米索前列醇舌下含服对胎膜早破引产的观察

目的：比较米索前列醇（以下简称米索）与催产素对足月妊娠、胎膜早破、宫颈不成熟病例引产的效果与安全性。方法：待产的足月、单胎、头位、胎膜早破、合并宫颈不成熟的初产妇６０ 例,随机分成米索舌下含服组和催产素静脉内持续滴注组。结果：从引产开始到分娩的时间,米索组明显短于催产素组（Ｐ＜ ０．００１）;２４ ｈ 内引产成功率米索组明显高于催产素组（Ｐ＜ ０．００５）。米索组７０．０％病例一次含服达到引产成功。分娩期并发症,新生儿或母亲的副反应,两组相似。结论：米索舌下含服对足月妊娠、胎膜早破、宫颈不成熟者,是一种有效、安全的引产方法。     

米索前列醇在妊娠晚期引产中的应用

为探讨米索前列醇在计划分娩中的可用性。本次将１０２例妊娠达４０周尚未临产的孕妇随机分为两组，米索前列醇（以下简称米索）组５１例，催产素组５１例。分别用米索５０μｇ阴道后穹窿放置引产及催产素引产。结果，米索组引产的有效率为９５％，显著高于催产素组６２％（Ｐ〈０．０５）。两组宫颈评分提高程度比较差异有非常显著性意义（Ｐ〈０．０１）。说明阴道后穹窿放置米索用于晚期妊娠引产能促进宫颈成熟及发动子宫收缩，是     

米索前列醇用于足月妊娠引产的临床观察

目的 观察阴道置米索前列醇（简称米索），中止晚期妊娠的有效性和安全性。方法 对４０例有引产指征的足月或过期单胎头位，无宫缩，宫颈评分≤４分，ＮＳＴ反应型的初产妇（研究组），用米索前列醇５０μｇ阴道置药，每４ｈ１次，与４０例同等条件（对照组）接受催产素引产者进行比较分析。结果 米索组引产成功率显著高于催产素组（Ｐ〈０．０１），阴道分娩平均引产时间显著短于催产素组（Ｐ〈０．０１），宫颈评分提高显著高于     

米索前列醇用于足月妊娠引产的临床研究

目的探讨米索前列醇用于足月妊娠引产的临床应用价值。方法将２３６例符合引产指征的单胎、头位,尚未临产的孕妇随机分为米索前列醇引产组及催产素引产组。结果米索前列醇用于足月妊娠引产的有效率为９４．３％,显著高于催产素组７８．３％（Ｐ＜０．０１）;其临产发动时间及总产程分别为２．８１±０．４９ｈ和６．４０±２．３１ｈ,短于催产素的３．９８±０．２９ｈ及９．１２±２．５０ｈ（Ｐ＜０．０１）;剖宫产率为９．０４％;亦显著低于催产素组（１９．１４％）（Ｐ＜０．０１）;两组胎儿宫内窘迫发生率、新生儿体重及Ａｐｇａｒ评分、产后出血量均无显著差异（Ｐ＞０．０５）。结论米索前列醇用于足月妊娠引产疗效显著,安全、方便,而且有利于计划分娩,值得临床推广应用     

不同方法用于孕晚期引产的疗效观察与比较

目的　研究Foley尿管低位小水囊、米索前列醇、缩宫素三种方法用于孕晚期引产促宫颈成熟的有效性、孕妇依从性、不良反应、分娩结局以及对胎儿及新生 儿的影响.方法　选取我院２０１５年１月至２０１５年１２月住院的有引产指征的孕晚期孕妇共１５０例,随机分为３组,水囊组５０例,米索前列醇组５０例,缩宫素组５０ 例,观察比较三组促宫颈成熟的有效性,不良反应,孕妇依从性,分娩结局,对胎儿及新生儿的影响.结果　水囊组与米索前列醇组促宫颈成熟有效性无统计学差异 (P ＞０．０５),两组均明显高于缩宫素组(P ＜０．０５);米索前列醇组孕妇依从性最高,与水囊组无明显差异(P ＞０．０５),均明显高于缩宫素组(P ＜０．０５);水囊组和米索前 列醇组用药至临产时间均明显短于缩宫素组(P ＜０．０５);米索前列醇组总产程明显短于其他两组(P ＜０．０５);水囊组阴道分娩率最高,与米索前列醇组无明显差异 (P ＞０．０５),均高于缩宫素组(P ＜０．０５),缩宫素组剖宫产率最高,明显高于其他两组(P ＜０．０５).;水囊组置入水囊时少量阴道出血发生率较高,米索前列醇组宫缩过 频发生率高,缩宫素组胎膜早破发生率高;对胎儿及新生儿的影响三组无差异(P ＞０．０５).结论　Foley尿管低位小水囊、小剂量米索前列醇促宫颈成熟效果均显 著,安全、经济、有效,孕妇依从性高,缩短用药至临产时间,缩短总产程,提高阴道分娩率,降低剖宫产率,适合基层医院推广.     

