N-乙酰-β-D氨基葡萄糖苷酶与流行性出血热各期关系的研究

目的 :探讨各期流行性出血热 (EHF)患者尿 N-乙酰 -β-D氨基葡萄糖苷酶 (NAG)改变及其与 EHF病程的相互关系。方法 :用比色法对 1 0例 EHF患者进行尿 NAG酶活性 ,NAG酶活性指数测定 ,同时随机选取 1 2 0例体检正常者为正常对照组。结果 :EHF患者尿 NAC酶活性 ,NAG酶活性指数均较对照组增高 ,差异有显著性 (P<0 .0 1 )。其中以休克期、少尿期、多尿期最为显著 (P<0 .0 0 1 ) ,发热期次之 (P<0 .0 1 ) ,恢复期差异无显著性 (P>0 .0 5)。结论 :尿 NAG酶活性及 NAG酶活性指数与 EHF患者肾损伤程度呈正相关 ,且 NAG酶活性指数较 NAG酶活性更稳定、更可靠 ,适时开展此项检测有助于 EHF的早期诊断、疗效评估和预后判断。     

流行性出血热患者外周血淋巴细胞产生免疫干扰素能力的研究

采用细胞病变效应抑制微量培养法对81例次流行性出血热(EHF)患者外周血淋巴细胞(PBL)产生免疫干扰素(IFNγ)的能力进行了研究。结果表明,EHF患者PBT 产生IFNγ的水平在病程早期高于正常对照组,其他各病期与对照组相此无明显差异,不同病型之间的IFNγ水平亦未见统计学差异。并对EHF 患者IFNγ水平的动态变化类型及其意义作了初步探讨。     

流行性出血热患者可溶性白细胞介素-2受体的动态观察

应用双抗体夹心ELISA法检测了20例流行性出血热（EHF）患者外周血清可深性白细胞介素-2受体（SIL-2R）浓度的动态变化。结果表明EHF患者SIL-2R浓度在发热期、低血压期、少尿期及多尿期均显著高于健康对照组，并且随病情加重而明显升高。研究提示SIL-2R升高与EHF免疫病理损伤相关，动态检测SIL-2R对判定患者病情变化有一定意义。     

中药大黄对流行性出血热患者血液流变学的影响

研究目的探讨中药掌叶大黄对流行性出血热(EHF)患者血液流变学的影响。研究方法流行性出血热患者89例,其中发热期47例,少尿期42例,各分为治疗组(服用掌叶大黄)和对照组。静脉采血,肝素抗凝,以玻璃毛细管法检测血液流变学指标,对比用药前后血液流变学指标。统计学处理采用t检验。结果 EHF发热期23例,用大黄2天后,全血粘度明显下降(P<0.001),血沉加快(P<0.01),血浆粘度下降及红细胞电泳时间缩短(P<0.05)。而EHF发热期24例对照组患者除红细胞电泳时间缩短外,其余各项指标均无统计学差异(P<0.05)。EHF多尿期用药组和对照组患者,除红细胞压积降低外,其余各项指标均无统计学意义。结论大黄可改善流行性出血热发热期患者的血粘滞性,可能由此发挥止血和预防出血的作用。     

流行性出血热患者外周血单个核细胞对重组白细胞介素-2的体外增殖反应

作者采用~3H-TdR参入法检测了流行性出血热(EHF)患者外周血单个核细胞(PBMC)对重组IL-2的体外增殖反应。结果表明,EHF患者各病期的刺激指数为:发热期39.7±10.7(x±S_x)、少尿期43.1±8.3、多尿期28.7±5.2、恢复期29.9±7.4,与正常对照组(35.8±4.5)相比,无明显差异。提示EHF患者PBMC对外源性IL-2保持着良好的反应能力。早期使用IL-2治疗或许有助于纠正EHF患者非特异性细胞免疫功能低下。     

流行性出血热发热期血小板参数的临床意义

流行性出血热(EHF)是由汉坦病毒感染引起的自然疫源性疾病。该病典型的临床表现分为发热期、低血压休克期、少尿期、多尿期和恢复期5个时期。非典型的轻型病例可出现越期现象。本病的实验室检查中以血小板数(PLT)下降为典型特征之一。本文对我院自2001年以来收治的70例EHF患者发热期的PLT、血小板平均体积(MPV)、血小板分布宽度(PDW)进行了测定并与健康对照组比较进行了观察,现报道如下。1材料与方法1.1观察对象流行性出血热发热期组,选择经我院感染科病房确诊的EHF病例70例,其中男46例,女24例,年龄28岁~52岁,符合典型的EHF发热期临床表现,其中36例为典型的EHF,病情较重。34例没有出现典型的少尿期,病情较轻。1.2健康对照组随机门诊健康体检人群82例,男42例,女40例,年龄25岁~55岁。1.3仪器与试剂由美国ABBOTT公司生产的CD-3700全自动血细胞分析仪和该公司生产的全部配套试剂,定标物和质控物。1.4方法静脉采血1ml,用EDTA-K2抗凝后,按操作规程进行测定,测出PLT、MPV、PDW值,进行统计学处理。2结果2.1EHF发热期组与健康对照组的血小板参数的测定结果从表1可以...     

老年人流行性出血热45例临床分析

本文为60岁以上45例老年人流行性出血热(EHF)与60岁以下的 EHF 进行了对比临床分析,发现老年人 EHF 的临床症状不典型,与对照组比较,消化道出血、低血压体克期、少尿期多见。并发症以肺部感染及室性早搏较多,值得重视。     

环胞苷治疗流行性出血热的初步观察

60例流行性血热(下称EHF)随机分成两组,环胞苷组30例除综合治疗外,加用环胞苷200～300mg/d,连用3天。对照组30例,采取综合性治疔。结果低血压休克期十少尿期和少尿期越期率环胞苷组分别为52. 4%和28%,对照组分别为38. 6%和13%。环胞苷组病死率6. 7%,对照组为13. 3%。经显著性检验无差异。该药对EHF 的肯定疗效尚须进一步观察。     

异搏定用于瓣膜替换术心肌保护的临床效果

本文在瓣膜替换术中观察了异搏定对缺血心肌的保护作用。165例分为两组。甲组84例用含异搏定1mg/L的冷钾停跳液经主动脉根部灌注。乙组81例,单用冷钾停跳液灌注作为对照。与对照组对比,结果显示:(1)心脏停跳快,缺血期心电活动消失完全;(2)心肌停跳前或复灌后室颤发生率显著低于对照组,术后循环功能稳定,对正性肌力药的需要量小,严重低排发生率低;(3)电镜检查结果提示心肌缺血后超微结构改变轻,尤其是线粒体的损伤少而轻。结论:异搏定与冷钾停跳液合用能加强缺血期的心肌保护作用,比单用钾停跳液为优,适用于瓣膜替换术的心肌保护     

流行性出血热患者血清超氧化物歧化酶、丙二醛含量变化与其发病机理的关系

本文测定32例健康人和101例流行性出血热(EHF)患者血清超氧化物歧化酶(SOD),丙二醛(MDA)的含量。结果表明EHF患者血清SOD、MDA含量均高于健康对照组,以低血压少尿期升高最为明显。测定中还发现SOD、MDA含量升高与病情变化程度有一定关系。作者认为自由基参与了EHF的发病过程。研究EHF与自由基的关系有助于进一步阐明EHF的发病机理并为其临床治疗提供一定的参考价值。     

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.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

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.     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.