补元聪脑汤联合针灸对老年痴呆肾虚痰瘀型患者日常生活能力的影响及其作用机制

目的：探讨补元聪脑汤联合针灸对老年痴呆肾虚痰瘀型患者日常生活能力的影响及其作用机制。方法：老年痴呆肾虚痰瘀型患者86例,随机分为对照组和观察组各43例。对照组采用针刺治疗,观察组在此基础上予以补元聪脑汤内服。比较两组患者临床疗效、日常生活能力和血清同型半胱氨酸（Hcy）、C反应蛋白（CRP）及叶酸（FA）水平。结果：治疗前Barthel指数（BI）观察组46.01±8.85分,对照组46.18±9.02分,差异无统计学意义（P＞0.05）;治疗后观察组68.37±10.74分,对照组58.31±9.42分,两组均较治疗前升高,差异均有统计学意义（P＜0.05）,但观察组较对照组更高,差异有统计学意义（P＜0.05）。观察组总有效率为81.39%,明显高于对照组的60.47%,差异有统计学意义（P＜0.05）。治疗前对照组血清Hcy、CRP、FA分别为19.26±6.28 μmol/L,5.72±1.38 mg/mL和6.30±1.94 ng/mL,观察组分别为19.54±7.03 μmol/L,5.80±1.59 mg/mL和6.25±2.07 ng/mL,两组差异均无统计学意义（P＞0.05）;治疗后对照组Hcy、CRP、FA分别为16.31±5.26 μmol/L,4.25±1.14 mg/mL和8.14±2.17 ng/mL,观察组分别为10.37±4.10 μmol/L,2.16±0.68 mg/mL和12.17±3.08 ng/mL,两组血清Hcy、CRP均较治疗前下降,FA较治疗前升高,差异均有统计学意义（P＜0.05）,但观察组与对照组比较,下降和升高的幅度更大,差异均有统计学意义（P＜0.05）。结论：补元聪脑汤联合针灸较单独使用针灸可明显提高老年痴呆肾虚痰瘀型患者临床疗效,增强患者日常生活能力,其作用机制可能与降低Hcy、CRP,提高FA水平有关。     

骨化三醇联合雷公藤多苷治疗IgA肾病效果观察

目的：探讨骨化三醇联合雷公藤多苷治疗IgA肾病的效果。方法：IgA肾病患者60例,随机分为对照组和观察组各30例。对照组口服雷公藤多苷片20 mg/次,3次/日;观察组口服雷公藤多苷片20 mg/次,3次/日,骨化三醇胶丸0.25 μg/次,1次/日。所有患者治疗12周。比较两组治疗前后血肌酐（Scr）、血清白蛋白（Alb）、血钙、血磷、24 h尿蛋白定量,估算肾小球滤过率（eGFR）,尿蛋白缓解效果及不良反应。结果：两组治疗前、后血钙、血磷比较,差异均无统计学意义（P＞0.05）。治疗后对照组Alb 39.30±1.64 mmol/L,eGFR 90.4±19.3 mL/min,观察组为44.07±1.91 mmol/L,95±14.3 mL/min,两组均高于治疗前,但观察组较对照组更高,差异均有统计学意义（P＜0.05）;治疗后对照组24 h尿蛋白定量1.06±0.42 g,Scr 70.32±9.10 μmol/L,观察组为0.79±0.38 g,66.12±6.42 μmol/L,两组均低于治疗前,但观察组较对照组更低,差异均有统计学意义（P＜0.05）。观察组治疗有效率为72.5%,高于对照组的40.0%,差异有统计学意义（P＜0.05）。不良反应发生率对照组为3.3%,观察组为6.6%,差异无统计学意义（P＞0.05）。结论：骨化三醇联合雷公藤多苷治疗IgA肾病可改善肾功能,减少尿蛋白,延缓病情进展,疗效优于单用雷公藤多苷。     

腹膜透析过渡期自动化与渐进式非卧床方案疗效比较

目的：比较腹膜透析过渡期采用自动化腹膜透析和渐进式非卧床腹膜透析的疗效。方法：终末期肾脏病患者98例,随机分为对照组和观察组各49例。对照组采用渐进式非卧床腹膜透析方案进行过渡期透析,观察组采用自动化腹膜透析方案进行过渡期透析,比较两组患者治疗前后肾功能、营养指标及并发症发生情况。结果：治疗后血肌酐、尿素氮、尿酸水平对照组分别为696.03±106.40 μmol/L,16.85±4.20 mmol/L和389.06±83.20 μmol/L,观察组分别为633.09±118.97 μmol/L,12.68±4.15 mmol/L和366.20±77.93 μmol/L,两组均较治疗前明显下降,但观察组下降幅度更大,差异均有统计学意义（P<0.05）。观察组治疗前后血白蛋白、前白蛋白、血红蛋白的差异均无统计学意义（P>0.05）,对照组治疗后白蛋白（29.14±4.25 g/L）、前白蛋白（243.62±71.09 mg/L）水平较治疗前明显下降,差异均有统计学意义（P<0.05）,但血红蛋白治疗前后的差异无统计学意义（P>0.05）。对照组出现并发症5例（10.20%）,观察组出现并发症6例（12.24%）,差异无统计学意义（P>0.05）。结论：腹膜透析过渡期行自动化腹膜透析比渐进式非卧床腹膜透析可明显改善患者肾功能、提高营养水平。     

