心肌损害早期标志物的研究进展

寻求理想的血生物标记物诊断心肌损伤和心肌缺血是当今研究的热点,而理想的心肌生化标志物应具有靶细胞富集、合适的半衰期、高度心脏专一性等特征.目前已经有越来越多的心肌标志物在临床中得到应用,现就心肌损伤和心肌缺血早期标志物研究领域的最新进展作一综述.     

非痴呆性血管性认知功能障碍患者记忆功能研究

目的探讨非痴呆性血管性认知功能障碍（VCIND）患者记忆功能特点。方法选取VCIND患者21例（VCIMD组）、脑血管病无认知障碍（CVD）患者15例（CVD组）、对照组22例。入选对象均测查记忆力、注意力、语言能力,且采用改良的诊断标准进行诊断。结果VCIND组患者85．7％（18／21）有记忆功能减退的主诉,明显多于CVD组[26．4％（4／15）]和对照组[36．4％（8／22）]（P〈0．05）。简易智力状态检查：对照组（28．0±1．3）分,CVD组（28．5±lO）分,VCIND组（26。4±1．8）分;阿尔茨海默病评价量表一认知分表：对照组（5．1±2．6）分,CVD组（5．7±2．2）分,VCIND组（11．5±4．4）分;语言流畅性测验：对照组（16．0±2．6）分,CVD组（17．3±1．2）分,VCIND组（12．8±3．0）分。单词回忆：对照组（3．0±1．2）分,CVD组（3．1±1．2）分,VCIND组（5．3±2．0）分。VCIND组总体认知功能、记忆功能、语言功能较CVD组和对照组均明显衰退（均P〈0．05）。结论绝大多数VCIND患者存在近记忆力损害,词语记忆困难突出,且大多数以记忆力下降为首发症状。     

葛根异黄酮对运动训练大鼠血液生化指标及抗氧化的影响

[摘目的探讨葛根异黄酮对运动训练大鼠血液生化指标及抗氧化的影响。方法将健康雄性sD大鼠分为安静组、训练组、训练组＋不同剂量的葛根异黄酮组。通过游泳运动训练比较各组大鼠血清中血液生化指标（谷草转氨酶、谷丙转氨酶、血糖、全血血红蛋白）及抗氧化能力（超氧化物歧化酶的活性、丙二醛的含量）。结果100．0、200．0mg／kg的葛根异黄酮能显著升高运动训练大鼠的血清超氧化物歧化酶活性、血糖、全血血红蛋白含量（P〈0．05）,并显著降低丙二醛含量和谷草转氨酶活性（P〈0．05）。结论葛根异黄酮对运动训练大鼠具有明显的抗氧化作用,可明显改善血液生化指标。     

利尿剂对老年高血压患者血压、血钾、尿酸及三酰甘油的影响

目的 探究利尿剂对老年高血压患者血压、血钾、尿酸及三酰甘油的影响,为该病临床治疗积累相关实践性经验.方法 选取本院心内科于2010年1月～2012年12月收治的102例高血压患者,根据服用降压药物的不同进行分组,分为利尿剂组（50例）和非利尿剂组（52例）.同时选取同期来院门诊或复查的老年高血压者（未服用降压药或自行停药1个月以上者）,设为对照组.结果 3组的血压、体质指数、肌酐、TC、HDL-C、LDL-C和LVEF差异无统计学意义（P＞0.05）;利尿剂组、非利尿剂组的收缩压、舒张压均低于对照组（P＜0.05）,利尿剂组的血钾低于非利尿剂组、对照组（P＜0.05）,尿酸和三酰甘油均高于非利尿剂组、对照组（P＜0.05）;继续服用利尿剂组的血钾低于停服利尿剂组,血尿酸高于停服利尿剂组（P＜0.05）.结论 老年高血压患者服用利尿剂与非利尿剂的降压效果相当,但长期服用会增高低血钾、高尿酸及高血脂发生率,因此,医生应指导服用利尿剂患者定期来院检测上述指标,并针对异常数值给予早期干预.     

