阿卡波糖对糖耐量降低合并心血管疾病患者干预治疗的临床研究

目的 探讨阿卡波糖对糖耐量降低（IGT）患者的心血管疾病的干预治疗效果.方法 选择120例IGT患者,随机分为两组,试验组（n=60）,给予阿卡波糖;对照组（n=60）,给予等量的安慰剂.两组平均随访年限为（1.6±0.3）年,观察两组心血管事件（急性心肌梗死、新发生的心绞痛、充血性心力衰竭）发生率,并进行比较.结果 阿卡波糖可以显著降低IGT患者心血管事件的发生率,其中急性心肌梗死的发生率减少11.67%,新发生心绞痛的发生率减少11.67%,充血性心力衰竭的发生率减少11.33%,总的心血管事件的发生率降低36.67%.结论 阿卡波糖可有效改善糖耐量降低合并心血管疾病患者的预后,能够显著降低心血管事件的发生.     

阿卡波糖对葡萄糖耐量减低患者心血管疾病预防的研究

目的 通过观察阿卡波糖对葡萄糖耐量减低(IGT)患者心血管事件发生率的影响,了解其对IGT患者心血管疾病的预防作用.方法 选择139例IGT患者,随机分为实验组和对照组,实验组(n=73)接受阿卡波糖50 mg,3次/天;对照组(n=66).两组平均随访年限为(1.6±0.3)年,观察两组心血管事件(急性心肌梗死、新发生的心绞痛、充血性心力衰竭)发生率,并进行比较.结果 阿卡波糖可以显著降低IGT患者心血管事件的发生率,其中急性心肌梗死的发生率减少11.53%(P=0.017),新发生的心绞痛的发生率减少11.80%(P=0.029),充血性心力衰竭的发生率减少11.39%(P=0.012),总的心血管事件的发生率降低34.72%(P＜0.001).     

阿卡波糖干预老年心肌梗死并糖耐量减低患者的疗效及安全性研究

目的 探讨阿卡波糖干预对合并糖耐量减低( IGT)的老年急性心肌梗死(AMI)患者预后的影响及其安全性.方法 105例合并IGT的老年AMI患者随机分为干预组(53例)和对照组(52例).两组给予相同基础治疗,干预组同时加予阿卡波糖( 50 mg,3次/d)治疗,平均随访1.8年,观察两组再发心血管事件的情况、颈动脉内膜-中层厚度( IMT)的变化及干预组的不良反应.结果 平均随访1.8年后,干预组总的心血管事件再发率较对照组明显降低(P＜0.01),其中心血管病因死亡率差异无统计学意义(P＞0.05),但次要终点事件(非致命性再梗死、新发的心绞痛、脑卒中、严重心力衰竭)明显减少(P＜0.05);干预组颈动脉IMT显著低于对照组(P＜0.05);两组间严重胃肠不良反应发生率差异无统计学意义(P＞0.05).结论 阿卡波糖可有效延缓老年AMI合并IGT患者的颈动脉IMT增厚,降低再发心血管事件的风险,同时阿卡波糖在老年患者中安全性、耐受性良好.     

阿卡波糖对葡萄糖耐量减低冠心病患者预后的影响

目的探讨阿卡波糖对葡萄糖耐量减低的冠心病患者心血管事件发生情况的影响。方法选择经冠状动脉造影证实冠心病且合并葡萄糖耐量减低的患者154例,将其随机分为两组,治疗组77例,在常规治疗的基础上加用阿卡波糖进行干预;对照组77例,仅予常规治疗。结果6个月内149例患者获得随访;治疗组心血管事件发生率10.7%(8/75例),明显低于对照组的25.7%(19/74例),P<0.05。结论在葡萄糖耐量减低合并冠心病的患者中,应用阿卡波糖进行干预,可以降低心血管事件的发生率。     

糖耐量减低的冠心病患者早期干预的预后分析

目的:探讨早期干预对糖耐量异常的冠心病患者预后的影响.方法:将154例糖耐量异常的冠心病患者随机分为治疗组和对照组各77例,对照组予以常规治疗,治疗组予以规范性干预,对比观察两组预后.结果:治疗组发生急性心肌梗死2例,新发生心绞痛5例,充血性心力衰竭1例;对照组发生急性心肌梗死5例;新发生心绞痛11例,充血性心力衰竭3例.治疗组心血管事件的总发生率为10.7%,对照组心血管事件的总发生率为25.7%,差异有统计学意义(χ2=5.295,P<0.05).结论:糖耐量减低的冠心病患者早期干预可改善其预后,减少心血管事件的发生.     

