颈动脉溶栓治疗急性脑梗死的临床观察及护理

20 0 2年 1月～ 2 0 0 2年 11月 ,我院采用颈动脉注射尿激酶溶栓治疗急性脑梗死病人 2 1例 ,取得了明显的疗效 ,现将治疗及护理体会报告如下。1　临床资料1 1　一般资料　 2 1例病人其中男 13例 ,女 8例 ,平均年龄 5 6岁 ,均为发病后 12h内入院 ,经临床诊断为急性脑梗死 ,其中颈内动脉系统梗死 19例 ,椎动脉系统梗死 2例。CT检查除外脑出血 ,并排除大面积脑梗死及意识不清者。1 2　方法　尿激酶 5 0万U溶于生理盐水 6 0ml,于病灶侧颈动脉内缓慢注射 ,之后每天静点复方丹参 ,口服肠溶阿斯匹林75mg,视病情应用 2 0 %甘露醇治疗。1 3　结果　…     

纳洛酮治疗急性脑梗死45例疗效观察

本院从 1999年 1月至 2 0 0 0年 12月 ,共用纳洛酮治疗急性脑梗死患者 4 5例 ,对其疗效进行了临床对照研究 ,报告如下。1　资料与方法1.1　一般资料 :全部病例经头颅ＣＴ证实有与临床表现相关的脑梗死病灶。病例分为两组 ,治疗组 4 5例 ,男 2 6例 ,女 19例 ,年龄 5 0～ 80岁 ,平均 6 1岁。其中基底节区梗死 2 4例 ,脑叶梗死 11例 ,多发性梗死 8例 ,小脑梗死 2例。对照组 :4 5例 ,男 2 8例 ,女 17例 ,年龄4 9～ 81岁 ,平均 6 0岁。其中基底节区梗死 2 3例 ,脑叶梗死 10例 ,多发性梗死 9例 ,小脑梗死 3例。根据第二届全国脑血管病学会议 :①脑…     

中西药物联合应用治疗脑梗死28例疗效观察

随着人口老龄化 ,脑梗死发病率呈上升趋势 ,2 0 0 1年 12月至 2 0 0 3年 12月 ,我们联合应用脉络宁注射液与脑活素注射液治疗脑梗死 2 8例 ,疗效满意 ,现报告如下。1　资料和方法1.1　一般资料　将同期收治的均符合 1986年全国第二届脑血管病学术会指定的脑梗死诊断标准 ,并经颅脑CT确诊 5 6例患者 ,随机分为观察组和对照组 ,每组各 2 8例。其中观察组男 2 0例 ,女 8例 ;年龄 5 3岁～ 78岁 ,平均年龄 6 2 .5岁 ,发病 1d～ 5d。基底节区梗死 13例 ,多发性脑梗死 6例 ,大脑中动脉梗死 4例 ,脑干梗死 3例 ,腔隙性梗死 2例 ,合并高血压病史者…     

颈动脉加压注射复方维脑路通合剂治疗脑梗死180例临床分析

本科自2000年6月以来,采用颈动脉加压注射复方维脑路通合剂治疗脑梗死180例,并与静脉给药组相比较,现总结如下.     

颈动脉加压滴注神经活素治疗脑梗塞38例临床分析

自 1995年 8月以来 ,采用颈动脉加压滴注神经活素治疗脑梗塞 3 8例 ,并与静脉给药组相比较 ,现总结如下 :1　资料与方法1.1　临床资料　治疗组 3 8例 ,男 2 6例 ,女 12例 ,年龄 42～ 73岁 ,平均 5 8.3 0岁。均为颈内动脉系统脑梗塞 ,其中大面积脑梗塞 2例 ,腔隙性脑梗塞 2 0例。无意识障碍及脑疝 ,在发病 10天后即脑水肿高峰期后开始颈动脉加压滴注神经活素。治疗组病例选择除外以下禁忌 :①严重高血压 (血压≥ 2 6.6/16ｋＰａ) ;②脑出血 ,出血性梗塞 ;③严重心脏病、精神病、癫痫、过敏性疾病 ;④意识障碍者 ;⑤颈动脉高度狭窄、颈动脉窦…     

