美托洛尔治疗慢性充血性心衰临床观察

目的 :观察 β1受体阻滞剂对慢性充血性心衰的疗效。方法 :将 76例充血性心衰患者随机分为对照组 39例 ,常规强心利尿 ,ACEI治疗 ;治疗组 37例 ,在常规治疗基础上加用美托洛尔 ;治疗 8周后观察临床症状及左室功能改善。结果 :治疗组临床心功能改善有效率明显升高有显著性差异 (P <0 .0 5 ) ,左室功能EF(P <0 .0 1) ,ESV(P <0 .0 5 )。结论 :加用美托洛尔能明显增加对慢性充血性心衰的疗效。     

结核性脑膜脑炎并发败血症抢救成功1例

目的　临床观察小剂量美托洛尔治疗充血性心力衰竭的作用。方法　收集临床充血性心力衰竭患者 10 4例 ,随机分成两组 ,治疗组在常规抗心衰治疗基础上加用小剂量美托洛尔治疗 ,对照组采用常规抗心衰治疗。结果　治疗 8w后 ,治疗组射血分数明显增高 ,症状明显改善 ,两组差异有显著性 (P <0 .0 5)。结论　小剂量美托洛尔治疗充血性心力衰竭疗效显著     

美托洛尔对充血性心脏病心力衰竭患者的治疗影响

目的:观察美托洛尔治疗充血性心脏病心力衰竭的临床疗效.方法:将60例患者随机分为对照组和治疗组各30例.对照组给予常规抗心力衰竭治疗;治疗组在对照组治疗基础上加用美托洛尔,起始量为6.25mg,2次/d,口服,2周后剂量加倍,最大剂量为50mg,2次/d,治疗4周和半年后进行比较.结果:美托洛尔治疗组患者的心功能、心率、左室射血分数,与对照组相比,差异均有统计学意义(P0.05).结论:在常规治疗基础上加用美托洛尔治疗充血性心力衰竭安全有效。     

螺内酯联用美托洛尔治疗慢性充血性心力衰竭疗效观察

目的 :观察螺内酯联用美托洛尔治疗慢性充血性心力衰竭的临床疗效。方法 :选择 96例慢性充血性心力衰竭患者 ,随机分为对照组 4 8例和观察组 4 8例 ,对照组采用常规治疗 ,观察组在常规治疗基础上加用螺内酯联用美托洛尔。在治疗前和观察期满 12周时 ,分别进行测定心率、血压、血清钾离子浓度、肾功能及心脏超声检测左室收缩末期内径 (LVIDs) ,左室舒张末期内径 (LVIDd)和左室射血分数 (LVEF)。结果 :治疗12周后 ,总有效率 95 .8%、心率明显下降、心脏LVIDs及LVIDd缩小、LVEF提高均有统计学意义 (P <0 0 5 )。结论 :螺内酯联用美托洛尔治疗慢性充血性心力衰竭疗效确切 ,无明显不良反应     

缬沙坦联合美托洛尔治疗心力衰竭临床观察

目的　探讨缬沙坦联合美托洛尔治疗慢性充血性心力衰竭的临床效果。方法　选择 60例慢性充血性心力衰竭患者随机分为治疗组和对照组 ,每组 3 0例。两组均常规治疗 ,在此基础上治疗组加缬沙坦联合美托洛尔治疗。结果　治疗组的总有效率明显优于对照组 (χ2 =4.812 ,P <0 .0 5 ) ;治疗组治疗后心率、收缩压以及超声心动图各项指标均较对照组明显改善 ,P <0 .0 1。结论　缬沙坦联合美托洛尔治疗慢性充血性心力衰竭效果满意 ,值得临床推广应用。     

卡托普利加美托洛尔治疗慢性心力衰竭的临床观察

目的　观察卡托普利加美托洛尔治疗慢性心力衰竭(CHF)的远期疗效。方法　将47例CHF患者随机分为对照组(2 3例)和治疗组(2 4例) ,对照组采用常规治疗。治疗组在此基础上加用卡托普利(6 .2 5～75mg/d)和美托洛尔(6 2 5～75mg/d)。治疗前和观察期满3年分别行多普勒超声心功能指标检查,对心功能NYHAⅡ～Ⅲ级患者作6min步行试验,记录步行距离。结果　3年间,治疗组与对照组病死率分别为8 3 .3 %和3 9. 13 %(P <0 . 0 5 ) ,与治疗前比较,治疗组多普勒超声心功能指标及6min步行距离有明显改善(P <0 . 0 5 )。结论　卡托普利加美托洛尔长期治疗可使心功能明显改善,能降低病死率。     

