糖化血红蛋白在诊断2型糖尿病中的价值

目的对比分析空腹血糖(FPG)、餐后2h血糖(2hPG)及糖化血红蛋白(HbA1c)诊断糖尿病的敏感性和特异性,探讨HbA1c在诊断糖尿病中的价值。方法选取门诊查体疑似2型糖尿病患者285例,男158例,女127例,平均年龄(48±11)岁。所有研究对象行口服糖耐量试验(OGTT),同时测定HbA1c。结果①按WHO 1999年糖尿病诊断标准判断,285例中2型糖尿病(DM)176例,糖调节受损(IGR)71例,糖耐量正常(NGT)38例,三组HbA1c水平呈递增趋势(P<0.05)。②Spearman相关分析显示HbA1c与OGTT中FPG、2hPG为直线正相关(r=0.72,0.59,P<0.05)。③通过绘制ROC曲线图,HbA1c诊断糖尿病的最佳切点为6.1%,诊断的灵敏度高于FPG,低于2hPG;当HbA1c的切点为6.5%时,诊断的灵敏度低于FPG和2hPG,但联合检测FPG和HbA1c其灵敏度大于2hPG。结论在无法进行OGTT的情况下,HbA1c可用于糖尿病诊断,但应联合FPG检测。     

血浆内皮素和一氧化氮与糖尿病性视网膜病变的关系

目的　观察糖尿病 (Diabetesmellitus,DM)及伴有视网膜病变患者血浆内皮素 (Endothe lin ,ET)和一氧化氮 (Nitricoxide,NO)水平 ,探讨其与糖尿病性视网膜疾病的关系。方法　用放射免疫法和酶法测定血浆ET、NO水平。结果　糖尿病患者血浆ET、NO水平高于对照组 (P <0 .0 1 )。ET随DM的发生 ,视网膜病变的出现及加重渐次升高 ,与血糖、糖化血红蛋白、收缩压、舒张压呈正相关 ;NO随视网膜病变的出现及加重渐次下降 ,与病程呈负相关。结论　ET、NO参与糖尿病性视网膜病变的发生、发展 ,对判断病情、指导治疗、估计预后均有一定意义。     

大剂量VitC治疗慢性阻塞性肺病疗效观察

比较了常规治疗和常规加大剂量VitC治疗慢性阻塞性肺病（COPD）的疗效。结果显示：COPD加重期，加用大剂量VitC，能明显提高显效率，抑制血小板活化，改善肺功能和血气指标，未见明显副作用。提示，COPD加重期加用大剂量VitC是安全、有效的治疗方法。     

大剂量VitC治疗慢性阻塞性肺病疗效观察

比较了常规治疗和常规加大剂量VitC治疗慢性阻塞性肺病（COPD）的疗效。结果显示：COPD加重期，加用大剂量VitC，能明显提高显效率，抑制血小板活化，改善肺功能和血气指标，未见明显副作用。提示，COPD加重期加用大剂量VitC是安全、有效的治疗方法。     

The effect of Levocarnitine on nutritional status and lipid metabolism during long-term maintenance hemodialysis

Objective To investigate the effect of Levocarnitine on lipid metabolism and nutritional status of maintenance hemodialysis (MHD) patients and possible mechanism. Methods A total of 40 MHD patients [mean age (53.5±7.1) years] who underwent normal hemodialysis more than 6 months were randomly classified into two groups, Levocarnitine supplemented group (LS-G) (n=20; Levocarnitine supplementation after each normal hemodialysis session, at a dose of 1.0 g/day by intravenous administration) and control group (C-G) (n=20; normal hemodialysis). Before treatment, one month and three months after treatment we respectively measured or observed the following items, the tolerance to hemodialysis, carnitine level in plasma, C-reactive protein, IL-6, TNF-α, percentage of neutrophil, and some relevant nutritional parameters, such as lipid profile, transferrin, total protein, albumin and prealbumin levels. Comparative analysis was conducted between the two groups. Results In LS-G three months after treatment, the levels of carnitine, hemoglobin, and prealbumin in plasma were significantly increased (P<0.05), but C-reactive protein, neutrophil percentage, low-density lipoprotein and triglyceride were significantly decreased (P<0.05) in contrast to those in C-G and before treatment. Transferrin, total protein, and albumin were elevated in LS-G, with no statistical significance. Conclusion There was a significant improvement of lipid metabolism and nutritional status for the long-term maintenance hemodialysis patients with Levocarnitine supplementation. And this improvement is related to the decrease of inflammatory factors.     

