丙酸氟替卡松联合孟鲁司特预防毛细支气管炎后反复喘息的作用

目的探讨吸入丙酸氟替卡松联合孟鲁司特预防毛细支气管炎后反复喘息的临床效果。方法将86例痊愈后毛细支气管炎患儿按出院顺序分成观察组和对照组各43例,观察组给以吸入丙酸氟替卡松加口服孟鲁司特干预治疗3个月,对照组不采用任何干预,随访1年并统计观察期内两组发生反复喘息的病例数、发生喘息的次数及持续时间。结果观察组出现喘息症状的病例数、每次喘息持续时间均值明显少于对照组,差异有统计学意义（P〈0.05）。结论短期吸入丙酸氟替卡松加孟鲁司特能够有效预防毛细支气管炎后1年内反复喘息的发生。     

丙酸氟替卡松吸入气雾剂联合孟鲁司特治疗儿童慢性咳嗽效果分析

目的 观察丙酸氟替卡松吸入气雾剂联合孟鲁司特治疗小儿慢性咳嗽的效果.方法 整群选取2013年6月—2014年6月于该院儿科门诊就诊的174例慢性咳嗽患儿,随机分为A、B、C 3组,每组58例,A组给予综合性基础治疗,B组在A组的基础上加用丙酸氟替卡松吸入气雾剂治疗,C组在B组的基础上加用孟鲁司特(顺尔宁)治疗,3组疗程均为1个月,观察3组患儿临床疗效、 随访1年的复发情况.结果 C、B、A3组总有效率分别为89.7%、74.1%、48.3%,C组的总有效率高于B组和A组,B组的总有效率高于A组,差异均有统计学意义(P<0.05);C组的复发率低于B组和A组,B组的复发率低于A组,差异均有统计学意义(P<0.05).3组均无严重不良反应发生.结论 丙酸氟替卡松吸入气雾剂联合孟鲁司特治疗小儿慢性咳嗽安全有效,可减少复发,值得临床推广.     

沙美特罗加氟替卡松联合孟鲁司特治疗儿童哮喘疗效分析

目的：探讨沙美特罗加氟替卡松联合孟鲁司特对支气管哮喘（简称哮喘）患儿的疗效。方法：选取34例哮喘患者随机分成治疗组（18例）和对照组（16例）。治疗组应用沙美特罗加氟替卡松吸入剂2次/d,1吸/次,口服孟鲁司特咀嚼片5 mg/d,每晚顿服;对照组应用沙美特罗加氟替卡松吸入剂2次/d,1吸/次。比较治疗前和用药3个月最大峰流速值（PEF）及血清IgE、嗜酸细胞阳离子蛋白（ECP）。结果：沙美特罗加氟替卡松联合孟鲁司特治疗优于沙美特罗加氟替卡松组,两组比较差异有显著意义（P〈0.05）。结论：沙美特罗加氟替卡松联合孟鲁司特治疗儿童哮喘可明显减轻哮喘症状,疗效优于单纯吸入沙美特罗加氟替卡松,可作为儿童哮喘治疗的一线选择。     

孟鲁司特钠、丙酸氟替卡松联合治疗小儿支气管哮喘的可行性分析

目的:观察孟鲁司特钠与丙酸氟替卡松联合治疗小儿支气管哮喘的临床疗效。方法:选取80例小儿支气管哮喘患儿为研究对象,将其按照随机数字表法分为联合组与对照组,对照组给予丙酸氟替卡松治疗,联合组在对照基础上应用孟鲁司特钠治疗,观察两组效果。结果:联合组总有效率95.0%,对照组总有效率70.0%,联合组高于对照组(P<0.05)。治疗后两组FVC、FEV1、PEF、IC指标比较,差异有统计学意义(P<0.05)。结论:孟鲁司特钠与丙酸氟替卡松联合治疗小儿支气管哮喘效果显著,提高临床治疗有效率,并且改善肺功能,值得临床中应用。     

孟鲁司特钠联合丙酸氟替卡松治疗支气管哮喘疗效分析

目的比较孟鲁司特钠联合吸入丙酸氟替卡松与单用丙酸氟替卡松治疗支气管哮喘的疗效。方法将60例支气管哮喘患者随机分为观察组和对照组,每组各30例。二组均予平喘、止咳、化痰、吸氧等对症支持治疗,对照组吸入丙酸氟替卡松250μg,2次/d;观察组在对照组基础上再口服孟鲁司特钠10mg,每晚1次;观察治疗前及治疗3个月后第一秒用力呼气量(FEV1)、用力肺活量(FVC)及自测呼气峰值流速(PEF),并对哮喘临床症状积分及总体疗效进行评价。结果二组在治疗期间均未出现严重不良反应,观察组和对照组总有效率分别为93.3%、73.3%,差异有统计学意义(P<0.05),且观察组在临床控制率上显著高于对照组,差异有统计学意义(P<0.05)。二组治疗3个月后临床症状积分、FEV1、PEF、FVC均有显著改善,且观察组优于对照组,差异均有统计学意义(P<0.05)。结论口服孟鲁司特联合吸入丙酸氟替卡松治疗支气管哮喘疗效肯定,能有效改善患者的支气管症状和肺功能,提高患者生活质量。     

