^131I治疗Graves病后甲状腺缩小程度及相关因素分析

目的：对^131I治疗Graves甲亢患者甲状腺体积缩小程度及相关因素进行综合性分析。方法：对首次接受^131I治疗的190例Graves甲亢患者，随访观察3个月，详细记录其治疗前后3个月临床及相关检查资料。采用x^2检验、方差分析及多因素回归分析等方法对其进行统计学分析。结果：（1）单因素统计学分析结果显示：甲状腺最高吸^131I率（辟0．033）、^131I治疗前甲状腺重量、服用^131I剂量及患者服用抗甲状腺药物情况、血清甲状腺激素水平等因素与^131I治疗后甲状腺体积缩小程度有关（P〈0．05）。（2）多因素统计学分析结果显示：未服抗甲状腺药的患者比服用药物的患者、血清甲状腺激素水平高于正常3倍者较其余血清甲状腺激素水平患者的甲状腺体积缩小较为明显。结论：^131I治疗后甲状腺体积缩小程度与患者服用抗甲状腺药物情况、血清甲状腺激素水平以及甲状腺最高吸^131I率、^131I治疗前甲状腺重量以及服用^131I剂量等因素有关。     

^131I治疗甲状腺功能亢进症的疗效及影响因素

目的探讨应用^131I治疗甲状腺功能亢进症的临床疗效及影响因素。方法选取我院甲状腺功能亢进症患者160例，对其行^131I治疗，根据病情变化调整^131I剂量，观察治疗效果。结果治疗总有效率100％，治疗1次的有效率为96．9％。结论^131I治疗甲状腺功能亢进症疗效确切。     

甲硫咪唑联合131I治疗甲状腺功能亢进症临床疗效观察

目的探讨抗甲状腺功能亢进药物甲硫咪唑联合小剂量131I治疗甲状腺功能亢进症的临床疗效。方法139例甲状腺功能亢进症患者分为观察组和对照组,对照组给予常规131I治疗,观察组给予甲硫咪唑＋小剂量131I治疗,观察2组患者甲状腺素水平、临床疗效及甲状腺功能减退（甲减）发生率。结果观察组24h摄131I率为（79．67±6．94）％,有效半衰期（Te）为（4．3±0．5）天,临床总有效率为96．5％（84／87）;对照组24h摄131I率为（59．83±5．23）％,有效半衰期（Te）为（2．9±0．6）天,临床总有效率为69．3％（36／52）;2组间差异有统计学意义（P〈0．05）。观察组甲状腺激素水平及甲减发生率显著低于对照组,2组间差异有统计学意义（P〈0．05）。结论甲硫咪唑联合小剂量131I治疗甲状腺功能亢进症疗效显著。     

^131I加中西医结合治疗甲状腺功能亢进症35例临床观察

目的观察较小剂量^131I加中西医结合治疗甲状腺功能亢进症的疗效。方法对本组35例甲状腺功能亢进症病人，采用较小剂量^131I加中西医结合的方法进行治疗。结果临床总治愈率80．0％，总有效率100％，早发甲减2．8％。结论应用较小剂量^131I加中西医结合的综合治疗方法，是治疗甲状腺功能亢进症的一种有效、可行的方法。     

放射性^131碘对老年人甲亢治疗的临床效果分析

目的：观察老年甲状腺功能亢进症（甲亢）患者放射性^131碘（^131I）治疗的效果。方法：对65例已确诊的老年甲亢患者行放射性^131碘治疗，定期随访并观察治疗后1年甲亢治愈率及其并发症的转归。结果：在治疗后1年，65例接受治疗的老年甲亢患者中痊愈53例（81．5％），好转8例（12．3％），出现甲低4例（6．2％）。25例合并甲亢性心脏病的患者中有18例（72％）临床治愈，好转5例（20％）。结论：放射性^131碘治疗老年人甲亢效果显著，可作为老年甲亢患者的首选治疗方法。     

放射性131碘治疗老年人甲亢的临床价值

目的 观察老年甲状腺功能亢进症（甲亢）患者放射性^131碘（^131I）治疗的效果。方法 对65例已确诊的老年甲亢患者行放射性^131碘治疗，定期随访并观察治疗后1年甲亢治愈率及其合并症的转归。结果 在治疗后1年，65例接受治疗的老年甲亢患者中痊愈53例（81．5％），好转8例（12．3％），出现甲低4例（6．2％）。25例合并甲亢性心脏病（甲心）的患者中有18例（72％）临床治愈，好转5例（20％）。结论 放射性^131碘治疗老年人甲亢效果显著，可作为老年甲亢患者的首选治疗方法。     

动态脑电图监测对癫痫诊断的意义

目的：探讨24h动态脑电图对癫痫诊断和鉴别诊断的意义。方法：对46例临床诊断为癫痫及可疑阗痫患者进行24h监测后作离线回放分析，并与普通EEG相比较。结果：动态脑电图总异常率（60．9％）明显高于常规EEG（30．4％），动态脑电图痫样放电率在癫痫组为65．6％，可疑癫痫组为21．4％。睡眠期出现痫样放电占95．8％。结论：动态脑电图对癫痫诊断、鉴别诊断有重要作用。     

甲状腺功能亢进症合并血细胞减少症29例临床分析

回顾性分析29例甲状腺功能亢进症（甲亢）合并血细胞减少患者的临床资料。血细胞减少5例于甲亢治疗前出现、24例为行抗甲状腺药物治疗后出现。17例使用甲巯咪唑、7例服用丙硫氧嘧啶治疗,多发生于服药后半年内,与剂量相关。20例患者在血细胞上升后行^131I治疗甲亢,血细胞均稳定。提示血细胞减少多发生在抗甲状腺药物治疗早期,与药物种类、剂量有关,^131I对抗甲状腺药物所致血细胞减少症者的甲亢后续治疗较为安全。     

放射性131I治疗甲状腺功能亢进症的护理

目的 探讨放射性131I治疗甲状腺功能亢进症患者的护理方法.方法 回顾性总结182例放射性131I治疗甲状腺功能亢进症的临床资料及护理体会.结果 接受放射性131I治疗的182例患者中,3个疗程总治愈率为98％(178/182);甲减发生率为46％(84/182).临床护理安全有效.结论 高质量的临床护理对安全有效地开展131I治疗甲亢具有重要的临床意义.     

碳酸锂增强甲状腺功能亢进症^131I吸收剂量的研究

目的探讨碳酸锂对提高甲状腺功能亢进症的甲状腺摄碘功能，延长有效半衰期（Teff）及增强^131I吸收剂量的作用。方法50例甲亢患者随机分为碳酸锂组与对照组，每组各25例。碳酸锂组给予碳酸锂250mg／次，4次／d，连用一周；对照组给予安慰剂维生素B610mg／次，3次／d，连用一周。两组均分别于服药前后测定24h甲状腺吸^131I率及Teff，通过自身前后比较，组间比较及可能影响因素相关分析以评价试验效果。结果碳酸锂组24h吸^131I率明显提高，Teff明显延长，^131I吸收剂量增加，其24h吸1311率提高与Teff延长有关。结论碳酸锂能提高甲状腺功能亢进症吸^131I率甲状腺摄碘功能，延长Teff，明显增强甲状腺^131I吸收剂量。     

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.