培哚普利联用美托洛尔治疗慢性充血性心力衰竭疗效观察

目的　观察培哚普利联用美托洛尔对慢性充血性心力衰竭的治疗效果。方法　慢性充血性心力衰竭患者 5 4例 ,随机分为治疗组、对照组。治疗组 32例给予培哚普利2～ 6mg/d ,美托洛尔 12 .5～ 5 0mg/d ;对照组 2 2例 ,仅给予培哚普利 2～ 6mg/d ,疗程均为 4周。对照观察两组治疗前后心功能、左室收缩末期容量 (ESV)、左室舒张末期容量 (EDV)及左室射血分数 (LVEF)、血压、心率等。结果　治疗组总有效率为 93 75 % ,对照组为 86 36 % (P <0 0 5 ) ,两组治疗前后LVEF均明显增高 (P <0 0 1) ,治疗组ESV有所改善明显优于对照组。结论　培哚普利和美托洛尔联用对治疗心功能NYHA分期为 2～ 3级的慢性充血性心力衰竭患者是合理、安全、有效的     

美托洛尔治疗慢性充血性心力衰竭疗效观察

目的 探讨美托洛尔治疗慢性充血性心力衰竭的疗效.方法 将患者随机分为治疗组和对照组,治疗组34例,对照组34例.分组前经最佳的充血性心力衰竭治疗2周以上,治疗组在此基础上加用美托洛尔,剂量从6.25mg,2次/日开始,无病情恶化可递增.结果 治疗组症状明显改善.结论 经最佳的充血性心力衰竭治疗2周以上的基础上加用美托洛尔治疗慢性充血性心力衰竭疗效更佳.     

美托洛尔对慢性充血性心力衰竭患者的疗效及心功能的影响

目的　本文研究 β受体阻滞剂美托洛尔 (倍他洛克 )治疗慢性充血性心力衰竭的疗效及其对心功能的影响。方法　慢性充血性心力衰竭 (CHF)患者 88例 ,其中 4 7例常规抗心衰治疗作对照组 ,4 1例在常规治疗基础上 ,给予倍他洛克 6 2 5mg ,每天 2次逐渐增加至 5 0mg ,每天 2次作为治疗组 ,治疗 8周 ,观察疗效并分别于治疗前后进行彩色多普勒超声心动图测定心功能。结果　 (1 )治疗组临床症状改善总有效率为 92 7% ,明显高于对照组 72 3% (P <0 .0 5 )。 (2 )两组治疗后心脏射血分数 (EF)每搏输出量 (SV)心脏指数 (CI)较治疗前明显改善 (P <0 .0 5 ) ,且治疗组优于对照组 (P <0 .0 5 ,P <0 .0 1 )。结论　倍他洛克在常规治疗心衰基础上能显著改善临床症状及心功能     

美托洛尔对充血性心力衰竭的治疗作用

①目的　观察美托洛尔对充血性心力衰竭 (CHF)的治疗效果。②方法　 6 2例CHF病人随机分为 2组 ,治疗组 32例 ,对照组 30例 ,两组均给予强心、利尿、扩血管治疗 ,治疗组在此基础上加用美托洛尔 ,维持治疗6 0d后判断疗效。③结果　治疗组心功能改善情况优于对照组 (uc=2 .0 5 ,P <0 .0 5 ) ,超声心动图检测心脏各功能参数以及心率、血压均较治疗前有明显改善 (t =2 .2 8～ 8.96 ,P <0 .0 5 ,0 .0 1) ,且变化较对照组明显 (t =2 .17～2 5 .75 ,P <0 .0 1)。有 5例出现轻微副作用。④结论　美托洛尔治疗CHF效果确切 ,但应用时需严密监测血压、心率、ECG变化 ,防止不良反应发生     

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.     

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.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.