PREVENTIVE EFFECT OF BORON ON DAMAGE TO CARTILAGE OF RATS WITH INTAKE EXCESSIVE FLUORIDE

Althoughfluorideinthebodymayhelpthe growthofbonesandteethinitsrangeofsafety,ex cessiveintakeoffluoridefromtheenvironmentcan damagetissuesandorgansinhumanandanimal, thusinducingskeletalfluorosis(SF)[1,2].Control lingoffluoridesources(suchastodefluoridate…     

Survey on arteriovenous fistula in maintenance hemodialysis patients with type 2 diabetic nephropathy

This paper summed up the characteristics of native arteriovenous fistulas (AVFs) in maintenance hemodialysis patients with type 2 diabetic nephropathy (DN) in Chinese hemodialysis centers. A survey was conducted on AVF in maintenance hemodialysis patients with type 2 DN. A total of 224 cases of maintenance hemodialysis patients were included in this study, among which, 65 cases in DN group, 33 cases in diabetes mellitus (DM) group and 126 cases in non-diabetic control (C) group. Hemoglobin, albumin, blood urea nitrogen, parathyroid hormone and calcium-phosphate product of the three groups of patients were not significantly different. Glycated hemoglobin A1c of DN group and DM group was not significant different. AVF life of (28.7 ± 10.0) months in DN group was significantly shorter than that of (36.5 ± 19.4) months in C group (statistic probability P <0.01), and AVF life of (32.5 ± 10.1) months in DM group (P <0.05) was also shorter than that in C group, while there was no significant difference in AVF life between DN group and DM group. Proportion of upper arm fistula in DN patients (11/65) was significantly higher than that in C group (6/123, P < 0.01). Life of AVF in patients with DN was relatively short, with more times of angioplasty and greater possibility of selecting upper arm internal fistula.     

EFFECTS OF DIPSACUS ASPER AND VITAMIN E ON THE SS NEURONS IN THE HIPPOCAMPAL FORMATION OF RAT MODELS OF ALZHEIMER‘S DISEASE

Ａｌｚｈｅｉｍｅｒ’ｓｄｉｓｅａｓｅ (ＡＤ)ｉｓｔｈｅｍｏｓｔｃｏｍｍｏｎｄｅｍｅｎｔｉａｉｎｔｈｅｓｅｎｉｏｒ ,ａｎｄｔｈｅｒｅｉｓｎｏｃｕｒｅｏｒｅｆｆｅｃ ｔｉｖｅｔｒｅａｔｍｅｎｔ .ＡｌｔｈｏｕｇｈｔｈｅｅｔｉｏｌｏｇｙｏｆＡｌｚｈｅｉ ｍｅｒ’ｓｄｉｓｅａｓｅｉｓｎｏｔｆｕｌｌｙｕｎｄｅｒｓｔｏｏｄ ,ａｃｃｕｍｕｌａｔｉｎｇｅｖｉｄｅｎｃｅｄｅｍｏｎｓｔｒａｔｅｓｔｈａｔｂｏｔｈｔｈｅｃｏｎｃｅｎｔｒａｔｉｏｎｏｆｔｈｅｓｏｍａｔｏｓｔａｔｉｎ (ＳＳ)ａｎｄｔｈｅＳＳｎｅｕｒｏｎｓｉｎｔｈ…     

秦巴山区婴幼儿维生素A、铁蛋白、骨钙素水平及营养状况调查

目的研究秦巴山区婴幼儿维生素A、钙、铁营养状况以及体格生长和喂养情况。方法采用分层多级整群抽样方法对该区3县10乡425名0~3岁婴幼儿进行体格检查和膳食结构调查;对144名儿童进行了血清铁蛋白、骨钙素、生长激素和血红蛋白的测定,123名儿童进行了血清VitA的测定。结果婴幼儿血清铁蛋白、骨钙素、生长激素、VitA和血红蛋白异常率分别为32.3%、28.6%、36.8%、31.6%和25.6%;生长迟缓、低体重及消瘦的平均患病率分别为19.8%、24.3%和7.6%。结论婴幼儿维生素A、钙及铁缺乏与家庭经济状况,乳母营养状况及不良饮食结构和习惯有关。     

