血尿酸对判断慢性心衰治疗效果的意义

目的 观察慢性心衰急性失代偿期患者血尿酸水平与心功能的关系.方法 (1)检测58例心功能Ⅲ～Ⅳ级(NYHA分级)患者血尿酸浓度,与60例急性心衰患者血尿酸浓度进行比较.(2)对不同病因(分别为冠心病、扩张性心肌病、高血压心脏病、风湿性心脏病组)的心功能Ⅲ～Ⅳ级患者的血尿酸浓度进行比较.(3)对58例慢性心力衰竭患者急性失代偿期治疗前后血尿酸程度进行比较.结果 (1)急性心功能不全组(对照组)血尿酸浓度(176±22) μmol/L,心功能Ⅲ～Ⅳ级组(观察组)血尿酸浓度(485±62) μmol/l,对照组与观察组间比较差异有统计学意义(P＜0.05).(2)心功能Ⅲ～Ⅳ级不同病因组间血尿酸浓度差异无统计学意义(P＞0.05).(3)对照组治疗前血尿酸浓度(176±22) μmol/L,治疗后(168±35) μmol/L,差异无统计学意义(P＞0.05),观察组治疗前后分别为(485±62) μmol/L、(299±47) μmol/L,治疗前后差异有统计学意义(P＜0.05).(4)心衰患者血尿酸水平变化与性别无关.结论 慢性心衰急性失代偿期血尿酸浓度高,心功能改善后血尿酸浓度明显下降,动态检测血尿酸浓度这一生化指标对判断慢性心衰的治疗效果是有意义的.     

血尿酸浓度与原发性高血压冠心病病情程度关系

目的　探讨血尿酸浓度与原发性高血压 (EH) ,冠心病 (CHD)病情程度的相关性。方法　采用酶学法 ,用全自动生化分析仪AU 4 0 0测定血尿酸浓度。结果　 10 8例EH患者血尿酸浓度为 (4 2 2 .83± 15 0 .6 6 )μmol/L ,高血尿酸症 (HUA)总发生率为 4 2 .6 %。其中 :Ⅲ级EH患者血尿酸水平较Ⅰ级EH患者尿酸水平显著升高 (P <0 .0 5 ) ,Ⅲ级EH患者较Ⅱ级EH患者血尿酸水平、Ⅱ级EH患者血尿酸水平较Ⅰ级EH患者血尿酸水平显著升高 (P <0 .0 5 ) ,冠心病 (CHD)患者血尿酸浓度为 (4 31.83± 15 1.36 ) μmol/L ,高血尿酸症 (HUA)总发生率为 4 3.1%。冠状动脉 2支或 2支以上病变与高血尿酸检出率成正相关 (P <0 .0 5 )。结论　HUA与EH、CHD的发生率及病情程度关系密切     

原发性高血压患者血尿酸浓度的观察

目的 :观察不同分期高血压 (EH)患者血尿酸浓度与高尿酸血症 (HUA)的发生率 ,探讨其临床意义。方法 :用尿酸酶 POD终点法 ,在全自动生化分析仪上测定血尿酸浓度。男 >4 2 0 μmol L、女 >380 μmol L为HUA。结果 :2 80例EH患者血尿酸浓度 (40 2 .81± 130 .6 6 ) μmol L ,HUA总发生率为 4 2 .5 %。男性明显高于女性 (P <0 .0 1) ,年龄 >6 0岁者明显高于≤ 6 0岁者 (P <0 .0 1)。按HE分期比较 ,Ⅰ期、Ⅱ期、Ⅲ期血尿酸浓度分别为 (35 1.94± 115 .73) μmol L、(382 .0 5± 10 4 .4 4 ) μmol L、(438.2 6± 15 9.78) μmol L ,HUA分别为 2 5 .5 %、39.6 %、5 0 .2 % ,(均P <0 .0 1)。男性随临床分期和年龄增长均有升高但无显著性差异 (P >0 .0 5 ) ,女性则明显升高 (P <0 .0 5 )。结论 :(1)血尿酸浓度和HUA发生率与年龄和临床分期密切相关 ;(2 )女性血尿酸浓度和HUA与年龄增长和临床分期的相关性比男性更为密切。     