透析依赖的尿毒症合并急性冠脉综合征患者PCI术后行杂合式肾脏替代治疗效果研究

目的：探讨透析依赖的尿毒症合并急性冠脉综合征（ACS）患者经皮冠状动脉支架植入术（PCI）后行杂合式肾脏替代治疗（HRRT）的临床效果。方法：透析依赖的尿毒症合并ACS患者62例,在PCI术后随机分为HRRT组和间歇性血液透析（IHD）组各31例。HRRT组患者在PCI术后行连续性肾脏替代治疗（CRRT）过渡到HRRT再进行IHD治疗;IHD组患者在PCI术后行CRRT直接过渡为IHD治疗。比较两组患者心功能、肾功能和透析相关并发症的发生。结果：治疗前HRRT组MAP、LVEF、LVEDD和CI分别为85.34±9.21 mmHg,（40.12±1.82）%,58.36±3.26 mm和3.39±0.81 L/min·m2;IHD组分别为83.82±8.41 mmHg,（45.21±1.23）%,54.13±4.34 mm和3.46±0.77 L/min·m2,两组差异均无统计学意义（P＞0.05）。治疗后HRRT组MAP、LVEF、LVEDD和CI分别为52.21±1.23 mmHg,（55.15±2.34）%,42.12±1.52 mm和4.81±1.02 L/min·m2;IHD组分别为55.01±0.23 mmHg,（54.13±1.3）%,43.15±2.37 mm和4.83±0.98 L/min·m2,治疗后两组患者MAP较治疗前降低,LVEDD较治疗前缩小,LVEF和CI较治疗前升高,差异均有统计学意义（P＜0.05）,两组治疗后MAP、LVEF、LVEDD和CI比较,差异均无统计学意义（P＞0.05）。治疗前两组患者各项肾功能指标比较,差异均无统计学意义（P＞0.05）;治疗后两组SCr、BUN、K+较治疗前下降,Ccr和CHE较治疗前升高,差异均有统计学意义（P＜0.05）,但治疗后两组间各项肾功能比较,差异均无统计学意义（P＞0.05）。治疗后HRRT组低血压、心房纤颤和再发心肌梗死发生率及肌钙蛋白水平分别为（6.45±1.21）%,（3.23±0.42）%,（16.13±1.23）%和182±0.26 μg/L,低于IHD组的（9.68±0.98）%,（6.45±0.56）%,（19.35±1.21）%和220±0.45 μg/L,差异均有统计学意义（P＜0.05）。结论：透析依赖的尿毒症合并ACS患者行PCI术后采用CRRT过渡到HRRT再进行IHD,其改善心肾功能的效果与CRRT直接改为IHD相同,但可降低透析相关并发症发生的风险。     

丁苯酞治疗轻中度血管性痴呆临床效果研究

目的：观察丁苯酞治疗对改善轻中度血管性痴呆患者认知功能的临床效果,以及对患者血清丙二醛（malondialdehyde,MDA）、过氧化脂质（lipid peroxide,LPO）、超氧化物歧化酶（superoxide dismutase,SOD）水平和脑血流量的影响。方法：轻中度血管性痴呆患者111例随机分为对照组55例和观察组56例,对照组给予吡拉西坦口服治疗,观察组给予丁苯酞胶囊口服,治疗2个月,比较两组患者治疗前后认知功能、脑血量、血清指标水平的变化。结果：治疗后观察组MDA 3.01±0.41 mmol/L、SOD 108.22±11.29 U/L、LPO 4.22±0.31 μmol/L;对照组MDA 4.51±0.77 mmol/L、SOD 96.01±10.33 U/L、LPO 6.30±0.61μmol/L。两组治疗后MDA、LPO水平较治疗前降低,SOD较治疗前升高,差异均有统计学意义（P<0.05）,治疗后观察组MDA、LPO水平较对照组更低,SOD较对照组更高,差异均有统计学意义（P<0.05）。治疗后各动脉血流速度观察组BA 39.06±4.66 cm/s、VA 32.02±2.11 cm/s、ACA 60.01±6.30 cm/s、MCA 69.93±5.03 cm/s、PCA 44.05±6.02 cm/s;对照组BA 28.86±4.51 cm/s、VA 25.02±2.55 cm/s、ACA 48.99±6.11 cm/s、MCA 56.02±4.63 cm/s、PCA 33.79±5.81 cm/s。两组治疗后各动脉血流速度较治疗前增快,差异均有统计学意义（P<0.05）,治疗后观察组各动脉血流速度较对照组更快,差异均有统计学意义（P<0.05）。治疗后观察组HDS评分20.01±1.52分、MMSE评分23.01±1.77分;对照组HDS评分17.02±1.30分、MMSE评分19.03±1.46 分。两组治疗后HDS、MMSE评分均较治疗前明显改善,差异均无统计学意义（P<0.05）,治疗后观察组HDS、MMSE评分较对照组更高,差异均有统计学意义（P<0.05）。结论：丁苯酞软胶囊能有效改善血管性痴呆患者血清MDA、LPO、SOD水平,提升脑血流量,改善认知功能。     