生长因子诱导骨髓间充质干细胞成软骨分化的研究

目的　建立一种体外分离兔骨髓间充质干细胞 (MSCs)的方法 ,诱导其表达软骨细胞表型。方法　抽取兔骨髓 ,经密度梯度离心和粘附分离得到MSCs。用生长因子诱导 ,观察细胞的增殖情况和软骨特异性基质的表达水平。结果　①纤维粘连蛋白促进MSCs贴壁 ,可提高细胞分离率 ;②TGF β1 ,IGF Ⅰ和维生素C结合可促进MSCs增殖 ,表达软骨特异性的Ⅱ型前胶原mRNA和基质蛋白多糖成分。结论　①密度梯度离心结合粘附分离可提高MSCs的分离效率。②TGF β1 ,IGF Ⅰ和维生素C结合诱导可促进MSCs增殖 ,表达软骨细胞表型     

应用荧光偏振免疫法监测肾移植患者全血环孢素A浓度的临床评价

应用荧光偏振免疫法（ＦＰＩＡ）对２７４例肾移植术后患者行２３１２人次全血环孢素Ａ（ＣｓＡ）浓度测定。结果表明∶①ＣｓＡ在三联免疫抑制疗法中的理想治疗窗浓度范围是∶术后第１、２、３和４～１２个月全血ＣｓＡ浓度分别为３００～４３０、２８０～３５０、１８０～２８０和１１０～２５０μｇ／Ｌ；②ＦＰＩＡ法具有快速、准确、操作简便，适于批量测定等优点。讨论了肝肾中毒、排斥反应、高危人群及合并用药与全血ＣｓＡ浓度的关系。     

营养支持在肾移植围手术期的应用

目的探讨肾移植围手术期的营养支持。方法对163例肾移植患者围手术期营养支持方案和营养状况进行回顾性分析。根据患者手术前后2周内实际营养摄入量的不同分为实验组(相对高氮摄入量组,n=89)和对照组(相对低氮摄入量组,n=74)。对比其术后第2周末的氮平衡、体重、血清蛋白及血红蛋白、血脂、肾功能的变化情况。结果实验组氮平衡显著优于对照组;两组间体重无明显差异;实验组血清蛋白明显高于对照组;两组血红蛋白无显著差异;两组血脂术后除载脂蛋白AI实验组显著高于对照组外,其他指标差异不显著;对照组肾功能指标恢复明显好于实验组。结论肾移植术后早期仍应控制氮的摄入量,尽量减轻移植肾的负担,保护移植肾的功能。     

液氮保存对人同种瓣组织代谢及活性的影响

目的　主要观察液氮 (- 1 96℃ )保存 1～ 2 4个月不同时间瓣膜组织葡萄糖代谢率和同位素标记的胸腺嘧啶核苷掺入量的变化 ,为临床适用的冷冻保存人同种主动脉瓣的适宜保存期限提供实验依据。方法　选取健康成年男性的主动脉瓣膜 2 0个。实验依据保存时间分为 1 0组 ,Ⅰ组为新鲜对照组 ,Ⅱ～Ⅹ组分别为冷冻保存 1～ 2 4个月瓣膜。新鲜瓣膜取材后直接供实验用 ,冷冻组各瓣膜缓慢降温 (1℃·min- 1 ) ,液氮中保存 ,快速复温。瓣膜置入培养液 2 4h ,置入前后分别测定培养液中的葡萄糖含量并计算其差值。同位素测定标本加入氚标记的胸腺嘧啶核苷 ,做CBPM计数 ,计算每mg组织3H TdR掺入量。结果　新鲜瓣膜组葡萄糖消耗量和3H TdR掺入量均最高 ,冷冻保存组随液氮保存时间延长 ,组织的葡萄糖消耗量和3H TdR掺入量逐渐减低 ;冷冻保存 1～ 1 5个月瓣膜葡萄糖代谢率与新鲜瓣膜组比较无统计学意义 ,冷冻保存 1 8～ 2 4个月瓣膜葡萄糖消耗量明显减低 (P <0 .0 5 ) ,冷冻保存 1 2～ 2 4个月瓣膜3H TdR掺入量较对照组明显减低 (P <0 .0 5 )。结论　液氮保存对人同种瓣膜组织葡萄糖代谢率和胸腺嘧啶核苷掺入量有一定影响 ,其程度随保存时间增长而加重 ,液氮保存 1 5～ 2 4个月瓣膜组织代谢率明显减低 ,因此瓣膜耐久性可?     

