倍他乐克治疗慢性充血性心衰的疗效观察

目的：探讨β受体阻滞剂在慢性充血性心力衰竭中的疗效。方法：选择38例慢性充血性心力衰竭患者,在常规应用强心、利尿、扩血管药物的基础上,加用β受体阻滞剂倍他乐克治疗2个月后观察心力衰竭患者心率、血压和心功能的变化。结果：应用倍他乐克后心力衰竭患者心功能分级显著改善,心率明显降低,收缩压和舒张压也显著降低。结论：在常规抗心力衰竭药物治疗基础上加用β受体阻滞剂可明显改善慢性心力衰竭患者的心功能,提高生活质量,延长患者寿命。     

倍他乐克在慢性充血性心力衰竭中的应用

目的:探讨β受体阻滞剂倍他乐克在慢性充血性心力衰竭中的疗效。方法:选择56例慢性充血性心力衰竭住院患者,随机分为治疗组和对照组,治疗组在常规应用强心、利尿、扩血管药物的基础上,加用β受体阻滞剂倍它乐克。结果:治疗3个月后治疗组心力衰竭患者心功能分级显著改善,心率明显降低,收缩压及舒张压也显著降低。结论:在常规抗心力衰竭药物治疗基础上加用β受体阻滞剂可明显改善慢性心力衰竭患者的心功能,提高生活质量,延长患者寿命。     

ACEI联合β受体阻滞剂治疗慢性心力衰竭患者的临床疗效分析

目的 探讨ACEI联合β受体阻滞剂治疗慢性心力衰竭患者的临床疗效.方法 选取60例慢性心力衰竭患者,随机分为对照组与观察组,对照组采用常规治疗,观察组采用在常规治疗基础上加用ACEI联合β受体阻滞剂治疗,对比分析2组疗效.结果 经过治疗后观察组在TEI指数、LVEF、SV、LVEDD改善显著优于对照组,差异有统计学意义(P<0.05),观察组治疗总有效率为90.00%,明显高于对照组,差异有统计学意义(P<0.05).结论 ACEI联合β受体阻滞剂治疗慢性心力衰竭患者有益于改善患者心功能,疗效显著,值得在临床应用中推广.     

倍他乐克对冠心病心力衰竭的治疗观察

目的探讨β-受体阻滞剂在治疗冠心病心力衰竭中的疗效。方法选择冠心病心力衰竭患者36例,在常规应用强心、利尿、扩血管药物治疗基础上,加用β-受体阻滞剂倍他乐克12.5～50mg/d6周,用自身对照比较治疗前后患者心率、血压、心胸比率,左心室射血分数的变化,评估其有效性和安全性。结果患者心率减慢、血压降低、心胸比率缩小,左室射血分数增加P<0.01,心功能明显改善。结论在常规抗心衰药物基础上加用β-受体阻滞剂倍他乐克不仅能有效地改善心功能状态,而且能逆转心脏扩大。     

卡维地络、倍他乐克治疗慢性心力衰竭的疗效比较

目的:对比卡维地洛和倍他乐克治疗两种不同类型的β-受体阻滞剂对慢性心力衰竭的临床疗效.方法:将60 例慢性心力衰竭患者在常规治疗心力衰竭基础上随机分为卡维地洛组(n=30 例)和倍他乐克组(n=30 例),随治6~12 个月观察两组治疗前后心率、左室射血分数(LVEF) 及心功能变化.结果:两组间治疗前、后,在心率及LVEF 方面.无统计学意义(P>0.05),但同组治疗前后有差异(P<0.05); 两组间有效率有差异(P<0.05).结论:卡维地络在LVEF 及心率方面比倍他乐克的优越性,卡维地洛在治疗慢性心力衰竭中安全有效,且有效率优于倍他乐克组.     

老年慢性充血性心力衰竭小剂量倍他乐克疗效观察

目的观察倍他乐克治疗老年慢性充血性心力衰竭的临床疗效和安全性。方法将60例病因不同的老年心衰患者随机分为两组,对照组按常规抗心力衰竭治疗,治疗组常规心力衰竭治疗加倍他乐克。结果两组治疗前后血压、心率明显降低,而治疗组改变较对照组更明显,P〈0.05。两组治疗前后心功能指标均有显著提高,但治疗组心功能改善明显优于对照组。结论对于老年慢性充血性心力衰竭小剂量应用β-受体阻滞剂倍他乐克,是一种安全有效的治疗方法,在临床上值得推广应用。     

美托洛尔治疗慢性充血性心力衰竭临床研究

目的评价美托洛尔治疗慢性心力衰竭的临床疗效及安全性。方法 120例慢性充血性心力衰竭患者除治疗原发性病因及诱因外随机分为对照组和治疗组。对照组采用常规抗心力衰竭:强心剂(地高辛)、利尿剂(速尿、氨体舒通)和扩血管药物(卡普托利)及对症辅助治疗;治疗组在常规治疗的基础上加用β受体阻滞剂(美托洛尔)治疗,2个月后观察心力衰竭患者心率、血压和心功能的变化心功能改善一级者为有效。结果应用美托洛尔后心力衰竭患者心功能分级显著改善,心率明显降低,收缩压和舒张压显著降低。结论β受体阻滞剂美托洛尔能显著改善心功能,提高患者生活质量及增加运动量。     

倍他乐克治疗慢性充血性心力衰竭疗效观察

目的：探讨倍他乐克在慢性充血性心力衰竭中的疗效。方法：选择56例慢性充血性心力衰竭患者,随机分为两组．治疗组在常规应用强心、利尿、扩血管药物的基础上,加用倍他乐克。2个月后观察患者心功能、心率的变化,评估其临床疗效。结果：应用倍他乐克后心力衰竭患者心功能分级显著改善,心率明显降低。结论：在常规抗心力衰竭药物治疗基础上加用倍他乐克可明显改善慢性心力衰竭患者的心功能。     

β受体阻滞剂治疗慢性心力衰竭20例疗效观察

目的观察β受体阻滞剂治疗慢性心力衰竭的疗效。方法将慢性心力衰竭患者40例随机分为对照组和观察组。对照组应用强心、利尿、扩血管药治疗;观察组在对照组治疗的基础上加用倍他乐克,1周后酌情加量至12.5 mg,2次/d,以后逐渐增至患者的最大耐受量。观察半年,比较2组治疗前后静息心率、心脏射血分数、心功能分级等临床指标变化,评估β受体阻滞剂的临床有效性和安全性。结果β受体阻滞剂在改善静息心率,改善心功能,降低病死率及住院率方面较对照组效果明显。结论β受体阻滞剂可明显改善心脏功能,提高患者生存质量,延缓心力衰竭进程。     

选择性β受体阻滞剂治疗慢性心衰的疗效观察

目的 观察选择性β受体阻滞剂治疗慢性心衰的临床疗效。方法 １５０例患者随机分成两组,７５例为治疗组,用倍他乐克加常规疗法,７５例为对照组,单用常规疗法。结果 治疗组在改善心功能、减慢心率和降低病死率方面均成于对照组,两组比较有显著差异（Ｐ〈０．０５）。结论 在常规综合疗法的基础上加用选择性β受体阻滞剂治疗慢性心衰可明显提高疗效。     

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.     

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.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.