依达拉奉治疗急性脑梗死的疗效观察

目的评价依达拉奉注射液治疗急性脑梗死(AC I)的有效性和安全性。方法选择发病24h内的急性脑梗死患者60例,随机分为治疗组和对照组,每组30例。对照组给予甘油果糖、复方丹参注射液、维脑路通、阿斯匹林治疗,治疗组加用依达拉奉注射液30mg静脉滴注,每日2次,共14d。治疗前后对患者进行欧洲卒中量表评分(ESS),以治疗后第14d ESS增分率作为主要疗效判断标准。结果14d后治疗组、对照组ESS增分率分别为(50.4±29.4)%、(27.1±19.9)%,两组比较差异有显著性意义(P<0.05);治疗组无明显不良反应。结论依达拉奉治疗急性脑梗死是安全有效的。     

依达拉奉治疗急性脑梗死154例临床疗效观察

目的脑梗死是严重威胁人类健康的常见疾病,本研究分别采用依达拉奉和常规方案治疗急性脑梗死154例,对急性脑梗死的治疗效果进行对比分析。方法将154例发病在48h以内的急性脑梗死患者随机分为依达拉奉治疗组76例和常规治疗对照组78例,治疗组采用依达拉奉30mg静脉滴注,2次/d,常规治疗对照组采用维脑路通和阿司匹林等治疗方法,疗程共14d。以神经功能缺损评分(european stroke scale,ESS)和日常生活能力评分(activities of daily living,ADL)的增分率来判断、比较不同治疗方案的疗效。结果依达拉奉组和对照组患者在治疗前的一般情况差异无显著性(P>0.05),14d治疗结束后,依达拉奉治疗组和常规治疗对照组的ESS增分率分别为(50.39±23.37)和(23.52±22.71);ADL增分率分别为(48.76±21.32)和(26.72±21.73)。依达拉奉的运用显著提高了对急性脑梗死的治疗效果(P<0.01)。结论依达拉奉能安全有效地治疗急性脑梗死。     

依达拉奉合并东灵迪芙治疗急性脑梗死32例临床观察

目的:比较依达拉奉单药及合并东灵迪芙对急性脑梗死(ACI)的治疗效果。方法:随机选取发病48h以内的ACI患者101例,分依达拉奉与东灵迪芙合并治疗组(即治疗组32例)及东灵迪芙单药治疗组(即对照1组52例),依达拉奉单药治疗组(即对照2组17例)。治疗组:依达拉奉注射液30mg+(NS)250mL静脉滴注,2次/d,共7d;合并以东灵迪芙注射液按隔天10IU,5IU,5IU方案治疗;对照1组:以东灵迪芙注射液按隔天10IU,5IU,5IU方案治疗;对照2组:依达拉奉注射液30mg+(NS)250mL静脉滴注,2次/d,共7d。治疗前后定期对患者进行欧洲卒中评分(ESS)、日常生活能力评分(ADL)和常规检查,以治疗第21d ESS增分率和ADL增分率作为主要疗效判断标准。结果:21d后治疗组、对照1组和对照2组的ESS增分率分别为(58.9±27.8、36.8±23.4、34.1±24.1),治疗组与两对照组相比差异有极显著性(P<0.001),两对照组疗效相当(P>0.05),ADL增分率分别为(63.4±33.6、30.4±31.8、31.2±31.7),治疗组与两对照组相比差异有极显著性(P<0.001),两对照组疗效相当(P>0.05)。结论:依达拉奉与东灵迪芙合并治疗效果明显优于依达拉奉与东灵迪芙单药治疗组。依达拉奉与东灵迪芙单药治疗组疗效相当。     

依达拉奉注射液治疗急性脑梗死对神经功能缺损和日常生活活动能力的影响

目的探讨依达拉奉注射液治疗脑梗死的临床效果。方法随机将60例脑梗死患者分为两组,每组30例。对照组给予常规治疗,研究组在此基础上加用依达拉奉注射液治疗。比较两组的临床疗效。结果治疗后14 d、21 d研究组ESS得分显著高于对照组(P<0.05或P<0.01),治疗后14 d、21 d、3个月研究组ADL得分显著高于对照组(P<0.01)。治疗后7d、14d、21d,研究组的ESS增分率和ADL增分率临床疗效均显著优于对照组(P<0.01)。结论依达拉奉注射液治疗急性脑梗死能够显著改善患者神经功能缺损状况,提高患者日常生活活动能力。     

依达拉奉治疗急性脑梗死30例效果观察

目的：观察依达拉奉对急性脑梗死（ACI）的治疗效果。方法：选择诊断明确、发病24小时内的ACI患者60例，随机分为两组，每组30例，对照组给予常规药物（丹参、阿司匹林），观察组在常规治疗基础上加用依达拉奉30mg静脉滴注，每日2次，共14天。治疗前后对患者进行欧洲卒中量表评分（ESS），以治疗后第14天ESS增分率作为主要疗效标准。结果：14天后观察组、对照组ESS增分率分别为（52．6±28．9）％、（26．7±18．8）％，两组比较差异有统计学意义（P〈0．05）：观察组无明显不良反应。结论：依达拉奉治疗ACI安全有效。     

