埃索美拉唑联合莫沙比利治疗反流性食管病的临床疗效分析

目的 探讨埃索美拉唑与莫沙比利联合应用与单独应用埃索美拉唑治疗反流性食管病的临床疗效差异.方法 将入选的120例反流性食管病随机分成单一用药组与联合用药组,前者为单服埃索美拉唑镁肠溶片,后者为埃索美拉唑镁与莫沙比利联合应用,疗程为6周.结果 联合用药组能更明显的改善反流性食管病的临床症状.结论 埃索美拉唑镁与莫沙比利联合应用于反流性食管病的治疗,临床效果明显,应予以推广.     

埃索镁拉唑联合磷酸铝胶浆治疗反流性食管炎142例疗效观察

目的：探讨埃索镁拉唑联合磷酸铝胶浆治疗反流性食管炎的临床疗效。方法：选择内镜诊断为反流性食管炎的患者142例，随机分为二组，治疗组71例；给予埃索镁拉唑40mg／次1天1次，磷酸铝胶浆1袋／次1天2次；对照组71例：埃索镁美拉唑40mg／次1天1次；疗程均为8周。结果：两组临床症状评价总有效率为95％、85％，内镜下评价总有效率为93％、85％，结论：埃索镁拉唑联合磷酸铝胶浆治疗反流性食管炎效果显著。     

泰妥拉唑的合成

目的：合成新型质子泵抑制剂泰妥拉唑。方法：以2，6-二氯吡啶（Ⅰ）为起始原料，经3-位硝化、2-位氨代、6-位甲氧基化、还原和环化得到5-甲氧基-2-巯基咪唑并[4，5-b]吡啶（Ⅵ），Ⅵ与2-氯甲基-4-甲氧基3，5-二甲基-吡啶缩合，经氧化得泰妥拉唑（Ⅷ）。结果：反应总收率20．9％，产物结构经^1H NMR和MS确证。结论：本合成的收率与文献报道相当．是一条可行的合成泰妥拉唑。     

埃索美拉唑镁治疗消化性溃疡的药物经济学评价

目的:从药物经济学角度对埃索美拉唑镁治疗消化性溃疡的临床价值进行评价。方法:择取2015.4-2017.3在我院消化内科接受治疗的180例消化性溃疡患者进行分析。依随机数字表法及对每位患者所采用治疗药物的不同将其分至埃索美拉唑镁治疗的观察组(88例)与雷贝拉唑肠溶胶囊治疗的对照组(92例)。对比分析埃索美拉唑镁与雷贝拉唑肠溶胶囊在治疗消化性溃疡方面的药物经济学差异。结果:无论在消化性溃疡治疗总愈合率方面,还是在幽门螺旋杆菌清除率方面,亦或是在其两种药物不良反应方面,埃索美拉唑镁同雷贝拉唑肠溶胶囊二者均无明显差异,P0.05,无统计学意义。而在药物成本方面,雷贝拉唑肠溶胶囊明显低于埃索美拉唑镁,P0.05,即雷贝拉唑肠溶胶囊其药物经济学价值更高。结论:对于消化性溃疡的治疗埃索美拉唑镁同雷贝拉唑肠溶胶囊均具有显著的疗效,但在药物经济学分析方面,雷贝拉唑价值更高,更为经济。     

不同质子泵抑制剂联合莫沙必利治疗反流性食管炎的效果比较

目的比较3种不同质子泵抑制剂奥美拉唑、埃索美拉唑和雷贝拉唑联合莫沙必利治疗反流性食管炎的效果。方法选取广西来宾市人民医院收治的120例反流性食管炎患者,随机均分为奥美拉唑组（20mg/次,2次/d）、埃索美拉唑组（40mg/次,2次/d）和雷贝拉唑组（20mg/次,2次/d）。三组患者均与莫沙必利（5mg/次,3次/d）联合治疗,比较三组治疗有效率,评价临床疗效。结果奥美拉唑组治疗有效率为72．5％,埃索美拉唑组为92.5％,雷贝拉唑组为75.0％,埃索美拉唑组治疗有效率明显高于另外两组,三组比较差异有统计学意义（P〈0.05）,奥美拉唑组和雷贝拉唑组治疗有效率比较差异无统计学意义。结论对反流性食管炎的治疗,埃索美拉唑联合莫沙必利在3种不同质子泵抑制剂中临床疗效最好。     

