目的 观察血脂康胶囊联合依折麦布治疗老年高脂血症的疗效.方法 将40例老年高脂血症病人随机分为对照组与观察组,每组20例.对照组接受血脂康胶囊治疗,观察组接受血脂康胶囊联合依折麦布治疗,治疗12周.比较两组血脂谱及肝肾功能、血糖、肌酸激酶、高敏C反应蛋白(hs-CRP).结果 两组治疗后总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)较治疗前显著下降(P<0.05);观察组治疗后TC和LDL-C明显低于对照组(P<0.05);治疗后两组hs-CRP均较治疗前下降(P<0.05),且观察组较对照组降幅更大(P<0.05).结论 血脂康联合依折麦布治疗老年高脂血症,可降低TC、LDL-C、hs-CRP水平.

Atrial fibrillation (AF) is the most common sustained arrhythmia causing high morbidity and mortality. While changing of the cellular calcium homeostasis plays a critical role in AF, the L-type calcium channel α1c protein has suggested as an important regulator of reentrant spiral dynamics and is a major component of AF-related electrical remodeling. Our computational modeling predicted that miRNA-223 may regulate the CACNA1C gene which encodes the cardiac L-type calcium channel α1c subunit. We found that oxidized low-density lipoprotein (ox-LDL) cholesterol significantly up-regulates both the expression of miRNA-223 and L-type calcium channel protein. In contrast, knockdown of miRNA-223 reduced L-type calcium channel protein expression, while genetic knockdown of endogenous miRNA-223 dampened AF vulnerability. Transfection of miRNA-223 by adenovirus-mediated expression enhanced L-type calcium currents and promoted AF in mice while co-injection of a CACNA1C -specific miR-mimic counteracted the effect. Taken together, ox-LDL, as a known factor in AF-associated remodeling, positively regulates miRNA-223 transcription and L-type calcium channel protein expression. Our results implicate a new molecular mechanism for AF in which miRNA-223 can be used as an biomarker of AF rheumatic heart disease.

Objective To investigate the relations between adiponectin(APN) and lipoprotein associated phospholipase A2 (LP‐PLA2) with the development and progress of essential hypertension .Methods 60 patients with essential hypertension were collect‐ed and divided into 3 groups of the hypertension grade 1 ,2 ,3 groups according to the levels of blood pressure ,20 cases in each group .Contemporaneous 20 healthy controls were selected .The peripheral venous blood samples were collected from the cubital vein and the serum levels of APN and LP‐PLA2 were measured by ELISE .The related biochemical indicators were simultaneously detected .Results The serum APN levels in the hypertension grade 1 ,2 ,3 groups were significantly lower than that in the control group ,moreover which in the hypertension grade 3 group was significantly lower than that in the hypertension grade 1 group(P<0 .05);on the contrary ,serum levels of LP‐PLA2 in the hypertension grade 1 ,2 ,3 groups were significantly higher than that in the healthy control group ,moreover which in the hypertension grade 3 group was obviously higher than that in the hypertension grade 1 group(P<0 .05);serum APN was significantly negatively correlated with LP‐PLA2(r= -0 .772 ,P<0 .05) .Conclusion Serum levels of APN and LP‐PLA2 are closely related with the development and progress of essential hypertension .

Objective To investigate the relations between adiponectin , LOX-1 and the development of essential hypertension. Methods 120 patients with essential hypertension were divided into 3 groups according to the levels of blood pressure : hypertension grade 1,2,3 groups with 37,40, and 43 cases, respectively; another 40 normal controls as control group. Peripheral blood samples were collected from cubital vein , and the plasma concentrations of adiponectin and LOX-1 were measured by ELISA technique , and also the related biochemical indicators were tested. Results The plasma levels of adiponectin in hypertension grade 1 ,2,3 groups were significantly lower than that in control group , and that in hypertension grade 3 group was lower than that in hypertension grade 1 group (P 0.01). The plasma levels of LOX-1 in hypertension grade 1 ,2,3 groups were significantly higher than that in control group , and that in hypertension grade 3 group was higher than that in hypertension grade 1 group (P 0.01 ). Plasma level of LOX-1 was negatively correlated with adiponectin (r = -0.903, P 0.05). Conclusion Plasma levels of LOX-1 and adiponectin were closely related to essential hypertension.

