急性心肌梗死时房颤发生的时期及预后

目的 探讨急性心肌梗死(AMI)病人不同时期发生房颤(AF)的临床特点、治疗及预后。方法 采用非创伤性12导联心电图及心电监测法，监测460例AMI病人AF的发生率、原因、药物治疗反应及预后。其中40例病人发生AF，按发生时期分为两组：(1)早发组24例为发病24小时内出现AF；(2)晚发组16例为发病24小时后出现AF。结果 460例AMI病人中，发生AF40例(8．7％)。AF病人的住院病死率、心力衰竭、恶性心律失常发生率比无AF病人高(P＜0.05)。其中，晚期AF组病人住院病死率比早期AF组病人增加(P＜0．05)。结论 AMI病人并发AF，尤其并发晚发AF，提示病情重，预后不良。     

急性心肌梗塞与房室传导阻滞的临床分析

为了解急性心肌梗塞 (AMI)时梗塞部位与合并出现房室传导阻滞 (AVB)的相关性及临床意义 ,对 49例AMI合并AVB的临床资料进行分析。结果显示 :AMI合并AVB者下壁组发生率明显高于前壁组 (P <0 .0 1) ,且AMI合并AVB组病死率高于无AVB组 (P <0 .0 5 )。认为下壁AMI易并发AVB ,且AVB是影响AMI近期预后的一个重要因素。     

急性心肌梗死患者心房颤动的临床和预后意义

目的：探讨急性心肌梗死（AMI）时发生心房纤颤（AF）的临床和预后的意义。方法：分析446例急性心肌梗死患，并发心房纤颤35例，根据房颤发生时间分为AF1组（于AMI后24小时内发生16例）和AF2组（于AMI后24小时后发生19例）；合并窦性心律411例。回顾性分析三组临床特征及住院病死率。结果：窦性心律组患年龄明显小于AF1组（P＜0．05）和AF2组（P＜0．05）；AF1组患下壁心梗的发生率明显高于窦性心律组成AF2组；AF2组前壁心梗的发生率明显高于AF1组；35例并发AF住院病死率、心力衰竭和心源性休克的发生率均明显高于窦性心律组。结论：AMI并发AF患住院病死率高于窦性心律，AMI患AF发作时间对评价心脏状态是一个有价值的参考。     

糖尿病患者合并急性心肌梗死的临床特点及预后分析

目的　探讨糖尿病 (DM )合并急性心肌梗死 (AMI)的临床特点及预后。方法　回顾性分析 63例患者的临床资料 ,对DM组 ( 2 3例 )合并AMI和无DM的AMI组 ( 4 0例 )的临床特点进行比较。结果　DM组血糖 11.1mmol/L明显高于对照组 6.0mmol/L(P <0 .0 5 ) ,肌酸激酶 (CK)峰值 64 5 .7IU/L明显低于对照组 12 82 .8IU /L(P <0 .0 5 ) ;DM组并发症发生率高心衰 3 4.8% ,对照组 12 .5 % (P <0 .0 5 ) ,病死率是对照组的 2 .6倍。结论　糖尿病合并急性心肌梗死患者心力衰竭发生率高 ,病情较重 ,病死率高。     

糖尿病患者合并急性心肌梗塞的临床特点及预后分析

目的　探讨糖尿病 (DM )合并急性心肌梗塞 (AMI)的临床特点及预后。方法　回顾性分析 90例AMI患者的临床资料 ,比较DM并AMI(DM组 )和非DM的AMI(非DM组 )患者的临床特点和预后。结果　DM组发生多部位梗塞明显多于非DM组 (χ2 =4.18,P <0 .0 5 ) ,DM组发生AMI时并发症的发生率及病死率明显高于非DM组 (P <0 .0 5或 0 .0 1) ,主要死于心力衰竭、室颤。结论　DM合并AMI患者心力衰竭发生率高 ,病情较重 ,病死率高。     

