曲美他嗪在老年稳定性心绞痛中的作用

目的:研究应用曲美他嗪治疗稳定型劳累性心绞痛的疗效。方法:对60例稳定型劳累性心绞痛患者在应用阿司匹林、硝酸酯类和β-受体阻滞剂基础上随机分为2组,治疗组加用曲美他嗪,对照组加用安慰剂,服用12周,观察用药前后两组每周心绞痛发作次数、硝酸甘油用量,运动至ST段压低1mm的时间及诱发心绞痛发作所需时间。结果:治疗组较对照组每周心绞痛发生次数及舌下含服硝酸甘油用量明显减少(P<0.05);运动开始至心绞痛发作时间及至发生ST段下移1mm的时间显著延长(P<0.05)。结论:曲美他嗪与其他药物联用对稳定性心绞痛患者能增加运动耐量,减少心绞痛发生率,且安全有效,为一种理想的抗心绞痛药物。     

曲美他嗪治疗冠心病心绞痛的临床观察

目的 :观察曲美他嗪治疗冠心病心绞痛的临床疗效。方法 :将 6 2例冠心病心绞痛患者随机分为曲美他嗪治疗组和对照组。在常规治疗包括硝酸盐、β 阻滞剂和钙拮抗剂的基础上 ,治疗组加用曲美他嗪治疗 4周。观察用药前后下述指标变化 :(1)心绞痛发作次数 ;(2 )硝酸甘油消耗量 ;(3)心电图的ST T改变情况 ;(4)血压、心率的变化。结果 :用曲美他嗪治疗后 ,冠心病患者的心绞痛发作次数、硝酸甘油消耗量及心电图均有明显改善 ,两组比较差异有显著性 (P <0 .0 5 )。结论 :曲美他嗪能改善心肌缺血 ,对冠心病心绞痛患者有明显疗效。     

曲美他嗪治疗冠心病心绞痛合并糖尿病患者疗效观察

目的探讨曲美他嗪对冠心病合并糖尿病患者的临床治疗效果。方法84例冠心病合并糖尿病患者随机分为观察组和对照组,对照组采用常规方法治疗,观察组在常规治疗的基础上加用曲美他嗪,比较两组治疗效果。结果治疗组加用曲美他嗪后心绞痛发作次数、心绞痛持续时间和硝酸甘油用量均明显下降,而且无明显不良反应,血糖稳定。结论曲美他嗪可明显改善心功能,减少心绞痛发作频率、心绞痛持续时间和硝酸甘油用量,安全有效。     

曲美他嗪辅助治疗冠心病不稳定性心绞痛患者的疗效观察

目的:观察曲美他嗪辅助治疗冠心病不稳定性心绞痛患者的临床疗效。方法:选择103例冠心病不稳定性心绞痛患者,随机分为治疗组和对照组。治疗组患者51例,在常规治疗基础上给予曲美他嗪辅助治疗;对照组患者52例,给予常规治疗,两组患者的疗程均为8周。比较两组患者在用药前后心绞痛持续时间、每周发作频率及硝酸甘油每周的用量。结果:治疗组与对照组均能减少不稳定心绞痛的发作次数及硝酸甘油每周的用量,降低心绞痛持续时间,治疗组与对照组比较有统计学意义(P<0.05)。结论:在常规治疗基础上加用曲美他嗪辅助治疗冠心病不稳定性心绞痛患者的疗效优于单纯常规治疗。     

低分子肝素钙在不稳定型心绞痛患者中的应用

目的　探讨低分子肝素钙治疗不稳定型心绞痛的疗效。方法　对传统抗心绞痛药 肠溶阿司匹林等治疗不佳的不稳定型心绞痛患者 3 8例加用低分子肝素钙皮下注射 ,5 0 0 0u/次 ,Q 12h ,连用 7d。结果　 3 8例患者加用该药后 ,与治疗前相比 ,心绞痛日均发作次数 ,每次心绞痛平均持续时间、硝酸甘油含片日均用量、心电图ST段压低的导联数 (NST)和ST段压低数值总和(ΣST)均显著改善 (P均 <0 .0 1)。结论　低分子肝素钙治疗不稳定型心绞痛有效、安全、便利     

