乌司他丁联合纳洛酮在急性有机磷农药中毒治疗中的应用

目的探讨乌司他丁与纳洛酮联合使用在急性有机磷农药中毒（APPO）治疗中的应用效果方法将急性有机磷农药中毒患者56例,随机分为治疗组和对照组,两组病例均进行洗胃,静注阿托品、氯磷定和综合治疗,治疗组加用乌司他丁、纳洛酮治疗。观察两组患者阿托品化时间、阿托品用量、住院时间、治愈率、中间综合症（IMS）例数。结果治疗组与对照组（行常规治疗）比较,差异有统计学意义（P〈0.05）。结论对急性有机磷中毒使用乌司他丁联合纳洛酮治疗疗效确切。     

乌司他丁与奥曲肽联合治疗急性重症胰腺炎的疗效观察

目的：观察乌司他丁、奥曲肽联合治疗急性重症胰腺炎的临床疗效。方法：67例证实急性重症胰腺炎的患者进入本研究，其中，乌司他丁、奥曲肽联合治疗组24例，乌司他丁对照组21例，奥曲肽对照组22例，治疗组分别与两个对照组进行临床疗效比较及统计学处理。结果：联合治疗组与两个对照组治疗急性重症胰腺炎疗效比较，差异有显著性（P〈0．05）。结论：乌司他丁、奥曲肽联合治疗急性重症胰腺炎有较好的临床疗效，值得临床推广。     

乌司他丁联合奥曲肽对急性胰腺炎患者细胞因子的影响

【摘要】目的 探讨乌司他丁联合奥曲肽对急性胰腺炎患者细胞因子的影响。方法 选取2012年3月～2016年7月于本院接受治疗的126例急性胰腺炎患者,将所有患者随机分配到奥曲肽组、乌司他丁组及联合组,每组各42例。3组患者均进行常规治疗,奥曲肽组同时进行奥曲肽静脉泵注治疗,乌司他丁组同时进行乌司他丁静脉滴注治疗,联合组同时进行两种药物的联合用药治疗。回顾性分析3组患者的临床资料,观察分析3组患者治疗的临床疗效及对细胞因子的影响。结果 3组患者进行治疗后临床疗效的比较,奥曲肽组痊愈13例,有效14例,无效15例,总有效率为64.29 %;乌司他丁组痊愈14例,有效12例,无效16例,总有效率为61.90 %;联合组痊愈28例,有效11例,无效3例,总有效率为9286 %。联合组与奥曲肽组及乌司他丁组进行比较,3组临床疗效比较差异有统计学意义（P＜0.05）。治疗前,3组进行细胞因子水平比较差异无统计学意义（P＞0.05）;治疗后,3组细胞因子水平比较差异有统计学意义（P＜0.05）;治疗后,奥曲肽组及乌司他丁组细胞因子水平进行对比,差异无统计学意义（P＞0.05）。奥曲肽组并发症发生率为1111%,乌司他丁组并发症发生率为7.93%,联合组并发症发生率为317%,三组比较差异有统计学意义（P＜0.05）。结论 乌司他丁联合奥曲肽治疗急性胰腺炎患者相比两种药物单纯治疗的临床疗效更显著,能够明显改善患者临床体征及症状,降低并发症的发生率,提高治疗的安全性,有利于患者病情快速恢复,值得临床推广。     

乌司他丁联合奥曲肽治疗急性胰腺炎的疗效分析

目的探讨乌司他丁联合奥曲肽治疗急性胰腺炎的疗效。方法将70例急性胰腺炎患者随机分为2组,观察组（n=35）接受乌司他丁联合奥曲肽治疗,对照组（n=35）接受奥曲肽治疗,比较两组患者的疗效。结果①观察组的腹痛缓解时间、血淀粉酶（AMY）恢复正常时间、尿AMY恢复正常时间、住院时间显著短于对照组,差异有统计学意义（P〈0.05）。②观察组治疗效果显著优于对照组,差异有统计学意义（P〈0.05）。结论乌司他丁联合奥曲肽治疗急性胰腺炎具有恢复快、疗效确切等优点。     

乌司他丁联合奥曲肽治疗重症急性胰腺炎的临床效果分析

目的探讨乌司他丁联合奥曲肽治疗重症急性胰腺炎的临床效果。方法 77例急性胰腺炎患者被随机分为乌司他丁组,奥曲肽组和联合组。所有患者均给予常规治疗,乌司他丁组加用乌司他丁治疗,奥曲肽组加用奥曲肽治疗,联合组同时加用上述两种药物。结果 1周后联合组总有效率（x2=7.486,P〈0.05）和APACHEⅡ评分（t=5.324,P〈0.05）均显著优于单用组。结论乌司他丁和奥曲肽配合基础治疗应用于SAP患者,安全有效,能显著改善患者病情,是临床上值得考虑的用药方案。     

