盘锦地区ALT参考区间的建立以及血脂(TG、TC)对ALT的影响

目的建立盘锦地区ALT参考区间,同时分析血脂(TG、TC)对ALT的影响。方法收集1816名健康体检者资料,以IFCC推荐的非参数方法建立盘锦周边健康人群ALT参考范围,并根据血脂(TG、TC)水平,将其分为A组(正常组)、B组(TC异常组)、C组(TG异常组)、D组(TC、TG均异常组),分析TG、TC与ALT的相关性,比较各组间ALT水平。结果 ALT参考区间除按性别划分外,男性参考区间还需按年龄划分,盘锦地区男性ALT参考区间为:20~69岁组:8.00~56.00 U/L,70~79岁组:7.50~45.75 U/L,女性ALT参考区间为:7.00~44.00 U/L;TG与ALT水平显著相关,而TC只与男性ALT水平相关,男女D组ALT水平与A组、B组差异有统计学意义,男性C组与A组、B组比较差异有统计学意义,与偏相关结果相符。结论本研究建立了盘锦地区ALT的参考区间并初步分析了血脂(TG、TC)对ALT水平的影响,为临床诊疗工作提供了更有意义的参考数据。     

血清胱抑素C参考区间的建立及其应用

目的 建立健康人群血清胱抑素C(Cys C)的参考区间,并评价Cys C的临床应用效能.方法 选取健康体检者477例为参考组,其中男287例,女190例;按年龄分为3组:＜40岁组,40～60岁组和＞60岁组.选取肾功能不全患者78例为病例组,用于临床应用效能评价.血清Cys C浓度用乳胶颗粒增强免疫比浊法,在全自动生化分析仪上测定.结果 健康体检者血清Cys C浓度与年龄、性别有关.随着年龄增长,血清Cys C水平呈上升趋势,3个年龄组比较其差异有统计学意义(P＜0.05).男、女性两组水平差异有统计学意义(P＜0.05).健康人群血清Cys C参考区间分别为:<40岁组,男性:0.62～1.08 mg/L,女性:0.52～0.93 mg/L;40～60岁组,男性:0.61～1.22 mg/L,女性:0.51～1.05 mg/L;>60岁组,男性:0.64～1.52 mg/L,女性:0.61～1.21 mg/L.以Cys C参考区间上限为分界限,评估肾功能不全者的灵敏度为79.6%,特异度为92.3%,准确度为85.7%.结论 Cys C的参考区间在不同人群中存在差异,临床应用时应建立或选择适宜的参考区间.     

老年人群血清胱抑素C参考试区间建立及GFR评估

目的:统计健康老年群体的血清胱抑素C的浓度并用肾小球滤过率公式换算成GFR来评估老年群体的肾功能变化。方法:通过比较老年组与中年组的血清胱抑素C及其相应的GFR。结果:老年组的血清胱抑素C水平;男性(1.07±0.203)mg/L、女性(1.03±0.197)mg/L与中年组的血清胱抑素C水平:男性(0.91±0.193)mg/L、女性(0.89±0.192)mg/L,两者差异有统计学意义(P<0.01)。老年组GFR:男性(72.00±15.65)ml/min,女性(68.50±16.67)ml/min。中年组GFR:男(87.00±12.65)ml/min、女性:(85.00±11.65)ml/min。结论:本试验老年组与中年组之血清胱抑素C水平比较,差异有统计学意义,老年组血清胱抑素C的参考区间为:0.67～1.46 mg/L(男)、0.64～1.42 mg/L(女)。     

