雾化吸入治疗慢性阻塞性肺疾病的临床观察

目的探讨雾化吸入布地奈德、硫酸沙丁胺醇治疗慢性阻塞性肺疾病急性加重期的疗效。方法将76例慢性阻塞性肺疾病急性加重期患者随机分为2组,在常规综合治疗的基础上,治疗组给予布地奈德混悬液、硫酸沙丁胺醇雾化液以氧气驱动为动力雾化吸入;对照组给予地塞米松、糜蛋白酶以氧气驱动为动力雾化吸入。观察治疗7d后患者症状和体征的改善情况。结果治疗组总有效率为92.10%,高于对照组的73.68%（P〈0.05）。结论雾化吸入布地奈德、硫酸沙丁胺醇治疗慢性阻塞性肺疾病急性加重期有明显疗效。     

两种药物联合治疗AECOPD患者的临床疗效研究

目的 探讨布地奈德联合硫酸沙丁胺醇雾化吸入治疗慢性阻塞性肺疾病急性加重期(AECOPD)患者的临床疗效.方法 选取我院2015年6月—2016年10月收治的66例慢性阻塞性肺疾病急性加重期患者为研究对象,将其随机分为观察组和对照组,对照组采用硫酸沙丁胺醇2.5 mg加4 mL生理盐水雾化吸入治疗,观察组则采用布地奈德2 mg联合硫酸沙丁胺醇2.5 mg加4 mL生理盐水雾化吸入治疗.治疗后根据英国医学委员会的呼吸困难量表对2组患者的呼吸困难评分比较,同时对患者的恢复情况进行统计.结果 经治疗后,观察组患者的呼吸困难评分较对照组患者呼吸困难评分低,差异具有统计学意义(P<0.05);同时,观察组的治疗总有效率为84.85%,明显高于对照组的60.61%,差异具有统计学意义(P<0.05).结论 对慢性阻塞性肺疾病急性加重期患者采用布地奈德联合硫酸沙丁胺醇雾化吸入治疗,可以有效改善患者呼吸困难等症,治疗效果较好,值得在临床上进一步推广.     

沙丁胺醇联合布地奈德对COPD急性加重期的临床疗效

目的探讨沙丁胺醇联合布地奈德治疗急性加重期慢性阻塞性肺疾病的疗效。方法选取我院2012年6月-2014年2月收治的80例急性加重期慢性阻塞性肺疾病患者,随机分为观察组和对照组,每组40例,两组患者均给予包括抗生素、祛痰、茶碱及营养支持等常规治疗,观察组在常规治疗的基础上加用沙丁胺醇及布地奈德混悬液雾化吸入治疗,对照组采用沙丁胺醇吸入治疗,对两组患者的治疗效果观察和比较。结果对照组总有效率为65%,观察组总有效率为92.5%,两组患者总有效率比较,P〈0.05,差异有统计学意义。结论沙丁胺醇联合布地奈德雾化吸入治疗急性加重期慢性阻塞性肺疾病效果显著,患者依从性高,值得临床推广使用。     

沙丁胺醇联合布地奈德雾化吸入治疗慢性阻塞性肺疾病急性加重期65例疗效观察

目的:观察沙丁胺醇联合布地奈德雾化吸入治疗慢性阻塞性肺疾病急性加重期的临床疗效。方法:选择75例慢性阻塞性肺疾病急性加重期患者,随机分为观察组和对照组,两组患者均给予包括氧疗、抗生素、茶碱、祛痰及营养支持治疗等常规治疗,观察组在此基础上给予沙丁胺醇2ml联合布地奈德2mg氧气驱动雾化吸入,2次/d;对照组给予沙丁胺醇雾化吸入,2ml/次加入4ml的生理盐水中,吸入方法同上,2次/d。结果:治疗7d后,观察组总有效率优于对照组,两组比较差异有统计学意义(P<0.05)。结论:沙丁胺醇联合布地奈德雾化吸入治疗慢性阻塞性肺疾病急性加重期效果显著,值得在基层医院推广。     

沙丁胺醇联合布地奈德雾化吸入对慢性阻塞性肺疾病急性加重期患者肺通气功能的影响

目的研究慢性阻塞性肺疾病急性加重期(AECOPD)采用沙丁胺醇联合布地奈德雾化吸入治疗对患者肺通气功能的影响。方法选取荥阳市中医院2014年4月至2016年8月收治的82例AECOPD患者,将其随机分为对照组与观察组,各41例。对照组予以常规治疗,观察组在对照组基础上予以布地奈德联合沙丁胺醇雾化吸收治疗。比较两组临床疗效及肺通气功能改善情况。结果观察组治疗有效率高于对照组,差异有统计学意义(P<0.05);观察组1 s用力呼气容积(FEV1)、用力肺活量(FVC)及FEV1/FVC均高于对照组,差异有统计学意义(P<0.05)。结论沙丁胺醇联合布地奈德雾化吸入治疗慢性阻塞性肺疾病急性加重期效果显著,可改善患者肺通气功能。     

