尼莫地平治疗蛛网膜下腔出血120例疗效观察

目的：探讨尼莫地平治疗蛛网膜下腔出血的疗效。方法：将120例SAH患者随机分为两组,各60例,治疗组采用尼莫地平持续泵入加口服药物治疗,并与对照组常规治疗进行对比观察。结果：两组治愈率比较,治疗组明显高于对照组,差异有统计学意义（P〈0．01）;治疗组脑血管痉挛（CVS）发生率低于对照组,差异有统计学意义（P〈0．01）;再出血发生率两组比较差异无统计学意义（P〉0．05）;死亡率两组比较差异无统计学意义（P〉0．05）。结论：尼莫地平明显降低SAH后CVS发生率,提高CVS治愈率且无增加再出血的风险,但不能降低SAH后的死亡率。     

不同剂量尼莫通治疗自发性蛛网膜下腔出血后脑血管痉挛的疗效观察与护理

目的：观察不同剂量尼莫通治疗自发性蛛网膜下腔出血（SAH）后脑血管痉挛（CVS）的临床疗效及护理效果。方法：依据使用尼莫通输液剂量的不同，将56例患者分为3组：大剂量18例（1．1～2．0mg／h）。中剂量20例（0．6～1．0mg／h），小剂量18例（0．2～0．5mg／h））；分别观察比较3组疗效。结果：大剂量组与中剂量组疗效明显优于小剂量组（P〈0．05），大剂量组与中剂量组之间疗效差异无统计学意义（P〉0．05）。结论：适当剂量的尼莫通对于自发性蛛网膜下腔出血后的脑血管痉挛有良好的疗效，药物使用过程中临床护理工作尤为关键。     

尼奠地平治疗蛛网膜下腔出血120例疗效观察

目的：探讨尼莫地平治疗蛛网膜下腔出血的疗效。方法：将120例SAH患者随机分为两组,各60例,治疗组采用尼莫地平持续泵入加口服药物治疗,并与对照组常规治疗进行对比观察。结果：两组治愈率比较,治疗组明显高于对照组,差异有统计学意义（P〈0．01）;治疗组脑血管痉挛（CVS）发生率低于对照组,差异有统计学意义（P〈0．01）;再出血发生率两组比较差异无统计学意义（P〉0．05）;死亡率两组比较差异无统计学意义（P〉0．05）。结论：尼莫地平明显降低SAH后CVS发生率,提高CVS治愈率且无增加再出血的风险,但不能降低SAH后的死亡率。     

尼莫通预防和治疗珠网膜下腔出血后脑血管痉挛60例的临床观察

目的：探讨尼莫通预防和治疗蛛网膜下腔出血（SAH）后脑血管痉挛（CVS）引起的缺血性神经功能障碍的价值。方法：对照组30例,入院后给预6－氨基已酸等抗溶药降低颅内压力及一般对症治疗,治疗组60例,加用尼莫通每日10mg,用微量静脉输液泵,静脉序贯给药5－10天,后口服至21天的治疗方法,结果：2周内临床症状体征缓解消失率尼莫通组高于对照组,P＜0．05,1月后致残,致死率对照组高于尼莫通组,P＜0．01。结论：尼莫通能降低SAH病人延迟性缺血性神经功能障碍的发生和病死率,尼莫通治疗SAH有明显效果。     

脑脊液置换疗法治疗蛛网膜下腔出血并发脑血管痉挛疗效分析

目的：探讨脑脊液置换疗法治疗蛛网膜下腔出血（SAH）并发脑血管痉挛（CVS）的临床效果。方法：选取我院收治的SAH并发CVS忐者98例,随机分为观察与对照两组,观察组在常规治疗的基础上配合进行腰椎穿刺进行脑脊液置换疗法治疗,对照组采用常规治疗,对比两组患者治疗效果。结果：观察组治疗后神经功能缺损评分改善显著优于对照组,组间比较差异显著（P〈0．05）;卉疗组死亡率显著低于对照组（P〈0．05）。结论：在常规治疗基础上配合腰椎穿刺置换脑脊液疗法治疗SAH并发CVS,疗效确切,能明显缩短疗程,降低致残率,是治疗SAH并发CVS的有效治疗方案。     

尼莫地平治疗高血压蛛网膜下腔出血疗效观察

目的：探讨针对高血压蛛网膜下腔出血（ SAH）患者,选择尼莫地平完成治疗后的临床效果。方法：选取我院2012年3月～2014年3月高血压SAH患者100例。通过随机数表法将所有高血压SAH患者分为A1组（观察组50例）与A2组（对照组50例）。针对A2组患者,选择常规治疗的方法。针对A1组患者,选择常规治疗＋尼莫地平持续泵入的方法给予临床治疗。对比A1组与A2组高血压SAH患者完成治疗后的效果表现。结果：在临床出现CVS（脑血管痉挛）概率方面,A1组低于A2组患者非常明显（P＜0．05）;在临床出现再出血概率方面,组间无显著差异（P＜0．05）;在临床治愈率方面,A1组高于A2组患者极为明显（P＜0．05）;在临床患者死亡率方面,A1组低于A2组患者明显（P＜0．05）。结论：针对高血压SAH患者,选择尼莫地平给予临床治疗后,在降低临床出现脑血管痉挛概率以及再出血概率等方面,表现出显著的意义,患者的临床治愈率表现为明显增高,成功凸显临床应用价值。     

