间苯三酚在产程中应用的临床研究

目的 观察探讨间苯三酚消除宫颈水肿、促进产程的临床效果.方法 选择正常初产妇,宫口开大3-4 cm,伴宫颈水肿110例.随机分为间苯三酚组(56例),待宫口开大3-4cm后,给予间苯三酚80mg静脉推注,安定组(54例),待宫口开大3-4cm后,给予安定10mg静脉推注.观察两组产程进展,宫颈水肿消退程度及围产结局.结果 (1)用药后2h的宫颈水肿消失率,间苯三酚组为94.8%,安定组为81.5%,两组比较,差异有统计学意义(P<0.01),较用药前平均宫口开大,间苯三酚组为(7.3±0.2)cm,安定组平均为(5.8±0.3)cm,两组比较,差异有显著统计学意义(P<0.01); (2)用药至宫口开全的时间,间苯三酚组平均为(2.8±0.3)h,安定组平均为(4.4±0.4)h,两组比较,差异有显著统计学意义(P<0.01);(4)产时羊水情况,新生儿窒息情况及新生儿体重在两组间比较,差异无统计学意义(P>0.05);(5)两组产妇产后出血量比较,差异无统计学意义(P>0.05).结论 间苯三酚在消除宫颈水肿及促进宫口扩张的效果均优于安定,能有效地促进产程,同时对母儿无不良影响.     

654-2联合斯帕丰在阴道分娩中的应用

目的探讨654-2(山莨菪碱)和斯帕丰(间苯三酚)联合用药在阴道分娩过程中的作用和围产结局。方法选择足月妊娠,无剖宫产指征,愿意阴道分娩的初产妇共180例,随机分为三组,每组60例。A组在产程进入潜伏期即静脉注射10mg 654-2和宫口开大3cm时静脉注射80mg斯帕丰,B组和C组在宫口开大3cm时分别静脉注射斯帕丰80mg和安定10mg。观察三组产妇用药后,潜伏期时间、活跃期时间、第二产程时间、阴道分娩率、产后2h出血量和新生儿Apgar评分。结果A组潜伏期时间较B、C两组明显缩短(P<0.01),A、B两组活跃期时间短于C组(P均<0.01)。三组第二产程时间比较差异无显著性。A组阴道分娩率高于B组、C组(P均<0.05)。三组产后2h出血量比较差异无显著性。A组新生儿Apgar评分显著高于B组(P<0.01)。结论654-2联合斯帕丰对促进宫口扩张,加速产程进展,降低剖宫产率有良好的作用,且对母婴无明显不良影响,可在临床推广使用。     

间苯三酚在第一产程活跃期的临床应用

目的 探讨间苯三酚用于第一产程活跃期对促进宫口扩张加速产程的效果及对母婴安全的影响.方法 选择正常足月妊娠临产进入活跃期而产程进展缓慢或无进展的初产妇56例,随机分为间苯三酚组（28例）,在产程进入活跃期,宫口开大3～4cm后给予间苯三酚80mg肌注,和安定组（28例）给予安定10mg静推（静推时间〉2分钟）,观察两组产妇用药后的产程变化及新生儿情况.结果 两组第一产程活跃期时间、用药2小时后宫口开大情况及新生儿Apgar评分方面比较差异有显著性（P〈0.05）;两组第二产程时间、用药2小时后宫颈水肿消失情况、自然分娩率及产后2h出血量方面比较差异无显著性（P〉0.05）.结论 间苯三酚在第一产程活跃期应用能促进宫口扩张、加速产程进展、缓解产妇紧张情绪,对母婴无明显不良影响,值得临床应用.     

斯帕丰在产程中应用的对比观察

目的:观察斯帕丰在产程中的作用。方法:选择正常初产妇规律宫缩者118例,随机分为斯帕丰组60例及安定 654-2组58例(简称安定组),两组均静脉滴注催产素2.5U 5%葡萄糖500m l至宫口开大2~3cm,前组静脉注射斯帕丰80m g,后组静脉注射安定10m g 654-2 10m g,观察两组产妇用药后的产程变化及围产结局。结果:①用药至宫口开全的时间,斯帕丰组196m in,安定组257m in,两组比较差异有极显著性(P<0.01)。②药物副作用:斯帕丰组产妇及胎儿未发现明显副作用,安定组产妇嗜睡、口干、心率增快。③阴道分娩率:斯帕丰组47例,占78.3%;安定组44例,占75.9%,两组比较差异无显著性(P>0.05)。④产时羊水情况、新生儿窒息情况,两组比较差异无显著性(P>0.05)。⑤两组产后出血比较差异无显著性(P>0.05)。结论:斯帕丰对促进宫口扩张,加速产程进展有良好的作用,且对母儿无明显的不良影响。     

斯帕丰在产程中的临床观察

目的:观察斯帕丰在产程中促进宫口扩张,加速产程进展的作用。方法:选择正常初产妇宫口开大2~3cm,伴宫颈水肿或质韧者123例,随机分为斯帕丰组(64例)和安定组(59例),分别予以斯帕丰80mg及安定10mg静推。结果:斯帕丰活跃期平均时间3.23±0.14小时,安定组平均3.65±0.12小时,差异有显著性(P<0.05)。斯帕丰组Apgar评分8~10分61例,3~7分3例。3分以下0例。安定组Apgar评分8~10分50例,3~7分8例,3分以下1例。两者有显著性差异(P<0.05)。结论:斯帕丰对宫颈扩张效果较好,且对母儿无明显影响。     

