盐酸拉贝洛尔联合硫酸镁治疗妊娠期高血压的疗效研究

目的探究盐酸拉贝洛尔联合硫酸镁治疗妊娠期高血压的临床效果。方法选取2013年2月‐2015年2月该院收治的妊娠期高血压患者78例,随机分为观察组和对照组,每组患者各39例;对照组给予硫酸镁常规治疗,观察组给予盐酸拉贝洛尔联合硫酸镁治疗;对比两组治疗前后平均动脉血压(MAP)、尿蛋白指标情况和不良反应发生率。结果观察组患者治疗后MAP、尿酸和尿素氮显著优于对照组患者(P0.05);两组患者不良反应发生率比较差异无统计学意义(P0.05)。结论盐酸拉贝洛尔联合硫酸镁治疗妊娠期高血压效果显著,且不良反应发生率低,值得推广。     

银杏达莫联合拉贝洛尔对妊娠期高血压疾病患者内皮功能及分娩结局的影响

目的:探讨银杏达莫注射液联合盐酸拉贝洛尔片对妊娠期高血压疾病(HDCP)患者内皮功能及分娩结局的影响。方法:选择我院2017年6月—2018年5月期间收治的76例HDCP患者为观察对象。采用随机数字表分组法将其分为对照组和观察组,各38例。观察组采用银杏达莫注射液联合盐酸拉贝洛尔片治疗。对照组单独采用盐酸拉贝洛尔片治疗。比较两组治疗前后血清NO、ET-1及FIB水平变化及妊娠结局情况。结果:治疗前,两组患者血浆NO、ET-1及FIB水平比较差异无统计学意义(P>0.05);治疗后,两组患者血浆NO水平升高(P<0.05),ET-1及FIB水平均降低(P<0.05);观察组治疗后血浆NO水平高于对照组(P<0.05),ET-1及FIB水平低于对照组(P均<0.05)。观察组不良结局发生率明显低于对照组(P<0.05)。结论:银杏达莫注射液联合盐酸拉贝洛尔片可显著提高HDCP患者血浆NO水平,降低ET-1及FIB水平,改善血管内皮功能与妊娠结局,临床疗效显著,可进行推广应用。     

拉贝洛尔治疗高血压急症的临床观察

在临床急诊工作中，经常遇到高血压急症病例，能否迅速地控制其血压，对抢救患者的生命和改善预后具有重要的意义。拉贝洛尔注射液是一种兼有α/β受体阻滞作用的降压药。我们使用拉贝洛尔对高血压急症进行降压治疗，现将结果报告如下。     

盐酸拉贝洛尔联合丹参注射液治疗重度子痫前期患者的效果观察

目的:观察盐酸拉贝洛尔联合丹参注射液治疗重度子痫前期患者的效果。方法:选取61例重度子痫前期患者为研究对象,依据随机数字表法将其分为观察组31例和对照组30例。对照组采用盐酸拉贝洛尔联合硫酸镁注射液治疗,观察组采取盐酸拉贝洛尔联合丹参注射液治疗。比较治疗前及治疗7 d后两组血压水平[舒张压(DBP)、收缩压(SBP)]、24 h尿蛋白定量(24 h UP)和羊水指数(AFI)、胎儿脐动脉收缩压与舒张压比值(S/D)的变化情况、分娩结局及不良反应发生情况。结果:治疗后,观察组DBP与SBP、24 h UP水平均明显低于对照组,差异有统计学意义(P<0.05);观察组AFI明显高于对照组,S/D明显低于对照组,差异有统计学意义(P<0.05);观察组活产率90.32%高于对照组,窒息发生率7.14%、流产或死胎率9.68%均低于对照组(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:盐酸拉贝洛尔联合丹参注射液治疗重度子痫前期患者的效果优于盐酸拉贝洛尔联合硫酸镁注射液治疗。     

盐酸拉贝洛尔注射液联合硝苯地平控释片对妊娠高血压患者血糖控制及妊娠结局的影响

目的分析盐酸拉贝洛尔注射液与硝苯地平控释片联合对妊娠高血压(PIH)患血糖控制及妊娠结局的影响。方法选取2016年10月至2017年11月郏县人民医院收治的PIH患者94例为研究对象,根据治疗方案分为对照组和观察组,每组47例。对照组口服硝苯地平控释片治疗,观察组在对照组基础上静脉滴注盐酸拉贝洛尔治疗。比较两组患者治疗后临床疗效、治疗前后空腹血糖和血压以及妊娠结局的变化情况。结果治疗后观察组总有效率[93.62%(44/47)]高于对照组[76.60%(36/47)],差异有统计学意义(P<0.05)。两组治疗后空腹血糖比较,差异无统计学意义(P>0.05)。治疗后两组舒张压、收缩压均低于治疗前,且观察组低于对照组,差异有统计学意义(均P<0.05)。治疗后观察组不良母婴结局发生率[21.28%(10/47)]低于对照组[46.81%(22/47)],差异有统计学意义(P<0.05)。结论盐酸拉贝洛尔注射液与硝苯地平控释片联合治疗PIH能有效提高临床疗效,改善妊娠结局,降低血压水平,且不影响患者血糖水平。     

