米非司酮联合氨甲喋呤保守治疗异位妊娠疗效分析

目的 探讨米非司酮联合氨甲喋呤保守治疗异位妊娠的疗效.方法 A组:56例异位妊娠采用氨甲喋吟50 mg/m2单次肌肉注射保守治疗;B组:71例异位妊娠采用米非司酮+氨甲喋呤联合保守治疗.结果 氨甲喋呤组的成功率为91.07%,米非司酮+氨甲喋呤组的成功率为98.59%,两组之间比较,差异有统计学意义(x2=3.933,P＜0.05).结论 米非司酮与氨甲喋呤联合用药起协同作用,能更有效地抑制滋养细胞增长;小剂量的米非司酮联合氨甲喋呤异位妊娠成功率高,值得推广.     

异位妊娠药物治疗四种办法比较

目的 寻找一种简单、有效、成功率高又不影响生育功能的异位妊娠的药物治疗方法。方法 120例患者分氨甲喋呤（M似）组（A组）和中药组（B组）；米非司酮组（C组）及氧甲喋岭与米非司酮配合中药联合治疗组（D组）进行治疗对比。结果 D组较A,B、C三组能明显缩短血β-hcG（绒毛膜促性腺激素）降至正常范围的时间，减少住院日，提高治疗成功率（P〈0．01）。结论 MTX与米非司酮配合中药治疗异位妊娠，疗效高，副作用小，可作为临床首选治疗方案。     

保守治疗异位妊娠的三种方法疗效比较

目的 通过对比研究了解异位妊娠的最佳保守治疗方法。方法 对我院1995年-2006年保守治疗116例异位妊娠病人进行分析，根据采用的三种方法将病人分成三组，A组口服米非司酮（Ru486）的病人；B组用甲氨蝶蛉（MTX）的病人；C组用以上两种药物联合加中药治疗的病人。结果三组成功率分别是A组46．1％、B组71．4％、C组93．8％。其中C组高于A．B组。三组病例的血HCG转阴的平均时间是A组23±9．1天；B组20．2±6．32天；C组15．7±6．12天，C组的治疗时间明显短于A．B组。结论 联合用药保守治疗异位妊娠可以提高疗效和缩短疗程。     

米非司酮联合中药或甲氨蝶呤治疗异位妊娠的疗效观察

目的探讨简单、有效、成功率高且不影响生育功能的异位妊娠的药物治疗方法。方法162例确诊异位妊娠患者分为A组78例，B组84例，A组用米非司酮联合中药治疗，B组用米非司酮联合甲氨蝶呤（MTX）治疗。结果A组治疗成功率为85．89％，B组治疗成功率为89．28％，2组比较差异无显著性（P〉0．05）。B组平均住院臼（13．15±4．16）d，短于A组（20．02±5．08）d（P〈0．05）。结论米非司酮联合MTX及米非司酮联合中药组治疗异位妊娠均有效，副作用小，可作为异位妊娠的治疗方案；米非司酮联合MTX能缩短住院日。     

奥曲肽联合奥美拉唑治疗肝硬化并发非静脉曲张上消化道出血疗效观察

目的观察奥曲肽联合奥美拉唑治疗肝硬化并发非静脉曲张上消化道出血的疗效。方法将76例肝硬化并非静脉曲张上消化道出血患者，随机分为治疗组（A组）39例和对照组（B组）37例，治疗组采用奥曲肽和奥美拉唑联合治疗，对照组单用奥美拉唑治疗，并观察相关指标。结果A组48h再出血率（7．70％）明显低于B组（27．00％），P〈0．05；A组住院天数（5．20±2．10天）明显少于B组（7．80±2．90天），P〈0．05；A组输血量（3．60±2．20u）与B组输血量（3．40±2．30u）比较差异无显著性（P〉0．05）；A、B两组死亡率无明显差异（P〉0．05）。结论奥曲肽联合奥美拉唑治疗肝硬化并发非静脉曲张上消化道出血，能有效预防早期再出血发生和缩短住院天数。     

