联合雾化吸人毛细支气管炎53例

目的 探讨布地奈德联合特布他林、异丙托溴铵雾化吸入治疗毛细支气管炎的疗效.方法 将106例收治住院的毛细支气管炎患儿随机分为两组,在相同的综合治疗基础上,治疗组予布地奈德混悬液联合特布他林、异丙托溴铵三联雾化吸入治疗7d;对照组仅常规使用激素治疗7d.观察两组患儿临床症状消失时间、住院天数.结果 治疗组治愈38例,好转12例,无效3例,总有效率94.3％;对照组治愈21例,好转17例,无效15例,总有效率71.8％,两组比较差异有显著性(P＜0.05).结论 布地奈德联合特布他林、异丙托溴铵雾化吸入治疗毛细支气管炎方法简单、起效快、患儿耐受性好、疗效确切.     

干扰素联合布地奈德、特布他林、异丙托溴铵雾化吸入佐治毛细支气管炎疗效观察

目的 观察重组人干扰素α-1b联合布地奈德、特布他林、异丙托溴铵雾化吸入治疗婴幼儿毛细支气管炎临床疗效. 方法 148例婴幼儿毛细支气管炎患儿随机分为两组,各为74例,对照组给予常规综合治疗,观察组在常规综合治疗基础上给予重组人干扰素α- 1b联合布地奈德、特布他林、异丙托溴铵雾化吸入.结果 观察组治疗的总有效率98.6%,明显高于对照组72.9%( P＜0.01);止咳时间、喘憋缓解时间和肺部罗音消失时间较对照组明显缩短( P＜0.01).结论 雾化吸入重组人干扰素α-1b联合布地奈德、特布他林、异丙托溴铵治疗婴幼儿毛细支气管炎疗效确切.     

布地奈德联合异丙托溴铵治疗小儿毛细支气管炎的临床效果

目的:探究布地奈德联合异丙托溴铵在小儿毛细支气管炎中的治疗效果。方法:选取我院88例小儿毛细支气管炎患者作为观察对象,通过随机数表法将其平均分至A组与B组,每组44例。A组患儿予以甲强龙进行治疗,B组患儿予以布地奈德联合异丙托溴铵进行治疗,对比两组患儿的咳嗽、气喘、肺部湿啰音消失时间以及炎性因子水平。结果:B组患儿的咳嗽、气喘、肺部湿啰音消失时间以及炎性因子指标均显著优于A组,且组间比较差异具有统计学意义(P<0.05)。结论:布地奈德联合异丙托溴铵在小儿毛细支气管炎治疗中具有显著的减轻患者炎症,促进其恢复的效果,因此具有临床推广价值。     

异丙托溴铵特布他林及布地奈德佐治儿童喘息性支气管炎

目的：探讨异丙托溴铵、特布他林联合布地奈德雾化吸入佐治儿童喘息性支气管炎、肺炎的临床疗效。方法将2011年1月-2013年1月我院儿科收治的170例喘息性支气管炎、肺炎患儿分为2组,对照组采用常规治疗,治疗组采用异丙托溴铵、特布他林及布地奈德雾化吸入治疗,比较2组患儿的临床疗效。结果经治疗,治疗组患儿呼吸困难、喘憋及喘鸣音消失时间明显短于对照组,差异有统计学意义（P〈0.01）;治疗组较对照组痊愈率明显增高,差异有统计学意义（P〈0.01）。结论异丙托溴铵、特布他林联合布地奈德雾化吸入佐治儿童喘息性支气管炎、肺炎能使患儿尽快缓解咳嗽、呼吸困难、喘憋症状,缩短住院时间,疗效可靠,值得临床推广应用。     

联合雾化吸入毛细支气管炎53例

目的探讨布地奈德联合特布他林、异丙托溴铵雾化吸入治疗毛细支气管炎的疗效。方法将106例收治住院的毛细支气管炎患儿随机分为两组,在相同的综合治疗基础上,治疗组予布地奈德混悬液联合特布他林、异丙托溴铵三联雾化吸入治疗7d;对照组仅常规使用激素治疗7d。观察两组患儿临床症状消失时间、住院天数。结果治疗组治愈38例,好转12例,无效3例,总有效率94．3％;对照组治愈21例,好转17例,无效15例,总有效率71．8％,两组比较差异有显著性（P〈0．05）。结论布地奈德联合特布他林、异丙托溴铵雾化吸入治疗毛细支气管炎方法简单、起效快、患儿耐受性好、疗效确切。     

