通心络对脑梗死伴颈动脉粥样硬化患者血清超敏C反应蛋白和D-二聚体的影响

目的 探讨通心络对脑梗死伴颈动脉粥样硬化患者血清超敏C反应蛋白(hs-CRP)和D-二聚体(D-dimer)的影响.方法 选择120例住院脑梗死伴颈动脉粥样硬化患者,随机分为对照组和治疗组.治疗组在对照组常规治疗的基础上加服通心络胶囊1.14g tid口服,连用6个月.观察两组治疗前后患者血浆超敏C-反应蛋白(hs-CRP)和D-二聚体的变化,并通过彩超观察治疗前后颈动脉粥样硬化斑块的变化.结果 治疗组治疗6个月后,患者血浆hs-CRP和D-二聚体水平均较治疗前明显下降(P＜0.01);治疗组斑块大小和中层内膜厚度(IMT)均较治疗前明显减小(P＜0.05),两组治疗后比较发现治疗组斑块大小和IMT明显小于对照组(P＜0.05).结论 通心络对脑梗死伴颈动脉粥样硬化具有抗炎和抗血栓作用,可降低颈动脉内膜厚度,减少颈动脉斑块大小,可阻断和逆转颈动脉粥样斑块.     

通心络对脑梗死伴颈动脉粥样硬化患者血清超敏C反应蛋白和D-二聚体的影响

目的 探讨通心络对脑梗死伴颈动脉粥样硬化患者血清超敏C反应蛋白(hs-CRP)和D-二聚体(D-dimer)的影响.方法 选择120例住院脑梗死伴颈动脉粥样硬化患者,随机分为对照组和治疗组.治疗组在对照组常规治疗的基础上加服通心络胶囊1.14g tid口服,连用6个月.观察两组治疗前后患者血浆超敏C-反应蛋白(hs-CRP)和D-二聚体的变化,并通过彩超观察治疗前后颈动脉粥样硬化斑块的变化.结果 治疗组治疗6个月后,患者血浆hs-CRP和D-二聚体水平均较治疗前明显下降(P＜0.01);治疗组斑块大小和中层内膜厚度(IMT)均较治疗前明显减小(P＜0.05),两组治疗后比较发现治疗组斑块大小和IMT明显小于对照组(P＜0.05).结论 通心络对脑梗死伴颈动脉粥样硬化具有抗炎和抗血栓作用,可降低颈动脉内膜厚度,减少颈动脉斑块大小,可阻断和逆转颈动脉粥样斑块.     

血清D-二聚体水平与颈动脉粥样硬化患者复发性脑梗塞

目的探讨血清D-二聚体水平与颈动脉粥样硬化患者复发性脑梗塞的关系。方法对85例颈动脉粥样硬化复发性脑梗塞患者与87例颈动脉粥样硬化首次脑梗塞患者的主要相关疾病及吸烟和血中D-二聚体、尿酸(uric ac id,UA)、血脂进行比较。结果颈动脉粥样硬化患者复发性脑梗塞发生时血浆D-二聚体水平明显高于首次脑梗塞患者(p<0.001),其它均差异无显著性(p>0.05)结论血浆中D-二聚体水平较高与颈动脉粥样硬化患者复发性脑梗塞有关。     

NO与缺血性脑卒中患者颈动脉粥样硬化斑块的相关性分析

目的 分析一氧化氮(NO)与缺血性脑卒中患者颈动脉粥样硬化斑块的相关性.方法 选取42例缺血性脑卒中出现颈动脉粥样硬化斑块患者(研究组)与42例缺血性脑卒中未出现颈动脉粥样硬化斑块患者(对照组)作为本组研究对象,对NO与缺血性脑卒中患者颈动脉粥样硬化斑块之间的相关性进行探讨.结果 研究组患者的NO水平显著低于对照组(P<0.05);2 组患者的 D- 二聚体(D-D)、 高密度脂蛋白(HDL)以及甘油三酯(TG)等指标对比差异不明显(P>0.05).结论 缺血性脑卒中颈动脉粥样硬化斑块患者的NO水平高于缺血性脑卒中未伴有颈动脉粥样硬化斑块患者,且存在明显相关性,故可将其作为一个重要的观察指标.     

