芪苈强心胶囊治疗慢性心力衰竭60例临床观察

目的 观察芪苈强心胶囊治疗慢性心力衰竭的临床效果.方法 120例慢性心力衰竭患者分为对照组(n=60)和治疗组(n=60),所有患者根据心衰治疗指南给予常规的抗心衰治疗,治疗组在此基础上给予芪苈强心胶囊治疗,随访3个月,观察患者心力衰竭症状和体征的改变、心力衰竭好转的时间、住院时间、出院后1周内再住院率,治疗前、治疗2周、1月、3月心功能参数测定结果比较.结果 两组总有效率差异无显著性(P=0.94),但治疗组心衰改善的时间、住院时间比对照组明显减少(P均<0.01).结论 芪苈强心胶囊治疗慢性心力衰竭效果确切,能明显改善心衰患者的心功能及生活质量.     

芪苈强心胶囊治疗慢性心力衰竭73例临床观察

目的:观察芪苈强心胶囊治疗慢性心力衰竭的临床效果和对患者生活质量的影响.方法:115例慢性心力衰竭患者分为对照组(n=42)和治疗组(n=73),所有患者根据心衰治疗指南给予常规的抗心衰治疗,治疗组在此基础上给予芪苈强心胶囊治疗,随访3个月,观察患者心力衰竭症状和体征的改变、心力衰竭好转的时间、住院时间、出院后1周内再住院率、明尼苏达心衰生活质量(MLWHF).结果:两组总有效率差异无显著性(P=0.94),但治疗组心衰改善的时间、住院时间比对照组明显减少(P均＜0.01).与治疗前比较,两组均能改善患者的生活质量(P＜0.01).结论:芪苈强心胶囊治疗慢性心力衰竭效果确切,能明显改善心衰患者的生活质量.     

芪苈强心胶囊治疗难治性心力衰竭临床疗效观察

目的:探讨芪苈强心胶囊治疗难治性心力衰竭的临床疗效。方法:将96例难治性心力衰竭患者随机分为治疗组和对照组,对照组48例给抗心力衰竭常规治疗,治疗组48例在常规抗心衰治疗基础上加用芪苈强心胶囊口服,疗程均为2 w。观察治疗前后2组的心功能分级、血浆NT端脑钠肽前体(NTpro BNP)水平、六分钟步行试验、24小时尿量。结果:治疗组总有效率为91.67%,对照组总有效率为72.92%,2组比较有显著性差异(P0.05)。结论:在优化内科治疗基础上联合芪苈强心胶囊治疗难治性心力衰竭,临床疗效显著,可以更有效地改善患者心功能,提高患者的生存质量。     

芪苈强心胶囊佐治收缩性心力衰竭96例临床观察

目的观察芪苈强心胶囊对收缩性心力衰竭(CHF)的临床疗效。方法156例CHF患者随机分为治疗组和对照组。对照组(60例):给予强心剂、利尿剂、血管扩张剂、血管紧张素转换抑制剂、血管紧张素受体Ⅱ拮抗剂、β-受体阻滞剂等常规抗心力衰竭药物;治疗组(96例):在常规抗心力衰竭用药的基础上加芪苈强心胶囊1.6 g口服,每日3次。均治疗4周后统计疗效。结果治疗组治疗后临床总有效率、血流动力学及血液流变学的改变情况和不良反应均好于对照组(P<0.05,P<0.01)。结论芪苈强心胶囊佐治CHF能明显提高临床疗效。     

左西孟旦联合芪苈强心胶囊治疗43例慢性心力衰竭老年患者的疗效及安全性分析

目的分析左西孟旦联合芪苈强心胶囊治疗慢性心力衰竭(CHF)老年患者的疗效及安全性。方法选取我院CHF老年患者86例,按照治疗方式不同分为实验组、常规组,各43例,常规组给予左西孟旦治疗,实验组于常规组基础上联合芪苈强心胶囊治疗。观察治疗效果及不良反应。结果实验组总有效率(90.70%)高于常规组(69.77%),差异显著(P0.05);实验组不良反应发生率(6.98%)低于常规组(25.58%),差异显著(P0.05)。结论左西孟旦联合芪苈强心胶囊治疗CHF老年患者疗效显著,不良反应发生率低,安全性高。     