目的探讨氨氯地平联合厄贝沙坦或美托洛尔两种降压方案对男性中青年高血压病患者性功能的影响。方法 109例中青年高血压患者随机分为两组,A组57例,予苯磺酸氨氯地平片5mg/d,厄贝沙坦胶囊150mg/d。B组52例,予苯磺酸氨氯地平片5mg/d,美托洛尔缓释片47.5mg/d。于治疗即刻、24周用国际男性性功能问卷(IIEF)评价患者性功能。结果 A组治疗后性欲积分值增高(P<0.05),B组勃起功能积分值下降(P<0.05),其余指标差异无统计学意义(P>0.05)。结论相对于苯磺酸氨氯地平片联合美托洛尔缓释片,苯磺酸氨氯地平片联合厄贝沙坦胶囊可能更有益于男性中青年高血压病患者性功能。

目的对本院推进阳光用药的措施和成效进行归纳,进一步提高阳光用药管理水平。方法实施阳光用药的措施进行理论总结,对推进前后的用药情况进行比较对照。结果和结论院推进阳光用药的措施成效显著。推进阳光用药工作,有助于监督和规范医生用药行为,促进临床合理用药水平,保障医疗质量,降低药品费用、减轻群众的医疗费用负担。

目的通过64排螺旋CT(64排MSCT)对冠状动脉易损斑块的变化检测,探讨血脂康对冠状动脉易损斑块的稳定性疗效。方法选择78例经64排MSCT确诊有冠状动脉易损斑块患者,随机分为血脂康组(试验组)和辛伐他汀组(对照组),两组均随访治疗1年,分别于治疗前后行64排MSCT检测患者易损斑块所在位置的冠状动脉腔径狭窄度(SE)和截面积(S)、易损斑块的最长径(L)及CT值。并进行临床疗效比较。结果两组患者治疗后与治疗前比较,SE明显减少(P<0.05),L显著缩短(P<0.01),CT值显著升高(P<0.01)。两组间比较差异无统计学意义(P>0.05)。结论血脂康具有抗动脉粥样硬化,稳定斑块作用;血脂康和辛伐他汀稳定易损斑块作用相同。

By yuebei people's hospital for example,the article introduce this hospital how to implement dynamic-monitoring and early-warning mechanism in clinical medicine.This measure adapts the situation of heath in today and tallies the request of some laws,like Drugs Management Law and new Prescription Policing Method.The mechanism is innovating and consummating to contribute for promoting the medical service and heath as possible as it can.

目的探讨不同时间服用降压药对高血压治疗有效性和平稳性的影响。方法将90例2级以上原发性高血压病人分为3组。A组早晨顿服氨氯地平和厄贝沙坦组。B组早晨服厄贝沙坦,晚上服氨氯地平组。C组早晨服用氨氯地平,晚上服厄贝沙坦组,病人均于服药前及服药两周后进行动态血压监测。结果服药2周后各组夜间时段及24h平均收缩压明显下降。组间比较A组<B组、A组<C组(P<0.01),B组和C组间差异无统计学意义(P>0.05);各组夜间时段及24h平均动脉压明显下降,组间比较A组<B组、A组<C组(P<0.01),B组和C组间差异无统计学意义(P>0.05);各组夜间时段舒张压明显下降,组间比较A组<B组、A组<C组(P<0.01),B组和C组间差异无统计学意义(P>0.05)。结论联合用药的降压效果显著,早晚分次服药较早晨顿服两种药物更有效控制夜间血压,早晚分次服药使夜间及24h血压下降更平稳。

