维持性血液透析患者微炎症相关因子与贫血的关系

目的:探讨维持性血液透析(MHD)患者血清中C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、血红蛋白(Hb)水平变化,分析MHD患者微炎症相关因子与贫血的关系。方法:选择MHD患者30例、尿毒症非透析组28例、健康人(对照组)28例,分别检测CRP、IL-6、TNF-α、Hb水平。结果:血液透析组CRP、IL-6、TNF-α水平明显高于对照组和未透析组(P<0.01),血液透析组Hb水平明显低于对照组和未透析组(P<0.01)。透析组CRP、IL-6、TNF-α与Hb呈负相关(P<0.01)。结论:维持性血液透析患者微炎症相关因子水平增高与贫血相关。     

血液灌流联合血液透析对维持性血液透析患者微炎症状态的影响

目的:探讨血液灌流联合血液透析对维持性血液透析患者微炎症状态的影响。方法:将48例维持性血液透析患者随机分为血液透析组和血液灌流联合血液透析组,每组各24例;另选择24例健康体检者作为对照组。比较透析前、透析治疗12周后,各组研究对象的白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、超敏C-反应蛋白(hs-CRP)、清蛋白水平。结果:透析前,血液灌流联合血液透析组和血液透析组患者的血清IL-6、TNF-α、hs-CRP水平明显高于对照组(P<0.01),清蛋白水平均明显低于对照组(P<0.01)。治疗12周后,血液透析组患者的血清TNF-α水平较治疗前有显著上升(P<0.05);血液灌流联合血液透析组患者的血清IL-6、TNF-α、hs-CRP水平均较治疗前下降(P<0.05)。结论:血液灌流联合血液透析可降低维持性血液透析患者炎症因子水平。     

超纯透析对维持性透析患者微炎症反应的影响

目的:探讨超纯透析对维持性血液透析患者血清单核细胞趋化蛋白-1(MCP-1)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)及晚期糖基化终末产物(AGEs)水平的影响。方法:选择2013年12月-2014年12月在本院肾内科血液透析中心诊断为终末期肾病并行维持性血液透析的120例患者,按照随机数字表法将其分为研究组与对照组,每组60例。对照组患者给予维持性常规血液透析方式治疗,3次/周。研究组患者透析液由碳酸氢钠透析液替代为Bibag联机干粉,其余治疗方式与对照组相同。治疗时间为3个月。治疗前及治疗后晨空腹抽血6 m L,检测血清MCP-1、IL-6、TNF-α及AGEs水平变化,比较两组患者治疗后各项观察指标差异。结果:两组患者的糖化血红蛋白(Hb A1c)和平均动脉压(MAP)比较差异均无统计学意义(P>0.05)。两组患者治疗前MCP-1、IL-6、TNF-α、AGEs水平及血红蛋白与血清白蛋白水平比较差异均无统计学意义(P>0.05)。治疗后,研究组与对照组比较,MCP-1[(45.89±9.36)vs(94.36±13.95)pg/m L,t=3.542]、IL-6[(35.98±8.16)vs(71.36±10.28)pg/m L,t=3.041]、AGEs[(13.69±5.03)vs(31.76±4.69)AU/mg,t=2.937]、TNF-α[(48.36±6.95)vs(82.36±10.62)ng/L,t=3.094]水平均明显下降,血红蛋白及血浆白蛋白水平均明显升高,比较差异均有统计学意义(P<0.05)。结论:超纯透析能明显减少维持性血液透析患者血清单核细胞趋化蛋白-1、白介素-6、肿瘤坏死因子-α及晚期糖基化终末产物水平,减轻体内微炎症反应状态,值得临床推广。     

