孟鲁司特钠联合布地奈德治疗CVA患儿的价值研究

目的探讨孟鲁司特钠联合布地奈德治疗咳嗽变异性哮喘(CVA)患儿的价值。方法以2017年1至12月在我院接受治疗的62例CVA患儿作为本次研究对象,随机等分为对照组和观察组,各31例。对照组给予布地奈德治疗,观察组实施孟鲁司特钠联合布地奈德治疗。对比两组患儿治疗效果。结果观察组临床症状消失时间均低于对照组,差异有统计学意义(P0.05);观察组患儿肺功能指标高于对照组,差异有统计学意义(P0.05);观察组患儿血清炎性因子水平均低于对照组,差异有统计学意义(P0.05);观察组不良反应发生率基本相同,对比无统计学意义(P0.05),观察组患儿复发率低于对照组,差异有统计学意义(P0.05)。结论对CVA患儿实施孟鲁司特钠联合布地奈德治疗,改善了患儿的临床症状,改善了患者的肺功能,疗效显著,且安全性极高。     

布地奈德/福莫特罗联合孟鲁司特钠治疗咳嗽变异型哮喘的效果观察

目的探讨布地奈德/福莫特罗联合孟鲁司特钠治疗咳嗽变异型哮喘的临床效果。方法选取2014年1—12月在洛阳市第十一人民医院采取单用孟鲁司特钠治疗的56例咳嗽变异型哮喘患者作为单用组,同时选取2015年1—12月采取孟鲁司特钠联合布地奈德/福莫特罗治疗的76例咳嗽变异型哮喘患者作为联合组,比较两组患者治疗前后临床症状积分以及肺功能改善情况。结果治疗前,联合组患者FEV1、PEF、FEV1%Pred肺功能指标以及症状积分与单用组患者比较,差异无统计学意义(P>0.05);治疗后,联合组患者FEV1、PEF、FEV1%Pred肺功能指标以及症状积分优于单用组,差异有统计学意义(P<0.05)。结论孟鲁司特钠联合布地奈德/福莫特罗疗法有助于改善咳嗽变异型哮喘患者临床症状以及肺功能指标,值得推广应用。     

布地奈德/福莫特罗干粉剂与孟鲁司特钠联合治疗咳嗽变异性哮喘的效果分析

目的探讨布地奈德/福莫特罗干粉剂与孟鲁司特钠联合治疗咳嗽变异性哮喘的效果。方法 102例患者均为2017年10月～2018年10月来我院就诊的咳嗽变异性哮喘患者,按随机数字表法分为两组,每组51例,对照组用孟鲁司特钠治疗,研究组使用布地奈德/福莫特罗干粉剂联合孟鲁司特钠治疗,两组均连续治疗4周。比较两组临床疗效、症状积分及肺功能。结果研究组的治疗总有效率为92.16%,明显高于对照组的70.59%,差异有统计学意义(P0.05)。治疗后两组临床症状积分均较治疗前明显降低,差异有统计学意义(P0.05);治疗后研究组临床症状评分与对照组比较更低,差异有统计学意义(P0.05)。治疗后两组肺功能均较治疗前明显提高,差异有统计学意义(P0.05);治疗后研究组FEV1、FEV1预计值、FEV1/FVC与对照组比较更高,差异有统计学意义(P0.05)。结论咳嗽变异性哮喘用布地奈德/福莫特罗干粉剂与孟鲁司特钠联合治疗效果显著,可有效改善患者的临床症状,提高肺功能,建议临床推广应用。     

孟鲁司特钠联合布地奈德治疗小儿咳嗽变异性哮喘的疗效研究

目的对孟鲁司特钠联合布地奈德治疗小儿咳嗽变异性哮喘的疗效进行分析。方法将2015年2月至2017年2月我院小儿咳嗽变异性哮喘患儿48例随机分两组。对照组用单纯布地奈德治疗,研究组用孟鲁司特钠联合布地奈德治疗。比较两组患儿咳嗽变异性哮喘治疗效果;症状消除时间、实验室检查正常时间;治疗前和治疗后患儿肺功能的差异。结果研究组患儿咳嗽变异性哮喘治疗效果高于对照组,P0.05;研究组症状消除时间、实验室检查正常时间短于对照组,P0.05;治疗前两组肺功能相似,P0.05;治疗后研究组肺功能更好,P0.05。结论孟鲁司特钠联合布地奈德治疗小儿咳嗽变异性哮喘的疗效确切,可快速缓解症状,改善肺功能,值得推广。     

孟鲁司特钠联合布地奈德治疗老年支气管哮喘的临床效果观察

目的观察孟鲁司特钠联合布地奈德治疗老年支气管哮喘的临床效果。方法选择老年支气管哮喘患者156例,随机均分为观察组和对照组,各78例。观察组采取孟鲁司特钠联合布地奈德治疗,对照组采用常规抗支气管哮喘治疗,治疗10d后比较两组患者临床症状缓解时间及肺功能指标,治疗12周后比较两组患者临床疗效并于治疗6个月后随访复发情况。结果两组患者治疗后喘息、胸闷和咳嗽症状的缓解时间比较,差异有统计学意义(P<0.05);治疗10d后肺功能指标比较,差异有统计学意义(P<0.05);治疗12周后显效率、无效率比较,差异有统计学意义(P<0.05);治疗6个月后复发率比较,差异有统计学意义(P<0.05)。结论在老年支气管哮喘常规药物治疗过程中,加用孟鲁司特钠联合布地奈德治疗,可促进患者的恢复,提高临床疗效,并减少治疗后复发。     

