短程三联疗法根除幽门螺旋杆菌临床分析

目的：探索奥美拉唑＋阿莫西林＋呋喃唑酮在小儿幽门螺旋杆菌（ＨＰ）的治疗中,ＨＰ根除率,即疗效、安全性及价格是否为大众所接受。方法：６５例,经胃镜查实,消化性溃疡或慢性胃炎患者。给予奥美拉唑＋阿莫西林＋呋喃唑酮疗程１４ｄ,治疗结束１月后复查胃镜,并检测ＨＰ。结果：ＨＰ根除率８７．７％。胃炎好转变９２．９％。胃炎愈合率８３．３％,溃疡愈合率９５．７％,溃疡有效率１００％。副反应发生率４．６％。１２岁患儿抗ＨＰ所需费用约为２５０．５４元。结论：此方案不失为根除率高、安全、实用的一根除ＨＰ的方案。     

奥美拉唑,阿莫西林分别联合灭滴灵和痢特屡根除幽门？…

为寻找治疗慢性胃炎、消化性溃疡更有效的方法,将ＨＰ阳性患者８３例随机分为两组,采用奥美拉唑、阿莫西林分别联合灭滴灵和痢特屡,用药７天。结果两组ＨＰ要除率分别为８０．００％和９５．３５％,两者差异有显著性（ｘ＾２＝４．６１,Ｐ〈０．０５）;不良反应率分别为２０．００％和３０．２３％,但差异无显著性（ｘ＾２＝１．１５,Ｐ〉０．０５）,认为联合应用痢特屡的疗效优于联合应用灭滴灵,可能与ＨＰ对灭滴灵部分产     

幽门螺杆菌相关性消化性溃疡的药物治疗

为了进一步寻找对ＨＰ有较高根除率的治疗方案，本文采用原子泵抑制剂加甲硝唑和庆大霉素三联疗法治疗ＨＰ阳性的消化性溃疡，５２例病人随机分为两组：治疗组口服奥美拉唑，甲硝唑及庆大霉素，对照组单纯口服奥美拉唑，用药时间均为两周，停药后一个月作胃镜及ＨＰ复查，结果，治疗组ＨＰ根除率９２．５％明显高于对照组０％（Ｐ〈０．０１）；治疗且溃疡愈合率９６．３％与对照组９６％无显著差异（Ｐ〉０．０５），结论：奥美拉唑     

洛赛克呋喃唑酮和铋剂合用治疗消化性溃疡疗效对比分析

目的筛选疗效好、疗程短、简便、经济的治疗消化性溃疡的最佳治疗方案。方法将幽门螺杆菌（ＨＰ）相关性消化性溃疡患者，随机分为Ａ、Ｂ、Ｃ３组，分别以洛赛克、呋喃唑酮和铋剂；洛赛克和羟氨苄青霉素；法莫替丁、甲硝唑和铋剂治疗。疗程：Ａ与Ｂ组为２周，Ｃ组４周。结果各组溃疡愈合率分别为９７．６％、９０％和７５％；ＨＰ根除率分别为８５．７％、８０％和７２．２％，Ａ组和Ｃ组的愈合率有显著性差异（Ｐ＜０．０５），其余各组之间差异无显著性（Ｐ＞０．０５）。一年内３组溃疡复发率分别为１４．６％、１６．７％和３７％，ＨＰ复发率分别为１９．４％、２５％和４６．２％，Ａ组和Ｃ组的复发率有显著性差异（Ｐ＜０．０５），其余各组的复发率差异不显著（Ｐ＞０．０５）。３组ＨＰ根除者共７８例，其溃疡全部愈合（１００％），ＨＰ未根除者２０例，溃疡愈合者８例（４０％），两者有显著差异（Ｐ＜０．００５），并且其溃疡累计复发率分别为０和７．７％，亦有显著性差异（Ｐ＜０．００５）。结论Ａ组的近期和远期疗效明显优于Ｃ组而与Ｂ组相当；根除ＨＰ对消化性溃疡的愈合和防止溃疡复发均有重要作用     

奥美拉唑、吉福士、甲硝唑联合治疗消化性溃疡78例效果分析

对７８例消化性溃疡患者联合应用奥美拉唑、吉福士、甲硝唑进行治疗,并与６０例单纯应用雷尼替丁治疗作比较。结果表明：治疗组治愈率９１％,而对照组治愈率为５８．３％,治疗组ＨＰ阴转率９６．７％,对照组ＨＰ阴转率４２．８％,两组比较差异有高度显著性（Ｐ＜０．００１）。提示：奥美拉唑、吉福士、甲硝唑联合应用是治疗消化性溃疡的一种高效的方法。     

