入住疗养院者骨质疏松患病及防治状况研究

目的：探讨美国圣路易斯州入住疗养院者骨质疏松的患者及防治状况。方法：用定量超声骨密度测定仪测定217例入住疗养院者（年龄42－102岁，平均83．3岁）右侧跟骨的骨密度，结合病史及病历记录情况，对入住疗养院者骨质疏松防治状况进行。结果：入住疗养院者的骨密度低于同年龄段的社会居民，骨质疏松的患病率较高（58．5％），只有18．4％的疗养院入住者跟骨骨密度在青年成人骨密度均值1个标准差内，未诊断的骨质疏松占83．5％，未治疗骨质疏松占63．0％，只有37．0％的骨质疏松患者服用钙剂及／或维生素D治疗，用雌激素替代或用阿伦二膦酸盐积极治疗的仅有3．1％，结论：疗养院入住者骨密度低，骨质疏松患病率高，但防治状况差。     

50例系统性红斑狼疮患者血脂水平分析

目的探讨系统性红斑狼疮（SLE）患者血脂的变化及其临床意义。方法检测18例初诊未用激素治疗、32例已用激素治疗的SLE患者和30例正常健康体检者的血脂水平,并分析其变化与临床病情资料的相关性。结果SLE患者组血清胆固醇（TC）和三酰甘油（TG）水平明显高于对照组（P〈0．01）,HDL水平显著低于对照组降低（P〈0．05）。有肾脏病变SLE患者组TG水平明显高于无肾脏病变SLE患者组（P〈0．01）,TC和HDL水平在两组间差别无统计学意义（P〉0．05）。SLE应用激素治疗组血清TC和TG水平明显高于对照组（P〈0．01）,HDL水平在两组间差别无统计学意义（P〉0．05）。另外HDL水平与血沉（ESR）呈负相关。结论系统性红斑狼疮患者血脂异常主要系肾脏损害和大剂量激素使用所致。     

系统性红斑狼疮是否存在胰岛抵抗

目的：探讨系统性红斑狼疮是否存在胰岛素抵抗。方法：选择12例未使用激素治疗的初诊系统性红斑狼疮患者和1例正常人（对照组），进行糖耐量试验，分别测定0、30、60、120分钟时的血糖、血胰岛水平及胰岛敏感指数。结果：系统性红斑狼疮组与对照组比较，0、120分钟时的血糖无显著变化（P＞0．05），而30、60分钟时的血糖较对照组高（P＜0．05），服糖后血胰岛素水平及胰岛素敏感素水平及胰岛素敏感指标显著高于对照组（P＜0．01）。结论：系统性红斑狼疮存在胰岛素抵抗。     

老年男性骨密度与钙调节激素关系的探讨

目的 探讨老年男性骨密度与钙调节激素的关系。方法：用双能X线骨密度仪（DEXA）测定65例老年男性骨密度（BMD）。用放免法测定睾酮（T）、甲状旁腺激素（PTH）、降钙素（CT）、骨钙素（BGP）。结果 （1）随年龄增加,骨质疏松及骨量减少患者逐渐增加;（2）T、CT随年龄增加而逐步减少,PTH逐渐增加,而BGP无明显变化;（3）骨质疏松及骨量减少组T、CT均显著低于正常组（均P＜0．001）,PTH显著高于正常组（P＜0．001,P＜0．01）,BGP在骨质疏松组显著高于正常组（P＜0．001）,而骨量减少组则与正常组无差异（P＞0．05）。结论 增龄、钙调节激素异常是引致老年男性骨质疏松的重要原因之一。     

