灯盏细辛对不稳定型心绞痛及慢性心力衰竭的影响

目的 观察灯盏细辛注射液对冠心病患者不稳定型心绞痛及慢性心力衰竭的治疗效果.方法 将108例冠心病不稳定型心绞痛合并慢性心力衰竭患者随机分为对照组及观察组,对照组接受常规治疗,观察组在常规治疗基础上加用灯盏细辛注射液治疗,观察两组治疗前、后心绞痛缓解情况(心绞痛发作频率、心绞痛持续时间、硝酸甘油用量)及心功能指标(左心室舒张末期内径、左心室收缩末期内径、每搏输出量、心输出量、左室射血分数)变化,并对两组结果加以比较.结果 治疗后两组心绞痛发作均较治疗前减少(P<0.05),观察组较对照组改善更为明显(P<0.05);两组左心室舒张末期内径、左心室收缩末期内径、每搏输出量、心输出量、左室射血分数等心功能指标较治疗前亦明显改善,观察组与对照组治疗后相比差异有显著性(P<0.05);观察组临床疗效优于对照组(P<0.05).结论 常规治疗基础上加用灯盏细辛注射液,可明显减少不稳定型心绞痛患者心绞痛发作.改善其心功能.     

曲美他嗪改善糖尿病患者心功能不全的临床研究

目的探讨曲美他嗪对合并糖尿病的心功能不全患者的影响.方法45例合并糖尿病的收缩性心功能不全患者随机分为二组,对照组22例给予常规治疗,曲美他嗪组23例在常规治疗基础上加用曲美他嗪20 mg,3次/d口服,12周后用心功能改善程度、心动超声图、6 min步行距离评价心功能.结果曲美他嗪组治疗总有效率比对照组高(95.7% VS 63.6%,P＜0.05),曲美他嗪组左室收缩末期内径、左室舒张末期内径均较对照组明显缩小(P＜0.05),射血分数明显提高(P＜0.05),6 min步行距离(m)明显较对照组远(290±44.3 VS 216±41.2,P＜0.05).结论曲美他嗪通过改善心肌代谢有利于提高合并糖尿病的心功能不全患者心功能,是安全有效的辅助用药.     

曲美他嗪治疗糖尿病合并冠心病56例临床观察

目的探讨曲美他嗪治疗糖尿病合并冠心的临床效果.方法对112例糖尿病合并冠心病的患者,随机分为治疗组和对照组各56例,对照组常规治疗,治疗组在对照组的基础上应用盐酸曲美他嗪20mg,3次/d.连续口服3个月.观察两组患者心功能级改善情况.结果治疗组在心绞痛发作次数、持续时间、左室射血分数均有改善,与对照组比较,差异有统计学意义,P<0.05.但血糖变化不大.结论曲美他嗪可明显改善糖尿病合并冠心病患者的心功能.     

曲美他嗪治疗冠心病合并慢性心功能不全的临床研究

目的观察曲美他嗪治疗冠心病合并慢性心功能不全的疗效。方法将114例冠心病合并慢性心功能不全患者分为两组,各57例。对照组给予常规药物治疗,研究组在对照组治疗基础上加用曲美他嗪20mg口服治疗,3次／d,疗程3个月。治疗前后测定两组患者血浆N末端B型利钠肽原（NT-proBNP）水平、6min步行距离,并评价心功能和心脏超声指标改善情况。结果研究组总有效率高于对照组（P〈0．05）。两组治疗后NT-proBNP水平均较治疗前低,6min步行距离延长,但研究组改善更明显（均P〈0．05）。两组治疗后左室收缩末期内径、左室舒张末期内径均较治疗低,左室射血分数、二尖瓣口舒张早期和舒张晚期血流峰值之比高,但研究组改善更明显（均P〈0．05）。结论曲美他嗪治疗冠心病合并慢性心功能不全临床疗效确切,能提高心功能和运动耐力,改善左室重构。     

阿托伐他汀联合曲美他嗪治疗冠心病的疗效研究

目的：探讨冠心病患者采用阿托伐他汀联合曲美他嗪治疗的临床效果。方法将142例冠心病患者随机分为对照组与观察组各71例,所有患者均采用利尿剂、血管扩张剂、β受体阻滞剂以及硝酸酯类药物进行常规治疗,对照组在此基础上给予盐酸曲美他嗪治疗,观察组在此基础上应用阿托伐他汀联合盐酸曲美他嗪治疗。比较2组患者的心功能与临床疗效。结果观察组患者的左室射血分数为（47.5±7.9）%,左室舒张末期内径为（60.2±4.1）mm,左室收缩末期内径为（45.3±6.1）mm,室间隔厚度为（10.1±1.1）mm,左室后壁厚度为（9.3±2.2）mm,临床治疗总有效率为93.0%,上述各项指标均显著优于对照组,差异具有统计学意义（P<0.05）。结论阿托伐他汀联合曲美他嗪治疗冠心病可迅速改善心功能,抑制心绞痛等疾病症状,提高临床治疗效果。     

