AMI溶栓后QTd降低预示梗塞相关血管再通

通过急性心肌梗塞溶栓治疗前后ＱＴ主散度变化的研究，探讨溶栓后ＱＴｄ变化与冠脉再通的关系。方法：顺序选择ＡＭＩ国产尿激酶静脉溶栓的住院患者６６例及冠状动脉造影正常者３０例，ＣＡＧ判断溶栓效果，测量并比较溶栓前后及ＣＡＧ正常者标准１２导联ＥＣＧ上的ＴＱｄ。     

国产r-SK溶栓治疗急性心肌梗塞的冠脉造影及临床观察

应用国产重组链激酶（ｒ－ ＳＫ）１５０ 万Ｕ 加入５ ％ ＧＳ１００ ｍｌ １ｈ 内静脉滴注治疗２８ 例急性心肌梗塞，治疗后９０ ｍｉｎ行冠状动脉造影评价治疗效果，结果梗塞相关血管再通率为７５ ％ ，起病后３ｈ 内溶栓再通率为８７ ．５ ％ ，３ ～６ｈ 再通率为８０ ％ ，６ ～１２ｈ 再通率为６０ ％ 。梗塞相关血管前降支再通率为８１ ．３ ％ ，回旋支再通率为７５ ％ ，右冠脉再通率为６２ ．５ ％ 。未通的立即补救ＰＴＣＡ 及冠脉内支架术开通梗塞相关性血管，全部病例５ 周观察无一例死亡。     

急性心肌梗死静脉溶栓再通临床标准与冠状动脉造影的对比分析

目的：64例急性心肌梗死（AMI）患者进行静脉溶栓治疗，以冠状动脉造影结果标准，对AMI溶栓治疗再通临床标准进行评价。方法：对64例急性心肌梗死患者行静脉溶栓治疗，1-3天行冠状动脉造影，以造影结果为标准，达到TIMI分级标准Ⅱ级以上为再通，分析参考方案中2项、3项指标的不同组合及4项指标与血管再通的关系。结果：冠脉造影评判冠脉再通46例，未通18例；以临床标准评判冠脉再通42例，未通22例。临床再通指标对血管开通判断敏感性为78.3%；特异性为66.7%；阳性预测值为85.7%；阴性预测值为54.5%；临床准确度为75.0%。结论：冠脉造影与临床再通指标有很好的相关性，临床标准判断冠脉血管再通的准确性提高。     

急性心肌梗塞静脉溶栓临床观察

目的：为了解国产尿激酶（ＵＫ）静脉溶栓治疗急性心肌梗塞（ＡＭＩ）的效果及安全性。方法：采用国产ＵＫ静脉溶栓治疗ＡＭＩ７５例，观察其疗效与梗塞部位，溶栓时间与疗效的关系，并观察了并发症及病死率。其中６８例作了冠状动脉造影。结果：临床判断梗塞相关血管开通率６８％（５１／７５），前壁梗塞血管开通率７２７３％（２４／３３），下后壁梗塞血管开通率６５７９％（２５／３８）。６小时溶栓血管再通率７６７９％（４３／５６），６～１２小时溶栓血管开通率４２１１％（８／９）。冠状动脉造影判断血管再通率６１７６％（４２／６８）。结论：国产ＵＫ是安全有效的溶栓剂，疗效与梗塞部位无关，与溶栓时间有关。     

冠状动脉内溶栓治疗急性心肌梗塞（附32例冠脉造影分析）

目的：用国产尿激酶经冠脉内溶栓，观察对急性心肌梗塞（ＡＭＩ）的疗效。方法：患者３２（男３０，女２）例，年龄５４．８±１１．９（２９￣８２）岁，心绞痛发病后２．５￣１２ｈ，经ＥＣＧ证实ＡＭＩ，并作选择性冠脉造影确诊梗阻部位，给０．５ｇ硝基甘油以排除血管痉挛，经导管内注入国产尿激酶２００￣２５０ｋＵ以５￣８ｋＵ／ｍｉｎ之速度进行溶栓治疗，观察１５ｍｉｎ后再作冠脉造影观察疗效，如未溶开可重复给尿激酶２￣     

3h内急性心肌梗死溶栓后临床与冠脉造影血管再通的评价

目的对3h内急性心肌梗死（AMI）溶栓治疗后临床与冠脉造影血管再通进行评价。方法42例发病3h内AMI患者,采用静脉给药溶栓治疗后7h-15d行冠脉造影,判定冠脉是否再通,同时与临床判断再通的指标进行比较。结果临床判定冠脉再通率为76．19％,与冠脉造影判定再通率为83．33％,二者比较差异无统计学意义（P〉0．05）。结论发病3h内AMI静脉溶栓是开通梗死相关血管的有效方法,临床与冠脉造影判定冠脉再通率基本一致。     

急性心肌梗塞溶栓治疗后T波演变的临床观察

目的 通过观察急性心肌梗塞（ＡＭＩ）溶栓治疗后Ｔ波的动态演变,了解早期Ｔ波倒置与闭塞冠状动脉（冠脉）再通的关系及其临床诊断意义。方法 将４６例ＡＭＩ接受静脉溶栓治疗的患者分为２４小时内Ｔ波倒置和未倒置组,依据冠脉再通的临床间接指征观察两组冠脉再通情况。结果 两组冠脉再通率分别为８８．５％和３０％（Ｐ〈０．０１）。结论 早期Ｔ波倒置亦可作为冠脉再通的间接临床观察指标之一。     

溶栓后早期T波的变化与冠脉再通的关系

目的 探讨急性心肌梗塞溶栓后早期Ｔ波的变化与闭塞冠脉再通的关系。方法 对８０例接受静脉溶栓治疗的ＡＭＩ患者进行前瞻性研究,根据溶栓后２４小时内有无Ｔ波倒置分为两组。依据临床间接判断冠脉再通的标准观察两组血管再通情况。结果 Ｔ波倒置组与未倒置组血管再通率分别为９３．１％和１１．３％（Ｐ〈０．０１）。结论 溶栓后早期Ｔ波倒置可作为判定梗塞相关血管再通的参考指标。     

德国链激酶,国产重组链激酶静脉溶栓治疗急性心肌梗塞49例疗 …

目的：观察德国链激酶（ＳＫ）与国产重组链激酶（ｒ－ＳＫ）在急性心肌梗塞（ＡＭＩ）静脉溶栓治疗中的临床疗效和安全性。方法：将我院ＣＣＵ病房１９９６年３月￣１９９７年１２月静脉溶栓治疗ＡＭＩ４９例，分为ＳＫ组２５例和ｒ－ＳＫ组２４例。２组分别用ＳＫ及ｒ－ＳＫ１５０万单位６０ｍｉｎ静脉滴入，伴随用药２组相同。结果：血管再通率ＳＫ组６８％，ｒ－ＳＫ组６６．６７％（Ｐ〉０．０５）。溶栓距发病≤６ｈ；前壁梗塞     

尿激酶溶栓治疗急性心肌梗塞39例临床观察

目的：观察尿激酶（ＵＫ）静脉溶栓治疗急性心肌梗塞（ＡＭＩ）的溶栓时机及临床疗效。方法：３９例ＡＭＩ患者,用ＵＫ静脉溶栓治疗。半小时内输注１００～１５０万单位。结果：①临床判断梗塞相关智力这再通２４例,再通率６１．５％,２小时内、２～４小时、４～６小时及６～１２小时内相关血管再通率分别为８０．０％、７２．７％、５７．１％和４４．４％,死亡４例,病死率１０．３％;并发出血３例,出血率７．７％。②溶栓再     

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.