小儿支原体肺炎序贯治疗的成本及效果分析

目的评价阿奇霉素的两种不同给药方案在治疗小儿肺炎支原体肺炎中的成本及效果。方法将217例小儿肺炎支原体肺炎患者随机分为常规治疗组（98例）、序贯治疗组（119例）。其中常规治疗组采用注射用乳糖酸阿奇霉素按7d用药方案连续静脉滴注,序贯治疗组采用注射用乳糖酸阿奇霉素静脉注射4d,后改用阿奇霉素颗粒剂口服序贯给药治疗3d,并对两种方案进行成本及效果分析。结果两组在有效率及不良反应发生率方面无显著差异性（P〉0．05）,但常规治疗组的治疗成本却明显高于序贯治疗组（P〈0．001）。结论对小儿肺炎支原体肺炎,采用阿奇霉素静脉给药治疗,患者病情稳定后及时改用口服序贯给药治疗不但安全、有效,而且费用明显减少。     

3种方案治疗小儿肺炎支原体肺炎的成本-效果分析

目的评价3种方案治疗小儿肺炎支原体肺炎的成本-效果。方法A组：乳糖红霉素每日2次,静脉滴注5d。热退、症状控制后改用阿奇霉素,连服3d,停4d,如此服用3个周期。B组：阿奇霉素静脉滴注,一日一次,连续使用5d;热退、症状控制后改用阿奇霉素连服3d,停4d,如此服用3个周期。C组：乳糖红霉素每日2次,静脉滴注10d。结果A组（红霉素＋阿奇霉素序贯治疗方案）成本最低。结论红霉素＋阿奇霉素序贯治疗方案是治疗小儿肺炎支原体肺炎的最佳方案。     

采用阿奇霉素序贯疗法治疗小儿肺炎支原体肺炎40例的疗效与安全性分析

目的：分析采用阿奇霉素序贯疗法治疗小儿肺炎支原体肺炎的疗效与安全性。方法：于2014年9月至2015年9月期间选取小儿肺炎支原体肺炎患者80例,随机分为对照组和观察组两组,分别采取红霉素、阿奇霉素序贯疗法治疗,后比较两组患者的临床疗效。结果：观察组患儿的住院时间、疾病症状消失时间、不良反应发生率等均优于对照组,P ＜0．05。结论：采取阿奇霉素序贯疗法治疗小儿肺炎支原体肺炎,疗效显著且安全性较好。     

3种方案治疗小儿肺炎支原体肺炎的成本-效果分析

目的 评价3种方案治疗小儿肺炎支原体肺炎的成本-效果.方法 A组:乳糖红霉素每日2次,静脉滴注5 d.热退、症状控制后改用阿奇霉素,连服3 d,停4d,如此服用3个周期.B组:阿奇霉素静脉滴注,一日一次,连续使用5d;热退、症状控制后改用阿奇霉素连服3 d,停4d,如此服用3个周期.C组:乳糖红霉素每日2次,静脉滴注10d.结果 A组(红霉素+阿奇霉素序贯治疗方案)成本最低.结论 红霉素+阿奇霉素序贯治疗方案是治疗小儿肺炎支原体肺炎的最佳方案.     

阿奇霉素序贯疗法对小儿肺炎支原体的临床疗效观察

目的：分析阿奇霉素序贯疗法对小儿肺炎支原体的临床疗效。方法：将84例肺炎支原体患儿按照平行分组法分为治疗组和对照组2组各42例,治疗组行阿奇霉素序贯疗法,对照组行红霉素静脉滴注,对比2组患者治疗效果。结果：治疗组治疗总有效率明显高于对照组,退热时间、咳嗽消失时间、啰音消失时间及住院时间均少于对照组,并发症发生率低于对照组（P＜0．05）。结论：阿奇霉素序贯疗法可有效治疗小儿肺炎支原体肺炎,效果显著,可作为治疗小儿肺炎支原体肺炎的首选药物。     