曲美他嗪对老年稳定型劳累性心绞痛的疗效及安全性观察

①目的　观察曲美他嗪治疗老年稳定型劳累性心绞痛的疗效及安全性。②方法　选择老年稳定型劳累性心绞痛患者 53例 ,随机分为曲美他嗪组和对照组。两组用药前后观察每周心绞痛发作的次数 ;每周硝酸甘油含片的消耗剂量 ;心率及心率和收缩压的乘积 ;运动诱发心绞痛发作所需的时间 ;运动后ST段下降≥ 0 .1mm所需的时间 ;运动持续时间 ;血生化检验。③结果　曲美他嗪组心绞痛的发作次数、每周硝酸甘油含片的消耗剂量、运动诱发心绞痛发作所需的时间及ST段下降≥ 0 .1mm所需的时间较治疗前有明显差异 (P <0 .0 5) ,与对照组比较差异显著 (P <0 .0 5) ,未出现不良反应。④结论　曲美他嗪可提高老年稳定型劳累性心绞痛患者的心肌耐缺氧能力 ,改善缺血症状 ,从而提高患者的运动耐量 ,改善生活质量 ,且用药安全 ,值得临床推广应用。     

曲美他嗪治疗卧位心绞痛疗效观察

目的　观察曲美他嗪对卧位心绞痛的治疗效果。方法　 4 2例卧位心绞痛患者在原有治疗不变的情况下 ,加用曲美他嗪 2 0mg ,每天 3次 ,治疗 4w。治疗前后均行平板运动试验 ,观察用药前后的临床效果及运动耐量变化。结果　治疗后患者每周心绞痛发作的次数及硝酸甘油片的用量均明显下降 (P <0 .0 1) ;运动总工作量显著提高 ,至心绞痛发作时间及ST段下降 1mm的时间均明显延长 (P <0 .0 1) ,心率和收缩压乘积轻度变化 (P >0 .0 5 )。结论　曲美他嗪能提高卧位心绞痛患者的运动耐量 ,可作为治疗该病的辅助药物     

丹参多酚酸盐联合曲美他嗪治疗冠心病心绞痛的疗效及安全性分析

目的：探讨丹参多酚酸盐联合曲美他嗪治疗冠心病心绞痛的临床疗效及安全性，为临床进一步治疗冠心病心绞痛提供参考。方法：选取2016年1月至2017年1月我院80例冠心病心绞痛患者，随机分为对照组（硝酸甘油等常规治疗）和观察组（丹参多酚酸盐联合曲美他嗪治疗），每组各40例，比较两组治疗的临床疗效，每天发作次数、每次发作持续时间、硝酸甘油用量以及治疗前后生活质量评分及治疗期间不良反应。结果：观察组临床症状治疗及心电图治疗的总有效率均明显增高，差异有统计学意义（P<0.05）；与对照组相比，观察组治疗后每天发作次数、每次发作持续时间、硝酸甘油用量均明显减少，差异有统计学意义（P<0.05）；与对照组相比，观察组治疗后生活质量评分升高，差异有统计学意义（P<0.05）；治疗期间两组都没有出现严重不良反应。结论：丹参多酚酸盐联合曲美他嗪治疗冠心病心绞痛，能够明显提升临床疗效，改善患者生活质量，具有治疗安全性。     

曲美他嗪在心肌缺血再灌注损伤中的研究

目的:观察曲美他嗪对心肌再灌注损伤的保护作用,并探讨其可能机制。方法:观察用药前后两组患者心绞痛发作频率、持续时间、硝酸甘油消耗量。详细记录治疗前后所有入选患者脂联素指数。结果:治疗组用药后每次心绞痛发作持续时间较前缩短、心绞痛发作次数较前减少,硝酸甘油消耗量减少,脂联素指数上升,差异有统计学意义(P<0.05)。结论:曲美他嗪能抑制心肌缺血再灌注的损伤。     

曲美他嗪治疗冠心病心绞痛临床观察

目的观察曲美他嗪治疗冠心病心绞痛的临床疗效。方法选取86例冠心病心绞痛患者随机分为曲美他嗪治疗组和对照组,对照组常规给予硝酸盐制剂、β-受体阻滞剂、钙离子拮抗剂、他汀类制剂和小剂量阿司匹林;治疗组在此基础上加用曲美他嗪治疗,比较两组心绞痛发作次数、持续时间、硝酸甘油用量、心电图、血压、心率变化等指标。结果与对照组相比,治疗组冠心病患者的心绞痛发作次数、持续时间、硝酸甘油用量及心电图有明显改善,两组比较有显著性差异(P<0.05),而血压、心率无明显变化,两组比较无显著性差异(P>0.05),并无明显不良反应。结论加用曲美他嗪治疗冠心病心绞痛效果明显,且安全方便。     

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.