血液透析滤过联合血液透析治疗慢性肾衰竭的临床疗效

目的：分析血液透析滤过联合血液透析治疗慢性肾衰竭的临床疗效。方法：选择80例慢性肾衰竭患者作为研究对象,按照不同的入院时间将其分成两组,即对照组(n=40)与研究组(n=40)。对照组采用血液透析治疗,研究组采用血液透析滤过联合血液透析治疗,对比两组患者的治疗前后肾功能指标[血清尿素氮(BUN)、血清肌酐(Scr)、血清尿酸(UA)]与血清炎性细胞因子[白细胞介素(IL)-6、IL-8、肿瘤坏死因子-α(TNF-α)、超敏C-反应蛋白(hs-CRP)]以及治疗后并发症发生情况(腹膜感染、皮肤瘙痒、贫血、恶心)。结果：治疗前,两组BUN、Scr、UA、IL-6、IL-8、TNF-α、hs-CRP水平差异无统计学意义(P>0.05);治疗后,两组BUN、Scr、UA、IL-6、IL-8、TNF-α、hs-CRP水平均降低,但研究组BUN、Scr、UA、IL-6、IL-8、TNF-α、hs-CRP水平均比对照组低,差异有统计学意义(P<0.05);治疗后,研究组并发症总发生率明显低于对照组,差异有统计学意义(P<0.05)。结论：采用血液透析滤过联合血液透析治疗慢性肾衰竭,...     

氯吡格雷联合阿司匹林治疗进展性缺血性脑卒中的疗效及对炎性因子水平的影响

目的:观察氯吡格雷联合阿司匹林治疗进展性缺血性脑卒中的疗效及对炎性因子水平的影响。方法:选取100例进展性缺血性脑卒中患者作为观察对象,按照随机数表法将其分为对照组(阿司匹林治疗)和研究组(氯吡格雷联合阿司匹林治疗)各50例,比较两组临床疗效、不良反应发生率及用药第4周的血清超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)水平。结果:研究组临床治疗总有效率(90.0%)明显高于对照组(72.0%),组间差异显著(P<0.05);治疗前两组患者血清hs-CRP、TNF-α、IL-6水平比较,差异无统计学意义(P>0.05),治疗后,两组患者血清hs-CRP、TNF-α、IL-6水平均较治疗前明显较低(P<0.05),且研究组患者的hs-CRP、TNF-α、IL-6水平下降幅度大于对照组(P<0.05);研究组不良反应发生率(12.0%)与对照组(10.0%)比较,差异无统计学意义(P>0.05)。结论:氯吡格雷联合阿司匹林治疗进展性缺血性脑卒中的疗效及改善血清炎性因子水平的效果优于单纯阿司匹林治疗效果。     

左卡尼汀对维持性血液透析患者微炎性反应状态相关炎性因子的影响

目的探讨静脉注射左卡尼汀(L-CN)对维持性血液透析(MHD)患者微炎性反应状态相关炎性因子的影响。方法选择透析龄大于6个月的MHD患者76例,随机分为治疗组40例,对照组36例,治疗组于每次透析结束时静脉注射左卡尼汀1g,对照组静脉注射等量生理盐水,治疗3个月,分别检测治疗前及治疗1个月、3个月时MHD患者的血生化指标、超敏C反应蛋白(hs-CRP)、白细胞介素(IL)-6、IL-8、肿瘤坏死因子-α(TNF-α)水平变化。结果治疗1个月后治疗组hs-CRP、IL-6、IL-8、TNF-α水平均较治疗前下降(P均<0.05),对照组治疗前后无显著性差异(P均>0.05),治疗组与对照组比较差异有统计学意义(P<0.05);治疗3个月后治疗组hs-CRP、IL-6、IL-8、TNF-α水平均较治疗前进一步下降(P均<0.01),对照组仍无显著性差异(P均>0.05),治疗组与对照组比较差异有统计学意义(P<0.01)。结论左卡尼汀可以降低维持性血液透析患者血清hs-CRP、IL-6、IL-8、TNF-α水平,改善微炎性反应状态。     

高通量血液透析对重症肾衰竭患者炎症指标及营养状态的影响

目的:探讨高通量血液透析对重症肾衰竭患者炎症指标及营养状态的影响.方法:选择2016年7月—2019年12月期间河南省焦作市第二人民医院收治80例重症肾衰竭患者作为研究对象,随机分为观察组与对照组,每组各40例.对照组患者实施常规血液透析治疗,观察组患者实施高通量血液透析治疗,对比两组患者治疗前后炎症指标[白细胞介素-6(IL-6)与肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)]与营养状态[血浆白蛋白(ALB)与血浆总蛋白(TP)]变化.结果:治疗3个月后,两组患者TNF-α、IL-6、hs-CRP水平均低于治疗前,且观察组患者TNF-α、IL-6、hs-CRP水平比对照组患者更低,差异有统计学意义(t=13.593、3.707、12.306,P均=0.000);两组患者ALB、TP水平均高于治疗前,且观察组患者ALB、TP水平比对照组患者更高,差异有统计学意义(t=19.672、4.149,P均=0.000).结论:高通量血液透析治疗重症肾衰竭患者临床效果显著,可有效减轻炎症反应,改善其营养状态,进而促使患者获益.     

