Humans ; Metabolic Syndrome

Objective To investigate the changes of the anion gap(AG)in the premature suffered from hyperbilirubinemia,to provide the basis for treatment.Methods The serum electrolyte,the renal function and the liver function in 94 premature babies suffered from hyperbilirubinemia were tested,and then calculated the value of AG,while the arterial blood gas analyses were done in 36 cases.Results 44 cases had high AG(46.81％),44 cases had normal AG(46.81％)and 6 cases had low AG(6.38％).The increase of AG was directly proportional to the concentration of Na+in blood,while was inversely proportion to the concentration of HCO3-.There was no close relationship between the AG and BUN,Scr in the serum.Conclusion The incidence rate of metabolic acidosis poisoning was high in premature suffered from hyperbilirubinemia with high AG,so the routine test of blood electrolyte,renal function and arterial blood gas should be done.Calculate the value of AG to guide the treatment,and to avoid correcting the acid by the alkali blindly.

Objective To study the effects of combined telmisartan and ramiprll on heart function and renin - angiotensin - aldoste-tone system and ventricle remodeling and brain natriuretie peptide in patients with chronic heart failure (CHF). Methods 100 patientswith chronic heart failure were randomly divided into three groups: telmisartan group (A group, treated with telmisartan 80mg once daily, n =33), ramipril group (B group treated with ramipril 5mg once daily, n =33) and telmisartan plus ramipril group (treated with telmis-artan 40mg plus ramipril 2.5mg once daily, n = 34). Left ventricular end - diastolic dimensions (LVEDD) and left ventricular ejection fraction (LVEF) were assessed, and plasma renin activity (Ren) , angiotensinIl (Angll), aldosterone (Aid) and brain natriuretic pep-tide (BNP) were measured before and after therphy. Results After 6 months of treatment, LVEDD and LVEF were improved in all groups(P < 0.01). All changs were significant in C group than those in A group or B group(P < 0.01). The concentration of Ren were in-creased in all groups(P <0.01). The concentration of Angll was increased in A group and decreased in B group(P <0.01)while there was no difference at pre or post treatment in C group (P > 0.01). The concentration of Ald and BNP was decreased in all groups (P < 0.01). Ald and BNP were decreased more significantly in C group than those in A group or B group. Conclusion Combination of low dose of telmisartan and ramipril therapy has more benificial clinical features than telmisartan or ramipril alone in patients with CHF.

Objective To investigate awareness of knowledge about iron deficiency anemia (IDA)in patients with it.Methods Patients diagnosed as IDA at their initial visits to Affiliated Hospital of Qingdao University Medical School were randomly selected for the study during January 2008 to January 2009 with self-designed questionnaire to investigate their awareness of knowledge about IDA.Results Among 199 patients with IDA investigated, their awareness was lower in general, five percent about its etiologies, 34.2 percent about its clinical manifestations, 18.1 percent about its hazard to health, and two percent about food abundant of iron.For preventive measures of IDA, 50.7 percent (101/199) of them knew that daily diet should be diversified and 43.7 percent (87/199) knew that meals should be prepared with ferric cooking pot.Awareness of knowledge about other preventive measures of IDA was lower in them.No significant difference in awareness of IDA-related knowledge between them at varied ages was found, except for knowledge about etiology and hazard of IDA.Awareness of etiology of IDA differed between them at varied ages (P ＜0.05), and about 75.3 percent (64/85)of patients with IDA aged 30 -45 years were caused by chronic blood loss.There was no significant difference in awareness of IDA-related knowledge between patients with IDA caused by varied etiologies (P ＞ 0.05).Conclusions In general, awareness of IDA-related knowledge was lower in patients with IDA.It is necessary to strengthen its popularization, with varied focuses in preventive measures for IDA patients with different etiologies.

Objective To analyse the change of the blood serum electrolyte in asphyxial neonates.Methods To test the concentration of blood serum K~+、Na~+、Cl~-、Ca~(2+) in enzyme linked immunosorbhent assay.In 343 cases,there were 297 cases of slight asphyxial neonates and 46 eases of serious neonates.In control group,there were 41 cases.Results The concentration of blood serum K~+、C~l-、Ca~(2+) in asphyxial neonates were significamly less than control group(all P<0.01) and the concentration after birth 24h～48h were significantly less than within 24h(all P<0.01).The incidence of hyponatremia,hypochloremia and hypocalcemia after birth 24h～48h were significantly hisher than within 24h(all P<0.01),There were no significant differences in the concentration of blood serum K~+、Na~+、Cl~-、Ca~(2+) between the slight asphyxial group and the serious asphyxial group(P>0.05).Conclusions The concentration of blood serum K~+、Na~+、Cl~-、Ca~(2+) in asphyxial neonates gradually reduced after birth 48h and tbe incidence of electrolyte disturbance gradually increased.The change of blood electrolyte should be dynamically routinely monitored.

