巴曲抗栓酶治疗发病6～48h急性脑梗死疗效观察

目的：观察巴曲抗栓酶治疗急性脑梗死（发病６～４８ｈ）的监床疗效。方法：发病６～４８ｈ内经临床和ＣＴ证实脑梗死４２例为治疗组,男２４例,女１８例,年龄６５±１４岁,在常规治疗的基础上加用巴曲抗栓酶（ｄ１１０ＢＶ,ｄ３和ｄ５各５ＢＶ）治疗。另外３０例为对照组,男１８例,女１２例,年龄６８±９岁,单以常规方法治疗。结果：神经缺损评分显示治疗组显效率７３．８％;对照组显效率４６．７％,两组比较Ｐ〈０．０５     

1,6-二磷酸果糖联合复方丹参治疗慢性活动型肝炎疗效观察

为探索１,６－二磷果糖（ＦＤＰ）联合复方丹参治疗慢性活动型乙型肝炎的疗效。将１３５例病人随机分两组。两组均采用基础疗法,治疗组加用ＦＤＰ联合复方丹参进行治疗,静滴,１次／ｄ,１５ｄ为 １疗程,共 ３个疗程。结果显示,治疗组显效 ４３例（５７． ３３％）,有效 ２５例（３３． ３４％）,无效 ７例（９． ３３％）,总有效率 ９０． ６７％。对照组显效 １６例（２６． ６７％）,有效 ２８例（４６．６６％）,无效１６例（２６．６７％）,总有效率７３．３３％。两组疗效比较有明显显著性差异。提示１,６－二磷酸果糖联合复方丹参治疗慢性活动型乙型肝炎疗效好,并且显著改善肝功能。     

舒血宁片辅助治疗充血性心力衰竭

本文将充血性心力衰竭（ＣＨＦ）病人，随机分为两组，其中５０例（男２６例，女２４例；年龄４９±１３ａ），采用常规疗法（地高辛、氢氯噻嗪、硝酸异山梨酯）作为对照组；５０例（男２８例，女22例；年龄５０±１３ａ）在上述常规治疗基础上加用舒血宁片２片，３次／ｄ，口服，作为治疗组。两组疗程为１４ｄ。对照组、治疗组依次显效２８％与４６％，总有效率７４％与８８％（Ｐ〉０．０５），未见副作用。结论：舒血宁片辅助治疗     

奥美拉唑与法莫替丁抗消化性溃疡的临床评价

为了观察消化性溃疡患者分别应用奥美拉唑（Ｏｍｅｐｒａｚｏｌｅ，Ｏｍｅ）和法莫替丁（Ｆａｍｏ－ｔｉｄｉｎｅ，Ｆａｍ）治疗后的疗效和不良反应。对１６０例经确诊的消化性溃疡患者随机分为２组，Ｏｍｅ组（男性６１例，女性１１例，年龄４５．１±１４．３岁），每天口服Ｏｍｅ２０ｍｇ，早餐后顿服。Ｆａｍ组（男性７２例，女性８例，年龄４３．７±１１．２岁）每天口服Ｆａｍ两次，每次１０ｍｇ。结果：Ｏｍｅ组溃疡４周愈合率９５．０％，明显高于Ｆａｍ组８３．７５％（Ｐ＜０．０５），２周愈合率８２．５％，明显高于Ｆａｍ组６５．０％（Ｐ＜０．０５）。服药１～３ｄ的疼痛消失率６８．６％，远高于Ｆａｍ组的５２．２％（Ｐ＜０．０５）。可见Ｏｍｅ在抗消化性溃疡方面有溃疡愈合快、愈合率高及缓解症状迅速的优点。在治疗过程中Ｏｍｅ组出现了多种不良反应，发生率１８．７５％，高于Ｆａｍ组（Ｐ＜０．０１），但出现的不良反应继续用药可自行减轻至消失。结论：Ｏｍｅ是目前治疗消化性溃疡的较安全有效的药物之一。     

青少年学生无症状性心律失常临床意义探讨

对５１例青少年学生无症状性心律失常进行临床意义分析，结果：患有病毒性心肌炎６例，占１１．８８％，中度以上心律失常１５例，占２９．７％，给与抗心律失常治疗，１４例治愈，一例因间断给药再次复发，其余３０例为单纯性室早占５９．４％。     

补阳还五汤治疗早期脑梗塞血清肿瘤坏死因子的变化

为探讨补阳还五汤治疗早期脑梗塞机理，将６０例患者分为补阳还五汤治疗组和对比治疗组（用７０６代血桨、复方丹参注射液、肠溶阿斯匹林治疗），动态观察发病第４ｄ、７ｄ、１４ｄ血清肿瘤坏死因子（ＴＮＦ）水平，并观察了治疗效果。结果：发病４ｄ两组ＴＮＦ分别为（２．９０３±０．４１０）ｎｇ／ｍｌ、（２．８９６±０．３９８）ｎｇ／ｍｌ，７ｄ时为（１．９０５±０．３５０）ｎｇ／ｍｌ、（２．００１±０．３８６）ｎｇ／ｍｌ，１４ｄ时为（１．３０１±０．２２３）ｎｇ／ｍｌ、（２．５０５±０．４０１）ｎｇ／ｍｌ（Ｐ＜０．０１），补阳还五汤组显效１６例，对比治疗组显效８例（Ｐ＜０．０５）。结论：补阳还五汤能改善早期脑梗塞患者ＴＮＦ代谢失衡状态，从而减轻ＴＮＦ介导的神经损伤而获效。显效率优于对比治疗组     

