糖化血红蛋白联合血清糖类抗原19-9对2型糖尿病的诊断价值

目的 探讨糖化血红蛋白（HbA1c）与血清糖类抗原19-9(CA19-9)联合检测在2型糖尿病（T2DM）中的诊断价值。方法 选取2021年1月至2023年1月在漯河医学高等专科学校第二附属医院就诊的T2DM患者89例作为T2DM组,并以1∶1配比选取同期健康体检者89名作为健康组,均检测HbA1c、CA19-9水平,对比2组HbA1c、CA19-9水平、有无血管病变T2DM患者HbA1c、CA19-9水平,统计不同HbA1c水平、CA19-9阳性和阴性T2DM患者并发症情况,分析HbA1c水平与CA19-9的关系。结果 T2DM组HbA1c、CA19-9高于健康组（P<0.05）;与无血管病变相比,有血管病变T2DM患者HbA1c、CA19-9水平较高（P<0.05）;与HbA1c水平<7.5%、7.5～9.5%并发症发生率15%(2/13)、37%(10/27)相比,HbA1c>9.5%并发症发生率65%(32/49)较高（P<0.05）;与CA19-9阴性并发症发生率13%(4/31)相比,阳性T2DM并发症发生率52%(30/58)较高（P<...     

2型糖尿病患者血清CA199水平的相关因素研究

目的 探讨2型糖尿病(T2DM)患者中影响血清CA199的因素.方法 以396例住院T2DM患者为研究对象,按血清CA199水平分为阴性(＜37 U/ml)、阳性(≥37 U/ml)组,比较两组之间的空腹血糖(FBS)、糖化血红蛋白(HbA1c)、血脂、肾功能间有无差异.计算FBS、HbA1c等指标与CA199的相关性;以年龄、性别、病程、FBS、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)等为自变量,进行逐步多元回归分析,比较各变量对CA199的影响程度.结果 CA199阳性组FBS、HbA1c、TC明显高于对照组,尿酸(URIC)明显低于对照组,差异均有统计学意义(P＜0.05);CA199与FBS、HbA1c、TC、FIB及hsCRP存在线性关系;回归分析显示HbA1c的标准回归系数为0.395(P=0.00).结论 HbA1c是影响CA199的独立危险因素,糖尿病患者CA199升高与血糖长期控制不佳有密切关系.     

血清CA19-9水平与2型糖尿病患者糖脂代谢的相关性

目的探究血清CA19-9水平与2型糖尿病(T2DM)患者血糖、血脂代谢的相关性。方法选取731例住院T2DM患者为研究对象,按糖化血红蛋白(HbA1c)水平分为血糖控制良好组(A组,HbA1c<7%)、控制欠佳组(B组,HbA1c 7%～9%)、控制差组(C组,HbA1c> 9%),比较3组血清CA19-9升高的患病率,并分析CA19-9水平与各项糖脂代谢指标的相关性。结果入组患者血清CA19-9升高的患病率为25.30%,其中C组明显高于A组和B组,差异有统计学意义(P<0.001)。Pearson相关性分析提示血清CA19-9与HbA1c、空腹血糖(FPG)、餐后2 h血糖(2hPG)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL-C)、胰岛素抵抗指数(HOMA-IR)之间呈正相关性(P<0.05)。结论 T2DM患者血清CA19-9升高与血糖控制水平及血脂代谢异常密切相关。     

2型糖尿病患者血清CA19-9水平分析及影响因素研究

目的:探讨2型糖尿病(T2DM)患者血清CA19-9水平的变化及相关影响因素。方法:选取T2DM患者100例,根据糖化血红蛋白(HbA1C)含量分为T2DM血糖控制不良组(HbA1C≥7%,49例)和T2DM血糖控制良好组(HbA1C<7%,51例),选取健康体检者50例为对照组。对比分析3组血清CA19-9水平的差异,并对血清CA19-9水平的影响因素进行相关分析。结果:T2DM血糖控制不良组血清CA19-9水平明显高于T2DM血糖控制良好组和对照组(P<0.05);T2DM血糖控制良好组血清CA19-9水平明显高于对照组(P<0.05)。CA19-9水平与HbA1C呈正相关(r=0.321 5,P<0.05)。结论:T2DM患者血清CA19-9水平高于正常人,且与血糖控制水平相关。     

