培元通脑胶囊对中风病恢复期患者血脂影响的临床观察

目的观察培元通脑胶囊对中风病恢复期患者血脂的影响.方法将164例中风病恢复期患者随机分为治疗组84例、对照组80例,2组均使用阿司匹林肠溶片及针灸治疗,治疗组加用口服培元通脑胶囊.观察2组治疗前后美国国立卫生研究院卒中量表评分(NIHSS)、血脂检测指标的变化.结果2组NIHSS评分治疗后均较本组治疗前降低,治疗组较对照组降低明显.治疗组治疗后与本组治疗前比较甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)显著降低,高密度脂蛋白胆固醇(HDL-C)显著升高(P＜0.01).对照组治疗后与本组治疗前比较LDL-C显著降低(P＜0.01),TG降低(P＜0.05),HDL-C升高(P＜0.05).治疗组TG,TC,LDL-C,HDL-C较对照组改善明显(P＜0.01).结论培元通脑胶囊除改善中风病患者神经功能缺损评分外,对中风病恢复期患者的血脂具有明显的调节作用.     

高脂血症患者不同血脂异常分型与糖代谢的相关性研究

目的:探讨高脂血症患者中糖代谢异常的检出情况,对比不同血脂异常分型患者糖代谢异常的差异.方法:入选既往无糖尿病或心血管病史的单纯高脂血症患者及血脂正常者共197例,根据空腹血脂水平将受试者分为4组:高胆固醇血症组(HCh组,45例)、高甘油三酯组(HTG组,46例)、混合型血脂异常组(58例)以及正常对照组(48例).分别测量上述受试者空腹血清胰岛素(insulin,Ins)及血糖(glucose,GLU0)水平,计算胰岛素抵抗指数(HOMA-IR),并给予受试者口服75 g葡萄糖耐量试验(oral glucose tolerance test,OGTT),检测OGTT 2 h血糖(GLU120)水平.结果:HTG组及混合型组GLU120水平分别为(10.5±3.2)mmol/L及(12.0±5.4)mmol/L,均显著高于对照组[(8.7±3.5)mmol/L,P分别为0.045和0.024];HTG组及混合型组患者糖耐量异常(impaired glucose tolerance,IGT)的比例分别为39.1%和31.0%,显著高于对照组22.9%(P分别为0.009和0.014).在空腹血糖＜6.1 mmol/L的亚组人群中,HTG组及混合型组IGT的比例分别为51.4%和43.9%,亦显著高于对照组29.7%(P分别为0.009和0.015).结论:在尚未发生心血管事件的高脂血症患者中也存在相当比例未及时诊治的糖代谢异常患者,尤其应重视甘油三酯异常和混合型高脂血症患者,应对这部分患者进行OGTT检查,以期在更早阶段发现糖代谢异常.     

120例脑梗死合并糖尿病临床分析

目的:探讨脑梗死合并糖尿病患者的临床、CT特点、及预后差异.方法:收集我院的120例脑梗死合并糖尿病患者,对照组为我院120例非糖尿病的脑梗死患者,比较两组的临床资料及CT结果例如:空腹血糖(FBG)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、极低密度脂蛋白胆固醇(VLDL-C)水平以及神经功能缺损等情况.结果:非糖尿病性脑梗死患者多属轻、中型;而脑梗死合并糖尿病患者,重者多,TC、TG、LDL-C、VLDL-C、FBG水平明显升高,神经功能缺项程度严重,恶化和死亡率高.讨论:脑梗死中临床症状的轻重及病情转归与入院时血糖水平的高低有关,脑梗死合并糖尿病组的疗效及预后较非糖尿病组差,若血糖≥16.7 mmol·L-1提示病情严重,而且是急性期预后不良的指标之一,控制好血糖是预防及治疗的关键.     

凉山彝族地区高脂血症人群的健康教育

脂质代谢异常与动脉硬化密切相关,血清总胆固醇(TC)升高,低密度脂蛋白胆固醇(LDL-C)升高和高密度脂蛋白胆固醇(HDC-C)降低均使冠心病和脑卒中的发病危险性增加.血脂水平与动脉粥样硬化发病率和严重程度呈正相关,降低血浆胆固醇浓度可明显降低冠状动脉硬化发病率和严重程度.对高脂血症人群的健康教育,是防治动脉硬化的关键,是防治冠心病.脑卒中最经济有效的策略和方法,是提高广大人群的健康意识.     

苏子提取物对高脂血症家兔血脂及脂质过氧化的影响

[目的]研究苏子提取物(EPS)对家兔高脂血症的防治作用.[方法]采用高脂饮食建立家兔高脂血症模型,分别测定正常对照组,高脂模型组,苏子提取物低剂量组(0.1g/ml)、中剂量组(0.5g/ml)、高剂量组(1.0 g/ml)血清中的TC、TG、LDL-C、HDL-C及肝匀浆MDA 含量及SOD 活性.[结果]EPS能显著降低血清中的TC、TG、LDL-C,提高血清中HDL-C的含量,降低肝匀浆MDA的含量,提高SOD的活性.[结论]EPS 具有一定的调节血脂及抗脂质过氧化作用.     

