2型糖尿病患者血尿酸水平与血管并发症的关系

目的探讨2型糖尿病（T2DM）患者血尿酸水平与血管并发症之间的关系。方法 T2DM患者150例,按血尿酸水平分为非高尿酸血症组（NUA）99例、高尿酸血症组（HUA）51例,检测两组患者各项生化指标,并观察血管并发症的发生情况。结果 HUA组体重指数、收缩压、糖化血红蛋白、总胆固醇、24 h尿微量白蛋白、肌酐水平均明显高于NUA组,而高密度脂蛋白-胆固醇明显低于NUA组,差异均有统计学意义（P〈0.05）;HUA组脑梗死、冠心病、高血压、糖尿病肾病、糖尿病视网膜病变发生率均明显高于NUA组,差异均有统计学意义（P〈0.05）。结论高尿酸血症可加重T2DM患者代谢紊乱,并促进T2DM患者血管并发症的发生、发展。     

2型糖尿病患者的血尿酸水平与血管并发症的相关分析

目的 探讨2型糖尿病血清尿酸水平与血管并发症的关系.方法 对342例2型糖尿病患者,根据血尿酸水平分成尿酸正常组(NUA)和高尿酸组(HUA),测定两组病人的UA、TG、TCH、HDL和LDL,分析两组病人的血管并发症发病率的差别.结果 (1)HUA组的BMI、TG、BP、TC、LDL、WHR均高于NUA组(P＜0.05);(2)HUA组的冠心病、脑血管病、视网膜病变、肾脏病变的发病率均高于NUA组(P＜0.05).结论 高尿酸血症是引起糖尿病血管并发症的危险因素.     

2型糖尿病患者的血尿酸水平与血管并发症的相关分析

目的 探讨2型糖尿病血清尿酸水平与血管并发症的关系.方法 对342例2型糖尿病患者,根据血尿酸水平分成尿酸正常组(NUA)和高尿酸组(HUA),测定两组病人的UA、TG、TCH、HDL和LDL,分析两组病人的血管并发症发病率的差别.结果 (1)HUA组的BMI、TG、BP、TC、LDL、WHR均高于NUA组(P＜0.05);(2)HUA组的冠心病、脑血管病、视网膜病变、肾脏病变的发病率均高于NUA组(P＜0.05).结论 高尿酸血症是引起糖尿病血管并发症的危险因素.     

血尿酸与2型糖尿病胰岛素抵抗及血管并发症的关系

目的:评价高尿酸血症对2型糖尿病胰岛素抵抗及血管并发症的影响,并探讨其可能的发生机制。方法:68例2型糖尿病患者,根据血尿酸水平分成尿酸正常(NUA)组(42例)和高尿酸(HUA)组(26例),分析两组病人的胰岛素抵抗指数和大血管、微血管病变发生率的差异。结果:(1)HUA组体重指数(BM I)、甘油三酯(TG)、血压(BP)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、腰臀比值(WHR)、胰岛素抵抗指数(HOMA-IR)均高于NUA组(均P<0.05),而高密度脂蛋白胆固醇(HDL-C)则低于NUA组(P<0.05)。(2)HUA组冠心病、脑血管病、视网膜病变、肾脏病变、颈动脉斑块和下肢动脉斑块的发生率均高于NUA组(均P<0.05)。结论:高尿酸血症与肥胖、血脂异常、胰岛素抵抗明显相关,并可导致大血管及微血管并发症的发生。     

糖尿病前期与高尿酸血症的相关因素分析

目的 研究糖尿病前期(PDM)与高尿酸血症(HUA)的相关因素,探讨高尿酸血症与糖尿病前期的关系.方法 糖尿病前期患者72例,按照血尿酸水平分为高尿酸(HUA)组(42例)和正常尿酸(NUA)组( 38例),对两组的临床资料进行分析.结果 (1)HUA组甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C...     

高尿酸血症对2型糖尿病心脑血管并发症的影响

目的:评价高尿酸血症对2型糖尿病(T2DM)心脑血管并发症的影响,探讨其可能的作用机制.方法:对288例T2DM患者,根据血尿酸水平分成高尿酸组(HUA)和尿酸正常(NUA)组,分析比较两组及心脑血管等并发症发病率的差别.结果:①HUA组的TC、TG、LDL-C及BMI、WC均高于NUA组(P＜0.05,P＜0.01),而HDL-C则低于NUA组(P＜0.01).②HUA组的高血压、冠心病、脑血管病变、视网膜病变、肾脏病变、周围神经病变的发病率均高于NUA组(P＜0.05,P＜0.01).结论:①高尿酸血症与肥胖、血脂异常明显相关;②高尿酸血症加重T2DM患者的代谢紊乱,并促进心脑血管并发症的发生和发展.     