多囊卵巢综合征患者糖代谢异常的发生与临床特征的相关性

目的 探讨多囊性卵巢综合征(PCOS)患者糖代谢异常的发生及临床特征.方法 对257例PCOS患者进行75 g葡萄糖耐量(OGTY)及胰岛素释放试验,分别检测空腹、餐后1、2 h血糖及胰岛素.应用世界卫生组织(WHO)对糖尿病及糖代谢异常的诊断标准进行诊断.结果 257例PCOS患者中178例(69.3%)糖耐量正常(NGT),73例(30.7%)糖代谢异常,其中67例(26.1%)为糖耐量损伤(IGT),12例(4.7%)为2型糖尿病(2DM)(P<0.05).NGT、IGT与2DM组间年龄、体重指数、卒腹血糖、餐后2 h血糖(2 hPG)、空腹胰岛素(FINS)、餐后2 h胰岛素(2 hINS)及胰岛素抵抗指数均逐渐升高(P<0.05),胰岛素敏感指数逐渐降低(P<0.05);30～34岁年龄段糖代谢异常的发生率是20～29岁之间的2倍;肥胖PCOS患者中糖耐量异常(IGT/2DM)的发生率是非肥胖患者的近4倍(P<0.001).结论 PCOS患者中糖代谢异常的发生与年龄及体重指数有关;胰岛素抵抗是PCOS患者发生糖代谢异常的基础.     

津力达对老年冠心病伴糖耐量低减者预后的影响

目的 探讨津力达颗粒对伴糖耐量低减的老年冠心病患者心血管事件的发生率的影响.方法 选择130例伴糖耐量低减的老年冠心病患 者,随机分为治疗组和对照组各65例,观察试验前后患者空腹血糖、餐后2h血糖、血压、血脂、心率等生理参数的变化并记录包括急性心肌梗死、新发生 的心绞痛、充血性心力衰竭等心血管事件的发生率,比较两组各生理参数变化的差异,以及心血管事件的发生率的差异.结果 试验前两组生理参数差 异无显著性（P＞0.05）.试验后治疗组餐后血糖较对照组降低（P＜0.05）,治疗组总的心血管事件的发生率较对照组低（P＜0.05）.结论 津力达颗粒能 减少伴糖耐量低减的老年冠心病患者心血管事件的发生率.     

生活方式干预在糖耐量异常患者中的应用情况探讨

目的:探讨生活方式干预在糖耐量异常患者中的应用效果。方法:选取体检糖耐量异常患者122例,随机分为两组,即试验组和对照组各61例,对照组给予常规指导,试验组在常规指导的基础上实行生活方式干预。对比1年后两组的体重指数(BMI)、血压、血脂、血糖水平及脂肪肝发生率。结果:试验组BMI、血压、血脂、血糖水平均优于对照组,差异有统计学意义(P<0.05);同时试验组脂肪肝患病率均明显低于对照组,差异有统计学意义(P<0.05)。结论:生活方式干预可明显改善糖耐量异常患者糖尿病病情,同时还有利于血脂水平的控制及降低脂肪肝患病率。     

149例多囊卵巢综合征患者糖代谢异常分析

为了研究多囊卵巢综合征(PCOS)患者中糖代谢异常发病情况及其发生相关危险因素,对2006年7月-2008年3月就诊于宁夏医科大学附属生殖医学中心的149例PCOS患者,所有患者于禁食10h晨行75g口服葡萄糖耐量试验,测定空腹、服糖后120min血糖.结果 ,糖代谢异常总患病率为39.6%(59/149);其中腹血糖异常(IFG)为11.3%(17/149);糖耐量减退(IGT)为25.5%(38/149);糖尿病(DM)为8.1%(12/149);民族、年龄、婚育状况不同的患者间糖代谢异常发生率无统计学意义;糖代谢异常组BMl显著高于正常组(t=1.47,P=0.042);糖代谢异常组肥胖发生率49.15%显著高于正常组31.11%(x2=4.91,P=0.027),且肥胖患者DM发生率显著高于非肥胖患者(x2=4.437,P=0.035).PCOS患者糖代谢异常发生风险高,尤其是肥胖患者,应常规进行糖耐量试验的评估,以便于及早发现、及时干预.     

三清降糖方对糖耐量减低冠心病患者的干预作用

目的：探讨三清降糖方对合并糖耐量异常的冠心病患者心血管意外的影响。方法选取经冠状动脉造影诊断为冠心病且合并糖耐量异常的患者180例,随机分为阿卡波糖组、三清降糖方组及对照组,每组60例,其中对照组仅给予基础治疗,其余二组均在基础治疗基础上给予相应药物治疗。结果各药物治疗组心血管意外发生率均明显低于对照组（P＜0．01）,而阿卡波糖组与三清降糖方组比较心血管意外发生率差异有统计学意义（P＜0．05）。结论对合并糖耐量异常的冠心病患者应用三清降糖方治疗可显著减少患者心血管意外的发生。     

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.     

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.     

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.     

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.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

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.