参芪强心胶囊对慢性心力衰竭患者心功能及细胞因子的影响

目的观察参芪强心胶囊对慢性心力衰竭(CHF)患者心功能及血浆N端前脑钠肽(NT-pro BNP)与肿瘤坏死因子(TNF-α)水平的影响。方法把80例心衰患者随机分为对照组、治疗组。对照组常规抗心力衰竭治疗,治疗组加服参芪强心胶囊,2组疗程均为4周。观察两组临床疗效、左室收缩末期容积(LVESV),左室舒张末期容积(LVEDV)、左室射血分数(LVEF),检测治疗前后血浆NT-pro BNP、TNF-α水平。结果治疗组加用参芪强心胶囊后临床症状、左室收缩末期容积(LVESV),左室舒张末期容积(LVEDV)、左室射血分数(LVEF)、血浆N端前脑钠肽(NT-pro BNP)与肿瘤坏死因子(TNF-α)比治疗前明显改善,且明显优于对照组,并有显著性差异(P<0.05)。对照组治疗后临床疗效、左室收缩末期容积(LVESV),左室舒张末期容积(LVEDV)、左室射血分数(LVEF)、血浆N端前脑钠肽(NT-pro BNP)与肿瘤坏死因子(TNF-α)也有明显改善(P<0.05)。结论参芪强心胶囊治疗心衰能改善心衰患者临床疗效并降低左室收缩末期容积(LVESV),左室舒张末期容积(LVEDV)、血浆N端前脑钠肽(NT-pro BNP)与肿瘤坏死因子(TNF-α)水平,提高心衰患者左室射血分数(LVEF),改善左室功能。     

参麦注射液联合比索洛尔治疗冠心病心力衰竭的疗效观察

目的:观察参麦注射液联合比索洛尔治疗冠心病心力衰竭的临床疗效。方法:选取我院2014年8月-2016年8月就诊的100例冠心病心力衰竭患者,随机分为观察组(参麦注射液+比索洛尔)和对照组(常规治疗)各50例。对比两组左心室收缩末期容积(LVESV)、左室射血分数(LVEF)、左心室舒张末期容积(LVEDV)。结果:观察组总有效率显著高于对照组(P0.05)。治疗前两组LVEDV、LVESV和LVEF比较,差异无统计学意义(P0.05)。治疗后两组LVEDV、LVESV和LVEF与治疗前比较,差异均具有统计学意义(P0.05)。且观察组LVEDV和LVESV均显著小于对照组(P0.05),LVEF显著高于对照组(P0.05)。结论:冠心病心力衰竭应用参麦注射液联合比索洛尔治疗效果显著,可有效改善患者心功能,值得临床推广。     

比索洛尔对左心室射血分数保留的心力衰竭患者神经内分泌因子的影响

目的:探析左心室射血分数保留的心力衰竭患者应用比索洛尔疗法对其神经内分泌因子的影响。方法:选择2013年6月-2016年4月本院收治的左心室射血分数保留的心力衰竭患者90例,根据随机数字表法分为对照组和观察组,每组45例,对照组进行利尿剂、醛固酮受体拮抗剂、血管紧张素Ⅱ受体拮抗剂或血管紧张素转化酶抑制剂联合治疗,观察组在此基础上加用5~10 mg/d比索洛尔,两组均治疗14 d。比较两组治疗前后的左心室射血分数(LVEF)、左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)、左室舒张末期内径(LVEDd)等心功能指标情况;比较两组治疗前后超敏C反应蛋白(hs-CRP)、内皮素(ET)、肿瘤坏死因子-α(TNF-α)、血栓烷B2(TXB2)、白介素-6(IL-6)、嗜铬粒蛋白A(CGA)、瘦素(LP)、心房钠尿肽(ANP)、B型尿钠肽(BNP)等神经内分泌因子水平的变化;比较两组治疗后的不良反应的发生情况。结果:观察组治疗后的LVEF、LVEDV、LVESV、LVEDd等心功能指标显著优于对照组,差异均有统计学意义(P0.05);两组治疗后的hs-CRP、ET、TNF-α、TXB2、IL-6、CGA、LP、ANP、BNP等神经内分泌因子指标均有改善,但观察组治疗后的各项指标均显著优于对照组,差异均有统计学意义(P0.05)。结论:左心室射血分数保留的心力衰竭患者进行比索洛尔疗法,可显著改善患者的神经内分泌因子和心功能指标水平,临床效果确切,安全性高,值得临床推广。     

