联合应用醒脑静和盐酸纳洛酮治疗脑出血后昏迷患者的临床效果分析

目的：观察为脑出血后昏迷患者联合应用醒脑静和盐酸纳洛酮进行治疗的临床效果。方法：将我院收治的68例脑出血后昏迷患者随机分为治疗组和对照组,每组各34例患者。为对照组患者使用盐酸纳洛酮进行治疗,为治疗组患者在使用盐酸纳洛酮的基础上加用醒脑静进行治疗,对比分析两组患者的临床疗效。结果：两组患者的临床疗效相比较,差异显著（P＜0.05）,有统计学意义。两组患者治疗前的GCS评分（格拉斯哥昏迷评分）相比较,差异不显著（P＞0.05）,无统计学意义。在进行治疗后,两组患者的GCS评分均得到明显的改善,与治疗前相比差异显著（P＜0.05）,有统计学意义。在进行治疗后,治疗组患者的GCS评分明显优于对照组患者,差异显著（P＜0.05）,有统计学意义;两组患者的清醒时间相比较,差异显著（P＜0.05）,有统计学意义。结论：联合应用醒脑静和盐酸纳洛酮治疗脑出血后昏迷的疗效确切,可显著改善患者的临床症状,促使其尽早清醒,此法值得在临床上推广应用。     

醒脑静联合盐酸纳洛酮治疗脑出血后昏迷的临床效果观察

目的探讨醒脑静联合盐酸纳洛酮治疗脑出血后昏迷的临床效果观察。方法选取我院2015年6月-2017年12月98例脑出血后昏迷患者,根据抽签法分为两组,即观察组(醒脑静联合盐酸纳洛酮治疗)与对照组(盐酸纳洛酮治疗),每组各49例。对比两组患者治疗效果。结果观察组意识好转起效时间、住院时间与对照组比较明显缩短,且GCS评分治疗后明显升高(P0.05);临床疗效100.00%,与对照组91.84比较显著较高(P0.05);两组不良反应发生率比较中数据差异比较无意义(P0.05)。结论醒脑静联合盐酸纳洛酮治疗脑出血后昏迷的临床效果显著,值得推广。     

醒脑静联合盐酸纳洛酮治疗脑出血后昏迷患者的疗效观察

目的观察醒脑静联合盐酸纳洛酮治疗脑出血后昏迷患者的疗效。方法抽取本院于2016年6月至2017年11月收治的77例脑出血后昏迷患者为研究对象。随机分为对照组和观察组。分别给予两组常规盐酸纳洛酮治疗、醒脑静联合盐酸纳洛酮治疗,观察患者的疗效、脑血肿量及格拉斯哥昏迷量表(glasgow coma scale,GCS)评分变化。结果观察组治疗总有效率高于对照组,治疗后,观察组脑血肿量少于对照组,GCS评分高于对照组,差异均有统计学意义(P0.05)。结论醒脑静联合盐酸纳洛酮用于脑出血后昏迷患者的治疗,疗效显著,可有效改善患者的预后。     

醒脑静联合盐酸纳洛酮治疗脑出血后昏迷患者的临床疗效

目的探讨醒脑静联合盐酸纳洛酮治疗脑出血后昏迷患者的临床疗效。方法选取本院2017年12月至2018年12月收治的脑出血后昏迷患者116例,按照随机分组原则,分成实验组和对照组,每组58例,对照组给予盐酸纳洛酮治疗,实验组给予醒脑静联合盐酸纳洛酮治疗,比较两组的治疗效果,以及各项指标水平。结果实验组患者总有效率为91.38%,对照组患者总有效率为75.86%,实验组的临床疗效明显优于对照组,两组差异有统计学意义(P0.05);实验组患者的苏醒时间为(7.25±1.07)d,对照组患者的苏醒时间为(12.68±1.32)d,实验组的苏醒时间明显短于对照组,两组差异有统计学意义(P0.05);治疗前,两组患者的脑血肿量与GCS评分相差不大,不具有统计学意义(P0.05);治疗后,两组患者的脑血肿量与GCS评分均有所改善,而实验组患者的改善幅度更为显著,两组的差异具有统计学意义(P0.05)。结论采用醒脑静联合盐酸纳洛酮治疗脑出血后昏迷,临床疗效显著,患者的脑血肿量明显减少,意识恢复明显,具有推广借鉴的价值。     

刍议应用醒脑静联合盐酸纳洛酮治疗脑出血后昏迷患者的临床疗效

目的：分析醒脑静联合盐酸纳洛酮治疗脑出血后昏迷患者的临床疗效。方法：收集我院2012年10月∽2013年10月期间诊治的脑出血后昏迷患者80例作为研究对象,随机分组的方式将患者分为观察组与对照组,每组患者各40例。对照组单纯采用常规吸氧、抗感染、纠正水电解质紊乱、盐酸纳洛酮等治疗模式,观察组在对照组的基础上加用醒脑静治疗,对2组患者的临床效果进行分析对比。结果：研究结果显示,2组患者治疗前格拉斯哥昏迷评分和脑血肿量比较没有明显差异（P＞0．05）,治疗后均得到明显改善,且观察组患者的改善效果明显优于对照组（P＜0．05）,观察组患者的清醒时间也明显短于对照组（P＜0．05）。结论：醒脑静联合盐酸纳洛酮治疗脑出血后昏迷患者具有良好的临床疗效,值得在临床上推广应用。     

