106例青年高血压病的临床分析

目的探讨青年高血压病的临床处理，总结认识与体会。方法对106例青年高血压病的临床资料进行回顾性分析。结果原发性高血压占82．1％，单纯舒张期高血压占51．9％，单纯收缩期高血压占13．2％．收缩期、舒张期高血压占34、9％；无临床症状者占30、2％；青年高血压病患者存在代谢紊乱；经治疗血压控制满意率达83、0％。结论早期诊断、早期治疗青年高血压病，实施健康教育，改善生活行为，使用降压药物，减少高血压引起的并发症。     

洛德治疗慢性心力衰竭的临床观察

临床资料：①心衰病人心功能Ⅱ-Ⅲ级，左室射血分数（LVEF）〈50％；②年龄40—76岁；③无支气管哮喘；④无心动过缓与高度传导阻滞病史。男16例，女20例；年龄40～76岁；NYHA心功能分级Ⅱ级16例，Ⅲ级20例，单纯随机抽样分为络德组36例，对照组36例。两组资料差异无显著性，具有可比性。     

血府逐瘀口服液治疗心绞痛120例

120例均为住院病人,其中男66例、女54例;年龄小于40岁者7例,41～50岁者32例,51～60岁者60例,60岁以上者21例,合并高血压41例,合并高血脂75例,合并糖尿病35例。稳定型心绞痛95例,不稳定型心绞痛18例,变异型心绞痛7例。全部病例均有不同程度的胸部闷痛、刺痛,伴舌紫,心电图见劳损或缺血性改变。治疗方法：采用血府逐瘀口服液。疗效判断：①显效：临床症状消失,心电图正常。②有效：临床症状基本消失,心电图好转。③无效：临床症状改善不明显,心电图无变化。治疗结果：其中显效63例,占52．5％;有效48例,占40％;无效9例,占7…     

糖调节受损者的临床干预研究

目的评价对糖调节受损（IGR）患者药物及非药物干预作用。方法将IGR患者263例随机分为5组：①饮食及运动干预组（51例）；②二甲双胍纽（53例），二甲双胍0．25g，3；L／d；③吡格列酮纽（52例），吡格列酮15mg，1次／d；④诺和龙组（51例）：诺和龙0．25rag，3次／d；⑤对照组（56例）。空腹及餐后血糖、空腹胰岛素、糖化血红蛋白、血脂、血压、肝肾功能与干预前后分别监测。结果糖调节受损者糖尿病年发生率：药物干预组与对照组和饮食运动组比较显著降低，差异有显著性（P〈0．05）；药物及饮食运动组空腹及餐后血糖降低；空腹胰岛素降低；HOMA，IR降低；胰岛素敏感性改善；甘油三酯降低，SOD升高，收缩压、舒张压降低，与对照组相比，差异有显著性（P〈0．05）；发生糖尿痛的危险度饮食及运动组降低37．3％，二甲双胍组降低75．3％，吡格列酮组降低74．6％，诺和龙组降低84．9％．结论药物干预可延缓和预防糖尿病及心血管疾病的发生和发展，优于非药物干预。     

江苏无锡地区机关人员血压分类及其与血尿酸水平的关系

目的：探讨机关人员的血压水平及其与血尿酸水平的关系。方法：通过对江苏无锡地区部分机关的5821名工作人员的系统体检，计算不同性别的血压分类及高血压患病率，分析不同血压水平的血尿酸水平及高尿酸血症发生率。结果：①男性正常高限血压占11．63％，高血压病占38．95％；女性正常高限血压占7．01％，高血压病占21．84％，男性正常高限及高血压病患病率显著高于女性（P〈O．01）。②高血压患病率随年龄增高而增高，除70—79岁组外，均为男性显著高于女性（P〈0．01）。③随着血压升高，血尿酸水平增高；随着高血压程度加重，高尿酸血症发生率显著增加（P〈0．01）。结论：随着血压升高，血尿酸水平增高，高尿酸血症发生率也随之增加。血压达到高血压病1期时，高尿酸血症发生率已开始增加。     

飞行人员头痛状况调查

目的调查飞行人员头痛患病情况：方法采用调查问卷方法,针对基层部队飞行人员进行有关头痛的调查。结果基层部队组经常头痛者患病率约为10％,其中紧张型头痛占90．5％,偏头痛占9．5％;直升机飞行人员头痛患病率18．8％,教练机飞行员头痛患病率36．5％。导致头痛的因素多为飞行任务重占42．9％、心理负荷大占35．7％。缓解头痛的方法休息占84．9％、药物占5．8％、运动占4．7％。结论头痛是飞行人员的常见疾病,以紧张型头痛为主。建议合理安排飞行任务,鼓励休息和运动消除症状.     

194例高血压临床干预的评价

目的：评价门诊194例高血压患者实施2年的临床干预效果。方法：对门诊建立病历的高血压患者进行临床干预,积极控制血压,指导患者药物治疗原则和非药物治疗原则的干预。结果：通过三级管理显示,对高血压患者的积极控制和干预,使其血压控制在一级管理者中“优良”者为30例,“尚可”者为21例;二级管理者中“优良”者为33例,“尚可”者为17例;三级管理者中“优良”者为37例,“尚可”者为11例;规范服用阿司匹林者占54．30％;服降脂药占40．1％。结论：为减少心脑血管病终点事件的发生,必须对高血压患者积极控制血压等综合干预,使不同情况的高血压患者得到合理、有效的治疗。     

老年高血压患者的出院指导与心理护理

高血压是老年疾病中的常见病、多发病和慢性病，也是影响老年人健康长寿的重要疾病，可并发心、脑、肾等多种疾病。因此对做好老年高血压患者的出院保健指导工作是十分必要的。我科从1997年1～11月对50例高血压病患者进行了出院生活保健指导，收到一定效果，现报道如下。1临床资料1．时般资料：本组50例中，男42例，女8例，年龄60～86岁，病史2～35年。1.2发病前因素：本组50例中，因情绪激动，疲劳后发病20例，占40％；因受凉感冒后发病10例，占20％；因自行停药或突然减量或乱滥用药物者7例，占14％；嗜烟酒者7例，占14％；无明显诱因6例…     

肝硬化大出血的观察与护理

一般资料：共22例，男18例，女4例，年龄40—68岁。出血量：800—1000m110例；1000—1200m15例；1200—1500m17例。并发症：诱发肝性脑病6例；引起失血性休克7例。诱因：饮食不当10例；过度劳累7例；无明显诱因5例。根据以往临床经验，以下为大出血的标志：①临床症状：呕血、黑便、血便；②原来血压正常的患者，血压降至98mmHg以下，脉搏大于100次／分或出现一过性低血压；③原来无贫血，出血后Hb〈7g/L；④随着出血量的增多，症状更为明显者。     

西比灵治疗眩晕症86例临床观察

眩晕症病人86例，年龄28～56岁，平均年龄42岁。病程6个月至15年。其中推基底动脉供血不足38例，美尼尔氏综合征34例，高血压病10例，不明原因的眩晕症4例，随机分为两组。治疗组43例（男性23例，女性20例）和对照组43例（男性22例，女性21例）。治疗方法：治疗组服西比灵每晚10mg，这用40天；对照组眼眩晕停2片1日3次，连用40天．服药10天无效者停药。疗效标准：①治愈：眩晕、耳鸣、听力障碍、眼球震颤及呕吐均消失，高血压病人血压降至正常。②显效：除突然头部或体位改变时有轻度头晕外，其他症状消失，高血压者血压趋向正常。③有效：…     

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.