强化降脂联合强化降压预防脑卒中不良事件的疗效评价

目的 :探讨强化降脂联合强化降压预防脑卒中患者不良事件方面的临床价值。方法 :将我院收治的190例脑卒中患者随机分为观察组和对照组,观察组的采用强化降脂联合强化降压治疗,对照组采用常规降脂联合常规降压治疗,治疗12个月后,比较两组患者血脂、血压水平及不良事件发生情况。结果 :观察组的舒张压、收缩压、LDL-C水平明显低于对照组,不良事件的主要终点事件和次要终点事件的发生率显著低于对照组。结论 :强化降脂联合强化降压有助于改善脑卒中患者的血压和血脂,还可有效预防心血管不良事件的发生,故可将其作为治疗脑卒中的优先考虑方案。     

强化降脂患者的临床疗效及超声观察

目的:观察强化降脂的临床疗效。方法:将180例冠心病患者分成两组各90例,对照组给予常规剂量阿托伐他汀钙10 mg/d,强化降脂组给予阿托伐他汀钙40 mg/d。观察两组患者用药前及用药5个月后的总胆固醇(TC),低密度脂蛋白胆固醇(LDL-C),三酰甘油(TG),颈动脉血管内膜中层厚度(CIMT),两组患者的服药后的不良反应。结果:两组患者的TC、LDL-C、TG的水平都明显好于用药前,但强化降脂组的下降程度要明显好于对照组(P<0.01),两组患者的CIMT也都减少,但强化降脂组比对照组减少的明显(P<0.01)。结论:阿托伐他汀钙强化降脂能更有效降低TC、LDL-C、CIMT,且不良反应无明显增加,应在临床推广。     

阿托伐他汀对急性心肌梗死患者C反应蛋白及血脂的影响

目的 探讨急性心肌梗死(AMI)早期阿托伐他汀标准降脂治疗与强化降脂治疗对降脂及炎症反应的影响.方法 本院收治75例AMI患者,分为2组,阿托伐他汀强化治疗组和常规治疗组,分别于入院12h内给予阿托伐他汀40mg/d和10mg/d.连续使用4周,观察治疗前后患者血清总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL-C)及C反应蛋白(CRP)的水平.结果 阿托伐他汀强化治疗组治疗4周时血浆中TC、TG、LDL-C及CRP水平均显著低于阿托伐他汀常规治疗4周组.常规治疗组治疗后TC、TG、LDL-C水平降低,差异有统计学意义,CRP水平有降低趋势,但差异无统计学意义.结论 早期40mg/d阿托伐他汀强化降脂治疗可减轻AMI患者冠状动脉粥样斑块的炎症反应,明显降低血脂水平,10mg/d阿托伐他汀常规治疗仍获得很好的调脂作用.     

强化降脂治疗对急性心肌梗死患者预后的影响

目的 探讨强化降脂对急性心肌梗死患者预后的影响.方法 118例急性心肌梗死患者随机给予辛伐他汀20mg/d(传统降脂组)及40mg/d(强化降脂组)治疗,观察1、3、6、12个月后低密度脂蛋白胆固醇(LDL-C)的变化、一年后心脏事件发生的情况及不良反应发生的情况.结果 强化降脂组LDL-C下降明显(P＜0.05),心脏事件减少明显(P＜0.05),两组不良反应发生无差异(P＞0.05).结论 辛伐他汀40mg/d可改善急性心肌梗死患者的预后.     

观察强化降脂在冠心病及脑梗死治疗中的应用

目的观察强化降脂在冠心病及脑梗死治疗中的应用。方法选取我院2016年至2018年接诊的50例冠心病及脑梗死患者为观察对象,将其按照治疗方式不同,随机分为观察组与对照组。观察组患者强化降脂,服用阿托伐他汀大剂量;对照组患者常规降脂,服用常规剂量的阿托伐他汀。观察两组患者在治疗前后的血脂(TC、TG、LDL-C、HDL-C)的变化、炎症因子与不良反应发生率。结果观察组(强化降脂)在治疗后TC、TG、LDL-C、明显比对照组要低,HDL-C比对照组稍高,观察组患者的炎症因子IL-6、IL-8、hs-CRP在治疗后明显要比对照组低,观察组的不良反应发生率比对照组稍高。结论冠心病合并脑梗死用强化降脂治疗不仅可以有效降脂,还可以抑制炎症反应,降低心脑血管疾病的出现。     