用盐酸拉贝洛尔注射液治疗100例妊娠高血压患者的疗效观察

分析用盐酸拉贝洛尔注射液治疗妊娠高血压的临床疗效。方法：将2011年7月至2013年11月我院收治的100例妊娠高血压患者随机分为治疗组（52例）和对照组（48例）。为对照组患者进行吸氧、镇静等常规治疗,并为其应用硫酸镁进行治疗。为治疗组患者在进行常规治疗的基础上静脉滴注盐酸拉贝洛尔注射液进行治疗。观察两组患者治疗前后的舒张压（DBP）、收缩压（SBP）及24h尿蛋白含量等指标的变化,比较两组患者的母婴结局。结果：与治疗前相比,两组患者在进行一周的治疗后DBP、SBP及24h尿蛋白水平均明显下降,差异显著（P<0.05）,有统计学意义。在进行治疗后,治疗组患者DBP、SBP、24h尿蛋白的水平均低于对照组患者,差异显著（P<0.01）,有统计学意义。与对照组患者相比,治疗组患者的终止妊娠率和胎心异常率较低,差异显著（P<0.05）,有统计学意义。两组患者发生产后出血、新生儿窒息的几率相比较,差异不显著（P>0.05）,无统计学意义。结论：用盐酸拉贝洛尔注射液治疗妊娠高血压可明显降低患者的血压和24h尿蛋白水平,增加其胎儿的存活率,减少其发生并发症的几率,获得理想的疗效,此法值得在临床上推广应用。     

盐酸拉贝洛尔联合复方丹参注射液治疗妊娠高血压综合征

目的观察盐酸拉贝洛尔、复方丹参注射液联合应用在降低妊娠高血压综合征（简称妊高征）患者血压、消除蛋白尿、延长孕周、减少产后出血、降低胎儿窘迫率的效果。方法中重度妊娠高血压综合征患者279例，随机抽取130例为治疗组，另外149例为对照组，观察治疗前后两组患者血压变化、尿蛋白改善情况、胎儿窘迫发生率及产后出血情况。结果联合应用组降血压有效率86．9％，降低尿蛋白率85．3％，平均延长孕周2．6周，胎儿窘迫发生率、产后出血率明显低于对照组，结论盐酸拉贝洛尔联合复方丹参注射液联合应用及安全有效应用于妊娠高血压综合征的治疗，较传统单纯应用硫酸镁解痉治疗效果好，可应用于临床。     

尼莫地平与拉贝洛尔联合硫酸镁注射液对妊娠高血压的疗效

目的探讨尼莫地平与拉贝洛尔联合硫酸镁注射液对妊娠高血压的疗效。方法选取2016年5月至2018年2月鲁山县人民医院收治的92例妊娠高血压患者,按随机数表法分为对照组和观察组,每组46例。在常规治疗的基础上,对照组患者接受拉贝洛尔联合硫酸镁注射液治疗,观察组患者接受尼莫地平与拉贝洛尔联合硫酸镁注射液治疗,均治疗10 d。比较两组患者治疗前后血压,包括舒张压(DBP)和收缩压(SBP)。随访至分娩结束,统计不良妊娠结局发生率。结果治疗后,两组患者DBP、SBP低于治疗前,观察组患者DBP、SBP低于对照组,差异有统计学意义(均P<0.05)。观察组不良妊娠结局发生率低于对照组,差异有统计学意义(P<0.05)。结论尼莫地平与拉贝洛尔联合硫酸镁注射液对妊娠高血压患者的血压控制效果显著,有助于减少不良妊娠结局的发生。     

盐酸川芎嗪注射液联合拉贝洛尔治疗妊娠期高血压疾病的临床效果

目的观察盐酸川芎嗪注射液联合拉贝洛尔治疗妊娠期高血压疾病的临床效果。方法将2017年1月至2018年1月镇平县中医院收治的98例妊娠期高血压疾病患者纳入研究,根据随机数表法分为对照组和观察组,各49例。对照组患者接受拉贝洛尔治疗,观察组患者加用盐酸川芎嗪注射液治疗。比较两组患者治疗前后收缩压(SBP)、舒张压(DBP)和尿蛋白水平;检测两组患者治疗前后凝血酶原时间(PT)、凝血活酶时间(APTT)、纤维蛋白(Fbg)等凝血功能指标水平;统计两组患者不良妊娠结局发生率。结果治疗后,两组患者SBP、DBP及尿蛋白水平低于治疗前,观察组患者SBP、DBP及尿蛋白水平低于对照组,差异有统计学意义(P<0.05)。治疗后,两组患者PT、APTT水平高于治疗前,Fbg水平低于治疗前,观察组患者PT、APTT水平高于对照组,Fbg水平低于对照组,差异有统计学意义(P<0.05)。观察组患者剖宫产、早产、产后出血、新生儿窒息不良妊娠结局发生率低于对照组,差异有统计学意义(P<0.05)。结论盐酸川芎嗪注射液联合拉贝洛尔治疗妊娠期高血压疾病临床效果较好,可有效改善患者血压水平和凝血功能,降低不良妊娠结局发生率,具有临床推广价值。     

硝苯地平控释片与拉贝洛尔联合硫酸镁注射液对妊娠高血压患者血压及母婴结局的影响

目的探究硝苯地平控释片+拉贝洛尔+硫酸镁注射液对妊娠高血压患者母婴结局及血压的影响。方法选取2016年4月至2018年2月开封市人民医院收治的147例妊娠高血压患者,依据治疗方案分为对照组和研究组。对照组73例,采取硝苯地平控释片+硫酸镁注射液进行治疗。研究组74例,在对照组治疗的基础上增加拉贝洛尔治疗。对比两组母婴结局及患者血压控制情况。结果研究组新生儿窒息、胎儿窘迫、产后出血和早产发生率均低于对照组,差异有统计学意义(均P<0.05);治疗前两组患者舒张压和收缩压差异无统计学意义(P>0.05),研究组患者治疗后1周舒张压、收缩压均低于对照组,差异有统计学意义(均P<0.01)。结论采取硝苯地平控释片+拉贝洛尔+硫酸镁注射液治疗妊娠高血压可改善母婴结局,控制产妇血压。     

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.