甲氟喹治疗恶性疟与青蒿琥酯的随机比较

目的：评价甲氟喹治疗恶性疟的疗效与安全性。方法：采用甲氟喹７５０ｍｇ一次顿服与青蒿琥酯片５ｄ疗程总量６００ｍｇ各治疗无合并症恶性疟３０例，进行随机比较。结果：两组病例均能迅速控制临床症状，平均退热时间两组相似，分别为甲氟喹组（２４．２±１４．７）ｈ和青蒿琥酯组（１８．３±９．０）ｈ（ｔ＝１．８４３，Ｐ＞０．０５）。平均原虫转阴时间甲氟喹组（５７．２±２０．０）ｈ慢于青蒿琥酯组（４３．０±１７．１）ｈ（ｔ＝２．９０７，Ｐ＜０．０１）。追踪观察２８ｄ，甲氟喹组治愈率为７６．７％，原虫复燃率为２３．３％；青蒿琥酯组治愈率为７３．３％，复燃率为２６．７％，两组无显著性差异（χ２＝０．０８９，Ｐ＞０．０５）。两组除极少数患者可见轻微的恶心或呕吐，可能与病情本身有关外，未见其他明显毒副作用。结论：甲氟喹７５０ｍｇ一次顿服与青蒿琥酯５ｄ疗程总量６００ｍｇ治疗恶性疟的治愈率及症状控制疗效相似，甲氟喹组原虫清除时间慢于青蒿琥酯组。     

芬氟拉明对磺脲类失效的非胰岛素依赖型糖尿病的疗效

３１例经磺脲类（ＳＵ）口服降糖药治疗继发失效的非胰岛素依赖型糖尿病（ＮＩＤＤＭ） 患者，在足量ＳＵ药物的基础上联合应用芬氟拉明治疗。疗程为６周。结果显示：联合治疗前 后空腹血糖（ＦＢＧ）分别为：１２．０５±２．３８ｍｍｏｌ／Ｌ与８．３５±９．４３ ｍｍｏｌ／Ｌ，Ｐ＜０．００１；餐后血 糖（ＰＢＧ）分别为：１９．０６±５．４５ｍｍｏｌＬ与１３．１８±５．３７ｍｍｏｌ／Ｌ，Ｐ＜０．００１；糖基化血红蛋白 （ＨｂＡ１Ｃ）分别为：９．５１±２．４２％与６．６８±１．３１％。Ｐ＜０．００１。体块指数（ＢＭＩ）、空腹血浆胰 岛素（ＦＰＩ）及餐后血浆胰岛素（ＰＰＩ）均无明显改变。胰岛素敏感试验结果显示于治疗后各点 血糖水平均有不同程度下降。     

丹参-果糖治疗新生儿缺氧缺血性脑病的疗效评价

目的：对１２６例新生儿缺氧缺血性脑病治疗资料进行回顾性分析,评价复方丹参－１．６二磷酸果糖在治疗本症的临床疗效．方法：采用复方丹参－果糖治疗缺氧缺血性脑病。观察治疗前后患者意识、反射、肌张力恢复的情况。结果：治疗组与对照组的总有效率分别为８９．７ ％和７４．１％（Ｐ＜０．０５）;意识恢复天数分别为３．８６±０.８３和５.８７±１．１８（Ｐ＜０．０１）;反射恢复天数分别为４．４２±１．１４和５．９６±１．５２（Ｐ＜０．０１）;肌张力恢复天数分别为４．２０±１．１４和５．１１±１．１４（Ｐ＜０．０１）;住院天数分别为９．５７±２．７３和１２．８９±３．１６（Ｐ＜０．０１）．均有显著性差异。结论：采用复方丹参－ｌ．６二磷酸果糖治疗新生儿缺氧缺血性脑病,疗效显著。     

维克胃炎冲剂治疗慢性浅表性胃炎44例临床观察

将胃镜确诊的慢性浅表性胃炎８４例分为两组，治疗组４４例，男性２８例，女性１６例、平均年龄３３±１６岁。口服维克胃炎冲剂１包（５ｇ３次／ｄ）疗程为２０ｄ，显效率７９．５％。对照组４０例：男性２６例，女性１４例，平均年龄３６±１３岁，口服三九胃泰１包３次／ｄ，疗程为２０ｄ，显效率为２５％，两组比较Ｐ＜０．０１，值得选用维克胃炎冲剂。     

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.