小剂量磷酸肌酸钠联合甲状腺素治疗甲状腺功能减退性心脏病的短期疗效分析

目的：本文主要分析小剂量磷酸肌酸钠联合甲状腺素治疗甲状腺功能减退性心脏病的短期疗效。方法：选取我院于2011年12月-2012年12月收治146例甲状腺功能减退性心脏病患者临床资料,随机分为治疗组和对照组,治疗组74例,对照组72例。对照组患者给予口服甲状腺素,治疗组在此基础上加用小剂量磷酸肌酸钠。结果：在CK、CK—MB、LDH等方面的比较,观察组明显低于对照组（P〈0．05）。观察组SV、LVEF、LVDd治疗后的效果明显胜于治疗前（P〈0．05）。结论：小剂量磷酸肌酸钠联合甲状腺素治疗甲状腺功能减退性心脏病的短期疗效显著,有利于降低患者血清心肌酶水平,值得临床推广。     

妊娠期妇女甲状腺功能减退症的66例临床研究分析

目的观察妊娠期妇女合并甲状腺功能减退症的患病情况、合并症、妊娠结局及治疗方法。方法选取本院内分泌科门诊2015年10月至2016年8月妊娠合并甲状腺功能减退患者66例,应用化学发光法(CIA)测定甲状腺功能并分析不同妊娠期甲状腺功能减退症患者的FT3、FT4、TSH指标的变化,给予口服左旋甲状腺素钠片(优甲乐L-T4)25~125ug/日不同剂量治疗;以妊娠晚期TSH3.0u IU/m L为治疗目标,观察不同妊娠期妇女合并甲状腺功能减退症的药物剂量变化。结果妊娠中期,临床甲减组与亚临床甲减组TSH均明显高于正常对照组水平(P0.01);亚临床甲减组的FT4水平高于临床甲减组(P0.05)。妊娠晚期,临床甲减组FT3、FT4水平比正常对照组低(P0.05),且TSH显著高于正常对照组水平(P0.01);临床甲减组妊娠中期和晚期左旋甲状腺素钠片(L-T4)需求剂量明显高于妊娠早期(P0.05);与亚临床甲减组妊娠早期的左甲状腺素钠(L-T4)片的需求量有显著性差异(P0.01);临床甲减组与亚临床甲减组产后左旋甲状腺素钠片(L-T4)的需求剂量明显低于妊娠晚期的需求剂量(P0.05)。结论临床甲减组和亚临床甲减组患者妊娠中、晚期左旋甲状腺素钠片(L-T4)治疗剂量明显增加。对高危的妊娠期妇女全程进行严密地监测甲状腺功能水平,及时诊断和治疗对于孕妇及胎儿的健康具有十分重要的意义。     

益气振心汤联合左甲状腺素片治疗甲状腺功能减退性心脏病的疗效观察

目的探讨益气振心汤联合左甲状腺素片治疗甲状腺功能减退性心脏病的临床疗效。方法选择68例甲状腺功能减退性心脏病患者为研究对象,按照随机数表法分为对照组(n=34)和观察组(n=34)实施对比研究,对照组给予每日口服左甲状腺素片12.5μg进行治疗,每日1次。观察组在对照组基础上给予口服益气振心汤联合治疗,益气振心汤每日1剂。两组患者均以2个月为1个疗程。观察两组患者的甲状腺功能相关指标和超声心动图检测结果、治疗有效率、生活质量。结果治疗后两组患者甲状腺功能相关指标、心脏三维彩超相关指标水平均得到明显改善,但观察组的改善效果更为明显(均P0.05)。经临床治疗效果判定,在显效、有效的患者方面,观察组分别有20例和12例,对照组分别有12例和10例。组间对比总有效率差异有统计学意义(94.12%vs64.71%,P0.05)。治疗后两组患者生活质量总分均明显提高,但观察组的治疗后评分显著高于对照组(P0.05)。两组均未出现与治疗相关的不良反应。结论益气振心汤联合左甲状腺素片治疗甲状腺功能减退性心脏病疗效显著,可以更好的改善患者的甲状腺功能和心脏功能,提高治疗有效率。     

应用曲美他嗪和左甲状腺素钠治疗甲状腺功能减退性心脏病的疗效分析

目的：分析联合应用曲美他嗪和左甲状腺素钠治疗甲状腺功能减退性心脏病的临床疗效。方法：将2012年9月至2014年3月我院收治的60例甲状腺功能减退性心脏病患者按数字表法随机分为研究组和对照组,每组各30例患者。为对照组患者使用左甲状腺素钠进行治疗,为研究组患者在使用左甲状腺素钠的基础上加用曲美他嗪进行治疗,分析两组患者的临床疗效、治疗前后的甲状腺功能和超声心动图参数等指标。结果：研究组患者的治疗效果明显优于对照组患者,差异显著（P＜0.05）,有统计学意义。两组患者的甲状腺功能和超声心动图参数等指标均较治疗前明显改善,研究组患者此类指标的改善程度明显优于对照组患者,差异显著（P＜0.05）,有统计学意义。结论：为甲状腺功能减退性心脏病患者联合应用曲美他嗪和左甲状腺素钠进行治疗可明显改善其心功能,取得确切的疗效,而且用药的安全性较高,此法值得在临床上推广应用。     