低温游泳结合银杏叶提取物给药对高脂血症大鼠血脂代谢的影响

[目的]研究低温游泳运动结合银杏叶提取物(GBE)给药对高脂血症大鼠血脂代谢的影响.[方法]通过高脂饲料喂养大鼠模型试验42 d,获高脂血症试验鼠,将大鼠随机分成4组(n=3),分别为对照组、安静药物组、单纯低温游泳运动和低温游泳结合GBE给药组,测定各组大鼠血清总胆固醇(TC)、甘油三酯(TG) 和高密度脂蛋白-胆固醇(HDL-C)含量,同时测定血清、肝脏、心脏组织中过氧化脂质(LPO)及超氧化物歧化酶(SOD)活性.[结果]各试验组均能降低肝脏指数,SOD活性也明显降低;低温游泳联合GBE组能明显降低大鼠血清TC、TG值.[结论]低温游泳联合GBE给药可以调节高血脂大鼠血脂代谢,明显降低血液总胆固醇和甘油三酯,有助于高脂血症的改善.     

荜茇-13味治疗大鼠非酒精性脂肪肝病的实验研究

目的:研究荜茇-13味对大鼠非酒精性脂肪肝病的疗效.方法:雄性Wister大鼠40只随机分组,每组8只.正常对照组仅喂饲普通饲料,其他大鼠喂饲高脂饲料(88%标准普通饲料+10%猪油+2%胆固醇)12周.分为模型对照组和荜茇-13味低(2mg/kg)、中(4mg/kg)、高(8mg/kg)给药组.治疗组于13周开始灌胃荜茇-13味.药物干预8周末结束实验,测定体重、肝湿重和肝指数,检测血清中甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-c)高密度脂蛋白胆固醇(HDL-c)、丙氨酸转移酶(ALT)、门冬氨酸转移酶(AST)、丙二醛(MDA)、超氧化物歧化酶(SOD)和肝组织TG、TC.结果:与对照组比较,模型组体重、肝湿重、肝指数以及血清中TG、TC、LDL-c、、ALT、AST、MDA和肝组织TG、TC含量均增加,具有显著性差异(P＜0.05,P＜0.01)而HDL-c和SOD下降(P＜0.05);与模型组比较,药物干预组大鼠肝湿重和肝指数及血清TG、TC、LDL-c、ALT、AST、MDA和肝组织TG、TC降低,且肝脏脂肪变性和炎症坏死减轻(P＜0.05,P＜0.01).结论:荜茇-13味对大鼠高脂饮食诱导的NAFLD有治疗作用.     

72例慢性咳嗽患者中医相关病理因素及生活质量调查分析

目的 调查慢性咳嗽患者的中医相关病理因素、主要中医证候及生活质量.方法 收集符合纳入标准的72名慢性咳嗽患者的莱彻斯特咳嗽问卷(Leicester Cough Questionnaire,LCQ)评分结果、中医四诊信息,应用聚类分析、秩和检验,研究慢性咳嗽中医相关病理因素及主要中医证候,并比较不同证候慢性咳嗽患者LCQ各区域的得分差异情况.结果 慢性咳嗽对患者生理、心理、社会等方面均造成影响.主要病理因素有风邪、湿热、寒邪、痰湿、阴虚,主要证候类型为风邪伏肺、痰湿蕴肺、寒邪伏肺、湿热内蕴、肺阴亏虚5种,其中风邪伏肺的症状(咽痒、风冷油烟诱咳)发生频率最高.各证型LCQ得分在生理、心理2个方面及总分差异显著(P<0.05).结论 风邪是慢性咳嗽的主要病理因素,此外可见湿热、寒邪、痰湿、阴虚4种病理因素;5种主要证型中湿热内蕴、肺阴亏虚2种证型患者的生活质量相对较差,对具有相应临床表现者施以祛风宣肺、清热燥湿、养阴润肺等治疗,应可有效提高这些患者的生活质量.     

糖尿病和高血压对大血管并发症的影响

目的:探讨糖尿病和高血压对大血管并发症的影响,明确降压和控制血糖的意义.方法:对我院2009年6月到2010年12月门诊及住院患者146例的临床资料进行回顾性分析,将其分为三组,其中高血压组(EH)47例,糖尿病组(DM)53例,糖尿病合并高血压组(DM+EH)46例,另选择体检健康人群40例作为对照组,分别测定各组患者血压,血脂,糖化血红蛋白,空腹血糖及餐后2h血糖,检测大血管并发症的发生率.对高血压患者采取降压治疗,糖尿病患者控制血糖.随诊观察大血管并发症的发生情况.结果:大血管发病率依次为DM+EH组(17例,占36.96%)>DM组(12例,占22.64%)>EH组(5例,占10.64%).治疗后血压达到目标值后,糖尿病合并高血压组,糖尿病组大血管并发症患病率为6.06%.结论:糖尿病和高血压均是大血管并发症的主要危险因素,及时有效控制患者血糖和血压,可预防大血管并发症的发生.     

