NIDDM患者血清性激素变化与胰岛素抵抗的关系

为探讨非胰岛素依赖型糖尿病（ＮＩＤＤＭ）患者血清性激素变化及其与胰岛素抵抗的关系,应用放射免疫法检测了６０例５０岁以上ＮＩＤＤＭ患者血清雌二醇（Ｅ２）,睾酮（Ｔ）等性激素水平。结果：男性患者Ｅ２升高,Ｔ呈下降趋势,Ｅ２／Ｔ比值显著高于正常对照（Ｐ〈０．０５）;女性患者Ｅ２较对照组显著降低（Ｐ〈０．０１）,Ｔ略高于正常,Ｅ２／Ｔ比值平衡失调。Ｅ２、Ｅ２／Ｔ与空腹血糖（ＦＢＧ）,空腹胰岛素（ＦＩｎｓ）     

丽参注射液对老年男性冠心病肾虚患者性激素的影响

本研究观察了３２例经丽参注射液治疗前后老年男性冠心病肾虚患者雌二醇（Ｅ２）、睾酮（Ｔ）及Ｅ２／Ｔ的变化。结果表明：肾阳虚和肾阴虚两组Ｔ均降低（Ｐ＜０．０５～０．０１）；肾阴虚组Ｅ２、Ｅ２／Ｔ升高，而肾阳虚组Ｅ２则降低（Ｐ＜０．０１）。治疗后随着肾虚症状改善两组Ｔ均回升，肾阴虚组Ｅ２、Ｅ２／Ｔ回落，肾阳虚组Ｅ２回升（Ｐ＜０．０１），均接近对照组水平。提示老年男性冠心病肾虚患者阴阳失调与性激素紊乱有关，主要表现在血清Ｔ浓度的降低和Ｅ２水平的升高或降低；人参既可调整阴阳改善肾虚症状又可逆转性激素变化，在提高Ｔ水平的同时，对Ｅ２有很好的双向调节作用，有助于人体内环境雌雄性激素的平衡     

NIDDM患者血清性激素变化与胰岛素抵抗的关系

为探讨非胰岛素依赖型糖尿病（ＮＩＤＤＭ） 患者血清性激素变化及其与胰岛素抵抗的关系, 应用放射免疫法检测了６０ 例５０ 岁以上ＮＩＤＤＭ 患者血清雌二醇 （Ｅ２）、睾酮（Ｔ） 等性激素水平。结果： 男性患者Ｅ２ 升高, Ｔ呈下降趋势, Ｅ２／Ｔ比值显著高于正常对照 （Ｐ＜ ０． ０５）; 女性患者Ｅ２ 较对照组显著降低（Ｐ＜ ０． ０１）, Ｔ略高于正常, Ｅ２ ／Ｔ比值平衡失调。Ｅ２、Ｅ２／Ｔ与空腹血糖 （ＦＢＧ）、空腹胰岛素（ＦＩｎｓ） 呈正相关, 与胰岛素敏感性（ＩＳ） 呈负相关。认为ＮＩＤＤＭ 患者存在严重的性激素失调及胰岛素抵抗, 在“胰岛素抵抗—糖代谢紊乱—性激素内环境失衡”之间, 可能有规律性的内在联系。     

性激素水平与冠心病关系探讨

应用放射免疫法测定３０例非心梗型冠心病（ＣＨＤ）血清性激素水平，其中男性２０例，女性１０例（绝经期后妇女），并设对照组对比。结果显示：国性ＣＨＤ组Ｅ２即雌二醇经对照组明显升高（Ｐ〈０．０１），Ｔ略低无统计学意义，Ｅ２／Ｔ比值ＣＨＤ组显著高于对照组（Ｐ〈０．０１）。女性ＣＨＤ组Ｅ２高于对照组（Ｐ〈０．０５），Ｔ略低，Ｅ２／Ｔ比值比对照组升高，但无统计学意义。本文认为高雌激素血症与性内环境紊乱所致Ｅ２     

