醒脑静、纳洛酮联合高压氧治疗急性一氧化碳中毒的疗效观察

目的观察醒脑静、纳洛酮联合高压氧治疗急性一氧化碳中毒（ACOP）的疗效。方法将80例患者随机分为治疗组和对照组各40例,两组均给予常规药物治疗加高压氧治疗。治疗组则在以上治疗基础上再给予醒脑静和纳洛酮,观察两组疗效。结果治疗组与对照组有效率分别为96．67％和83．33％;迟发性脑病发生率为3．33％和16．67％;治疗组意识恢复时间较短,两组比较差异有统计学意义（P〈0．05）。结论醒脑静、纳洛酮联合高压氧对ACOP疗效显著,且可降低迟发性脑病的发生率。     

醒脑静和奥扎格雷治疗急性一氧化碳中毒102例疗效观察

目的研究醒脑静和奥扎格雷合用治疗急性一氧化碳中毒(ACOP)的疗效及其预防迟发性脑病的作用。方法204例ACOP患者,按入院顺序随机分为治疗组和对照组各102例,2组均予常规治疗,治疗组加用醒脑静注射液20ml,奥扎格雷120mg静脉滴注,10～14d为1疗程,观察2组疗效及病情好转时间,随防60d,观察迟发性脑病发生率。结果治疗组总有效率96.1%,对照组90.2%,差异无统计学意义(P>0.05);治疗组显效率(84.3%)高于对照组(39.2%),差异有统计学意义(P<0.05)。治疗组平均显效时间(16.0±1.2)h短于对照组(32.0±7.0)h,差异有统计学意义(P<0.05)。随访60d迟发性脑病发生率治疗组(5.9%)低于对照组(19.6%),差异有统计学意义(P<0.05)。结论醒脑静和奥扎格雷合用可以明显缩短ACOP患者意识障碍时间,显著提高效率,有效地减少迟发性脑病的发生率。     

醒脑静联合乙酰谷酰胺治疗急重型颅脑损伤的疗效观察

目的：探讨醒脑静联合乙酰谷酰胺治疗急重型颅脑损伤的临床疗效。方法：选取我院神经外科于2010年1月～2012年1月收治的急重型颅脑损伤60例,作为本次研究的对象。随机分为实验组和对照组两个组别,每个组别30例患者;在常规支持治疗的基础上,对照组患者给予单-乙酰谷酰胺治疗,而实验组则给予醒脑静联合乙酰谷酰胺治疗。2周为1个治疗疗程,治疗结束后,主要观察：①两组患者治疗前及治疗1后的GCS评分情况;②1个月时患者清醒人数及清醒时间情况,3、4个月时,治疗疗效评估情况。综合以上数据评估醒脑静联合乙酰谷酰胺治疗急重型颅脑损伤的临床疗效。结果：①治疗2周时,两个组别的患者GCS评分均有显著升高,实验组较对照组升高明显,P＜0．05;②治疗1个月时,两组患者均有不同人数恢复神智,逐渐清醒,实验组患者较对照组患者清醒率更高,平均清醒时间则短,P＜0．05;3、治疗4个月,临床疗效及预后评估,实验组显著高于对照组患者,P＜0．05。结论：醒脑静联合乙酰谷酰胺治疗急重型颅脑损伤的是一种安全有效的方法,可以在临床上进一步推广应用。     