优泌乐25强化治疗对糖尿病外周动脉血管病变的影响

目的:探讨精蛋白锌重组赖脯胰岛素混合注射液(25R)(优泌乐25)对初诊2型糖尿病(T2DM)患者外周血管病变的影响.方法:新诊断的T2DM患者114例.随机分2组,即强化治疗组56例,年龄50±16岁,采用优泌乐25强化治疗;非强化治疗组58例,50±17岁.不设定严格的治疗控制目标.2组的疗程均为12周.收集2组患者的血压、体质指数、空腹及餐后血糖和HbAlc等资料.应用多普勒仪检测踝肱指数(ABI).结果:糖尿病患者外周血管病变患病率明显增高,强化治疗组ABI较治疗前无明显下降(P>0.05).非强化治疗组ABI较治疗前显著降低(P<0.05).结论:应用多普勒仪检测踝肱指数(ABI)使早期提示糖尿病患者动脉外周血管病变,可以用优泌乐25短期强化有助于保护T2DM患者的血管内皮细胞,延缓外周动脉粥样硬化.     

Phaeochromocytoma with myocarditis managed with alpha-methyl-p-tyrosine

A case of bilateral phaeochromocytoma with catecholamine-induced myocarditis is described. The two operations needed allowed comparison of the use of alpha-methyl-p-tyrosine alone and in conjunction with adrenergic blocks in the management of the patient. The combination of both drugs was particularly successful in the relief of symptoms and reduction of catecholamine metabolism as monitored by 4-hydroxy-3-methoxymandelic acid (HMMA) excretion. As myocarditis is a potentially fatal complication, further investigation of the combined use of alpha-methyl-p-tyrosine and adrenergic blocking drugs is suggested in the pre-operative management of patients with phaeochromocytoma.     

Factors related with compliance with tuberculosis chemoprophylaxis

OBJECTIVES: To determine therapeutic tolerance and compliance level with antituberculous chemoprophylaxis. PATIENTS AND METHODS: 587 patients were proposed for antituberculous chemoprophylaxis with isoniazid from January 1995 to June 1996 in Murcia (Spain). RESULTS: 3.6% of the patients gave up treatment because of hepatic intolerance and 73% completed the prophylaxis. Non-compliance related factors were: social risk factors (odds ratio [OR] = 9.31), previous history of allergies (OR = 2.87), previous personal history of tuberculosis-related events (OR = 0.49) and interaction between sex and age. CONCLUSIONS: Support and intervention measures directed to risk groups of a social origin deem to be needed. Control measures and information provided to middle-aged males, with particular emphasis to the first weeks of prophylaxis, should also be implemented.     

Communication with parents of children with cancer

The authors summarize the results of recent work evidencing the existence of latent merozoites during the course of the erythrocytic cycle of the rodent Plasmodia. These merozoites, unlike the majority of merozoites released at schizogony, do not penetrate immediately into the erythrocytes and remain latent for a variable length of time. The merozoites of each of the species or subspecies show marked peculiarities which are responsible for the characteristics of their cycle. The presence of latent merozoites free in the blood, the asynchronous development, and the resistance to chloroquine, are three closely related factors. Knowing that the merozoite is so far drug resistant, and that latent merozoites can maintain the infection for any length of time, it appears important to take into account these purely biological data, when studying the drug resistance of the human falciparum malaria.     

Surgical outcome in patients with epilepsy with occult vascular malformations treated with lesionectomy

PURPOSE: This retrospective study reports the long-term surgical outcome of patients with medically refractory epilepsy and vascular malformations who were treated with lesionectomy. A detailed analysis of surgical failures had been performed in an attempt to define predictors of surgical success and failure. METHODS: Fifteen patients with medically intractable epilepsy and angiographically occult vascular malformations (AOVMs) were treated surgically with lesionectomy at Duke University Medical Center. Lesionectomy consisted of removal of the AOVM and surrounding hemosiderin-stained brain only, without the use of electrocorticography (ECoG) to guide resection. RESULTS: Eleven (73%) patients are seizure free after lesionectomy. Three showed no significant improvement, and one patient died, presumably after a seizure. Age of onset, duration of seizures, age at resection, and gender did not affect outcome. All patients with neocortical AOVMs in whom EEG findings correlated with the site of the lesion were seizure free after lesional resection. Treatment failures were associated with the presence of multiple intracranial lesions, poorly localized or diffuse EEG findings, discordant positron emission tomography (PET) imaging, or with a lesion in close proximity to the limbic system. CONCLUSIONS: Lesionectomy, with removal of surrounding hemosiderin-stained brain, can be considered the procedure of choice in carefully selected patients with epilepsy with occult vascular malformations.