斯帕丰促进产程的临床研究

目的 观察斯帕丰在产程中促进宫口扩张,加速产程进展,减轻产痛的作用.方法 选择正常初产妇宫口开大2～3cm产妇242例随机分为斯帕丰组122例和对照组120例,斯帕丰组给予斯帕丰80mg静推,对照组无特殊处理.结果 斯帕丰组活跃期时间明显短于对照组,差异有显著意义( P<0.05);斯帕丰能减少部分产痛、缩短产痛时间;对新生儿无不良反应.临床使用简便、安全、有效.     

使用安定加催产素促进活跃期产程的临床观察

目的探讨安定加催产素在活跃期促进产程进展的作用.方法把75例单胎头位的初产妇,且潜伏期均超过6小时者,随机分成研究组(38例),对照组(37例).两组均于宫口开大3cm时,研究组应用静注安定10mg半小时后,加催产素3u 5%GS500ml静滴;对照组仅应用5%GS 催产素3u静滴.观察两组药物对促进产程进展效果的比较.结果研究组在用药至宫口开全、用药至分娩时间及第一产程、总产程均短于对照组,两组比较差异有显著性(P＜0.01).研究组的剖宫产率低于对照组,而阴道分娩率则高于对照组,两组比较差异有显著意义(P＜0.05).结论对于潜伏期较长的初产妇,在活跃期应用安定加催产素可明显促进产程的进展,提高阴道分娩率和降低剖宫产率.     

斯帕丰(间苯三酚)在产程中应用的对比观察

目的:观察斯帕丰(spasfon)在第一产程封闭宫颈水肿中的应用,观察斯帕丰促进和加速产程的疗效以及对母婴安全的影响。方法:200例宫口开张缓慢或有宫颈水肿活跃期阻滞的头位难产孕妇随机分为观察组和对照组各100例,观察组给予斯帕丰40mg静脉推注,对照组给予安定10mg静脉推注。比较两组产程进展,宫颈水肿消退程度、剖产率、阴道分娩率、宫颈裂伤、新生儿Apgar评分及产后出血。结果:观察组活跃期时间为(2.93±0.31)h,明显短于对照组的(4.15±0.26)h(P<0.01)。观察组第二产程时间(46.56±2.15)min,对照组(46.23±4.19)min,比较差异无统计学意义(P>0.05)。观察组宫颈水肿消退的有效率为87.0%(87/100例),明显高于对照组的70.0%(70/100例),两组比较差异有统计学意义(P<0.05)。观察组的阴道分娩率为96.0%,明显高于对照组的72.0%(P<0.01)。两组的产后出血、宫颈裂伤及新生儿Apgar评分比较差异无统计学意义(P>0.05)。结论:斯帕丰在宫颈水肿的治疗及对促进宫口扩张效果优于安定,能有效地促进产程,降低剖宫产率,同时对母儿无不良影响,在临床中有一定的可推广应用价值。     

斯帕丰用于产程活跃期的最佳给药途径研究

目的:探讨不同给药途径(静脉注射、肌肉注射)斯帕丰对产程活跃期及母婴的影响,找出斯帕丰的最佳给药途径。方法:选择符合如下条件的初产妇(年龄22岁~34岁,足月妊娠、单胎头位、无妊娠合并症并要求经阴试产者180例),随机分为A、B、C三组,每组各60例。A组斯帕丰40mg静脉注射;B组斯帕丰40mg肌肉注射;C组不用斯帕丰。A、B两组均于宫口开大3cm时立即给药。结果:A组与B组在产程活跃期时间、促进宫颈软化、镇痛、分娩方式及对母婴影响等方面无显著性差异;A组与B组同C组相比,能明显缩短活跃期时间、促进宫颈软化,镇痛效果好,而在对母儿影响等方面无显著性差异。结论:斯帕丰静脉注射、肌肉注射均能缩短活跃期时间,起到良好的镇痛作用,促进产程进展,在各项观察指标上无显著差异。相同剂量斯帕丰静脉注射与肌肉注射效果相同,对母婴无不良影响,而肌肉注射操作简单、经济、安全,是最佳给药途径。     

间苯三酚治疗产程活跃期延缓及停滞的疗效观察

目的:观察间苯三酚治疗产程活跃期延缓及停滞的疗效.方法:选择正常初产妇、宫口开大3～4 cm后出现活跃期延缓及停滞120例,随机分为间苯三酚组(60例),给予间苯三酚40 mg宫颈注射,80 mg静脉推注;阿托品+安定组(60例),给予阿托品0.5 mg宫颈注射,安定10 mg静推.观察两组产妇用药后的产程变化及围产结局.结果:观察组活跃期平均为(160±81) min,明显短于对照组(230±73) min (P<0.05),两组胎心变化、新生儿Apgar评分及产后出血量比较差异无统计学意义(P>0.05).结论:间苯三酚治疗活跃期延缓、停滞效果显著,对促进产程进展效果肯定,同时分娩前后对产妇及胎儿无不良影响.     

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.