2型糖尿病患者血清载脂蛋白AⅠ、AⅡ、 B100、CⅡ、CⅢ、E含量分析

目的　探讨2型糖尿病患者血清中载脂蛋白(apo)AⅠ、AⅡ、B100、CⅡ、CⅢ、E含量的改变特点。方法　对143例2型糖尿病患者(其中合并冠心病20例,合并高甘油三酯血症66例,合并高胆固醇血症55例)和127例非糖尿病对照进行了空腹12小时后血糖、胰岛素、甘油三酯(TG)、胆固醇(TC)、高密度脂蛋白胆固醇及apoAⅠ、AⅡ、B100、CⅡ、CⅢ、E含量的测定。结果　与非糖尿病对照组相比,男性2型糖尿病患者腰臀比(WHR)、空腹血糖(FBG)及apoCⅡ明显升高(P<0.05),apoAⅠ、AⅡ明显降低(P<0.05)。女性糖尿病患者较女性非糖尿病者体重指数(BMI)、WHR、FBG、TG水平明显升高(P<0.05),HDL-C、apoAⅠ、AⅡ水平则明显降低(P<0.01)。在伴有脂质异常血症和冠心病的2型糖尿病患者中,apo(s)与血脂的变化更为明显。2型糖尿病伴高甘油三酯血症的患者较TG正常的糖尿病患者BMI、WHR、空腹胰岛素(INS)、TG、TC、apoB100、CⅡ、CⅢ和E水平明显升高,同时伴HDL-C、apoAⅠ水平降低(P均<0.05);2型糖尿病伴高胆固醇血症的患者与TC正常的的患者相比,WHR、TG、TC和apoB100、CⅡ、CⅢ、E水平也明显升高(P<0.01)。载脂蛋白的变化与血脂的变化呈明显相关。在2型糖尿病合并冠心病的患者中,BMI、FBG、INS、apoB100、CⅡ、CⅢ和E水平显著升高,HDL-C、apoAⅡ水平则显著降低(P均<0.05)。结论　载脂蛋白异常是2型糖尿病患者的代谢紊乱特征,同时可能是2型糖尿病发生脂代谢紊乱和冠心病的重要原因。     

高血压病及其伴冠心病患者血脂,脂蛋白,载脂蛋白分析

高血压病Ⅰ期患者210例，合并冠心病3例；高血压病Ⅱ期患者50树，合并冠心病20例（P＜0．005）。检测30例高血压病Ⅰ期患者、30例高血压病Ⅱ期患者、20例高血压病Ⅱ期并冠心病患者及30例正常对照者血清胆固醇（TC）、甘油三酯（TG），高密度脂蛋白（HDL－C）、低密度脂蛋白（LDL－C）、载脂蛋白A1（apoA1），载脂蛋白B（apoB）水平。结果：高血压病Ⅰ期仅apoA1降低，高血压病Ⅱ期HDL-C、apoA1、apoA1／apoB显著下降，高血压病Ⅱ期伴冠心病者除此三项下降外，Tc、LDL－C、apoB显著升高。提示：高血压病越严重，血脂紊乱越重，尤其合并冠心病者。高血压病降血脂治疗是降低冠心病发病率的措施之一。     

贵州省威宁县秀水乡回族人群血脂与血压关系分析

目的 :测定贵州省威宁县秀水乡回族人群血总胆固醇 (TC)、甘油三酯 (TG)、载脂蛋白A1(apoA1)、载脂蛋白B(apoB) ,探讨血脂与当地高血压发病之间的关系。方法 :随机抽样测定了 2 5 0名回族人群血压 ,酶法测定高血压组 39例及随机抽取的血压正常组 4 7例血浆TC、TG ,免疫透射比浊法测定血apoA1,apoB。结果 :2 5 0例人群中检出高血压 39例 ,占 15 6 %。通过对高血压组与血压正常组血脂水平比较 ,发现高血压组血TC、TG、apoA1、apoB升高 ,TC、TG、apoA1差异有显著性 (P <0 0 5 ) ,apoB无显著性差异 (P >0 0 5 )。结论 :威宁县秀水乡回族高血压者比率较高 ,TC、TG、apoA1、apoB与高血压发病有一定关系。     

围绝经期前后妇女性激素变化与血浆脂蛋白水平分析

目的探讨围绝经期前后妇女性激素变化与血浆脂蛋白水平的关系,了解性激素在心脑血管疾病中的作用。方法对绝经前、围绝经期、绝经后三组妇女共76例,分别测定FSH、LH、PRL、P、E2、T、TCH、TG、HDL-C、LDL-C、apoA1、apoB水平。结果绝经后妇女E2水平较绝经前期及围绝经期妇女明显下降(P<0.01),后两者无明显差异(P>0.05),绝经后与围绝经期妇女的FSH及LH均较绝经前期妇女明显升高(P<0.01),绝经后期较围绝经期组升高更明显,两者相比有显著差异(P<0.01)。绝经前期与围绝经期妇女的血脂水平无显著差异(P>0.05),绝经后期与绝经前期相比,TC、TG、LDL-C、apoB水平升高,HDL-C水平下降(P<0.05)。绝经后妇女E2与TC、LDL-C水平呈负相关,与HDL-C水平呈正相关。结论围绝经期前后妇女体内性激素水平下降与血脂异常改变有关。     

