抑肽酶对胸腰椎爆散骨折伴截瘫术中及术后失血的影响

目的：观察抑肽酶对胸腰椎爆散骨折伴截瘫术中及术后病人失血量、输血量、Hb浓度及Hct的影响。方法：选择因胸腰椎爆散骨折伴截瘫拟在全麻下行择期手术的成年病人40例，随机分为观察组（抑肽酶组）和对照组，各20例。观察组手术开始前静脉输入抑肽酶100万KIU（500ml乳酸林格液），手术结束前再输入20万KIU，对照组不使用抑肽酶。观察并记录术中、术后24小时的出血情况、Hb及Hct变化、需输血量。结果：观察组术中失血及输血量明显少于对照组（P〈0．05）。观察组术后12、24小时失血量及术后24小时输血量明显低于对照组（P〈0．05）。两组术后4、8小时失血量无明显差异（P〉0．05）。两组术前、术毕及术后4小时Hb浓度及Hct无显著差异（P＞0．05）。观察组术后8、12及24小时Hb浓度及Hct明显高于对照组（P〈0．05）。结论：抑肽酶能有效减少胸腰椎术中、术后的失血量及输血需要量。     

抑肽酶减少心脏瓣膜置换术中出血及输血的临床观察

52例心脏瓣膜置换术，随机分两组，抑肽酶组30例，对照组22例。两组年龄、体重、手术种类、麻醉方法及体外循环转流无差异。抑肽酶组术中应用抑肽酶300～600万KIU（平均410．0±113．7万KIU）、结果抑肽酶组术中失血量和输血量，术后24h心包纵隔引流量（598．7±113．7ml，746．7±191．6ml，407.8±281．5ml）比对照组（755.6±252．6ml，983．3±383．0ml，602．6±358.0ml）减少，且有显著差异（P＜0．01，P＜0．05）。术后输血量抑肽酶组比对照组减少12．8％。证实术中应用抑肽酶可减少心脏瓣膜置换术术中及术后渗血及输血量。     

体外循环心脏手术中血液保护与血液麻醉的措施与机制

目的 采用血液保护、血液麻醉措施，减少体外循环（ＣＰＢ）手术后出血。方法 采用基本血液保护（术前预储备自体血，术中控制性降压麻醉，提前肝素化回收开胸出血，超滤回输ＣＰＢ引流血等）加以下一种血液麻醉方案：１．小剂量抑肽酶；２．大剂量抑肽酶；３．大剂量止血芳酸＋小剂量抑肽酶。结果 术后２４ｈ纵隔及心包引流液：对照组（８９６±２８８）ｍｌ；小剂量抑肽酶组为（５２６±１３７）ｍｌ；大剂量抑肽酶组为（３８２     

抑肽酶对体外循环心脏手术炎性反应的作用

1 资料和方法 32 例双瓣膜替换术患者,年龄 40~65 岁,ASA 分级 Ⅱ~Ⅲ级,随机分为三组：①对照组：不用抑肽酶（n=6）;②小剂量组：体外循环（CPB）前静滴抑肽酶 100 万 KIU,预充液加入 100 万 KIU,术中持续静滴 25 万 KIU／h,直至关胸结束（n=13）。③大剂量组：CPB 前静滴抑肽酶 200 万 KIU,预充液中加入 200 万 KIU,术中持续静滴 50 万 KIU／h,直至关胸结束（n=13）。应用统一术式、麻醉和体外循环方法。分别于CPB前、CPB 结束、停 CPB 后 2 h取桡动脉血,以流式细胞术检测中性粒细胞 CD11b 的平均荧光强度（MF…     

体外循环心脏手术中血液保护与血液麻醉的措施与机制

目的采用血液保护、血液麻醉措施，减少体外循环（ＣＰＢ）手术后出血。方法采用基本血液保护（术前预储备自体血，术中控制性降压麻醉，提前肝素化回收开胸出血，超滤回输ＣＰＢ引流血等）加以下一种血液麻醉方案：１．小剂量抑肽酶；２．大剂量抑肽酶；３．大剂量止血芳酸＋小剂量抑肽酶。结果术后２４ｈ纵隔及心包引流液：对照组（８９６±２８８）ｍｌ；小剂量抑肽酶组为（５２６±１３７）ｍｌ；大剂量抑肽酶组为（３８２±２１８）ｍｌ；大剂量止血芳酸＋小剂量抑肽酶组为（３３６±１６０）ｍｌ。血液保护及血液麻醉各组与对照组有极显著差异（Ｐ＜０．０１）。结论ＣＰＢ心脏手术中，采用血液保护及血液麻醉能明显减少术后出血，减少围手术期输血。     

