国产和进口rHuEPO治疗长期血透慢性肾衰竭贫血患者的疗效比较

研究和比较国产与进口基因重组人红细胞生成素（ｒＨｕＥＰＯ）对长期血液透析（ＨＤ）慢性肾衰竭（ＣＲＦ）贫血患者的影响。将６０例长期血透慢性肾衰竭贫血病人随机分成２组,分别应用国产ｒＨｕＥＰＯ（益比奥）、进口ｒＨｕＥＰＯ（生血素）１００μｇ／（ｋｇ·周）,均分３次治疗。２组患者在治疗第２周网织红细胞（ＲＲＢＣ）均显著上升,治疗１２周内血细胞比容（ＨＣＴ）均达到０．３０以上,且生活质量均有所改善。表明国产、进口ｒＨｕＥＰＯ疗效无显著性差异,均可安全、有效地改善ＣＲＦ患者贫血状态。     

重组人类促红细胞生成素治疗慢性肾功能衰竭贫血

应用重组人类促红细胞生成素（ｒＨｕＥＰＯ）治疗１６例慢性肾功能衰竭（ＣＲＦ）维持血液透析（ＨＤ）患者的贫血，８周后，贫血明显改善，生活质量提高。共观察１２周。血红蛋白（Ｈｂ）由５１．４±９．３ｇ／Ｌ增至８８．４±４．７ｇ／Ｌ（Ｐ＜０．００１），红细胞比积（Ｈｃｔ）由１７．５±２．８％增至３１．７±４．２％（Ｐ＜０．００１）。     

人类重组红细胞生成素作用的研究进展

人类重组红细胞生成素（ｒＨｕＥＰＯ）是利用ＤＮＡ重组技术人工合成的激素，它的产生，标志着贫血治疗的一个新阶段，目前ｒＨｕＥＰＯ已成为治疗肾性贫血的首选药物。近年来随着对ｒＨｕＥＰＯ研究的不断深入，人们对ｒＨｕＥＰＯ在慢性肾功能衰竭（ＣＲＦ）患者中的临床作用又增添了许多新的知识。下面就这些研究进展作一简述。１ 对红细胞质量及免疫功能的影响 研究表明ＣＲＦ患者氧自由基脂质过氧化物（ＬＰＯ）水平、超氧化物歧化酶（ＳＯＤ）活性、红细胞膜Ｎａ＋－Ｋ＋ＡＴＰａｓｅ活性　，经ｒＨｕＥＰＯ治疗后，不但ＬＰＯ、ＳＯ…     

国产重组人促红细胞生成素临床疗效观察

采用随机对照的方法，观察了２５例（对照）和２４例（开放）国产重组人促红细胞生成素（ＥＰＯ）的对慢性肾功能衰竭肾性贫血患者的疗效和副作用，结果表明，采用皮下和静脉给药的方法，用国产ＥＰＯ治疗慢性肾功能不全肾性贫血患者总有效率为９３．９％，显效率为６７．３％，有效率为２６．５％，无效率为６．１％，与进口ＥＰＯ疗效相当。国产ＥＰＯ不良反应，透析器凝血发生率为４．０％，内瘘堵塞发生率为８．５％，与进口ＥＰ     

rHuEPO治疗肾性贫血对血液流变学的影响及临床意义

慢性肾功能不全病人，当内生肌酐清除率（Ｃｃｒ）降至２５ｍｌ／ｍｉｎ以下，常合并有贫血，随着肾功能的继续减退，贫血会进一步加重。导致肾性贫血的主要原因是肾脏产生促红胞生成素（ＥＰＯ）减少，而重组人类红细胞生成素（ｒＨｕＥＰＯ）的应用可以彻底纠正贫血，改善病人生存质量，在ｒＨｕＥＰＯ治疗中，随着血液红细胞压积（Ｈｃｔ）升高，血液流变学也随之发生相应变化，且产生不利的影响。本文观察了１４例ｒＨｕＥＰＯ治疗的肾性贫血的血液流变学的改变，以及应用抗凝治疗后的血液流变学的变化。临床资料１．一般资料：１４例为…     

