冠心病患者血清脂质过氧化物、超氧化物歧化酶水平及与血脂的相关性

目的 :探讨冠心病 (CHD)患者血清脂质过氧化物 (LPO)、超氧化物歧化酶 (SOD)、血脂的变化及其相互关系。方法 :测定了 46例CHD患者及 37例正常人血清丙二醛 (MDA)、SOD、总胆固醇 (TC)、甘油三酯 (TG)、低密度脂蛋白胆固醇 (LDL -C)、高密度脂蛋白胆固醇 (HDL -C)水平。结果 :CHD患者MDA、TC、TG、LDL -C显著高于正常 (P <0 0 1) ,SOD、HDL -C显著低于正常 (P <0 0 2 ) ,而且MDA与TC、LDL -C呈显著正相关 (r=0 31,P <0 0 5 ;r =0 37,P <0 0 2 ) ,SOD与HDL -C呈显著正相关 (r =0 34,P <0 0 5 )。结论 :CHD患者脂质过氧化 (LP)增强与抗氧化功能降低及脂质代谢障碍之间存在一定关系     

血清n-HDL-C对冠心病合并高脂血症的诊断及监测

[目的 ]探讨非高密度脂蛋白胆固醇 (n -HDL -C)是否对冠心病合并高脂蛋白血症患者具有诊断意义及病情监测的意义。 [方法 ]5 7名 (42～ 82岁 )冠心病稳定期合并高脂蛋白血症患者 ,并且将患者组分为高甘油三酯型 ,高胆固醇型和混合型三组 ,以及 36名 (5 0～ 77岁 )身体健康正常体检者 ,测定血清中HDL -C和低密度脂蛋白胆固醇 (LDL -C)的浓度。对于临床治疗后病情减轻、明显好转的部分病例同时监测其治疗后的LDL -C和n -HDL -C值。 [结果 ]患者组的LDL -C及n -HDL -C含量与正常对照组比较有显著性差异 (P <0 .0 0 1) ,并且n -HDL -C与LDL -C呈正相关 (r =0 .838,P <0 .0 0 1)。治疗后的监测指标LDL -C与n -HDL -C也呈正相关 (r =0 .839,P <0 .0 0 1) ,且在少数病例中n -HDL -C的敏感性要好于LDL -C。 [结论 ]血清n -HDL -C含量变化在冠心病的诊断和病情监测上有意义 ,并且与LDL -C呈正相关。     

冠心病患者血脂异常与胰岛素抵抗的关系

目的 :探讨冠心病患者血脂异常与胰岛素抵抗的关系。方法 :观察 68例冠心病患者与 66例对照者的血脂、血糖、胰岛素等生化指标 ,以胰岛素释放指数———空腹胰岛素 (FIns) /空腹血糖 (FBG)和胰岛素敏感指数(1 /FBG×FIns)作为胰岛素抵抗 (IR)的指标 ,与空腹血脂进行直线相关分析。结果 :冠心病组与对照组对比 ,血糖水平无明显差异 (P >0 .0 5) ,而血胰岛素、胰岛素释放指数明显较对照组增高 (P <0 .0 5) ,胰岛素敏感指数明显较对照组低 (P <0 .0 5)。冠心病组的甘油三酯 (TG)、总胆固醇 (TC)、低密度脂蛋白胆固醇 (LDL -C)明显较对照组增高 (P <0 .0 5)、高密度脂蛋白胆固醇 (HDL -C)明显较对照组低 (P <0 .0 5)。冠心病组胰岛素释放指数、胰岛素敏感指数分别与TG ,TC和LDL -C呈正相关 ,与HDL -C呈负相关。结论 :冠心病患者存在着高胰岛素血症和胰岛素抵抗 ,而且冠心病患者的胰岛素抵抗和血脂异常密切相关。     

血清中正常或偏低胆固醇冠心病患者的脂蛋白谱分析

目的　探讨血清总胆固醇 (TC)正常或低于平均水平的冠心病 (CHD)患者的脂蛋白谱特点。方法　观察诊断明确的男性CHD 2 2 5例 ,以年龄 ,生活水平相似的健康男子 2 2 5例为对照 ,均排除与脂代谢有关的疾病及用药 ,对血脂作多指标综合分析。结果　CHD患者中TC高于 5 17mmol/L者 10 8例 ( 4 8% ) ,低于此水平者 117例( 5 2 % ) ,高TC组的血脂特点以LDL -C和apoB增高为重 ,低TC组的特点是HDL -C偏低 ,尤以apoAI低下最明显 ,多数HDL -C低的病例并无TG增高 ,部分病例以低HDL(包括HDL -C·apoAI)为单一的血脂异常。结论　低TC组在LDL致动脉硬化作用明显减弱的情况下 ,低TC组在LDL致动脉硬化作用明显减弱的情况下 ,低HDL成为主要的 (独立的 )脂类危险因素     