纳洛酮联合醒脑静在一氧化碳中毒急诊抢救中的效果分析

目的:分析纳洛酮联合醒脑静在一氧化碳中毒急诊抢救中的效果。方法:80例一氧化碳中毒患者根据治疗措施不同分为两组,对照组(n=40例)在对症支持治疗基础上予以纳洛酮注射液治疗,观察组(n=40例)在对照组基础上加用醒脑静脉滴注射液治疗,两组患者治疗时间均为2周。比较两组患者治疗总有效率及清醒时间、运动功能恢复时间、迟发性脑病发生率及治疗前后格拉斯哥昏迷评分(GCS)变化。结果:观察组患者治疗总有效率(92.5%)明显高于对照组(70.0%),差异有统计学意义(P<0.05);观察组清醒时间及运动功能恢复时间均明显快于对照组,差异有统计学意义(P<0.05),迟发性脑病发生率明显低于对照组,差异有统计学意义(P<0.05),两组患者治疗前GCS评分比较,差异无统计学意义(P>0.05),两组患者治疗后GCS评分均明显升高,差异有统计学意义(P<0.05),且观察组治疗后GCS评分升高较对照组更为明显,差异有统计学意义(P<0.05)。结论:纳洛酮联合醒脑静治疗一氧化碳中毒患者疗效显著,可明显促进患者清醒和运动功能恢复,降低脑病发生率,值得临床广泛应用。     

醒脑静联合乙酰谷酰胺治疗急重型颅脑损伤的疗效观察

目的:探讨醒脑静联合乙酰谷酰胺治疗急重型颅脑损伤的临床疗效。方法:选取我院神经外科于2010年1月~2012年1月收治的急重型颅脑损伤60例,作为本次研究的对象。随机分为实验组和对照组两个组别,每个组别30例患者;在常规支持治疗的基础上,对照组患者给予单-乙酰谷酰胺治疗,而实验组则给予醒脑静联合乙酰谷酰胺治疗。2周为1个治疗疗程,治疗结束后,主要观察:①两组患者治疗前及治疗1后的GCS评分情况;②1个月时患者清醒人数及清醒时间情况,3、4个月时,治疗疗效评估情况。综合以上数据评估醒脑静联合乙酰谷酰胺治疗急重型颅脑损伤的临床疗效。结果:①治疗2周时,两个组别的患者GCS评分均有显著升高,实验组较对照组升高明显,P0.05;②治疗1个月时,两组患者均有不同人数恢复神智,逐渐清醒,实验组患者较对照组患者清醒率更高,平均清醒时间则短,P0.05;3、治疗4个月,临床疗效及预后评估,实验组显著高于对照组患者,P0.05。结论:醒脑静联合乙酰谷酰胺治疗急重型颅脑损伤的是一种安全有效的方法,可以在临床上进一步推广应用。     

醒脑静治疗急性一氧化碳中毒迟发性脑病30例疗效观察

目的观察醒脑静注射液治疗急性一氧化碳中毒迟发性脑病的临床疗效。方法将60例急性一氧化碳中毒迟发性脑病患者随机分为对照组和治疗组,两组均给予常规治疗,治疗组在常规治疗基础上加用醒脑静治疗。结果治疗组总有效率为93.3%,对照组为73.3%,差异有统计学意义(P<0.01)。结论醒脑静治疗可促进一氧化碳中毒迟发性脑病患者的神经功能恢复,改善其预后。     

醒脑静及神经节苷脂治疗CO中毒迟发型脑病对照研究

目的:比较醒脑静及神经节苷脂治疗急性CO中毒迟发性脑病的临床疗效。方法:将90例CO中毒迟发性脑病患者随机分为醒脑静治疗组(30例)、神经苷脂治疗组(30例)和对照组(30例),对照组予高压氧等常规治疗,治疗组在对照组基础上加用醒脑静或神经苷脂治疗,观察比较疗效。结果:神经苷脂治疗组总有效率(90%)高于醒脑静组(70%),两组比较有统计学意义,且均高于对照组(54%)。结论:神经苷脂治疗急性CO中毒迟发性脑病疗效好于醒脑静。     