老年冠心病心功能不全血尿酸浓度测定及临床意义

目的探讨老年冠心病心功能不全与血尿酸的关系。方法选择117例冠心病心功能不全患者和125例冠心病患者（心功能正常者）,年龄≥75岁,应用尿酸氧化酶法测定血尿酸浓度（男≥420μmol/L,女≥360μmol/L为高尿酸血症）,并分析患者心功能程度与血尿酸浓度的关系。结果117例冠心病心力衰竭患者血尿酸浓度为（419.51±163.23）μmol/L,高尿酸血症发生率为44.44%,125例冠心病非心力衰竭患者血尿酸浓度为（330.83±88.04）μmol/L,高尿酸血症发生率为15.20%。血尿酸浓度与心功能程度呈正相关（P〈0.01）。结论血尿酸升高与老年冠心病心功能不全关系密切。     

冠心病患者血尿酸水平与心功能不全的相关性研究

目的:分析血尿酸水平与冠心病慢性心功能不全(CHF)的相关性。方法:将确诊为冠心病的325例患者依据心功能情况分为两组,心功能正常组192例,心功能不全组133例。心功能不全组按纽约心功能分级标准分为Ⅱ~Ⅳ级;采用尿酸氧化酶法测定空腹血尿酸浓度;运用统计学方法分析患者血尿酸浓度与心功能程度的相关性。结果:心功能正常组和心功能不全组患者性别、年龄方面比较差异有统计学意义(P0.05)。心功能正常组血尿酸浓度为(325.87±91.32)μmol/L,高尿酸血症(HUA)发生率为20.31%;心功能不全组血尿酸浓度为(424.85±102.23)μmol/L,HUA发生率为48.87%,两组比较差异有统计学意义(P0.01)。随着心功能分级的增高,患者的血尿酸浓度逐渐增高,高尿酸血症发生率也逐渐升高,比较差异有统计学意义(P0.01)。结论:冠心病心功能不全患者的血尿酸浓度高于心功能正常患者,并随着心功能的下降而不断升高,同时,高尿酸血症发生率也会增加,血尿酸水平与心功能分级呈正相关。     

原发性高血压血尿酸升高临床意义及相关性研究

目的:探讨原发性高血压(EH)合并高尿酸血症(HUA)的临床意义及与心血管疾病危险因素的关系。方法:选择108例原发性高血压病患者及114例正常对照组,测定血尿酸(BUA)、空服血糖(FBG)、血脂各项指标。结果:1108例EH患者血尿酸浓度为(422.83±150.66)μmol/L,HUA总发生率为42.6%。2级EH患者较级EH患者血尿酸水平、级EH患者较级EH患者血尿酸水平、级EH患者较级EH患者血尿酸水平显著升高。3各级EH组中,HUA与FBG、TG、LDL密切相关,且在级EH组中变化最明显。结论:EH与HUA密切相关,HUA是导致心血管疾病的危险因素之一。     

血尿酸水平与缺血性心脏病之间的关系研究

目的:探讨血尿酸水平与缺血性心脏病之间的关系。方法:经冠状动脉造影确诊的缺血性心脏病患者102例,按照ISFC/WHO诊断标准,缺血性心脏病患者按照心功能分级标准分为心功能Ⅰ级组患者26例,Ⅱ级组患者25例,Ⅲ级组患者25例,Ⅳ级组患者26例。分别测定不同心功能分级患者的血清尿酸(SUA),统计分析血尿酸水平与缺血性心脏病心功能分级之间的关系。结果:经测定心功能Ⅰ级组、Ⅱ级组、Ⅲ级组、Ⅳ级组的血尿酸水平分别为(306.6±49.7)μmol/L、(318.4±45.4)μmol/L、(391.9±68.5)μmol/L、(482.4±80.3)μmol/L,Ⅰ级、Ⅱ级组比较差异无统计学意义(P0.05);Ⅲ级、Ⅳ级两组与Ⅰ级、Ⅱ级组比较差异有统计学意义(P0.01)。结论:血尿酸水平与缺血性心脏病患者的发生发展密切相关,血尿酸水平的变化与心功能的分级呈正相关性,医师可以根据患者血尿酸水平的变化判断患者心血管疾病的发展,从而更有效的提出改善患者症状的手段。     