同型半胱氨酸与高血压病、冠心病的相关性

目的　探讨同型半胱氨酸 (Hcy)与高血压病、冠心病的关系。研究与Hcy相关的某些因素。 方法　高血压病患者 30人 ,对照组 30人 ,冠心病患者 2 3人 ,用酶联免疫吸附法进行血Hcy的测定 ,同时测定血叶酸 (FA)、维生素B12 (VitB12 )及血脂的浓度。结果　①三组间在性别、年龄、吸烟情况上分布均衡 ,无显著性差异。②高血压病患者血Hcy显著高于对照组 (P <0 .0 5 ) ,冠心病患者血Hcy非常显著高于对照组 (P <0 .0 1)。③年龄与Hcy有非常显著的正相关性 (P =0 .0 0 1)。④高血压病患者FA及VitB12 水平与对照组无显著性差异。⑤Hcy与FA、VitB12 及血脂均无相关性。结论　Hcy与高血压病有关 ,它的升高可能参与某些人高血压的发生及造成血管病变。Hcy是冠心病的一个新的危险因素。     

Increased expression of the 20S proteasome in peripheral blood mononuclear cells of type 2 diabetic patients

Objective To investigate the dynamic expression of the 20S proteasome in peripheral blood mononuclear cells (PBMCs) of type 2 diabetic patients without vascular complications. Methods PBMCs were prepared from 30 type 2 diabetic patients and 30 nondiabetic controls. The general indexes including weight, height and blood pressure were recorded. Fasting plasma glucose, fasting plasma insulin and glycosylated hemoglobin were measured. The protein level of the 20S proteasome was measured by Western blotting. The mRNA expression levels of the 20S proteasome β1, β2 and β5 subunits were detected by real-time PCR. Results Compared with that in the nondiabetic controls, the protein level of the 20S proteasome was significantly increased in the diabetic patients and was positively associated with glycosylated hemoglobin. Conclusion Type 2 diabetic patients without vascular complications have an increased 20S proteasome expression, the significance of which needs to be explored by further study.     

陕西关中农村地区两所中学学生贫血原因的探究

目的探索陕西关中农村地区中学生贫血发生的原因。方法对陕西关中农村地区两所中学1 135名学生进行膳食调查和贫血筛检,筛检出贫血者,作为贫血组,并在非贫血者中选取与贫血者同年龄、同性别的个体作为非贫血组,测定两组平均红细胞体积、血清叶酸、维生素B12、铁蛋白的含量,并留取粪便进行消化道寄生虫感染的检测。结果贫血检出率为25.5%;在贫血检出者中,MCV>100 fL、100-80 fL、<80 fL者的构成比分别为45.2%、51.6%、3.2%,同时贫血组血清叶酸、维生素B12缺乏率高于非贫血组(P<0.05),两组血清铁蛋白缺乏率无显著性差异(P>0.05);该群体学生谷类摄入量足够,蔬菜、水果、豆类、蛋类、肉禽类、鱼虾类、奶类摄入量不足,两组之间粪检阳性率无显著性差异。结论该调查人群发生贫血的主要原因是膳食结构不合理,造成机体叶酸、维生素B12缺乏。     