血清CA19-9、HbA1c、C肽联合检测对糖尿病的诊断价值

目的：观察血清糖类抗原19-9(CA19-9)、糖化血红蛋白（HbA1c）、C肽联合检测对糖尿病（DM）的诊断价值。方法：选取2020年1月-2022年3月乐平市中医医院接收的确诊为DM的40例患者,纳入DM组,另选取同期在本院体检健康的人群40例,纳入无DM组。记录并比较两组一般资料,检测并比较全部入选者的血清CA19-9、HbA1c、C肽水平,绘制受试者工作特征（ROC）曲线,分析血清CA19-9、HbA1c、C肽联合检测对DM的诊断价值。结果：DM组血清CA19-9、HbA1c、C肽均显著高于无DM组,差异均有统计学意义（P<0.05）;血清CA19-9、HbA1c、C肽单独及联合诊断DM的AUC均>0.750,均有一定诊断价值,且以联合诊断价值最高,当cut-off值分别取时37.860 U/mL、5.910%、3.885μg/L时,可获得最佳诊断价值。结论：血清CA19-9、HbA1c、C肽联合检测诊断DM的价值较高,可提高诊断敏感度。     

2型糖尿病患者血清CA19-9、CA125水平及其相关因素分析

目的：观察分析2型糖尿病（type 2 diabetes mellitus,T2DM）患者血清糖类抗原19-9（carbohydrate antigen19-9,CA19-9）、糖类抗原125（carbohydrate antigen125,CA125）水平及其影响因素。方法：选取117例T2DM患者和132例健康体检者,计量资料采用t检验、非参数检验,计数资料采用?字2检验,比较糖、脂、蛋白指标及血清CA19-9、CA125水平。T2DM患者再按糖化血红蛋白（haemoglobin A1c,HbA1c）水平、并发症情况分组比较CA19-9和CA125水平;观察治疗前后CA19-9或CA125异常升高T2DM患者糖类抗原水平变化。结果：（1）与正常人群相比,T2DM患者糖脂组份和CA19-9、CA125水平均明显升高,白蛋白水平明显降低（均P＜0.05）;（2）与HbA1c≤7.5%T2DM患者（n=34）比,HbA1c ＞7.5% T2DM患者（n=83）的糖代谢指标及CA19-9、CA125水平均明显升高（均P＜0.01）;（3）与无并发症者（n=50）和伴慢性并发症者（n=51）相比,伴急性并发症者（n=16）糖代谢指标及CA19-9、CA125水平均明显升高（均P＜0.05）;（4）与入院时相比,治疗后CA19-9或CA125异常升高T2DM患者糖类抗原均显著降低（均P＜0.05）;（5）相关分析显示,T2DM患者中血糖（r值分别为0.353、0.269,P值均＜0.01）、HbA1c（r值分别为0.320、0.325,P值均＜0.01）、糖化血清白蛋白（r值分别为0.307、0.324,P值均＜0.01）、总胆固醇（r值分别为0.215、0.359,P值均＜0.05）与CA19-9、CA125升高呈正相关,白蛋白（r值分别为-0.296、0.359,P值均＜0.05）与CA19-9、CA125升高呈负相关。结论：T2DM患者不仅存在糖脂代谢紊乱,也存在蛋白代谢异常;血糖控制越差时,CA19-9或CA125水平升高更明显;血糖控制好转后,CA19-9或CA125水平将明显降低;糖脂蛋白代谢紊乱可能是影响CA19-9或CA125升高的因素。     

