肝素抗凝血浆与血清中微量元素测定的对比分析

目的通过对肝素抗凝血浆与血清微量元素测定的对比,以探讨门诊用肝素抗凝血浆代替血清进行微量元素快速检验的可行性。方法采用HITATCH7170S全自动生化分析仪同时分别检测60例肝素抗血浆和血清3种微量元素浓度。结果肝素抗凝血浆锌（Zn）与血清锌之间无显著性差异（P〉0．05）;肝素抗凝血浆铁（Fe）与血清铁之间无显著性差异（P〉0．05）;而肝素抗凝血浆与血清之间铜（Cu）的检测值有显著性差异（P〈0．01）。结论用肝素抗凝血浆代替血清进行锌和铁的检验时无显著性差异;而用肝素抗凝血浆代替血清进行铜的检验而未建立血浆铜参考范围时,可用直线回归方法式Y=0．98X＋1．67进行换算。     

不同抗凝剂对电化学发光法检测孕酮的影响

目的探讨不同抗凝剂对电化学发光法检测孕酮的影响。方法用普通真空采血管及含有肝素锂抗凝剂和柠檬酸钠抗凝剂的真空采血管各采取患者样本20例分别检测孕酮,以血清检测结果为标准,肝素锂抗凝血浆和柠檬酸钠抗凝血浆检测结果分别与其比对。结果肝素锂抗凝血浆与血清两组数据比较差异无显著性(P>0.05),柠檬酸钠抗凝血浆与血清两组数据比较差异有显著性(P<0.05),相关系数r=0.99,回归方程为y=0.84725x+0.5。结论使用肝素锂抗凝血浆电化学发光法检测孕酮对结果无影响,使用柠檬酸钠抗凝血浆检测孕酮结果须进行校正以修正抗凝剂的影响。     

不同抗凝剂和放置时间对脑钠肽测定结果的影响

目的探讨不同抗凝剂和标本保存时间对脑钠肽（BNP）测定结果的影响。方法采用美国雅培I2000SR全自动化学发光分析仪,共检测34例血清和不同抗凝剂血浆中BNP的水平。结果17例患者血清、EDTA-Na2抗凝和肝素钠抗凝血浆中BNP浓度分别为（286.11±87.16）pg/ml、（219.64±65.80）pg/ml和（415.64±122.99）pg/ml,血清中BNP浓度显著低于EDTA抗凝血浆（P〈0.05）,而肝素抗凝血浆BNP水平显著高于EDTA抗凝血浆（P〈0.01）;与2h内检测结果比较,17例EDTA-Na2抗凝血浆在4℃放置24h和-70℃保存3个月BNP水平差异均无统计学意义（P〉0.05）。结论不同抗凝剂对BNP测定结果有显著影响,在BNP临床检测过程中应注意不同抗凝剂对BNP测定结果所造成的影响及血浆的放置时间和保存温度,采用厂家推荐的抗凝剂和保存状态,使检测结果具有可比性,以满足临床诊疗需要。     

用肝素锂抗凝血浆代替血清进行生化项目测定的可行性探讨

目的探讨肝素锂抗凝血浆代替血清进行生化项目测定的可行性。方法采用奥林巴斯AU2700全自动生化分析仪对60例门诊病人的血清和肝素锂抗凝血浆同时进行38项临床生化项目的测定，测定结果用SPSSl0．0统计软件进行处理，组间比较采用配对资料t检验。结果在肝素锂抗凝血浆与血清38项临床生化指标测定结果中，除NA、GGT、TBIL、PA、AMY5个项目测定结果无显著性差异外（P〉0．05），K、CL、CA、P、MG、ALT、AST、ALP、CHE、DBIL、TP、ALB、TBA、UREA、UA、CREA、TCO2、TG、TCHO、HDL、LDL？APOA、APOB、GLU、CK、CK—MB、LDH、HBDH、IGG、IGA、IGM、C3、C4等33个项目测定结果有显著性差异（P〈O．05）。结论肝素锂抗凝血浆对临床生化项目测定结果影响较大，不能用肝素锂抗凝血浆代替血清进行临床生化项目的测定。     

喉癌病人血清肿瘤坏死因子的测定

①目的探讨喉癌病人血清肿瘤坏死因子（ＴＮＦ）水平的改变及其临床意义。②方法采用ＥＬＩＳＡ法测定３７例喉鳞状细胞癌病人、２５例喉良性疾病病人和４０例正常人血清ＴＮＦ水平。③结果喉癌病人血清ＴＮＦ水平较良性疾病组和正常对照组增高（ｔ′＝５．８２，５．６７，Ｐ均＜０．０１）；以大于正常对照组血清ＴＮＦ的ｘ±２ｓ为阳性，喉癌组阳性率为７５．７％，良性疾病组阳性率为８．０％，两组比较差异有极显著性（χ２＝２４．７２，Ｐ＜０．０１）；喉癌病人血清ＴＮＦ水平与临床分期无关（ｔ＝０．１６，Ｐ＞０．０５）。④结论喉癌病人血清ＴＮＦ水平升高，检测血清ＴＮＦ水平有助于喉癌的诊断。     

