乳酸左氧氟沙星片联合三联疗法治疗幽门螺杆菌相关性胃溃疡效果观察

目的探讨乳酸左氧氟沙星片联合三联疗法治疗幽门螺杆菌(Hp)相关性胃溃疡的临床效果。方法选取淮阳县人民医院77例Hp相关性胃溃疡患者,随机分为观察组(39例)和对照组(38例)。对照组实施常规三联疗法,观察组于三联疗法基础上加用乳酸左氧氟沙星片治疗,观察比较两组Hp根除率、溃疡愈合率及复发率。结果治疗后观察组Hp根除率(84.62%)、溃疡愈合率(82.05%)均高于对照组(60.53%、57.89%),差异有统计学意义(P<0.05);观察组治疗后复发率低于对照组,差异有统计学意义(P<0.05)。结论三联疗法与乳酸左氧氟沙星片联合治疗幽门螺杆菌相关性胃溃疡效果显著,可有效根除幽门螺杆菌,促进溃疡愈合,减少复发。     

三联疗法联合双歧杆菌对幽门螺杆菌感染的消化性溃疡的治疗作用分析

目的 分析新三联疗法对幽门螺杆菌感染的消化性溃疡的治疗作用.方法 观察组使用均使用新三联疗法即奥美拉唑肠溶片+阿莫西林+甲硝唑,同时联合双歧杆菌抗幽门螺杆菌治疗,对照组使用传统三联疗法即洛赛克+克拉霉素+阿莫西林胶囊.分析治疗前、后均两组的症状积分及HP清除率.结果 治疗后观察组、对照组症状积分分别为(20.4±3.8)分、(11.5±2.1)分,均明显低于治疗前,且观察组治疗后症状积分显著低于对照组治疗后,差异有统计学意义(P＜0.05).观察组HP根除率为77.1%,显著高于对照组(P＜0.05).结论 新三联用药联合双歧杆菌可有效改善胃溃疡患者症状,降低HP感染率,有助于消化性溃疡的愈合.     

幽门螺杆菌根除治疗方案的对照研究

根除幽门螺杆菌(Helrcobacter pylori,HP)可促进消化性溃疡的愈合,使慢性活动性胃炎的炎症消退[1].幽门螺杆菌阳性的十二指肠溃疡和胃溃疡患者,溃疡的年复发率为72%,根除幽门螺杆菌后,溃疡年复发率可降至＜3%.当前抗幽门螺杆菌的治疗方案以两大类为主:一类是以质子泵抑制剂(PPI)为基础的三联7d疗法[2];另一类是以胶体铋(CBS)为基础的二联或三联低剂量14d疗法及三联7d疗法[3].而以H2受体拮抗剂为基础的三联疗法研究较少.     

乳酸菌联合三联疗法根除幽门螺杆菌的临床观察

目的:探讨乳酸菌联合三联疗法根除幽门螺杆菌(Hp)的临床效果。方法:将60例胃Hp阳性患者分为观察组、对照组各30例,观察组在三联疗法(雷贝拉唑+克拉霉素+阿莫西林)基础上加乳酸菌,分别进行治疗前后Hp的比较评价。结果:观察组和对照组总Hp根除率分别为90.0%和66.7%,两组差异性比较有统计学意义(χ2=4.8055,P<0.05)。结论:乳酸菌联合三联疗法根除Hp效果优于单纯三联疗法的效果。     

西咪替丁片联合地塞米松乳膏、维生素B2片治疗复发性口腔溃疡的效果

目的分析西咪替丁片联合地塞米松乳膏、维生素B_2片治疗复发性口腔溃疡的效果。方法选取2017年6月至2018年5月方城县中医院收治的94例复发性口腔溃疡患者作为研究对象,按照治疗方法分为对照组与观察组,各47例。对照组接受地塞米松乳膏、维生素B_2片治疗,观察组在对照组基础上接受西咪替丁片治疗。比较两组治疗后1 a的疗效、创面愈合时间、疼痛缓解时间、治疗前后免疫功能(CD3~+、CD4~+)、炎症因子[白细胞介素-2(IL-2)、白细胞介素-6(IL-6)、肿瘤细胞坏死因子-α(TNF-α)]水平。结果治疗后1 a,观察组治疗总有效率[91.49%(43/47)]较对照组[65.96%(31/47)]高(P<0.05)。观察组创面愈合时间、疼痛缓解时间短于对照组(P<0.05)。与治疗前比较,治疗后观察组CD3~+、CD4~+水平升高,且观察组CD3~+、CD4~+水平高于对照组(P<0.05)。与治疗前比较,治疗后两组血清IL-2水平升高,IL-6、TNF-α水平降低,且观察组血清IL-2水平高于对照组,IL-6、TNF-α水平低于对照组(P<0.05)。结论西咪替丁片联合地塞米松乳膏、维生素B_2片治疗复发性口腔溃疡效果显著,能有效缩短溃疡愈合时间,减轻疼痛程度和炎症反应,提高免疫能力。     

益生菌联合三联疗法在幽门螺杆菌(HP)根除治疗中的疗效

目的探讨益生菌联合三联疗法在幽门螺杆菌根除治疗中的疗效。方法选取2009年5月～2011年5月期间收治的90例幽门螺杆菌阳性的消化性溃疡患者,随机分为2组,观察组使用益生菌联合三联疗法进行治疗,对照组仅给予三联疗法进行治疗,对比两组患者的治疗效果。结果观察组患者症状缓解率为95.5%,溃疡愈合率为86.7%,与对照组差别无统计学意义(P>0.05);观察组患者的幽门螺杆菌根除率为88.9%,明显高于对照组患者(P<0.05),且患者耐受性佳,未出现严重的不良反应。结论采用益生菌联合三联疗法对幽门螺杆菌阳性的消化性溃疡患者进行治疗,能够明显提高幽门螺杆菌的根除率,并减少不良反应。     