目的通过回顾性分析冠状动脉造影(CAG)阳性患者与平板运动试验(TET)结果,评价TET在冠心病诊断中的价值。方法行CAG确诊冠心病并于CAG前两周行TET检查的250例患者,对比分析CAG与TET结果。结果 250例CAG阳性中,TET阳性及可疑阳性218例(87.2%),阴性32例(12.8%);TET阳性者冠脉病变较重,且多为多支病变;假阴性率为12.8%,且这部分患者冠脉病变较轻,多为单支病变。结论 TET用于评价心肌缺血及诊断冠心病时具有较高敏感度,仍是目前诊断冠心病常用检查方法之一,但存在一定的假阴性率。

<正>抗菌药物是临床应用最广泛的药物之一,为预防和治疗感染性疾病起到了重要作用。然而,由于抗菌药物的滥用和临床病原学检测方法的滞后等原因,细菌耐药性、不良反应发生率、费用等大幅攀升,抗菌药物的合理使用已成为医药界特别关注和需要解决的问题。为此,我国卫生部为了规范医疗机构和医务人员的用药行为,推动抗菌药物的合理应

Objective To realize the implementation of electronic database of basic medicine directions the application of HIS-Trakcare system,then to provide real-time and quick inquiries for medical staff through the local area network of the hospital.Methods Information concerning medicine directions were collected and sorted.The dispensatory database was established by using SQL server 2000 and Visual Basic programming language.Results The basic medicine directions database system was easy to operate.It could guide the rational clinical application of drug.Conclusion The established basic medicine directions database is a useful way to realize the rational clinical application of drug,and therefore can provide the patients with better service.

目的:调查我院病原菌的分布与耐药趋势,探讨病原菌耐药性与抗菌药物使用强度的相关性,提出临床抗菌药物换药策略。方法:对2008年1-6月临床细菌学标本病原菌的耐药性进行统计分析,结合同期临床抗菌药物的使用强度,分析病原菌耐药率与抗菌药物使用强度的相关性。结果:从临床细菌学标本中共检出病原菌16种,分离细菌总数量756株。病原菌耐药率与抗菌药物使用强度呈正相关。结论:常见病原菌的耐药率与临床使用抗菌药物的强度成正比,对耐药率高的抗菌药物考虑换用其他敏感药物,提高临床抗感染的治愈率。

目的研究糖化血红蛋白(HbA1c)浓度、入院血糖(AG)及第2日清晨空腹血糖(FBG)对急性心肌梗死(AMI)患者30d时发生心力衰竭(HF)的预测价值。方法测定AMI患者HbA1c、AG及FBG值。根据AMI患者发病30d时有无HF分为两组,观察上述指标与HF的关系。结果145例AMI患者的HbA1c(P=0.041)和FBG(P=0.043)与30d发生HF相关,且HbA1c(P=0.016)为AMI 30 d HF发生的独立危险因子。结论高血糖能预测AMI近期发生HF。HbA1c是AMI短期HF发生的独立危险因子。

目的探讨胰岛素抵抗(IR)与冠状动脉病变的相关性。方法连续收集经冠状动脉造影证实至少有1支血管狭窄≥50%的135例患者作为研究对象,均行口服葡萄糖耐量试验(OGTT)及胰岛素水平测定。以内环境稳(评估模型(HOMA)指数作为评价IR程度指标,对冠状动脉病变程度作相关性分析。结果随着IR程度的增高,冠状动脉病变程度逐渐增高。IR与冠状动脉病变程度具有明显相关性(P<0.05)。结论IR和动脉粥样硬化相关,在冠心病的预防和治疗中应重视IR。