双重血浆分子吸附术治疗肝衰竭的疗效观察

目的：探讨双重血浆分子吸附术（DPMAS）治疗肝衰竭的临床疗效.方法：选择2013年1～11月在我院治疗的45例肝衰竭作为研究对象,随机分为治疗组22例（双重血浆分子吸附术治疗）和对照组23例（血浆置换治疗）.对治疗前后的实验室指标及临床效果情况进行综合分析.结果：①治疗组治疗后血清总胆红素（TBIL）、谷丙转氨酶（ALT）比治疗前明显下降,差异有统计学意义（P＜0.05）,血浆白蛋白（ALB）、凝血酶原活动度（PTA）治疗前后相比无明显变化,差异无统计学意义（P＞0.05）;对照组治疗后TBIL、ALT比治疗前明显下降,差异有统计学意义（P＜0.05）,ALB、PTA治疗前后相比,差异有统计学意义（P＜0.05）;TBIL、ALT组间相比差异无统计学意义（P＞0.05）;ALB、PTA组间相比,差异有统计学意义（P＜0.05）.②治疗组有效率为68.2％,对照组有效率为65.2％,两组有效率相比差异无统计学意义（P＞0.05）.结论：双重血浆分子吸附术不仅能有效地降低血清胆红素水平,对ALB、PTA无影响,与血浆置换术比较,可取得相同的疗效,且无明显不良反应,不受血浆紧缺的限制,无输血感染及血浆过敏的风险,是治疗肝衰竭有效的、安全的方式,值得推广.     

不同人工肝方法治疗亚急性重型肝炎的疗效对比研究?

目的：观察血浆置换(PE)、血浆置换联合血浆胆红素吸附(PE+PBA)与血浆置换联合双重血浆分子吸附系统(PE+DPMAS)治疗亚急性重型肝炎的临床疗效,探讨重型肝炎的最佳人工肝治疗方案。方法统计同期收治的应用人工肝治疗的140例乙型肝炎病毒(HBV)感染亚急性重型肝炎病例,按照 PE、PE+PBA、PE+DPMAS 分为3组,对比3组患者治疗前、后临床症状及血常规、电解质和主要生化指标的变化。结果PE+DPMAS 组治疗有效率70.8%,稍高于 PE、PE+PBA 两组(60.9%、67.4%),但差异无统计学意义(P >0.05);治疗前、后3组患者血清总胆红素(TBIL)、丙氨酸氨基转氨酶(ALT)、天门冬氨酸氨基转移酶(AST)、谷氨酰转肽酶(GGT)、碱性磷酸酶(ALP)、球蛋白(GLB)等生化指标较治疗前明显下降(P <0.001),治疗后 PE 组前清蛋白(PA)较治疗前升高,PE+PBA 组和 PE+DPMAS 组均较治疗前降低,差异有统计学意义(P <0.05);PE 组凝血酶原时间(PT)较治疗前下降(P <0.05),PE+PBA 组 PT 较治疗前下降,PE+DPMAS 组 PT 较治疗前稍升高,但差异无统计学意义(P >0.05);PE 组血清 K+、Cl-较治疗前明显降低(P <0.001);PE 组治疗前、后血清 Na+差异无统计学意义(P >0.05),PE+PBA、PE+DPMAS 组血清 Na+较治疗前降低(P <0.001);3组血清 Ca2+均较治疗前降低,差异有统计学意义(P <0.001);血常规 WBC、Hb、PLT 治疗前、后比较差异有统计学意义(P <0.05)。结论PE 单独应用和联合 PBA 或 DPMAS,均可有效改善亚急性重型肝炎患者的肝功能,提高救治率;联合治疗可节省血浆用量2/3,方便更多患者使用;PE 联合 DPMAS 对患者血清 Cl-、Ca2+及 Hb 下降的影响幅度最小,具有更佳的临床应用价值。     