药物联合健康管理对社区血脂异常患者治疗的影响

目的:观察药物联合健康管理与单纯药物治疗对血脂异常患者血脂的影响。方法:将62例血脂异常患者分为对照组和研究组,对照组仅给予辛伐他汀治疗,研究组在此基础上增加联合健康管理,治疗12周后,观察两组血脂指标的变化。结果:两组治疗后总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL-C)均较治疗前显著下降;研究组患者的高密度脂蛋白(HDL-C)治疗后升高,载脂蛋白A1(apoAⅠ)、载脂蛋B(apoB)治疗后均降低;研究组治疗后的TC、TG、LDL-C、apoAⅠ、apoB、HDL-C明显优于对照组,两组比较差异显著(P0.05)。结论:药物联合健康管理对高脂血症患者的疗效更显著,能在社区实现更佳的血脂管理效果。     

379例高脂血症患者血脂及载脂蛋白水平分析

本文对379例高脂血症患者及84例年龄相近的正常人的血脂及载脂蛋白（apo）AⅠ、B100、CⅡ及CⅢ的含量进。行了分析，结果表明，高甘油三酯（TG）血症组及高甘油三酯、胆固醇（TG、Ch）血症组患者皿清除apoAⅠ含量呈不同程度降低外，apoB100、CⅡ及CⅢ水平都显著升高，三组高脂血症患者的apoAⅠ和B100的比值均呈极显著的降低，经直线相关分析表明，对高血脂影响最大的是apoB100，其次是apoAⅠ、CⅡ及CⅢ。     

妊娠期高血压疾病血脂代谢改变及临床意义的探讨

目的:探讨妊娠期高血压疾病血脂代谢改变的特征及临床意义。方法:检测50例妊娠期高血压疾病及50例正常妊娠孕妇血清总胆固醇(CHOL),甘油三酯(TG),高密度脂蛋白胆固醇(HDL-C),低密度脂蛋白胆固醇(LDL-C),载脂蛋白A1(apoA1)及载脂蛋白B(apoB),并计算LDL-C/HDL-C及apoA1/apoB的比值。结果:妊娠期高血压疾病组与正常妊娠组相比,其CHOL,TG,LDL-C,apoB,LDL-C/HDL-C比值显著升高,HDL-C,apoA1,apoA1/apoB比值显著降低。结论:妊娠期高血压疾病的发生、发展,可能血脂代谢异常有关。     

原发性肾病综合征患者血脂及载脂蛋白的变化

目的观察原发性肾病综合征患者血脂及载脂蛋白的变化,探讨血脂代谢异常的特征和临床意义.方法选择30例原发性肾病综合征患者和30例健康人,检测血脂及载脂蛋白包括血清总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、载脂蛋白A1、载脂蛋白B100.结果原发性NS患者血清TC、TG、LDL、apoB100明显升高,与正常对照组比较P＜0.01,有显著性差异,而apoA1/apoB100比值较正常对照组明显下降,P＜0.05.结论原发性肾病综合征患者常存在血脂代谢异常,监测血脂及载脂蛋白的变化,对预防动脉粥样硬化（AS）和肾功能的进行性损害,具有一定的临床指导意义.     

血脂异常对脑梗死的影响

目的 考察血脂异常对老年人脑梗死的影响.方法 筛选100例脑梗死患者,年龄45-81岁,与100例健康受试者作对照,抽取受试者清晨空腹静脉血3mL,离心后将分离的血清置-25℃冰箱备用.采用双抗夹心ElISA法检测血清脂蛋白(a),氧化本科法检测血清总胆固醇(TC)和甘油三酯(TG),磷钨酸镁沉淀检测高密度脂蛋白(HDL-C);低密度脂蛋白(LDL-C)采用计算公式:LDL-C=TC(TG/2.2+HDL-C);免疫比浊法检测载脂蛋白A.B(apoA、apoB).结果 脑梗死患者血清LPa、TC、TG、LDL-C、apoB水平显著高于对照组患者,血清HDI-C、apoA水平显著低于对照组,且患者组血清中各项脂质浓度异常发生率与对照组比较差异具有显著性,P＜0.05.结论 血脂异常与老年人脑梗死密不可分,调解血脂水平至正常对于预防和治疗老年人脑梗死具有重要义. (TC)和甘油三酯(TG),磷钨酸镁沉淀检测高密度脂蛋白(HDL-C);低密度脂蛋白(LDL-C)采用计算公式:LDL-C=TC(TG/2.2+HDL-C);免疫比浊法检测载脂蛋白A.B(apoA、apoB).结果 脑梗死患者血清LPa、TC、TG、LD -C、apoB水平王著高于对照组患者,血清HDI-C、apoA水平显著低于对照组,且患者组血清中各项脂质浓度异常发生率与对照组比较差异具有显著性,P＜0.05.结论 血脂异常与老年人脑梗死密不可分,调解血脂水平至正常对于预防和治疗老年人脑梗死     

沙棘总黄酮（TFH）改善血管性痴呆血脂的实验研究

目的探讨沙棘总黄酮（TFH）对＂血管性痴呆＂（VD）血脂的改善作用。方法①采用＂高脂血症血管性痴呆大鼠模型＂进行造模。②造模后和干预后,分别测血脂（TC,TG）,血清脂蛋白（HDL-C和LDL-C）;载脂蛋白A（apoAⅠ）、载脂蛋白B（apoB）。结果①实验组（TFH低、中、高剂量组）干预后与造模后血脂（TC、TG、HDL-C、LDL-C、apoAⅠ、apoB）相比,有统计学意义（P〈0.05）;对照组（丹参注射液）干预后与造模后相比,有统计学意义（P〈0.05）;空白组干预后与造模后相比,无统计学意义（P〉0.05）;②空白组与实验组（低、中、高剂量组）、对照组相比,无统计学意义（P〉0.05）。结论 TFH能明显降低高脂血症型VD模型大鼠的TC、TG、LDL-C、apoAⅠ、apoB,并提高HDL-C。     

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.     

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.     

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.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.