海藻玉壶汤联合左旋甲状腺素钠片治疗甲状腺腺瘤临床观察

目的观察海藻玉壶汤联合左旋甲状腺素钠片治疗甲状腺腺瘤临床疗效,进一步指导临床。方法将80例确诊为甲状腺腺瘤患者随机分为治疗组和对照组,每组各40例,对照组给予左旋甲状腺素钠片治疗,治疗组在对照组的基础上给予海藻玉壶汤中药口服治疗,两组均治疗3个月后评价效果。结果治疗组总有效率为90.00%,对照组总有效率为72.50%,两组比较差异显著,具有统计学意义(P0.05);两组治疗前甲状腺激素水平(FT3、FT4、TSH)比较无明显差异,不具有统计学意义(P0.05),两组治疗后甲状腺激素水平(FT3、FT4、TSH)均较治疗前有所改善,且治疗组优于对照组(P0.05);治疗组不良反应明显低于对照组,差异显著,具有统计学意义(P0.05)。结论海藻玉壶汤联合左旋甲状腺素钠片治疗甲状腺腺瘤能有效改善患者临床症状,调节甲状腺激素水平,值得临床借鉴。     

玉屏风胶囊联合优甲乐治疗甲状腺功能减退症疗效分析

目的探讨玉屏风胶囊联合优甲乐(左旋甲状腺素纳片)治疗甲状腺功能减退症对患者甲状腺功能、免疫功能及临床疗效影响。方法选取2016年1月~2017年12月本院收治的甲状腺功能减退症患者72例,将其按随机数字表法分为治疗组(n=37)与对照组(n=35),两组患者均给予单纯对症治疗,其中对照组患者在此基础上给予单纯优甲乐片(左旋甲状腺素纳片)治疗,治疗组患者则在此基础上给予玉屏风胶囊+左旋甲状腺素钠片治疗,连续治疗4个月后,对比两组患者甲状腺功能和免疫功能改善情况,并对比其临床疗效。结果治疗前,两组患者TSH、FT3、FT4水平比较无明显差异(P 0. 05),治疗后,两组患者TSH水平较治疗前比较明显降低,且治疗组患者TSH水平明显低于对照组(P 0. 05),两组患者FT3、FT4水平较治疗前比较明显上升,且治疗组患者FT3、FT4水平明显高于对照组(P 0. 05);治疗前,两组患者CD3+、CD4+、CD8+、CD16+、CD4+/CD8+指标比较无明显差异(P 0. 05),治疗后两组患者CD3+、CD4+、CD4+/CD8+指标较治疗前比较明显上升,且治疗组患者CD3+、CD4+、CD4+/CD8+指标明显高于对照组(P 0. 05),两组患者CD8+、CD16+指标较治疗前比较明显降低,且治疗组患者CD8+、CD16+指标降明显低于对照组(P 0. 05);治疗后,治疗组患者临床总有效率(86. 49%)明显高于对照组(65. 71%)(P 0. 05)。结论针对甲状腺功能减退症患者给予玉屏风胶囊联合左旋甲状腺素钠治疗临床疗效显著,对有效改善患者甲状腺功能和免疫功能具有重要作用。     

左甲状腺素钠片对妊娠期亚临床甲减患者甲状腺功能的影响

目的观察左旋甲状腺素钠片治疗甲状腺功能减退症(甲减)、亚临床甲状腺功能减退症(亚临床甲减)临床疗效,探讨妊娠甲状腺功能对亚临床甲减患者的影响。方法将120例甲状腺功能减退症和亚临床甲状腺功能减退症随机分为观察组和对照组各60例。观察组采用左甲状腺素钠片治疗,对照组采用常规治疗。比较治疗前后血清FT3、FT4、TSH血清FT3、FT4、TSH水平,比较两组妊娠结局。结果治疗后2组FT3、FT4、TSH水平明显下降,观察组变化幅度明显高于对照组,差异有统计学意义(P0.05);对照组早产发生率为2.86%、胎儿畸形的发生率为0、新生儿窒息发生率为0、死胎发生率为0,均低于观察组的13.33%、8.33%、11.67%、8.33%(P0.05)。结论甲状腺功能减退怀孕期间女性的左甲状腺素钠治疗,能有效改善TSH水平,减少不良妊娠结局的发生,治疗效果显著。     