血清Hcy、IMA、炎性因子水平与非ST段抬高急性心肌梗死患者冠状动脉病变程度的关系

目的:探索血清同型半胱氨酸(Hcy)、缺血修饰蛋白(IMA)及各炎性因子与非ST段抬高急性心肌梗死(NSTEMI)患者冠状动脉病变程度的相关性.方法:将符合入选标准并经临床确诊的96例NSTEMI患者作为研究组,另外选择30例健康体检者作为对照组,检测其血清Hcy、IMA及肿瘤坏死因子-α(TNF-α)、超敏C-反应蛋白(hs-CRP)、白介素-6(IL-6)水平,并分析各因子与NSTEMI患者冠状动脉病变程度的相关性.结果:NSTEMI患者Hcy、IMA及TNF-α、IL-6、hs-CRP水平与健康对照组比较均有明显增加,且差异存在统计学意义(P＜0.05);NSTEMI冠状动脉双支病变组患者Hcy、IMA及TNF-α、IL-6、hs-CRP水平与单支病变组进行比较均有明显增加,而多支病变组患者上述各项指标与双支病变组进行比较均有明显增加,且各组间差异均存在统计学意义(P＜0.05);Hcy、IMA及TNF-α、IL-6、hs-CRP水平与冠状动脉病变程度均呈明显正相关(P＜0.05).结论:非ST段抬高急性心肌梗死患者Hcy、IMA及TNF-α、IL-6、hs-CRP水平均较健康对照组明显增加,且随患者冠状动脉病变程度增加而增加.     

高通量血液透析对维持性血液透析患者的预后影响分析

目的：了解高通量血液透析对维持性血液透析患者的预后影响分析.方法：择取我院2011年12月至2013年12月收治的64例维持性血液透析患者随机分成两组,其中对照组应用低通量方式透析,实验组利用高通量方式透析,比较两组患者治疗前后血浆白蛋白（ALB）、体重指数（BMI）、血浆总蛋白（TP）、超敏C反应蛋白（hs-CRP）、白细胞介素6（IL-6）、肿瘤坏死因子α（TNF-α）变化.结果：实验组治疗12w后血浆细胞因子水平明显低于治疗前,微炎症状态、营养状况均得到显著改善（P＜0.05）;对照组治疗后血浆细胞因子水平与治疗前无显著性变化（P＞0.05）,营养状况亦无明显变化（P＞0.05）;两组患者治疗后ALB、BMI、IL-6、hs-CRP、TNF-α水平等差异具有显著统计学意义（P＜0.05）.结论：高通量透析能显著清除维持性血液透析患者微炎症细胞因子,改善患者预后.     

慢性炎症与血透患者促红细胞生成素低反应性关系研究

目的观察血液透析患者体内慢性炎症对重组人红细胞生成素（rHuEPO）反应性的影响。方法将40例维持性血液透析（MHD）患者按照rHuEPO反应性的不同分为两组：rHuEPO反应良好组22例和rHuEPO反应低下组18例,另设一健康对照组20例。透析前检测血清急性期反应蛋白hs-CRP和炎症因子IL-6、TNF-α的水平,并比较分析rHuEPO反应良好组和反应低下组之间的差异。结果尿毒症MHD患者体内平均TNF-α、IL-6、hs-CRP水平显著高于正常对照组。rHuEPO反应低下组的TNF-α、IL-6、CRP水平显著高于反应良好组。结论尿毒症MHD患者体内存在慢性炎症状态,慢性炎症是导致rHuEPO低反应性的重要原因之一。     

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.     

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.