OBJECTIVE:To study the effects of ephrinB2 gene transfection on the differentiation of bone marrow mesenchymal stem cells (BMSCs) into vascular endothelial cells.METHODS:Wistar rat BMSCs were isolated by density gradient centrifugation and purified on the basis of their adhesion ability. The BMSCs were transfected with a lenti-virus vector encoding a constitutively active form of human ephrinB2 gene, and the cell markers including CD105, CD73, CD44, von Willebrand factor (VWF) and vascular growth factor receptor 2 (KDR) were detected using flow cytometry. The potential of ephrinB2-BMSCs for differentiation into osteoblasts and adipoblasts in vitro were tested, and the differentiation of the cells into endothelial-like cells was induced by culture in the presence of 2% fetal bovine serum and 50 ng/ml vascular endothelial growth factor.RESULTS:EphrinB2-BMSCs were positive for the markers CD105, CD73 and CD44, and negative for the typical endothelial markers like VWF and KDR, and retained high potentials for differentiation into osteoblasts and adipoblasts in vitro after cultivation in respective media. After induced differentiation, ephrinB2-BMSCs expressed VWF and KDR and showed greater ability of differentiation into vascular endothelial cells and formation of capillary structures on matrix gel than the BMSCs without transfection.CONCLUSIONS:EphrinB2 gene transfection efficiently promotes the differentiation of BMSCs into vascular endothelial cells. These genetically engineered cells provide valuable sources for new therapies of coronary heart disease.

目的分析心理应激与急性冠脉综合征(ACS)的关系,探讨心理应激诱发ACS发生的危险因素。方法135例(年龄≤60岁)经冠状动脉造影确诊为冠心病患者,根据焦虑、贝克抑制自评量表得分分为心理应激组和非心理应激组。心理应激组:焦虑或(和)抑郁自评分≥50分;非心理应激组:焦虑(或)和抑郁自评分<50分。结果心理应激组与非心理应激组ACS的发生率分别为80.6%和53.2%,稳定型心绞痛分别为20.8%和46.0%,两组比较均有统计学意义(P<0.01)。心理应激组的血清白细胞介素-6(IL-6)及C反应蛋白(CRP)明显高于非心理应激组(P<0.01)。结论心理应激可使体内炎症因子分泌增加,从而使动脉粥样硬化斑块由稳定变成不稳定,并通过炎症促使ACS发生、发展。

Objective To investigate the relation between white blood cell (WBC) count and mortality of acute coronary syndromes with non-ST elevation(ACSNST).Methods Two hundred and forty-two consecutive patients with ACSNST were stratified according to quartiles of WBC determined on admission.Results The mortality in the fourth quartile(WBC>10.0×109/L) was higher than that in other quartiles in the hospital and at 6 months(P<0.001 ).Conclusion WBC count was a economic and convenient independent predictor of outcomes in patient with ACSNST.

Objective To study the main influential factors of seeking medical tendency for city resident. Methods 2100 residents were stratified cluster sampled randomly to complete the questionnaires of their seeking medical attention,and the data were analyzed by Logistic regression.Results The variable of medical organization had significance of difference (P0.01) ,its regression coefficients was 0.491,the largest regression coefficients was the variable of whether work (1.180) among all variablesthat being into regression equation.Conclusion The main influential factors of seeking medical tendency were medical service quality and economic situation of resident .

Objective To study the influential factors of seeking medical care tendency of municipal residents in(Shaoguan). Methods Stratified cluster sampling method was randomly assigned 2,100 municipal residents in Shaoguan to complete the questionnaires for their influencing factors to seek medical care services,and the data were stratified into quantitative and stepwise regression analysis. Results There were 930 residents(45.1%) considered the expensive medical care cost as the major factor that influenced their seeking medical care tendency, 461 residents(22.4%) thought they were unable to pay the medical care service cost,and 1,350 residents(65.5%) regarded the prior factor as medical quality when they select hospital.The coefficient variables between medical organization and personal income came into the regression equation were 0.348 and 0.208 respectively. Conclusion The major influential factors of seeking medical care are economic condition of the municipal residents and the medical service quality.