Updating the use of biochemical biomarkers in fish for the evaluation of alterations produced by pharmaceutical products

The evaluation of toxic effects in stressful environmental conditions can be determined through the imbalance between exogenous factors (environmental contaminants) and enzymatic and non-enzymatic defenses in biological systems. The use of fish for the identification of alterations in biochemical biomarkers provides a comprehensive vision of the effects that pharmaceutical products cause in the aquatic ecosystem, as they are organisms with high sensitivity to contaminants, filtering capacity, and potential for environmental toxicology studies. A wide range of pharmaceuticals can stimulate or alter a variety of biochemical mechanisms, such as oxidative damage to membrane lipids, proteins, and changes in antioxidant enzymes. This review includes a summary of knowledge of the last 20 years, in the understanding of the different biochemical biomarkers generated by exposure to pharmaceuticals in fish, which include different categories of pharmaceutical products: NSAIDs, analgesics, antibiotics, anticonvulsants, antidepressants, hormones, lipid regulators and mixtures. This review serves as a tool in the design of studies for the evaluation of the effects of pharmaceutical products, taking into account the most useful biomarkers, type of matrix, enzyme alterations, all taking the pharmaceutical group of interest.     

热咳散治疗痰热内蕴型哮喘患儿的临床研究

目的:探讨痰热内蕴型哮喘婴幼儿西医常规治疗基础上使用自拟热咳散治疗的临床疗效,为其临床应用提供理论依据。方法:选取2017年3月至2018年9月中山市中医院收治的痰热内蕴型哮喘婴幼儿112例作为研究对象,根据治疗方式的不同分为对照组与观察组,每组56例。对照组采用常规治疗,观察组在对照组基础上加用自配热咳散,比较2组患儿肺功能指标（FEF25%、FEF50%、IgE）;血清生化指标（IL-6、TNF-α、CRP、Cal-3）和C-ACT和MARS-A评分的差异。结果:对照组FEF25%、FEF50%显著低于观察组,对照组IgE含量显著高于观察组,差异均有统计学意义（P<0.05）。2组患儿治疗有效率和治疗效果构成差异有统计学意义（P<0.05）。治疗后观察组IL-6、TNF-α、CRP、Cal-3含量低于对照组,观察组C-ACT评分、MARS-A评分高于对照组,差异均有统计学意义（P<0.05）。结论:相比于西医常规治疗的治疗手段,在其基础上连用自拟热咳散的治疗效果更佳,患者症状改善时间也相对较短。     

血清生化指标对胆源性胰腺炎的诊断意义

目的探讨血清生化指标的改变对诊断胆源性胰腺炎的临床意义。方法将107例急性胰腺炎患者分为胆源性及非胆源性胰腺炎两组,并对其血清生化指标TBIL、DBIL、ALT、AST、ALP、r-GT的改变进行回顾性分析。结果胆源性胰腺炎组生化指标异常升高的改变显著高于非胆源性胰腺炎组（P〈0.01）。结论血清TBIL、DBIL、ALT、AST、ALP、r-GT的异常升高对急性胆源性胰腺炎诊断有重要的参考意义。     

建立中医临床教学全面质量管理体系的探讨

在既往临床教学管理经验的基础上,汲取ISO9000族标准管理理念的精华,结合东方医院自身特点,探讨建立符合高等中医教育规律,具有自我监控、自我改进能力的中医临床教学全面质量管理体系。     

State selection in Markov models for panel data with application to psoriatic arthritis

Markov multistate models in continuous‐time are commonly used to understand the progression over time of disease or the effect of treatments and covariates on patient outcomes. The states in multistate models are related to categorisations of the disease status, but there is often uncertainty about the number of categories to use and how to define them. Many categorisations, and therefore multistate models with different states, may be possible. Different multistate models can show differences in the effects of covariates or in the time to events, such as death, hospitalisation, or disease progression. Furthermore, different categorisations contain different quantities of information, so that the corresponding likelihoods are on different scales, and standard, likelihood‐based model comparison is not applicable. We adapt a recently developed modification of Akaike's criterion, and a cross‐validatory criterion, to compare the predictive ability of multistate models on the information which they share. All the models we consider are fitted to data consisting of observations of the process at arbitrary times, often called ‘panel’ data. We develop an implementation of these criteria through Hidden Markov models and apply them to the comparison of multistate models for the Health Assessment Questionnaire score in psoriatic arthritis. This procedure is straightforward to implement in the R package ‘msm’. Copyright © 2015 John Wiley & Sons, Ltd.