颅内压控制下持续腰大池引流治疗19例外伤性蛛网膜下腔出血疗效观察

目的探讨颅内压控制下持续腰大池引流对蛛网膜下腔出血的治疗效果。方法19例外伤性蛛网膜下腔出血（traumatic subarachnoid hemorrhage，t—SAH）患者作为治疗组，实行颅内压控制下持续腰大池引流置换脑脊液，同时对16例患者采用腰穿引流脑脊液作为对照组，通过观察蛛网膜下腔积血的清除时间及脑脊液生化检测蛋白变化情况，头痛缓解时间、再出血、脑积水等并发症的例数及治疗结果判断两者之间的差别。结果蛛网膜下腔积血清除时间治疗组比对照组快（P〈0．05）；脑脊液蛋白正常时间治疗组比对照组快（P〈0．05）；头痛缓解时间治疗组比对照组快（P〈0．05）；并发症的发生率及患者的治疗结果两组无明显区别（P〉0．05）。结论采用颅内压控制下持续腰大池引流脑脊液治疗外伤性蛛网膜下腔出血疗效优于腰穿脑脊液置换术。     

辛伐他汀联合尼莫地平治疗蛛网膜下腔出血的临床观察

目的探讨辛伐他汀联合尼莫地平对蛛网膜下腔出血（SAH）的治疗作用。方法将96例原发性SAH患者随机分为治疗组和对照组,对照组给予常规治疗,治疗组在常规治疗基础上给予辛伐他汀联合尼莫地平治疗。比较两组患者神经功能缺损情况和脑血管痉挛、脑积水、再出血的发生率及病死率。结果治疗组较对照组患者神经功能缺损评分、脑血管痉挛、脑积水发生率及病死率明显降低（P〈0．05）,而再出血与对照组比较差异无统计学意义（P〉0．05）。结论辛伐他汀联合尼莫地平能明显改善SAH患者的神经功能,同时可以减少SAH后脑血管痉挛和脑积水的发生,降低病死率。     

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。     

辛伐他汀治疗蛛网膜下腔出血临床观察

目的探讨辛伐他汀治疗蛛网膜下腔出血（SAH）的临床效果。方法随机将本院蛛网膜下腔出血病人76例分为两组，治疗组40例，对照组36例，两组在性别、年龄上无显著差异；对照组予以解痉、止血、输液等一般治疗，治疗组在对照组基础上予以辛伐他汀20mg，口服，1次／日。比较两组患者脑血管痉挛、脑积水和再出血的发生率以及死亡率。结果TCD观察脑血管痉挛发生率，治疗组较对照组有显著差异（P〈0．05）；脑积水发生率治疗组较对照组有显著差异（P〈0．05）；再出血率与死亡率两组比较无显著差异（P〉0．05）。结论辛伐他汀治疗SAH有显著疗效，可减少SAH后脑血管痉挛、脑积水的发生。     

脑脊液置换治疗蛛网膜下腔出血60例临床观察

目的：观察脑脊液置换疗法治疗蛛网膜下腔出血（SAH）的有效性及安全性。方法：将117例SAH随机分为60例治疗组和57例对照组。两组入院后均给予常规药物治疗，治疗组在常规药物治疗的基础上于入院当日起给予腰椎穿刺并留置引流导管。每日用生理盐水置换脑脊液两次，每次循环置换15～25ml，连续5-7d。结果：治疗组较对照组临床症状持续时间、症状缓解程度、并发症的发生率及病死率均明显减低。治疗组总有效率为88％，对照组总有效率74％，两组比较有差异显著性（P〈0．05）。结论：脑脊液置换术为SAH急性期治疗的有效手段之一，且简便、安全、易操作。     

