雌激素用于治疗绝经后妇女泌尿系统感染的临床研究

目的 :探讨阴道使用雌激素治疗绝经后妇女反复泌尿系统感染的效果及可行性。方法 :将 84例有反复泌尿系统感染病史的绝经后妇女分成两组 ,阴道局部使用雌激素 (己烯雌酚 ) 5 4例 (雌激素组 ) ,口服抗生素 30例 (抗生素组 ) ,疗程 3个月。结果 :治疗后雌激素组泌尿系统感染的发生率明显低于抗生素组 ,两组比较 ,差异有极显著性 (P<0 0 0 1)。结论 :阴道局部使用雌激素 ,能有效减少绝经后妇女泌尿系统感染的反复发作 ,较使用抗生素副反应轻 ,治疗效果明显提高。     

绝经后女性冠心病患者性激素水平与降钙素基因相关肽和内皮素的关系

测定 40例绝经前后正常妇女及 30例绝经后冠心病 (CHD)妇女性激素、血浆降钙素基因相关肽 (CGRP)和内皮素 (ET 1)水平。将 30例冠心病 (CHD)妇女随机分为两组 ,治疗组服尼尔雌醇 ,对照组服用安慰剂 ,疗程 2 4周。结果显示 ,绝经后妇女雌激素 (E2 )、降钙素基因相关肽 (CGRP)降低 ,睾酮 (T)、内皮素 (ET 1)升高 ,而女性冠心病患者此种改变更显著 ;E2 与CGRP呈正相关 ,与ET 1呈负相关 ;T与ET 1、CGRP相关程度不显著 ;尼尔雌醇治疗后CGRP上升 ,ET 1下降。提示雌激素对血管内皮细胞有一定效应 ,这可能是其心血管保护作用的重要机制之一。     

骨膦用于治疗绝经后妇女骨质疏松症的临床疗效观察

骨质疏松症是绝经后妇女一种常见的严重并发症,因骨量减少及骨组织微结构的破坏使骨脆性增加,故轻微撞伤即可使患者发生骨折。骨质疏松症的治疗通常包括雌激素疗法、降钙素、氟化物、一磷酸盐等,其中骨膦是二磷酸盐类化合物中第一代产品之一,近年来用于治疗骨质疏松,疗效较明显。本实验观察骨膦在国内绝经后妇女中的临床疗效。选择1996年12月～1997年9月于本院妇科内分泌就诊的绝经后妇女,45岁以上,绝经1～10年的骨质疏松患者,其腰椎或髋骨的骨密度低于正常绝经前妇女骨密度平均值两个标准差。选取符合用药条件的患者14例,无禁忌证。骨膦(由…     

激素治疗与阿尔茨海默病发病风险：关键的时期

人们对绝经后妇女采用激素治疗对健康的影响可能一直不甚关注。最近，一个绝经后激素治疗随机临床试验，即妇女健康启动(Women’s Health Initiative．WHI)研究，在平均随访5．2年后提前(计划随访8．5年)终止了雌激素加孕激素联合治疗组(而不是单用雌激素治疗)。初步结果显示，接受雌激素加孕激素     

骨质疏松新疗法

在国家骨质疏松基金会、美国骨和矿物质研究学会和国立卫生研究院主持召开的第二届国际骨质疏松症研究进展会议上,研究人员报告了骨质疏松新疗法的研究进展。在临床试验中显示疗效的治疗是二磷酸盐和用鼻喷雾式的降钙素。一项尚未发表的研究的初步结果提示一种新的、联合激素疗法确能增加骨质疏松妇女脊柱骨质密度。而降钙素-鲑(由Rorer药品公司生产的一种降钙素)近来被批准治疗雌激素禁忌的、已确诊的骨质疏松,但因它需定期注射,所以未用以预防骨质疏松。丹麦Glostrup医院的GlausChristiansen进行一项对照研究了37名确诊为绝经后的骨质疏松症妇女,结果表明,一种新     