贝那普利联合美托洛尔对慢性心力衰竭患者的影响

目的 分析贝那普利联合美托洛尔对慢性心力衰竭(CHF)患者左心重构与B型尿钠肽(BNP)水平的影响。方法 前瞻性选择医院2019年1月至2021年1月诊治的CHF患者120例。采用计算机随机数分组法将患者等分为对照组和观察组,60例/组。对照组口服贝那普利治疗,观察组口服贝那普利联合美托洛尔治疗。比较2组左室重构指标[左室舒张末期内径(LVEDD)、平均室壁反应力(MWS)、左方容积指数(LAVI)、左心室质量指数(LVMI)]、血清指标[高敏C反应蛋白(hsCRP)、血管内皮生长因子(VEGF)及B型尿钠肽(BNP)]、心功能指标[左心室射血分数(LVEF)、左心室收缩末期容积(LVESV)、左心室舒张末期容积(LVEDV)]、不良反应。结果 治疗前,2组LVEDD、MWS、LAVI、LVMI值比较差异无统计学意义(P>0.05)。治疗结束1d,观察组LVEDD、MWS、LAVI、LVMI值均低于对照组(均P<0.05)。治疗前,2组hsCRP、VEGF、BNP、LVEF、LVESV、LVEDV、6MWD值比较差异无统计学意义(P>0.05),但在治疗结束1d,观察...     

氯沙坦联合比索洛尔治疗扩张型心肌病临床疗效

目的探讨氯沙坦与比索洛尔联合治疗扩张型心肌病的疗效。方法86例患者在常规治疗基础上，随机分为治疗组和对照组（每组各43例）、治疗组口服氯沙坦50mg／d，比索洛尔5mg／d；对照组口服比索洛尔5mg／d治疗前、后分别进行心功能（NYHA分级）评估，行血常规，血生化，肝、肾功能，心电图，超声心动图检查。结果治疗1年后两组左房内径（LA）、左室舒张未期容量（LVEDV）、左室收缩末期容量（LVESV）、左心室射血分数（EF）、短轴缩短率（FS）、心输出量（CO）、心排血指数（CI）均有显著改善（P均〈0．05）。LVEDV、LVESV、EF、FS及心功能改善总有效率治疗组与对照组比较改善更为显著（P〈0．05）．两组治疗前后血生化，肝、肾功能均无显著变化，不良反应发生率相仿（P〉0．05）。结论氯沙坦与比索洛尔联合治疗扩张型心肌病效果优于单用比索洛尔。     

沙库巴曲缬沙坦联合参附注射液对慢性充血性心力衰竭心室重塑和细胞因子的影响

目的探究沙库巴曲缬沙坦钠片联合参附注射液对慢性充血性心力衰竭患者心功能、心室重塑以及血清中细胞因子表达的影响。方法选择接受诊治的慢性充血性心力衰竭患者106例,随机分为对照组和观察组,每组53例患者,基于常规治疗下,分别采用沙库巴曲缬沙坦、沙库巴曲缬沙坦联合参附注射液进行治疗,观察并记录两组患者左心室收缩末期容积（LVESV）、左心室舒张末期容积（LVEDV）、左室射血分数（LVEF）、舒张期室间隔厚度（IVST）、舒张期左室后壁厚度（LVPWT）和左室质量指数（LVMI）。同时采用荧光免疫法定量检测患者血清中脑利钠肽（BNP）的含量,采用酶联免疫吸附分析法检测患者血清中超敏C反应蛋白(hs-CRP)和内皮素-1(ET-1)的含量。结果治疗前,两组患者的IVST、LVPWT、LVMI、LVESV、 LVEDV和LVEF之间的差异均无统计学意义（P>0.05）。治疗后,两组患者的IVST、LVPWT、LVESV和LVEDV明显降低, LVMI和LVEF则是明显升高（P<0.05）。而与对照组相比,观察组患者的心功能和心室重塑指标的变化更加显著（P<0.05）。另外,治疗前,两组患者BNP、hs-CRP和ET-1的含量差异无统计学意义（P>0.05）,而治疗后,两组患者血清中BNP、hs-CRP和ET-1的含量均显著降低（P<0.05）。与对照组相比,观察组患者血清中BNP、hs-CRP和ET-1的含量下降得更加显著（P<0.05）。结论沙库巴曲缬沙坦联合参附注射液能够有效改善慢性充血性心力衰竭患者的心功能,并抑制心室重塑,同时还可以降低患者血清中BNP、hs-CRP和ET-1的含量,提高心力衰竭患者的临床疗效。     

