脑梗死和冠心病患者血清同型半胱氨酸改变

目的 :了解西北地区脑梗死和冠心病等心脑血管疾病患者血清同型半胱氨酸 (homocysteine,Hcy)、血脂水平的关系 .方法 :采用荧光偏振免疫分析方法 ,对 34例脑梗死患者 ,5 8例冠心病患者及 1 2 2例健康人进行血清Hcy的检测 ,同时测定其血脂水平 .结果 :脑梗死患者血清Hcy水平为(30 .5± 1 5 .4 ) μmol·L-1 ,冠心病患者血清Hcy水平为 (2 5 .5±1 3.5 ) μmol·L-1 ,与正常对照 (1 4 .2± 6 .9) μmol·L-1 比较 ,具有显著性差异 (P <0 .0 1 ) .脑梗死和冠心病患者血清Hcy水平与血脂无明显相关 (P >0 .0 5 ) .结论 :高Hcy血症是脑梗死、冠心病等心脑血管疾病独立的致病因素 ,与血脂无明显相关     

尿毒症腹膜透析患者同型半胱氨酸清除机制的临床研究

目的:探讨持续不卧床腹膜透析(CAPD)及残余肾功能(RRF)对尿毒症患者血同型半胱氨酸(Hcy)的清除的影响.方法:留取22例CAPD患者24 h的透出液及尿液,同日取血标本,用高压液相色谱技术(HPLC)测定血清、透出液的总同型半胱氨酸(tHcy)浓度;常规检测血、透出液和尿液的尿素氮、肌酐值;计算总尿素清除指数(Kt/V)、RRF、腹膜tHcy清除率和每日腹透液tHcy清除量.结果:CAPD患者的血tHcy平均浓度高于正常人[(15.95±3.77) vs (8.87±2.43) μmol/L,P＜0.05],平均每日tHcy清除量为(15.24±4.52) μmol.RRF与血tHcy浓度无关,与每日腹透液tHcy清除量呈负相关;Kt/V与每日腹透液tHcy清除量呈正相关,与血tHcy浓度无关.结论:CAPD患者血tHcy水平较正常人升高;RRF及Kt/V对CAPD患者血tHcy浓度的降低影响较小.     

癫痫患者联合测定血同型半胱氨酸、叶酸、维生素B12临床价值探讨

<正>有研究证明,癫痫(Epilepsy)患者的缺血性心脏病和脑血管病的发生率比正常人高,而服用抗癫痫药物的患者空腹血Hcy增高。血同型半胱氨酸(Homocysteine,Hcy)浓度的升高对心脑血管疾病的发生率起着重要作用。即使是Hcy水平的中度升高也被认为是心脑血管疾病的一个独立危险因素。本研究通过对癫痫患者血Hcy、血清叶酸和维生素VitB12浓度的检测,旨在探讨血中同型半胱氨酸(Hcy)、叶酸、VitB12浓度在抗癫痫药物使用前后的变化以及对治疗的指导意义,为癫痫患者心脑血管疾病的预防和治疗提供依据。     

血浆同型半胱氨酸与血透患者缺血性脑血管病并发症的关系

目的 :研究血液透析患者血浆总同型半胱氨酸 (t Hcy)水平与缺血性脑血管病 (ICD)并发症的关系。方法 :选择 6 1例维持性血透患者 ,按有无 ICD并发症分为缺血性脑血管病 (ICD)组(31例 )和无 ICD组 (30例 ) ,采用高效液相色谱 (HPLC)法测定血浆 t Hcy水平。结果 :ICD组平均血浆 t Hcy水平明显高于无 ICD组 (P<0 .0 5 ) ;多因素逐步 Logistic回归分析显示 :血浆 t Hcy浓度升高 (>36 .91μmol/ L)使血透患者发生 ICD的危险增加。结论 :血浆同型半胱氨酸水平升高是血透患者发生缺血性脑血管病并发症的危险因素。     

老年颈动脉硬化患者同型半胱氨酸与血脂血糖尿酸的关系

目的探讨老年颈动脉硬化患者血清同型半胱氨酸(Hcy)与血脂、血糖、血尿酸的相关性。方法测定42例老年颈动脉硬化患者及15例正常老年人的血清三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A1(Apo A1)、载脂蛋白B(Apo B)、载脂蛋白B/载脂蛋白A1(Apo B/Apo A1)、空腹血糖、尿酸及Hcy水平,并进行比较及相关性分析。结果颈动脉硬化组TG、TC、LDL-C、Apo A1、Apo B、Apo B/Apo A1、空腹血糖、Hcy显著高于正常对照组,差异有统计学意义(P<0.05);颈动脉硬化组血清Hcy水平与HDL-C、Apo B、尿酸无明显相关性(P>0.05),而与TG、TC、LDL-C、Apo A1、Apo B/Apo A1、空腹血糖呈显著相关(P<0.05)。结论血清Hcy和血脂、血糖升高都是颈动脉硬化发生的独立危险因素,其中TG、TC、LDL-C、Apo A1、Apo B/Apo A1、空腹血糖水平与血清Hcy水平密切相关。     

