冠心病无痛性心肌缺血的临床诊治分析

目的:分析冠心病无痛性心肌缺血的临床治疗效果。方法:选择冠心病无痛性心肌缺血患者120例,分为治疗组与对照组,每组60例。对照组患者采用复方丹参滴丸治疗。治疗组患者在对照组治疗基础上再结合硝酸异山梨酯和硝苯地平治疗。观察两组治疗效果。结果:120例患者通过治疗后,ST段低压次数和持续时间与治疗前相比差异有统计学意义(P<0.05),治疗组患者下降幅度明显高于对照组,差异有统计学意义(P<0.05),治疗后ST段低压次数和持续时间较对照组明显减少,治疗效果更佳(P<0.05)。结论:在冠心病无痛性心肌缺血治疗中,早期的诊断结果较为重要,采用复方丹参滴丸结合硝酸异山梨酯和硝苯地平治疗效果更明显,具有较高的临床价值。     

冠心病无痛性心肌缺血的临床诊治分析

目的分析冠心病无痛性心肌缺血的临床治疗效果。方法选择2010年10月—2011年11月来我院治疗冠心病无痛性心肌缺血患者120例。随机分成治疗组60例,对照组60例。对照组患者采用复方丹参滴丸治疗。治疗组患者在对照组治疗基础上再结合硝酸异山梨酯和硝苯地平治疗。观察两组治疗效果。结果 120例患者通过治疗后,ST段压低次数和持续时间与治疗前相比有差异(P<0.05),治疗组患者下降幅度高于对照组(P<0.05),治疗后ST段压低次数和持续时间较对照组减少(P<0.05)。结论在冠心病无痛性心肌缺血治疗中,早期的诊断结果较为重要,采用复方丹参滴丸结合硝酸异山梨酯和硝苯地平治疗效果更明显,具有较高的临床价值。     

冠心病无痛性心肌缺血的临床诊治分析

目的探讨冠心病无痛性心肌缺血的临床诊治措施及临床意义。方法以我院2009年1月-2010年12月临床确诊为冠心病无痛性心肌缺血的48例患者为观察对象,分析临床诊断方法及综合治疗效果。结果综合治疗8周后,患者血压值、心脏指数CI及运动持续时间方面均好于治疗前,差异有统计学意义（P〈0.05）。结论综合治疗措施可以显著改善冠心病无痛性心肌缺血病患者的预后,延缓动脉硬化的进程,保护患者心脏,值得临床应用。     

老年冠心病患者动态心电图监测的诊疗价值探讨

目的：探讨老年冠心病患者动态心电图监测的诊疗价值。方法选取冠心病老年患者共110例,将患者随机分为观察组与对照组,各55例,对照组患者入院后给予常规心电图监测,观察组患者使用动态心电图监测,2组患者在接受治疗期间后,比较2组患者监测效果。结果观察组患者采用动态心电图监测,其心肌缺血及心率失常阳性检出率显著高于常规心电监测,组间监测效果差异有统计学意义（P<0.05）。受试110例患者中心肌缺血ST段改变阵次中有症状心肌缺血阵次显著低于无症状心肌缺血;ST段压低程度有症状心肌缺血与无症状心肌缺血组间比较,差异有统计学意义（P<0.05）。结论临床上采用动态心电图监测可有效提升患者心肌缺血及心律失常阳性检出率,有利于老年冠心病患者诊断及治疗,提高预后质量,获得理想治疗效果,值得在临床上大力推广。     

辛伐他汀治疗高血压合并冠心病临床应用探讨

目的：探讨辛伐他汀在高血压合并冠心病患者中的临床效果。方法对2013年4月—2014年4月来该院诊断、治疗的80例患者相关资料进行分析,根据不同治疗方法分为两组。对照组采用血脂康胶囊治疗,实验组采用辛伐他汀片治疗,比较两组治疗效果。结果验组TC指标为（4.07±0.19）%、TG指标为（1.92±0.45）%、LDL-C指标为（2.13±0.18）mmoL/L,均低于对照组,差异有统计学意义（P<0.05）;实验组HDL-C指标为（1.27±0.22）mmoL/L,高于对照组,差异有统计学意义（P<0.05）;实验组95%治疗效果理想,高于对照组（85%）,差异有统计学意义（P<0.05）。结论血压患者合并冠心病发病率较高,采用辛伐他汀片治疗效果理想,值得推广使用。     

