酪酸梭菌颗粒联合美莎拉嗪片治疗溃疡性结肠炎的临床疗效分析

目的分析酪酸梭菌颗粒（米雅）联合美莎拉嗪片（莎尔福）治疗溃疡性结肠炎的临床疗效。方法收集该院收治的80例溃疡性结肠炎患者临床资料,按照其住院号尾号的奇偶分为观察组、对照组,各40例。对照组采取美莎拉嗪片治疗,观察组采取酪酸梭菌颗粒联合美莎拉嗪片治疗,最后分析两组患者的临床效果。结果观察组患者治疗总有效率为95．00％,明显高于对照组的77．50％,差异有统计学意义（P〈O．05）。观察组患者体温、血Hb、ESR变化明显优于对照组,差异有统计学意义（P〈0．05）。结论酪酸梭菌颗粒联合美莎拉嗪片治疗溃疡性结肠炎,有利于降低炎症反应,改善患者预后隋况,值得临床推广。     

穴位埋线联合美沙拉嗪治疗溃疡性结肠炎的临床观察

目的：分析穴位埋线与美沙拉嗪联合治疗溃疡性结肠炎的临床效果,并总结护理经验。方法选取70例溃疡性结肠炎患者为研究对象,随机分为观察组（穴位埋线联合美沙拉嗪治疗）与对照组（美沙拉嗪单一治疗）,各35例,比较2组的临床效果。结果观察组的治疗总有效率为97.14%,显著高于对照组,2组间疗效比较差异具有统计学意义（P＜0.05）;且观察组的6个月复发率、不良反应发生率均显著低于对照组,组间比较差异具有统计学意义（均P＜0.05）。结论穴位埋线与美沙拉嗪联合治疗溃疡性结肠炎的临床效果确切,在治疗过程中应注意采取恰当的护理措施,临床推广价值较高。     

溃疡性结肠炎患者运用奥硝唑联合美沙拉嗪治疗的效果研究

目的：探究奥硝唑联合美沙拉嗪在治疗溃疡性结肠炎患者的治疗效果。方法随机选取临床诊断为溃疡性结肠炎患者180例作为研究对象,根据治疗方法的不同将其分为观察组（采用奥硝唑联合美沙拉嗪治疗方法进行治疗）和对照组（单独采用美沙拉嗪进行治疗）,每组90例。观察统计2组患者的治疗效果、患者满意率、不良反应等情况。结果观察组患者的治疗总有效率（96.7%）明显高于对照组患者的治疗总有效率（83.3%）,组间比较差异具有统计学意义（P＜0.05）;观察组患者的满意率为100.0%,对照组患者的满意率为94.5%,组间比较差异具有统计学意义（P＜0.05）;观察组患者无不良反应,对照组不良反应率为1.1%,组间比较差异无统计学意义。结论奥硝唑联合美沙拉嗪治疗溃疡性结肠炎患者具有非常好的临床疗效,且能大大提高患者的满意率水平,值得在临床中进一步推广使用。     

美沙拉嗪联合布拉氏酵母菌散治疗溃疡性结肠炎的疗效及对炎症因子的影响

目的 评价联合应用美沙拉嗪和布拉氏酵母菌散治疗溃疡性结肠炎的疗效及对炎症因子的影响。方法 将64例溃疡性结肠炎患者随机分为联合治疗组与对照组各32例,联合治疗组给予美沙拉嗪和布拉氏酵母菌散治疗,对照组单用美沙拉嗪治疗,均治疗8周后比较两组治疗前后临床疗效和不良反应,测定两组炎症因子白介素10(IL 10)、肿瘤坏死因子 α(TNF α)水平并进行比较。结果 联合治疗组及对照组治疗前内镜评分无差异（P＞0.05）,治疗后组内比较及组间比较均有统计学意义（P＜0.05）。联合治疗组总有效29例（906%）,对照组总有效22例（688%）,联合治疗组疗效优于对照组（P＜0.05）。与治疗前相比,两组IL 10水平均明显升高,TNF- α水平均明显降低,差异均有统计学意义(P＜0．05);治疗后联合治疗组较对照组IL-10水平升高更明显,TNF- α水平下降更明显,差异均有统计学意义(P＜0．05)。两组均出现不良反应,但差异无统计学意义（P＞0.05）。 结论 美沙拉嗪联合布拉氏酵母菌散治疗溃疡性结肠炎可有效调节炎症因子水平,具有更好的疗效,可在临床推广应用。     

