广州市荔湾区208例脑梗塞患者危险因素调查分析

目的探讨脑梗塞的主要危险因素及神经内科预防措施。方法收集我院住院的208例脑梗塞患者病例相关资料，与对照组进行比较。结果合并高血压者达73．1％，合并糖尿病者达32．7％，而合并糖代谢异常者达到63．5％；吸烟率脑梗塞组明显高于对照组（P〈0．05）；脑梗塞组与对照组间收缩压、舒张压、总胆固醇、餐后2小时血糖、糖化血红蛋白、体重指数、血尿酸及C反应蛋白水平差异有统计学意义（P〈0．05）。结论吸烟、高血压、高胆固醇血症、餐后高血糖、高糖化血红蛋白及体重指数增高是脑梗塞的主要危险因素；血尿酸及c反应蛋白水平可能为其强的预测指标。     

肝硬化患者高发胆结石的回顾性研究

回顾性分析６０例肝硬化失代偿期患者及１００例同期住院的非肝硬化患者胆石发生情况。结果发现肝硬化组胆石发生率为３０％，非肝硬化组为８％，二者有显著差异（Ｐ＜０．００５）。１８例并发胆石的肝硬化患者及４２例无胆石的肝硬化患者血白蛋白浓度分别为２５．７２±５．６３及２９．５４±３．４６，二者比较差异显著（Ｐ＜０．０１）。本研究提示：肝硬化是胆石发生的高危因素之一；胆石的发生可能与肝病严重程度有关。     

72例旅途精神病患者的生理指标分析

对７２例旅途精神病患者和９５例正常旅客进行机体生理指标的对照研究，以期探索旅途精神病的生理指标特征。结果表明，患者血红蛋白、血钾浓度低于对照组（Ｐ＜０．０１），白细胞计数、血糖浓度高于对照组（Ｐ＜０．０１）。按超载与非超载分组，发现超载组病人血红蛋白、血钾、血尿素氮低于正常人（Ｐ＜０．０１），白细胞计数、血糖、红细胞计数、红细胞压积高于正常人（Ｐ＜０．０１）；而非超载组病人血红蛋白、血钾低于正常人（Ｐ＜０．０１），白细胞计数、血糖、红细胞压积则显著高于正常人（Ｐ＜０．０１）。     

β3肾上腺素能受体Trp／Arg突变与糖尿病视网膜病变

目的：研究中国人β3肾上腺素能受体（β3AR）基因Trp64Arg突变与糖尿病视网膜病变（DR）的相关性。方法：随机选取2型糖尿病住院患者144例，男60例，女84例，平均体重指数（BMI）25．2，病程均≥5年。根据眼底荧光造影结果，分为增殖性糖尿病视网膜病变（PDR组）、非增殖性糖尿病视网膜病变（NPDR组）及无糖尿病视网膜病变（对照组）。用酶法测血脂，用葡萄糖氧化酶法测血糖，放免法测血胰岛素、C肽，HPLC法测HbAlc，用PCR—RFLP法判断β3AR基因型。结果：（1）中国人β3AR基因突变率为18．6％，低于Pima印地安人的31％，而高于欧关等白色人种的7％～12％，与日本人突变频率相似。②与正常基因型相比，杂合子BMI（25．8±3．8vs25．0±3．4，P〈0．05）增高，血糖、血脂、血胰岛素、C肽无明显差异。③NPDR组、PDR组与对照组之间β3AR 64Arg等位基因频率无明显差异。结论：β3AR基因参与中国人体重的调节，β3AR Trp64Arg突变与中国人DR发病无关。     

肥胖、血脂和胆石症关系的研究

目的：研究肥胖、血脂和胆石症的关系。方法：通过对１１１例胆石症和１４０例对照的体重指数、血脂进行比较分析。结果：胆石且体重指数显著高于对照组，胆石症组肥胖的比例显著高于对照组（ＯＲ＝２．３２，Ｐ＝０．００４），而两组腰臀比值无显著差别。胆石症组的甘油三酯、高密度脂蛋白胆固醇显著高于对照组。结论：全身性肥胖、高甘油三酯是胆石症发生的独立危险因素，同时提示高密度脂蛋白胆固醇对结石形成的作用尚待研究。     