重组人类红细胞生成素治疗肾性贫血后患者红细胞脂质过氧化物变化

为探讨重组人类红细胞生成素（ｒＨｕＥＰＯ,简称ＥＰＯ）治疗肾性贫血后患者红细胞脂质过氧化物变化,该文对２５例慢性肾功能不全血透患者在ＥＰＯ治疗前后,测定血红蛋白、红细胞压积、红细胞丙二醛（ＭＤＡ）、红细胞超氧化物歧化酶（ＳＯＤ）及全血谷胱甘肽过氧化物酶（ＧＰＸ）活性。结果示ＥＰＯ治疗后患者血红蛋白含量、红细胞压积显著升高,而红细胞ＭＤＡ,ＳＯＤ及全血ＧＰＸ则无显著变化。提示ＥＰＯ能有效地改善肾性贫血,但不能改变红细胞脂质过氧化物水平和抗氧化酶系统活性,不能使红细胞寿命恢复正常。     

叶酸对红细胞生成素疗效的影响

目的：探讨叶酸对红细胞生成素（ｒＨｕＥｐｏ）疗效的影响。方法：将４２例尿毒症患者中对ｒＨｕＥｐｏ疗效差的９例作为实验组,随机抽取５例作为治疗组加用叶酸１０ｍｇ,每日３次,余４例作为对照组,不补充叶酸。两组均持续应用ｒＨｕＥｐｏ及剂。结果：治疗组病人红细胞压积（ＨＣＴ）较前显著升高（Ｐ〈０．０１）,红细胞体积（ＭＣＶ）显著下降（Ｐ〈０．０５）,网织红细胞（ＲＣ）显著升高（Ｐ〈０．０１）。结论：叶酸可改善ｒＨｕＥｐｏ的疗效。当用ｒＨｕＥｐｏ治疗肾性贫血时,如果疗效差,ＭＣＶ升高,应据病情补充叶酸。     

福乃得配合促红素治疗肾性贫血的疗效观察(附28例报告)

福乃得配合促红素治疗肾性贫血的疗效观察（附２８例报告）广西区人民医院肾内科李季上海市第四人民医院内科张庆文贫血是慢性肾功能衰竭（ＣＫＦ）的表现之一，目前已公认使用重组人类红细胞生成素（ｒＨｕＥＰＯ）治疗肾性贫血有效。在使用ｒＨｕＥＰＯ治疗时，铁的缺乏...     

甲状腺功能对血清促红细胞生成素的影响

为了观察甲状腺功能的改变对血清促红细胞生成素（ＥＰＯ）的影响，用放射免疫分析法测定了６３例甲状腺疾病患者的血清促红细胞生成素（ＥＰＯ）水平，根据甲状腺激素水平将患者分成甲状腺功能亢进组（Ⅰ组）、甲状腺功能减退组（Ⅱ组）、及正常对照组（Ⅲ组），分别观察各组的血清ＥＰＯ水平。测定结果：Ⅰ组血清ＥＰＯ平均值２３２０±１３８７Ｕ／Ｌ，Ⅱ组ＥＰＯ平均值１２９３±７３７Ｕ／Ｌ，Ⅲ组ＥＰＯ平均值１２８４±７０９Ｕ／Ｌ。结果显示：Ⅰ组血清ＥＰＯ水平明显高于Ⅱ组和Ⅲ组（Ｐ＜００１），Ⅱ组和Ⅲ组无差异（Ｐ＞００５）。提示：在甲状腺激素分泌增多情况下，血清ＥＰＯ水平可增高。     

国产宁红欣配合腹膜透析治疗肾性贫血的疗效观察

采用国产的ＥＰＯ（宁红欣）配合腹膜透析治疗肾性贫血。将３０ 例尿毒症患者随机分为治疗组和对照组,结果显示：２月后治疗组血红蛋白（Ｈｂ）和红细胞压积（ＨＣＴ）显著增高（Ｐ分别小于０．０１,０．０５）,而对照组治疗结果无显著差异（Ｐ＞ ０．０５）。提示：国产ＥＰＯ对肾性贫血治疗有效。     

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.     

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.     

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.