病毒性肝病患者的生化检验指标变化特点及其临床意义

目的:探讨病毒性肝病患者的生化检验指标变化特点及其临床意义。方法:选择100例病毒性肝病患者设为观察组;另外选择同时健康体检者100例作为对照组。对两组研究对象的天门冬氨酸氨基转移酶(AST)、谷氨酸氨基转移酶(ALT)、血清白蛋白(PA)、亮氨酸氨基转肽酶(LAP)、总胆红素(TBil)、腺苷脱氨酶(ADA)及胆碱酯酶(CHE)指标检测结果进行比较。结果:观察组患者的AST、ALT、CHE、TBil等指标均明显高于对照组(P<0.05);肝癌患者的LAP指标较急、慢性肝炎患者及其他类型肝病患者明显升高(P<0.05);急、慢性肝炎患者的PA指标较肝癌和其他类型肝病患者明显升高(P<0.05);急性肝炎患者的LAP指标较慢性肝炎患者及其他类型肝病患者明显升高(P<0.05);慢性肝炎、肝癌患者的ADA指标较急性肝炎、其他类型肝病患者明显升高(P<0.05)。结论:病毒性肝病患者的AST、ALT、CHE、TBil等指标水平明显高于健康者,可作为临床诊断的依据。     

肝病患者AFu ADA和CHE联合检测的临床价值

目的:探讨联合检测a-L-岩藻糖苷酶(AFu)、腺苷脱氨酶(ADA)、胆碱酯酶(CHE)对肝病诊断的临床价值。方法:应用日立7080全自动生化分析仪对肝病患者135例,健康对照组92例血清AFu、ADA、CHE水平进行联合检测。结果:实验组血清AFu、ADA水平明显高于正常人组(P<0.01),CHE水平实验组明显低于正常对照组。AFu在肝癌组阳性率为79.2%,ADA、CHE在肝硬化组阳性率高于90%。结论:肝癌时,AFu应用价值较高;肝硬化时,ADA和CHE应用价值较高,联合检测AFu、ADA、CHE水平在一定程度上能反映肝脏的功能,对于肝病的诊断,临床疗效及预后判断具有一定参考价值。     

血清胆汁酸、胆碱酯酶检测在肝病诊断中的临床应用

目的:探讨血清胆汁酸(TBA)、胆碱酯酶(CHE)与常规肝功指标联合检测在肝病诊断和鉴别诊断中的应用.方法:采用日立～7170全自动生化分析仪测定健康人、慢性迁延性肝炎、慢性活动性肝炎、肝硬化和肝癌等人群血清中TBA、CHE、ALT、AST、TBIL、ALP和GGT.结果:各肝病组血清TBA活性均显著高于正常对照组(P<0.01),且以急性肝炎最高,肝硬化次之,即急性肝炎>肝硬化>慢性活动性肝炎>肝癌.另外,慢性肝病组血清TBA异常率显著高于常规肝功指标(P<0.01);血清CHE测定中,肝病组CHE活性均低于正常对照组(P<0.05或P<0.01),其活性依次为肝硬化<慢性活动性肝炎<慢性迁延性肝炎<肝癌<急性肝炎,且除急性肝炎、慢性迁延性肝炎和肝癌组之间无显著差异外(P>0.05),与其余肝病组之间均有显著性差异(P<0.01).结论:血清胆汁酸(TBA)、胆碱酯酶(CHE)与常规肝功指标联合检测,对各类肝病特别是慢性肝损害的诊断、鉴别诊断以及预后判断具有重要的临床意义.     

RBP及相关指标检测在肝脏合成功能中的临床应用

目的观察视黄醇结合蛋白(RBP)、血清前白蛋白(PA)、血浆白蛋白(ALB)和胆碱酯酶(CHE)在各组肝病中的水平变化,探讨四项指标在肝脏合成蛋白功能中的临床应用及价值。方法用免疫透射比浊法测定122例肝病患者及36例正常对照组的血清RBP、PA水平;用溴甲酚绿法检测ALB;用速率法测定CHE活性。结果血清RBP、PA、CHE含量在各组肝病中均低于对照组(P<0.01);ALB含量除急性肝炎偶见降低外,其他各组肝病亦低于对照组(P<0.01);血清RBP、PA、ALB、CHE异常率随肝脏损伤加重而增高,ALB在急性肝炎组异常率较低,与其他各组比较差异有统计学意义(P<0.01)。结论血清RBP、PA及CHE浓度测定较之血清ALB浓度测定,更能及时地反映肝脏细胞合成蛋白能力。四项指标联合检测,可作为判断肝脏合成功能和肝脏疾病严重程度的有效指标,对评价肝炎患者病情变化及预后判断具有良好的临床参考价值。     

