老年男性非杓型高血压合并糖尿病对血压昼夜节律及靶器官损害的影响

目的探讨老年男性非杓型高血压合并糖尿病对血压昼夜节律形态及心、肾靶器官损害的影响。方法入选老年男性原发性非杓型高血压患者656例,根据是否合并2型糖尿病,分为合并糖尿病组(n=366)与非糖尿病组(n=290)。采用全自动生化分析仪测定空腹血糖(FBG),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),氨基末端脑利钠肽前体(NT-proBNP),肌钙蛋白T(TnT),并依据MDRD公式计算肾小球滤过率(eGFR);行心脏超声检查,计算左室质量指数(LVMI)。分析两组患者上述指标差别。结果与非糖尿病组比较,合并糖尿病组患者血红蛋白[(132.3±15.62)mmol/L vs.(131.14±12.32)mmol/L]、TG[(1.52±1.09)mmol/L vs.(1.35±0.69)mmol/L]、HDL-C[(1.15±0.32)mmol/L vs.(1.20±0.33)mmol/L]、T3[(4.05±0.69)nmol/L vs.(4.27±0.85)nmol/L]、TnT[(0.05±0.18)μg/L vs.(0.02±0.02)μg/L]、LVMI[(179.82±44.83)g/m2 vs.(168.21±32.16)g/m2]、24h收缩压[(125.00±12.14)mmHg vs.(123.00±11.11)mmHg]、白昼收缩压[(127.00±13.09)mmHg vs.(125.30±12.29)mmHg]、夜间收缩压[(128.12±16.28)mmHg vs.(125.34±14.59)mmHg]、夜间血压与白天血压比值[(0.99±0.05)mmHg vs.(0.98±0.04)mmHg]有统计学意义(P均0.05)。结论老年男性原发性非杓型高血压合并糖尿病患者收缩压升高更为严重,血压昼夜节律消失更为明显,心功能损害加重。     

51例糖尿病合并高血压患者的中西医护理体会

目的探讨糖尿病合并高血压患者最佳的护理方法。方法将该院内分泌科近期收治的糖尿病合并高血压患者,随机分为对照组和观察组2组。对照组采取传统的西医护理方法,观察组患者采取中西医结合的护理方法。结果从患者患者血糖检测数值和血压达标率2方面进行评价比较。在血糖检测方面,对照组患者空腹血糖和餐后2 h血糖分别为(7.90±0.77)mmol/L和(10.57±0.68)mmol/L,观察组患者空腹血糖和餐后2 h血糖分别为(6.02±0.68)mmol/L和(8.52±0.71)mmol/L。在血压达标率方面,对照组与观察组患者的达标率分别为60.78%和90.20%。以上各项比较,差异均有统计学意义(P0.05)。结论对糖尿病合并高血压患者,采取中西医结合的护理方法,效果显著。     

初诊原发性高血压患者血压昼夜节律改变与胰岛素抵抗及相关因素的研究

目的探讨初诊原发性高血压患者血压昼夜节律改变与胰岛素抵抗及其相关因素之间的关系。方法根据动态血压监测结果 ,将297例初诊原发性高血压患者分为杓型血压组56例,非杓型组58例,超杓型组46例,反杓型组37例,进行体质指数(BMI)、空腹血糖(FBG)、餐后2 h血糖(P2hBG)、空腹胰岛素(FINS)、餐后2 h胰岛素(P2hINS)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、尿酸(UA)、尿微量白蛋白(UAlb)、超敏C反应蛋白(hs-CRP)、胰岛素抵抗指数(HOM A-IR)、胰岛素敏感性指数(ISI)等检测,分析其与血压节律变化的相关性。结果非杓型组、超杓型组、反杓型组夜间平均收缩压(nSBP)、夜间平均舒张压(nDBP)、UAlb、hs-CRP与杓型组比较差异有统计学意义(P<0.05或0.01);血压昼夜节律异常与HOMA-IR、ISI非常显著相关(r分别为2.306、1.594,P<0.01),与UAlb、hs-CRP显著相关(r分别为1.005、0.676,P<0.05)。结论血压昼夜节律异常与HOMA-IR、ISI、U Alb、hs-CRP密切相关,改善IR及炎症反应、恢复正常血压昼夜节律可能改善患者预后。     

