原发性高血压应用苯磺酸氨氯地平联合氯沙坦治疗的效果研究

目的研究苯磺酸氨氯地平联合氯沙坦治疗原发性高血压(EH)的临床疗效。方法 160例EH患者按照数字随机法分为观察组和对照组,每组80例。对照组应用氯沙坦治疗,对照组应用苯磺酸氨氯地平联合氯沙坦治疗,对比两组的临床治疗效果。结果治疗后两组的SBP及DBP均较治疗前显著性降低,且观察组显著低于对照组(P0.05);观察组的治疗总有效率为92.50%,较对照组的81.25%显著性提高(P0.05);两组不良反应比较无明显差异(P0.05)。结论苯磺酸氨氯地平联合氯沙坦治疗EH相较于氯沙坦单用可获得更为显著的疗效,不良反应较少,值得推广应用。     

胺碘酮联合苯磺酸氨氯地平治疗冠心病高血压的临床效果及安全性分析

目的:探讨胺碘酮联合苯磺酸氨氯地平治疗冠心病高血压的临床效果及安全性。方法:选取2018年5月-2019年5月本院收治的冠心病高血压患者84例。依据随机数字表法将其分为研究组和对照组,每组42例。对照组应用胺碘酮,研究组在对照组基础上联合应用苯磺酸氨氯地平。比较两组的临床疗效、不良反应发生情况及治疗前后的相关血压指标。结果:治疗后,研究组的24 h DBP及SBP水平均低于对照组,差异均有统计学意义(P0.05)。研究组治疗总有效率为95.2%,显著高于对照组的78.6%,差异有统计学意义(P0.05)。两组的不良反应发生情况比较,差异无统计学意义(P0.05)。结论:给予冠心病高血压患者应用胺碘酮联合苯磺酸氨氯地平进行治疗,可显著提高患者的临床治疗有效率,降低患者的收缩压及舒张压水平,且安全性高。     

苯磺酸氨氯地平联合厄贝沙坦片治疗高血压的效果探析

目的探讨高血压采用苯磺酸氨氯地平、厄贝沙坦片联合治疗的效果。方法择取2018年1月8日至2018年12月26日我院高血压患者63例作为研究对象,随机数字表法分组,对照组28例采用厄贝沙坦片治疗,于对照组基础上,观察组35例加用苯磺酸氨氯地平,对比两组治疗前后血压水平,分析疗效,探讨苯磺酸氨氯地平、厄贝沙坦片联合用药方案的临床价值。结果观察组总有效率94.29%明显高于对照组82.14%(P0.05);治疗前,两组DBP、SBP指标水平无明显差异,治疗后两组DBP、SBP指标水平均下降,而观察组治疗后DBP (80.65±3.10) mmHg、SBP (130.65±2.78) mmHg明显低于对照组DBP (88.26±3.23) mmHg、SBP (139.53±3.12) mmHg (P0.05)。结论临床针对高血压患者采用苯磺酸氨氯地平、厄贝沙坦片联合用药方案,疗效显著,可有效控制和缓解患者血压水平,改善患者临床症状表现,临床用药价值较高。     

安宫降压丸治疗初发难治性高血压临床疗效分析

目的探讨安宫降压丸治疗初发难治性高血压的临床疗效。方法选取2016年1月‐2016年12月在该院治疗的初发难治性高血压患者60例为研究对象,将其随机分为研究组和对照组,每组患者各30例。两组患者均采用标准的抗高血压治疗方法治疗,研究组患者在此基础上联合安宫降压丸治疗。比较两组患者治疗前后血压水平,血压临床疗效情况以及中医证候积分疗效。结果研究组患者治疗后24 h收缩压(SBP)、24 h舒张压(DBP)、白昼SBP、白昼DBP、夜间SBP以及夜间DBP较治疗前均显著下降(P0.05);对照组患者治疗前后24 h SBP、24 h DBP、白昼SBP、白昼DBP、夜间SBP以及夜间DBP比较差异均无统计学意义(P0.05);治疗后研究组患者24 h SBP、24 h DBP、白昼SBP、白昼DBP、夜间SBP以及夜间DBP水平均显著低于对照组患者(P0.05);研究组患者血压控制总有效率为43.33%(13/30),显著高于对照组患者的13.33%(4/30)(P0.05);两组患者头晕症状显效、有效和无效例数比较差异有统计学意义(P0.05);两组患者头痛、心悸和失眠症状显效、有效和无效例数比较差异均无统计学意义(P0.05)。结论在常规治疗的基础上联合安宫降压丸治疗初发难治性高血压能够显著提高临床疗效。     

贝那普利联合吲达帕胺用于高血压合并心力衰竭的临床研究

目的探讨贝那普利联合吲达帕胺用于高血压合并心力衰竭的临床疗效。方法选择我院2017年3月至2018年3月收治的高血压合并心力衰竭患者200例为研究对象,按照随机字母表法分为对照组和研究组,两组各100例,对照组应用贝那普利治疗,研究组应用贝那普利联合吲达帕胺治疗,比较两组临床疗效、血压水平、心功能及心室重构指标变化。结果研究组总有效率95.00%与对照组83.00%比较显著较高(P0.05);两组治疗后SBP、DBP水平与治疗前比较明显下降,且治疗后研究组SBP、DBP水平明显低于对照组(P0.05);与对照组比较,研究组LVEF、LVSSVI及E/A明显较高,LVEDVI明显较低,差异具有统计学意义(P0.05)。结论贝那普利联合吲达帕胺治疗高血压合并心力衰竭效果显著,其可降低血压水平,并改善心功能及心室重构指标,具有较高的临床应用价值。     