埃索美拉唑和阿莫西林及克拉霉素在Hp相关性胃溃疡治疗中的安全性分析

目的 分析埃索美拉唑、阿莫西林及克拉霉素在Hp相关性胃溃疡治疗中的安全性.方法 选取本院2016年6月至2019年6月收治的Hp相关性胃溃疡患者96例,随机分为埃索美拉唑组(n=48)和奥美拉唑组(n=48).埃索美拉唑组采用埃索美拉唑+阿莫西林+克拉霉素治疗,奥美拉唑组采用奥美拉唑+阿莫西林+克拉霉素治疗组,比较两组患者临床症状评分、临床疗效、Hp根除及不良反应发生情况.结果 埃索美拉唑组患者腹痛、腹胀、嗳气、反酸评分均显著低于奥美拉唑组(P<0.05),埃索美拉唑组治疗总有效率为95.8％,明显高于奥美拉唑组的72.9％(P<0.05),Hp根除率为97.9％,明显高于奥美拉唑组的83.3％(P<0.05),不良反应发生率为2.1％,明显低于奥美拉唑组的12.5％(P<0.05).结论 埃索美拉唑、阿莫西林及克拉霉素治疗Hp相关性胃溃疡效果显著,且安全性高,值得临床推广应用.     

埃索美拉唑钠中七种残留溶剂的测定

埃索美拉唑是奥美拉唑的S-异构体,埃索美拉唑钠是埃索美拉唑的钠盐形式,是全球首个用于治疗消化性溃疡的手性质子泵抑制剂(PPI),注射用埃索美拉唑钠是2005年3月被FDA批准用于治疗短期胃食管反流疾病的处方药[1].埃索美拉唑钠较奥美拉唑具有更高的生物利用度和更一致的药代动力学,使到达质子泵的药物增加,抑酸效果优于其它质子泵药物[2].埃索美拉唑钠合成制备路线[3]中用到的化学试剂较多,根据中国药典对原料药残留溶剂测定的要求,本研究建立了埃索美拉唑钠制备工艺中七种残留溶剂的测定方法,以便有效控制埃索美拉唑钠的质量,保证药品安全.     

RP-HPLC法测定埃索美拉唑镁的含量及有关物质

目的:建立以反相高效液相色谱法测定埃索美拉唑镁原料药的有关物质及含量的方法。方法:采用Agilent C18柱(150 mm×4.6 mm,5μm),以磷酸盐缓冲液(pH=7.6)-乙腈(75∶25)为流动相,流速为1.0 mL/min,检测波长为280 nm,柱温为室温,进样量为10μL。结果:主峰能与相邻杂质峰较好分离。埃索美拉唑镁在60~140μg/mL范围内呈良好的线性关系;检出限为1 ng/mL。埃索美拉唑镁平均加样回收率为102.03%;RSD为1.5%。结论:该方法准确,简便,灵敏,重复性好,可用于埃索美拉唑镁原料药有关物质及含量的测定以及质量控制。     

埃索美拉唑镁肠溶片治疗反流性食管炎50例疗效分析

目的 探讨埃索美拉唑镁肠溶片联合西沙必利治疗反流性食管炎的疗效. 方法 将50例经胃镜检查证实返流性食管炎患者,随机分为两组:观察组予埃索美拉唑镁肠溶片20mg,1日2次,连用7d,连用1周后改为埃索美拉唑镁肠溶片20mg,1日 1次,多潘立酮10mg,3次/日.对照组予雷尼替丁0.15mg,1日2次, 多潘立酮10mg,3次/日,两组疗程8周,疗程结束后行胃镜复查. 结果 临床症状缓解情况及食管炎内镜愈合情况,观察组均明显优于对照组,两组之间有显着性差异. 结论 埃索美拉唑镁肠溶片与多潘立酮联合治疗反流性食管炎有迅速缓解症状,且食管炎症愈合率高的优点,具有明显的疗效,特别对于中重度食管炎患者更是治疗的首选药物.     

埃索美拉唑镁、阿莫西林、莫西沙星联合铋剂根除幽门螺杆菌疗效观察

目的：对照比较埃索美拉唑镁肠溶片、阿莫西林胶囊、莫西沙星片联合枸橼酸铋钾颗粒四联方案与埃索美拉唑镁肠溶片、阿莫西林、克拉霉素片传统三联方案根除幽门螺杆菌（Hp）的疗效。方法：将106例Hp阳性的十二指肠球部溃疡或慢性非萎缩性胃炎患者随机分为2组各53例,观察组采用埃索美拉唑镁肠溶片＋莫西沙星片＋阿莫西林胶囊＋枸橼酸铋钾颗粒四联方案根除Hp;对照组采用埃索美拉唑镁肠溶片＋克拉霉素片＋阿莫西林胶囊（传统标准三联方案）根除Hp,疗程均为两周,比较两组Hp根除率及不良反应。结果：Hp根除率观察组90.6%,对照组73.6%,两组比较差异有统计学意义（P〈0.05）;不良反应发生率两组均为3.7%,差异无统计学意义（P〉0.05）。结论：采用埃索美拉唑镁肠溶片＋莫西沙星片＋阿莫西林胶囊＋枸橼酸铋钾颗粒的四联方案能提高Hp根除率,具有更好的临床价值。     

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.