缬沙坦对高血压患者大动脉弹性的影响

目的:评价缬沙坦4周治疗对原发性高血压患者大动脉结构和功能的影响.方法:应用PWV自动测定系统观察23例进行缬沙坦治疗的原发性高血压患者,均为男性,平均年龄(61.3±10.5)岁.8例服用缬沙坦160mg/日,15例服用缬沙坦80mg/日.分别在治疗前和治疗4周后重复对患者进行PWV检测.结果:收缩压、舒张压、平均压、脉压、颈动脉-股动脉PWv治疗4周后明显降低(分别为P=0.0003,P=0.0447,P=0.0014,P=0.0222,P=0.0030).结论:缬沙坦对心血管系统的影响不仅与血压降低有关,同时能明显改善高血压患者大动脉弹性.     

硝酸酯类药物对高血压患者大动脉顺应性的影响

目的:评价长效硝酸酯类药物IS-5-MN对高血压患者大动脉顺应性的影响。方法:PWV自动侧量系统测定颈动脉-股动脉PWV作为评价大动脉顺应性的指标。对17例原发性高血压患者进行了研究,平均年龄(62.53±7.94)岁。研究期间在维持原降压治疗不变的情况下,加用IS-5-MN(30mg/d)。分别在治疗2周和4周后重复PWV测定。结果:与治疗前相比,治疗2周和4周后收缩压、舒张压、脉压和心率无显著性差异。颈动脉-股动脉PWV在治疗2周和4周后均显著降低(分别为P<0.05,P<0.05)。结论:长效硝酸酯类药物能有效地改善高血压患者的大动脉顺应性,对预防高血压患者的远期心血管并发症有重要临床价值。     

缬沙坦对原发性高血压患者血管内皮功能的影响及意义

目的 :研究缬沙坦对原发性高血压患者血管内皮依赖性舒张功能的影响。 方法 :采用高分辨率超声技术对 30例原发性高血压患者服用缬沙坦前后和 30例正常对照者的血管内皮依赖性舒张功能进行检测。 结果 :缬沙坦治疗组肱动脉内皮依赖性舒张较正常对照组明显减弱 (t=2 .4 2 2 ,P <0 .0 5 ) ,30例轻、中度高血压患者服用缬沙坦 12周后 ,收缩压、舒张压均较治疗前明显降低 (t分别为 2 .13、2 .2 1,P均 <0 .0 5 ) ,同时肱动脉内皮依赖性舒张较治疗前明显改善 (t=2 .371,P <0 .0 5 )。 结论 :轻、中度原发性高血压患者存在血管内皮依赖性舒张功能障碍 ,缬沙坦在降压的同时可有效改善其血管内皮依赖性舒张的功能。     

血管紧张素II受体拮抗剂对老年高血压患者大动脉缓冲功能的影响

目的:探讨血管紧张素II受体拮抗剂氯沙坦对老年高血压患者大动脉缓冲功能的影响。方法:口服氯沙坦治疗原发性高血压患者108例,其中男性85例,女性23例,平均年龄(66.48±5.16)岁,应用自动脉搏波传导速度测定仪检测治疗前和治疗3个月后患者的颈动脉-股动脉脉搏波传导速度(PWV),以判断其大动脉缓冲功能。结果:与治疗前相比,治疗3个月后患者的收缩压和舒张压显著降低(P=0.0022,P=0.0081);颈动脉-股动脉PWV显著降低[(13.60±2.31)m/svs(11.89±2.11)m/s,P=0.0416]。结论:氯沙坦不仅能良好地控制血压,亦能明显改善大动脉缓冲功能。     

缬沙坦对高血压患者脉搏波速度的影响

目的观察缬沙坦对高血压患者脉搏波速度(pulse wave velocity,PWV)的影响。方法选择40例高血压患者,缬沙坦治疗12周前后分别测定其PWV,并以30例年龄相匹配的正常人作对照,测定其PWV。进行统计分析。结果与正常组比较,高血压患者的PWV明显加快,分别为(10.81±0.54)和(7.32±0.71)m/s(P<0.05);经缬沙坦治疗后,其PWV降低至(8.16±0.35)m/s(P<0.05)。结论缬沙坦能明显降低高血压患者的PWV。     

