葛根素联合甲钴胺治疗糖尿病周围神经病变

目的　评价葛根素联合甲钴胺治疗糖尿病周围神经病变的疗效。方法　 74例糖尿病周围神经病变患者随机分为两组 ,治疗组 3 8例 ,给予葛根素注射液 40 0mg溶于生理盐水 2 5 0ml,静脉滴注 ,每日 1次 ,同时每日肌注甲钴胺 0 5mg ,共 4周 ;对照组3 6例 ,单用甲钴胺每日肌注 0 5mg ,共 4周。结果　治疗组的总有效率为 92 11% ,而对照组为 68 42 % ,两组比较有显著差异 (P <0 0 5 ) ,治疗组与对照组对神经传导速度的改善均有效 ,但治疗组优于对照组 (P <0 0 1)。结论　葛根素联合甲钴胺治疗可明显改善糖尿病周围神经病变的疗效。     

甲钴胺联合通心络胶囊治疗2型糖尿病周围神经病变疗效观察

目的探讨甲钴胺联合通心络胶囊治疗2型糖尿病周围神经病变的疗效。方法将63例患者,随机分为两组,在常规应用口服降糖药物或胰岛素的治疗基础上,观察组加用甲钴胺针500ug肌注,每日1次;通心络胶囊3粒／次,每日3次;对照组加用维生素B1针100mg肌注,每日1次;复方丹参注射液20ml加入生理盐水250ml中静脉滴注,每日1次,疗程均为4周。结果观察组总有效率100％,部分患者正中神经、腓总神经和腓肠神经传导速度恢复正常,与对照组比较差异有统计学意义（P〈0．01）。结论甲钴胺联合通心络胶囊治疗2型糖尿病周围神经病变是一种较好的治疗方法。     

银杏达莫联合甲钴胺治疗糖尿病周围神经病变疗效观察

目的观察银杏达莫联合甲钴胺治疗糖尿病周围神经病变（DPN）的疗效。方法选择2型糖尿病并伴有不同程度周围神经病变临床症状患者68例,分成2组各34例。在常规应用口服降糖药物或胰岛素的治疗基础上,对照组用甲钴铵片0.5mg,每日口服3次,治疗组按照上述方法服用甲钴胺片的基础上加银杏达莫20ml加入0.9%氯化钠注射液250ml中静脉滴注,1次/d,疗程均为4周。观察患者症状和体征变化情况。结果治疗组临床症状的总有效率88.2%,对照组为64.7%,差异有统计学意义（〈0.05）。结论银杏达莫、甲钴胺联合应用治疗DPN可以明显改善患者的临床症状,是治疗DPN的一种有效方法。     

甲钴胺治疗糖尿病周围神经病变46例疗效观察

目的 观察甲钴胺治疗糖尿病周围神经病变疗效.方法 将90例糖尿病周围神经病变随机分为2组,在严格控制血糖的基础上,治疗组46例,采用甲钴胺注射液500 ug加入生理盐水250 ml中,静脉滴注,1次/日;对照组44例采用细胞色素C30 mg加入生理盐水250 ml中,静脉滴注,1次/日;两组均以15天为一个疗程,观察甲钴胺治疗糖尿病周围神经病变的疗效.结果 治疗组总有效率为80.44%,对照组为45.45%(p＜0.01).在改善患者肌电图方面,治疗组优于对照组(p＜0.05).结论 甲钴胺治疗糖尿病周围神经病变有较好的疗效.     

灯盏花素联合甲钻胺治疗糖尿病周围神经病变

目的 研究灯盏花素联合甲钴胺治疗糖尿病周围神经病变的临床疗效及观察其不良反应.方法 对确诊为糖尿病合并周围神经病变33例的患者给予灯盏花素注射液40mg加入250mL生理盐水,静滴每天一次及每天甲钴胺0.5mg肌注一次,共两周后,口服血塞通片2片/次,每天三次,甲钴胺胶囊0.5mg/次,每天三次,共两周.对照组肌注甲钴胺0.5mg每天一次,两周后口服甲钴胺胶囊0.5mg/次,每天三次,共两周.结果 治疗组总有效高于对照组,两组之间检验差异有统计学意义(P<0.01).药物治疗过程中未见明显不良反应.结论 灯盏花素联合甲钴胺是治疗糖尿病周围神经病变有效且安全的药物,值得临床推广应用.     