糖尿病患者血浆内皮素改变及与慢性血管并发症的关系

目的 探讨糖尿病（ＤＭ）患者病情控制前后血浆内皮素（ＥＴ）浓度改变及ＥＴ与ＤＭ慢性血管并发症的关系。方法 测定５０例ＤＭ患者血浆ＥＴ浓度及血糖、果糖胺（ＦＴＭ）、ＤＭ血管并发症积分等相关指标,选择正常对照组３０例。结果 ＤＭ患者血糖控制前、后血浆ＥＴ浓度均明显高于对照组（Ｐ〈０．０１）,并有发症者ＥＴ浓度显著高于无并发症者（Ｐ〈０．０１）;治疗前后血浆ＥＴ浓度前后血浆ＥＴ浓度与ＤＭ并发症严重程度、     

性激素及其比例与原发性高血压关系的探讨

为研究性激素及其比例对原发性高血压（ＥＨ）发病的影响，我们测定了男性ＥＨ和绝经后女性ＥＨ患者及相应对照者血清雌二醇（Ｅ２）、孕酮（Ｐ）和睾酮（Ｔ）水平，进行对比研究。结果显示：（１）男性ＥＨ血清Ｔ水平及Ｔ／Ｅ２比值明显低于对照组。（２）绝经后女性ＥＨ组血清Ｅ２水平明显降低，Ｐ水平、Ｔ／Ｅ２及Ｐ／Ｅ２比值升高与对照组相比较存在显著差异。提示性激素水平及其比例失衡与男性及绝经后女性ＥＨ发病有一定关系     

男性高血压病患者血清性激素变化及临床意义

本文测定了４２例男性高血压病患者及１４例与之年龄接近的正常男性血清性激素水平。结果高血压病组血清雌二醇（Ｅ２）及雌二醇／睾酮（Ｅ２／Ｔ）比值明显高于对照组（Ｐ＜０．０１），此种变化与年龄无关。两组Ｔ水平相似。Ｅ２与高密度脂蛋白（ＨＤＬ２）呈负相关。提示高血压病患者存在性激素水平变化；此种变化可能在高血压及动脉硬化的发生中起一定作用。     

糖尿病患者治疗前后的甲状腺功能变化

目的：观察糖尿病患者治疗前后的甲状腺功能变化。方法：测定４０名未经控制的糖尿病患者甲状腺功能指标，并将患者分为无并发症组（Ａ组）急性并发症组（Ｂ组）及慢性并发症组（Ｃ组），其中２７例经治疗空腹血糖持续稳定在７．２ｍｍｏｌ／Ｌ以下达２ｍｏ复查甲状腺功能。结果：与正常对照组相比，糖尿病患者治疗前血清ｒＴ３比值均明显降低（Ｐ〈０．０１），Ｔ３，Ｔ４，ＦＴ３，ＦＴ４及Ｔ３／ｒＴ３比值均明显降低（Ｐ〈０．０     

男性冠心病人性激素及性激素受体的变化

目的探索男性冠心病（ＣＨＤ）患者性激素和性激素受体的关系。方法选择男性ＣＨＤ患者３５人，对照组３０人，采用放射配体结合法检测外周血白细胞上雌激素受体（ＥＲ）和雄激素受体（ＡＲ）；采用放免法检测雌二醇（Ｅ２）和睾酮（Ｔ）。结果ＣＨＤ组Ｅ２及Ｅ２／Ｔ明显高于对照组（Ｐ＜０．０１），而ＥＲ明显低于对照组（Ｐ＜０．０１）。结论男性ＣＨＤ的发生与ＥＲ减少有关     

糖尿病患者血浆同皮素,血管紧张素转换酶的变化及关系

目的 探讨糖尿病患者血浆内皮素（ＥＴ）、血清血管紧张素转换酶（ＡＣＥ）的变化及两者的关系。方法：正常对照组４３例,糖尿病组４６例,测定血浆ＥＴ、血清ＡＣＥ及血压。结果 糖尿病组ＥＴ、ＡＣＥ及血压比正常对照组显著性增高（Ｐ〈０．０１）;ＥＴ与ＡＣＥ显著性正相关（Ｐ〈０．０１）;糖尿病组有血管并发症患者的ＥＴ、ＡＣＥ比无血管并发症患者显著性增高（Ｐ〈０．０１）。结论 糖尿病患者血浆ＥＴ及ＡＣＥ水平比正     

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.     

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.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.