芪苈强心胶囊对心力衰竭合并高尿酸血症患者的临床疗效

目的 探讨芪苈强心胶囊对心力衰竭合并高尿酸血症患者临床疗效.方法 选择60例心力衰竭合并高尿酸血症患者,随机分为对照组(n=38)和治疗组(n=42),对照组使用基础抗心衰药物治疗,治疗组除使用基础抗心衰药物治疗外,加用芪苈强心胶囊治疗,4周后测定BUA、NT-proBNP和LVEF.结果 治疗后2组NT-proBNP较治疗前均降低,且治疗组较对照组降低更明显,LVEF较治疗前均升高,且治疗组较对照组升高更明显,SUA较治疗前均降低,且治疗组较对照组降低更明显(P＜0.05).与对照组相比,治疗组呋塞米与螺内酯用量显著降低,且治疗的总有效率升高(P＜0.05).结论 芪苈强心胶囊可以显著降低心力衰竭合并高尿酸血症患者NT-proBNP和SUA,提高LVEF,可以减小呋塞米与螺内酯的用量,改善心功能.     

硝普钠联合芪苈强心胶囊治疗慢性充血性心力衰竭效果观察

目的探究硝普钠联合芪苈强心胶囊对慢性充血性心力衰竭(CHF)患者心功能及生活质量的影响。方法选取义马市人民医院94例CHF患者,抽签法分为观察组和对照组,各47例。对照组行硝普钠+葡萄糖液(5%)250 ml微量泵入治疗,观察组在对照组基础上加用芪苈强心胶囊治疗。比较两组治疗6个月后临床疗效、心功能相关指标[左室舒张末内径(LVEDD)、左室射血分数(LVEF)及左室收缩末期内径(LVESD)]及生活质量(SF-36)评分。结果观察组治疗6个月后总有效率(85.11%)较对照组(63.83%)高,LVEDD、LVEF、LVESD均优于对照组,SF-36评分高于对照组,差异均有统计学意义(P<0.05)。结论采用硝普钠联合芪苈强心胶囊治疗CHF患者疗效显著,可改善其心功能各指标及生活质量。     

应用芪苈强心胶囊治疗慢性心力衰竭的临床疗效观察

目的：探讨分析应用芪苈强心胶囊治疗慢性心力衰竭的临床疗效。方法：选取2011年6月至2013年6月间我院收治的慢性心力衰竭患者110例作为研究对象,将其随机分为治疗组（55例）和对照组（55例）,为对照组患者进行常规的抗心衰治疗,为治疗组患者在进行常规抗心衰治疗的基础上加用芪苈强心胶囊进行治疗,观察对比两组患者的临床疗效及其心功能的变化情况,并将对比的结果及两组患者的临床资料进行回顾性的分析。结果：经过一段时间的治疗,两组患者心功能的改善程度均明显优于治疗前,差异显著（P＜0.05）,具有统计学意义。治疗组患者心功能的改善程度明显优于对照组患者,差异显著（P＜0.05）,具有统计学意义。治疗组患者的临床疗效明显优于对照组患者,差异显著（P＜0.05）,具有统计学意义。结论：应用芪苈强心胶囊治疗慢性心力衰竭的临床疗效显著,值得在临床上推广应用。     

芪苈强心胶囊治疗慢性心力衰竭73例临床观察

目的观察芪苈强心胶囊治疗慢性心力衰竭的临床效果和对患者生活质量的影响。方法115例慢性心力衰竭患者分为对照组(n=42)和治疗组(n=73),所有患者根据心衰治疗指南给予常规的抗心衰治疗,治疗组在此基础上给予芪苈强心胶囊治疗,随访3个月,观察患者心力衰竭症状和体征的改变、心力衰竭好转的时间、住院时间、出院后1周内再住院率、明尼苏达心衰生活质量(MLWHF)。结果两组总有效率差异无显著性(P=0.94),但治疗组心衰改善的时间、住院时间比对照组明显减少(P均<0.01)。与治疗前比较,两组均能改善患者的生活质量(P<0.01)。结论芪苈强心胶囊治疗慢性心力衰竭效果确切,能明显改善心衰患者的生活质量。     

芪苈强心胶囊治疗慢性心力衰竭60例临床观察

目的观察芪苈强心胶囊治疗慢性心力衰竭的临床效果。方法120例慢性心力衰竭患者分为对照组（11=60）和治疗组（11=60），所有患者根据心衰治疗指南给予常规的抗心衰治疗，治疗组在此基础上给予芪苈强心胶囊治疗，随访3个月，观察患者心力衰竭症状和体征的改变、心力衰竭好转的时间、住院时间、出院后1周内再住院率，治疗前、治疗2周、1月、3月心功能参数测定结果比较。结果两组总有效率差异无显著性（P=0，94），但治疗组心衰改善的时间、住院时间比对照组明显减少（P均〈0．01）。结论芪苈强心胶囊治疗慢性心力衰竭效果确切，能明显改善心衰患者的心功能及生活质量。     

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.