血府逐瘀汤与阿托伐他汀钙联合治疗对老年高血压患者同型半胱氨酸的影响

目的探讨血府逐瘀汤与阿托伐他汀钙联合治疗对老年高血压患者同型半胱氨酸的影响,从而减少心脑血管事件发生。方法研究对象为2009年11月~2013年11月期间我院收治的103例老年高血压患者,按照入院的先后顺序分为两组,对照组51例采用阿托伐他汀钙治疗,研究组52例采用血府逐瘀汤与阿托伐他汀钙联合治疗,比较两组有效降压率、24h SBP、24h DBP及血浆Hcy水平的变化。结果 1对照组有效降压率（72.55%）与研究组（76.92%）比较差异无统计学意义（P〉0.05）。2对照组及研究组治疗后24h SBP、24h DBP均明显低于治疗前,治疗前后比较差异有统计学意义（P〈0.05）。治疗后研究组24h SBP、24h DBP与对照组治疗后比较差异无统计学意义（P〉0.05）。3对照组及研究组Hcy水平均低于治疗前,研究组治疗前后差异有统计学意义（P〈0.05）,研究组治疗后Hcy水平明显低于对照组治疗后,两组差异有统计学意义（P〈0.05）。结论采用血府逐瘀汤与阿托伐他汀钙联合治疗老年高血压患者可明显降低患者的血压水平,对Hcy的降低程度显著优于单独应用阿托伐他汀钙治疗。     

缬沙坦联合苯磺酸氨氯地平在社区原发性高血压治疗效分析

目的对缬沙坦联合苯磺酸氨氯地平应用在社区原发性高血压中的效果进行分析。方法选取2014年8月至2017年10月收治的82例原发性高血压患者临床资料作为研究对象,将其分为对照组(41例)与研究组(41例),对照组给予缬沙坦治疗,研究组给予缬沙坦联合苯磺酸氨氯地平治疗,比较两组治疗后SBP(收缩压)、DBP(舒张压)的变化及生活质量评分情况。结果研究组治疗后SBP、DBP均显著优于对照组(P 0.05);生活质量评分与对照组相比,差异具统计学意义(P0.05)。结论缬沙坦联合苯磺酸氨氯地平治疗原发性高血压具有显著的效果,可有效改善患者的血压水平,提高生活质量。     

氯沙坦钾联合氨氯地平治疗原发性高血压合并高尿酸血症的疗效研究

目的 探讨氯沙坦钾联合氨氯地平治疗原发性高血压合并高尿酸血症的临床疗效和安全性.方法 选择2010年1月～2012年1月在我院住院治疗的原发性高血压合并高尿酸血症患者60例为研究对象,全部入选病例随机分为治疗组和对照组各30例,对照组给予氯沙坦50 mg,每日1次,连用4周;治疗组给予氯沙坦50mg,每日1次,氨氯地平2.5 mg,每日1次,连用4周.每周监测两组患者的血压和血尿酸各1次,观察期4周.比较两组患者治疗前及治疗4周后收缩压(SBP)、舒张压(DBP)及血尿酸(UA)的变化情况,并观察不良反应情况.结果 治疗4周后,治疗组和对照组患者的SBP、DBP均较治疗前明显降低,差异有统计学意义(P＜0.05),而治疗组SBP、DBP治疗后分别较对照组降低更显著,差异有统计学意义(P＜0.05).治疗4周后,治疗组和对照组患者的UA水平均较治疗前明显下降,且治疗组UA水平较对照组降低更显著,差异有统计学意义(P＜0.05).结论 应用氯沙坦钾联合氨氯地平治疗原发性高血压合并高尿酸血症疗效确切,安全可靠,值得推广运用.     

苯磺酸氨氯地平治疗老年原发性高血压患者的临床效果分析

目的：探讨苯磺酸氨氯地平治疗老年原发性高血压的临床效果。方法将123例老年原发性高血压患者随机分为对照组62例和治疗组61例,对照组给予美托洛尔片12.5mg/次,1次/d;治疗组给予苯磺酸氨氯地平5mg/次,1次/d,2个月为1疗程。用药结束后记录患者的心率、收缩压（SBP）和舒张压（DBP）情况,并统计疗效。结果治疗组总有效率明显高于对照组（P 〈0.05）;治疗后两组患者SBP和DBP明显减少（P 〈0.05）,心率明显降低（P 〈0.05）,且治疗组心率和SBP、DBP明显低于对照组（P 〈0.05）。结论苯磺酸氨氯地平治疗老年原发性高血压疗效显著,效果优于美托洛尔。     

健脾平肝降压汤联合西药治疗高血压的效果分析

目的：探讨健脾平肝降压汤联合西药治疗高血压的效果。方法：选取2018年2月-2021年2月上海市长宁区天山路街道社区卫生服务中心收治的62例高血压患者作为研究对象,采用随机数表法将其分为两组,各31例。对照组患者接受西药治疗,研究组患者在对照组的基础上口服健脾平肝降压汤治疗,比较两组患者治疗前后收缩压(SBP)水平、舒张压(DBP)水平、治疗总有效率、生活质量及不良反应发生率。结果：治疗前,两组SBP、DBP水平比较,差异无统计学意义(P>0.05);治疗后,两组SBP、DBP水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);研究组治疗总有效率高于对照组,差异有统计学意义(P<0.05);研究组治疗后的各项生活质量评分均高于对照组,差异有统计学意义(P<0.05);研究组不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论：健脾平肝降压汤联合西药可有效增强血压控制效果并提高患者的生活质量,可减少西药所致的不良反应,疗效显著,对控制高血压患者病情进展具有积极意义。     

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.