富马酸比索洛尔联合贝那普利治疗扩张型心肌病

目的探讨富马酸比索洛尔联合贝那普利治疗扩张型心肌病(DCM)的临床效果。方法选取济源市人民医院治疗的84例DCM患者,采用随机数表法分为对照组和观察组,各42例。对照组单用贝那普利治疗,观察组接受富马酸比索洛尔+贝那普利治疗。统计对比两组临床疗效及心功能[左心室射血分数(LVEF)、左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDV)]情况。结果观察组治疗总有效率(90.48%)较对照组(71.43%)高(P<0.05)。治疗后观察组LVESD、LVEDV值较对照组低,LVEF值较对照组高(均P<0.05)。结论富马酸比索洛尔联合贝那普利治疗DCM可改善患者心功能,提高临床治疗效果。     

脑钠肽在急性心肌梗死患者中的变化及与左室重构的关系

目的:探讨急性心肌梗死(AMI)患者早期脑钠肽(BNP)水平与左室重构的关系.方法:选择AMI患者(60例)和对照组(22例)在入院后(24 h内)采用酶联免疫法(ELISA)测定血清BNP浓度,入院后第7～10天内行心脏超声检查,测量左室收缩末期容积(LVESV)和舒张末期容积(LVEDV)及左室射血分数(LVEF),观察BNP水平与AMI患者心功能,心肌梗死范围及左室重构指标LVESV、LVEDV和LVEF的关系.结果:AMI患者心功能越差,心肌梗死范围越大,BNP浓度越高(P<0.01);血清BNP水平与LVESV、LVEDV呈正相关,与LVEF呈负相关.结论:急性心梗后BNP水平升高与左室重构相关.     

比索洛尔治疗老年心力衰竭疗效观察

目的:观察比索洛尔对老年心力衰竭的疗效。方法:选择73例老年心力衰竭患者,按纽约心功能分级为Ⅱ~Ⅳ级,随机分为比索洛尔治疗组和对照组,两组均给予心力衰竭常规治疗。对照组不选用β阻滞剂,比索洛尔治疗组给予比索洛尔1.25~5mg/d,6个月后对心功能及超声心动图指标及生化指标进行对比。结果:比索洛尔治疗组总有效率达到93.01%,对照组为76.67%(P<0.05)。比索洛尔治疗组改善左室重塑,提高LVEF优于对照组(P<0.05)。结论:两组治疗前后肝肾功能、血脂、血糖无显著变化(P>0.05),比索洛尔治疗老年心力衰竭安全有效。     

实时三维超声心动图在心肌梗死后左室容量与功能检测中的应用价值

目的:探讨实时三维超声技术(RT-3DE)用于评价心肌梗死患者左室容量与功能准确性的价值。方法:应用电影磁共振(cine-MRI)、RT-3DE和二维超声心动图(2DE)测量陈旧性心肌梗死患者(Ⅰ组,28例)左室舒张末期容量(LVEDV)、左室收缩末期容量(LVESV)、左室射血分数(EF);应用RT-3DE测量急性心肌梗死患者(Ⅱ组,33例)和正常对照者(Ⅲ组,30例)LVEDV、LVESV、EF;比较3组间或同组不同检测方法之间的测量结果。结果:Ⅰ组RT-3DE各参数测值同cine-MRI相应测值比较,差异无统计学意义(P>0.05);2DE各参数测值明显低于cine-MRI相应测值(P<0.05)。RT-3DE检查结果表明,与Ⅲ组比较,Ⅱ组EF显著降低(P<0.01),Ⅰ组和Ⅱ组LVEDV与LVESV均显著增加,LVEDV的增加以Ⅰ组明显(P<0.01),LVESV改变以Ⅱ组明显(P<0.01)。Ⅰ组RT-3DE测得的LVEDV、LVESV测值同cine-MRI相应测值呈高度相关(r=0.91,0.89);2DE测得的LVEDV、LVESV测值同cine-MRI相应测值呈中度相关(r=0.68,0.73)。结论:RT-3DE测定左室容量与功能准确可靠,能够反映心肌梗死患者不同时期左室容量与功能的变化特点,为临床更全面准确地评价心肌梗死后的心功能变化和观察左室重塑的过程提供了新的检测方法。     

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…     

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.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

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.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.