代谢综合征合并高尿酸血症31例临床分析

目的探讨血清尿酸(UA)水平与代谢综合征(MS)各组分的关系。方法将MS患者分为高尿酸(HUA)血症组与血尿酸正常(NUA)组,比较不同血UA水平的两组MS患者的血脂、血压、体重指数、腹围及血糖的关系。结果MS合并HUA血症组较血NUA组腹围、甘油三酯(TG)、总胆固醇(TC、)均明显增高,有统计学意义;血糖、血压、体重指数差异无统计学意义。结论血UA水平与MS组分中的高甘油三酯血症、高胆固醇血症、中心型肥胖密切相关。     

2型糖尿病患者血尿酸与蛋白尿的关系

目的 探讨2型糖尿病(T2DM)患者血尿酸(SUA)与蛋白尿的关系.方法 选择2016年5月至2017年9月安徽省立医院住院的T2DM患者791例,根据血尿酸(SUA)水平将患者分为正常尿酸(NUA)组656例和高尿酸(HUA)组135例,通过单因素分析比较两组患者尿白蛋白/肌酐(UACR)的差异;通过Pearson相关分析,比较UACR与其他生化指标的相关性,并将有统计学意义的指标纳入logistic回归分析中,了解SUA对蛋白尿发生的相对危险度.结果 ①HUA组患者UACR高于NUA组[(225.53±870.90)mg/g vs(576.58±1213.86)mg/g],差异有统计学意义(P<0.05);②Pearson相关分析显示,UACR与SUA呈正相关(P<0.05);Logistic回归分析显示,血尿酸水平每增加1 mg/dL,发生蛋白尿的相对危险度为1.096(P=0.005).结论 T2DM患者中,血尿酸水平升高可引起UACR升高,是蛋白尿发生的危险因素,在糖尿病的治疗中需监测血尿酸水平.     

高尿酸血症患者血清抵抗素水平及相关因素分析

目的 分析高尿酸血症(HUA)患者抵抗素水平及其相关影响因素.方法 测定208例HUA患者(HUA组)及200例血尿酸正常者(NUA组)的空腹血清抵抗素水平及其他生化指标,进行组间比较,并分析影响抵抗素水平的相关因素.结果 HUA组的收缩压(SBP)、体质指数(BMI)、腰围(WC)、空腹胰岛素(FINS)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、胰岛素抵抗指数(HOMA-IR)及抵抗素水平高于NUA组,差异均有统计学意义(P＜0.05);两组服糖后2 h血糖(2 hPG)、舒张压(DBP)、高密度脂蛋白胆固醇(HDL-C)和总胆固醇(TC)水平间差异均无统计学意义(P＞0.05).在HUA组,以抵抗素为因变量,以年龄、SBP、DBP、BMI、WC、FPG、FINS、2 hPG、HDL-C、LDL-C、TC、TG和HOMA-IR为自变量进行Logistic回归分析显示,HUA患者抵抗素水平升高的危险因素为BMI、WC、FINS、FPG和TG.结论 HUA患者的抵抗素水平显著高于尿酸正常者,抵抗素水平主要与FPG、FINS、TG、BMI及WC有关.     

2型糖尿病足溃疡患者足部病变程度与血尿酸水平的关系

目的 探讨住院2型糖尿病患者足部溃疡的严重程度(Wagnerl 5级)与血尿酸之间的关系。方法 选取 2017年1月?2018年5月在我院内分泌科住院的134例2型糖尿病足溃疡患者,根据血尿酸水平分为高尿酸组及尿酸 正常组,比较两组患者一般资料及临床指标的差异,分析2型糖尿病足溃疡患者合并高尿酸血症的影响因素。同时将 Wagnerl级(Wl)、2级(W2)、3级(W3)各分为一组,4级和5级为一组(W4) ,分析4组患者的临床特征及血尿酸水平的 情况,了解4组患者足部病变严重程度与血尿酸水平的相关性。结果 与NUA组相比,HUA组患者Wagner分级均升 高(P<0.05),同时HUA组吸烟率增加,糖尿病病程、WBC、血肌肝均升高,差异有统计学意义(P<0. 05),但HUA组 较NUA组糖化血红蛋白降低(P<0.05)。二元logistic回归分析结果显示,糖尿足合并HUA组中,Wagner分级是血 尿酸升高的独立危险因素?( P<0. 05)。W1 W4组间患者中吸烟、糖尿病病程、TC、LDL、WBC、RBC、Hb、Alb、Ca、UA 均有统计学差异(P<0. 05),且随着足部病变程度的加重,患者血尿酸水平逐渐升高。Wagner分级与糖尿病病®.WBC 及血尿酸呈正相关(PV0. 05),与RBC、Hb、Alb、Tc、LDL、Ca呈负相关(P<0. 05)。校正多因素Logistic回归分析后, 与W1组相比,W2、W3、W4组与血尿酸的OR值逐渐增加(P<0.05)。结论 2型糖尿病足溃疡患者足部病变程度与 血尿酸之间具有相关性,糖尿病足溃疡合并高尿酸血症的患者足溃疡更严重。同时随着足部病变程度的加重,患者血 尿酸水平逐渐升高。     

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.