米索前列醇用于足月妊娠引产的效果观察

目的：观察５０μｇ 米索前列醇对晚期妊娠引产的有效性和安全性。方法：选择有引产指征的单胎、头位、胎膜完整的足月妊娠妇女２００ 例,随机分成两组,研究组（１００例）用米索前列醇５０μｇ 阴道用药,对照组（１００ 例）用人工破膜点滴小剂量催产素。结果：米索组足月妊娠引产成功率达７８％ ,催产素组成功率达４９％ ,其临产发动时间及总产程米索组为４．９ｈ、５．９３ｈ,催产素组为１４．３７ｈ、６．２７ｈ,分娩方式、新生儿体重、新生儿窒息及宫缩过强伴发胎心监护异常,两组比较差异无显著性（Ｐ＞ ０．０５）,但米索组剖宫产率低于催产素引产组,差异非常显著（（Ｐ＜ ０．０１）。结论：阴道放置米索前列醇用于足月妊娠引产能缩短产程,降低剖宫产率,是疗效显著、安全有效、方便的引产方法。     

米索前列醇用于晚期妊娠引产的探讨

目的：评价米索前列醇（米索）用于晚期妊娠引产的效果。方法：选择具有引产指征的单胎头位妊娠１０８例，随机分为米索组５４例，催产素组５４例，比较两组引产成功率，用药至临产时间，产后出血，剖宫产率，新生儿Ａｐｇａｒ评分。结果：米索组引产成功率高于催产素组（Ｐ〈０．０１），米索组用药至临产时间短于催产素组（Ｐ〈０．０１）。产后出血，剖宫产率，新生儿体重，Ａｐｇａｒ评分、胎儿窘迫发生率，两组间差异均无显著性     

米索前列醇用于足月妊娠引产时对胎儿的影响

米索前列醇用于足月妊娠引产时能缩短产程,降低剖宫产率,是一种有效的引产方法。这些结论已有不少文献作过报道［１～３］,但关于米索前列醇用于引产时对胎儿的影响,尚未见有专门报道。本文通过观察应用米索前列醇表１　两组４项观察指标的比较例（％）组别例数羊水污染胎心音异常新生儿窒息宫缩过频米索９５１８（１８．９）１５（１５．８）７（７．４）１６（１６．８）催产素５３３（５．７）２（３．８）３（５．７）０（０）Ｐ值＜０．０５＜０．０５＞０．０５＜０．０１引产时的羊水污染率、胎心音异常率、新生儿窒息率和宫缩过…     

阴道内放置米索前列醇足月妊娠引产效果分析

本文采用阴道内放置米索前列醇进行足月妊娠引产，其目的在于研究米索前列醇的引产效果及使用安全性。对１１０例符合引产指征的足月妊娠妇女，随机分为二组；二组妇女在年龄、孕周、孕产次及宫颈Ｂｉｓｈｏｐ评分等方面条件相似，分别采用阻道内放置米索前列醇引产（研究组）和静脉点滴催产素引产为（对照组）。结果：用药后宫颈Ｂｉｓｈｏｐ评分研究组由原５．９８分提高至９．４８分，对照组由原６．１６分提高至８．５５分，两组宫颈Ｂｉｓｈｏｐ评分平均变化相比有极显著差异（Ｐ＜０．００１），用药至分娩时间研究组为９．０小时较对照组为１４．４小时明显缩短（Ｐ＜０．００１），自然分娩率研究组为７９％，对照组为４６％（Ｐ＜０．０５），而产后出血，新生儿Ａｐｇａｒ评分及用药副作用等两组相比均无显著差异（Ｐ＞０．０５），提示：阴道内放置米索前列醇是一种安全有效的引产方法。     

米索前列醇与催产素用于晚期妊娠引产的疗效

目的：探讨米索前列醇在晚期引产中的作用。方法：对７８例妊娠３８～４１＋周的正常孕妇有引产指征者，随机分为米索组４２例，催产素组３６例。米索组阴道穹窿放置米索前列醇２００μｇ，２４小时未临产重复用药，累计不超过４００μｇ。催产素组静脉滴注催产素１ｕ，２４小时未临产增至２．５ｕ，４８小时仍未临产行人工剥膜后重复使用２．５ｕ。用药前和重复用药时行宫颈评分，观察引产效果，并对妊娠结局进行比较。结果：宫颈成熟总有效率米索组明显高于催产素组（Ｐ＜０．００５）。妊娠结局比较两组无差异（Ｐ＞０．０５）。副反应少。结论：米索前列醇阴道上药对于晚期妊娠引产尤其是宫颈评分低时效果好，不失为有效、安全的晚期妊娠引产方法。     

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.