盆腔炎性疾病患者血清AMH水平规律初探

目的调查不同程度盆腔炎性疾病(pelvic inflammatory disease,PID)患者血清抗苗勒管激素(antiMullerian hormone,AMH)水平并与正常生育期女性血清AMH水平比较,以探讨PID患者AMH的表达规律及临床意义。方法选择健康女性67例为对照组,轻中度PID患者121例、重度PID患者34例为观察组,各组再按年龄分为5组:<25岁A组、26~30岁B组,31~35岁C组、36~40岁D组、>40岁E组。ELISA法检测血清AMH水平并分析各组不同年龄段的分布规律及表达差异。结果轻中度PID患者血清AMH平均(4.48±0.36)ng/m L,与年龄呈负相关(r=-0.432,P<0.01),即AMH随年龄的增长不断下降;A组、B组均值与C组、D组、E组比较差异均有统计学意义(P<0.01),E组与A、B、C组比较差异也有统计学意义(P<0.01)。重度PID患者血清AMH平均(2.12±0.26)ng/m L,与年龄呈负相关(r=-0.428,P<0.05),AMH随着年龄的增长下降幅度不大,但40岁后女性AMH骤降;E组与其余各组比较,差异均有统计学意义(P<0.01)。对照组血清AMH平均(3.91±0.51)ng/m L,与年龄呈负相关(r=-0.742,P<0.01),即AMH随年龄的增长不断下降;E组与其余各组两两比较,差异均有统计学意义(P<0.01),A、B组与C、D、E组两两比较差异也有统计学意义(P<0.05)。不同年龄组重度PID患者与轻中度PID患者、对照组血清AMH均值比较差异有统计学意义(P<0.05)。结论年龄是影响PID患者和正常生育期女性血清AMH水平的重要因素,重度PID患者与轻中度PID患者、正常女性血清AMH水平在不同年龄段均有差异;轻中度PID患者血清AMH水平可参照正常生育期女性的水平。     

老年男性冠心病患者血清总胆固醇水平与其病死率的相关性探讨

目的:探讨血清总胆固醇的水平与老年男性冠心病患者病死率的相关性。方法:208例老年男性冠心病患者按照血清总胆固醇的检测结果分为A组(血清总胆固醇<4.16 mmol/L)、B组(血清总胆固醇4.16~<4.68 mmol/L)、C组(血清总胆固醇4.68~<5.2 mmol/L)和D组(血清总胆固醇>5.2 mmol/L)。同时对患者进行血清三酰甘油水平检测和体格检查,记录年龄、体质量指数和死亡情况。结果:4组患者血清总胆固醇水平差异均有统计学意义(P<0.01);A组和D组病死率均高于B组,D组病死率亦高于C组(P<0.05);A组和D组、B组和C组的病死率差异均无统计学意义(P>0.05)。4组患者年龄、体质量指数和三酰甘油水平差异均无统计学意义(P>0.05)。血清总胆固醇水平<4.16 mmol/L或>5.20 mmol/L均可增加老年男性冠心病患者的病死率。结论:老年男性冠心病患者的血清总胆固醇水平和病死率有紧密的相关性,血清总胆固醇水平过高或过低均为引起老年男性冠心病患者病死的危险因素。     

乐山市健康人群胱抑素C正常参考范围的建立

目的研究乐山市不同年龄和性别的健康人群胱抑素C(Cys-C)正常参考范围。方法采用颗粒增强免疫比浊法检测2687例健康体检人群(年龄3～88岁)血清Cys-C的浓度。用非参数检验比较不同性别和年龄组Cys-C的浓度的差异,用2.5%～97.5%百分数范围,表示95%参考范围。结果乐山市健康人血清Cys-C的频数分布均为非正态性分布,不同性别之间血清Cys-C浓度的差异有统计学意义(P<0.01);按年龄分组后分析显示,女性血清Cys-C的值在Ⅰ组(3～17岁)和Ⅱ组(18～59岁)中无统计学意义,而Ⅲ组(60～88岁)中Cys-C的值显著高于Ⅰ组和Ⅱ组;男性各组间血清Cys-C的值有统计学意义,且血清Cys-C的值随着年龄的增长而升高。各组血清Cys-C的值的95%的参考范围为:男性,3～17岁:0.49～1.05mg/L,18～59岁:0.54～1.14mg/L,60～88岁:0.71～1.63mg/L;女性,3～59岁:0.51～0.97mg/L,60～88岁:0.62～1.54mg/L。结论乐山市健康人群血清胱抑素C浓度存在着年龄和性别的差异,临床医生在应用该检测指标时应注意因年龄和性别不同而带来的变化,选择适合的参考范围。     

2518例体检成人空腹血糖水平及高血糖的年龄分布状况

目的了解本地区成人不同年龄段空腹血糖（FPG）水平、以及高血糖分布状况。方法 2 518例体检人群按年龄段分组：20-29岁组（A组）、30-39岁组（B组）、40-49岁组（C组）,50-59岁组（D组）和≥60岁组（E组）,检测受检者FPG水平。结果 A组男、女的FPG平均浓度均为最低,分别为（5.20±0.93）mmol/L、（5.00±0.37）mmol/L。男性以D组为最高,女性以E组最高,各组女性FPG水平均低于男性。受检男性A、B组与C、D、E组FPG差异均有统计学意义,而A、B组间差异无统计学意义。女性仅A、B组间和D、E组间的差异无统计学意义,其他各组间FPG水平差异均有统计学意义。A组空腹血糖受损（IFG）、糖尿病（DM）检出率最低,E组为最高。结论本地区成人的FPG浓度、IFG和DM检出率随年龄增加总体呈上升趋势,应该重视高血糖、糖尿病发生的年轻化。     