小剂量抑肽酶在小儿体外循环手术中的作用

目的：评价小剂量抑肽酶在小儿体外循环（CPB）手术中的作用。方法：将86例先天性心脏病患儿分为抑肽酶用药组（40例）和对照组（46例），观察两组患儿术后24h纵隔心包引流量，并从两组中各抽取18例监测凝血和纤溶各项指标。结果：与对照组比较用药组CPB术后Plat、PT、FIB无显著影响，APTT缩短，PLG、AT－Ⅲ活性明显下降，α^2-AP活性明显提高。术后3h用药组APTT仍低于对照组，α^2-AP活性则高于对照组。术后24h用药组心包纵隔引流血量较对照组显著减少（P≤0.010。结论：在小儿体外循环手术中应用小剂量抑肽酶能减少术后出血。     

抑肽酶对胸腰椎爆散骨折伴截瘫术中及术后失血的影舷

目的:观察抑肽酶对胸腰椎爆散骨折伴截瘫术中及术后病人失血量、输血量、Hb浓度及Hct的影响.方法:选择因胸腰椎爆散骨折伴截瘫拟在全麻下行择期手术的成年病人40例,随机分为观察组(抑肽酶组)和对照组,各20例.观察组手术开始前静脉输入抑肽酶100万KIU(500ml乳酸林格液),手术结束前再输入20万KIU,对照组不使用抑肽酶.观察并记录术中、术后24小时的出血情况、Hb及Hct变化、需输血量.结果:观察组术中失血及输血量明显少于对照组(P＜0.05).观察组术后12、24小时失血量及术后24小时输血量明显低于对照组(P＜0.05).两组术后4、8小时失血量无明显差异(P＞0.05).两组术前、术毕及术后4小时Hb浓度及Hct无显著差异(P＞0.05).观察组术后8、12及24小时Hb浓度及Hct明显高于对照组(P＜0.05).结论:抑肽酶能有效减少胸腰椎术中、术后的失血量及输血需要量.     

围术期应用抑肽酶减少脑肿瘤手术出血及脑水肿的临床研究(附60例分析)

目的　对围术期应用抑肽酶减少脑肿瘤手术出血及脑水肿进行前瞻性研究。方法　将 6 0例择期手术病人随机分为 2组 ,每组 30例。实验组术前 12h至术后 2 4h内连续给药 ,抑肽酶剂量为 7× 10 3 KIU/kg ,加入林格氏液中静滴。对照组单纯使用等容量林格氏液静滴。结果　实验组出血和脑水肿明显减轻 ,两组对比手术出血量和脑水肿有极显著差异 (P <0 .0 1)。结论　围术期应用抑肽酶可明显减少脑肿瘤手术出血及脑水肿 ,有较好的止血作用     

抑肽酶对体外循环心脏直视手术患者血液纤溶活性的影响

将４８例先天性心脏病和风湿性心脏病患者分层后随机均分为四组。对照组不给抑肽酶，小、中、大剂量组分别给予抑肽酶１．５、３．０、６．０万ＫＩＵ·ｋｇ－１一次性加入预充液。用药组血浆中Ｄ－二聚体含量在体外循环（ＣＰＢ）末及术后１ｈ均较对照组明显减少（Ｐ＜０．０１），表明抑肽酶对ＣＰＢ过程中继发性纤溶亢进有一定的抑制作用。这可能为抑肽酶减少ＣＰＢ术后失血的机制之一。     

立止血与抑肽酶对胸科围术期出血量影响的比较

目的：评价立止血和抑肽酶减少胸科手术中出血的临床效果。方法：行单一肺叶切除术成年病人96例，随机分为3组：Ⅰ组（对照组），Ⅱ组（立止血组）和Ⅲ组（抑肽酶组），观察术中出血总量、手术后出血总量及用药后副作用。结果：Ⅱ组病人术中出血总量、手术后出血总量、术前后血红蛋白差值明显小于Ⅰ组和Ⅲ组，Ⅲ组病人术中出血总量、术前后血红蛋白差值明显小于Ⅰ组，差异均有显著性（P〈0．05）。Ⅲ组病人中有3例在用药后出现过敏反应。结论：胸科手术中选用立止血比选用抑肽酶能更有效地减少胸科手术中和手术后的出血，且不良反应少。     

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.