护理干预对老年糖尿病合并高血压患者用药管理效果评价

目的对老年糖尿病合并高血压患者行护理干预,评价护理干预对患者用药管理的效果。方法选择老年糖尿病合并高血压患者,患者例数90例,时间:2016年7月—2017年7月,分不同的护理干预方式:常规护理、全面护理,对应组别为对照组、研究组。分析组间的空腹血糖水平、餐后2 h血糖水平和护理总满意率、血压数据指标。结果研究组老年糖尿病合并高血压患者行全面护理后的空腹血糖水平(6.31±1.16)mmol/L、餐后2 h血糖水平(9.02±2.03)mmol/L低于对照组空腹血糖水平:(9.01±1.75)mmol/L、餐后2 h血糖水平(15.26±2.13)mmol/L,且研究组的护理总满意率(95.56%)高于对照组(73.33%),差异有统计学意义(P0.05)。结论全面护理应用于老年糖尿病合并高血压患者的用药管理之中,可以有效降低患者的血糖水平,获得令人满意的护理干预效果。     

老年高血压合并2型糖尿病患者餐后血糖与血压关系的研究

目的探讨老年高血压合并2型糖尿病患者,餐后血糖与炎症因子C-反应蛋白、脉压、昼夜血压的关系及临床意义。方法选择单纯高血压、高血压合并2型糖尿病餐后高血糖患者及健康体检者各30例,均测定空腹血糖（FPG）、餐后2h血糖（2hPG）、空腹血浆胰岛素（FINs）、糖化血红蛋白（HbAlC）、血清C-反应蛋白（CRP）,计算胰岛抵抗指数（IRI）,高血压患者行动态血压监测（ABPM）。对各组的CRP、糖代谢指标、动态血压参数等进行统计学分析,并比较高血压合并2型糖尿病餐后高血糖患者治疗前后各项指标。结果高血压合并糖尿病组FPG、2hPG、FINS、IRI、HbAlC及CRP各指标与单纯高血压组及正常对照组比较差异有统计学意义（P〈0．05）,单纯高血压组FINS、IRI及CRP高于正常对照组,差异有统计学意义（P〈0．05）;与单纯高血压患者相比,高血压合并糖尿病餐后高血糖组患者脉压（PP）增大,非杓型比率高,差异有统计学意义（P〈0．05）;高血压合并糖尿病餐后高血糖患者治疗后PP、非杓型比率下降,与治疗前比较差异有统计学意义（P〈0．05）。结论高血压与糖尿病同样存在胰岛素抵抗,高血压合并糖尿病患者,餐后血糖与CRP水平、PP、血压昼夜节律异常相关,餐后血糖的控制可能有助于夜间杓型血压的恢复,延缓动脉粥样硬化的进程。     

社区老年高血压合并2型糖尿病病人餐后血糖和血压的关系探讨

目的分析社区老年高血压合并2型糖尿病患者餐后血糖和血压间的关系。方法选取老年高血压合并2型糖尿病患者45例、单纯高血压患者45例及体检健康者40名,比较3组受试者血糖及血压。结果高血压合并糖尿病患者FPG、2 h PG、FINS、Hb Al C均明显高于单纯高血压组与健康者(P0.05),日间平均收缩压、日间平均舒张压、日间平均脉压、夜间平均收缩压、夜间平均舒张压、夜间平均脉压及非杓型动态血压节律占比均显著高于单纯高血压患者。结论社区老年高血压合并2型糖尿病患者餐后血糖和血压昼夜节律异常、患者脉压等密切相关。     