2型糖尿病病人血清铁蛋白的变化及意义

①目的 探讨血清铁蛋白（ＳＦ）与２型糖尿病病人糖代谢和胰岛素抵抗的关系。②方法 采用放免法测定９６例２型糖尿病病人及３２例正常人的ＳＦ和胰岛素水平,并同时检测血糖、血脂等。③结果 ２型糖尿病病人血清ＳＦ明显高于正常人（ｔ＝４．２２,Ｐ〈０．０１）。ＳＦ水平与血糖、糖尿病慢性并发症及胰岛素抵抗有关（Ｆ－６７．３６,７２．８２,ｑ－６．２４～９．３２,Ｐ均〈０．０１;ｔ－３．２４０,Ｐ〈０．０１）。④     

尿游离皮质醇固相放免法的建立

尿游离皮质醇固相放免法的建立张育青汪寅章汪保安关键词肾上腺皮质激素类；尿游离；放射免疫测定中国图书资料分类法分类号Ｒ３９２．６１材料１．１二氯甲烷用于提取ＵＦＣ。１．２无醇液０．０５ＭＰＢ－０．２％ＢＳＡ－０．０２ＭＥＤＴＡ－Ｎａ２，ｐＨ７．０。１．...     

老年肺心病患者血浆内源性类洋地黄物质及心钠素水平测定的临床意义

应用放免方法同步测定了２５例健康老年人及３０例老年肺心病患者急性发作期和缓解期血浆内源性洋地黄（ＥＤＬＳ）和心钠素（ＡＮＦ）水平。结果表明，老年肺心病急性发作期组血浆ＥＤＬＳ和ＡＮＦ水平明显增高，与健康老年组比较有极显著性差异（Ｐ＜０．０１）；缓解期时血浆ＥＤＬＳ和ＡＮＦ与健康老年组比较差异无显著性意义（Ｐ＞０．０５），直线相关分析表明，血浆ＥＤＬＳ与ＡＮＦ呈显著性正相关（ｒ＝０．４５）。提示：血浆ＥＤＬＳ和ＡＮＦ可能与老年肺心病的病理生理变化有关，测定肺心病患者血浆ＥＤＬＳ和ＡＮＦ水平，可做为估价肺心病患者心功能状态参考的生化指标     

食物对胰岛素样生长因子—Ⅰ及其结合蛋白的影响

目的：研究营养对胰岛素样生长因子（ＩＧＦⅠ）和胰岛素样生长因子结合蛋白（ＩＧＦＢＰｓ）的影响。方法：检测限制食物５０％的幼年大白鼠，并以随意进食的同龄大白鼠作对照。血清ＩＧＦⅠ和胰岛素采用放射免疫分析法测定，血清ＩＧＦＢＰ３、ＩＧＦＢＰ４与ＩＧＦＢＰ２、ＩＧＦＢＰ１分别采用Ｗｅｓｔｅｒｎｌｉｇａｎｄｂｌｏｔ与Ｉｍｍｕｎｏｂｌｏｔ方法测定；肝脏的ＩＧＦＢＰｓｍＲＮＡ采用Ｎｏｒｔｈｅｒｎｂｌｏｔ方法测定。结果：食物限制组的体重、身长的增长以及食物效益明显低于对照组。血清ＩＧＦⅠ（Ｐ＜００１）和血清ＩＧＦＢＰ４（×６１％，Ｐ＜００５）也同时降低。而血清ＩＧＦＢＰ１（×３４４％，Ｐ＜００１）和肝脏ＩＧＦＢＰ１、ＩＧＦＢＰ２ｍＲＮＡ（×４２０％、×３７０％，Ｐ均＜００１）明显升高。结论：①食物限制可导致血清ＩＧＦⅠ和ＩＧＦＢＰ４降低，可能与儿童生长障碍有关；②增加的ＩＧＦＢＰ１可能是ＩＧＦⅠ活性抑制因子；③ＩＧＦＢＰ２可能有异常代谢存在。     

淮南市1 993

目的：了解淮南市居民的血清甲胎蛋白（ＡＦＰ）及癌胚抗原（ＣＥＡ）水平，以供临床检验参考和原发性肝癌的普查。方法：采用放射免疫法进行测定。结果：正常成人血清ＡＦＰ男性为１０．６４±８．９８μｇ／Ｌ，女性为９．１０±５．５３μｇ／Ｌ，差异有显著性（Ｐ＜０．０１）。血清ＣＥＡ男性为７．２３±４．１３μｇ／Ｌ，女性为７．５２±５．６３μｇ／Ｌ，差异无显著性（Ｐ＞０．０５），故正常参考范围为７．２８±４．４６μｇ／Ｌ；并发现１名女性肝癌患者，其血清ＡＦＰ异常升高，＞４０００μｇ／Ｌ。ＣＥＡ检测中未发现异常升高者。结论：该市人群血清ＡＦＰ及ＣＥＡ水平无异常变化，而放免法测定血清ＡＦＰ可作为肝癌普查的有效指标。     

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.