白水平显著高于对照组(P <0. 05),肾损伤组孕妇血清β-痕迹蛋白、肌酐、尿素氮、胱抑素C、KIM-1及尿β2-微球蛋白水平显著高于无肾损伤组(P <0. 05)。Pearson相关性分析显示,妊娠期高血压疾病患者血清β-痕迹蛋白和尿β2-微球蛋白水平与血清肌酐、尿素氮及KIM-1水平呈正相关(R2=0. 565 2～0. 711 5,P <0. 05)。ROC曲线分析显示,妊娠期高血压疾病患者血清β-痕迹蛋白、肌酐、尿素氮、胱抑素C、KIM-1及尿β2-微球蛋白水平对肾损伤有预测价值(P <0. 05)。结论血清β-痕迹蛋白和尿β2-微球蛋白检测在妊娠期高血压疾病患者早期肾损伤的临床诊断中具有潜在的应用价值。     

血液灌流／透析治疗尿毒症顽固性皮肤瘙痒10例临床报告

目的：探讨血液灌流联合血液透析对尿毒症皮肤瘙痒的临床应用价值。方法：对10例维持性血液透析合并重度皮肤瘙痒患者进行血液灌流联合血液透析，同时检测血尿素氮、肌酐、β2-微球蛋白、甲状旁腺激素（PTH）水平。结果：所有患者皮肤瘙痒即明显减轻，血尿素氮、肌酐和β2-微球蛋白、血PTH水平均保持在较低水平。结论：血液灌流联合血液透析对尿毒症皮肤瘙痒患者疗效显著。     

血清β2-微球蛋白检测价值分析

目的探讨血清β2-微球蛋白(β2-microglobulin,β2-MG)与机体各项功能指标的相关性,探讨β2-微球蛋白作为生化指标常规检测价值分析。方法选用2014年04月至2016年05月入组的463例健康人群采用免疫比浊法用自动生化仪检测血中β2微球蛋白,同时检测各项生化指标。分析β2-MG与年龄、心脏功能、肝脏功能等生化指标的相关性。结果β2-MG与年龄正相关,与HDL-C有显著负相关、与脂蛋白(a)、(LP(a))、乳酸脱氢酶(LDH)、肌酸激酶同工酶(CK-MB)、羟丁酸脱氢酶(HBDH)、转氨酶(AST)、球蛋白(GLB)、同型半胱氨酸(HCY)、肌酐等均有显著正相关。结论血清β2微球蛋白与年龄正相关,可称为衰老因子,可能作为机体心脏、肝脏、肾脏超早期功能损伤的预测指标,有极为重要的临床指导意义;将其作为临床常规检测项目,可能会提高疾病的早期诊断率,有助于疾病的早期监测、预防。     

48例急性肾炎患儿血β_2-微球蛋白测定的临床观察

本文采用放射免疫法对48例急性肾炎患儿进行血β_2—微球蛋白(β_2—MG)的检测,并与常用的肾功能检查血肌酐(Cr)和血尿索氮(BUN)作比较及进行相关性探讨。结果表明,血β_2—微球蛋白测定是一项反映肾小球滤过功能的敏感指标血,β_2—微球蛋白与血肌酐、尿素氮呈正相关,而且在检测肾小球滤过功能方面较血肌酐及血尿素氮敏感。     

视黄醇结合蛋白测定在肾脏疾患诊治中的临床应用

目的:探讨视黄醇结合蛋白(RBP)在肾脏疾患中的临床应用,并比较其与β2-微球蛋白、尿素氮、肌酐几项化验指标之间的敏感性和实用性.方法:选取51例肾脏疾病患者,分别检验RBP、BUN、Cr、β2-微球蛋白指标,对其阳性率结果进行比较.结果:RBP与β2-微球蛋白在肾脏疾患中阳性率无显著差异,P ＞0.05,RBP与BUN、Cr比较阳性率有显著差异,P ＜0.05.结论:BRP可做为早期发现肾功能损害的实验室指标,对监测肾功能变化,推测肾脏疾病的预后有重要意义.     

血清胱抑素检测在狼疮性肾炎肾功能评价中的意义

目的:探讨血清胱抑素C(CysC)检测在狼疮性肾炎肾功能评价中的临床意义。方法:对20例狼疮性肾炎患者及20例健康体检者采用免疫速率散射比浊法检测血清CysC水平。同时,用酶法检测24h尿蛋白定量(24HU-P)、血清尿素氮(BUN)、血肌肝(CR)和尿β2微球蛋白(β2-MG)等生化指标。结果:狼疮性肾炎患者在慢性肾小球疾病临床分型中以肾病综合征表现为主;当肾功能指标尿素氮、肌酐和β2-微球蛋白无变化时,血清胱抑素水平已升高;当尿素氮、肌酐和β2-微球蛋白有变化时,血清胱抑素水平明显升高;血清胱抑素水平显著高于健康体检者。结论 :血清胱抑素C(CysC)可作为狼疮性肾炎早期肾损害的血清学指标,为临床早期判断狼疮性肾炎肾损害提供依据,同时也可作为评价肾功能损害程度的重要指标之一。     

血清β2-微球蛋白与肾病综合征患者肾功能指标、凝血指标的相关性分析

目的探讨血清β2-微球蛋白与肾病综合征(NS)患者肾功能指标、凝血指标的相关性。方法以50例NS患者为观察组,以同期50例健康体检者为对照组。检测两组凝血、肾功能指标及β2-微球蛋白水平,分析其相关性。结果NS患者β2-微球蛋白、血尿素氮(BUN)、血肌酐(SCr)和血尿酸(UA)、24 h尿蛋白定量(24 h Upr)、血浆黏度、抗凝血酶(AT)、凝血活酶时间(PT)、血小板聚集率水平均低于对照组,而D二聚体(D-D)水平高于对照组(P<0.05)。结论NS患者血清β2-微球蛋白水平升高,并与患者凝血及肾脏功能指标高度相关,可用于反映NS患者病情的指标。     

子痫前期患者血清β2-微球蛋白的变化及其临床意义

目的探讨子痫前期患者血清β2-微球蛋白水平改变的临床意义。方法入选105例孕妇分为两组:正常妊娠组49例,子痫前期组56例。入选病例均进行血清β2-微球蛋白、尿素、肌酐及尿酸浓度检测。结果子痫前期组患者血清β2-微球蛋白水平明显高于正常妊娠组(P<0.01)。在子痫前期患者,血清β2-微球蛋白水平与血清肌酐、尿酸水平呈显著正相关(r=0.60,0.50;P<0.01)。结论子痫前期患者血清β2-微球蛋白水平增高,能够反映患者肾脏损害的严重程度。     

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.