优质护理模式在糖尿病合并高血压患者中的应用价值探究

目的探究优质护理模式在糖尿病合并高血压患者中的应用价值。方法研究对象抽选自2016年12月—2018年1月期间该院收治的66例糖尿病合并高血压患者,采用奇数偶数方式分组,奇数为对照组,偶数为观察组,每组有33例患者,给予对照组患者常规护理,给予观察组患者优质化护理。记录分析两组患者护理前后的血压情况(舒张压、收缩压)、血糖情况(空腹血糖、餐后2 h血糖)及护理后生活质量评分。结果护理前两组患者血压与血糖差异无统计学意义(P0.05),护理后,两组患者血压、血糖均有所改善,观察组舒张压为(68.13±4.16)mmHg,收缩压为(119.18±2.04)mmHg比对照组(74.11±3.08)mmHg、(122.09±1.85)mmHg低;观察组空腹血糖为(5.45±1.36)mmol/L、餐后2 h血糖为(7.12±1.05)mmol/L比对照组的(5.90±1.14)mmol/L、(7.58±1.20)mmol/L低;观察生活质量评分高于对照组;数据差异有统计学意义(P0.05)。结论优质化护理模式应用于糖尿病合并高血压患者中,可有效改善患者血压血糖情况,使其生活质量得以提高,有较好临床应用价值。     

缬沙坦与氨氯地平联合治疗社区老年人原发性高血压合并糖尿病的治疗效果

目的对缬沙坦与氨氯地平联合治疗社区老年人原发性高血压合并糖尿病的治疗效果进行探究。方法选取2014年10月—2015年10月该院收治的70例原发性高血压合并糖尿病的老年患者为观察对象,并按其治疗方法的不同将其均分为两组(对照组与观察组),对照组予以单一缬沙坦治疗,观察组在对照组的基础上予以氨氯地平联合治疗,观察两组患者治疗前后的舒张压、收缩压,以及空腹血糖、饭后1h血糖、空腹胰岛素等指标的变化情况。结果两组患者治疗后的相关指标均较治疗前有明显改善,但是观察组患者的收缩压(130.42±1.26)mm Hg、舒张压(80.25±1.23)mm Hg均大幅度低于对照组的收缩压(140.28±4.22)mm Hg、舒张压(88.56±1.34)mm Hg,且观察组治疗后的空腹血糖(5.23±1.20)mmol/L、饭后1 h血糖(10.23±1.20)mmol/L、空腹胰岛素(10.32±1.20)mmol/L亦明显低于对照组的空腹血糖(7.60±1.03)mmol/L、饭后1 h血糖(15.33±1.23)mmol/L、空腹胰岛素(15.25±1.10)mmol/L,几组指标的比较结果差异有统计学意义(P0.05)。结论予以原发性高血压合并糖尿病的社区老年患者缬沙坦与氨氯地平联合治疗,可以有效降低患者的血压水平,改善患者的脂代谢紊乱现象,促进患者生活质量的提高,值得临床推广应用。     

药剂师干预对2型糖尿病合并高血压患者血压血糖及生活质量的影响

选择2015年4月-2016年4月40例T_2DM合并高血压患者作为对照组,选择2016年5月-2017年5月期间在商丘市第三人民医院药剂科取药的40例2型糖尿病合并高血压患者作为观察组,对照组未实施药剂师干预,观察组实施药剂师干预,比较两组患者服药1个月后血压、血糖控制情况及生活质量改善情况。结果观察组患者服药1个月后空腹血糖为(6.41±0.79)mmol/L、餐后2h血糖为(8.52±1.41)mmol/L、舒张压为(79.52±6.59)mmHg、收缩压为(118.34±12.43)mmHg,均低于对照组(6.86±0.83)mmol/L、(9.25±1.39)mmol/L、(85.36±7.62)mmHg、(125.57±13.46)mmHg,观察组GQOL I274量表各维度评分均高于对照组,差异有统计学意义(P0.05)。结论药剂师干预2型糖尿病合并高血压患者用药情况,可有效控制血压及血糖水平,提高生活质量。     

糖尿病人昼夜血压变化与昼夜血糖变化的关系

高血压与高血糖是糖尿病人大血管与微血管病变的已知危险因子。糖尿病人如有夜间血压不降（非杓型）或餐后高血糖，心血管危险更高。该文研究糖尿病人昼夜高血压与高血糖的关系。107名高血压2型糖尿病人做24h血压监护（ABPM），同时也做昼夜血糖监测：早餐前、早餐后2h；午餐前、午餐后2h；晚餐前、晚餐后2h、10：00PM、午夜；     

