中西医结合治疗异位妊娠

目的观察MTX、Ru486及中药三联用药治疗未破裂型异位妊娠的临床疗效及中药在治疗中发挥的作用。方法对40例未破裂型异位妊娠病人,按药物治疗方法不同分为两组进行对照研究：治疗组使用Ru486口服、MTX单次静注、中药联合治疗;对照组单独使用Ru486口服、MTX单次静注治疗。定期测定两组病人血HCG值以监测血HCG下降情况,测量异位妊娠包块三径线值以监测病灶包块缩小情况,同时观察临床症状持续时间、副作用发生率及总有效率。、结果血HCG下降治疗组较对照组明显,差异有显著性;临床症状持续时间治疗组较对照组短,差异有显著性;副作用发生率两组间有显著差异;包块缩小程度两组无显著性差异;两组的总有效率均为95%,差异无显著性．结论三联药物中活血化瘀、消包块杀胚的中药既有助于消除症状,又能减轻副作用,保留生育功能。     

甲氨蝶呤加米非司酮及中药三联治疗异位妊娠的临床研究

目的观察甲氨蝶呤（MTX）加米非司酮（Ru486）及中药三联治疗异位妊娠的临床疗效。方法确诊为异位妊娠的住院病人173例。（1）按用药方法不同随机分为2组：A组使用MTX20mg肌内注射（连用5d），同时口服Ru486片剂（50mg／d，连服3d）及中药联合治疗；B组仅使用MTX20mg肌内注射（连用5d），分别记录血13-HCG下降水平及包块缩小程度、临床症状持续时间、治愈率以副反应发生率；（2）按血13-HCG高低将A组患者随机分为甲、乙、丙3组，分别记录治愈率以及副反应发生率。结果（1）血B—HCG下降水平及包块缩小程度A组较B组明显，差异有显著性（P〈0．05）；临床症状持续时间A组较B组明显缩短。差异有显著性（P〈0．05）；治愈率A组较B组明显增高，差异有显著性（P〈0．05）；副反应发生率A、B2组无显著性差异（P〉0．05）。（2）A组中，甲与乙治愈率比较无显著差异（P〉0．05），乙与丙、甲与丙治愈率差异有显著性（P〈0．05）；3组副反应发生率比较无统计学差异（P〉0．05）。结论MTX加Ru486及中药三联用药治疗异位妊娠治愈率高，不增加副反应发生率，同时扩大了异位妊娠保守治疗适应证的范围。     

三联药物治疗异位妊娠临床观察

目的探讨药物保守性治疗异位妊娠的最佳治疗方案。方法分别采用米非司酮（Ru486）、氨甲蝶呤（MTx）以及两药物结合再加以中药活血化瘀三联药物治疗84例异位妊娠，随机分成三个治疗组进行临床观察。结果Ru486和MTX分别单用保守性治疗时成功率为75％和82．1％；两者联合再辅以中药活血化瘀称三联药物治疗，成功率上升达92．9％，HCG转阴时间及附件包块消失时间联合组均较单一组短，有显著性差异（P〈0．05）。结论米非司酮（Ru486）、氨甲蝶呤（MTX）12．2中药三联药物保守性治疗异位妊娠疗效确切，较单一用药快捷、成功率高。     

保守治疗异位妊娠两种方法效果比较

目的:探讨甲氨蝶呤(MTX)单次肌注配伍米非司酮和甲氨蝶呤多次肌注保守治疗异位妊娠的效果比较。方法:A组:MTX(50mg/m2)单次肌注并口服米非司酮,B组MTX0.4mg.kg-1.d-1肌注,5d一疗程,定期监测血β-HCG水平,B超监测包块缩小情况。结果:A组成功率90%,B组成功率85%,两组对照,A组明显缩短血-βHCG降至正常所需时间、减少住院天数、异位妊娠包块缩小明显(P<0.01)。结论:两种方法比较,MTX配伍米非司酮治疗异位妊娠疗效好,副反应少,值得临床推广。     

米非司酮配伍甲氨蝶呤保守治疗异位妊娠疗效分析

目的探讨米非司酮配伍甲氨蝶呤保守治疗异位妊娠的疗效。方法将108例患者随机分为口服米非司酮（Ru486）治疗组（A组），肌注甲氨蝶呤治疗组（B组）及米非司酮和甲氨蝶呤联合治疗组（C组）进行对比分析。三组在年龄、孕龄、治疗前血β-HCG值和异位妊娠包块直径等差异无显著性（P〉0．05）。结果三组治疗成功率分别为63．89％（A组）、61．76％（B组）、92．11％（C组）。结论米非司酮与甲氨蝶呤联合治疗异位妊娠疗效高、方法简单，可作为保守治疗的首选治疗方案。     