强化降脂治疗与介入治疗在冠心病二级预防中效果比较

目的:探讨强化降脂与介入治疗在冠心病二级预防中的效果。方法:将168例冠心病患者,采用随机数字法平均分为两组,A组(强化降脂组)给予患者阿托伐他汀强化降脂治疗措施,B组(介入治疗组)给予患者介入治疗及常规治疗措施,观察患者冠心病再发率及相关生化指标。结果:治疗后两组间血脂水平比较结果显示,治疗前,两组患者LDL-C、HDL-C、TG、TC及CRP水平差异比较无统计意义;治疗后1个月,LDL-C、TG、TC及CRP水平下降,HDL-C水平升高,其中A组下降更明显,且LDL-C及CRP水平比较差异有统计学意义;治疗后3个月,与B组相比,A组LDL-C、TG、TC及CRP水平下降更明显,HDL-C水平升高更明显,差异比较有统计学意义。治疗3个月后两组间预防比较结果显示:A组的心肌梗死发生率、心绞痛发生率均明显低于B组,差异比较有统计学意义。A组每月检测患者肝功能未发现,6例患者1个月后谷丙转氨酶(ALT)升高,但随后两个月后正常,其余患者有明显的肝功能的损害出现。结论:在CAD患者的二级预防中,与介入治疗相比,强化降脂治疗可以得到更好的预防治疗效果,可以明显降低患者的血脂水平,且患者之后的CAD再发生率亦降低,该预防治疗值得临床推广应用。     

强化降脂治疗对合并冠心病的糖尿病患者血脂、血糖的影响

目的观察强化降脂治疗对合并冠心病的糖尿病患者血脂、血糖的影响,以探讨强化降脂治疗对糖尿病患者临床使用的降脂效果及安全性。方法选择80例确诊合并冠心病的糖尿病患者,抽血检查后随机分为常规组40例,强化降脂治疗组40例,常规组常规治疗：阿托伐他汀组10毫克/日,强化降脂治疗组：阿托伐他汀40毫克/日,所有患者入院后30分钟内服用上述药物。入院后24小时、3天、2周空腹采血,测定血清低密度脂蛋白胆固醇（LDL-C）及甘油三酯（TG）、谷丙转氨酶（ALT）、C反应蛋白（CRP）、糖化血红蛋白浓度（HbAIC）。结果两组治疗后,阿托伐他汀40毫克组较10毫克组服用药物后血清LDL-C下降更明显,两组HbAIC、ALT均较服药前均略有升高,但无统计学差异。结论强化降脂能更显著降低合并冠心病的糖尿病患者的血脂水平、对糖尿病患者肝功能、血糖有一定影响。     

急性脑梗死患者应用阿托伐他汀强化降脂治疗对其血脂指标的改善作用

目的探讨阿托伐他汀强化降脂治疗急性脑梗死患者对其血脂的改善效果。方法本次研究对象来源于我院2016年1月至12月收治的急性脑梗死患者42例,随机分成两组,各21例,其中对照组采用20mg/d阿托伐他汀治疗,观察组采用40mg/d阿托伐他汀强化降脂治疗,比较两组血脂指标改善情况。结果观察组HDL-C明显高于对照组,LDL-C、TC及Tg明显低于对照组;观察组总有效率为95.2%,明显高于对照组的85.7%。以上比较有显著性差异(P0.05)。结论阿托伐他汀强化降脂治疗急性脑梗死患者可有效改善其血脂指标,值得推广。     

强化降脂对急性冠脉综合征患者血清生化指标的影响

目的：探讨强化降脂对急性冠脉综合征患者血脂（LDL-C）、肝功（ALT）、高敏C反应蛋白（hs-CRP）和肌钙蛋白I（CTnI）的影响,以了解强化降脂对急性冠脉综合征患者降脂幅度、使用安全性、炎性反应抑制及斑块稳定的作用。方法：选则80例ACS患者抽血检查后随机分为常规组40例,强化降脂治疗组40例,常规组常规治疗：阿托伐他汀组20mg/d,强化降脂治疗组阿托伐他汀40mg/d,入院后患者入院后30min内服药。入院后24h、3d、2周空腹采血,测定血清血脂（LDL-C）、肝功（ALT）、高敏C反应蛋白（hs-CRP）和肌钙蛋白I（CTnI）浓度。结果：阿托伐他汀40mg组较20mg组服用药物后高敏反应蛋白（hs-CRP）下降更明显。两组治疗后3d及2周肌钙蛋白I（CTnI）浓度较治疗前均明显降低,但两组相比无明显差异。起始3d两组血脂（LDL-C）水平无明显变化,2周后两组均明显下降,且强化降脂组较常规治疗组下降明显,两组肝功与用药前相比差异无统计学意义。结论：强化降脂能更显著降低冠心病患者的血脂水平,抑制ACS患者的炎性反应,稳定斑块,而且临床用药安全。     

急性冠脉综合征强化降脂疗效及护理干预对策

目的:探讨急性冠脉综合征(ACS)的强化降脂疗效及临床护理干预效果。方法:选取2013年4月-2015年4月本院收治的急性冠脉综合征患者1200例作为研究对象,根据随机分组原则分为观察组和对照组,每组600例,分别给予强化降脂治疗和常规治疗,并给予观察组有效的护理干预,比较两组患者治疗后总肝固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、血脂达标率及临床药物不良反应。结果:观察组TC、TG、LDL-C及HDL-C均优于对照组,3个月和12个月血脂达标率高于对照组,临床药物不良反应发生率低于对照组,比较差异均有统计学意义(P<0.05)。结论:在急性冠脉综合征的治疗上给予强化降脂治疗及优质护理干预可改善患者预后,值得在临床上进一步推广应用。     

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.     

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.