金双歧联合三联疗法根除幽门螺杆菌的疗效观察

目的:探讨金双歧(内蒙古双奇药业股份有限公司出品,批准文号:国药准字S19980004,全名为双歧杆菌乳杆菌三联活菌片,金双歧为其商品名)联合三联疗法在幽门螺杆菌根除治疗中的疗效。方法:选取50例幽门螺杆菌阳性的消化性溃疡患者,随机分为两组。观察组使用金双歧联合三联疗法进行治疗,对照组仅给予三联疗法进行治疗,对比两组患者的治疗效果。结果:观察组患者症状缓解率为92.0%,溃疡愈合率为96.0%,与对照组比较差异无统计学意义(P>0.05);观察组患者的幽门螺杆菌根除率为88.0%,明显高于对照组患者的根除率(P<0.05),且患者耐受性佳,未出现严重的不良反应。结论:采用金双歧联合三联疗法对幽门螺杆菌阳性的消化性溃疡患者进行治疗,能够明显提高幽门螺杆菌的根除率,并减少不良反应。     

双歧杆菌三联活菌胶囊联合三联疗法根除小儿幽门螺杆菌有效性及安全性评价

目的:探析双歧杆菌三联活菌胶囊联合三联疗法根除小儿幽门螺杆菌(Hp)的有效性及安全性,为临床医师选择合理用药方案提供参考。方法:选取收治的小儿幽门螺杆菌感染患者52例作为研究对象,以入院日期单双号为基准,分为治疗组(26例)、对照组(26例),治疗组:双歧杆菌三联活菌胶囊联合三联疗法治疗,对照组:三联疗法治疗,对比两组临床总有效率、pH值、不良反应发生率。结果:临床总有效率对比:治疗组高于对照组;pH值对比:治疗组低于对照组;不良反应发生率对比:治疗组低于对照组,差异有统计学意义(P<0.05)。结论:小儿幽门螺杆菌感染患者实施双歧杆菌三联活菌胶囊联合三联疗法治疗的临床效果显著,既可降低不良反应发生率,又可改善pH值,值得在临床工作中借鉴。     

荆花胃康胶丸联合三联疗法根除幽门螺杆菌疗效评估

目的 观察中药荆花胃康胶丸联合三联疗法治疗幽门螺杆菌感染患者的疗效以及不良反应.方法 采取回顾性研究方法对有消化道症状伴幽门螺杆菌感染患者,分成治疗组和对照组.治疗组（中药联合三联疗法）患者46例：给予荆花胃康胶丸,疗程4周,联合雷贝拉唑＋左氧氟沙星＋呋喃唑酮,疗程1周;对照组（传统三联疗法）患者40例：雷贝拉唑＋阿莫西林＋甲硝唑疗程为1周,通过13C-尿素呼吸试验判断根除幽门螺杆菌效果,并评价临床症状缓解情况及不良反应.结果 中药联合三联疗法（治疗组）幽门螺杆菌根除率82.6%;传统三联疗法（对照组）幽门螺杆菌根除率67.5%.两组比较有显著性差异（P＜0.05）,症状缓解治疗组优于对照组（P＜0.05）,两组均无严重不良反应.结论 中药荆花胃康胶丸联合三联疗法（7d）（治疗组）和标准三联疗法（7d）（对照组）比较,在幽门螺杆菌感染患者根治率和改善症状方面治疗组均优于对照组,为根除幽门螺杆菌治疗方案提供了新途径和新思路.     

西帕依固龈液联合双黄连颗粒外用治疗复发性口腔溃疡疗效分析

目的 观察西帕依固龈液联合双黄连颗粒外用治疗复发性口腔溃疡的临床效果。 方法 将2014年1月—2015年12月间丽水市人民医院就诊的166例复发性口腔溃疡患者采用随机数字法分为2组,每组患者83例。对照组给予西帕依固龈液含漱治疗,观察组在此基础上加用双黄连颗粒涂于溃疡面。2组均治疗5 d。治疗前后,检测患者血清中肿瘤坏死因子α(TNF-α)、白细胞介素-2(IL-2)和白细胞介素-6(IL-6)水平。并统计2组溃疡面情况、疼痛程度和治疗效果。采用SPSS 20.0统计学软件对收集的2组数据进行统计学分析,进而对西帕依固龈液联合双黄连颗粒外用治疗复发性口腔溃疡的临床效果进行分析。 结果 2组治疗后TNF-α、IL-6水平显著降低(P＜0.05),且观察组患者TNF-α、IL-6水平显著低于对照组(P＜0.05);2组治疗后IL-2水平显著升高(P＜0.05),且观察组患者IL-2水平显著高于对照组(P＜0.05)。治疗后,2组溃疡直径、溃疡疼痛均显著降低(P＜0.05),观察组溃疡直径、溃疡疼痛均显著低于对照组(P＜0.05)。观察组总有效率为86.5％,明显高于对照组的75.6％(P＜0.05)。 结论 西帕依固龈液联合双黄连颗粒外用可有效降低复发性口腔溃疡患者的炎性反应,促进溃疡面愈合,减少疼痛,治疗效果满意,值得推广。      

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.