老年高血压病24小时动态血压监测初探

本文80例老年高血压病患者，单纯收缩期高血压（ISH）占47.5％（38／80）；非单纯收缩期高血压（混合性／舒张期高血压）（non－ISH）占52．5％（42／80）。两组并发肾功能不全及眼底动脉Ⅲ或Ⅳ期改变的发生率无显著性差异（P＞0.05），而ISH组高心病的发生率高于non－ISH组（P＜0．05）。24小时无创性动态血压监测结果显示：24小时动态血压曲线呈物形改变者ISH组占52．6％，而non－ISH组占57．1％，两组间无统计学差异（P＞0．01）；但非物形改变者并发症的发生率高于构形者（P＜0.05）；表明老年高血压病血压节律减弱或消失发生心脑肾并发症危险性增加。血压变异系数分析发现：两组收缩压变异系数大于舒张压，白昼大于夜间（P均＜0．05）；且在ISH组收缩压变异系数大于non－ISH组（P均＜0．05），表明老年ISH病人24小时收缩压的波动程度更大，舒张压相对较低，更容易加重心脏等靶器官的损害。本文提示：老年高血压病的治疗不仅要使血压水平下降，而且要纠正血压节律和波动的紊乱。     

大剂量环磷酰胺冲击治疗系统性红斑狼疮时的闭经危险

目的 研究大剂量环磷酰胺冲击治疗系统性红斑狼疮时的闭经危险。方法 前瞻性对比研究51例接受大剂量环磷酰胺冲击治疗的生育期女性患者与22例接受甲基强的松龙治疗的生育期女性患者的闭经发生率及其规律。结果 大剂量环磷酰胺冲击治疗组闭经率19．6％，比甲基强的松龙治疗组的闭经率明显增高（P＝0．025），大剂量环磷酰胺冲击治疗组中，年龄大于30岁比组比30岁及30岁以下组闭经率高（P＝0．0018）。结论 大剂量环磷酰胺冲击治疗系统性红斑狼疮时，生育期女性患者患闭经率升高，年龄愈大，闭经的危险愈高。     

148例原发性高血压钙代谢失调与骨质疏松的关系

目的：探讨原发性高血压患者钙代谢失调与骨质疏松的关系。方法：对148例原发性高血压患者进行血Ca、P、ALP、PTH、Scr及尿Ccr、Ca、P和骨矿物测量的变化,同时与年龄性别相匹配的正常人进行对照研究。结果：高血压组尿Ca排泄量、血PTH高于正常人（P＜0．05）;BMC、BMC／BW均低于正常对照组,并与尿Ca排泄量、血PTH呈负相关（r=-0．213,P＜0．05）。高血压组骨质疏松的发生率为20．9％,其中男性20,6％,女性21．3％,男、女之间无差异（P＞0．05）。结论：原发性高血压患者骨质疏松的发生率为20．9％,并且与尿钙排泄、血PTH呈负相关。     

应用DEXA测定Ⅱ型糖尿病和正常人骨密度的配对研究

目的：探讨Ⅱ型糖尿病患身体各部位骨密度改变及其骨质疏松的关系。方法：Ⅱ型糖尿病组及正常对照组各73例，分别用DEXA测定全身、腰椎正位（L1－L4）、腰椎侧位（L2－L4）、股骨近端（Neck、Troch、Inter、Ward's区）、上肢、下肢骨密度，并拍腰椎X线照片。按性别、年龄、体重指数等因素进行配对比较。结果：2型糖尿病组全身、腰椎骨密度明显高于对照组（P＜0．01），股骨近端骨密度与对照组无明显差异（P＞0．05），而上、下肢骨密度则明显低于对照组（P＜0．05）。2型糖尿病组骨质疏松发病率（31．8％）明显低于正常组（45．1％）（P＜0．01）。X线片显示Ⅱ型糖尿病组腰椎骨质增生发病率明显高于正常组（P＜0．01）。结论：Ⅱ型糖尿病全身骨密度改变不同，骨质疏松不是Ⅱ型糖尿病的并发症。     