米非司酮联合甲氨喋呤保守治疗异位妊娠110例疗效观察

目的探讨米非司酮联合甲氨喋吟保守治疗异位妊娠的疗效及不良反应。方法将100例异位妊娠患者随机分为治疗组与对照组,对两组疗效及不良反应进行比较。结果治疗组50例成功47例,成功率94%,3例选择开腹手术治疗。对照组50例中39例成功,成功率76%,11例给予手术治疗。两组间治疗成功率比较差异有统计学意义（P〈0.05）;治疗组50例有4例出现胃肠道反应,1例口腔溃疡,1例转氨酶轻度升高,不良反应发生率为12%。对照组有10例出现胃肠道反应,3例转氨酶轻度升高、1例皮疹,不良反应发生率为28%,均经处理后正常。治疗组不良反应发生率明显低于对照组（P〈0.05）。结论米非司酮联合甲氨喋吟治疗异位妊娠有效安全。     

异位妊娠药物治疗三种方法比较

目的：探讨氨甲喋呤（MTX）及米非司酮治疗异位妊娠的效果。方法：94例患者分氨甲喋呤单次注射（A组）、米非司酮单次口服（B组）及注射配合米非司酮单次口服（C组）进行比较．定期测绒毛膜促性腺激素（血β-hcG）直至正常。结果：C组较A、B两组能明显缩短血β-hcG降至正常范围的时间，减少住院日，提高治疗成功率（P〈0．01）。结论：MTX单次注射配合米非司酮单次口服治疗异位妊娠疗效高，副作用小，可作为临床首选化疗方案。     

甲氨蝾呤保守治疗异位妊娠不同方法的疗效比较

目的：探讨甲氨喋岭保守治疗异位妊娠的治疗方案。方法：将38例异位妊娠患者随机分为A、B两组，A组采用甲氨蝶呤单次肌内注射，B组采用甲氨蝶呤多次肌内注射并配合四氢叶酸钙解毒，观察两组成功率，HCG转阴时间及药物的副作用。结果：两组成功率差异无显著性（P〉0．05）。血HCG转阴时间，B组低于A组，差异有显著性（P＜0．05）。药物副反应A组明显低于B组，差异有显著性（P＜0．05）。结论：两种方法治疗异位妊娠成功率相近，但单次注射法药物副作用明显低于多次注射法，所以单次注射法优于多次注射法。     

甲氨喋呤联合米非司酮治疗异位妊娠的疗效观察

目的：观察甲氨喋呤（Mrrx）联合米非司酮与单用米非司酮治疗异位妊娠的疗效。方法：A组MTX单次肌内注射并口服米非司酮;B组：米非司酮口服。定期测血B-HCG直至正常。结果：治愈率A组为94．74％,B组为81．25％,A组较B组明显缩短血p—HCG降至正常所需时间,减少住院日（P〈0．01）。结论：MTX单次肌内注射联合米非司酮治疗输卵管妊娠疗效好,不良反应少,值得临床推广。     

甲氨喋呤联合米非司酮治疗异位妊娠46例临床分析

目的：探讨甲氨喋呤（MTX）联合米非司酮治疗异位妊娠的疗效。方法92例异位妊娠患者随机分为甲氨喋呤联合米非司酮（治疗组）以及甲氨喋呤（对照组）各46例,观察两组治疗效果。结果：治疗组治疗有效率为97．83％,血β-HCG下降至正常所需的时间为（18．46±3．04）d,盆腔内异位妊娠包块吸收的时间为（24．83±5．71）d,对照组分别为76．96％、（25．90±3．05）d、（32．90±5．69）d,差异有显著性（p〈0．05）。结论：MTX联合米非司酮保守治疗异位妊娠疗效明显优于单用MTX治疗,并且副反应少,值得临床推广。     

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.     

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.     

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.     

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.