溶栓后血压管理在急性脑梗死治疗中的作用

目的探讨溶栓后血压管理在急性脑梗死治疗中的效果。方法选择2015年3月至2017年3月期间我院收治的急性脑梗死患者90例为研究对象,给予患者实施溶栓治疗,平均分为对照组和观察组,每组患者45例,对照组患者未采用血压管理,观察组患者采用血压管理,对比两组患者管理前后神经功能缺损评分、日常生活能力评分情况。结果管理前,两组患者的神经功能缺损评分、日常生活能力评分进行组间比较,差异无统计学意义(P0.05);管理后,观察组患者的神经功能缺损评分、日常生活能力评分情况改善情况相比于对照组,观察组明显更好,组间比较,差异存在统计学意义(P0.05)。结论急性脑梗死溶栓治疗后应用血压管理效果显著,患者的血压得到有效控制,能够有效的恢复神经功能和日常生活能力,值得推广应用。     

CT指导下急性脑梗死患者的静脉溶栓治疗

目的探讨头颅CT指导下静脉尿激酶溶栓治疗急性脑梗死的临床效果。方法两组患者各60例均常规进行原发病的对症治疗,低分子肝素静注,阿司匹林口服,研究组患者在此基础上,加用CT指导下尿激酶静脉溶栓治疗。结果治疗前两组患者神经功能缺损评分差异无统计学意义(P>0.05),治疗后两组评分均有明显下降(P<0.05),研究组患者治疗后神经功能缺损评分明显低于对照组(P<0.05)。研究组患者治疗总有效率明显高于对照组,数据经统计学比较差异有统计学意义(P<0.05)。结论 CT指导下行尿激酶静脉溶栓治疗急性脑梗死具有较好疗效,可有效改善患者神经功能缺损情况,改善血液动力学,提高患者生活质量。     

阿替普酶静脉溶栓治疗急性脑梗死的临床疗效研究

目的探究阿替普酶静脉溶栓治疗急性脑梗死的临床疗效。方法选择2017年12月至2019年6月本院收治的52例急性脑梗死患者作为研究对象,采用随机数表法分为治疗组和对照组,各26例。对照组采用阿司匹林联合强他汀治疗,治疗组在对照组基础上采用阿替普酶静脉溶栓治疗。比较两组临床疗效、神经功能恢复情况及日常生活能力。结果治疗后,治疗组总有效率为92.31%,高于对照组的69.23%,差异有统计学意义(P<0.05);治疗后,治疗组NIHSS评分为(3.18±2.48)分,低于对照组的(6.68±2.19)分,差异有统计学意义(P<0.05);治疗后,治疗组BI评分(82.45±2.39)分高于对照组(73.65±2.49)分,差异有统计学意义(P<0.05)。结论急性脑梗死患者行阿替普酶静脉溶栓治疗的临床疗效更佳,有助于患者神经功能恢复,提升其日常生活能力,且利于患者预后,值得临床推广应用。     

急性脑梗死尿激酶溶栓治疗后血清尿酸水平变化与梗死体积及神经功能缺损关系

目的探讨急性脑梗死患者溶栓治疗后尿酸水平变化与梗死体积及神经功能缺损的关系。方法 选取急性脑梗死患者59例,按梗死体积分为小体积梗死组(≤5 cm~3),大体积梗死组(>5 cm~3);根据神经功能缺损程度评分分为轻中度损伤组(0～12分),重度损伤组(≥13分),比较不同梗死体积和损伤程度患者溶栓前后尿酸水平变化。结果重度损伤组尿激酶溶栓患者较轻中度损伤组溶栓第2天尿酸水平显著下降,差异有统计学意义(P<0.05);大体积梗死组尿激酶溶栓治疗后较小体积梗死组溶栓第2天尿酸水平明显下降,差异具有统计学意义(P<0.05)。而溶栓后第7天、3个月差异无统计学意义(P>0.05)。结论急性脑梗死溶栓后,梗死体积越大者尿酸水平下降越显著;同时,神经功能缺损程度越高者尿酸水平下降越明显。     

纳洛酮联合尿激酶溶栓治疗急性脑梗死临床观察

目的 探讨纳洛酮在急性脑梗死溶栓治疗前的应用价值.方法 84例急性脑梗死患者溶栓治疗前静脉应用纳洛酮,观察溶栓前后神经功能变化及继发颅内出血的发生率.结果 A组神经功能缺损评分溶栓前后有显著差异(P<0.01),溶栓前(24.50±5.10)分,溶栓后(5.05±3.15)分,而B组溶栓后神经功能无明显改善(P>0.05),溶栓前(23.80±4.10)分,溶栓后(18.65±6.15)分;A组继发颅内出血发生率为7.69%,B组为43.75%,两组有显著差异(P<0.01).结论 静脉应用纳洛酮可作为筛选急性脑梗死溶栓治疗病例的方法.     

