盐酸贝那普利片联合苯磺酸氨氯地平片治疗糖尿病肾病伴高血压临床观察

目的 观察盐酸贝那普利片联合苯磺酸氨氯地平片治疗糖尿病肾病伴高血压的临床疗效.方法 将64例早期糖尿病肾病随机分成两组,对照组给予饮食管理、纠正糖代谢紊乱、盐酸贝那普利片控制血压、调脂等处理,治疗组在对照组基础上联合苯磺酸氨氯地平片治疗.疗程为8周.治疗前后检测24 h尿白蛋白定量等指标.结果 两组治疗前后收缩压、舒张压均有显著变化(P<0.01),治疗组降压效果优于对照组;两组治疗后24 h尿蛋白定量水平均有下降,且治疗组较对照组下降明显,二者比较差异有统计学意义(P<0.05).结论 盐酸贝那普利片联合苯磺酸氨氯地平片治疗糖尿病肾病伴高血压临床疗效确切,而且对肾功能有保护作用.     

盐酸贝那普利片联合黄葵胶囊治疗2型糖尿病肾病蛋白尿临床观察

目的:观察盐酸贝那普利片联合黄葵胶囊治疗2型糖尿病肾病蛋白尿的情况。方法:将60例糖尿病肾病患者随机分为治疗组(31例)和对照组(29例),两组均应用胰岛素针控制血糖,使空腹血糖在7.0mmol/L以下,餐后2h血糖在10.0mmol/L以下,两组患者均应用盐酸贝那普利片等降压药物控制血压在140/90mmHg(1mmHg=0.133kPa)以下,治疗组加用黄葵胶囊,2.5g,3次/d,用药12周,比较治疗前及用药4周、8周、12周尿β2微球蛋白、24h尿蛋白定量、血尿素氮(BUN)、肌酐(Cr)、血白蛋白等指标变化情况。结果:治疗组尿β2微球蛋白、24h尿蛋白定量、血尿素氮(BUN)、肌酐(Cr)较对照组有明显下降,血浆白蛋白有上升,差异有统计学意义。结论:盐酸贝那普利片联合黄葵胶囊能减少蛋白尿,提高血清肌酐清除率,延缓糖尿病肾病的进展。     

硝苯地平控释片与盐酸贝那普利片联合应用治疗老年高血压疗效分析

目的:观察硝苯地平控释片和盐酸贝那普利片联合治疗老年高血压一个月的疗效。方法:将我科收治的103例老年高血压患者随机分成两组:观察组(51例)和对照组(52例)。观察组应用硝苯地平控释片和盐酸贝那普利片进行治疗,对照组单纯应用盐酸贝那普利片治疗。观察两组患者的疗效及不良反应。结果:经过治疗后,观察组患者的总有效率(98.03%)明显高于对照组患者(86.54%),差异具有统计学意义(P<0.05)。两组患者不良反应的发生率差异不明显(P>0.05)。结论:联合应用硝苯地平控释片和盐酸贝那普利片治疗老年高血压安全有效。     

黄葵胶囊联合氯沙坦治疗120例早期糖尿病肾病的疗效及对血清炎症因子的影响

目的:观察黄葵胶囊联合氯沙坦治疗早期糖尿病肾病的疗效及对血清炎症因子的影响。方法:选取早期糖尿病肾病120例,依据随机综合序贯法分为观察组和对照组,每组各60例。对照组应用氯沙坦钾片。观察组在对照组基础上加用黄葵胶囊,分析比较两组临床疗效、炎症因子指标及不良反应。结果:治疗后观察组炎症因子水平显著低于对照组(P<0.01);观察组临床疗效明显优于对照组(P<0.05);观察组不良反应总发生率20.0%明显高于对照组6.7%(P<0.05)。结论:黄葵胶囊联合氯沙坦治疗早期糖尿病肾病可降低炎症因子水平,提高治疗效果,但需要密切关注不良反应。     

盐酸贝那普利联合用药治疗糖尿病性肾病80例临床观察

目的 比较盐酸贝那普利片分别联合前列地尔和立普妥对早期糖尿病性肾病治疗的影响.方法 糖尿病早期肾病患者80例,随机分成两组（每组40例）：盐酸贝那普利片联合前列地尔组,盐酸贝那普利片联合立普妥组.观察治疗3周前后两组患者的24 h尿白蛋白排泄率（Urinary albumin excretion rate,UAER）、甘油三酯（TG）和总胆固醇（Tch）的变化.结果 两组均能减少UAER（P ＜0.05）,而联合前列地尔组效果更明显.两组治疗后TG和Tch均有不同程度的降低,且联合立普妥组效果更明显.结论 盐酸贝那普利片联合前列地尔治疗早期糖尿病性肾病能更有效地降低UAER;盐酸贝那普利片联合立普妥则降低Tch、TG更明显,提示两组治疗效果各有侧重.临床治疗早期糖尿病性肾病时,可将盐酸贝那普利片、前列地尔和立普妥三药联合应用.     

