140例痰浊阻遏型高脂血症患者临床分类及血液流变学结果的分析

目的通过分析140例痰浊阻遏型高脂血症患者临床分类及其血液流变学的结果,探讨痰浊阻遏型高脂血症中医证候特点。方法对临床辨证为痰浊阻遏型的140例高脂血症患者的血脂和血液流变学进行检测,分析高胆固醇血症、混合型高脂血症、高甘油三酯血症和低高密度脂蛋白血症患者血脂的特点及血液流变学的变化,对其相关性进行分析。结果 140例痰浊阻遏型高脂血症中,低HDL-C血症所占的比例最大,其次是混合型高脂血症,高TG血症次之,高TC血症所占的比例最小;高TG血症和混合型高脂血症TG水平和高TC血症TC显著高于其他各型(P0.01),低HDL-C血症HDL-C显著低于其余各型(P0.01),其余指标各型之间未见显著性差异(P0.05);高TC血症和混合型高脂血症LDL-C水平显著高于其余各型(P0.01),ApoAl、ApoB、ApoAl/ApoB各型之间未见显著性差异(P0.05);混合型高脂血症血液流变学各项指标高于其它各型(P0.01),其次是高TG血症(P0.05)。结论痰浊阻遏型高脂血症多见于低HDL-C血症,混合型高脂血症血液流变学各项指标变化最明显。     

高频电离子治疗仪治疗睑黄瘤150例临床观察

目的：观察高频电离子治疗仪治疗睑黄瘤的临床疗效。方法我科2007年2月—2011年3月应用高频电离子治疗仪治疗睑黄瘤150例。结果150例睑黄瘤患者中,115例一次治疗全部皮损,33例分2次,2例分3次治疗不同部位皮损。其中治愈138例,占92%;有效12例,占8%。结论高频电离子治疗仪治疗睑黄瘤患者无痛苦、损伤小,疗效满意。且该治疗方法具有手术简单、精确、出血量少、安全性高、价廉等优点,值得临床推广应用。     

兰州市部分人群高脂蛋白血症的调查分析

目的了解兰州市部分人群高脂蛋白血症患病率及构成比,为兰州市高脂蛋白血症的调查分析提供基础资料,也为预防动脉粥样硬化性冠心病的发生、发展提供依据。方法选择2005年度来我院体检的5222名干部作为研究对象,用日立7170S全自动生化分析仪测定血脂,包括总胆固醇(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)。结果TG异常率最高,为30.87%;HDL-C异常率最低,为8.56%;TG、LDL-C异常率各年龄组男性高于女性,HDL-C异常率各年龄组女性高于男性;以TG升高为主的高脂蛋白血症所占比例最高,占57.91%,低高密度脂蛋白血症所占比例最低,占9.73%。结论兰州市部分人群中高脂蛋白血症患病率为21.66%,其中以TG升高的高脂蛋白血症最高,提示我们改变不科学的生活方式、改善不合理的饮食习惯是避免高脂蛋白血症发生最主要的手段之一,将对预防冠状动脉粥样硬化性心血管病的发生、发展具有重要意义。     

2型糖尿病血脂及脂蛋白的变化分析

目的:探索2型糖尿病患者血脂及脂蛋白与血管病变的相关性。方法:分析120例2型糖尿病患者(59例无血管病变,61例有血管病变)和100例正常人的血脂及脂蛋白。结果:2型糖尿病患者血清TG、TC、LDL-C和ApoB较正常人水平高(P<0.01);而HDL-C、ApoA低于正常人(P<0.01)。有血管病变糖尿病患者TG、TC、LDL-C、ApoB水平高于无血管病变糖尿病患者(P<0.01),HDL-C、ApoA1低于无血管病变患者(P<0.01)。结论:2型糖尿病患者血脂及脂蛋白代谢紊乱,这与血管病变密切相关。     