复方丹参静脉滴注配合普米克令舒、博利康尼、异丙托溴胺雾化吸入治疗毛细支气管炎疗效观察

目的研究分析采用复方丹参静脉滴注配合普米克令舒、博利康尼、异丙托溴铵雾化吸入治疗毛细支气管炎的临床治疗效果。方法选择该院2013年6月—2014年6月期间收治的毛细支气管炎患者80例作为研究对象,将所有患者按照随机分组法分为观察组和对照组两组,每组40例。对照组给予患者丹参静脉滴注配合普米克令舒、博利康尼空气压缩泵雾化吸入治疗,观察组给予患者复方丹参静脉滴注配合普米克令舒、博利康尼、异丙托溴铵雾化吸入治疗。对比观察两组患者的临床治疗效果、喘鸣音消失时间、肺部啰音消失时间、体温稳定正常时间、气促缓解时间、心率恢复正常时间以及住院时间情况。结果观察组患者在治疗后,治疗有效率达到82.5%（33/40）,明显高于对照组患者的62.5%（25/40）,差异有统计学意义（P〈0.05）。观察组患者的喘鸣音消失时间、肺部啰音消失时间、体温稳定正常时间、气促缓解时间、心率恢复正常时间以及住院时间均显著低于对照组,差异有统计学意义（P〈0.05）。结论对于毛细支气管炎患者采用复方丹参静脉滴注配合普米克令舒、博利康尼、异丙托溴铵雾化吸入治疗效果显著,能够有效缩短临床症状消失时间和住院时间,值得临床推广运用。     

干扰素联合布地奈德、特布他林、异丙托溴铵雾化吸入佐治毛细支气管炎疗效观察

目的观察重组人干扰素α-1b联合布地奈德、特布他林、异丙托溴铵雾化吸入治疗婴幼儿毛细支气管炎临床疗效。方法148例婴幼儿毛细支气管炎患儿随机分为两组,各为74例,对照组给予常规综合治疗,观察组在常规综合治疗基础上给予重组人干扰素α-1b联合布地奈德、特布他林、异丙托溴铵雾化吸入。结果观察组治疗的总有效率98.6%,明显高于对照组72.9%（P〈0.01）;止咳时间、喘憋缓解时间和肺部罗音消失时间较对照组明显缩短（P〈0.01）。结论雾化吸入重组人干扰素α-1b联合布地奈德、特布他林、异丙托溴铵治疗婴幼儿毛细支气管炎疗效确切。     

布地奈德联合异丙托溴铵治疗小儿毛细支气管炎效果观察

目的探究布地奈德联合异丙托溴铵治疗小儿毛细支气管炎(BII)的临床效果。方法选取荥阳市人民医院2015年6月至2016年6月收治的BII患儿116例作为研究对象,按照随机数字表法分为观察组(n=58)和对照组(n=58)。对照组行常规抗感染治疗,观察组加用布地奈德联合异丙托溴铵雾化吸入治疗。连续治疗7 d后,对比两组临床疗效及各临床症状痊愈时间。结果观察组总有效率明显优于对照组,咳嗽、气喘、肺啰音消失时间及体温恢复正常时间均短于对照组(P<0.05)。结论布地奈德联合异丙托溴铵应用于小儿毛细支气管炎效果显著,可有效缓解机体临床炎症反应,具有良好推广应用价值。     

丙酸倍氯米松联合复方异丙托溴铵治疗小儿毛细支气管炎的临床疗效

目的:观察丙酸倍氯米松联合复方异丙托溴铵治疗小儿毛细支气管炎的临床疗效。方法:选取毛细支气管炎患儿94例。按照随机数字表法分为对照组和观察组,各47例。对照组予以复方异丙托溴铵联合氯化钠溶液治疗,观察组采用复方异丙托溴铵联合丙酸倍氯米松治疗。比较两组临床疗效,气促、哮鸣音、湿啰音、憋喘、咳嗽等症状体征缓解消失时间和不良发生发生情况。结果:观察组临床治疗有效率为93.62%(44/47),高于对照组74.47%(35/47),差异有统计学意义(P<0.05);观察组湿啰音、哮鸣音、咳嗽、憋喘消失时间均少于对照组,差异有统计学意义(P<0.05);观察组不良反应发生率为2.13%(1/47),与对照组6.38%(3/47)比较,差异无统计学意义(P>0.05)。结论:丙酸倍氯米松联合复方异丙托溴铵治疗小儿毛细支气管炎临床疗效优于复方异丙托溴铵联合氯化钠溶液治疗疗效。     

联合用药雾化佐治伴有喘息的婴幼儿肺炎

目的探讨氧驱动雾化吸入布地奈德、异丙托溴铵、特布他林佐治小儿肺炎的疗效。方法将同期在我科住院的46例肺炎患儿。随机分为布地奈德＋异丙托溴铵＋特布他林佐组（简称为布异特组）和对照组,2组均给予相同的综合性治疗,布异特组加布地奈德、异丙托溴铵、特布他林氧驱动雾化吸入治疗。对治疗前后咳嗽、气喘、哮鸣音、湿性啰音消失及住院时间进行观察比较。结果2组咳嗽及湿性啰音消失时间无显著性差异（P〉0．05）,咳嗽气喘缓解,肺部哮鸣音消失及住院时间方面布异特组与对照组比较有显著性差异（P〈0．05）。结论联合用药氧驱动雾化吸入佐冶小儿肺炎疗效确切安全,操作方便,适用于各年龄段的患儿,临床广泛应用。     

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.