氨甲喋呤联合米非司酮治疗异位妊娠疗效观察

目的 :探讨氨甲喋呤 (MTX)与米非司酮 (RU486 )联合治疗异位妊娠的疗效。方法 :A组用 MTX每次 5 0 m g/ m2 ,每天 1次 ,治疗 1d,B组用 MTX5 0 mg/ m2 ,每天 1次 ,治疗 1d,RU486 ,15 0 m g/ d,连用 2 d。每周测定血、尿 HCG判断治疗效果。结果 :A组治疗成功率为 78.6 % ,B组成功率为 83.3% (P >0 .0 5 ) ;当附件区包块在 3～ 6 cm、HCG>2 0 0 0 IU/ L,B组治疗成功率高于 A组 (P <0 .0 5 ) ;B组尿 HCG转阴时间较 A组短 (P <0 .0 5 )。结论 :MTX联合 RU486治疗异位妊娠 ,HCG下降快 ,住院时间短 ,在附件区包块大且 HCG水平高的病例中治愈率高于单独使用 MTX。     

甲氨蝶呤联合米非司酮治疗异位妊娠的疗效观察

目的:观察甲氨蝶呤(MTX)联合米非司酮治疗输卵管妊娠的疗效.方法:A组28例患者应用MTX单次肌内注射并口服米非司酮药物治疗为观察组;B组28例患者MTX(50mg/m2)单次肌内注射为对照组.两组均于用药后d5监测血β-HCG水平及阴道B超监测包块情况直至正常.结果:两组成功率分别为84.6%,73.7%,两组在年龄、孕龄、治疗前血HCG值和异位妊娠包块直径间差异无显著性(P＞0.05).A组较B组明显缩短血HCG降至正常所需的时间,减少住院日(P＜0.01).结论:MTX单次肌内注射联合米非司酮治疗输卵管妊娠的疗效好,值得推广.     

甲氨喋呤与米非司酮联合中药治疗异位妊娠的临床研究

目的 探讨甲氨喋呤(MTX)与米非司酮(Ru486)联合中药治疗异位妊娠的效果.方法 124例未破裂型异位妊娠患者随机分为观察组和对照组各62例,观察组采用MTX和Ru486联合中药治疗,对照组给予MTX和Ru486治疗,比较观察两组的临床疗效及副反应.结果 观察组第一疗程有效率、总有效率、血β-HCG恢复正常时间、平均住院时间、包块消失时间、输卵管通畅率均优于对照组,差异有统计学意义(P＜0.05);观察组副反应发生率少于对照组(P＜0.05).结论 MTX与Ru486联合中药治疗异位妊娠,方法 简便,疗效高,疗程短,副作用小,患者易于接受,值得临床推广应用.     

中药在异位妊娠保守治疗中的疗效观察

目的：观察用中药联合甲氨蝶呤（MTX）及米非司酮治疗异位妊娠的效果。方法：A组,MTX单次肌注并口服米非司酮及中药,B组,MTX单次肌注并仅口服米非司酮,比较两组的治疗效果。结果：A组治愈率为95．9％,B组为54．1％;A组与B组比较,血β—HCG降至正常所需的时间明显缩短,包块缩小快,再次宫内妊娠率高,两组间差异有统计学意义（P〈0．05）。结论：在传统的MTX等药物保守治疗异位妊娠中加服中药可促进疗效,提高再次宫腔妊娠率,减少MTX的重复用量而减轻药物毒副作用,值得推广。     

异位妊娠保守治疗112例疗效分析

目的：研究甲氨蝶呤（MTX）联合米非司酮（Ru486）在异位妊娠保守治疗中的效果及适应证的选择。方法：回顾性分析确诊异位妊娠病例临床资料。结果：治愈率A组82．69％,B组88．33％。两组差异无统计学意义。保守治疗成功率与β-HCG相关。B组血β—HCG下降至正常所需的时间及住院时间明显较A组缩短（P〈0．05）。结论：两种方法治疗异位妊娠成功率相同,成功率与β-HCG相关。MTX配伍米非司酮治疗有协同作用,可以提高治疗效果,值得推广。     

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.