奥扎格雷钠联合甲钴胺注射液治疗糖尿病周围神经病变36例疗效分析

目的 观察奥扎格雷钠联合甲钴胺注射液治疗糖尿病周围神经病变的疗效.方法 将糖尿病周围神经病变患者随机分为对照组34例,给予甲钴胺注射液500 μg,肌肉注射,隔日1次;治疗组36例在上述治疗基础上加用奥扎格雷钠氯化钠注射液250 ml,静脉滴注,每日1次,连用15 d.结果 治疗组在肢体疼痛、麻木、感觉异常自觉症状方面与对照组比较有显著性差异(P＜0.01),肌电图神经传导速度两组治疗前后相比均呈有意义的改善(P＜0.05),治疗组与对照组比较有显著性差异(P＜0.01).结论 奥扎格雷钠联合甲钴胺注射液治疗糖尿病周围神经病变安全、有效.疗效明显优于单独应用甲钴胺治疗.     

α-硫辛酸联合甲钴胺治疗糖尿病周围神经病变的疗效观察

目的观察和分析α-硫辛酸联合甲钴胺治疗糖尿病周围神经病变的疗效以及安全性。方法将2009年1月～2012年1月我院确诊的60例糖尿病周围神经病变作为研究对象,随机分为观察组和对照组各30例,两组患者在控制饮食、运动锻炼的基础上应用口服降糖药或者胰岛素控制血糖。治疗组在上述基础上予α-硫辛酸250 mL静脉滴注,每日3次,2周为一疗程。甲钴胺1 mg加入0.9%氯化钠注射液10 mL中静脉滴注,每日3次,2周为一疗程。比较两组的疗效以及治疗前后神经传导速度的变化。结果观察组治疗后无效3例,总有效率90.0%(27/30),对照组无效9例,总有效率为70.0%(21/30),观察组总有效率明显高于对照组,差异有统计学意义(P<0.05)。两组治疗后神经传导速度均较治疗前明显提高,且观察组较对照组改善更明显(P<0.05)。结论α-硫辛酸联合甲钴胺治疗糖尿病周围神经病变疗效显著,能明显改善患者的临床表现,增加神经传导速度,安全性好,值得推广和应用。     

杂志信息

据《中华内科杂志》1999年1月38卷第1期报道 为观察甲钴胺对糖尿病神经病变的疗效,中日友好医院内分泌科李充伟等对108例糖尿病神经病变患者进行随机阳性对照临床观察,治疗组以甲钴胺治疗,500μg肌注每周3次,4周后改口服,500μg每日3次,服8周。对照组前4周以维生素B_(12)500μg肌注每周3次,第5～12周服腺苷辅酶B_(12)500μg每日3次。结     

丹红、前列地尔联用甲钴胺治疗糖尿病周围神经病变疗效观察

目的:探讨丹红、前列地尔联用甲钴胺治疗糖尿病周围神经病变的临床疗效。方法:将52例糖尿病周围神经病变患者随机分为对照组和治疗组,每组各26例,两组均给予甲钴胺、前列地尔静脉滴注,治疗组给予丹红注射液20ml+5%GS250ml静脉滴注,1次/d,两组疗程均为2周。结果:治疗2周后,两组患者主观症状均有改善,对照组有效率为76.9%,治疗组有效率为92.3%,两组比较,差异有统计学意义(P0.05)。结论:丹红、前列地尔联用甲钴胺治疗糖尿病周围神经病变有明显疗效。     

丹红注射液联合甲钴胺治疗糖尿病周围神经病变30例临床疗效观察

目的观察丹红注射液联合甲钴胺治疗糖尿病周围神经病变患者的临床疗效。方法将60例糖尿病周围神经病变患者按照就诊顺序随机分成两组,治疗组30例,使用丹红20-30 ml+0.9%盐水250 ml静滴,1次/天,甲钴胺500μg肌注,1次/天;对照组30例,甲钴胺500μg肌注,1次/天,4周为一个疗程,记录患者治疗后症状、体征的改变及腓总神经传导速度。结果治疗后两组患者的临床疗效和神经传导速度均较治疗前明显改善,但以治疗组改善更为明显,两组间差异有统计学意义(P0.05)。结论丹红注射液联合甲钴胺治疗尿病周围神经病变优于单纯甲钴胺治疗。     

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.