探讨血清CHE、TBA和ADA联合检测在肝病诊断中的临床应用价值

目的评价血清胆碱酯酶(CHE)、腺苷脱氨酶(ADA)和总胆汁酸(TBA)的联合检测对不同病期肝病患者的临床价值。方法选择2011年3月至2012年2月在成都市传染病医院确诊的肝病患者151例和同期健康体检者120例(对照组),采用日立7180全自动生化分析仪检测样本血清CHE、TBA和ADA的水平,同时测定与其密切相关的血清学指标,包括丙氨酸氨基转移酶(ALT)、前白蛋白(PA)和总胆红素(TBIL)。结果 ALT、TBIL、TBA和ADA在肝病患者均显著增高,与对照组比较差异有统计学意义(P<0.05),CHE和PA在肝病患者均显著偏低,与对照组比较差异有统计学意义(P<0.01);CHE、TBA和ADA的阳性率均在83.0%以上,与相关的血清学指标比较,差异有统计学意义(P<0.05)。结论 CHE、TBA和ADA的联合检测有助于肝病的诊断和疗效观察以及预后的判断,为临床医师提供可靠、准确、有价值的临床诊断指导依据,具有较好的临床应用价值。     

血清总胆汁酸、胆碱酯酶及前白蛋白检测在各种肝病诊断中的应用

目的 探讨总胆汁酸(TBA)、胆碱酯酶(CHE)及前白蛋白(PA)在肝病诊断中的临床应用. 方法采用AU-400生化分析仪,对62例健康人和各种肝病患者268例检测TBA、CHE及PA,并对结果进行比较. 结果各种肝病患者血清TBA与对照组相比,除轻度慢性肝炎外,其它各组均显著高于正常对照组(P＜0.01);血清CHE与对照组相比,急性肝炎组、慢性肝炎轻度组和肝癌组差异无统计学意义(P＞0.05),慢性肝炎中、重度组及肝炎后肝硬化组,其含量明显降低(P＜0.01);PA 与对照组比较,除急性肝炎组和慢性肝炎轻度组,其它各组结果均显著低于对照组(P＜0.01). 结论血清TBA、CHE及PA是反映肝脏损害程度的较敏感指标,将其综合评价可提高诊断率,且对肝病鉴别诊断以及预后判断有着重要的临床意义.     

ADA与ALT、AST、GGT联合检测在肝脏疾病诊断中的意义

目的探讨血清腺苷脱氨酶（ADA）与ALT、AST、GGT联合检测在各类肝脏疾病诊断中的临床价值。方法采用日立7600全自动生化分析仪分别对160例肝病患者和60例正常对照组血清ADA、ALT、AST和GGT进行联合检测。结果各种肝病患者ADA、ALT、AST和GGT与正常对照组相比均明显升高：ADA的阳性检出率在肝癌,肝硬化,急性肝炎和慢性肝炎分别为76.7%,94.7%,83.3%和55.0%。ALT和GGT在各种肝病患者中均有不同程度的升高（P均〈0.01）。AST在肝癌有明显升高（P〈0.05）,在肝硬化,急性肝炎和慢性肝炎中有显著升高（P均〈0.01）,其阳性检出率均在80%以上。急性肝炎时,ALT和AST阳性检出率达到100%。结论血清ADA与ALT、AST、GGT联合检测是协助诊断肝脏疾病的良好指标。     

多种生化指标联合检测在肝病诊断中的应用

目的:探讨血清ALB、GLB、TBIL、ALT、AST、GGT、ALP、TBA和CHE在各种肝病诊断中的临床应用。方法:使用全自动生化分析仪对115例肝病患者和80例健康体检者进行8项生化指标的检测,对结果进行统计学分析。结果:不同肝病组8项生化指标与正常对照组相比,除急性肝炎组、肝癌组GLB外(P>0.05),其余各项指标均有统计学意义(P<0.05或P<0.01)。不同肝病组各项生化指标的检测阳性率不同,各组阳性率前5位的指标是:急性肝炎组,ALT>AST>TBA>TBIL>GGT;慢性肝炎组,ALT>AST>TBA>GGT>CHE;肝硬化组,CHE>TBA=ALB>TBIL>GGT;肝癌组,TBA>GGT>ALP=TBIL>CHE。结论:常用生化指标的检测有助于肝脏疾病的鉴别诊断及病情的预后判断。     

多种生化指标联合检测在肝病诊断中的应用

目的探讨血清ALB、GLB、TBIL、ALT、AST、GGT、ALP、TBA和CHE在各种肝病诊断中的临床应用。方法使用全自动生化分析仪对115例肝病患者和80例健康体检者进行8项生化指标的检测,对结果进行统计学分析。结果不同肝病组8项生化指标与正常对照组相比,除急性肝炎组、肝癌组GLB外(P0.05),其余各项指标均有统计学意义(P0.05或P0.01)。不同肝病组各项生化指标的检测阳性率不同,各组阳性率前5位的指标是:急性肝炎组,ALTASTTBATBILGGT;慢性肝炎组,ALTASTTBAGGTCHE;肝硬化组,CHETBA=ALBTBILGGT;肝癌组,TBAGGTALP=TBILCHE。结论常用生化指标的检测有助于肝脏疾病的鉴别诊断及病情的预后判断。     

肝病患者血清胆碱酯酶和前白蛋白检测的临床意义

目的探讨肝病患者血清胆碱酯酶(CHE)和前白蛋白(PA)的变化,为肝病的诊断和治疗提供依据。方法对161例肝病患者及40例健康对照组血清胆碱酯酶活力测定。结果乙肝病情重,CHE活力下降与对照组比较差异有显著性(P<0.05),血清PA测定与对照组比较差异有非常显著性(P<0.01)。结论对CHE和PA作动态观察,可作为肝病患者病情及预后的一项重要指标。     

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.