自由基、脑血液速度与蛛网膜下腔出血后脑血管痉挛关系的探讨

目的：探讨自由基、脑血流速度与网膜下腔出血后脑血管痉挛的关系,方法：对28例蛛网膜下腔出血（SAH）患者及39例健康人进行血自由基（TAO、MDA）和经颅多普勒（TCD）超声检测。结果：与对照组相比,病人组TAO、MDA显著升高,且均不同和蔼的脑血管痉挛（CVS）、结果：SAH后血自由基明显升高,是导致CVS的重要因素,CVS的产生促使脑血管内血流速度异常加快。     

经造影导管注入血管内应用尼莫地平治疗脑血管痉挛临床研究

目的：观察与研究经造影导管注入血管内应用尼莫地平治疗脑血管痉挛的效果。方法：随机选取60例行全脑数字减影血管造影（ DSA ）检查或是脑血管疾病介入栓塞治疗（规范化操作下）时出现脑血管痉挛（ CVS ）的蛛网膜下腔出血（ SAH ）者,且将其随机分为治疗组和对照组（每组30例）,其中治疗组经造影导管注入血管内应用尼莫地平、对照组给予传统的3H疗法,由专人分析与研究两组治疗效果等。结果：治疗组总有效率（100．00％）高于对照组,住院时间较对照组缩短;且在前3d,对照组患者大脑中动脉血流速度明显快于对照组（ P＜0．05）;第4天时,两组无明显差异,治疗组血压无明显变化（ P＞0．05）;生活质量评分优于对照组（ P＜0．05）。结论：经造影导管注入血管内应用尼莫地平能有效防治蛛网膜下腔出血时的脑血管痉挛,值得推广。     

实验性大鼠蛛网膜下腔出血后病理观察

在既往研究大鼠蛛网膜下腔出血（SAH）后局部脑血流量（rCBF）变化的基础之上，进一步观察SAH后颅底血管痉挛状态和结构变化、血脑屏障（BBB）开放及脑水肿过程．发现SAH后颅底动脉出现间期为72h的痉挛过程，rCBF变化与之有显著的相关性（r＝0．93，P＜0.01）；SAH后早期血管壁呈现强烈的收缩，无血管壁结构变化，晚期在血管壁扩张过程中有部分内皮细胞脱落，弹力膜断裂和平滑肌细胞退性变；SAH后早中期出现轻度BBB通透性增加和脑水肿，二者之间有显著的相关性（r＝0．92，P＜0．01）；BBB通透性改变与血管痉挛有显著的负相关关系（r＝－0．84，p＜005）．这些结果提示：SAH后rCBF变化是反映脑血管痉挛（CVS）状态的较好功能指标；SAH后CVS主要是由脑血管收缩功能改变所致而非血管壁结构改变所致；SAH后出现轻度的BBB开放和血管源性脑水肿，主要是由于CVS引起，但也可能间接部分地影响CVS过程。     

尼莫地平治疗蛛网膜下腔出血后脑血管痉挛的临床分析

目的探索尼莫地平治疗蛛网膜下腔出血后脑血管痉挛（CVS）患者的临床效果。方法2010年12月至2012年12月收治蛛网膜下腔出血后CVS患者60例。将患者按照随机数字表法分为两组,对照组25例采用常规止血、脱水、对症治疗,观察组35例在对照组基础上加用尼莫地平0．5μg·kg^-1·min^-1静脉滴注,每日2次,连用10d,后改尼莫地平片剂40mg,每日4次,连用1个月。治疗前后采用多普勒进行检查,观察两组患者CVS发生率及疗效。结果经积极治疗1个月后,观察组痊愈13例,有效18例,无效4例,总有效率为88．57％;对照组痊愈8例,有效9例,无效8例,总有效率为68．00％,观察组总有效率较对照组有所提高,但差异无统计学意义（P〉0．05）。经颅多普勒检测结果,观察组治疗后大脑前、中动脉的收缩峰流速较对照组明显降低（P均〈0．05）;CVS发生率显著低于对照组（11．43％vs44．00％,P〈0．05）,再出血率也低于对照组（2．86％vs24．0HD％,P〈0．05）。结论尼莫地平治疗蛛网膜下腔出血后CVS患者的临床效果显著。     

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.     

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     

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.     

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.