孟鲁司特联合丙酸氟替卡松治疗儿童支气管哮喘合并变应性鼻炎临床疗效观察

目的 探讨孟鲁司特联合丙酸氟替卡松治疗儿童支气管哮喘合并变应性鼻炎的临床效果。方法回顾性分析我院呼吸门急诊确证的95例儿童支气管哮喘合并变应性鼻炎患者,按照研究目的分为单用药组(45例)和联合用药组(50例)。单用药组仅给予丙酸氟替卡松喷鼻治疗,联合用药组在给予丙酸氟替卡松喷鼻基础上联合孟鲁司特口服治疗。比较两组治疗后的临床疗效、不良反应的发生率及β2受体激动剂的使用次数。结果单用药组和联合用药组的临床疗效总有效率分别是77.8%和90.0%。与单用药组比,联合用药组临床总有效率显著升高(P＜0.05);两组不良反应无明显差异(P＞0.05),联合用药组吸入β2受体激动剂的次数显著降低(P＜0.05)。结论在吸入丙酸氟替卡松鼻喷雾剂的基础上联用孟鲁司特较单用丙酸氟替卡松对哮喘合并变应性鼻炎有良好的治疗效果,不良反应少,且能降低吸入β2受体激动剂的次数,可在临床推荐使用。     

孟鲁司特钠联合抗敏定喘汤对儿童咳嗽变异性哮喘的疗效观察

目的:探讨孟鲁司特钠联合抗敏定喘汤对儿童咳嗽变异性哮喘的疗效。方法:将200例咳嗽变异性哮喘(CVA)患儿随机分为A组和B组。A组按照常规方案施予患儿吸入硫酸沙丁胺醇气雾剂,以及丙酸氟替卡松气雾剂,待急性发作期症状消失后停吸前者,丙酸氟替卡松气雾剂继续使用3个月。B组在急性发作期施予硫酸沙丁胺醇气雾剂,症状消失后停吸,另外加服孟鲁司特钠和抗敏定喘汤,症状消失后继续服用3个月。随访所有患儿6个月,观察药物不良反应、咳嗽消失时间、复发及典型哮喘转化情况。结果:共随访成功154例,其中A组74例,B组80例。随访期间A组出现1例口腔念珠菌感染,B组出现2例轻微胃肠道反应和1例轻微头痛;B组的咳嗽消失时间、复发率以及典型哮喘转化率均低于A组,且差异具有统计学意义(P<0.05)。结论:急性期吸入硫酸沙丁胺醇气雾剂的同时加施孟鲁司特钠联合抗敏定喘汤比单用丙酸氟替卡松气雾剂起效快,并且可有效减少复发和发展为典型哮喘的风险,且该方案安全可靠,值得临床推广。     

丙酸氟替卡松吸人联合孟鲁司特对中重度儿童支气管哮喘的影响

目的观察丙酸氟替卡松吸入联合孟鲁司特在中重度儿童支气管哮喘的治疗中的有效性和安全性。方法将2009年1月至2012年6月门诊和住院接受治疗的支气管哮喘患儿141例,随机分为两组。对照组（69例）给予丙酸氟替卡松吸人和氨茶碱口服;观察组（72例）给予丙酸氟替卡松吸入和孟鲁司特片口服。观察疗效和气道功能的变化。结果观察组总有效率明显优于对照组（93．1％vs78．3％,P〈0．05）。治疗后,两组FVC、FEV1、PEF改善明显（P均〈0．01）,但两组比较差异均无统计学意义（P均〉0．05）。两组均无明显不良反应发生。结论丙酸氟替卡松吸入联合孟鲁司特能提高临床疗效,改善大气道功能,缓解支气管哮喘患儿病情。     

孟鲁司特联合氟替卡松吸入治疗支气管哮喘的效果观察

目的:观察孟鲁司特联合氟替卡松吸入对支气管哮喘的治疗效果。方法:共有200例支气管哮喘患者参加研究。患者随机分为观察组(100例)和对照组(100例),除基本治疗外,观察组给予孟鲁司特联合氟替卡松吸入,对照组给予异丙托溴铵联合氟替卡松吸入,主要终点为哮喘恶化,次要终点为因症状加重而增加皮质激素治疗、症状恶化及FEV1减低。结果:观察组治愈率、症状缓解率优于对照组,哮鸣音持续时间明显缩短(P0.05)。两组哮喘恶化比较差异无统计学意义,治疗后FEV1改善比较差异有统计学意义(P0.05)。结论:孟鲁司特联合氟替卡松吸入治疗支气管哮喘有显著效果,不亚于异丙托溴铵联合氟替卡松吸入效果。     

孟鲁司特钠+丙酸氟替卡松治疗小儿支气管哮喘临床研究

目的:设计对照实验探讨孟鲁司特钠联合丙酸氟替卡松治疗小儿支气管哮喘的临床疗效及安全性.方法:以该院2013年3月至2015年5月接受治疗的100例支气管哮喘患儿为研究对象,随机将其均分为实验组、对照组,对照组患儿在常规治疗的基础上接受丙酸氟替卡松气雾剂辅助治疗;实验组患儿在常规治疗基础上接受孟鲁司特钠联合丙酸氟替卡松气雾剂辅助治疗,对两组患儿的临床治疗效果及安全性进行统计学分析研究.结果:实验组患儿治疗后第一秒用力呼气量(FEV1)、用力肺活量(FVC)以及呼气峰值流速(PEF)等均显著优于对照组,且实验组患者的临床总治疗有效率显著较高,不良反应发生率并不具有统计学差异.结论:在常规治疗基础上辅助以孟鲁司特钠联合丙酸氟替卡松综合疗法在治疗小儿支气管哮喘方面临床疗效显著且安全性较高,具有很好的临床意义.     

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.