曲美他嗪治疗冠心病心力衰竭的用药效果分析与研究

目的分析研究曲美他嗪治疗冠心病心力衰竭的用药效果。方法选取我院2016年12月至2017年12月因冠心病伴随心力衰竭入院的100例患者,分为对照组和观察组各组50例,对照组采用常规的冠心病心力衰竭临床治疗,观察组在对照组的基础上每日三餐之后口服曲美他嗪进行药物治疗,治疗周期为3个月,对比两组患者的临床治疗效果。结果两组患者治疗3个月后NYHA心功能分级明显改善(P0.05),曲美他嗪治疗冠心病心力衰竭的用药效果明显优于常规的冠心病心力衰竭临床治疗(P0.05),观察组的50例患者的左心室舒张末期内径、左心室收缩末期内径、左室射血分数等方面明显优于常规冠心病心力衰竭临床治疗(P0.05),且给予曲美他嗪药物治疗的观察组患者心率及血压变化小。结论曲美他嗪药物治疗冠心病心力衰竭疗效显著,能够有效的改善心功能,无明显不良反应,值得推广。     

盐酸曲美他嗪治疗冠心病合并慢性心力衰竭临床观察

目的观察盐酸曲美他嗪治疗冠心病合并慢性心力衰竭的疗效。方法冠心病合并慢性心力衰竭患者84例,随机分为对照组和治疗组,其中对照组39例,应用血管紧张素转换酶抑制剂、β受体阻滞剂、氢氯噻嗪或呋塞米、硝酸酯类、钙拮抗剂、地高辛、阿司匹林等进行常规治疗;治疗组45例,在上述常规治疗基础上加用盐酸曲美他嗪治疗,分别观察用药前及用药12周后两组患者临床心功能改善情况并测定超声心动图、左室射血分数（LVEF）、左室舒张末期内径（LVEDD）、左室短轴缩短率（FS）。结果用药12周后曲美他嗪组患者的总有效率明显优于对照组,LVEF、LVEDD、FS均显著改善,与对照组比较差异有统计学意义（P〈0.05）。结论曲美他嗪通过改善缺血心肌细胞的能量代谢,可显著改善冠心病慢性心力衰竭患者的临床临床疗效,提高心功能分级和心脏收缩功能。     

曲美他嗪对老年冠心病多支病变患者的治疗效果分析

目的:探讨曲美他嗪对老年冠心病多支病变患者的治疗效果。方法:选取40例老年冠心病多支病变患者为研究对象,在常规抗心绞痛药物的基础上给予曲美他嗪片20mg,3次/d,连续治疗6个月。比较治疗前后患者心绞痛发作频率,硝酸甘油用量,左室舒张末期内径及左室射血分数,并观察有无不良反应。结果:治疗6个月后,患者的心绞痛发作频率较少,发作的持续时间、疼痛严重程度也明显改善;硝酸甘油用量明显减少;左室舒张末期内径明显缩小;左室射血分数明显改善,与治疗前比较差异均有统计学意义(P<0.05)。40例患者均未发生明显的不良反应。结论:曲美他嗪可明显缓解老年冠心病多支病变患者的心绞痛症状,改善左室舒张末期内径及心功能。     

阿托伐他汀联合曲美他嗪治疗冠心病心绞痛的疗效分析

目的了解冠心病心绞痛患者用阿托伐他汀、曲美他嗪联合治疗的临床价值。方法分析对象30例,选自2016年6月至2017年6月本院诊治冠心病心绞痛患者,分为常规组与联合组各15例,对应接受常规冠心病心绞痛治疗、阿托伐他汀联合曲美他嗪治疗。比较两种治疗手段临床应用效果。结果联合组患者病情干预有效率明显高于常规组;联合组心功能指标左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左室后壁厚度(LVPWD)明显优于常规组。结论对冠心病心绞痛患者用曲美他嗪联合阿托伐他汀药物治疗方案,可缓解病情,提高心功能。     

曲美他嗪治疗缺血性心肌病心力衰竭的临床观察

目的 用6分钟步行试验和多普勒超声心动图评价曲美他嗪辅助治疗缺血性心肌病心力衰竭的疗效。方法 选取116例因缺血性心肌病而导致慢性心力衰竭患者（纽约心脏病学会分级Ⅱ～Ⅳ级）。采用随机、单盲试验,将病人分为两组,曲美他嗪组60例,采用常规治疗及口服曲美他嗪,每次20mg,每日3次;对照组56例,采用常规治疗,疗程3个月,观察两组治疗前后左心室收缩末期内径、左心室舒张末期内径、左室收缩末期容积、左心室舒张末期容积、左心室射血分数、心搏出量、短轴缩短分数、6分钟步行距离。结果用药3个月后,组间比较显示曲美他嗪组的、左心室收缩末期内径、左心室收缩末期容积、射血分数、心搏出量,短轴缩短分数及6分钟步行距离较常规治疗组有进一步的改善。结论在常规治疗缺血性心肌病心力衰竭的基础上加用曲美他嗪可以进一步改善患者的心脏收缩功能,提高患者的运动耐量,耐受性良好。     

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.