The causes of iatrogenic injury in choledo-cho-pancreatico-duodenai junction include iatrogenic factors, anatomic factors and pathological factors. T-tube, methylthionine chloride and fiber choledochoscopy are useful methods for early diagnosis. Accurate exploration of the injury site and reasonable choice of management were significant in dealing with the iatrogenie injury and can lead to a satisfactory result. Choledo-chojejunostomy and Oddi sphincteroplasty are not recommended unless the patients had distal bile duet stricture or the stones can not be removed. Accurate detection of the injury site, evaluation of the severity, and proper choice of the surgical method are important for the prognosis of the patients.

Atherosclerosis and arteriosclerosis are the common pathologic causes of such cardiovascular diseases as myocardial infarction,cerebral apoplexy,and so on.Early detecting the changes of artery's malfunction and proper treatment can effectively help to prevent those mortal diseases or slow down the its procedure.This review analyses currently used methods and devices evaluating the arterial stiffness.Three main methods and instruments which based upon analysis of pulse transit time,wave contour of the arterial pulse,and direct measurement of arterial geometry and pressure,which correspond to the evaluation of regional,local and systemic stiffness of body region are discussed.They are used in clinical laboratory and/or in clinical treatment particular attention is given to the reproducibility of each device.

BACKGROUND:At present,application revascularization and drug treatment may arrest aggravation of heart function and arrhythmic development,but effectiveness is limited.Infarcted myocardial cells are still impossible to regenerate.How to make necrotic myocardial cell regeneration and diastolic myocardial function is the problem to solve.OBJECTIVE:To analyze the study progress of bone marrow stem cells in treatment of myocardial infarction.RETRIEVAL STRATEGY:A computerized online database of Pubmed was searched to identify articles published from May 2000 to July 2006 with the key words of "the marrow stem-cell,cell transplant,myocardial infarction" in English.Simultaneously,articles published between October 1997 and December 2006 were identified in China Journal Full-text Database with the same key word in Chinese.Sixty-seven articles were retrieved and data were selected primarily.Inclusive criteria:①articles related to the transplantation of bone marrow stem cells for the treatment of myocardial infarction,②in the same field,articles recently published or in authoritative journals.Exclusive criteria:①articles of repetitive study,and ②Meta analysis.LITERATURE EVALUATION:Articles mainly analyzes the transplantation of stem cells for the treatment of myocardial infarction.Of the 30 included articles,10 were reviews and the rest was clinical or basic studies.DATA SYNTHESIS:①Bone marrow stem cells are composed of bone marrow mononuclear cells,hematopoietic stem cells,bone marrow mesenchymal stem cells,endothelial stem/progenitor cells,multipotent adult progenitor cells and so on.②After the transplantation,bone marrow stem cells can differentiate into myocardiocytes,and do effectively electromechanical coupling with receptors.Bone marrow stem cells can promote the angiogenesis in ischemic region,avoid ethical dispute and immunological rejection,and these cells are easy to collect.Bone marrow stem cells are adult stem cells,and its transdifferentiation deserves further study.Many clinical studies showed that autogeneic bone marrow stem cell transplantation for the treatment of acute myocardial infarction and heart failure could be achieved.③Matrix metalloproteinase,stem cell factor and stromal cell chemokine from bone marrow stem cells play important roles in stem cell mobilization,homing and myocardial repair.Tissue injury and high-level multipotential stem cells are two key factors of the differentiation of bone marrow stem cells in myocardial microenvironment.④ Problems in bone marrow stem cell transplantation included cell type,regulatory mechanism of transdifferentiation,optimal time,manner and safety of transplantation,etc.CONCLUSION:Through establishing complete animal model,the possibility of each technique in clinical procedures is explored.Bone marrow stem cells in treatment of acute myocardial infarction may become a new method,which has different from traditional drug treatment,interventional therapy of cardiovascular disease and surgical intervention.

The application management of surgical instrument is introduced from five aspects including risk control, operation rules, quality inspection and metering management, periodical maintenance and prompt service.

Objective To evaluate endothelium dysfunction of arteries for early preventing atherosis. Methods A new portable device for detection of endothelium dysfunction by photoplethysmographic method was designed, which depended on the principle of reactive hyperaemia. Results Experiments between hypertensive and normotensive showed that different degree endothelium dysfunction had emerged among hypertensive. Conclusion The proposed device has potential benefit to research, diagnosis and therapy evaluation for subclinic arterial disease.