胆舒胶囊治疗慢性结石性胆囊炎106例临床分析

目的观察胆舒胶囊对慢性结石性胆囊炎患者,利胆、消食、解痉、抗炎、镇痛的效果。方法将慢性结石性胆囊炎患者分成两组。胆舒胶囊组(A组),口服胆舒胶囊2粒,3次/d,疗程1个月;舒胆片组(B组),口服舒胆片5片,3次/d,疗程1个月。结果两组均能不同程度地缓解慢性结石性胶囊炎的临床症状,胆舒胶囊解痉、镇痛效果强于舒胆片组,B超显示:多数患者胆囊壁毛糙模糊减轻或消失,胆结石体积变小。结论胆舒胶囊是目前治疗慢性结石性胆囊炎的理想药物,在胆石症溶石、排石、镇痛等方面,具有一定优势,值得进一步的研究和推广。     

洛赛克治疗胃食管反流的临床疗效

目的　评价洛赛克治疗胃食管反流病 (GERD)的疗效。方法　选择我院 1999～ 2 0 0 3年 6月诊断的GERD患者 80例 ,进行内镜检查并分级。将 80例患者随机分成两组 ,每组 4 0例。治疗组口服洛赛克 2 0mg,1～ 2次 /d;对照组口服雷尼替丁 15 0mg,2次 /d。 4周后复查胃镜并观察临床症状改善情况 ,判定疗效并观察药物副作用。结果　两组患者疗效间的差别有显著性意义 (P <0 0 5 ) ;两组治疗后内镜检查结果间差别有显著性意义 (P <0 0 5 )。两组不良反应发生率均为 5 0 % ,均未发现血、尿常规及肝、肾功能异常。结论　洛赛克治疗GERD疗效好 ,副作用少 ,使用方便 ,值得推广应用。     

莫沙必利联合胆舒胶囊治疗胆汁反流性胃炎183例疗效观察

目的探讨莫沙必利联合胆舒胶囊治疗胆汁反流性胃炎的疗效。方法 183例胆汁反流性胃炎患者随机分成三组,胆舒胶囊组服用胆舒胶囊0.45mg,3次/d;莫沙必利组服用莫沙必利,餐前或餐后5mg/次,3次/d;莫沙必利+胆舒胶囊组,胆舒胶囊0.45mg,3次/d;莫沙必利餐前5mg/次,3次/d。疗程均为6周,采用临床症状总疗效和胃镜结果进行量化评分,计算有效率。结果三组比较莫沙必利+胆舒胶囊组治疗胆汁反流性胃炎有效率高于胆舒胶囊组和莫沙必利组,比较差异均有统计学意义(P均<0.05)。结论莫沙必利+胆舒胶囊组治疗胆汁反流性胃炎起到了协调增强作用,效果明显,多途径阻断BRG的发病机制,治愈率高且无不良反应。     

腺苷蛋氨酸联合熊去氧胆酸治疗妊娠期肝内胆汁淤积症的临床研究

目的　评估腺苷蛋氨酸 (SAMe)联合熊去氧胆酸 (UDCA)治疗妊娠期肝内胆汁淤积症 (ICP)的效果。方法　选择 6 3例ICP患者 ,随机分成 3组 ,SAMe联合UDCA组 (A组 ,2 1例 )采用SAMe 10 0 0mg加 5 %葡萄糖液 5 0 0ml静滴 ,1次 /d ,UDCA 10 0mg/次 ,3次 /d ,10天为 1个疗程。SAMe对照组 (B组 ) :用SAMe 10 0 0mg加 5 %葡萄糖液 5 0 0ml静滴 ,1次 /d,10天为 1个疗程。UDCA对照组 (C组 ) :单用UDCA 10 0mg/次 ,3次 /d ,10天为 1个疗程 ,观察 3组的疗效。结果　治疗后 3组患者瘙痒症状的评分间差别有显著性意义 (P <0 0 1)。治疗后 3组患者血清TBA、AST、ALT、TBil、DBil含量间的差别均有显著性意义 (P <0 0 1)。妊娠结局 :A组新生儿早产率 ,羊水污染率 ,新生儿窒息率与B组、C组间差别均有显著性意义。 3组患者新生儿体重间的差别也有显著性意义 (P <0 0 1)。结论　SAMe联合UDCA是治疗ICP的安全有效的方法 ,可改善妊娠预后。     