急性心肌梗死后溶血磷脂酸水平与心肌重塑的关系

目的　研究急性心肌梗死 (AMI)后溶血磷脂酸 (LPA)水平的变化及其与左室重塑的相关关系 ,及LPA在AMI后心肌重塑中的作用。方法　选择AMI患者 86例 ,分别于入院即刻及第 4天测定患者血浆溶血磷脂酸和Ⅲ型前胶原蛋白的水平 ,并于入院即刻和发病第 8～ 10天对患者进行心脏彩色超声的检查 ,测定左室舒张末期直径 (LVDEd)和左室射血分数 (EF) ,并计算心肌梗死占左室面积的百分比。正常对照 4 0例 ,测定其血浆溶血磷脂酸和Ⅲ型前胶原蛋白的水平。根据入院第 4天所测得的LPA水平把患者分为两组 :LPA水平较低组 (LPA <6 0 μmol/L)为A组 ,4 5例 ;LPA水平较高组(LPA≥ 6 0 μmol/L)为B组 ,4 1例 ,比较各组参数的差异性 ,分析它们的相关关系。 结果 (1)AMI后患者血溶血磷脂酸水平较正常对照明显升高 (5 1μmol/L± 1 1μmol/L和 6 4 μmol/L± 1 3μmol/Lvs 2 5μmol/L± 1 1μmol/L ,P =0 0 0 0 1) ;(2 )溶血磷脂酸水平较高组患者与溶血磷脂酸水平较低组患者相比其左室舒张末期直径较大 (5 4 0mm± 3 3mmvs 5 1 1mm± 2 7mm ,P <0 0 5 ) ,心肌梗死面积占左室总面积的百分比较高 (114 %± 6 %vs2 6 %± 12 % ,P <0 0 5 ) ,PCⅢ水平高 (136 μg/L± 10 μg/Lvs113μg/L± 12 μg/L ,P <0     

慢性乙型肝炎、肝硬化患者血清过氧化脂质变化的研究

研究慢性乙型肝炎 (CHB)、肝硬化病人血清过氧化脂质 (LPO)浓度的变化。方法 :用改良硫代巴比妥酸 (TBA)法测定 186例慢性乙型肝炎和 2 3例肝硬化患者及 10 0例正常人血清LPO浓度。结果 :慢性乙型肝炎轻度、中度、重度及肝硬化患者血清LPO分别为 (4.81± 0 .87) μmol/L ,(5 .5 3± 1.12 ) μmol/L ,(5 .96±1.0 1) μmol/L及 (6 .0 1± 0 .74 ) μmol/L ,较正常对照组 (3.86± 0 .75 ) μmol/L明显升高 (P <0 .0 1)。结论 :LPO浓度随肝炎病情发展而升高 ,测定血清LPO可作为动态观察病情 ,判断肝炎预后的指标之一。     

血尿酸升高与冠状动脉粥样硬化的关系

目的 探讨血尿酸升高与冠状动脉粥样硬化的关系.方法 行冠状动脉造影病例303例,狭窄50%或以上为阳性病变,其中左前降支、左回旋支、右冠状动脉均有病变者118例,2支冠状动脉病变者90例,1支冠状动脉病变者95例.入院后第2天早晨空腹测血尿酸,血尿酸的测定采用酶法.对血尿酸≥400μmol/L患者的发生率进行统计分析.结果 3支冠状动脉均有病变者118例,血尿酸≥400 μmol/L发生率为48.3%;2支冠状动脉病变者90例,血尿酸≥400 μmol/L发生率为31.1%;1支冠状动脉病变者95例,血尿酸≥400μmol/L发生率为29.5%.3支冠状动脉病变血尿酸≥400μmol/L的发生率明显高于2支及1支冠状动脉病变者(P＜0.05,P＜0.01).结论 血尿酸升高与冠状动脉病变具有相关性.对冠心病患者进行血尿酸测定可预测冠状动脉病变的严重性.     

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.