联合应用纳洛酮和醒脑静治疗急性脑出血的疗效观察

目的：探讨联合应用纳洛酮和醒脑静治疗急性脑出血的临床疗效。方法：将2011年10月至2013年12月我院急诊科收治的发病时间在48h以内的80例急性脑出血患者按照入院的先后顺序随机分为研究组和对照组,每组各40例患者。为对照组患者采用纳洛酮进行急诊治疗,为研究组患者联合应用纳洛酮和醒脑静进行治疗,并对比分析了两组患者的临床疗效及入院时、治疗14d后的NHISS和Glasgow评分。结果：研究组患者治疗的总有效率明显高于对照组患者,差异显著（P＜0.05）,有统计学意义,其治疗后的NHISS和Glasgow评分优于对照组患者,差异显著（P＜0.05）,有统计学意义。结论：对急性脑出血患者联合应用纳洛酮和醒脑静进行治疗可显著改善患者神经功能缺损的状况,取得理想的疗效。     

醒脑静联合盐酸纳洛酮治疗脑出血后昏迷患者的临床效果观察

目的:探析在治疗脑出血后昏迷患者中应用醒脑静与盐酸纳洛酮相联合的临床效果.方法: 选择2014年08月到2016年10月本院接收的68例脑出血昏迷的患者作为研究对象,随机分成两组,分别是对照组与实验组.对照组32例给予盐酸纳洛酮治疗,实验组36例在对照组给药基础上加用醒脑静治疗.观察两组临床效果、治疗前后格拉斯哥昏迷评分(GCS)以及清醒时间.结果:实验组的总有效率显著比对照组要高,P<0.05.治疗前两组GCS评分无显著差异,P>0.05,不具统计学意义.治疗后,实验组GCS评分明显比对照组低,P<0.05.实验组清醒时间显著比对照组长,P<0.05.结论:醒脑静与盐酸纳洛酮相联合对脑出血昏迷患者治疗效果显著,且能有效提高患者认知功能,延长清醒时间,提高患者的存活率,值得医学推广与应用.     

纳洛酮联合醒脑静治疗高血压性脑出血的临床疗效观察

目的：观察纳洛酮联用醒脑静治疗高血压性脑出血的临床疗效及对血肿的影响。方法根据随机数字表法将120例高血压性脑出血患者分为对照组、纳洛酮组、醒脑静组和联合治疗组,每组30例。对照组采用常规方法治疗,纳洛酮组、醒脑静组和联合治疗组在此基础上加用纳洛酮、醒脑静和两种药物联合治疗。观察并比较患者治疗前和治疗后第3、7、15和30天的血肿量、脑水肿指数、神经功能缺损评分。结果在治疗前和治疗后第3天,对照组、纳洛酮组、醒脑静组和联合治疗组间血肿量、脑水肿指数和神经功能缺损评分比较差异均无统计学意义（均P＞0.05）;在治疗后第7、15和30天,对照组、纳洛酮组、醒脑静组和联合治疗组间血肿量、脑水肿指数和神经功能缺损评分比较差异均有统计学意义（均P＜0.05）。联合治疗组血肿量、脑水肿指数和神经功能缺损评分较纳洛酮组和醒脑静组显著低于对照组（均P＜0.05）。结论纳洛酮联用醒脑静治疗高血压性脑出血可以更好地促进血肿吸收,减轻脑水肿,改善神经功能缺损。     

醒脑静联合盐酸纳洛酮治疗脑出血后昏迷患者的临床效果分析

目的：对联合应用醒脑静与盐酸纳洛酮治疗处于昏迷状态的脑出血患者的临床效果进行研究分析。方法：抽取86例处于昏迷状态的脑出血患者病例，将其分为对照组和治疗组，平均每组43例。对照组患者在脑出血常规治疗基础上加用盐酸纳洛酮进行治疗；治疗组患者在治疗组治疗方案基础上加用醒脑静与盐酸纳洛酮进行治疗。结果：治疗组患者脑出血症状改善效果明显优于对照组；治疗前后脑血肿程度的改善幅度明显高于对照组；GCS评分的改善幅度明显大于对照组；昏迷持续时间明显短于对照组；出现不良反应的人数明显少于对照组。结论：联合应用醒脑静与盐酸纳洛酮治疗处于昏迷状态的脑出血患者临床效果非常明显。     

联合应用醒脑静与盐酸纳洛酮治疗处于昏迷状态的脑出血患者疗效

目的：探讨联用醒脑静与盐酸纳洛酮治疗脑出血昏迷患者的临床疗效。方法：按就诊顺序编号将我院收治的90例处于昏迷状态的脑出血患者分为对照组和观察组,每组45例。对照组按西医常规并加用盐酸纳洛酮治疗,观察组在对照组基础上联用醒脑静治疗,比较2组患者的疗效。结果：对照组共治愈8例,显效10例,有效14例,无效13例,治疗总有效率为71．11％;观察组共治愈14例,显效17例,有效11例,无效3例,治疗总有效率为93．33％,比较差异具有统计学意义（P〈0．05）。经治疗后,对照组脑血肿量多于观察组,昏迷时间长于观察组,比较差异均具有统计学意义（P〈0．05）。结论：醒脑静与盐酸纳洛酮联合治疗脑出血昏迷患者可有效改善患者的脑出血症状,促使其神经功能迅速恢复,值得临床借鉴和推广。     

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.     

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.     

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.