清热利湿、祛痰消瘀法治疗胆石症的临床研究

采用胆腑舒胶囊治疗湿热内蕴、痰瘀内阻型胆石症。治疗组 4 2例用胆腑舒胶囊治疗 ,对照组 30例用肝胆结石片治疗 ,并观察两组治疗前后临床疗效、结石大小变化、主要症状、体征的变化以及胆腑舒胶囊的毒副作用。结果 :治疗组、对照组的总有效率分别为 90 4 7% ,6 6 6 7%。经统计学处理差异有显著性 (P <0 0 5 ) ,治疗组疗效明显优于对照组。临床观察中未发现胆腑舒胶囊有毒副作用。说明本方治疗湿热内蕴、痰瘀内阻型胆石症安全有效 ,也为清热利湿、祛痰消瘀法治疗胆石症提供了客观依据     

益肾汤联合西药治疗糖尿病肾病Ⅳ期45例疗效观察

目的探讨益肾汤联合西药治疗糖尿病肾病的临床疗效。方法选择2004年6月~2006年1月在商丘医专附属医院就诊的糖尿病肾病Ⅳ期患者90例,分为两组:对照组按常规给予格列喹酮30mg/d,分早、晚2次饭前30min口服;胰激肽原酶240U/次,3次/d口服;依那普利10mg/d,分1~2次口服。治疗组在对照组用药基础上加用自拟益肾汤治疗,两组均以8周为1疗程。观察两组患者的临床疗效及治疗前、后空腹血糖、血压、24h尿蛋白定量、尿白蛋白排泄率、肾功能、血脂的变化。结果两组患者临床疗效间差别有显著性意义(P<0·01)。治疗前两组患者的空腹血糖、血压、24h尿蛋白定量、尿白蛋白排泄率、肾功能、血脂间差别均无显著性意义(P>0·05),治疗后上述各指标间差别均有显著性意义(P<0·01)。结论益肾汤联合西药治疗糖尿病肾病Ⅳ期的疗效优于单纯西药治疗,可有效降低各项监测指标。     

阿奇霉素、阿莫西林、奥美拉唑三联疗法根除幽门螺杆菌的疗效观察

目的　观察阿奇霉素、阿莫西林、奥美拉唑三联疗法根除十二指肠球部溃疡患者的幽门螺杆菌 (Hp)的临床疗效及治疗费用 ,并与克拉霉素、阿莫西林、奥美拉唑联合疗法进行比较。方法　将经胃镜检查证实为十二指肠球部溃疡并有Hp感染的 10 0例患者 ,随机分为A、B两组。A组 (5 5例 )患者口服阿奇霉素 ,5 0 0mg/d ,仅疗程开始的前 3d服用 ;奥美拉唑 4 0mg,1次 /d ,阿莫西林 10 0 0mg,2次 /d ,共 1周。B组 (45例 )患者口服克拉霉素 5 0 0mg,2次 /d ,共 1周 ;奥美拉唑与阿莫西林的剂量与疗程同A组。疗程结束 4周后胃镜复查溃疡愈合情况 ,14 C -尿素呼气试验复查Hp根除情况。结果　Hp根除率 :A组和B组分别为 92 7% (5 1/5 5 )、 93 3% (42 /45 ) ,两组间差别无显著性意义 (P >0 0 5 ) ;溃疡愈合率 :A组和B组分别为 96 % (48/5 0 )、95 1% (39/41) ,两组间差别无显著性意义 (P >0 0 5 )。治疗费用 :A组患者总费用为 2 6 0 2 78元 ,B组患者总费用为 339 2 2元 ;不良反应发生率 :A组和B组分别为5 0 %、 17 8% ,两组间差别均有显著性意义 (P <0 0 1)。结论　 (1)阿奇霉素、阿莫西林、奥美拉唑三联疗法治疗1周的方案与克拉霉素、阿莫西林、奥美拉唑方案疗效相当 ;(2 )阿奇霉素、阿莫西林、奥美拉唑三联疗法具有H     