硫辛酸在脑梗死rtPA溶栓后的疗效观察

目的 探讨硫辛酸用于重组组织型纤溶酶原激活剂(rtPA)静脉溶栓治疗后的治疗效果.方法 选择2015年1月~2016年10月期间在本院行rtPA溶栓治疗的64例脑梗死患者作为研究对象,随机分为对照组和观察组,各32例.对照组患者常规行rtPA静脉溶栓治疗,观察组在对照组基础上增加硫辛酸治疗,观察两组患者临床疗效,并监测两组神经功能缺损改善情况.结果 观察组临床治疗总有效率为90.63%(29/32),显著高于对照组78.13%(25/32),组间差异具有统计学意义(P<0.05).两组均未见明显不良反应.治疗后,观察组NIHSS评分[(7.25±5.69)分]显著低于对照组[(9.14±6.14)分],组间比较差异具有统计学意义(P<0.05).结论 脑梗死rtPA溶栓后采用硫辛酸治疗可有效提升患者临床疗效,改善神经功能缺损程度良好,有助于改善患者预后,值得推广借鉴.     

阿替普酶治疗急性脑梗死的临床疗效探析

目的观察阿替普酶对急性脑梗死的临床治疗分析疗效及其安全性。方法将58例急性脑梗死患者随机分成治疗组、对照组。治疗组30例使用阿替普酶(rt-PA)静脉溶栓治疗,对照组28例非溶栓治疗。治疗前、后6 h、24 h、7 d两组患者进行神经功能缺损评分比较。结果两种治疗方法比较,神经功能缺损和总有效率差异有统计学意义(P<0.05)。结论阿替普酶治疗急性脑梗死,安全有效并能显著改善患者神经功能缺损症状。     

颈动脉尿激酶超时溶栓治疗急性脑梗死疗效观察

目的观察颈内动脉注射尿激酶超时溶栓治疗急性脑梗死的疗效及安全性。方法对60例急性脑梗死患者随机分为两组,对照组给予常规治疗,治疗组在对照组治疗基础上应用10万IU尿激酶溶入50ml生理盐水中,进行患侧经颈动脉推注溶栓治疗。分别对治疗前后患者神经功能缺损程度进行评定,观察治疗前后两组临床总有效率、显效率。结果两组比较,神经功能缺损评分有显著性差异。治疗组临床总有效率、显效率明显优于对照组,比较差异均有统计学意义(P<0.05或P<0.01)。结论经颈动脉小剂量尿激酶超时溶栓治疗急性脑梗死安全、有效。     

蕲蛇酶注射液治疗急性脑梗死疗效观察

目的研究蕲蛇酶注射液治疗急性脑梗死的效果。方法选取2016年11月～2017年11月期间收治的急性脑梗死者166例,随机分成对照组(仅用常规治疗)83例和观察组(常规治疗加用蕲蛇酶注射液)83例,将两组急性脑梗死患者的临床效果、神经功能缺损程度评分、血液流变学指标和血脂指标、不良反应发生情况进行对比。结果观察组急性脑梗死患者治疗后的临床总有效率为100.00%,两组比较,差异有统计学意义(P0.05);观察组治疗后的NIHSS评分[(2.14±0.57)分]以及血小板聚集率[(47.98±12.25)%]、纤维蛋白原[(3.40±0.71)g/L]、凝血酶原时间[(12.98±0.63)s]、血浆黏度[(1.38±0.40)m Pa·s]、红细胞压积[(44.11±4.32)%]同治疗前比较,差异具有统计学意义(P0.05);观察组治疗后的胆固醇[(3.89±1.30)mmol/L]、甘油三酯[(1.17±1.09)mmol/L]同对照组数据相比,差异无统计学意义(P0.05);两组的不良反应发生率比较,差异无统计学意义(P0.05)。结论蕲蛇酶注射液能够有效改善急性脑梗死患者的血液流变学指标和神经功能,临床效果确切,适合在临床中推广应用。     

丹红注射液治疗急性脑梗死的疗效观察

目的观察丹红注射液治疗急性脑梗死的临床疗效。方法应用丹红注射液治疗急性脑梗死60例,并与对照组(应用复方丹参注射液治疗)60例对比,观察两组治疗前后神经功能缺损程度评分变化并比较疗效。结果14 d后观察治疗组神经功能缺损评分(8.79±5.61)明显低于对照组(11.08±6.42),差异有统计学意义(t=2.345,P<0.05)。治疗组的总有效率(93.3%)与对照组(76.7%)比较,差异有统计学意义(χ2=4.118,P<0.05),且无明显不良反应。结论丹红注射液治疗急性脑梗死安全高效,值得推广应用。     

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.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

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.     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.