血浆D-二聚体水平与慢性阻塞性肺疾病急性加重期相关性胸腔积液关系的研究

目的:探讨血浆D-二聚体水平与慢性阻塞性肺疾病急性加重期(AECOPD)相关性胸腔积液之间的关系.方法:71例研究对象分为A组(AECOPD合并胸腔积液组)27例,B组(单纯AECOPD组)31例及C组(非COPD组,对照组)13例,并将A组随机分为A1组13例及A2组14例,所有入选AECOPD患者均按照COPD诊治指南治疗,A1组在规范治疗方案基础上加用低分子肝素钙治疗.观察治疗前后血浆D-二聚体及胸腔积液量.结果:①D-二聚体水平:治疗前A1组及A2组血浆D-二聚体水平均明显高于B组(P<0.05),而A、B组均明显高于C组(P<0.05);治疗1周后A1组D-二聚体水平较A2组、B组下降(P<0.05),2周后与C组对比,无明显差异(P>0.05),而A2组、B组D-二聚体水平下降缓慢,4周后与C组对比,无明显差异(P>0.05).②胸腔积液量:治疗前A1、A2组之间胸腔积液量无明显差异(P>0.05);治疗2周后两组患者胸腔积液量均减少(P<0.05),而A1组胸腔积液量少于A2组(P<0.05);治疗4周后A1组所有患者胸腔积液全部吸收,而A2组仍有5例患者存在少量胸腔积液(P<0.05).③胸腔积液量与血浆D-二聚体呈正相关(r=0.607,P<0.05).结论:AECOPD相关性胸腔积液的发病可能与肺循环高凝状态有关.使用低分子肝素钙治疗可加快AECOPD相关性胸腔积液的吸收.     

血浆vWF与2型糖尿病患者颈动脉内中膜厚度的关系

目的 探讨2型糖尿病患者颈动脉内中膜厚度(intima-media thickness,IMT)与血浆vwF的关系.方法 2型糖尿病71例患者分为预动脉IMT正常组(A组)37例,颈动脉IMT增厚组(B组)34例,另设正常对照组(C组)30例.采用酶联免疫吸附双抗体夹心法,检测血浆vWF水平;颈动脉IMT测定采用美国飞利浦IVV型超声诊断仪(7.5 MHz).结果 A组及B组血浆vWF水平较正常对照组明显升高(P<0.01),B组明显高于A组(P<0.01).血浆vWF与糖尿病病程(r=0.356,P<0.01)、IMT(r=0.699,P<0.01)、总胆固醇(r=0.351,P<0.01)、低密度脂蛋白(r=0.459,P<0.01)、收缩压(r=0.472,P<0.01)、舒张压(r=0.252,P<0.05)呈正相关.结论 2型糖尿病颈动脉增厚患者血浆vWF水平增高,血浆vWF与IMT呈显著正相关,血浆vWF可能参与颈动脉粥样硬化的发生.     

慢性肾脏病患者颈动脉粥样硬化与缺血性脑卒中的关系

目的 探讨慢性肾脏病(CKD)患者颈动脉粥样硬化程度与缺血性脑卒中之间的关系.方法 采用日本Aloka5500彩色多普勒超声诊断仪,检测97例CKD患者颈动脉粥样硬化程度,并分析缺血性脑卒中的发生情况.结果 97例CKD患者中,颈动脉血管内-中膜厚度(IMT)增厚者32例(33.0%),有颈动脉斑块形成者15例(15.5%).IMT增厚的患者中有13例发生缺血性脑卒中(13/32,40.6%),IMT正常者中有2例发生缺血性脑卒中(2/65,3.08%),两组缺血性脑卒中发生率间差异有统计学意义(P＜0.05);有颈动脉斑块患者中有11例发生缺血性脑卒中(11/15,73.3%),无颈动脉斑块患者中只有4例发生缺血性脑卒中(4/82,4.88%),两组比较缺血性脑卒中发生率间差异有统计学意义(P＜0.01).CKD发生和未发生缺血性脑卒中者比较,年龄、平均动脉压、血糖、血肌酐、尿素氮、总胆固醇、高密度脂蛋白、低密度脂蛋白、载脂蛋白A1、载脂蛋白B及清蛋白水平间差异均无统计学意义(P＞0.05),而三酰甘油、肾小球滤过率、C反应蛋白间差异有统计学意义(P＜0.05).结论 CKD患者发生缺血性脑卒中与颈动脉粥样硬化程度相关,应用超声技术检查颈动脉IMT及斑块形成情况,能够早期预测缺血性脑卒中的发生.     