泉州地区老年人血清胱抑素C生物参考区间的建立及其随年龄的变化趋势研究

目的 分析泉州地区60岁及以上老年人血清胱抑素C水平，建立本地区不同年龄组老年人血清胱抑素C的生物参考区间。方法 选取2019年8月至2021年7月在泉州医学高等专科学校附属人民医院门诊、住院和体检的60岁及以上的健康人群作为观察对象，按年龄分为3个观察组，其中60～<70岁组238人(男性149人，女性89人),70～<80岁组131人(男性64人，女性67人),≥80岁组189人(男性85人，女性104人)。对各年龄组观察对象进行血清胱抑素C结果统计分析，建立泉州地区老年人胱抑素C参考区间。结果 泉州地区60岁及以上人群血清胱抑素C结果呈偏态分布；各年龄组间血清胱抑素C水平差异有统计学意义(KW=85.485,P<0.05),血清胱抑素C水平随年龄增长逐渐增加；同年龄组男、女血清胱抑素C水平差异有统计学意义(KW=4.427、14.895、5.852,P均<0.05),男性血清胱抑素C水平高于女性。泉州地区60岁及以上人群血清胱抑素C生物参考区间如下(P_2.5～P_97.5):(1)60～<70岁组：男性0.8...     

海南地区健康男性血清前列腺特异性抗原参考区间的调查

目的 调查海南地区健康男性血清总前列腺特异性抗原(T-PSA)和游离前列腺特异性抗原(F-PSA)的参考区间.方法 根据C28-A3文件的要求,随机抽取3500例海南地区健康体检成年男性.按年龄分为6组,18~29岁组,30~39岁组,40~49岁组,50~59岁组,60~69岁组,>70岁组,调查海南地区健康男性血清T-PSA和F-PSA的参考区间,分析T-PSA、F-PSA与年龄的相关性,并比较海南地区与国内外不同地区的差异.结果 海南地区健康男性血清T-PSA 18~59岁组、60~69岁组、>70岁组的参考区间分别为(0.28~2.65)ng/mL、(0.31~6.62)ng/mL、(0.16~8.22)ng/mL;血清F-PSA分别为(0.11~0.64)ng/mL、(0.10~1.31)ng/mL、(0.06~1.76)ng/mL.血清T-PSA和F-PSA与年龄均呈正相关(r=0.212,P<0.001)、(r=0.106,P<0.001).结论 本课题建立了海南地区健康男性不同年龄段血清T-PSA和F-PSA的参考区间,并确定了两者与国内外一些地区参考区间存在差异.     

自拟平脉定悸方对快速性心律失常模型大鼠血清HSP70、NF-κB影响

目的:探讨自拟平脉定悸方对快速性心律失常大鼠血清中热休克蛋白70、核因子κB的影响。方法:70只健康雄性SD大鼠随机选取12只作为空白对照组A组,其余58只大鼠予以激惹情志诱导刺激,每天监测大鼠心电图,两周后将造模成功的大鼠随机选出48只,随机分为4组。B组模型组予生理盐水(2 m L/只)灌胃,C组予平脉定悸方(100 m L/kg)灌胃,D组给予酒石酸美托洛尔片(0.1 mg/kg)灌胃,E组同时给予平脉定悸方(100 m L/kg)和酒石酸美托洛尔(0.1 mg/kg)灌胃,连续14 d,每日1次,采血。应用ELISA法检测血清中热休克蛋白(HSP70)和核因子κB(NF-κB)的含量。结果:(1)C、D、E组血清HSP70含量明显高于造模前对照A组(P0.05)。(2)C、E两组均较B组血清HSP70含量明显升高(P0.05)。(3)B组较A组血清HSP70含量升高不明显(P0.05)。(4)D组较B组血清HSP70升高不明显(P0.05)。(5)C、D两组较A组血清NF-κB含量明显升高(P0.05)。(6)B、E两组较之A组血清NF-κB升高不明显(P0.05)。(7)D组较C、E两组血清NF-κB升高明显(P0.05)。结论:自拟平脉定悸方通过促进HSP70和抑制NF-κB的激活和表达治疗快速性心律失常。提示平脉定悸方在治疗快速性心律失常上具有多途径、多层面的治疗特点,具有西药无法比拟的优势。     

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.     

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.     

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.