2型糖尿病患者血清hs-CRP和TC/HDL-C联合检测的应用研究

目的:探讨超敏C反应蛋白在2型糖尿病中的应用价值。方法:用OlympusAU2700全自动生化分析仪对72例2型糖尿病患者和65例正常对照组进行血清超敏C反应蛋白和各项血脂的含量的检测,并计算总胆固醇与高密度脂蛋白之比,后采用SAS统计软件进行统计学处理作对比分析。结果:2型糖尿病患者血清超敏C反应蛋白及总胆固醇与高密度脂蛋白之比明显升高,与健康对照组比较,差异有统计学意义(P<0.01和P<0.05)。结论:hs-CRP与血脂测定在预测2型糖尿病并发心血管疾病中具有重要的临床应用价值;2型糖尿病患者常伴有血脂紊乱,TC/HDL-C升高提示患动脉粥样硬化的危险性增大。     

糖尿病和糖尿病动脉粥样硬化患者与血浆超敏C反应蛋白的关系探讨

目的探讨超敏C反应蛋白与糖尿病及糖尿病动脉粥样硬化患者的相关性。方法采用免疫透射比浊法测定30例2型糖尿病患者和35例2型糖尿病合并双下肢动脉硬化患者血浆hS—CRp的水平，并与20例正常健康对照组进行比较。结果（1）2型糖尿病患者的血浆hS—CRp水平明显高于正常对照组（P〈0．05），糖尿病合并下肢动脉硬化组血浆hS-CRp水平明显高于糖尿病无下肢动脉硬化组（P〈0．01）。（2）患者血浆超敏C反应蛋白水平与低密度脂蛋白、胆固醇、甘油三酯呈正相关，与高密度脂蛋白呈负相关。结论超敏C反应蛋白可能是糖尿病及动脉粥样硬化发生发展中的影响因素，与血脂代谢紊乱共同促进动脉粥样硬化的发生发展。     

2型糖尿病患者血脂水平的研究

目的：研究2型糖尿病患者的血脂水平。方法：用贝克曼LX-20全自动生化分析仪测定120例2型糖尿病患者血清的总胆固醇（CHOL）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL—C）、低密度脂蛋白胆固醇（LDL—C）、载脂蛋白A含量（ApoA）、栽脂蛋白B含量（ApoB）。结果：120例2型糖尿病患者组血脂水平与100例健康人对照组血清血脂含量比较,2型糖尿组的TG、-LDL—C、APOB显著升高（P＜0．01）,CHOL明显升高（P＜0．05）,HDL—C、APOA明显降低（P〈0．05）。结论：2型糖尿病患者普遍存在着明显的脂类代谢紊乱,提示在2型糖尿病的临床中应早期采取针对性预防措施。     

冠心病病人血胆红素及超敏C反应蛋白测定的意义

目的探讨冠心病（CHD）患者血脂、血清胆红素及超敏C反应蛋白（hs-CRP）测定的意义。方法临床符合CHD的患者56例及健康体检54例检测其TG、CH、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、血清胆红素及超敏C反应蛋白。结果高密度脂蛋白胆固醇、血清胆红素与对照组比较降（P〈0.05）TG、CH、低密度脂蛋白胆固醇、与对照组比较增高（P〈0.01）。超敏C反应蛋白与对照组比较增高（P〈0.05）结论冠心病病人血胆红素降低,超敏C反应蛋白增高。     

2型糖尿病患者C-反应蛋白检测的临床意义

目的：探讨C-反应蛋白（CRP）与2型糖尿病的关系,并分析其与糖化血红蛋白（HbA1c）及血脂的相关性。方法：测定2型糖尿痛患者46例及正常对照组30例的血清CRP、HhA1c、甘油三酯（TG）、胆固醇（TC）、高密度脂蛋白胆固醇（HDL—c）、低密度脂蛋白胆固醇（LDL—C）。结果：2型糖尿病组CRP为（4．86±1．67）mg／L,较正常对照组（0．85±0．61）mg／L明显升高,二者比较差异具有统计学意义（P〈0．01）。2型糖尿病患者血清CRP与HbA1c（r=0．675,P〈0．01）、TG（r=0．432,P〈0．01）、TC（r=0．409,P〈0．01）、LDL—C（r=0．516,P〈0．01）呈正相关关系;与HDL—C（r=-0．473,P〈0．01）呈负相关关系。结论：2型糖尿病患者CRP升高,与血清HbA1C、TG、TC、LDL—C、HDL—C密切相关,据此可预测2型糖尿病心血管并发症及预后。     