美莎拉嗪辅助治疗溃疡性结肠炎的临床疗效分析

目的 观察美莎拉嗪辅助治疗溃疡性结肠炎的临床疗效,提高临床治疗水平.方法 对近年来收治的150例溃疡性结肠炎患者随机分为观察组（美莎拉嗪辅助治疗组）78例和对照组（常规治疗组）72例,比较两组患者的临床效果.结果 观察组治愈45例,显效23例,总有效率为87.2%;对照组治愈32例,显效25例,总有效率为79.2%.两组患者总有效率比较差异显著（P〈0.01）,具有统计学意义.观察组出现胃部不适2例,恶心1例;对照组出现恶心2例.两组不良反应发生率无明显差异.结论 美莎拉嗪辅助治疗溃疡性结肠炎效果理想,且安全性较高,值得推广应用.     

用微生态制剂治疗溃疡性结肠炎的临床效果分析

目的：对应用微生物制剂治疗溃疡性结肠炎的临床效果进行观察。方法：将2012年11月至2013年9月我院收治的100例溃疡性结肠炎患者随机分为对照组和观察组,为对照组患者单用美沙拉嗪颗粒进行治疗,为观察组患者联合应用美沙拉嗪颗粒和微生态制剂美常安进行治疗,对比分析两组患者的临床疗效。结果：经过治疗,两组患者的临床症状均得到有效的改善。观察组患者临床症状的改善情况优于对照组患者,差异显著（P＜0.05）,有统计学意义。观察组患者治疗的总好转率为92.0%,对照组患者治疗的总好转率为82.0%,二者相比差异显著（P＜0.05）,有统计学意义。观察组患者治疗后的组织学炎症严重程度评分明显低于对照组患者,差异显著（P＜0.05）,有统计学意义。结论：使用微生态制剂治疗溃疡性结肠炎可显著改善患者的临床症状及体征,提高其治疗的有效性,值得在临床上推广应用。     

低FODMAP饮食联合美沙拉嗪对溃疡性结肠炎患者的疗效及安全性评价

目的探讨低FODMAP饮食联合美沙拉嗪对溃疡性结肠炎（UC）患者的疗效及其安全性。方法选取2018年1月至2019年12月浙江医院消化内科收治的活动性轻中度UC患者129例,采用随机数字表法分为实验组（63例）和对照组（66例）,两组患者均进行相同的临床治疗,在此基础上实验组患者予低FODMAP饮食,对照组患者予普通饮食,为期6周。测定并比较两组患者治疗前后营养状况指标、相关炎症因子指标、肝肾功能指标及临床疗效和生活质量指标。结果治疗后两组患者IL-17、IL-23、TNF-α水平均明显下降（均P＜0.05）,且实验组患者IL-17、IL-23、TNF-α水平均明显低于对照组（均P＜0.05）;白蛋白、前白蛋白、Hb、ALT、AST、GFR水平与治疗前比较差异均无统计学意义（均P＞0.05）,且组间比较差异均无统计学意义（均P＞0.05）;SoutherlandDAI评分、肠黏膜镜像评分均明显下降（均P＜0.05）,且实验组明显低于对照组（P＜0.05）;肠道症状、全身症状、情感功能、社会功能评分均明显上升（均P＜0.05）,且实验组均明显高于对照组（均P＜0.05）。结论低FODMAP饮食联合美沙拉嗪可以显著降低轻中度UC患者的相关炎症因子水平,抑制肠道炎症,缓解患者的胃肠道症状,提高其生活质量,且安全性较好。     