老年高血压患者颈动脉粥样硬化病变分析

目的:探讨老年高血压患者的颈动脉粥样硬化病变程度及其与血脂、血尿酸、C-反应蛋白的关系.方法:应用彩色多普勒超声检测22例正常老年人(C组:对照组)、47例老年高血压患者(A组)、43例老年高血压合并冠心病患者(B组)的颈动脉内中膜厚度(IMT)、粥样硬化斑块、血流参数[收缩期峰值流速(Vmax)、阻力指数(RI)];同时检测血脂、血尿酸(UA)及C反应蛋白(CRP).结聚:A组与对照组比较,平均IMT,最大IMT及CRP增高(均为P<0.001),斑块发生率、Vmax、RI、胆固醇(TC)、低密度脂蛋白(LDL-C)、UA增高(均为P<0.05);B组与A组比较,平均IMT、最大IMT、RI及CRP增加更为明显(均为P<0.001),斑块发生率、Vmax、TC、甘油三酯(TG)、LDL-C、UA也有相应变化(均为P<0.05).结论:老年颈动脉粥样硬化病变与许多危险因素有关,防治应采取综合措施.     

高血压病合并高尿酸血症与颈动脉粥样硬化的关系

目的:探讨高血压病合并高尿酸血症与颈动脉粥样硬化的关系.方法:以新疆煤矿总医院2006年7月-2007年9月心内科住院病人为研究对象,选择高血压合并高尿酸血症患者(A组)35例、单纯高血压病患者(B组)33例、单纯高尿酸血症患者(C组)28例及正常对照组(D组)30例.共126例,全部进行颈部血管超声检测,并常规记录患者年龄、性别、腰围、吸烟史及血脂等生化指标,观察各组颈动脉粥样硬化发生的情况.结果:1.A组、B组、C组及D组四组之间颈动脉粥样硬化发生率有明显差别(P<0.05);A组与B组、C组、D组相比颈动脉粥硬化发生率明显增加(P<0.0083);B组、C组与D组相比颈动脉粥样硬化发生率增加(P0.0083).2.A组、B组、C组HDL-C水平均低于D组(P<0.05):A、B、C三组问HDL-C水平无明显差别.3.A组腰围水平高于D组(P<0.05),其余各组间腰围水平无明显差别.结论:1.有高血压或有高尿酸血症者颈动脉粥样硬化发生率高于正常人;2.高血压合并高尿酸血症患者更易发生颈动脉粥样硬化,提示高尿酸血症可能促进了高血压患者颈动脉粥样硬化的形成.     

血浆D-二聚体测定对急性缺血性结肠炎的早期诊断价值

目的观察血浆D-二聚体水平在急性缺血性结肠炎发病过程中的变化,探讨其在急性缺血性结肠炎早期诊断中的价值。方法采用微粒子酶免分析法检测36例急性缺血性结肠炎(观察组)患者入院第1、7、14天血浆D-二聚体水平,并与34例健康体检者(对照组)比较;分析D-二聚体水平与急性缺血性结肠炎病变范围的关系。结果入院第1天及治疗第7、14天,观察组患者血浆D-二聚体水平均显著高于对照组,差异有统计学意义(P<0.01)。观察组中,全结肠病变患者血浆D-二聚体水平显著高于乙状结肠、降结肠、横结肠、升结肠病变患者,降结肠及乙状结肠病变患者血浆D-二聚体水平亦显著高于乙状结肠、降结肠、横结肠、升结肠病变患者,差异均有统计学意义(P<0.05)。结论急性缺血性结肠炎患者血浆D-二聚体水平较健康者显著升高,故通过检测血浆D-二聚体水平可以早期诊断急性缺血性结肠炎;病变范围广患者的血浆D-二聚体水平显著高于病变范围小患者。     

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…     

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.     

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.     

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.     

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.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…