依达拉奉联合苦碟子对急性脑梗死神经功能缺损症状的改善作用

[目的]观察依达拉奉联合苦碟子治疗急性脑梗死对神经功能缺损症状的改善作用.[方法]将92例急性脑梗死患者随机分为治疗组和对照组各46例.2组均给予常规治疗(包括肠溶阿司匹林和神经营养剂的使用,大面积脑梗死时降颅压及对症处理)和合并症处理,治疗组加用依达拉奉注射液联合苦碟子注射液静脉滴注,对照组仅予苦碟子注射液静脉滴注.2组均以14 d为1个疗程,典治疗2个疗程.于治疗前和治疗第1、第2疗程后分别进行神经功能缺损评定(ESS)和日常生活能力评分(ADL),并随时记录不良反应.[结果]第1疗程结束后,2组的ESS、ADL积分值均有所改善(与治疗前比较,P<0.05或P<0.01),但2组的ESS、ADL积分值和增分率比较,差异均无显著性意义(P>0.05).第2疗程结束后,2组的ESS、ADL积分值均有明显改善(与治疗前比较,P<0.01),且2组的ESS、ADL积分值和增分率比较,差异均有显著性意义(P<0.05).[结论]依达拉奉联合苦碟子治疗急性脑梗死在神经功能改善方面优于单用苦碟子.     

依达拉奉治疗急性大面积脑梗死的疗效观察

目的 观察并评价依达拉奉在急性期大面积脑梗死患者中的疗效.方法 将120例急性脑梗死患者随机分为治疗组(60例)和对照组(60例).两组均采用常规治疗,治疗组在常规治疗的基础上静脉输注依达拉奉30 mg,2次/d,共14 d.采用"中国脑卒中患者临床神经功能缺损程度评分标准",对治疗后3、7、14 d进行疗效评价.结果 治疗3 d开始起效,7 d后,依达拉奉组评分(11.4±8.3),对照组为(12.6±6.5).治疗14 d后,依达拉奉组评分为(10.1±5.4),对照组为(8.7±4.3).治疗组神经功能缺损程度评分显著低于对照组,治疗组的疗效显著优于对照组(P<0.05).结论 依达拉奉治疗急性脑梗死安全、有效.     

依达拉奉治疗缺血性脑卒中的临床观察

目的评价新型自由基清除剂—依达拉奉注射液治疗缺血性脑卒中的有效性和安全性。方法选择病程在48h内的缺血性脑卒中50例,随机分为治疗组和对照组各25例,在常规应用抗血小板凝集、改善微循环和对症等治疗的基础上,治疗组采用依达拉奉30mg,静脉滴注,每天2次,共用7天;对照组用维生素C 1.5g静脉滴注,每天2次,共用7天;第8天后两组治疗方案相同。在治疗前后用ESS对患者进行定期的临床神经功能缺损评分、日常生活活动能力(ADL)评定并进行肝肾功能、凝血因子、血常规检查,以治疗第21天ESS增分率和治疗90天日常生活活动量表(ADL)增分率作为主要疗效判断。结果21天后治疗组和对照组ESS显效率分别为92.00%、52.00%(P<0.001);90天后治疗组和对照组ADL显效率分别为92.00%、56.00%(P<0.001);治疗组无明显的不良反应。结论依达拉奉治疗缺血性脑卒中是安全、有效的。     

依达拉奉联合灯盏细辛治疗急性脑梗死临床观察

目的 观察依达拉奉联合灯盏细辛治疗急性脑梗死(ACI)的疗效及安全性.方法 采用随机、双盲对照,选择发病48h内的ACI患者64例,随机分为依达拉奉联合灯盏细辛(联合组)和灯盏细辛对照组.联合组予依达拉奉注射液30mg 生理盐水(NS)100ml静脉滴注2次/d,同时灯盏细辛注射30ml NS250ml静脉滴注1次/d,连续14d;对照组给予灯盏细辛30ml NS250ml静脉滴注1次/d,连续14d.两组均口服阿司匹林50-75mg/d.治疗前及治疗后第7d、第14d、第2ld分别进行欧洲卒中评分(ESS)、临床疗效评价及治疗前、治疗后第21d行血液流变学等实验室检查.结果 与对照组相比,第7d联合组ESS明显改善(p＜0.05),第14d、21d有极显著差异(均p＜0.001);联合组总有效率为93.8%,明显好于对照组(71.9%)(P＜0.05);两组血流变学治疗前后也有明显改善;两组各出现一例出血性脑梗死.结论 依达拉奉联合灯盏细辛治疗ACI安全、有效.     

依达拉奉治疗脑溢血50例临床观察

目的 探讨依达拉奉治疗脑溢血的临床疗效与安全性.方法 将100例脑溢血患者随机分成二组:依达拉奉组(治疗组)和常规治疗组(对照组),每组50例.观察治疗组和对照组在治疗2周、4周后欧洲脑卒中评分(ES8)增分率并进行统计学分析,以对比治疗组和对照组治疗有效率及不良反应.结果 治疗组ESS在治疗后2周、4周时较对照组显著增加;4周时治疗组显效率及总有效率显著高于对照组(P＜0.05),且治疗组无明显不良反应.结论 依达拉奉治疗脑溢血疗效确切,且无明显不良反应.     

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.