奥美拉唑联合阿莫西林治疗幽门螺杆菌相关性十二指肠溃疡观察

应用奥美拉唑联合阿莫西林治疗４１例幽门螺杆菌（ＨＰ）相关性十二指肠溃疡病，并与雷尼替丁组进行比较，结果表明：奥美拉唑和阿莫西林联合治疗ＨＰ相关性十二指肠溃疡病２周疼痛缓解率，４周溃疡愈合率，ＨＰ根除率均明显高于雷尼替丁组（Ｐ＜０．０５，Ｐ＜０．００１），患者依从性好，无明显不良反应。     

法莫替丁、阿莫西林合用呋喃唑酮根除幽门螺杆菌的疗效观察

６５例幽门螺杆菌（ＨＰ）感染的十二指肠溃疡（ＤＵ）分两组疗效观察,接受２周奥美拉唑,法莫替丁合用阿莫西林、呋喃唑酮的三联治疗。Ａ组：奥美拉唑２０ｍｇ,２次／ｄ。Ｂ组：法莫替丁２０ｍｇ,２次／ｄ,Ａ组和Ｂ组均并用阿莫西林０５,３次／ｄ,呋喃唑酮０１,２次／ｄ。两组间ＤＵ愈合率分别为８８６％（３１／３５）,８６６％（２６／３０）,根除率分别为８０％（２８／３５）,７３％（２２／３０）,两组间ＨＰ根除率差异无显著性（Ｐ＞００５）。     

兰索拉唑治疗消化性溃疡的近期疗效

目的：观察兰索拉唑治疗消化性溃疡的疗效，并与奥美拉唑、法莫替丁比较。方法：将１８８例病人随机分３组，７７例用兰索拉唑，每次３０ｍｇ，每ｄ１次，６１例用奥美拉唑，每次２０ｍｇ，每ｄ１次，５０例用法莫替丁，每次２０ｍｇ，每ｄ２次，３组疗程皆为４～６周。结果：对胃溃疡治疗６周的总愈合率，兰索拉唑组是９１．７％，奥美拉唑组是８６．７％，法莫替丁组是６６．７％。对十二指肠溃疡治疗４周的总愈合率，３组分别是９５．１％、９０．６％和７３．１％。兰索拉唑组和奥美拉唑组无显著差别（Ｐ＞０．０５），兰索拉唑组和法莫替丁组有显著差异（Ｐ＜０．０５）。结论：兰索拉唑与奥美拉唑疗效相近，而优于法莫替丁。     

茶色素治疗消化性溃疡合并幽门螺杆菌感染的疗效研究

１００例消化性溃疡（ＰＵ）并ＨＰ感染者,采用茶色素加抗酸剂治疗,结果与抗菌素治疗的对照组比较。结果：ＨＰ根除率为９６％,一年复发率为２％,皆显著优于对照组（２８％）（Ｐ〈０．０５～０．０１）。治疗组治疗前后血液流变和微循环均有显著性改变（Ｐ〈０．０５）。表明：茶色素对ＨＰ有较好的抑制和根除作用,对消化性溃疡有较好的疗效,并对其改善微循环,增强免疫和胃粘膜的防御能力有一定作用。     

胃癌前病变与幽门螺杆菌关系随访研究

目的：探讨胃癌前病变病理改变的性质、程度和幽门螺杆菌（ＨＰ）感染及药物治疗与其变化过程的关系。方法：胃镜活检慢性萎缩性胃炎（萎缩）３７例,伴肠上皮化生（肠化）１９例、不典型增生７例,观察其与ＨＰ关系,ＨＰ以Ｇｉｍｅｓａ染色,肠化者以粘液组织化学染色。１９例萎缩伴肠化服德诺２８ｄ加施尔康６个月,ＨＰ阳性者加阿莫西林１４ｄ治疗,常规胃镜查ＨＰ根除率。随访６～３１．５个月复查胃镜及ＨＰ。结果：萎缩、肠化、不典型增生ＨＰ阳性率分别为８６．５％（３２／３７）、７８．９％（１５／１９）和５７．１％（４／７）。１９例萎缩伴肠化ＨＰ根除率为６６．７％（１０／１５）,萎缩、炎症、肠化改善有效率分别为６３．２％（１２／１９）、７３．７％（１４／１９）和７８．９％（１５／１９）。其中已根除ＨＰ者分别占６６．７％（８／１２）、７１．４％（１０／１４）和６６．７％（１０／１５）,与未根除ＨＰ者炎症与肠化改善例数比较有显著性差异（Ｐ＜０．０１）。结论：胃癌前病变与ＨＰ关系密切,联合抗ＨＰ药物及多种维生素疗法对改善胃癌前病变有效。     

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.     

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.