黄芪治疗老年人原发性肾病综合征的初步报告

探讨中药黄芪治疗老年人原发性肾病综合征的疗效。对比观察了单用糖皮质激素（Ｉ组）与激素＋黄芪（Ⅱ组）治疗老年人（年龄≥６０岁）肾病综合征的临床疗效。结果Ⅱ组的完全缓解率和总有效率为４２％和６７％,显著高于１组的１７％和４２％（Ｐ＜０．０５）。而Ⅱ组的复发率仅８％,明显低于Ⅰ组３３％（Ｐ＜０．０５）。提示在常规糖皮质激素治疗的基础上加用黄芪治疗老年人原发性肾病综合征可明显提高疗效,减少复发。     

联用雷公藤多甙治疗儿童紫癜性肾炎的临床疗效观察

目的：对雷公藤多甙、复方丹参片加皮质激素联合治疗儿童紫癜性肾炎进行疗效分析。方法：将２１例患者随机分为对照组和治疗组,治疗组用雷公藤多甙、复方丹参片、强的松联合治疗,对照组单用强的松治疗,观察临床表现实验检测指标及不良反应。结果：治疗组临床治愈率为２０％,总有效率为９０％,对照组总有效率４５．５％,两者有显著性差异（Ｐ＜０．０１）。结论：雷公藤多甙、复方丹参片、糖皮质激素联合治疗紫癜性肾炎疗效显著,值得推广。     

血管紧张素Ⅱ加压化疗治疗恶性实体瘤53例临床及实验分析

本文共治疗恶性实体瘤１０４例，其中血管紧张素Ⅱ（ＡＴ－Ⅱ）加压化疗组５３例，静脉化疗组５１例。对两组病例各１０例于用药后以同位素方法检测了肿瘤组织、血、尿内的药物浓度。结果显示：加压化疗组肿瘤组织内抗癌药物浓度是静脉化疗组的２．６３倍（Ｐ＜０．０１）。血药浓度维持时间长，肾脏药物排泄量明显低于静脉化疗组（Ｐ＜０．０５）。临床疗效：加压化疗组的完全缓解率为６７．９％（３６１５３），３年存活率为５８．８％（２０／３４），静脉化疗组分别为４９％（２５／５１），３４．４％（１１／３２）。两组差异显著（均为Ｐ＜０．０５）。本结果表明ＡＴ－Ⅱ加压化疗对恶性实体瘤的局部强化治疗有相当的实用价值。     

持续性不卧床腹膜透析腹膜炎治疗新方案

为了比较两种不同治疗方案对持续性不卧床腹膜透析（ＣＡＰＤ）腹膜炎的疗效，我们研究４１例ＣＡＰＤ腹膜炎，其中２０例（Ａ组）用新方案治疗，２１例（Ｂ组）用以往常规方案治疗。两组的疗效明显不同，表现为Ａ组治愈率较Ｂ组高（９４．０％比７８．６％，Ｐ＜０．０５）；腹膜炎持续时间较Ｂ组短（２．８±１．６天比４．０±２．０天，Ｐ＜０．０５）；腹膜炎复发率较Ｂ组低（１５９±９８．８天比９８±９９．６天，Ｐ＜０．０５）；治疗失败率较Ｂ组低（６．０％比２１．４％，Ｐ＜０．０５）。研究证明：新方案治疗ＣＡＰＤ腹膜炎疗效优于以往的常规治疗方案。     

雷公藤多甙对哮喘豚鼠炎症的抑制作用

目的：通过哮喘豚鼠模型研究雷公藤多甙（ｔｒｉｐｔｅｒｙｇｉｕｍｐｏｌｙｇｌｙｃｏｓｉｄｅ，ＴⅡ）对哮喘豚鼠炎症的抑制作用。方法：用卵白蛋白诱发致敏豚鼠哮喘发作，同时进行ＴⅡ与地塞米松（ｄｅｘａｍｅｔｈａｓｏｎｅ，ＤＥＸ）的对照治疗，观察豚鼠支气管－肺泡灌洗液（ＢＡＬＦ）中细胞学、肺组织病理及超微结构的变化。结果：豚鼠诱发哮喘后２４ｈ和７２ｈＢＡＬＦ中炎性细胞、嗜酸细胞总数及其分类计数的结果显示，哮喘组较正常对照组明显增多，而ＴⅡ和ＤＥＸ治疗组尤其是ＴⅡ大剂量组则明显减少，与正常对照组比无显著差异（Ｐ＞０．０５），与哮喘组比有明显差异（Ｐ＜０．０５）。组织形态学也显示ＴⅡ对哮喘豚鼠迟发性哮喘反应有明显的抑制作用。结论：ＴⅡ对哮喘豚鼠炎症有明显的抑制作用。     