冠心病无痛性心肌缺血的临床诊断及治疗分析

目的:观察、探讨、分析并研究冠心病无痛性心肌缺血的临床诊断以及临床治疗效果。方法:将我院在2011年6月到2012年6月所收治的96例冠心病无痛性心肌缺血的患者随机分为观察组和对照组两组,每组各有患者48例。为对照组患者采用口服丹参滴丸进行治疗,对观察组的患者采用补中益气丸和丹参滴丸交替服用治疗。对两组患者均采用动态心电图的检测方法进行诊断,观察两组患者的治疗效果,随访一年,统计两组患者的复发率和并发症的发病率,对比两组患者的满意度。结果:经过治疗,观察组患者的治疗效果明显优于对照组患者的治疗效果,随访一年以后,观察组有2例患者出现并发症,有1例患者出现复发,而对照组患者当中出现并发症的患者有6例,复发的患者有2例,对比两组,观察组患者的效果明显优于对照组,而且观察组患者的满意程度也明显要高于对照组的患者,P0.05,具有统计学意义。结论:补中益气丸和丹参滴丸交替服用治疗冠心病无痛性心肌缺血具有更加显著的治疗效果,而且还具有低复发率和低并发症的发生率,此外,动态心电图的检测方法也是一种较为理想的诊断方法,值得在临床上大力推广使用。     

老年冠心病无痛性心肌缺血临床护理效果观察

目的探察老年冠心病无痛性心肌缺血的临床护理效果。方法选取我院冠心病患者68例,按照护理方式的不同分为观察组与对照组,每组34例;对照组患者给予常规护理,观察组在对照组的基础上给予患者优质的临床护理;观察两组患者的临床护理效果。结果临床护理后,两组患者的症状均有缓解,但观察组患者心肌缺血的发作次数、发作时间、ST段压低减少的次数及下移减少量显著优于对照组,结果差异有统计学意义(P<0.05)。结论对老年冠心病无痛性心肌缺血患者采用针对性合适的临床护理,缓解了患者的临床症状,减少了心肌缺血的发作次数,改善了患者的并发症,效果显著,值得推广。     

关于冠心病无痛性心肌缺血患者的临床诊治效果评价

目的：对应用硝苯地平与硝酸异山梨酯联合对患有冠心病无痛性心肌缺血疾病的患者实施治疗的临床效果进行研究。方法：选择在我院就诊的患有冠心病无痛性心肌缺血疾病的患者82例,随机分为对照组和治疗组,平均每组41例。采用丹参滴丸对对照组患者实施治疗;采用硝苯地平与硝酸异山梨酯联合治疗组患者实施治疗。结果：治疗组患者心电图监测结果复常时间和心肌缺血治疗总时间明显短于对照组;冠心病无痛性心肌缺血疾病治疗效果明显优于对照组。结论：应用硝苯地平与硝酸异山梨酯联合对患有冠心病无痛性心肌缺血疾病的患者实施治疗的临床效果非常明显。     

探讨冠心病无痛性心肌缺血的临床诊断及治疗

目的:探讨冠心病无痛性心肌缺血的临床诊断及治疗效果。方法:选取2009年1月~2013年12月冠心病无痛性心肌缺血确诊病人60例,分析患者的临床资料、治疗方法及治疗效果。结果:对患者采用综合治疗之后,患者的血压有了明显的下降,ST段压低有所好转,最大耗氧量、心脏指数等明显上升。患者在治疗后的数据情况具有统计学意义(P0.05)。结论:运用综合治疗方法治疗冠心病无痛性心肌缺血效果显著,减少并发症的出现,保护了病人及其心脏。     

通心络胶囊联合消心痛治疗70例冠心病无痛性心肌缺血疗效分析

目的:对比分析使用通心络胶囊联合消心痛治疗无痛性心肌缺血的临床疗效。方法:选择70例冠心病无痛性心肌缺血患者,根据随机原则将患者分为观察组和对照组,每组35例,两组患者在治疗时均使用阿司匹林肠溶片以预防冠心病的发作。对照组口服通心络胶囊;观察组在对照组的基础上加用消心痛。结果:治疗后两组治疗效果比较观察组总有效率为94.3%,对照组总有效率为71.4%,两组相比,差异有统计学意义(P<0.05);所有患者治疗后,ST段低压出线次数和持续时间和治疗前相比均有明显下降(P<0.05),和对照组相比,观察组治疗后ST段低压次数和持续时间的减少更为明显(P<0.05)。结论:使用通心络胶囊联合消心痛治疗无痛性心肌缺血临床效果良好值得推广。     

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.