慢性阻塞性肺疾病急性加重期雾化吸入布地奈德治疗效果观察

目的:观察慢性阻塞性肺疾病急性加重期患者雾化吸入布地奈德进行治疗的临床效果。方法:选择慢性阻塞性肺疾病急性加重期患者80例,患者知情同意后采取对照研究,将80例患者分为观察组及对照组,每组40例,观察组给予沙丁胺醇与布地奈德吸入2次/d,对照组给予沙丁胺醇雾化吸入,观察比较两组患者治疗前后的各项数据及治疗结果。结果:治疗期间两组患者均无明显不良反应,治疗后两组患者均有不同程度的恢复;观察组患者显效率为72.5%,总有效率为92.5%,对照组显效率为47.5%,总有效率为67.5%,观察组显效率及总有效率均明显高于对照组,差异有统计学意义(P<0.05)。结论:慢性阻塞性肺疾病急性加重期患者雾化吸入布地奈德进行治疗的临床效果显著,值得临床推广应用。     

布地奈德雾化吸入治疗慢性阻塞性肺疾病急性加重期效果观察

目的:结合临床实践经验,探讨布地奈德雾化吸入治疗慢性阻塞性肺疾病急性加重期患者的临床效果。方法:选取收治的慢性阻塞性肺疾病急性加重期患者124例为研究对象,采用对照研究,经患者知情同意,将其分为对照组与观察组,对照组给予沙丁胺醇雾化吸入,观察组在对照组的基础上加入布地奈德2次/d,比较两组患者治疗前后各项数据以及治疗效果。结果:经过治疗,两组患者都得到不同程度的恢复,治疗期间无患者出现明显不良反应。观察组显效率为74.19%,总有效率为91.94%,对照组显效率为48.39%,总有效率为70.97%,两组比较,观察组明显高于对照组,差异有统计学意义(P<0.05)。结论:采用布地奈德雾化吸入治疗慢性阻塞性肺疾病急性加重期患者疗效显著,值得临床推广应用。     

布地奈德雾化吸入对慢性阻塞性肺疾病急性加重期疗效的影响

目的:探讨布地奈德雾化吸入对慢性阻塞性肺疾病急性加重期(AECOPD)疗效的影响。方法:选择62例AECOPD患者,随机分为对照组(31例)与观察组(31例)。对照组给予常规加硫酸特布他林雾化吸入治疗,观察组在此基础上联合布地奈德雾化吸入治疗。结果:观察组的总有效率、治疗后FEV1%、PaO2和PaCO2均明显优于对照组(P<0.05),两组不良反应发生率比较差异无统计学意义(P>0.05)。结论:布地奈德联合硫酸特布他林雾化吸入等治疗AECOPD的疗效显著,可明显改善肺功能和PaO2、PaCO2,不良反应少,值得临床推广应用。     

不同方法雾化吸入治疗老年慢性阻塞性肺疾病急性加重期的疗效观察

目的 观察不同方法雾化吸入治疗老年慢性阻塞性肺疾病急性加重期的临床疗效.方法 68例老年慢性阻塞性肺疾病急性加重期患者随机分为对照组(34例)和联合组(34例).两组均采用综合治疗,对照组予以布地奈德雾化吸入治疗,联合组在对照组治疗基础上加用特布他林雾化吸入治疗,两组疗程均为7 d.观察和比较两组临床疗效.结果 治疗组治疗总有效率为82.4%,对照组治疗总有效率为70.6%,两组比较差异有统计学意义(P＜0.05).两组治疗过程中均未出现明显不良反应.结论 布地奈德联合特布他林雾化吸入治疗老年慢性阻塞性肺疾病急性加重期疗效显著,安全可靠,值得临床推广应用.     

布地奈德与沙丁胺醇联合吸入治疗急性加重期COPD患者效果评价

目的:分析布地奈德联合沙丁胺醇吸入治疗急性加重期慢性阻塞性肺疾病患者(AECOPD)的效果。方法:选择该院2014年5月至2015年11月间收治的AECOPD患者60例作为研究对象,并随机分为观察组及对照组30例。对照组在常规治疗基础上给予沙丁胺醇雾化吸入治疗,观察组在常规治疗基础上给予布地奈德联合沙丁胺醇雾化吸入治疗,对比两组患者治疗效果。结果:观察组总有效率为90.0%;对照组总有效率为80.0%。观察组总有效率要高于对照组(P0.05)。结论:布地奈德联合沙丁胺醇雾化吸入治疗AECOPD具有较好的效果,可有效控制患者病情,改善患者肺功能。     

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.     

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.