养血清脑颗粒治疗脑动脉硬化症伴记忆障碍的疗效观察

目的评价养血清脑颗粒对脑动脉硬化症伴记忆障碍患者的治疗效果。方法将50例脑动脉硬化症记忆减退患者按数字表法随机分为治疗组和对照组,每组25例,两组患者均给予阿司匹林肠溶片75mg,1次/d口服;潘生丁片50mg,3次/d口服。治疗组同时加用养血清脑颗粒4.0g/次,3次/d,均治疗4周。分别于治疗前和治疗4周后测定并比较两组患者的记忆商评分。结果治疗前两组患者记忆商分值间差别无显著性意义(P>0.05);治疗后两组患者记忆商分值间差别有显著性意义(P<0.05)。治疗组患者治疗前、后记忆商分值间差别有显著性意义(P<0.05),而对照组患者治疗前、后记忆商分值间差别无显著性意义(P>0.05)。结论养血清脑颗粒对脑动脉硬化症伴记忆障碍有一定的治疗作用。     

胆舒胶囊治疗慢性结石性胆囊炎疗效评价

[目的]评价胆舒胶囊治疗慢性结石性胆囊炎的疗效和安全性。[方法]将2006年6月至2010年6月在我院门诊就诊且确诊为慢性结石性胆囊炎的118例患者随机分成治疗组和对照组各59例。治疗组口服胆舒胶囊2粒/次,3次/d;对照组口服消炎利胆片6片/次,3次/d。疗程均为3个月。[结果]治疗3个月后,治疗组的总有效率为89.83%,不良反应发生率5.08%,优于对照组,差异均有统计学意义(P<0.05)。[结论]胆舒胶囊是目前治疗慢性结石性胆囊炎的理想药物,疗效肯定,不良反应较小。     

灭Hp胶囊与新三联并用对溃疡愈合质量及溃疡复发的影响

目的　观察灭Hp胶囊与新三联并用对消化性溃疡的溃疡愈合质量及溃疡复发的影响。方法　 75例活动期消化性溃疡并Hp阳性患者随机分为 3组 :A组 (新三联组 ) :口服兰索拉唑 30mg (1次 /d) 克拉霉素 2 5 0mg(2次 /d) 阿莫西林 5 0 0mg (2次 /d) ,连用 10d ;B组 (灭Hp胶囊四联组 ) :口服新三联 灭Hp胶囊 6粒 (2次 /d) ,连用 2 8d;C组 (安慰剂组 ) :口服胃舒平 3片 (2次 /d) ,连用 2 8d。疗程结束后 4周复查胃镜 ,观察Hp根治和溃疡愈合情况 ,对溃疡愈合者行光镜及电镜检查 ,评价溃疡愈合质量 ,并停服所有药物 ,随访 5年。结果　A、B两组患者溃疡愈合率、Hp根治率分别为 10 0 0 %、 96 4 % ,88 0 %、 92 0 % ;与安慰剂组的溃疡愈合率 (2 0 0 % )、Hp根治率 (0 )间差别均有显著性意义 (P <0 0 0 5 )。A、B两组与C组的溃疡愈合质量间的差别亦有显著性意义 (P <0 0 5 )。A组和B组溃疡复发率分别为 4 0 %和 10 0 % ,明显低于安慰剂的溃疡复发率 (10 0 % ) ,溃疡复发者均溃疡愈合质量不佳。结论　灭Hp胶囊四联疗法不但具有与新三联相当的Hp根治率和溃疡愈合率 ,而且更有显著提高溃疡愈合质量、降低溃疡复发的作用     

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.     

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.