中国人Ⅱb型高脂蛋白血症apoE基因多态性的研究

目的　探讨中国人 b型高脂蛋白血症患者载脂蛋白 E(apo E)基因多态性及其与血脂和载脂蛋白水平的关系。方法　采用聚合酶链反应 -限制性酶切片段长度多态性法 (PCR- RFL P) ,分别对 74例 b型高脂血症患者及 2 30例血脂正常者的 apo E基因型、空腹血脂及载脂蛋白 A 、A 、B10 0、C 、C 、E进行了全面分析。结果　 b型高脂血症患者的体重指数 (BMI) ,血清甘油三酯 (TG) ,总胆固醇 (TC) ,低密度脂蛋白胆固醇(L DL C) ,非高密度脂蛋白胆固醇 (n HDL C) ,载脂蛋白 A 、B10 0、C 、C 、E水平及 TG/ HDL C比值均较对照组显著升高 (P<0 .0 0 1) ;血清高密度脂蛋白胆固醇 (HDL C)水平及 apo E/ apo C 比值显著降低 (P<0 .0 5 )。 b型高脂血症组与对照组 apo E基因型及等位基因频率分布均以 E3/ 3和 ε3最高 , b型高脂血症组的 ε2 等位基因有增高的趋势 ,而 ε4等位基因有降低的趋势 (P>0 .0 5 )。携带 ε2 等位基因组血清 TG、apo C 、apo E水平及 apo E/ apo C 比值较 E3/ 3基因型组显著升高 ,而携带 ε4等位基因组血清 TC、n HDL C及 apo E水平较 E3/ 3基因型组显著升高(P<0 .0 0 1) )。结论　 ε2 及 ε4等位基因与 b型高脂蛋白血症患者的血清 TG、TC、n HDL C、apo C 及 apo E水平升高有关。     

老年人脂肪肝与血脂关系的研究

目的探讨老年人脂肪肝与血清脂质及脂蛋白的关系.方法 37例年龄>60岁的脂肪肝患者空腹抽血,查TC、TG、HDL-L、LDL-C、VLDL-C及FBG,并与无脂肪肝的老年人进行比较.结果脂肪肝组合并高TG血症70.27%,高TC血症40.54%,TC、TG、FBG明显高于无脂肪肝组(P<0.01),LDL-C、VLDL-C高于无脂肪肝组,两组HDL-C相似.结论老年人脂肪肝与高脂血症密切相关,尤其是高TG血症,同时脂肪肝与血糖亦有关联.调脂治疗对预防老年人脂肪肝的发生应有积极作用.     

早期类风湿关节炎（RA）患者病情活动期血清脂质代谢异常发生率及其影响因素

目的探讨早期类风湿关节炎（RA）患者病情活动期血清脂质代谢紊乱发生率及其影响因素。方法 2011年1月—2012年12月收治的50例病情活动期未用激素以及免疫调节药物治疗的早期RA患者进行总胆固醇（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）、载脂蛋白Al（apoAI）、载脂蛋白B（aPoB）、脂蛋白（a）=LP（a）检测,观察RA患者活动期血清脂质代谢特点。结果①病情活动期未经治疗RA患者中发生血症代谢异常总例数是45例,占90%,异常的发生率分别是：高LP（a）血症为68%、低apoAI血症为40%、低HDL-C血症为30%、高TG血症为22%、高apoB血症为22%、高TC血症为16%、高LDL-C血症为16%。②早期RA病情活动期42例女性患者与8例男性患者于血脂差异无显著性;③早期RA病情活动期Tc、LDL-C、apoB与年龄、BMI呈正相关;TG与BMI呈正相关;HDL-C与CRP、DAS28呈负相关,apoAI与DAs28呈负相关。结论 RA患者血脂异常影响着AS的发生而发展,年龄、病程、BMI等因素影响着RA的预后,早期诊断、早期治疗是减轻RA危害的重要措施。     