正常儿童粪便中sIgA含量分析

目的　了解正常儿童粪便中sIgA的含量及其与肠道菌群和摄入营养素的关系。方法采取随机整群抽样的方法对农村 3 91名出生至 1 8个月婴幼儿进行调查 ,并对其中 5 5名婴幼儿采用ELISA方法检测粪便中sIgA含量。调查结果采用EPI和SPSS软件进行统计分析。结果儿童粪便中sIgA的含量随着儿童年龄的增长有下降的趋势 ,但无显著性差异 (P >0 0 5 ) ,1岁后趋于平稳 ;母乳喂养量、维生素C的摄入量及双歧杆菌与粪便sIgA含量呈正相关 ;儿童体重、身长与粪便中sIgA含量呈正相关。结论　应加强母乳喂养宣传力度 ,加强乳母的营养 ,保证母乳喂养的质量 ;婴儿出生后要逐渐增加维生素C的摄入 ;在辅食添加时强化双歧杆菌活菌等 ,有利于婴幼儿健康成长     

脑梗塞患者血浆同型半胱氨酸水平与叶酸、B_(12)的关系

目的　研究同型半胱氨酸 (HCY)与脑梗塞的关系及叶酸、维生素B1 2 (B1 2 )对HCY水平的影响。方法　采用高效液相色谱荧光检测法测定 40例脑梗塞患者和 2 0例同龄健康对照组血浆HCY浓度 ,用SimulTRAC SNB放射法测定两组血清叶酸、B1 2 的含量。结果　①脑梗塞患者血浆HCY浓度 (2 4 0 2 μmol/L± 1 1 2 4 μmol/L)高于对照组 (1 4 0 μmol/L± 4 48μmol/L) (P <0 0 1 ) ;②脑梗塞患者叶酸水平 (4 82 μg/L± 1 97μg/L)显著低于对照组 (6 88μg/L± 2 85μg/L) (P <0 0 0 1 ) ;脑梗塞患者B1 2 含量 (2 4 7 56ng/L± 1 58 72ng/L)略低于对照组 (2 70 31ng/L±1 98 39ng/L) ,但无显著差异 (P >0 0 5) ,Pearson相关分析显示两组HCY浓度与叶酸水平均呈负相关性 ,与B1 2 水平无显著相关。结论　脑梗塞患者血浆HCY浓度高于同龄健康人 ;HCY浓度与叶酸水平呈负相关性 ,与B1 2 水平相关性不显著     

胎儿生长发育与孕母动物蛋白摄入量关系的探讨

１１８４例初生儿体格生长发育与其孕母动物蛋白摄入量的调查显示，孕母平均蛋白入量（ｇ／月）城市为７８８ｇ，郊区为３３９ｇ，城区明显高于郊区；随孕母蛋白质入量的增加，初生儿的体重、身长、头围、胸围、上臂围及小腿围值也有所增长，两者呈低度到中度正相关，且城区高于郊区。说明胎儿的生长发育与孕母动物蛋白入量有密切关系。要提高儿童健康水平，必须从孕期做起，尽可能为孕母提供更多的动物蛋白，并使食品多样化。     

ISOLATION AND INDUCTION OF RABBIT BONE MARROW MESENCHYMAL STEM CELLS TO EXPRESS CHONDROCYTIC PHENOTYPE

Ｍｅｓｅｎｃｈｙｍａｌｓｔｅｍｃｅｌｌｓ(ＭＳＣｓ)ｗｅｒｅｍｕｌｔｉｐｏ ｔｅｎｔｉａｌｃｅｌｌｓ ,ｌｏｃａｔｅｄｉｎｂｏｎｅｍａｒｒｏｗ ,ｓｋｅｌｅｔａｌｍｕｓ ｃｌｅａｎｄｓｙｎｏｖｉａｌｍｅｍｂｒａｎｅ ,ｗｈｉｃｈｃｏｕｌｄｄｉｆｆｅｒｅｎｔｉ ａｔｅｉｎｔｏｓｅｖｅｒａｌｔｙｐｅｓｏｆｃｅｌｌｓ,ｓｕｃｈａｓｏｓｔｅｏｃｙｔｅ ,ｃｈｏｎｄｒｏｃｙｔｅａｎｄａｄｉｐｏｃｙｔｅ[1,2 ] .ＳｅｐｅｒａｔｉｏｎｏｆＭＳＣｓｆｒｏｍｂｏｎｅｍａｒｒｏｗｗａｓｒｅｌａｔｉｖｅｌｙｃｏｎｖｅｎｉｅｔ ,ａｕｔ…