美沙拉嗪栓联合美沙拉嗪缓释颗粒治疗轻中度远段溃疡性结肠炎的疗效分析

目的评价美沙拉嗪栓联合美沙拉嗪缓释颗粒治疗远段溃疡性结肠炎的疗效。方法选取2018年2月至2019年2月我院收治的轻中度远段溃疡性结肠炎患者各60例为研究对象,将轻中度患者各随机分为实验组和对照组,平均每组各30例。对照组患者给予美沙拉嗪栓单药治疗,试验组患者联合美沙拉嗪缓释颗粒治疗,两组治疗时间均为6周,比较两组治疗前后临床疗效。结果轻度患者实验组总有效率(96.7%),对照组总有效率(93.3%),实验组临床疗效与对照组差异较小,无统计学意义(P0.05);中度患者实验组总有效率(96.7%),对照组总有效率(53.3%),实验组临床疗效明显优于对照组,差异有统计学意义(P0.05)。结论美沙拉嗪栓联合美沙拉嗪缓释颗粒治疗轻度远段结肠炎与单用美沙拉嗪栓效果相当,对治疗中度远段结肠炎疗效优于单独应用美沙拉嗪栓。     

益生菌联合美沙拉嗪治疗轻、中度活动期溃疡性结肠炎的效果及安全性

目的:探讨分析益生菌(双歧三联活菌)联合美沙拉嗪治疗轻、中度活动期溃疡性结肠炎的临床效果及安全性。方法:选择本院收治的51例轻、中度溃疡性结肠炎患者作为本次研究对象,按随机数字表法分成联合组(n=26)和对照组(n=25)。其中联合组患者予以美沙拉嗪、双歧三联活菌(口服),对照组患者仅予以美沙拉嗪(口服)。治疗2个月后比较两组患者的临床表现、疾病活动指数(DAI)、内镜下评分、不良反应事件、治疗效果及多种检查指标的差异。结果:联合组的治疗总有效率为88.46%,明显高于对照组的76.00%,差异有统计学意义(P0.05);两组患者治疗前的临床症状总分、疾病活动指数、内镜下评分、血沉、C-反应蛋白、TNF-α、IL-17及IL-23等指标比较,差异均无统计学意义(P0.05);治疗后,联合组患者的临床症状总分、疾病活动指数、内镜下评分、血沉、C-反应蛋白、TNF-α、IL-17及IL-23等指标均低于对照组,差异均有统计学意义(P0.05);而两组患者的药物不良反应发生率比较,差异无统计学意义(P0.05)。结论:益生菌联合美沙拉嗪治疗轻、中度活动期溃疡性结肠炎能够明显改善患者的临床症状,缓解活动期溃疡性结肠炎的炎症反应,具有良好的临床治疗效果及安全性。     

美沙拉嗪联合谷氨酰胺治疗溃疡性结肠炎疗效观察

目的探讨美沙拉嗪联合谷氨酰胺治疗溃疡性结肠炎的临床疗效。方法将本院收治的53例轻、中度溃疡性结肠炎患者,按治疗方法的不同分为治疗组28例与对照组25例,治疗组采用美沙拉嗪联合谷氨酰胺治疗,对照组采用美沙拉嗪治疗,比较两组患者的治疗效果。结果治疗组治疗第72小时后腹泻及便血临床症状缓解率为92.9%,高于对照组的88.0%,临床症状缓解率差异有统计学意义(P0.05);肠镜下黏膜愈合率治疗组为75%,对照组为68%,黏膜愈合率差异无统计学意义(P0.05)。结论美沙拉嗪联合谷氨酰胺治疗溃疡性结肠炎疗效显著。     

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.