股动脉介入溶栓治疗急性脑梗死18例疗效观察

20 0 0年 6月至 2 0 0 1年 10月 ,对本院 18例急性脑梗死患者进行了股动脉介入溶栓治疗 ,取得了较好的效果 ,现报道如下。1　临床资料1.1　一般资料　全组 18例 ,男 11例 ,女 7例 ,年龄 4 2～ 72岁 ,平均 6 5岁 ;全部病例均为首次发病 ;颈动脉系统梗死 15例 ,椎基底动脉系统梗死 3例。入选标准 :发病 <6ｈ ,脑ＣＴ排除颅内出血 ,无明显梗死灶、水肿及占位效应 ,无明显意识障碍 (椎基底动脉系统患者昏迷不作为禁忌 ) ,排除有出血性疾病或凝血时间延长者 ,以及肝、肾功能不全者。1.2　股动脉介入溶栓　全部患者急诊接诊后迅速完成脑ＣＴ扫描及…     

尿激酶颈动脉注射治疗急性脑梗死20例分析

目的　研究尿激酶颈动脉注射治疗脑梗死疗效。方法　随机选择急性脑梗死病人 40例 ,分为治疗组和对照组 ,治疗组颈动脉注射尿激酶第 1次 1 0万U ,第 2次 5万U ,共用 2次 ;对照组颈动脉注射复方丹参针 ,每次 1 0ml,共用 3次 ,总量 3 0ml,两者均为隔天注射 1次 ,治疗前后查头颅CT、凝血 4项、血小板、出凝血时间。结果　尿激酶颈动脉注射治疗后 ,肌力提高 3级以上 40 % (P <0 .0 1 ) ,与对照组相比有显著差异 (P <0 .0 1 )。结论　颈动脉注射尿激酶是治疗急性脑硬死的有效方法之一。     

疏血通与尼莫地平治疗脑梗死48例

2004年1月至2005年12月，我们将疏血通注射液与尼莫地平片联合应用治疗急性脑梗死患者48例，取得满意疗效，现报告如下。 1资料与方法 1．1一般资料：治疗组48例，男37例，女11例，年龄42。78岁，平均年龄60岁。其中颈动脉系统梗死30例，椎基底动脉系统梗死18例，一侧基底节梗死38例，多发性脑梗死6例，大面积脑梗死1例，丘脑梗死3例。     

速避凝佐治急性脑梗死32例疗效观察

我院于 1998年 2月至 1999年 11月应用速避凝治疗急性脑梗死 32例 ,对其疗效及安全性作了对照观察 ,现报道如下。1　资料与方法1.1　一般资料　急性脑梗死患者 6 2例 ,均符合第二届全国脑血管病会议制订的诊断标准[1] ,全部经头颅ＣＴ证实。随机分为两组 ,治疗组 32例 ,男 18例 ,女 14例 ,年龄 32～ 76岁 ,平均 5 9.5岁 ,其中基底核区梗死 2 0例 ,脑叶梗死 3例 ,丘脑梗死 2例 ,脑干梗死 1例 ,多发性梗死 6例。对照组 30例 ,男 17例 ,女 13例 ,年龄 36～ 78岁 ,平均 6 0 .5岁 ,其中基底核区梗死 16例 ,脑叶梗死 3例 ,丘脑梗死 1例 ,脑干梗死 …     

颈总动脉注射尿激酶治疗急性脑梗死32例

我科自 1 999年 3个月至 2 0 0 0年 6月 ,采用尿激酶(ｕｋ)颈总动脉注射治疗急性脑梗死 3 2例 ,疗效确切 ,现报告如下 :1　资料与方法1 1　资料 　将 60例患者随机分为两组 ,治疗组 3 2例 ,对照组 2 8例。全部急性脑梗死患者均为首次发病 ,起病在 1 2小时之内 ,均符合全国第二次脑血管病学术会议通过的诊断标准且经头颅ＣＴ排外出血亦无大面积梗死出现的早期脑水肿。治疗组男 2 1例 ,女 1 1例 ,年龄 4 5～ 70岁 ,平均 57 5岁 ;合并高血压 2 0例 ,糖尿病 3例 ,对照组男 1 9例 ,女 9例 ,年龄 4 3～ 69岁 ,平均 56岁 ,合并高血压 1 8例 ,糖尿…     

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.