血浆同型半胱氨酸水平及亚甲基四氢叶酸还原酶基因多态性与2型糖尿病患者微量白蛋白尿的关系

目的探讨血浆同型半胱氨酸(Hcy)水平及亚甲基四氢叶酸还原酶(MTHFR)基因多态性与2型糖尿病(T2DM)早期肾病的关系及影响因素。方法对252例T2DM患者[140例为无并发症者(NDC组),112例为早期糖尿病肾病者(DN组)]和30例对照者,测定血浆Hcy、叶酸、维生素B12(VitB12)、糖化血红蛋白(HbA1c)、空腹血糖、餐后2h血糖(PBG)、胆固醇(CHO)、甘油三酯(TG)、肌酐、转化生长因子β1(TGF-β1)水平,尿N-乙酰-D氨基葡萄糖苷酶(NAG)、微量白蛋白/肌酐(MAlb/Cr)值、MAlb水平,并以聚合酶链反应-限制性内切酶片段长度多态性技术(PCR-RFLP)检测MTHFR基因C677T突变率。结果DN组血浆Hcy水平高于对照组[(16·6±12·6)与(9·7±2·0)μmol/L,P<0·05],DN组又高于NDC组[(16·6±12·6)与(11·9±7·3)μmol/L,P<0·05];高Hcy血症患者的早期糖尿病肾病发生率明显高于血Hcy水平正常患者(61·4%与36·1%,P<0·05)。T2DM患者血浆Hcy水平与MTHFR基因型、体重指数、HbA1c、空腹血糖、PBG、NAG、MAlb/Cr、病程、吸烟、二甲双胍的使用呈正相关,与叶酸、VitB12呈明显负相关;logistic回归分析显示病程、舒张压、空腹血糖、NAG、Hcy均为早期糖尿病肾病的危险因素。结论空腹高Hcy血症是早期糖尿病肾病的危险因素;MTHFR基因型、叶酸、VitB12、MAlb/Cr、NAG以及代谢紊乱程度影响血浆Hcy水平。     

糖尿病及其视网膜病变患者对蛋氨酸负荷试验的异常反应

目的　探讨 2型糖尿病 (DM)及其视网膜病变 (DR)患者对蛋氨酸负荷 (PML)试验的反应 ;并探讨PML试验对高同型半胱氨酸血症 (Hhcy)的诊断价值及同型半胱氨酸 (Hcy)致血管损害的可能机制。方法　对 17例DR患者、15例单纯DM患者 (NDC)及 2 8例正常对照 (CON)进行了PML试验 ,荧光偏振免疫分析法测定空腹Hcy (Fhcy)及PML后 4h血浆Hcy浓度 (Phcy) ,测空腹血浆叶酸、维生素B12 ,并以PCR RFLP技术检测亚甲基四氢叶酸还原酶 (MTHFR)C6 6 7T突变 ,测定空腹血糖、餐后血糖、尿素、肌酐、胆固醇、甘油三酯以及HbA1c等生化指标 ,以Griess法测定空腹PML后 4hNO代谢终产物。结果　DM各组体重指数、HbA1c及PBG高于CON组 (P <0 0 5 ) ;DR组和NDC组Fhcy分别为 13 9± 1 4和 11 6± 1 3μmol/L ,高于CON组的 8 8± 1 4 μmol/L。DR组Phcy(37 3μmol/L)、PML前后Hcy差值 (2 4 4 μmol/L)和MTHFRBB基因型 (9/ 17)均高于CON组的 2 2 7μmol/L、15 1μmol/L和 5 /2 8以及NDC组的 2 5 0 μmol/L、14 3μmol/L和 2 / 15。以Fhcy为标准确定的Hhcy发病数为 9例 ,而以PML后的Phcy为标准发病数则为 15例 ;结合两者计算Hhcy发病率 ,DR组高于NDC组 ,两者又高于CON组 (P <0 0 0 1)。餐后NO代谢产物浓度明显高于空腹 ,而且血浆Hcy与     