中西医结合治疗原发性甲状腺功能减退42例

目的：探讨中西医结合治疗原发性甲状腺功能减退的临床疗效。方法：选取我原发性甲状腺功能减退患者84例,分为观察组与对照组,各42例,对照组采用左旋甲状腺素片治疗,观察组联合甲复康中药方治疗,比较两组疗效差异。结果：观察组治疗总有效率95．24％明显高于对照组的73．81％,差异有统计学意义（P ＜0．05）。结论：中西医结合治疗原发性甲状腺功能减退患者的临床疗效显著,值得临床推广应用。     

左甲状腺素钠治疗老年甲状腺功能减退的临床疗效及安全性探讨

目的分析对老年甲状腺功能减退运用左甲状腺素钠治疗的安全性与疗效观察。方法研究观察对象抽取我院2017年1月至2017年11月收治的老年甲状腺功能减退患者87例,使用随机双盲法分为两组,对照组43例、观察组44例,对照组应用常规甲状腺片治疗,观察组运用左甲状腺素钠治疗,对比两组疗效与并发症情况。结果观察组治疗有效率高于对照组(P0.05);观察组治疗期间药物副反应发生率低于对照组(P0.05)。结论临床研究显示,相比于传统甲状腺片治疗使用左甲状腺素钠对老年甲状腺功能减退患者治疗,具有药物副作用低,安全性高,治疗效果显著,值得推广。     

左旋甲状腺素钠片治疗妊娠期亚临床甲状腺功能减退症的疗效及对患者血脂水平的影响

目的探讨左旋甲状腺素钠片治疗妊娠期亚临床甲状腺功能减退症的疗效及对患者血脂水平的影响。方法选取2017年1月～2019年1月于我院诊治的妊娠期亚临床甲状腺功能减退症患者60例,采用随机数字表法随机分为观察组和对照组,每组30例,观察组给予左旋甲状腺素钠片治疗,初始剂量为50μg/次,1次/d,早餐前半小时口服;对照组不给予药物进行治疗。比较两组治疗前后TSH、FT4、FT3水平及血脂各项指标变化情况及用药安全性情况。结果两组治疗前TSH、FT4、FT3水平比较,无显著性差异(P0.05),治疗后,两组TSH及FT3水平明显降低,FT4水平明显升高,且观察组治疗后TSH及FT3水平显著低于对照组,FT4水平显著高于对照组,两组比较,差异有统计学意义(P0.05);两组治疗前TC、TG、HDL-C、LDL-C水平比较,均未见明显差异(P0.05),治疗后,两组TC、TG及LDL-C水平显著降低,HDL-C水平显著升高,且观察组治疗后TC、TG及LDL-C水平显著低于对照组,HDL-C水平显著高于对照组,两组比较,差异有统计学意义(P0.05)。两组治疗期间未见明显不良反应,安全性较好。结论左旋甲状腺素钠片治疗妊娠期亚临床甲状腺功能减退症疗效确切,能显著改善患者甲状腺功能,同时可纠正脂质代谢紊乱。     

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.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

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.     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

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…     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.     

Possible Spread of adenovirus type 3 from poultry to humans ：indirect evidence from an outbreak in China

Objective:To explore the epidemiology and etiology for an outbreak of acute respiratory tract infection that occurred in one county of Jiangsu Province, China 2004. Methods: Only cases meeting the case definition were included in the study. We reviewed the medical records of the cases who were admitted to the local hospitals, interviewed cases by a standard questionnaire, and then described the epidemiotogic features and analyzed risk factors by means of a case-control study. We collected pharyngeal swab specimens and sent them to different laboratories for isolation and culture. The laboratory used different detection methods such as DIP, PCR, electron microscope examination and microneutralization assay, to identify and then type the positive specimens. Results:A total of 871 cases were reported during the period from April 18 to July 4,2004. The distribution of onset times presented two peaks, one in late May and another in middle June. The epidemic occurred mainly in the elementary and junior high schools in ten townships of one county, and the mean age of the cases was 12 years (range 7 months to 18 years). The course of the disease was acute, and was characterized by fever accompanied with sore throat and tonsillitis. The WBC count of cases was normal or elevated. The mean duration of illness was 5 days (range 2 to 12 days). No fatalities from illness were reported. A case-control study indicated that the possible risk factors were close contact with a case and/or poultry before onset and sharing of towels among members of the family. The typical CPE was observed through inoculating pharyngeal swab specimens into the HEP-2 cell cultures in different laboratories. An infection of adenovirus type 3 was verified by detecting positive specimens in different methods. Conclusion:This investigation demonstrated that the acute respiratory infection in cases was caused by adenovirus type 3. Cases occurred in over 70 schools in ten townships in 2004, and the route of transmission was possibly close contact with cases or droplet transmission.