系统性红斑狼疮患者获得性活化蛋白C抵抗现象与抗磷脂抗体的检测

目的：通过检测系统性红斑狼疮（SLE）患者获得性活化蛋白C抵抗（APCR）和抗磷脂抗体的发生率,探讨APCR与SLE患者血栓形成的相关性,以及SLE患者血栓形成中,APCR与抗磷脂抗体的相关性。方法：采用APC－APTT法,dRVVT-LA法,ELISA法及PCR－酶切法分别对30例SLE患者和30例正常对照进行APCR及狼疮抗凝物,抗心磷脂抗体和FV Leiden突变检测,结果：SLE病人APCR阳性率（14／30,46．67％）明显高于正常对照组（1／30,3．3％,P＜0．005）,SLE患者无一例FV Leiden突变。APCR阳性患者中血栓发生率（6／14,42．85％）明显高于APCR阴性患者（1／16,6．25％,P＜0．05）,狼疮抗凝物阳性患者中血栓发生率（6／12,50％）明显高于其阴性患者（2／18,11．1％,P＜0．05）,结论：获得性APCR和狼疮抗凝物均是SLE患者合并血栓形成的危险因素之一,但获得性APCR的发生与抗磷脂抗体的存在无关,表明获得性APCR的发生并非抗磷脂抗体抑制蛋白C通路导致凝血异常及致血栓形成的唯一途径。     

广东地区男性系统性红斑狼疮患者的临床特征

目的：探讨广东地区男性系统性红斑狼疮（SLE）患者的临床特征，提高男性SLE患者认识和诊断率。方法：对146例男性及同时期的1108例女性SLE患者的确诊的时间、临床表现、免疫学指标、SLEDAI评分、肾脏的累及情况以及出院时的好转率等进行回顾性的对比分析。结果：两组间发病年龄无差异（P＞0.05）。男女比例为1：7.59。男性SLE患者家族史（P＜0.01）、口腔溃疡（P＜0.05）发生率较女性明显，但女性患者关节炎的发生率高于男性（P＜0.01）；男女两组SLE患者在ANA、dsDNA、C3、C4的阳性率相似，没有显著性差异（P＞0.05）；男性患者肾病综合征表现的发生率显著高于女性患者（P＜0.05）。而在蛋白尿、血尿、eGFR下降、接受透析治疗的发生率方面没有差异（P＞0.05）；男性患者入院时的SLEDAI积分显著高于女性患者（P＜0.01），出院时的好转率两组之间却无差异（P＞0.05）。结论：广东地区男性狼疮的临床表现较女性患者不同，男性狼疮患者病情较重，但对治疗的短期反应与女性无差别。     

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.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

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.     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.     

Possible Spread of adenovirus type 3 from poultry to humans ：indirect evidence from an outbreak in China

Objective:To explore the epidemiology and etiology for an outbreak of acute respiratory tract infection that occurred in one county of Jiangsu Province, China 2004. Methods: Only cases meeting the case definition were included in the study. We reviewed the medical records of the cases who were admitted to the local hospitals, interviewed cases by a standard questionnaire, and then described the epidemiotogic features and analyzed risk factors by means of a case-control study. We collected pharyngeal swab specimens and sent them to different laboratories for isolation and culture. The laboratory used different detection methods such as DIP, PCR, electron microscope examination and microneutralization assay, to identify and then type the positive specimens. Results:A total of 871 cases were reported during the period from April 18 to July 4,2004. The distribution of onset times presented two peaks, one in late May and another in middle June. The epidemic occurred mainly in the elementary and junior high schools in ten townships of one county, and the mean age of the cases was 12 years (range 7 months to 18 years). The course of the disease was acute, and was characterized by fever accompanied with sore throat and tonsillitis. The WBC count of cases was normal or elevated. The mean duration of illness was 5 days (range 2 to 12 days). No fatalities from illness were reported. A case-control study indicated that the possible risk factors were close contact with a case and/or poultry before onset and sharing of towels among members of the family. The typical CPE was observed through inoculating pharyngeal swab specimens into the HEP-2 cell cultures in different laboratories. An infection of adenovirus type 3 was verified by detecting positive specimens in different methods. Conclusion:This investigation demonstrated that the acute respiratory infection in cases was caused by adenovirus type 3. Cases occurred in over 70 schools in ten townships in 2004, and the route of transmission was possibly close contact with cases or droplet transmission.