新疆汉族冠心病患者血浆同型半胱氨酸水平变化的临床特点

目的研究新疆汉族冠心病患者血浆中同型半胱氨酸(Hcy)水平变化的临床特点及与叶酸、维生素B12水平的关系.方法采用酶联免疫法测定167例冠心病患者(冠心病组)和87例正常人(正常对照组)血浆Hcy、叶酸、维生素B12水平.结果冠心病组血浆Hcy水平(16.536±8.402μmol/L)明显高于正常对照组(10.844±6.348μmol/L),有显著差异(P＜0.01),高Hcy血症所占比例(53.29%)高于正常对照组(14.94%),有显著差异(P＜0.01).冠心病组男性血浆总Hcy水平(17.920±8.404μmol/L)明显高于正常对照组男性(12.846±7.537μmol/L),有显著差异(P＜0.01),而在冠心病组女性血浆总Hcy水平(13.643±7.697μmol/L)明显高于正常对照组女性(8.598±3.6μmol/L),有显著差异(P＜0.01).正常对照组男性血浆叶酸水平(6.607±2.73ng/ml)明显低于正常对照组女性(9.513±4.994ng/ml),有显著差异(P＜0.01),冠心病组男性血浆叶酸水平(6.014±2.904ng/ml)明显低于冠心病组女性(7.674±4.562ng/ml),有显著差异(P＜0.01).结论新疆地区汉族冠心病患者血浆总Hcy水平明显高于正常人,高Hcy血症所占比例较大,而Hcy和叶酸水平在男、女性别之间存在明显差异.     

精神分裂症患者血浆硫化氢、同型半胱氨酸、叶酸及维生素B6 水平 变化研究

目的探讨精神分裂症患者血浆硫化氢(H2S)、同型半胱氨酸(Hcy)、叶酸(FA)和维生素B6水平的变化及其相关性。方法检测66例精神分裂症患者和50名健康对照者的血浆H2S、Hcy、FA及维生素B6水平。精神分裂症患者血浆H2S水平与Hcy、FA和维生素B6水平的相关性用直线相关分析。结果精神分裂症组Hcy水平高于对照组(P<0.001);血浆H2S、FA、维生素B6水平低于对照组(P<0.05)。精神分裂症组高同型半胱氨酸血症(Hhcy)的人数(45.5%)高于对照组(10.0%)(P<0.001)。精神分裂症组血浆H2S水平与Hcy水平呈负相关(P<0.001),与血浆FA及维生素B6水平呈正相关(P<0.001,P<0.05)。结论精神分裂症患者血浆H2S、FA和维生素B6明显降低,Hcy水平升高。H2S水平降低可能参与了Hhcy致精神分裂症的发病机制。     

老年2型糖尿病周围神经病变患者的血清铁蛋白、同型半胱氨酸和维生素B12水平

目的研究老年2型糖尿病周围神经病变患者血清铁蛋白、同型半胱氨酸(Hcy)、维生素B_(12)(VitB_(12))的水平。方法选取2019年3—9月郑州大学第一附属医院老年内分泌科收治的99例2型糖尿病(T2DM)患者。将51例单纯T2DM患者纳入DM组,将合并周围神经病变的48例T2DM患者纳入DPN组。选取同时期于郑州大学第一附属医院进行体检的健康者45例,纳入NC组。比较3组糖化血红蛋白(HbA1c)、血清铁蛋白、Hcy及VitB_(12)的水平。统计DM组和DPN组患者的糖尿病病程。分析血清铁蛋白、Hcy及VitB_(12)与其他指标的关系。结果 DM组和DPN组年龄、HbA1c、铁蛋白及Hcy水平均高于NC组,DM组和DPN组VitB_(12)水平低于NC组,差异有统计学意义(均P<0.05)。DPN组HbA1c、铁蛋白及Hcy水平高于DM组,VitB_(12)水平低于DM组,差异有统计学意义(均P<0.05)。铁蛋白与HbA1c、Hcy呈正相关(均P<0.05)。Hcy与年龄、HbA1c、铁蛋白呈正相关(均P<0.05),与VitB_(12)呈负相关(P<0.05)。VitB_(12)与年龄、HbA1c、Hcy呈负相关(均P<0.05)。铁蛋白、Hcy及VitB_(12)均与病程无关(均P>0.05)。结论老年T2DM并周围神经病变患者血清铁蛋白、Hcy呈现高水平状态,VitB_(12)呈低水平状态,且铁蛋白与Hcy呈正相关,Hcy与VitB_(12)呈负相关。     

叶酸治疗维持性血液透析患者高同型半胱氨酸血症的疗效观察

目的:观察叶酸治疗慢性肾功能衰竭(CRF)维持性血液透析(HD)患者高同型半胱氨酸血症(HHcy)的效果。方法:64例稳定HD患者分为A、B两组,A组没有口服叶酸,B组口服叶酸15mg/d,3个月后,用荧光偏振免疫分析法分别测定A、B两组血浆中总同型半胱氨酸(tHcy)水平。结果:A组tHcy(μmol/L)为(18.34±6.38);B组tHcy(umol/L)为(9.27±2.71),P<0.01。结论:对HD患者,采用口服叶酸15mg/d治疗HHcy,可使tHcy水平降低。     