复方丹参滴丸联合丁苯酞治疗急性缺血性脑卒中有效性分析

目的：探究复方丹参滴丸联合丁苯酞注射液治疗急性缺血性脑卒中患者的有效性。方法：回顾性分析80例急性缺血性脑卒中患者,其中40例单用丁苯酞注射液治疗为对照组,40例采用复方丹参滴丸联合丁苯酞注射液治疗为观察组。比较两组治疗前后神经功能缺损情况和血清炎症因子水平。结果：治疗前两组NIHSS评分差异无统计学意义（P>0.05）;治疗后两组NIHSS评分较治疗前降低,差异均有统计学意义（P<0.05）;治疗后观察组NIHSS评分11.42±1.56分,低于对照组的19.43±6.98分,差异有统计学意义（P<0.05）。用药前两组患者血清IL-8、TNF-α及hs-CRP水平比较,差异均无统计学意义（P>0.05）;治疗后两组IL-8、TNF-α及hs-CRP水平较治疗前降低,差异均有统计学意义（P<0.05）;治疗后观察组IL-8（15.87±1.87 μmol/L）、TNF-α（7.25±1.25 μg/L）及hs-CRP（6.43±1.65 mg/L）水平低于对照组,差异均有统计学意义（P<0.05）。结论：复方丹参滴丸联合丁苯酞注射液治疗急性缺血性脑卒中效果显著,有利于改善患者神经功能缺损,促使炎症水平恢复正常。     

超声引导下球囊扩张术治疗自体动静脉内瘘狭窄107例临床分析

目的 研究超声引导下球囊扩张术（percutaneous transluminal angioplasty,PTA)治疗自体动静脉内瘘(ateriovenous fistula,AVF) 狭窄的临床疗效。方法 选取2017年1月-2019年9月浙江省中医药大学附属温州中西医结合医院超声引导下首次行PTA治疗的AVF狭窄患者107例,并随访12个月以上。 结果 PTA治疗AVF狭窄技术成功率100%( 107例/107例) ,临床成功率100%( 107例/107例) ,PTA前血管狭窄部位内径为(1.56±0.36) mm,PTA后为(3.13±0.35) mm,PTA前狭窄处收缩期峰值流速（ peak systolic velocity,PSV）为( 537.91±93.08) cm/s,PTA后为( 218.04±69.08) cm/s ;PTA前肱动脉平均血流量（flow volume,FV）为( 185.89±62.65) ml/min,PTA 后为(593.81±62.66) ml/min,差异有统计学意义( P＜0.01) 。PTA后3、6、12 个月的初级通畅率分别为97.2%、87.9%、71.0%,次级通畅率分别为100%,100%,96.3%。结论 超声引导下PTA能改善AVF狭窄,提高AVF通畅率,是一种安全有效的治疗手段。     

负压封闭引流联合低分子肝素对深度烧伤患者高凝状态、创面疼痛及愈合的影响

目的：探讨负压封闭引流联合低分子肝素对深度烧伤患者高凝状态、创面疼痛及愈合的影响。方法：深度烧伤患者196例,随机分为对照组和观察组各98例。对照组在常规治疗基础上予以负压封闭引流,观察组在对照组基础上加以低分子肝素治疗。比较两组临床疗效、创面疼痛程度、创面愈合时间、肉芽组织生长时间、凝血功能及并发症发生情况。结果：观察组总有效率为97.96%,高于对照组的90.82%,差异有统计学意义（P＜0.05）。治疗后对照组疼痛VAS评分5.48±1.06分,观察组3.71±0.83分,均较治疗前明显降低,但观察组下降幅度更大,差异均有统计学意义（P＜0.05）。观察组创面愈合时间7.84±1.63 d,肉芽组织生长时间4.23±1.30 d,分别短于对照组的13.27±2.08 d和7.75±1.88 d,差异均有统计学意义（P＜0.05）。治疗后对照组PT为17.08±2.14 s,APTT为31.28±6.05 s,观察组PT为19.47±2.25 s,APTT为33.96±6.74 s,均较治疗前显著延长,但观察组延长更明显;治疗后对照组FIB为4.31±1.19 g/L,观察组为3.68±1.26 g/L,均较治疗前明显下降,但观察组下降更明显,差异均有统计学意义（P＜0.05）。观察组并发症发生率2.04%低于对照组的9.18%,差异有统计学意义（P＜0.05）。结论：常规治疗基础上予以负压封闭引流联合低分子肝素治疗较单独使用负压封闭引流,可明显提高深度烧伤患者疗效,缩短创面愈合及肉芽组织生长时间,缓解患者创面疼痛,改善高凝状态,并降低并发症发生率。     

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.     

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.