糖尿病酮症酸中毒患者血清CA19-9水平的变化

目的:回顾性观察糖尿病酮症酸中毒患者血清CA19-9水平,分析糖尿病急性代谢紊乱状态下CA19-9升高的特点。方法:选取糖尿病酮症酸中毒患者73例和血糖控制差(糖化大于7.5%)的糖尿病非酮症酸中毒患者209例,对其性别、年龄、糖尿病病程、体重指数、HbA1c、CA19-9水平进行分析。结果:(1)酮症酸中毒组平均CA19-9水平29.7(57.8~15.35)U/mL,显著高于非酮症酸中毒组10.1(19.65~5.40)U/mL,比较差异有统计学意义(P0.01);前者CA19-9升高的比例为39.7%,而后者为7.7%(P0.01),两者比较差异有统计学意义。(2)CA19-9升高的45例患者中数值在200 U/mL以内者占95.6%,其中10例患者病情纠正后复查CA19-9均呈下降趋势。结论:糖尿病患者CA19-9水平在酮症酸中毒状态下较非酮症酸中毒状态下可更明显升高。     

2型糖尿病患者血清CA19-9、CEA水平的变化及其相关因素

目的 观察2型糖尿病患者血清肿瘤标志物CA19-9、CEA水平,分析2型糖尿病患者糖代谢紊乱中肿瘤标志物良性升高的特点及相关因素.方法 选择397例2型糖尿病患者和390名正常体检者,比较血清肿瘤标志物CA19-9、CEA水平,并分析其特点和相关因素.结果 (1)糖尿病组CA19-9和CEA水平较正常组明显升高(P＜0.01);(2)HbA1c分亚组研究显示CA19-9、CEA水平均为HbA1c高值亚组＞中值亚组＞低值亚组(P＜0.05或0.01);(3)年龄分亚组研究发现糖尿病组CEA水平＞61岁亚组高于46~60岁亚组高于＜45岁亚组(P＜0.05),CA19-9水平在2型糖尿病患者不同年龄亚组间无统计学差异;(4)性别分亚组研究显示糖尿病女性亚组CA19-9水平高于男性亚组(P＜0.01),CEA组男女亚组间无统计学差异;(5)相关及回归分析显示2型糖尿病患者血清CA19-9、CEA与HbA1c呈正相关,HbA1c是糖尿病患者CA19-9和CEA增高的独立危险因素.结论 在糖尿病人群中,血清CA19-9、CEA等肿瘤标志物可以有低水平的良性升高,与HbA1c存在一定相关性,在糖尿病人群中应动态观察血清肿瘤标志物水平的变化.     

血清CA19-9与2型糖尿病患者血糖控制的相关性研究

目的:探讨2型糖尿病(2 diabetes mellitus,T2DM)患者血糖控制水平与血清CA19-9的相关性.方法:化学发光法测定T2DM患者(A组,120例)及非糖尿病患者(B组,108例)的血清CA19-9水平.2组均排除其它可能导致CA19-9水平升高的常见疾病.按糖化血红蛋白水平将A组分为血糖控制组(A1...     

同型半胱氨酸、糖化血红蛋白和尿微量白蛋白联合检测对早期糖尿病肾损伤的诊断价值

目的探讨同型半胱氨酸(Hcy)、糖化血红蛋白(HbA1c)和尿微量白蛋白(U-mAlb)联合检测对糖尿病早期肾脏损伤的价值.方法分别检测69例2型糖尿病(T2DM)患者(尿蛋白阴性组38例和尿蛋白阳性组31例)和43例健康体检者(对照组)的血清Hcy、HbA1c和U-mAlb的含量.Hcy采用循环酶法,HbA1c采用离子交换液相色谱法,U-mAlb采用速率散射法.结果 DM患者Hcy、HbA1c、U-mAlb的水平明显高于正常对照组(P<0.01),且尿蛋白阳性组升高更为显著(P<0.01),尿蛋白阳性组较尿蛋白阴性组升高明显(P<0.01).相关分析显示,DM组中血清Hcy、HbA1c与U-mAlb的水平呈正相关(P<0.01),三者联合检测阳性率高达73.6﹪,明显高于单项检测.结论血清Hcy、HbA1c与U-mAlb的水平与T2DM患者的早期肾损伤程度密切相关,联合检测能大大提高检测阳性率,对于DN的早期诊断,早期治疗及监测有重要意义.     

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.