垂宁方治疗PRL型垂体腺瘤的临床疗效研究

目的：：观察“垂宁方”治疗泌乳素( PRL)型垂体腺瘤的临床疗效。方法：将60例垂体泌乳素腺瘤患者随机分为2组。治疗组予以“垂宁方”联合溴隐亭治疗;对照组予以溴隐亭治疗,治疗时间为期2年。观察两组在治疗前后中医证候积分、血清P RL水平变化及垂体MRI动态增强瘤体变化情况。结果：两组治疗前后中医证候积分、血清P RL水平、瘤体变化有差异有统计学意义。结论：“垂宁方”能有效改善P RL型垂体腺瘤患者中医证候积分、降低血泌乳素水平、缩小瘤体、不良反应少。     

ICU病房的非艰难梭菌相关性医院感染腹泻

【摘要】目的探讨溴隐亭对男性泌乳素腺瘤患者的治疗效果及性功能的影响。方法分析及随访29例男性泌乳素腺瘤患者采用溴隐亭治疗后不同时间内分泌学、影像学检测的变化,并采用国际勃起功能指数-5(IIEF-5)对患者在药物治疗前、后的性功能进行评估。结果男性泌乳素腺瘤患者临床表现以性功能障碍、头痛、视力障碍多见。溴隐亭治疗6个月后,患者临床症状改善明显;血清泌乳素(PRL)水平明显下降(P<0.05),睾酮(T)水平有所升高(P<0.05),总体PRL水平正常化率为82.8%;疗效评价全部患者均有不同程度缓解,药物治疗总体有效率达100%;按照IIEF-5评估,患者性功能障碍均有不同程度改善。结论溴隐亭能改善患者临床症状,使内分泌功能趋于正常,更重要的是明显改善患者的性功能障碍状况。     

溴隐亭口服联合手术治疗泌乳素型垂体瘤的疗效分析

目的：研究泌乳素(PRL)型垂体瘤患者行溴隐亭口服联合手术治疗效果。方法：选取自重庆市九龙坡区第二人民医院2017年5月-2020年5月收治的60例PRL型垂体瘤患者,依据双盲法分为手术组(单鼻孔经鼻蝶入路手术,n=30)、联合组(手术组基础联合溴隐亭口服,n=30),比较两组疗效。结果：治疗前,两组患者PRL、肿瘤体积比较,差异无统计学意义(P>0.05);治疗后,联合组PRL低于手术组,差异有统计学意义(P<0.05)。治疗前,两组骨痛、肌肉痛、头痛及视神经损伤评分比较,差异无统计学意义(P>0.05);治疗后,联合组骨痛、肌肉痛、头痛及视神经损伤评分低于手术组,差异有统计学意义(P<0.05)。联合组有效率高于手术组,差异有统计学意义(P<0.05)。两组不良反应比较,差异无统计学意义(P>0.05)。结论：溴隐亭口服联合外科手术治疗PRL型垂体瘤能提高疗效、值得临床应用并予以推广。     

垂体瘤泌乳素瘤性闭经11例临床分析

目的分析垂体泌乳素瘤性闭经的临床特征及治疗,方法对11例垂体瘤泌乳素瘤引起的闭经患者的临床症状及体征、实验室资料、影像学检查以及治疗方法进行分析。结果3例患（侵蚀型）者手术治疗,其余患者药物（溴隐亭）治疗,所有患者临床症状均明显改善,血清泌乳素（PRL）水平有不同程度下降。结论侵蚀型垂体泌乳素瘤手术治愈率低,局限型垂体泌乳素瘤以溴隐亭治疗安全、有效,可避免手术。     

高泌乳血症90例临床分析

目的探讨高泌乳素血症的中西结合治疗效果。方法用中药逍遥散加减联合西药溴隐亭治疗高泌乳素血症60例,并将单用溴隐停治疗30例作为对照组,观察血中泌乳素PRL水平及临床症状体征变化情况进行疗效对比。结果逍遥散加减联合溴隐亭不仅可显著降低患者血清PRL水平,改善患者症状,而且还可减少溴隐亭用量,降低不良反应的发生率。结论逍遥散加减联合溴隐亭临床疗效良好,值得推广应用。     

垂体泌乳素腺瘤患者溴隐亭耐药与血清PRL水平的关系

目的 了解在对溴隐亭耐药和有效的泌乳素腺瘤患者间,早期血清PRL水平是否存在差异.方法 收集了105例垂体泌乳素腺瘤患者的临床资料,根据溴隐亭疗效分为有效组和耐药组,其中有效组86例,耐药组19例.对两组患者药物治疗前血清PRL水平进行比较.结果 有效组中患者早期血清PRL水平为(689.4±136.9)μg/L高于耐...     