Exchange Transfusions with Frozen Blood

Abstract. On 15 newborn infants, 31 exchange transfusions were performed, 11 with previously frozen red blood cells resuspended in albumin-electrolyte-glucose solution, 4 with previously frozen red blood cells resuspended in fresh frozen plasma and 16 with ACD blood.
Good clinical effects were obtained in all cases and no untoward clinical reactions were noticed. More pronounced decreases in vB pH and vB standard bicarbonate were noted after exchange transfusions with frozen blood than after ACD blood transfusions. Small and unimportant changes of plasma electrolytes were recorded following exchange transfusions with frozen blood. The P-haemoglobin concentrations were higher in the frozen blood than in the ACD blood, resulting in an increase of P-haemoglobin following exchange transfusion with frozen blood.
The wash-out effect of the frozen blood was indicated by a reduction of platelets, fibrinogen and IgG during the exchange transfusions to 20% of the original value. Furthermore, a decrease in coagulation capacity was observed as revealed by considerable changes in TT and APTT values.
For newborn infants with suspected or manifest coagulation disorders and for newborn infants needing more than one exchange transfusion, frozen, thawed and washed red blood cells should be resuspended in fresh or fresh frozen plasma when used as transfusion blood.     

Raynaud's Disease: Reduced Hand Blood Flows with Normal Blood Viscosity

Summary: Raynaud's disease: Reduced hand blood flows with normal blood viscosity.
Hand blood flows and the blood and plasma viscosities were measured in patients with Raynaud's disease in an attempt to identify the mechanism of the episodic vascular insufficiency.
Using venous occlusion plethysmography the following observations were made: (1J the hand blood flows were significantly less than in normals at 32°, 27° and 20°C; (2) the percentage decrease in flow with cooling was greater than in normals and (3) cooling of one hand from 32° to 27°C caused an abnormal decrease in flow through the contralateral hand. Using a rotational viscometer the blood and plasma viscosities were found to be normal at both high and low shear rates. The percentage increase in the blood viscosity with cooling from 35° to 25° was also normal.
These studies demonstrate an increased constrictive response of the cutaneous vasculature of the hand to both local and reflex stimulation, and exclude a rheological abnormality, under conditions similar to those of the present study.     

Prestorage Leukocyte Depletion with In-Line Filtration of Whole Blood in Comparison with Blood Component Leukocyte Depletion

In-line filtration of blood components appears to be an effective method to reduce white-cell-induced adverse reactions. We have investigated whether whole blood filtration (WBF), prior to component preparation, is comparable with filtration of already prepared blood components (CF), i.e. the red cell concentrate (RCC) and fresh plasma. Conventionally prepared nonfiltered blood components served as a control. No significant differences for most parameters investigated were found between leukodepleted RCCs and plasma units prepared by CF or WBF. All filtered RCCs and plasma units (CF and WBF) had white blood cell contaminations <1'10⁵ per unit. Platelets were reduced in all filtered components: 95% in plasma and 99% in RCCs. Fresh-frozen plasma (FFP) prepared by CF and WBF had normal amounts of factors V, VIII, von Willebrand factor and thrombin-antithrombin-III complexes, whereas platelet factor 4 (PF-4) was slightly increased in FFP prepared by WBF. RCCs and plasma units prepared from filtered whole blood (n = 20) had a significantly greater volume (RCC: 288±19 ml; plasma: 274±20 ml) than conventionally prepared (n = 20) and filtered products (RCC: 257±19 ml, plasma: 259±19 ml). For early filtration of blood components, WBF prior to component preparation seems to offer an interesting technique for obtaining a leukocyte-depleted RCC and FFP.     