吉首市中小学教师3066例教师血糖血脂分析

目的了解我市教师的身体健康状脂的测定。结果教师高血糖发生状况和血糖血脂水平。方法对3066例教师及1597名非教师对照进行空腹血糖血率为3．7％（114／3066），其中男为4．0％，女为3.4％；高血脂发生率为14．4％，男15.3％，女13．5％；非教师人群高血糖发生率为4．9％（78／1597），其中男5．2％，女4．56％：高血脂者为16．8％（268／1597），男16．1％，女18．1％。结论教师与非教师相比血糖血脂水平有显著差异，教师低于非教师人群p〈0．05（x^2=3．995，4．790）；但两组男女之间的差异均无显著意义。     

红细胞葡萄糖6磷酸脱氢酶缺陷与糖尿病关系的研究

对３２８例（男１８３，女１４５）糖尿病患者作了红细胞葡萄糖６磷酸脱氢酶（Ｇ６ＰＤ）活性测定结果：男性糖尿病组Ｇ６ＰＤ活性较对照组低，差异显著（Ｐ〈０．０５）；女性糖尿病组也较对照组低，差异显著（Ｐ〈０．０５）。糖尿病病人Ｇ６ＰＤ活性低于正常值下限８．１４者男性组的发生率（１２．６％）较健康对照组（４．８６％）高，差异显著；女性糖尿病组也较健康对照组有升高趋势，对２８例次糖尿病人做了血糖浓度和Ｇ６Ｐ     

肝硬化病人胆石发生因素的B超观察

应用B超观察分析142例肝硬化病人的胆石发生情况，并阴机配对与同期142无肝胆病史的健康人进行比较，结果表明，肝硬化组胆石发生率明显高于对照组（P＜0．O1），血清非结合胆红素增高，在肝硬化伴结石与不伴结石的两组间有显著性差异（P＜0．05），并就肝硬化发生肝胆石的有关因素进行了讨论。     

综合康复对慢性精神分裂症认知功能影响的研究

目的 探讨综合康复对慢性精神分裂症的疗效、认知功能的改善。方法 52例慢性精神分裂症病人随机分为两组，康复组应用抗精神病药物加综合康复；对照组单用抗精神病药物。治疗前后分别用慢性病人标准化精神病量表评定。简易精神状况检查表（MMSE）评定认知功能。结果 康复组和对照组的慢性精神病人标准化精神病量表减分率分别为82．06％和30．67％，两者差异有显著性（t＝4．61，P＜0．01）；MMSE评定总分康复组治疗后显著性提高（P＜0．01）。结论 综合康复对慢性精神分裂症有肯定的协助治疗作用，改善认知功能有明显效果。     

孕妇体重增加幅度与孕期血糖异常的相关性分析

目的：探究并分析孕妇体重增加幅度与孕期血糖异常的相关性。方法：选取来我院进行产检的1000名产妇,将其作为临床研究对象。根据孕妇体重指数（BMI）分为正常组、超重组、肥胖组3组,根据孕期BMI的增幅可分为甲、乙、丙3组,根据孕期体重绝对值的增长分为A、B、C3组。分别检测以上3组产妇的血糖指标情况。结果：肥胖组产妇孕早期空腹血糖异常、OGTT异常及GDM比例分别为28．13％、46．88％、12．50％,血糖异常的比例高于正常产妇,差异具有统计学意义（P〈0．05）;且BMI增幅过多、体重绝对值增幅过大的产妇血糖异常比例也较正常孕妇高,差异均具有统计学意义（P〈0．05）。结论：孕妇孕前体重指数、孕期BMI增幅及孕期体重绝对值增长与孕期血糖异常密切相关,体重增加幅度过大可导致孕妇血糖异常的发生率增高。     

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.