脑脊液置换治疗对蛛网膜下腔出血患儿预后的影响

目的:探讨脑脊液置换治疗对蛛网膜下腔出血(SAH)患儿预后的影响。方法:将55例小儿SAH患者据家属意愿选择脑脊液置换治疗(观察组)30例,未采用置换治疗(对照组)25例,对比两组预后指标。结果:两组预后等级差异无统计学意义(P>0.05),观察组0~2级比重56.67%(17/30),对照组0~2级比重44.00%(11/25),两组差异无统计学意义(P>0.05);观察组迟发出血1例,脑积水1例,癫痫1例;对照组迟发出血2例,脑血管痉挛2例,脑积水3例,癫痫1例。两组差异无统计学意义(P>0.05);观察组昏迷患者清醒时间、治疗后神经功能缺损评分、住院时间低于对照组(P<0.05)。结论:脑脊液治疗SAH,并不能改善远期患儿预后,但可缩短住院时间,减轻早期神经功能缺损,缩短昏迷的时间。     

蛛网膜下腔出血脑脊液置换疗法36例疗效观察

目的：探讨脑脊液置换术治疗蛛网膜下腔出血的临床效果。方法：36例蛛网膜下腔出血患者随机分为治疗组及对照组各18例。治疗组在常规治疗的基础上进行脑脊液置换术治疗,对照组的常规治疗。结果：治疗组治疗有效率与对照组有明显的差异（P〈0．05）。治疗组中表现不同意识障碍者3例,经置换2～3次最短在5天内意识恢复正常,对照组意识障碍8例,意识障碍恢复8～15天,两组比较有显著差异。在脑血管痉挛、脑积水、脑梗死这SAH三大并发症中,治疗组与对照组比较,均有显著的差异。结论：脑脊液置换术治疗蛛网膜下腔出血,能减少脑血管痉挛,脑积水,脑梗死等并发症,有利于患者恢复,操作简单易行、安全,疗效显著,值得推广。     

脑脊液置换加鞘内注射治疗蛛网膜下腔出血

目的 探讨腰椎穿刺脑脊液置换术治疗原发性蛛网膜下腔出血（SAH）的疗效及临床应用价值.方法 对51例SAH患者随机分成两组,在对照组的治疗基础上,治疗组加用脑脊液置换加鞘内注射,对比分析两组疗效及并发症的发生.结果 治疗组的疗效明显高于对照组（P＜0.01）,脑血管痉挛（CVS）、再出血、脑积水等并发症的发生率低于对照组（P＜0.01）.结论 脑脊液置换加鞘内注射治疗SAH,安全有效,并能降低各种并发症的发生,降低致残率及病死率.     

脑脊液持续外引流联合鞘内注入尿激酶防治动脉瘤术后脑血管痉挛的临床研究

目的探讨腰池置管脑脊液持续外引流联合应用小剂量尿激酶鞘内注射对动脉瘤性蛛网膜下腔出血（SAH）患者术后症状性脑血管痉挛（Symptomatic Vasospasm）发生的预防作用和对预后的影响。方法对经DSA、CT、手术证实的40例动脉瘤性SAH患者，手术后用腰池置管脑脊液（CSF）持续外引流联合鞘内注入尿激酶（UK）治疗，并与对照组35例进行比较。结果治疗组症状性脑血管痉挛的发生率明显地降低，与对照组比较差异显著（P〈0．05）。随访6个月后总体预后亦明显好于对照组（P〈0．05），且未增加再出血率。结论应用腰池置管脑脊液持续外引流联合应用小剂量尿激酶鞘内注射。可较好地预防SAH患者术后脑血管痉挛等并发症的发生并改善预后，同时又不会增加再出血的危险性。     

脑脊液置换术治疗蛛网膜下腔出血疗效观察

目的探讨腰穿脑脊液置换术对蛛网膜下腔出血（SAH）疗效及临床应用价值。方法以51例SAH患者为研究对象,随机分为治疗组（26例）和对照组（25例）。对照组为常规内科治疗,治疗组在常规治疗基础上应用腰穿脑脊液置换术。结果治疗组头痛持续时间、脑膜刺激征症状消失时间及脑脊液恢复正常时间较对照组缩短,差异具有统计学意义（P〈0．01）;急性脑积水、脑血管痉挛、死亡率明显降低,经统计学处理差异有显著性（P〈0．05）。结论腰穿脑脊液置换术治疗蛛网膜下腔出血安全有效,可减少并发症及死亡率。     

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.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

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.