Experiments on the Preparation of Blood Components with the IBM 2991 Blood Cell Processor

Experiments were carried out with the IBM 2991 Blood Cell Processor in order to study the sedimentation behaviour of blood cells from human ACD blood during centrifugation. Based on this behaviour procedures were developed for plasmapheresis and leucapheresis using the Blood Cell Processor. Accumulation of platelets was observed to occur at the plasma-cell interface during centrifugation at 1,000 g; this led to the development of a one-step method for the preparation of platelet concentrates.     

Interaction of Influenza Virus with Blood Platelets

The interaction of human blood platelets with influenza virus (PR-8) wasstudied in vitro and in vivo.

It was found that "live" influenza virus was rapidly adsorbed onto humanblood platelets at 4 C. and completely eluted at 37 C. "Dead" virus wasadsorbed at 4 C. but not eluted at 37 C. unless the platelets were treated withRDE (receptor destroying enzyme). Adorption of virus also occurred at temperatures above 4 C. (from 20 to 37 C.). However, while adsorption wasmaintained throughout incubation at 4 C., slow elution occurred after 30 to 90minutes incubation at 26 to 37 C. Storage of the platelets for lengthy intervalsat 4 C. or coating of the platelets with macromolecules did not interfere withvirus adsorption. After one cycle of adsorption-elution, blood platelets couldnot adsorb virus again. Treatment with RDE greatly reduced virus adsorption.During the process of virus adsorption, prominent platelet clumping occurred.During elution, clumping remained unchanged, and gross alterations in morphology of the platelets were observed. In the process of virus adsorption-elution, large numbers of platelets were lysed.

Comparative experiments were performed simultaneously with human redblood cells (RBC) and identical results were obtained as with blood platelets.However, the extent of adsorption of live virus was equal for platelets andRBC only when the relationship between platelet number and RBC number inthe preparations used was 6:1. This suggested a direct proportion between thesurface area of both platelet and RBC and the number of available virusreceptors.

Virus suspensions infused into rabbits produced a sharp and sustained dropof the platelet count. Survival of radioactively labeled platelets treated withvirus prior to infusion was markedly shortened with live virus and was onlyslightly reduced with dead virus.

It is suggested from these experiments that blood platelets, as other bloodcells, may serve as carriers of viruses in the circulation and that in this processthe platelets are damaged and partially destroyed.

Submitted on June 30, 1965 Accepted on January 31, 1966     

大骨节病患儿外周血白细胞的病理学研究——揭示大骨节病病毒血症的形态学证据

目的 大骨节病(KBD)病因至今未明.本文做KBD患儿外周血白细胞的病理学研究拟验证KBD发病中有病毒血症的假设.方法 在病区小学,临床粗筛出KBD疑似儿童82例(经X线片检出KBD患儿65例),光镜查其外周血血涂片后,从中选出有白细胞病变者10例,以电镜寻找其白细胞内的病毒体. 结果 光镜查出外周血白细胞病变阳性者64/82例,可疑阳性者7/82例.电镜下,在9/10例白细胞内检出病毒核衣壳.衣壳直径70～100 nm,外形六角,部分有小核心.核衣壳外围见细胞核染色质溶解灶. 结论 在9/10例白细胞核内有病毒核衣壳的结果,使KBD发病中有病毒血症的假设得到验证.该病毒引发出白细胞坏死过程是具有细胞病变效应的.该病毒可能也是KBD软骨细胞坏死的原因.KBD病儿外周血白细胞坏死的病理学发现将对血液病理学有一定的参考意义.     

Blood Substitutes: Possibilities with Nanotechnology

Nanotechnology deals with molecules in the nanometer (10⁻⁹) range and is currently being used successfully in the field of medicine. Nanotechnology has important implications in nearly all the branches of medicine and it has all the capabilities to revolutionize the vast field of medicine in future. Nanotechnological advancements have been used for the preparation of artificial hemoglobin. It is formed by assembling the hemoglobin molecules into a soluble complex. A recent approach includes the assembling of this artificial hemoglobin with enzymes such as catalase and superoxide dismutase into a nano-complex. This complex acts as an oxygen carrier as well as an antioxidant in conditions with ischemia–reperfusion injuries.