2型糖尿病患者血清载脂蛋白AⅠ、AⅡ、 B100、CⅡ、CⅢ、E含量分析

目的　探讨2型糖尿病患者血清中载脂蛋白(apo)AⅠ、AⅡ、B100、CⅡ、CⅢ、E含量的改变特点。方法　对143例2型糖尿病患者(其中合并冠心病20例,合并高甘油三酯血症66例,合并高胆固醇血症55例)和127例非糖尿病对照进行了空腹12小时后血糖、胰岛素、甘油三酯(TG)、胆固醇(TC)、高密度脂蛋白胆固醇及apoAⅠ、AⅡ、B100、CⅡ、CⅢ、E含量的测定。结果　与非糖尿病对照组相比,男性2型糖尿病患者腰臀比(WHR)、空腹血糖(FBG)及apoCⅡ明显升高(P<0.05),apoAⅠ、AⅡ明显降低(P<0.05)。女性糖尿病患者较女性非糖尿病者体重指数(BMI)、WHR、FBG、TG水平明显升高(P<0.05),HDL-C、apoAⅠ、AⅡ水平则明显降低(P<0.01)。在伴有脂质异常血症和冠心病的2型糖尿病患者中,apo(s)与血脂的变化更为明显。2型糖尿病伴高甘油三酯血症的患者较TG正常的糖尿病患者BMI、WHR、空腹胰岛素(INS)、TG、TC、apoB100、CⅡ、CⅢ和E水平明显升高,同时伴HDL-C、apoAⅠ水平降低(P均<0.05);2型糖尿病伴高胆固醇血症的患者与TC正常的的患者相比,WHR、TG、TC和apoB100、CⅡ、CⅢ、E水平也明显升高(P<0.01)。载脂蛋白的变化与血脂的变化呈明显相关。在2型糖尿病合并冠心病的患者中,BMI、FBG、INS、apoB100、CⅡ、CⅢ和E水平显著升高,HDL-C、apoAⅡ水平则显著降低(P均<0.05)。结论　载脂蛋白异常是2型糖尿病患者的代谢紊乱特征,同时可能是2型糖尿病发生脂代谢紊乱和冠心病的重要原因。     

阿托伐他汀治疗老年人高胆固醇血症86例临床分析

目的探讨阿托伐他汀治疗老年人高胆固醇血症的临床效果。方法选择该院2011年4月—2012年6月治疗的86例高胆固醇血症患者,每晚口服阿托伐他汀20mg/次,连服4周。结果 86例患者经过治疗治疗后TC、TG、HDL-C、LDL-C、TC/HDL-C均有不同程度的下降,与治疗前比较差异有统计学意义(P<0.05),TC总有效率为90.7%,TG总有效率为59.3%,HDL-C总有效率为65.3%,LDL-C总有效率为93.0%,TC/HDL-C总有效率为94.2%。结论阿托伐他汀治疗老年人高胆固醇血症疗效显著,值得推广。     

肾功能衰竭时脂蛋白代谢异常的探讨

本文对38例内科保守治疗和15例经透析治疗由各种原因引起的尿毒症患者脂蛋白代谢进行了观察,并与284名年龄分布相近似的正常人血脂分析结果作对照,本组被测45例患者中,空腹三酸甘油酯(TG)浓度仅3例超过正常上限(130mg%),为6.7%,高TG血症的发生率明显低于其它作者所报导的结果,这可能与本组患者均采用饮食治疗有关。男女二组中最明显的脂蛋白异常是高密度脂蛋白胆固醇(HDL-C)降低(P<0.001),这种HDL-C降低似乎与透析无关。男女二组中尿毒患者的总胆固醇(TC)和低密度脂蛋白胆固醇(LDL-C)与对照组(除女性组LDL-C外)相比亦有明显降低(分别为P<0.01和P<0.001),TC/HDL-C亦与对照组有显著差异(P<0.05)。尿毒症患者尤其是经透析治疗的患者中心血管并发症增高可能与他们在脂蛋白代谢中发生上述变化有密切关系。在男性组中TC.LDL-C及HDL-C与肌酐(Cr)呈显著负相关(P<0.05),但女性组却未发现这种关系。     

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.