醒脑静联合高压氧治疗干预对急性一氧化碳中毒患者的影响研究

目的：探究急性一氧化碳中毒(ACOP)患者采取醒脑静联合高压氧治疗干预对其苏醒时间、迟发性脑病及肝肾功能的影响。方法：选取2021年1月—2022年1月信阳市中心医院收治的118例ACOP患者作为研究对象,根据抽签法分为两组,每组各59例。两组患者均接受常规基础治疗,在此基础上予以对照组高压氧治疗,予以观察组患者醒脑静联合高压氧治疗。评价两组患者临床疗效,记录苏醒时间、住院时间以及迟发性脑病发生情况。在治疗前和治疗后检测两组患者肝、肾功能。结果：观察组患者苏醒时间、住院时间相比对照组均显著更短,差异有统计学意义(t=15.774、9.484,P<0.05);迟发性脑病发生率相比对照组更低,差异有统计学意义(χ²=11.863,P<0.05);治疗后,两组患者丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、血尿素氮(BUN)、血肌酐(Scr)相比治疗前均有所下降,且观察组患者ALT、AST、BUN、Scr均显著低于对照组,差异有统计学意义(t=6.400、5.626、10.277、12.752,P<0.05);观察组患者临床总有效率相比...     

高压氧治疗急性中重度一氧化碳中毒疗效及预防迟发性脑病的临床价值

目的 探讨高压氧治疗急性中重度一氧化碳（CO）中毒疗效及预防迟发性脑病的临床价值。方法 选取2016年1月～2019年12月接受治疗的中重度CO中毒患者120例为研究对象，进行前瞻性研究，按照数字表法分为对照组和观察组，每组60例。对照组给予常规治疗，观察组给予高压氧治疗，比较两组患者的治疗效果，治疗前后的氧化应激指标水平变化，治疗后的意识水平（GCS）评分、神经损伤程度（ NFDS）评分、日常生活自理能力评分（BI）及迟发性脑病的发生情况。结果 观察组治疗的总有效率（9167%）高于对照组（7667%）（P＜0.05）。治疗后，两组患者的肌电图诱发电位FZ位点、PZ位点的事件相关电位P300的潜伏期、振幅均改善，且观察组改善情况优于对照组（P＜0.05）。治疗后，两组超氧化物歧化酶(SOD)水平升高，丙二醛(MDA)、神经元特异性烯醇化酶(NSE)水平下降，且观察组SOD水平显著高于对照组， MDA、NSE水平显著低于对照组（均P＜0.05）。治疗后，观察组的GCS评分、BI评分明显高于对照组，NFDS评分低于对照组（均P＜0.05）。治疗过程中对照组出现1例失眠，1例恶心、呕吐，不良反应发生率为3.33%；观察组出现1例食欲不振，不良反应发生率为167%；两组比较，差异无统计学意义（P＞0.05）。3个月后随访结果显示，观察组出现2例迟发性脑病，占比333%；对照组出现8例迟发性脑病，占比1333%；两组比较，差异有统计学意义（2=3.927，P=0.048）。结论 高压氧治疗急性中重度CO中毒疗效较好，可促进脑细胞血液循环，有效缓解患者的氧化应激状态，能降低神经功能损伤程度及迟发性脑病的发生率，促进认知功能和日常生活能力的恢复，不良反应少，具有临床应用价值。     

纳洛酮联合醒脑静注射液治疗重度一氧化碳中毒的疗效观察

目的 探讨纳洛酮联合醒脑静注射液治疗重度重度一氧化碳(CO)中毒的临床疗效.方法 将60例确诊为重度CO中毒的患者按随机数字表法分为联合组和对照组各30例.对照组采用常规处理+纳洛酮治疗,联合组在对照组的基础上加用醒脑静注射液治疗.观察两组的治疗效果及苏醒时间,并进行对比分析.结果 联合组死亡率为3.3%(1/30),与对照组的6.7%(2/30)比较,差异无统计学意义(P＞0.05).联合组患者苏醒时间快于对照组(P＜0.05);联合组临床疗效优于对照组(P＜0.05);随访2个月,联合组迟发型脑病发生率为6.7%(2/30),低于对照组的26.7%(8/30)(P＜0.05).结论 纳洛酮及醒脑静联合应用对重度中毒具有起效快,安全可靠、后遗症少的优点,值得临床推广.     

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.     

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.     

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.