尿激酶治疗糖尿病性周围神经病变42例疗效观察

以尿激酶治疗４２ 例糖尿病性周围神经病变患者，与１８ 例糖尿病性周围神经病变患者静滴生理盐水为对照进行疗效对比观察，总有效率尿激酶组为９２ ．８ ％ ，对照组为２７ ．８ ％ （ Ｐ ＜ ０ ．００５） 。两组患者治疗后生化指标的变化比较，胆固醇（ｃｈ） 变化无差异性（ Ｐ ＜ ０ ．０５） ，而甘油三脂（ Ｔ Ｇ） 高密度脂蛋白胆固醇（ Ｈ Ｏ Ｌ－ ｃｈ） 与空腹血糖（ Ｆ Ｂ Ｇ） 的变化均差异显著（ Ｐ ＜０ ．０１ 、 Ｐ ＜ ０ ．０５ 、 Ｐ ＜ ０ ．０１） 。在治疗过程中全部病例均未有出血和过敏现象。     

他巴唑与强的松合用对Graves病甲状腺功能及自身抗体的影响

目的：探讨他巴唑与强的松合用对Ｇｒａｖｅｓ病（ＧＤ）甲状腺功能及自身抗体的影响。方法：选择初诊的ＧＤ６７例,随机分成两组。治疗组给予他巴唑和强的松各 １５ ｍｇ／ｄ,对照组他巴唑 １５ ｍｇ／ｄ,均于上午８时顿服。结果：治疗４周及８周后Ｔ３、Ｔ４同时正常者：治疗组分别为２７例和３５例（７７．１４％、１００％）;对照组分别为１５例和２４例（４７％、７５％）,差异显著（Ｘ２＝６．５４７,Ｐ＜０．０２５; Ｘ２＝９．９３６,Ｐ＜０．００５）。Ｔ３、Ｔ４恢复正常所需时间治疗组为４．９１±１．７０周;对照组为７．０１±３．３２周,两组比较差异显著（Ｐ＜０．００５）。治疗３个月及１２个月后,ＴＧＡｂ、ＴＭＡｂ及ＴＲＡｂ抑制率明显高于对照组（ Ｐ均＜ ０． ０５）。结论：他巴唑与强的松联合应用疗效优于单用他巴唑。     

雷公藤多甙和丙酸倍氯米松治疗激素依赖性哮喘的临床观察

３０例激光依赖軎才喘随机分为治疗组和对照组，治疗组口服雷公藤多甙和吸入丙酸倍氯米松，对照组吸入ＢＤＰ，结果表明，治疗组撤减口服激素成功率８６．６７％，对照组为４０．０％（Ｐ〈０．０５），两组病人治疗前后ＰＥＦＲ均有明显好转（Ｐ〈０．０１），血皮质醇浓度较治疗前提高（Ｐ〈０．０１），治疗组皮质醇升高较对照组尤为显著（Ｐ〈０．０５），提示雷公藤多甙与ＢＤＰ联合用药是治疗激素依赖型哮喘的较好方法。     

中西医结合治疗硫脲类药致白细胞减少的甲亢30例临床观察

将１６０例硫脲类药物所致白细胞减少的甲亢患者随机分为治疗组（中西医结合治疗）和对照组（西药治疗）。结果表明：治疗组合与对照组总有效率分别为９６．８％和８６．２％，有显著性差异（Ｐ〈０．０５）；两组Ｈｂ、ＷＢＣ、ＰＬＴ均有不同程度升高，但治疗组组与对照组比较有显著性差异（Ｐ〈０．０５）；治疗组甲状腺ＴＣＡｂ、甲状腺ＴＭＡｂ，转阴率与对照组有显著性差异（Ｐ〈０．０１），对肝郁血虚型疗效较好，气阴两虚型     

凉血解毒化瘀汤治疗高黄疸型肝炎48例

对４８例高黄疸型肝炎住院病人用凉血解毒化瘀汤治疗并与甘露消毒丹组对照，结果：凉血解毒化瘀汤治疗重症肝炎的疗效明显优于对照组（Ｐ＜０．０１）；黄疸消退天数治疗组与对照组分别为３８．１天±１１．２天，４９．８天±１３．９天；总有效率分别为８７．５％，６８．１％（Ｐ＜０．０５）；凉血解毒化瘀汤和甘露消毒丹对急性黄疸型肝炎和瘀胆型肝炎的疗效无显著性差异（Ｐ＞０．０５）。     

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.     

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.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.