贝那普利与缬沙坦联合对原发性高血压患者尿蛋白的影响

目的观察贝那普利（ACEI）与缬沙坦（ARB）联合应用对原发高血压患者尿蛋白排泄的影响。方法30例确诊的原发性高血压的患者,测定基础血压水平,24小时尿蛋白定量,经贝那普利治疗4周后再次测定24小时尿蛋白定量,然后加用缬沙坦治疗4周,观察24小时尿蛋白定量的变化。结果30例原发性高血压患者平均24小时尿蛋白定量0.7±0.5g/L。贝那普利10mg/d治疗后平均24小时尿蛋白定量0.5±0.4g/L（与治疗前P〈0.01）;联合应用缬沙坦80mg/d治疗4周后24小时尿蛋白定量0.3±0.3g/L与联合用前比较差异显著（P〈0.01）。结论贝那普利与缬沙坦联合应用对原发性高血压减少尿蛋白排泄的作用优于贝那普利单独应用。     

血管紧张素Ⅱ受体拮抗剂对老年高血压患者大动脉缓冲功能的影响

目的探讨血管紧张素Ⅱ受体拮抗剂氯沙坦对老年高血压患者大动脉缓冲功能的影响.方法口服氯沙坦治疗原发性高血压患者108例,其中男性85例,女性23例,平均年龄(66.48±5.16)岁,应用自动脉搏波传导速度测定仪检测治疗前和治疗3个月后患者的颈动脉-股动脉脉搏波传导速度(PWV),以判断其大动脉缓冲功能.结果与治疗前相比,治疗3个月后患者的收缩压和舒张压显著降低(P=0.002 2,P=0.008 1);颈动脉-股动脉PWV显著降低[(13.60±2.31)m/s vs(11.89±2.11)m/s,P=0.041 6].结论氯沙坦不仅能良好地控制血压,亦能明显改善大动脉缓冲功能.     

缬沙坦和氢氯噻嗪治疗原发性高血压疗效观察

目的 观察缬沙坦和小剂量氢氯噻嗪治疗原发性轻、中度高血压的疗效.方法 将186例原发性轻、中度高血压患者随机分为两组,治疗组93例给予缬沙坦80mg,1次/d;氢氯噻嗪12.5mg,1次/d,对照组93例只给缬沙坦80mg,1次/d.在治疗4周和8周时评估治疗效果和药物的安全性.结果 治疗4周和8周时治疗组的总有效率均显著高于对照组(P均＜0.01),两组均无明显不良反应.结论 缬沙坦和氢氯噻嗪治疗原发性轻、中度高血压比单用缬沙坦疗效更好.     

缬沙坦和氢氯噻嗪治疗原发性高血压疗效观察

目的观察缬沙坦和小剂量氢氯噻嗪治疗原发性轻、中度高血压的疗效。方法将196例原发性轻、中度高血压患者随机分为两组,治疗组98例给予缬沙坦80 mg,1次/d;氢氯噻嗪12.5 mg,1次/d,对照组98例只给缬沙坦80 mg,1次/d。在治疗4周和8周时评估治疗效果和药物的安全性。结果治疗4周和8周时治疗组的总有效率均显著高于对照组(P均<0.01),两组均无明显不良反应。结论缬沙坦和氢氯噻嗪治疗原发性轻、中度高血压比单用缬沙坦疗效更好。     

缬沙坦治疗轻、中度原发性高血压的临床疗效观察

目的：观察缬沙坦对轻、中度原发性高血压患者的疗效及其安全性。方法：选取轻、中度原发性高血压患者104例,服用缬沙坦80mg/d,降压不明显者加至160mg/d。测定服药前及服药后2、4、8周的坐位血压,以及治疗前后的肾功能和心率,并记录治疗期间的不良反应。结果：在治疗8周末降压有效率为73.1%,服药后2周坐位血压已明显下降,继续服药直至8周,降压效果维持良好,与治疗前比较,差异均有显著性意义（P〈0.05）;治疗后尿蛋白显著减少（P〈0.01）,血清肌酐和尿素氮无明显变化;服药前后心率无明显变化。不良反应轻微,无患者退出治疗。结论：口服缬沙坦治疗轻中度原发性高血压降压效果确切,耐受性好。     

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.     

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.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.