肺结核大咯血及其窒息的救治

目的探讨肺结核大咯血及其窒息的救治。方法186例肺结核合并大咯血病人根据不同治疗方法分为三组:对照组单用脑垂体后叶素组(A组)、脑垂体后叶素伍用止血环酸组(C组),观察组脑垂体后叶素伍用地塞米松组(B组),观察四组止血效果。结果脑垂体后叶素伍用地塞米松组治疗肺结核大咯血的疗效优于单用脑垂体后叶素组、脑垂体后叶素伍用止血环酸组,经统计学处理有显著差异(P<0.05)。结论肺结核合并大咯血窒息的成功经验在于充分重视咯血窒息先兆及时救治。     

垂体后叶素与地塞米松联用治疗肺结核咯血24例

目的 探讨垂体后叶素和地塞米松联用治疗肺结核咯血的疗效.方法选自笔者所在医院2009年4月～2010年4月肺结核咯血患者47例,在临床中采用垂体后叶素与地塞米松联用治疗肺结核咯血和单用垂体后叶素进行对照,观察、比较治疗效果.结果联用组显效率70.8%,有效率20.8%,总有效率为91.6%;单用组显效率39.1%,有效率34.8%,总有效率为73.9%.结论两药联用治疗肺结核咯血疗效优于单用垂体后叶素.两药联合应用治疗肺结核咯血的作用快,疗效好,可减轻结核中毒症状.对于肺结核咯血患者,在充分进行病因治疗的同时,可将其作为基层医院首选止血措施.     

立止血联合垂体后叶素治疗肺结核咯血临床疗效

目的为提高肺结核大咯血病人的疗效,观察立止血联合垂体后叶素治疗肺结核咯血疗效。方法将80例初治肺结核咯血患者随机分为治疗组和对照组。治疗组40例用立止血和垂体后叶素,对照组40例用垂体后叶素。疗程5d,比较2组疗效。结果治疗组的显效率为85%,显著高于对照组的60%（P〈0.01）。治疗组的总有效率为97.5%,也显著高于对照组的80.0%（P〈0.05）。结论立止血和垂体后叶素联合治疗大咯血病人,中西药结合能显著提高止血作用,缩短出血时间,减少出血,无明显副作用。     

脑垂体后叶素联合硝酸甘油治疗肺结核咯血临床观察

目的 观察脑垂体后叶素联合硝酸甘油治疗肺结核咯血的疗效.方法 44例患者随机分为两组:对照组(26例)予脑垂体后叶素及常规内科综合用药.治疗组(18例)在对照组基础上联用硝酸甘油(5mg/d)静脉滴注,疗程5-7天.结果 治疗组和对照组止血率分别为83.3%和80.7%,治疗组略高于对照组,但无统计学差异(P＞0.05).治疗组不良反应发生率为11.1%,而对照组为42.3%,两组间有显著性差异(P＜0.01).结论 脑垂体后叶素联合硝酸甘油能改善止血率,且不良反应大大降低,是治疗肺结核咯血的有效联合.     

滋阴止血方加减治疗肺结核急性大咯血临床研究

目的:观察滋阴止血方加减治疗肺结核急性大咯血的临床疗效。方法:196例肺结核急性大咯血患者随机分为观察组98例和对照组98例。对照组给以支气管动脉栓塞术,观察组在对照组基础上给以滋阴止血方加减。术后随访2 a,观察两组患者的治疗效果、止血时间及不良反应等。结果:观察组治愈56例,显效27例,有效率为92.86%;对照组治愈36例,显效33例,有效率为80.61%。观察组止血时间(2.1±1.0)d,即时止血率87.76%,2年内复发率7.14%;对照组止血时间(3.8±1.9)d,即时止血率59.18%,2年内复发率29.59%;两组比较,差异均有统计学意义(P0.05)。两组患者均出现不同程度的腹泻腹痛、发热、胸胁胸痛等不良反应,经对症治疗后均缓解,且观察组的不良反应发生率显著低于对照组(P0.05)。结论:滋阴止血方加减治疗肺结核急性大咯血疗效较好,并且不良反应较少。     

肺结核大咯血及其窒息的救治

目的 探讨肺结核大咯血及其窒息的救治。方法 186例肺结核合并大咯血病人根据不同治疗方法分为三组：对照组单用脑垂体后叶素组（A组）、脑垂体后叶素伍用止血环酸组（C组），观察组脑垂体后叶素伍用地塞米松组（B组），观察四组止血效果。结果 脑垂体后叶素伍用地塞米松组治疗肺结核大咯血的疗效优于单用脑垂体后叶素组、脑垂体后叶素伍用止血环酸组，经统计学处理有显著差异（P〈0．05）。结论 肺结核合并大咯血窒息的成功经验在于充分重视咯血窒息先兆及时救治。     

奥曲肽治疗肺结核大咯血的临床观察

目的探讨奥曲肽(Octreotide)治疗肺结核大咯血的疗效。方法38例肺结核大咯血患者随机分成两组,治疗组以奥曲肽止血,对照组以垂体后叶素止血,观察临床疗效。结果治疗组总有效率90%,对照组总有效率72.22%,治疗组明显优于对照组(P<0.05)。结论奥曲肽是治疗肺结核大咯血的有效药物,使用安全,不良反应少,值得临床推广应用。     

地塞米松治疗难治性咯血的临床观察

目的 观察地塞米松对难治性咯血患者的临床疗效作用。方法 以难治性咯血患者为研究对象，采用抽签法将60例患者随机分成两组，在常规抗结核对症治疗基础上，治疗组用5％葡萄糖注射液20ml加地塞米松5mg静脉推注，每6小时1次病情稳定后改为每日2～3次，维持3～5天。对照组用5％葡萄糖注射液250ml加入酚妥拉明10mg静脉滴注，每日2次，病情稳定后改为每日1次巩固3天。结果 地塞米松治疗难治性咯血显效率明显高于酚妥拉明，但两组总有效率无显著性差异。结论 地塞米松用于治疗难治性咯血，疗效确切，治血快，副作用小。     

支气管动脉栓塞术治疗肺结核大咯血的临床研究

目的:探讨支气管动脉栓塞术治疗肺结核咯血的价值。方法:对15例肺结核大咯血病人,行支气管动脉栓塞治疗,栓塞剂为明胶海绵颗粒。结果:手术成功率93.33%(14/15),即刻止血率86.67%(13/15),治疗总有效率93.33%(14/15);无严重并发症发生。结论:支气管动脉栓塞术治疗肺结核大咯血是一有效、快速、微创、相对安全的方法。     

大剂量地塞米松与环磷酰胺双冲击治疗难治性肾病综合征34例临床分析

目的:探讨大剂量地塞米松与环磷酰胺双冲击治疗难治性肾病综合征的临床疗效和安全性。方法:对34例难治性肾病综合征的患者采用大剂量地塞米松与环磷酰胺双冲击治疗,同时给予泼尼松标准化治疗(每天1mg/kg),连用8周;并与对照组[给予泼尼松标准化治疗(每天1mg/kg)维持12周]两组做对比观察。结果:治疗组完全缓解率为82%,显著优于对照组(28%),两组存在极显著性差异(P<0.01);治疗组实验室指标较对照组明显改善(P<0.05);结论:大剂量地塞米松与环磷酰胺双冲击治疗难治性肾病综合征能提高缓解率,缩短疗程。     

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.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

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.