536例精神病人的血脂水平分析

目的 :对精神病人的血脂进行测定和分析 ,了解其血脂与健康人是否存在差异。方法 :对 5 36例精神病病例样本、2 2 4例正常对照 ,测定总胆固醇 (TC)、甘油三脂 (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)及载脂蛋白B(ApoB)等六项血脂指标 ,并将病例样本根据病种分为四组进行比较研究。它们是精神分裂症 4 18例、抑郁症 30例、酒精所致精神障碍 2 6例 ,其它精神病 6 2例。结果 :5 36例病例样本与 2 2 4例正常对照比较 ,TC、HDL -C、LDL -C及ApoA1无显著性差异 (P >0 .0 5 ) ,而TG及ApoB有显著性差异 (P <0 .0 5 ) ,其中TG升高、ApoB降低。与正常对照比较 ,精神分裂症组的TC、HDL -C、LDL -C及ApoA1无显著性差异 (P >0 .0 5 ) ,TG及ApoB显著升高 (P <0 .0 5 ) ;抑郁症组的HDL -C及ApoA1无显著性差异 (P >0 .0 5 ) ,TC、TG、LDL -C及ApoB有显著性差异 (P <0 .0 5 ) ,其中TC、LDL -C及ApoB下降 ,TG升高 ;酒精所致精神障碍组的TC无显著性差异 (P >0 .0 5 ) ,HDL -C及ApoA1显著降低 (P <0 .0 5 ) ,而LDL -C、TG及ApoB显著升高 (P <0 .0 5 ) ;其它精神病例组的TC、HDL -C、LDL -C及ApoA1无显著性差异 (P >0 .0 5 ) ,TG及ApoB显著升高 (P <0 .0 5 )。结论 :精神病人与健     

冠心病患者血浆同型半胱氨酸水平的变化及其与血脂的关系

目的　探讨血浆同型半胱氨酸 (HCY)水平变化对冠心病 (CHD)患病的意义以及HCY与血脂的相关性。方法　分别测定 10 5例CHD患者和 32例正常对照组血浆HCY及血脂各参数水平 ,并进行比较及相关性分析。结果　CHD组的HCY、甘油三酯 (TG)、总胆固醇 (TC)水平均明显高于对照组 (P <0 .0 1) ;TC、高密度脂蛋白胆固醇 (HDL -C)、低密度脂蛋白胆固醇 (LDL -C)对HCY均无明显影响 ,而CHD组HCY水平与TG呈正相关(r=0 .0 2 1,P <0 .0 5 )。结论　HCY与CHD具有密切联系 ,HHCY是CHD患病的一个新的危险因素 ,检测血浆HCY对预防和诊治CHD具有一定临床价值。HCY与TG具有一定相关性     

胆红素水平与冠心病发病、血脂水平相关关系的研究

目的　就胆红素水平与冠心病 (CHD)发病及血脂水平是否相关进行对照研究。方法　设定CHD组(10 0例 )与对照组 (6 0例 ) ,测定血清总胆红素 (TBIL)、甘油三酯 (TG)、总胆固醇 (CHO)、高密度脂蛋白 (HDL)、低密度脂蛋白胆固醇 (LDL -C) ,采用FRIEDWALD公式计算 (组间比较采用 t检验 )。结果　CHD组TBIL浓度明显低于对照组 (P <0 .0 5 ) ,CHD组TBIL浓度与LDL -C、TG呈一定的负相关。结论　CHD的发生与TBIL的降低有一定的相关性。TBIL具有防止脂质氧化的作用 ,从而防止CHD的发生     

载脂蛋白的检测及其临床应用

用Diasys公司生产的试剂盒对正常人群及冠心病 (CHD)人群进行 (TC、TG、HDL -C、ApoA1和ApoB的测定。结果显示 :CHD组TC、TG、HDL -C与对照组相比P <0 .0 1,而ApoA1、ApoB及ApoB/ApoA1值与对照组相比 ,差异有高度显著性 (P <0 .0 1)。认为载脂蛋白检测作为冠心病的诊断指标明显优于总胆固醇、甘油三酯、高密度脂蛋白胆固醇三项     

冠心病患者血清总胆红素、血脂及尿酸水平检测意义

目的　通过分析冠心病与非冠心病患者血清总胆红素、血脂及尿酸水平 ,探讨其在预测评估冠心病方面的临床意义。方法　 14 4例疑似冠心病患者 (CHD) ,经冠状动脉造影结果分为冠心病组 (CHD组 ) 92例和非冠心病组 (non CHD组 ) 5 2例 ,分别测定其血清总胆红素 (TBIL)、血脂各组分总胆固醇 (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Al(ApoAl)、载脂蛋白B10 0 (ApoB)及尿酸 (UA)水平。结果　①血清TBIL水平 :CHD组低于non CHD组 (P <0 0 5 ) ;②血清脂质各组分 :TC、LDL c及ApoB水平CHD组高于non CHD组 (P <0 0 5 ) ,LDL c/HDL c及ApoB/ApoAl比值CHD组显著高于non CHD组 (P <0 0 1) ,其余指标在组间分布差异不显著 (P >0 0 5 ) ;③血清尿酸水平 :CHD组高于non CHD组 (P <0 0 5 )。结论　检测冠心病患者血清TBIL、UA和血清脂质各组分水平对预测评估冠心病有一定临床价值     

冠心病患者超敏C—反应蛋白的检测

目的　探讨冠心病 (CHD)患者超敏C反应蛋白 (HS-CRP)水平及其与血脂的关系。　方法　6 9例冠心病和 82例冠脉造影正常的非冠心病患者 ,分别测定HS -CRP、甘油三酯 (TG)、高密度脂蛋白胆固醇 (HDL -C)、胆固醇 (TC)和低密度脂蛋白胆固醇 (LDL -C)血清水平 ,并作相关性分析。　结果　CHD组血清HS -CRP水平 ( 4 .76± 3.2 8mg L)与非CHD组 ( 2 .72± 1 .4 3mg L)比较差异无显著性 (P =0 .0 6 8) ,但CHD组高HS -CRP水平发生率 ( 4 4.93% )远高于非CHD组 ( 1 9.5 1 % ) ,P <0 .0 1 ;HS -CRP与TG具有相关性 (γ=0 .5 4 9,P =0 .0 0 2 )最强。　结论　冠心病患者可能存在隐性炎症 ;HS -CRP检测对了解冠心病患者血管内皮功能有一定的意义     

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.