血浆超敏C反应蛋白与糖尿病的关系

目的研究超敏C-反应蛋白（hs—CRP）和血脂预测在监视2型糖尿病并发动脉粥样硬化中的临床价值。方法收集85例糖尿病患者及35例体检正常者的血浆，用奥林帕斯Au640全自动生物化学分析仪检Sin,4hs—CRP、胆固醇（TC）、低密度脂蛋白胆固醇（LDLC）和高密度脂蛋白胆固醇（HDLC）。结果2型糖尿病组血清hs—CRP、TC、LDLC浓度均比正常对照组高，差异有统计学意义（其中hs—CRPP〈0．01，其它P〈0．05），而HDLC浓度低于正常对照组，差异有统计学意义（P〈0．05）。同时，hs—CRP浓度与LDLC浓度呈正相关（r=0．2159，P〈0．05），hs—CRP浓度与HDLC浓度呈负相关（r=-0．2705，P〈0．01）。结论hs—CRP作为一个炎症因子，在预测糖尿病并发动脉粥样硬化中具有重要的临床意义。联合血脂检测，对进一步预防2型糖尿病患者并发动脉粥样硬化有重要的临床意义。     

2 型糖尿病合并冠心病患者氯吡格雷抵抗的危险因素

目的观察老年2型糖尿病合并冠心病患者发生氯吡格雷抵抗的情况,探讨分析相应的危险因素。方法选择本院2011年7月—2013年7月期间收治的76例老年2型糖尿病合并冠心病患者作为观察对象,根据血小板聚集试验结果进行分组,其中血小板抑制率〉50％共40例（对照组）,〈50％共36例（观察组）,对比2组流行病学、脂代谢、糖代谢与超敏C反应蛋白等水平值。结果2组患者年龄、性别、体重、高脂血症与高血压发病史以及吸烟史等流行病学指标对比,差异均不具有统计学意义（均P〉0．05）;观察组空腹血糖、超敏C反应蛋白显著高于对照组,而高密度脂蛋白胆固醇显著低于对照组,差异均具有统计学意义（均P〈0．05）;经多因素分析后,高密度脂蛋白胆固醇、空腹血糖、超敏c反应蛋白均是影响患者发生氯吡格雷抵抗的危险因素（均P〈0．05）。结论老年2型糖尿病合并冠心病患者出现氯吡格雷抵抗的发生率大,且与患者的空腹血糖水平、高密度脂蛋白胆固醇、超敏C反应蛋白等因素有关,值得临床上进一步分析。     

血清尿酸及血脂与2型糖尿病合并急性脑梗死关系的探讨

目的探讨老年2型糖尿病患者血清尿酸（UA）、总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白（LDL-C）及高密度脂蛋白（HDL-C）与急性脑梗死的关系。方法选择98例老年2型糖尿病患者分为2组，48例2型糖尿病合并急性脑梗死为观察组，50例无脑梗死2型糖尿病患者为对照组。测定各组血清尿酸及血脂水平，分析与2型糖尿病合并脑梗死的关系。结果观察组的血清尿酸水平高于对照组，有统计学意义（P〈0．01）。观察组血脂TC、TG、LDL-C与对照组相比差异无显著性（P〉0．05），但HDL—C低于对照组，差异有显著性（P〈0．05）。结论高尿酸血是及低HDL—C是2型糖尿病患者发生脑梗死的两个重要危险因素。     

尿mAlb联合血清hs—CRP对糖尿病早期肾损害的诊断探讨

目的探讨尿做量白蛋白联合血清超敏C反应蛋白检测对诊断2型糖尿病早期肾损害的价值和临床意义。方法对30例2型糖尿病患者和30例缝康体检者分别检测尿微量白蛋白及血清超敏C反应蛋白水平，并对检测结果进行统计学分析：结果2型糖尿病患者尿微量白蛋白和血清超敏C反应蛋白水平均高于健康体检者，差异有显著统计学意义（P〈0．01）。结论尿微量白蛋白和血清超敏C反应蛋白是诊断糖尿病早期肾损害的敏感指标，两者联合检测能准确反映肾功能的早期损害，而早期糖尿病肾脏病变是治疗的关键时期，此时给于及时、正确的治疗可以阻止早期糖尿病肾脏病变的进展．甚至可以逆转其病理改变。     

老年2型糖尿病患者超敏C反应蛋白与动脉硬化的相关性研究

目的：探讨老年2型糖尿病（T2DM）患者血清超敏C反应蛋白（hs2CRP）水平与动脉硬化的相关性。方法：选择T2DM患者60例,分为糖尿病斑块组30例（超声检查颈内动脉见斑块）和糖尿病非斑块组30例（超声检查颈内动脉未见斑块）,对照组健康体检者30例,检测空腹血糖（FPG）、糖化血红蛋白（HbAlc）、血浆总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL—C）,低密度脂蛋白胆固醇（LDL—C）和hs2CRP。结果：糖尿病斑块组与非斑块组患者的FPG、HbAlc、TC、TG、LDL—C水平均明显高于正常对照组（P〈0．05）,HDL—C低于对照组（P〈0．05）;三组间的hs2CRP差异有统计学意义（P〈0．05）,斑块组hs2CRP水平高于非斑块组,且均高于正常对照组（P〈0．05）。结论：hs2CRP与老年T2DM患者颈动脉硬化的发生有密切相关性,在老年T2DM颈动脉硬化的发展中起重要作用。     

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.