BiPAP通气联合舒利迭对COPD肺功能和生活质量的影响

目的:探讨舒利迭联合双水平气道正压(BiPAP)通气对中度以上慢性阻塞性肺疾病(COPD)的肺功能和生活质量的影响。方法:将COPD稳定期患者100例,随机分为:A组33例单使用舒利迭,B组33例单使用(Bi-PAP)通气,C组34例使用BiPAP通气联合舒利迭。治疗前及治疗后3月测定患者肺功能,统计第1秒用力呼气容积(FEV1)占预计值%、FEV1/肺活量(FVC)%,比较各组治疗前后的改善率。通过SGRQ问卷调查表,比较治疗前后SGRQ总分的差值。结果:BiPAP通气加舒利迭治疗与单一采用BiPAP或舒利迭治疗比较,对FEV1占预计值%、FEV1/FVC%的改善率及SGRQ总分的差异均有统计学意义(P<0.05)。结论:对COPD稳定期患者采用BiPAP通气加舒利迭治疗,其效果比单一采用舒利迭或BiPAP通气,更能改善肺功能,提高生活质量,值得临床推广。     

舒利迭治疗稳定期慢阻肺43例

目的探讨舒利迭对稳定期慢性阻塞性肺疾病(COPD)的临床疗效。方法将86例稳定期慢阻肺患者随机分为治疗组和对照组,两组均给予常规治疗,治疗组在此基础上给予吸入舒利迭(50微克/250微克),每次一吸,每日两次,治疗8周,比较两组治疗前后肺功能指标及临床症状。结果治疗后治疗组肺功能指标显著优于对照组(P0.05)。结论对于稳定期慢阻肺患者,舒利迭能明显改善肺功能,减轻临床症状,提高患者生活质量。     

可必特联合舒利迭用于稳定期COPD临床疗效观察

目的观察可必特联合舒利迭治疗稳定期慢性阻塞性肺疾病(COPD)的临床疗效。方法将80例稳定期COPD患者分为两组,对照组采用可必特治疗,观察组联合可必特和舒利迭治疗,比较两组治疗前后症状评分、呼吸困难分级和肺功能变化。结果治疗前,两组症状评分、呼吸困难分级和肺功能相当,差异无统计学意义(P>0.05);治疗后,观察组症状评分、呼吸困难分级和肺功能改善情况均优于对照组,差异有统计学意义(P<0.05)。结论可必特联合舒利迭治疗稳定期COPD能有效改善患者临床症状、呼吸困难分级和肺功能,疗效良好且优于单独舒利迭,未出现严重不良反应,安全性较高,具有临床推广应用价值。     

舒利迭治疗重度COPD稳定期的疗效观察

目的观察舒利迭(50/500μg)在重度COPD稳定期的治疗疗效。方法我院呼吸内科81例重度COPD稳定期患者,随机分为试验组A、B和对照组C各27例。对照组C给予解痉、祛痰等基础治疗,试验组A、B在此基础上分别给予舒利迭50/500μg、50/250μg吸入治疗,2次/d,1吸/次,疗程3个月。分别对三组患者治疗前后的临床症状及肺功能指标进行观察对比,评价药物疗效。结果 81例患者有9例因COPD急性加重退出试验,A组25例、B组24例、C组23例。试验组A、B治疗前后临床症状评分明显改善(P<0.05),两组间差异无统计学意义;试验组A、B治疗前后肺功能FEV1、FEV1/FVC、FEV1%预计值,均明显改善(P<0.05);治疗后两组间比较,差异有统计学意义(P<0.05);对照组C治疗前后临床症状评分及肺功能各指标差异无统计学意义(P>0.05)。结论舒利迭治疗重度COPD患者疗效肯定,能提高患者肺功能,改善症状。而舒利迭50/500μg治疗重度COPD稳定期疗效优于舒利迭50/250μg。     

舒利迭对重度稳定期COPD患者辅助治疗的观察

目的探讨舒利迭对重度稳定期慢性阻塞性肺疾病(COPD)辅助治疗的疗效。方法按入院先后顺序,70例稳定期中重度COPD患者被随机分为对照组和观察组(n=35)。在止咳、平喘、抗感染等常规治疗基础上,对照组给予口服舒弗美(缓释茶碱)片0.2 g,2次/d,而观察组给予舒利迭吸入,每次l喷,2次/d;疗程均为8周。对各项临床指标进行观察比较。结果治疗后,观察组的肺功能、血气指标及临床症状评分改善情况均明显优于对照组,组间差异具有统计学意义(P<0.05)。结论舒利迭辅助治疗稳定期重度COPD优于舒服美,能显著改善患者的肺功能及临床症状。     