急性重症胰腺炎应用乌司他丁联合奥曲肽治疗的效果观察

目的 探讨急性重症胰腺炎应用乌司他丁联合奥曲肽治疗的效果.方法 资料随机选取在该院诊治的128例急性重症胰腺炎患者,将其分成研究组和对照组,每组64例,其中对照组患者给予奥曲肽治疗,研究组患者在奥曲肽的基础上加用乌司他丁,比较两组患者的恢复时间和临床疗效.结果 两组患者的恢复时间比较,研究组在腹痛缓解的时间、腹部压痛的消失时间、血淀粉酶恢复时间和尿淀粉酶的恢复时间均低于对照组患者,差异有统计学意义（P＜0.05）;两组患者的临床治疗效果比较,研究组患者总有效率为93.75％,明显高于对照组71.88％,差异有统计学意义（P＜0.05）.结论 急性重症胰腺炎患者应用乌司他丁联合奥曲肽治疗,疗效显著,值得使用和推广.     

奥曲肽联合乌司他丁治疗急性胰腺炎的临床观察

目的：探讨和研究应用奥曲肽联合乌司他丁治疗急性胰腺炎的临床疗效和价值。方法：将我院收治急性胰腺炎患者76例随机分为治疗组和对照组,两组患者入院后行常规对症支持治疗,在此基础上,治疗组应用奥曲肽联合乌司他丁治疗,对照组单纯应用奥曲肽治疗,治疗结束后,对两组患者症状改善情况以及治疗效果进行对比分析。结果：治疗组的腹痛缓解时间、血淀粉酶下降时间以及尿淀粉酶下降时间显著短于对照组（P＜0．05）;治疗组治疗总有效率为92．1％,对照组为73．7％,治疗组显著高于对照组（P＜0．05）。结论：奥曲肽联合乌司他丁治疗急性胰腺炎疗效确切,安全,具有在临床应用的重要现实意义。     

乌司他丁联合奥曲肽治疗急性胰腺炎32例疗效观察

目的:观察乌司他丁、奥曲肽同时应用治疗急腺炎的临床疗效.方法:64例急性胰腺炎患者随机分为两组,治疗组32例静肪滴注乌司他丁联合奥曲肽治疗,对照组32例静脉滴注奥曲肽等治疗.比较两组患者临床症状、体征、实验室检查(血、尿淀粉酶、血白细胞计数).结果:两组患者治疗后临床疗效比较有显著性差异(P＜0.05).结论:乌司他丁联合奥曲肽对急性胰腺炎有较好疗效.     

奥曲肽联合乌司他丁治疗急性胰腺炎疗效观察

目的:观察乌司他丁联合奥曲肽治疗急性胰腺炎的临床疗效.方法:选取我院收治的1 36例急性胰腺炎患者,随机均分为两组,对照组患者给予奥曲肽治疗,试验组患者在对照组治疗基础上加乌司他丁进行治疗,对比两组疗效.结果:试验组治愈率和总有效率显著高于对照组,两组差异有统计学意义,P＜0.05.结论:乌司他丁联合奥曲肽治疗急性胰腺炎见效迅速,疗效显著,值得临床推广应用.     

大剂量氨溴索联合乌司他丁治疗急性呼吸窘迫综合征的临床观察

目的 观察氨溴索联合乌司他丁治疗急性呼吸窘迫综合征（ARDS）的临床效果.方法 ARDS患者67例,按随机数字表分为治疗组36例和对照组31例,两组均给予常规治疗方法,治疗组加大剂量氨溴索联合乌司他丁治疗,对照组加甲强龙静脉注射.治疗10 d后,观察两组的临床疗效,以及治疗前后APACHEⅡ评分、肺损伤评分、机械通气率、住院时间、PaO2、SaO2、PaO2/ FiO2.方法 治疗10 d后治疗组总有效率为83.3%,高于对照组的61.3%,差异有统计学意义（P＜0.05）;APACHEⅡ评分、肺损伤评分、PaO2、SaO2和PaO2/ FiO2改善均优于对照组（P＜0.05）,住院时间短于对照组（P＜0.05）.结论 大剂量氨溴索联合乌司他丁治疗ARDS疗效好,可缩短住院时间,对提高诊疗质量具有积极的意义.     

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.