阿奇霉素与红霉素两种序贯疗法在治疗儿童肺炎支原体肺炎中的作用

目的：观察红霉素静滴序贯疗法和阿奇霉素序贯疗法治疗小儿肺炎支原体肺炎的疗效。方法：将85例肺炎支原体肺炎患儿随机分成两组,分为观察Ⅰ组和观察Ⅱ组。其中,观察Ⅰ组44例,先用阿奇霉素静滴,以后改为口服阿奇霉素序贯治疗;观察Ⅱ组41例,先用红霉素静滴,以后改为口服阿奇霉素序贯治疗。结果：观察Ⅰ组患儿症状及体征消失时间、痊愈率和副作用发生率明显优于对照组,差异均有统计学意义（P〈0.05）。结论：阿奇霉素治疗支原体肺炎显著优于红霉素,红霉素静滴序贯疗法治疗小儿肺炎支原体肺炎总疗效与阿奇霉素序贯疗法相近,值得临床推广。     

阿奇霉素结合中药治疗小儿肺炎支原体肺炎90例

目的评价阿奇霉素3种疗法结合中药治疗小儿肺炎支原体肺炎的效果。方法肺炎支原体肺炎患儿90例,随机分为3组,A组(阿奇霉素、静脉滴注组)、B组(阿奇霉素序贯治疗组)、C组(阿奇霉素口服组)。3 组均口服中药汤剂,比较3组疗效,不良反应。结果3组总有效率相比差异无统计学意义(P>0.05),但A组(25 例),B组(23例)共80%患儿治疗反应良好,48 h内症状迅速缓解。3组不良反应发生率低且轻微。结论阿奇霉素3周结合中药疗法,口服疗法治疗轻度小儿肺炎支原体肺炎,序贯疗法治疗重度小儿肺炎支原体肺炎值得临床推广应用。     

红霉素和阿奇霉素治疗小儿肺炎支原体肺炎疗效比较

目的:对红霉素和阿奇霉素治疗小儿肺炎支原体肺炎疗效和不良反应进行比较。方法:把确诊为肺炎支原体肺炎的患儿分成A、B两组,分别用红霉素静脉滴注和阿奇霉素序贯疗法进行治疗。结果:A组的治愈率为85.4%,不良反应发生率为29.2%;B组治愈率为100.0%,不良反应发生率10.4%,差异有显著性。结论:用阿奇霉素序贯疗法治疗小儿肺炎支原体肺炎比红霉素有较高的治愈率和较低的不良反应发生率。     

阿奇霉素序贯疗法治疗小儿肺炎支原体肺炎的临床观察

目的分析阿奇霉素序贯疗法治疗小儿肺炎支原体肺炎的临床效果。方法选取62例在我科室进行小儿肺炎支原体肺炎治疗患儿作为调查对象,选取时间为2016年2月至2017年1月。将患儿分为两组,每组31例。对比组采用常规治疗。实验组采用阿奇霉素序贯疗法。分析最终治疗结果。结果对比组发热消退时间、肺啰音消退时间、咳嗽消退时间高于实验组,两组差异明显,P0.05;实验组治疗有效率更高,两组差异明显,P0.05。结论在小儿肺炎支原体肺炎治疗中,阿奇霉素序贯疗法可作为首选的用药方案,效果理想,值得应用。     

小儿支原体肺炎采取阿奇霉素序贯疗法联合布地奈德雾化吸入法治疗的效果分析

目的：探讨采用阿奇霉素序贯疗法联合布地奈德雾化吸入法治疗小儿支原体肺炎的临床效果。方法：将2013年11月至2015年11月间该院儿科收治的56例小儿肺炎支原体肺炎患者平均分成两组,对照组患者采用阿奇霉素序贯疗法进行治疗,观察组在对照组基础上联合布地奈德雾化吸入法进行治疗,并对两组患者的临床效果进行比较。结果：观察组治愈19例,有效7例,无效2例,总有效率92．86％;对照组治愈6例,有效17例,无效5例,总有效率82．14;观察组明显高于对照组,联合治疗方案临床疗效显著。结论：应用阿奇霉素序贯疗法联合布地奈德雾化吸入法治疗小儿肺炎支原体肺炎,治疗时间短,医疗费用低,不良反应少,用药安全,明显提高临床治疗效果,治疗方法值得临床医生借鉴使用。     

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.