叶酸对女性冠心病患者血清同型半胱氨酸水平的影响

目的:探讨叶酸对女性冠心病伴高同型半胱氨酸(Hcy)血症患者的血清Hcy水平的影响。方法:对女性冠心病患者49例和正常对照组女性50例,采用荧光标记免疫检测法测定空腹血清Hcy水平,Hcy≥15μmol/L为高Hcy血症,将42例高Hcy血症女性冠心病患者随机分为对照组(20例,仅服用硝酸酯类、他汀类及肠溶阿司匹林等基础药物)和治疗组(22例,除基础用药外加用叶酸5mg口服每日3次),治疗前及治疗4周后测定患者空腹血清Hcy水平。结果:女性冠心病组患者血清Hcy水平(16.97±3.21μmol/L)明显高于正常对照组(11.21±2.92μmol/L,P<0.01)。治疗组患者治疗4周后Hcy水平为10.34±5.63μmol/L,平均降低了36.4%,治疗前、后Hcy水平有极显著性差异(P<0.01)。结论:女性冠心病患者Hcy水平较高,补充叶酸可明显降低女性冠心病高Hcy血症患者的血浆Hcy水平,改善血管内皮功能。     

甲钴胺对糖尿病周围神经病变患者血浆同型半胱氨酸的影响

目的 观察同型半胱氨酸(homocysteine,Hcy)在糖尿病周围神经病变(diabetic peripheral neuropathy,DPN)患者血浆中的水平及甲钴胺干预后变化.方法 将130例2型糖尿病患者分为两组,有DPN组(DPN+组)和无DPN组(DPN-组),30例健康者为正常对照组,检测血浆Hcy水平.将DPN+组中高Hcy患者随机分为两个亚组:甲钴胺治疗组和空白对照组,甲钴胺治疗组给予甲钴胺(500μg/d)肌注,空白对照组不给予干预治疗,2周后比较两个亚组Hcy水平,并通过临床和电生理方法评估神经病变的改善程度.结果 DPN+组中高Hcy血症患者占67.8％,其Hcy水平明显高于DPN-组和正常对照组(P＜0.05).经甲钴胺治疗可以明显降低患者血浆Hcy水平(P＜0.05),神经病变症状和神经传导速度也较空白对照组有明显改善(P＜0.05).结论 Hcy为DPN的危险因素,甲钴胺干预后可降低患者血浆Hcy水平,改善患者神经病变的症状.     

98例维吾尔族冠心病患者血浆同型半胱氨酸水平变化的临床特点

目的研究维吾尔族冠心病患者血浆中同型半胱氨酸(Hcy)水平变化的临床特点及叶酸、维生素B12水平的关系.方法采用酶联免疫法测定98例冠心病患者(冠心病组)和58例正常人(正常对照组)血浆Hcy、叶酸、维生素B12水平.结果冠心病组血浆Hcy水平(15.882±8.488 μmol/L)明显高于正常对照组(11.462±3.038 μmol/L),有显著差异(P<0.05),高Hcy血症所占比例(40.8%)高于正常对照组(13.8%),有非常显著差异(P<0.001).冠心病组男性血浆总Hcy水平(16.527～9.094 μmol/L)明显高于正常对照组男性(12.584±4.551umol/L),有显著差异(P<0.05),而在冠心病组女性(13.5813±6.0326 μmol/L)和正常对照组女性(12.29±6.087μmol/L)之间没有差异.冠心病组男性血浆叶酸水平(4.7206±1.609 ng/ml)明显低于正常对照组男性(5.813±2.013 ng/ml),有显著差异(P<0.05),且与血浆总Hcy水平呈负相关(r=-0.024,P<0.05),而女性无差异.结论新疆地区维吾尔族冠心病患者血浆总Hcy水平明显高于正常人,高Hcy血症所占比例较大,而Hcy对冠心病患者的影响主要在男性可能更为明显,并且血浆叶酸水平与其呈负相关.     

急性脑梗死与高同型半胱氨酸血症相关性分析

目的:探讨急性脑梗死与血浆高同型半胱氨酸(Hcy)血症的关系。方法:选取75例急性脑梗死住院患者和45例同期正常的健康体检者进行血浆Hcy、叶酸和维生素B12的测定,并进行比较。结果:急性脑梗死组患者血浆Hcy水平明显升高,叶酸、维生素B12水平明显低于对照组(P<0.05)。结论:急性脑梗死组患者血浆Hcy升高,而叶酸、维生素B12下降,高同型半胱氨酸血症是急性脑梗死的独立危险因素之一。     

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…     

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.     

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     

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.     

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.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.