不同性别急性心肌梗死患者临床对比研究

目的 :探讨男、女性急性心肌梗死 (AMI)患者临床特点的差别。方法 :对 390例急性心肌梗死的患者进行回顾性分析。结果 :在既往病史中 ,女性组糖尿病和高脂血症病史比例高于男性组 (P <0 0 5 ,P <0 0 1) ;男女组梗死部位比较差异无显著性 (P >0 0 5 ) ;女性组血糖、血脂均高于男性组 (P <0 0 1) ;女性组心源性休克、心力衰竭、猝死的发生率及住院病死率均高于男性组 (P <0 0 5 ) ;在接受静脉溶栓治疗的男女患者中 ,男性年龄较女性提前 (P <0 0 1) ,男性溶栓再通率高于女性 (P <0 0 1)。结论 :糖尿病、高脂血症是女性AMI患者的危险因素 ,绝经后女性AMI发病率增高 ,并发症发生率及住院病死率均高于男性 ,静脉溶栓治疗效果较差 ,女性AMI患者近期预后较男性差。     

右束支传导阻滞在急性心肌梗死中的意义

目的:评价急性心肌梗死(AMI)患者并发右束支传导阻滞(RBBB)的临床意义及预后.方法:将我院1990～1999年收治的伴有新出现的持续性RBBB的AMI患者15例作为观察组,以同期收治的无束支传导阻滞的AMI患者15例作为对照组,分析两组的心肌梗死范围(MIS),严重并发症及住院病死率.结果:两组比较,观察组的MIS大,严重室性心律失常发生率高,心功能受损严重,住院病死率高(P＜0.05).结论:伴随AMI新出现的持续性RBBB是临床经过凶险和预后不良的标志.     

老年急性心肌梗塞的临床分析

目的　了解老年急性心肌梗塞 (AMI)患者的临床特征及预后。方法　对 5 2例老年AMI患者的临床资料进行回顾性分析。结果　老年组女性患者比例高于男性 (P <0 .0 1) ,无痛性AMI、心力衰竭、心律失常的发生率及病死率均高于非老年组 (P <0 .0 1或 0 .0 5 )。结论　老年AMI以无痛性多见 ,并发症多 ,病死率高。     

白细胞计数与急性心肌梗死近期预后的关系

目的 :探讨血白细胞 (WBC)计数与急性心肌梗死 (AMI)近期预后的关系。方法 :根据WBC计数水平将 90例AMI患者分为A组 (WBC计数≥ 10× 10 9/L)和B组 (WBC计数 <10× 10 9/L) ,对照观察两组年龄、性别、既往病史、并发症及死亡率变化。结果 :A组并发症如严重心力衰竭 (KillipⅢ～Ⅳ )、各种心律失常发生率及住院期间病死率显著高于B组 (P分别为 <0 .0 1、<0 .0 5和 <0 .0 0 5 )。结论 :WBC计数能够评估AMI的近期预后 ,可作为AMI危险分层的简便而可靠的指标之一。     

急性心肌梗死并发室内传导阻滞的临床意义

目的　评价急性心肌梗死 (AMI)患者并发室内传导阻滞 (IVCB)的临床意义和预后。方法　回顾 170例AMI住院患者病历资料予以总结 ,分为室内传导阻滞 (IVCB)和无室内传导阻滞 (NIVCB)两组进行统计学分析。结果　IVCB的发生率为 2 9.4%,病死率为 40 .0 %(P <0 .0 1) ,前壁、多壁梗死、室性心律失常、泵衰竭在IVCB组中构成比较高 (P <0 .0 5 ) ,住院病死率亦高 (P <0 .0 1)。结论　AMI并发IVCB患者多提示有大面积心肌梗死 ,常伴各种严重并发症和高病死率 ,必须高度重视 ,积极治疗     

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.     

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…     

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     

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.     

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.     

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.     

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.