螺内酯片联合盐酸贝那普利片治疗慢性充血性心力衰竭48例

目的探讨螺内酯片联合盐酸贝那普利片治疗慢性充血性心力衰竭的临床疗效。方法 96例慢性充血性心力衰竭患者,分为对照组和观察组。对照组给予盐酸贝那普利片治疗,观察组给予螺内酯片联合盐酸贝那普利片治疗。结果观察组总有效率为91.67%,高于对照组总有效率77.08%,差异有统计学意义（P〈0.05）。观察组LVEF、步行运动耐量优于对照组,差异有统计学意义（P〈0.01）。结论螺内酯片联合盐酸贝那普利片治疗慢性充血性心力衰竭患者疗效较好。     

贝那普利联合瑞格列奈治疗早期糖尿病肾病能疗效观察

目的探讨贝那普利联合瑞格列奈治疗早期糖尿病肾病的疗效。方法运用随机数字表法将2011年6月。2012年6月在我院住院治疗的60例早期糖尿病肾病患者随机分为观察组和对照组,各30例,对照组患者给予盐酸贝那普利片治疗,观察组患者则加用瑞格列奈治疗,比较两组患者的临床疗效及治疗前后SCr的变化。结果观察组患者治疗总有效率（93．33％）明显高于对照组（70．00％）,治疗前两组患者SCr比较差异无统计学意义（P〉0．05）,治疗后观察组患者SCr降低较对照组更显著（P〈0．05）。结论贝那普利联合瑞格列奈治疗早期糖尿病肾病疗效确切,不良反应少,值得进一步推广。     

糖尿病肾病患者尿蛋白的临床药物治疗研究

目的研究糖尿病肾病患者尿蛋白的临床药物治疗效果。方法选取我院2014年3月-2015年7月收治的20例糖尿病肾病早期肾功能正常患者,采用随机数字表法分为对照组和观察组。对照组患者采用二甲双胍联合厄贝沙坦治疗,观察组患者采用二甲双胍联合盐酸贝那普利治疗。对比两组患者治疗前后尿蛋白含量变化情况。结果观察组患者的尿蛋白含量下降明显优于对照组(P0.05),差异具有统计学意义。结论临床上采用二甲双胍联合盐酸贝那普利治疗糖尿病肾病,能有效降低患者的尿蛋白含量,值得推广与应用。     

谷胱甘肽联合黄葵治疗糖尿病肾病临床观察

目的 探讨谷胱甘肽联合黄葵胶囊与黄葵胶囊治疗糖尿病肾病的临床疗效.方法 将50例糖尿病肾病患者分为观察组和对照组,分别检测治疗前后24 h尿蛋白、血尿素氮、肌酐和血液流变学,并进行比较.结果 2组治疗前后24 h尿蛋白量、血尿素氮、肌酐、血液流变学变化有显著性差异,治疗4、8周2组24 h尿蛋白量、血尿素氮、肌酐比较有显著性差异.结论 2组均可有效治疗糖尿病肾病,谷胱甘肽联合黄葵胶囊较单纯黄葵胶囊治疗糖尿病肾病可缩短疗程、改善症状、安全、无明显不良反应.     

贝那普利联合前列地尔治疗糖尿病肾病疗效观察

①目的 观察贝那普利联合前列地尔治疗糖尿病肾病的疗效.②方法 选择40例糖尿病肾病患者随机分为两组,对照组20例,采用常规治疗加氨氯地平;观察组20例,常规治疗加贝那普利联合前列地尔治疗4周.于治疗前后测定两组的尿素氮、血清肌酐水平、24h尿蛋白定量.③结果 观察组治疗后尿素氮、血清肌酐水平、24h尿蛋白定量较治疗前均有明显下降,差异有统计学意义(P<0.05).④结论 贝那普利联合前列地尔治疗糖尿病肾病在降低尿蛋白、改善肾脏损害方面有可靠疗效.     

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.