观察孟鲁司特钠、布地奈德联用对小儿咳嗽变异性哮喘(CVA)的治疗价值

目的:探究小儿咳嗽变异性哮喘(CVA)患儿应用孟鲁司特钠、布地奈德联合治疗的疗效。方法:选取小儿咳嗽变异性哮喘患儿80例,均分为两组,采用布地奈德雾化吸入的为对照组,采用孟鲁司特钠联合布地奈德治疗的为观察组。结果:对照组和观察组的治疗总有效率分别为82.5%、97.5%,两组比较,差异有统计学意义(P<0.05);观察组治疗后各项肺功能改善情况明显优于对照组,两组比较,差异有统计学意义(P<0.05);与对照组比较,观察组的复发率明显更低,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.5)。结论:小儿咳嗽变异性哮喘患儿采用孟鲁司特钠、布地奈德治疗的临床效果优越,有效提高患者的肺功能,减轻患者的症状,且复发率低,治疗安全性高。     

孟鲁司特钠与布地奈德治疗儿童咳嗽变异性哮喘临床对比

目的探讨孟鲁司特钠与布地奈德气雾剂治疗小儿咳嗽变异性哮喘(CVA)的临床疗效。方法选择60例咳嗽CVA患儿,随机分组,观察组30例予以孟鲁司特钠口服,对照组30例予以布地奈德气雾剂治疗,观察2组患儿临床疗效、不良反应以及复发情况。结果观察组与对照组在急性期达临床缓解所需的时间分别为(7.8±3.2)d和(7.1±3.9)d(P>0.05);观察组哮喘发生率稍低于对照组,但差异无统计学意义(P>0.05)。结论孟鲁司特钠与布地奈德气雾剂在控制CVA临床症状方面均有较好疗效,孟鲁司特钠组能降低CVA的哮喘发生率。     

孟鲁司特钠联合布地奈德治疗咳嗽变异性哮喘的临床效果评价

目的研究分析孟鲁司特钠联合布地奈德气雾剂对咳嗽变异性哮喘的治疗效果。方法将本院收治的100例患有咳嗽变异性哮喘的患者分为对照组与观察组,对照组采用孟鲁司特钠单药治疗,观察组则采用布地奈德气雾剂与孟鲁司特钠片联合治疗,比较两组患者治疗前后肺功能指标及治疗效率。结果治疗前两组患者肺功能指标差异不明显(P0.05),治疗后两组患者肺功能指标较治疗前均有所改善,且观察组明显优于对照组患者(P0.05),同时比较两组患者治疗效率,观察组亦优于对照组(P0.05)。结论孟鲁司特钠片联合布地奈德气雾剂治疗咳嗽变异性哮喘,有利于缓解患者炎症反应,改善患者肺功能,治疗效果明显。     

孟鲁司特钠联合复方异丙托溴铵治疗老年支气管哮喘急性发作患者的临床疗效

目的 探讨孟鲁司特钠联合复方异丙托溴铵治疗老年支气管哮喘急性发作患者的疗效。方法 选取2018 年12 月至2019 年12 月医院收治的102 例老年支气管哮喘急性发作患者为研究对象,随机分为对照组和研究组,每组各51 例,对照组在常规治疗基础上采用复方异丙托溴铵吸入治疗,研究组在常规治疗的基础上采用孟鲁司特钠片联合复方异丙托溴铵吸入治疗。比较两组临床疗效、肺功能指标（PEF、FEV1%、FVC）及临床症状积分。结果 研究组患者总有效率高于对照组,差异有统计学意义（P＜0.05）。研究组和对照组治疗后的临床症状（喘息、咳嗽、气促）积分低于治疗前,差异有统计学意义（P＜0.05）;研究组治疗后的临床症状积分低于同期对照组,差异有统计学意义（P＜0.05）。研究组和对照组治疗后的肺功能指标（PEF、FEV1%、FVC）高于治疗前,差异有统计学意义（P＜0.05）;研究组治疗后的肺功能指标高于同期对照组,差异有统计学意义（P＜0.05）。结论 老年支气管哮喘急性发作患者应用复方异丙托溴铵或者孟鲁司特钠联合复方异丙托溴铵治疗均可收到显著的效果,但是孟鲁司特钠联合复方异丙托溴铵治疗效果更好,能有效缓解患者的临床症状,改善患者的肺功能,优于单独应用复方异丙托溴铵治疗。     

孟鲁司特钠联合酮替芬治疗小儿咳嗽变异性哮喘疗效观察

目的探讨孟鲁司特钠联合酮替芬治疗小儿咳嗽变异性哮喘（cough variant asthma,CVA）的临床疗效,以求优化咳嗽变异性哮喘的治疗方案。方法将80例CVA患儿随机分为治疗组和对照组,每组各40例。治疗组予以孟鲁司特钠咀嚼片联合酮替芬治疗,对照组予以布地奈德粉吸入剂联合酮替芬治疗,观察治疗后2组患儿症状缓解及消失时间,以及2组治疗后的不良反应,并随访半年,观察该病的复发率。结果治疗组的临床疗效优于对照组,2组治疗后症状缓解及消失时间、总有效率、6个月复发率比较差异均有统计学意义（P〈0.05）。结论口服孟鲁司特联合酮替芬治疗小儿咳嗽变异性哮喘的临床效果优于布地奈德粉吸入剂联合酮替芬治疗,不良反应发生率低,使用方便,值得推广应用。     

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.