不同剂量舒利迭治疗老年中重度稳定期慢性阻塞性肺疾病疗效观察

目的:探讨不同剂量舒利迭用于老年慢性阻塞性肺疾病(COPD)中-重度稳定期的治疗效果。方法:将120例老年中-重度稳定期COPD患者随机分为对照组、观察1组和观察2组,每组40例。对照组采取常规治疗,观察1、2组在对照组基础上分别采用舒利迭50/250μg、50/500μg吸入治疗。比较三组患者的临床疗效。结果:治疗后,三组患者的肺功能指标、6-MWD、临床症状评分、PCO_2和PO_2均较治疗前明显改善(P<0.05),以观察2组最优(P<0.05)。结论:舒利迭对改善老年中-重度稳定期COPD患者的肺功能、临床症状及血气指标等疗效确切,而大剂量改善幅度更大,且无明显不良反应。     

舒利迭对老年慢性阻塞性肺疾病患者的临床研究

目的:观察舒利迭(丙酸氟替卡松/沙美特罗)对老年稳定期慢性阻塞性肺疾病(COPD)患者的疗效。方法:120例稳定期Ⅲ-Ⅳ期COPD患者分为两组,两组均按COPD稳定期常规处理,对照组给予茶碱缓释片及氨溴索,观察组给予吸入舒利迭,治疗12周,于治疗前后分别测定肺功能(FEV1/FVC,FEV1,FEV1%)、6分钟步行试验、Zung抑郁量表(SDS)。结果:与治疗后对照组相比,观察组肺功能指标明显升高(P<0.05),6分钟步行实验距离增加明显(P<0.05),Zung抑郁量表得分降低(P<0.05)。结论:舒利迭可减轻稳定期COPD患者的临床症状,改善肺功能,提高体力状态,改善情绪。     

针刺对COPD稳定期患者肺功能和生命质量影响疗效评价

目的观察针刺对慢性阻塞性肺病稳定期(COPD)患者肺功能的影响,比较其对患者临床症状、生命质量及呼吸困难的改善作用。方法将61例患者随机分为针刺组(31例)和舒利迭组(30例)。针刺组穴取定喘、肺俞、足三里为主,毫针针刺,隔日1次,每周3次;舒利迭组予舒利迭吸入剂治疗,每次1吸,每天2次。均治疗8周,观察两组病例治疗后的1s用力呼气量(FEV1)等肺功能指标改变、临床症状、圣乔治呼吸问卷(SGRQ)的评分,进行组间和组内的比较。结果针刺和舒利迭组均有效改善FEV1等肺功能指标(均0.05);治疗4周后对呼吸道症状的改善舒利迭组优于针刺组(0.05),治疗8周后两组效能相当(0.05);对生命质量的改善针刺组稍优于舒利迭组(改善值11.57±5.24 vs 9.89±4.76,0.05)。结论针刺能起到改善COPD稳定期患者肺功能的作用,缓解临床症状,提高生命质量,其效能与舒利迭治疗相当。     

舒利迭治疗老年慢性阻塞性肺疾病患者临床效果观察

目的:观察舒利迭(丙酸氟替卡松/沙美特罗)治疗老年稳定期慢性阻塞性肺疾病(COPD)患者的疗效。方法:将120例COPD患者分为观察组与对照组,两组均按COPD稳定期常规处理,对照组给予茶碱缓释片及氨溴索,观察组给予吸入舒利迭,治疗12周,于治疗前后分别测定肺功能(FEV1/FVC,FEV1,FEV1%)、6min步行试验、Zung抑郁量表(SDS)。结果:治疗后与对照组相比,观察组肺功能指标明显升高(P<0.05),6min步行实验距离增加明显(P<0.05),Zung抑郁量表得分降低(P<0.05)。结论:舒利迭可减轻稳定期COPD患者的临床症状,改善肺功能,提高体力状态,改善情绪。     

45例舒利迭治疗慢性阻塞性肺疾病稳定期的疗效观察

目的探讨舒利迭对慢性阻塞性肺疾病（COPD）Ⅲ-Ⅳ级患者稳定期肺功能改善的疗效。方法将90例COPD稳定期Ⅲ-Ⅳ级患者随机分为试验组45例和对照组各45例,两组患者在基础治疗相同的基础上,试验组吸入舒利迭,对照组吸入丙酸氟替卡松加万托林,治疗时间均为2个月。根据圣.乔治（St.George）呼吸疾病问卷（SGRQ）的方法对临床症状问卷调查及体征检查评分;测定肺功能指标FEV1、FEV1/FVC及FEV1占预计值的百分率（%）,评价治疗前后肺功能的变化。.结果两组患者在治疗前后肺通气功能指标均有改善,其中试验组COPD患者的肺通气功能较对照组改善更加显著;试验组的疗效（有效率91.1%）优于对照组（有效率75.6%）。比较均有统计学差异,P〈0.05。结论舒利迭可以改善稳定期COPD患者的肺功能,可作为稳定期COPD长期治疗的常规药物。     

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.