血清同型半胱氨酸与心脑血管疾病的相关性分析

目的：探讨血清同型半胱氨酸( Hcy)与心脑血管疾病的关系。方法：测定152例冠心病病人,82例脑卒中病人和105例健康对照组血清同型半胱氨酸( Hcy)水平。结果：冠心病组和脑卒中组血清同型半胱氨酸(Hcy)水平分别为(21.35依9.78)μmol/L和(24.12依11.21)μmol/L,均明显高于健康对照组血清同型半胱氨酸(Hcy)水平(10.23依6.83)μmol/L,比较差异有统计学意义(P<0.01)。结论：血清同型半胱氨酸(Hcy)与心脑血管疾病病人有密切关系,高浓度的血清同型半胱氨酸( Hcy)是心脑血管疾病病人的独立的危险因子,降低同型半胱氨酸( Hcy)可以预防和减少动脉粥样硬化的发生,值得进一步研究。     

冠心病患者同型半胱氨酸水平测定及其临床意义

目的 :通过对冠状动脉造影患者血清总同型半胱氨酸水平测定 ,探讨其对冠心病的诊断价值。方法 :将6 0例冠脉造影患者分为冠心病组 (狭窄程度≥ 5 0 % ) 31例 ,与非冠心病组 (狭窄程度 <5 0 % ) 2 9例 ,其中冠心病组统计病变累及支数 ,并按冠脉狭窄程度分级得出冠脉狭窄程度记分 (CSS)。运用酶免分析法分别测定两组的血清总同型半胱氨酸 (t Hcy)浓度并进行比较。将 t Hcy水平与性别、年龄、收缩压、冠心病病变累及支数及冠脉狭窄程度记分 (CSS)等采用多元回归进行分析。结果 :冠心病组患者血清 t Hcy浓度 (17.8± 7.1μmol/ L)显著高于非冠心病组 (10 .0± 5 .8μm ol/ L )。多元回归分析表明 :非冠心病组 t Hcy增高与收缩压的相关性最强 ;冠心病组 t Hcy增高与病变累及支数及冠脉狭窄程度记分 (CSS)成正相关。结论 :高同型半胱氨酸血症是冠状动脉粥样硬化性心脏病的危险因子 ,且其升高水平冠脉病变累及支数及狭窄程度呈正相关     

脑梗死与血Hcy及其他危险因素的相关性探讨

目的探讨脑梗死患者血同型半胱氨酸、血尿酸、血纤维蛋白原、血糖、血脂水平的变化及其临床意义。方法检测62例脑梗死患者(A组)的血同型半胱氨酸(Hcy)、血尿酸(UA)、血纤维蛋白原(FIB)、血糖(GLU)以及6项血脂指标,并与对照组(B组)39例的检测结果进行比较。结果脑梗死患者的血Hcy、UA、FIB、GLU、胆固醇(TC)、甘油三酯(TG)含量均高于对照组(P<0.001～P<0.05),高密度脂蛋白(HDL)、载脂蛋白A1(ApoA1)含量均低于对照组(P<0.005～P<0.05),低密度脂蛋白(LDL)、载脂蛋白B(ApoB)含量变化差异均无统计学意义(P>0.05)。结论血Hcy、UA、FIB、GLU、TC、TG的水平升高,HDL、ApoA1的水平下降与脑梗死均有一定关系,应重视对高同型半胱氨酸、高尿酸、高纤维蛋白原、高血糖、高血脂的积极防治。     

同型半胱氨酸测定在脑血管疾病中的应用

近年来越来越多的研究表明,同型半胱氨酸(Hcy)是一种反应性血管损伤氨基酸,高Hcy血症是心脑血管疾病发病的一个危险因素[1]。为了观察心脑血管疾病的Hcy水平变化与脂质代谢状况,对135例脑血管疾病患者和100例健康对照组血清同型半胱氨酸及血脂进行了测定。探讨其在脑血管发病中的应用。     

脑梗死患者血清同型半胱氨酸水平的变化

目的:探讨脑梗死患者血清同型半胱氨酸(homocysteine,Hcy)水平的变化。方法:应用循环酶法测定42例脑梗死患者(脑梗死组)和23例健康正常人(对照组)血清同型半胱氨酸,比较两组患者血清同型半胱氨酸水平的变化。结果:脑梗死组血清Hcy水平(20.39±3.17)μmol/L,高于对照组(12.06±2.45)μmol/L。结论:脑梗死患者血清同型半胱氨酸水平明显升高,同型半胱氨酸是脑梗死的独立危险因素之一。     

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.     

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.     

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.