溴隐亭治疗男性泌乳素腺瘤及对患者性功能影响的评价

目的 探讨溴隐亭对男性泌乳素腺瘤患者的治疗效果及性功能的影响。 方法 分析及随访29例男性泌乳素腺瘤患者采用溴隐亭治疗后不同时间内分泌学、影像学检测的变化,并采用国际勃起功能指数-5(IIEF-5)对患者在药物治疗前、后的性功能进行评估。 结果 男性泌乳素腺瘤患者临床表现以性功能障碍、头痛、视力障碍多见。溴隐亭治疗6个月后,患者临床症状改善明显;血清泌乳素(PRL)水平明显下降(P<0.05),睾酮(T)水平有所升高(P<0.05),总体PRL水平正常化率为82.8%;疗效评价全部患者均有不同程度缓解,药物治疗总体有效率达100%;按照IIEF-5评估,患者性功能障碍均有不同程度改善。 结论 溴隐亭能改善患者临床症状,使内分泌功能趋于正常,更重要的是明显改善患者的性功能障碍状况。     

通络地黄汤联合溴隐亭治疗泌乳素型垂体腺瘤疗效研究

目的 观察通络地黄汤联合溴隐亭治疗泌乳素型垂体瘤(PTPA)临床疗效。方法 将我院80例PTPA患者随机分为治疗组与对照组各40例。对照组服用溴隐亭治疗,治疗组服用通络地黄汤+溴隐亭治疗。比较两组临床疗效,主证、次证积分和总积分,瘤体体积、催乳素(PRL)、血管内皮生长因子(VEGF)水平,记录月经周期正常、经量正常、溢乳消失例数并计算百分率,记录治疗期间不良反应发生情况。结果 治疗后,治疗组总有效率高于对照组(P<0.05);两组主证、次证积分和总积分、瘤体体积、PRL、VEGF水平均低于治疗前,治疗组主证、次证积分和总积分、瘤体体积、PRL、VEGF水平均低于对照组(P<0.05);治疗组月经周期正常率、经量正常率、溢乳消失率均高于对照组;治疗组不良反应率低于对照组(P<0.05)。结论 通络地黄汤联合溴隐亭治疗PTPA的疗效较优,可缩小瘤体体积,降低PRL水平,抑制新生血管生成,促进症状消退,安全性好。     

溴隐亭联合大剂量维生素B6治疗高泌乳血症疗效观察

目的：探讨溴隐亭联合大剂量维生素B6在高泌乳血症治疗中的作用。方法：门诊高泌乳血症患者163例,随机分为两组,观察组82例,服用溴隐亭和维生素B6,对照组81例,服用溴隐亭,于服药后的1、2、3、4、5、6个月测定血清PRL。结果：治疗前两组血清PRL水平无明显差异（P〉0.05）。治疗6个月后,观察组血清PRL明显低于对照组（P〈0.01）。观察组有75例血清PRL正常,占91.46%,68例停药,占82.92%;对照组有64例血清PRL正常,占79.01%,有41例停药,占50.61%。观察组中无恶心呕吐副作用出现,对照组中有8例出现恶心呕吐症状;治疗组1例因不能坚持服药,血清PRL出现反弹现象,对照组2例。停服溴隐亭1个月后观察组无复发,对照组有2例复发。结论：溴隐亭联合大剂量维生素B6治疗高泌乳血症可以缩短疗程,减少溴隐亭用量,降低药物副作用。     

溴隐亭治疗女性高泌乳素血症性不孕的临床疗效

目的探讨溴隐亭治疗女性高泌乳素血症性不孕的临床疗效。方法回顾性分析我院2014年3月至2016年5月收治的高泌乳素血症性不孕患者114例,依照给药方式的不同将其分为观察组与对照组,各57例。对照组行口服溴隐亭治疗,观察组实施阴道溴隐亭给药治疗。对2组患者的血清泌乳素含量、排卵及妊娠状况进行比较。结果治疗2周后,2组患者血清PRL含量均有显著降低(P0.05),且2组比较差异较小(P0.05);2组排卵率及妊娠率均明显提高(P0.05),且2组间比较无显著差异(P0.05)。结论溴隐亭治疗女性高泌乳素血症性不孕,可有效改善患者血清PRL含量,促进其排卵及妊娠的发生。同时,由于不同给药方式临床疗效相当,因而可根据患者的临床实际情况采取合适的给药方式,以提高治疗的安全性。     

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.