鼻内镜下低温等离子消融治疗过敏性和血管运动性鼻炎疗效观察

目的:观察鼻内镜下低温等离子消融翼管、筛前神经集区治疗变应性和血管运动性鼻炎的疗效。方法:采用鼻内镜下低温等离子消融翼管、筛前神经集区治疗变应性鼻炎80例、血管运动性鼻炎50例。结果:变应性鼻炎组术后6个月、1年、3年总有效率分别为100%、78%、55%,血管运动性鼻炎组分别为100%、92%、85%,2组3年总有效率相比,P<0.05。结论:鼻内镜下低温等离子消融翼管、筛前神经集区治疗变应性和血管运动性鼻炎的短期疗效较好,血管运动性鼻炎的长期疗效优于变应性鼻炎。     

内窥镜下YAG激光烧灼筛前神经治疗变应性鼻炎和血管运动性鼻炎的疗效观察

目的 :研究鼻内窥镜下YAG激光烧灼治疗变应性鼻炎和血管运动性鼻炎的疗效。方法 :变应性鼻炎 80例 ,血管运动性鼻炎 70例 ,在鼻内窥镜明视下用YAG激光烧灼筛前神经治疗变应性鼻炎和血管运动性鼻炎。结果 :变应性鼻炎显效 32例 (40 % ) ,有效 12例 (15 % ) ,无效 36例 (45 % ) ,总有效率为 5 5 %。血管运动性鼻炎显效 4 9例 (70 % ) ,有效 15例 (2 1 4 % ) ,无效 6例 (8.6 % ) ,总有效率为 91.4 %。结论 :鼻内窥镜下YAG激光烧灼筛前神经是治疗变应性鼻炎和血管运动性鼻炎的有效方法 ,治疗血管运动性鼻炎尤为有效     

低温等离子体治疗过敏性鼻炎32例报告

目的探讨下鼻甲、筛前神经低温等离子体消融对变应性鼻炎的效果。方法对32例(男20例,女12例)变应性鼻炎患者,采用低温等离子手术系统在下鼻甲粘膜下打孔进行治疗,分析其疗效。结果疗效在6个月～1年随访时判断,结果显效15例(46.88%),有效17例(53.12%),总有效率为100%。结论对于药物治疗欠佳的变应性鼻炎患者,下鼻甲、筛前神经低温等离子消融可以明显改善变应性鼻炎症状。     

变应性鼻炎神经微波热凝术132例报告

根据翼管神经、筛前神经、下鼻甲微神经节、交感神经释放的血管活性肠肽和合成肽均参与变应性鼻炎的发病机制 ,提出神经微波热凝术治疗变应性鼻炎手术方案 ,施行手术 132例 ,并随访 4～ 2 3个月 ,近期治愈 10 0 % ,1年显效 74.2 % ,有效 2 2 .7% ,巩固率 97% ,认为这是治疗变应性鼻炎的一种新方法     

筛前神经灼断及下鼻甲部分切除治疗血管运动性鼻炎

研究目的探讨血管运动性鼻炎手术治疗的有效方法。研究背景翼管神经切断求治疗血管运动性鼻炎的效果不理想。近年来发现，筛前神经也含有副交感神经，下鼻甲粘膜内有副交感神经丛。研究方法设计了灼断筛前神经及切除部分下鼻甲粘膜的手术方法。通过手术效果与文献报告比较，对该手术方法的可行性作出结论。结果共手术36例。显效22例，占61％；有效13例，占36％；无效1例，占3%。经6～12个月随访，症状打分同术后。结论该手术方法是目前治疗血管运动性鼻炎的首选方式。     

改良单侧翼管神经切断术治疗难治性变应性鼻炎96例临床效果观察

目的:探讨鼻内镜下改良单侧翼管神经切断术治疗难治性变应性鼻炎的临床效果.方法:难治性变应性鼻炎患者96例行鼻内镜下改良单侧翼管神经切断术,分析手术相关情况,比较术前、术后6个月、1年及2年症状视觉模拟评分(VAS)和临床症状评分.结果:96例患者均顺利完成单侧翼管神经切断术.术后6个月、1年、2年VAS评分分别为4.0...     

醋酸泼尼松龙迎香穴封闭治疗变应性鼻炎的临床研究

目的探讨应用醋酸泼尼松龙注射液于迎香穴封闭治疗变应性鼻炎的临床效果。方法选取我院136例变应性鼻炎患者,在其迎香穴注射混合药液（含0.9%氯化钠1 mL、2%利多卡因0.5 mL、醋酸泼尼松龙注射液0.5 mL）,每侧2 mL。比较治疗前和注射1个疗程后和注射后6个月患者主要症状评分及临床疗效。结果注射后6个月,显效52例（38.2%）,有效72例（52.9%）,无效12例（8.8%）,总有效率为91.2%。72例随访1年,42例（30.9%）未复发,为临床痊愈。治疗前与治疗后1个疗程及6个月后的症状评分比较,差异有统计学意义（P〈0.05）。结论迎香穴注射醋酸泼尼松龙是治疗变应性鼻炎的简单有效方法之一。     

微波治疗变应性鼻炎102例临床分析

目的　探讨微波治疗变应性鼻炎的临床疗效及治疗机制。方法　采用微波热凝筛前神经治疗变应性鼻炎 1 0 2例 ,并观察其临床症状及体征变化。结果　通过随访 1个月、6个月、1年 ,总有效率达 80 .3 % ,其中显效 41 .2 %、有效 39.2 %、无效 1 9.6 % ,无一例产生并发症。结论　微波变应性鼻炎疗效持久、稳定 ,值得临床推广。     

鼻内窥镜下联合手术治疗常年性变应性鼻炎80疗效观察

目的 探讨鼻内窥镜下联合手术治疗常年性交应性鼻炎的效果.方法 对80例常年性变应性鼻炎患者,采用鼻内窥镜下蝶腭、筛前神经及鼻甲联合手术治疗.对术前、术后6个月、12个月症状评分及疗效进行比较.结果 术前、术后6个月、术后12个月症状严重程度评分分别为11.5±3.3、2.1±0.8、3.2±1.6,术后与术前差异有统计学意义.术后6个月及12个月时有效率均达90%.结论 鼻内窥镜下蝶腭、筛前神经及鼻甲联合手术治疗常年性变应性鼻炎疗效持久,手术操作简便,值得临床推广应用.     

低温等离子射频治疗变应性鼻炎

目的:探讨低温等离子射频治疗持续性、中-重度变应性鼻炎的手术方法及疗效。方法:2003年8月～2005年10月对58例持续性、中-重度变应性鼻炎患者,采用DNR(多尼尔)等离子治疗系统进行筛前神经切断术和下鼻甲低温等离子射频消融术治疗,术后1个月、6个月、1年进行观察随访,按照“变应性鼻炎治疗原则和推荐方案(2004年,兰州)”的疗效评定标准进行评分。结果:术后1个月58例患者症状全部消失;术后6个月显效87.93%(51/58),有效8.62%(5/58),无效3.45%(2/58),总有效率96.55%;术后1年显效75.86%(44/58),有效15.52%(9/58),无效8.62%(5/58),总有效率91.38%,全组病例术后均未出现鼻中隔穿孔、嗅觉丧失、眼干、萎缩性鼻炎等症状。结论:鼻内窥镜下低温等离子射频治疗变应性鼻炎,治疗部位准确、术中出血少、不良反应轻、并发症少、疗效显著,具有较好的临床应用价值。     

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.