高血压病患者血压昼夜节律与靶器官损害及中医证型关系的研究

目的 观察高血压病患者动态血压变化与靶器官损害及中医证型之间的关系。方法 将86例高血压病患者分为单纯高血压病组和靶器官损害组，中医辨证分为4个证型组，分别进行动态血压监测。结果 靶器官损害组血压昼夜节律显著减弱；肝火亢盛型24h平均收缩压异常增高，痰湿壅盛型24h平均舒张压明显增高，阴虚阳亢型昼夜收缩压节律明显异常，阴阳两虚型双重昼夜节律异常。结论 血压昼夜节律与靶器官损害的关系密切。肝火亢盛型和痰湿壅盛型多为高血压病早期正盛邪实阶段，阴虚阳亢型和阴阳两虚型多为高血压病的进一步发展。     

氟西汀对2型糖尿病合并抑郁症患者下丘脑-垂体肾上腺轴功能及临床疗效的影响

目的探讨氟西汀对 2型糖尿病合并抑郁症患者的下丘脑 垂体 肾上腺轴 (HPA)功能的影响及其临床意义。方法测定 98例 2型糖尿病患者和 3 4例正常对照组基础血皮质醇 (F ,0 8:0 0am、16:0 0pm)、小剂量地塞米松抑制试验 (DST)后血F、2 4h尿游离皮质醇 (UFC)。将 64例 2型糖尿病伴发抑郁症患者随机分成A组 (服用氟西汀组 ,3 2例 )和B组 (未服用氟西汀组 ,3 2例 )。予 6周治疗。分别于治疗前、后进行HAMD评分及代谢控制水平评估。结果 ( 1)血F( 0 8:0 0am、16:0 0pm)、2 4h尿UFC、DST脱抑制例数2型糖尿病患者较正常对照组增高 (P <0 .0 1) ,2型糖尿病伴抑郁症组 (DD组 )较无抑郁症组 (DM组 )增高(P <0 .0 5 ,P <0 .0 1)。 ( 2 )经 6周治疗后 ,服用氟西汀组 (A组 )较未服用氟西汀组 (B组 )糖皮质激素水平降低 (P <0 .0 1)、HAMD评分降低 (P <0 .0 1) ,糖脂代谢改善 (P <0 .0 5 ,P <0 .0 1)。 ( 3 ) 2 4h尿UFC与HbA1C呈正相关性 (r =0 .5 69,P <0 .0 1)、IR呈正相关 (r =0 .65 3 ,P <0 .0 1)、与HAMD评分呈正相关性 (r =0 .3 5 2 ,P <0 .0 5 )。结论 2型糖尿病及合并抑郁症患者HPA轴功能紊乱 ,加重了糖代谢紊乱和胰岛素抵抗 ;氟西汀干预治疗抑郁症可改善抑郁症和糖脂代谢。     

The Lipid-regulating Effects of Atorvastatin on Type 2 Elder Diabetes Patients with Hyperlipidemia

Inthisstudy,theeffectofatorvastatinonlipidmetabolism ,especiallysLDL ,intype 2elderdiabetespatientswithhyperlipidemiawasstudy .Theresultswerepresentedasfollows.1　SUBJECTSANDMETHODS1 1　SubjectsThesubjectsincluded 2 6patientswithtype 2elderdiabetesandhyp…     

生物型人工硬脑膜应用的实验研究

OBJECTIVE: To evaluate the safety and efficacy of a dural graft prepared using porcine membrane in duraplasty. METHODS: Eighteen New Zealand rabbits were randomly divided into groups A (n=4), B (n=4), C (n=5), and D (n=5) sacrificed 3, 14, 30 and 90 d after duraplasty, respectively. Each animal underwent bilateral parietal craniectomy behind the coronal suture and beside the midline to expose the dura, which was cut on the right side and substituted with the dural graft. The exposed dura on the left was kept intact as control. The rabbits were observed for WBC counts before the operation and before sacrifice by transcardiac formalin perfusion, respectively. The meninges and brain tissues were histologically examined after sacrifice. RESULTS: The WBC count varied little after the operation (P>0.05). Microscopic examination demonstrated tissue repair on both the implantation side and control side, without graft adhesion to the cortical surface. In group A, a large number of leukocytes were seen gathering on the lateral dura, suggesting acute tissue repair. In group B, endothelial cells covering the inner surface of the graft could be seen. Fibroblasts and fibrocytes were seen in the grafts between collagen fibers in group C, and in group D, fibroblasts and fibrocytes increased between the collagen fibers and the suture healed. CONCLUSION: The dura graft is safe and applicable for dural defect repair.     

黄芪注射液对糖尿病肾病患者尿Ⅳ型胶原的影响及意义

目的 观察黄芪注射液对糖尿病肾病（DN）患者尿Ⅳ型胶原(CⅣ)探讨黄芪注射液治疗DN的机制。方法 分别测定黄芪注射液治疗组(30例)，对照组(28例)治疗前后尿CⅣ、24小时尿白蛋白排泄率(UAE)、α1-微球蛋白(α1-MG）。结果 黄芪注射液能明显降低DN患者尿CⅣ水平，减少DN患者UAE、α1—MC。结论 黄芪注射液对DN患者肾脏有保护作用，可能与其抑制DN患者CⅣ有关。     

星状神经节阻滞治疗交感型颈椎病12例分析

交感型颈椎病临床主要表现为疼痛、感觉异常和植物神经功能紊乱,目前以非手术治疗为主,方法较多[1～3],各具特色.我科自2002年10月以来采用星状神经节阻滞治疗交感型颈椎病12例,取得满意的效果,总结如下.     

颅脑损伤患者脑型肌酸激酶同工酶变化的临床意义

近年研究发现，颅脑损伤患者脑型肌酸激酶同工酶活性(CK-BB)均有不同程度的升高。2001年11月至2002年9月，我们对52例急性颅脑损伤患者进行血清CK-BB活性测定，旨在探讨急性颅脑损伤患者CK-BB活性变化的临床意义。     

有机磷中毒并发症——中间型综合征的治疗体会

中间型综合征(IMS)是有机磷中毒的严重并发症，死亡率极高，IMS可预防，可治疗，下面谈谈治疗IMS的个人体会。