北京市房山区绝经前后妇女骨代谢情况报告

测定北京房山区１４４例绝经前后妇女桡骨骨密度值及４３例绝经妇女血清钙、雌激素、降钙素、甲状旁腺素值。结果表明：随着年龄和绝经年限的增加，骨密度值显著下降。血清钙各年龄组变化不大。雌激素、降钙素绝经后逐渐降低，甲状旁腺素明显增加，多因素回归分析提示，年龄、绝经年限、孕次、人工流产次数、服用营养补品、经济水平、雌激素、甲状旁腺素是影响骨密度的主要因素。     

绝经后妇女骨密度与血清降钙素及血清骨型碱性磷酸酶的关系

目的 :探讨绝经后妇女骨密度与血清降钙素及血清骨型碱性磷酸酶的关系 ;方法 :测定 15 0例绝经后妇女的上述 3项指标 ,并以 42例中青年妇女作对照 ;结果 :绝经后妇女骨密度与血清降钙素呈显著正相关关系 (r =0 .413 ,P <0 .0 1) ,而与血清骨型碱性磷酸酶呈显著负相关关系 (r =-0 .5 12 ,P <0 .0 5 ) ,并且绝经后妇女骨密度和血清降钙素显著低于中青年妇女 (P <0 .0 5 ,P <0 .0 1) ,而血清骨型碱性磷酸酶则显著高于中青年妇女 (P <0 .0 5 ) ;结论 :绝经后妇女骨密度和血清降钙素显著降低 ,而血清骨型碱性磷酸酶明显升高 ,易患骨质疏松症 ,应针对病因 ,及早防治     

生活质量指标在绝经后骨质疏松症治疗方案评价中的作用

目的 评价生活质量指标在评价绝经后骨质疏松症的三种常见治疗方案即雌激素替代疗法、补充维生素D加钙和二膦酸盐治疗的医疗后果中的作用。方法 将100例确诊为绝经后骨质疏松症的病人分为四组，其中对照组25例，雌激素替代疗法组25倒，维生素D加钙组25例，二膦酸盐组25例。重复测量治疗前、治疗后3个月和治疗后12个月的骨密度和生活质量评分，并分析生活质量评分的改变与骨密度的相关性。结果 二磷酸盐组和雌激素替代疗法组治疗一段时间后，生活质量评分总分以及疾病维度和生理维度的评分和对照组相比差异有统计学意义（F=13．335，P〈0．01），而维生素D加钙组与对照组相比差异无统计学意义；其他3个维度，4个处理组之间比较差异均无统计学意义。生活质量疾病评分的改变与各个部位骨密度变化均有直线相关关系，相关系数为0．608—0．827。结论 生活质量指标可以作为绝经后骨质疏松症治疗方案评价的指标和依据之一。     

绝经后妇女泌尿系感染应用小剂量雌激素预防治疗的效果观察

目的：探讨小剂量雌激素在绝经后妇女泌尿系感染预防治疗中的临床价值。方法：选取我院自20lO年8月～2012年8月收治的92例泌尿系感染绝经后妇女随机分为观察组与参考组，各为46例，观察组患儿采用左氧氟沙星治疗，观察组患儿在此基础上联合使用雌三醇软膏，比较2组患者的临床治疗率、不良反应发生率及复发率。结果：观察组患者治疗总有效率为91．3％，参考组患者治疗总有效率为78．3％，数据比较有统计学意义，P〈0．05；2组患者均未出现明显不良反应，P〉0．05；停药6个月后，观察组患者复发率明显低于参考组，P〈0．05，有统计学意义。结论：小剂量雌激素预防治疗绝经后妇女泌尿系感染效果显著，不良反应少，治疗彻底，值得推广。     

绝经后女性冠心病患者性激素水平与降钙素基因相关肽和内皮素的关系

测定40例绝经前后正常妇女及30例绝经后冠心病（CHD）妇女性激素、血浆降钙素基因相关肽（CGRP）和内皮素（ET-1）水平。将30例冠心病（CHD）妇女随机分为两组,治疗组服尼尔雌醇,对照组服用安慰剂,疗程24周。结果显示,绝经后妇女雌激素（E2）、降钙素基因相关肽（CGRP）降低,睾酮（T）、内皮素（ET-1）升高,而女性冠心病患者此种改变更显著;E2与CGRP呈正相关,与ET-1呈负相关;T与ET-1、CGRP相关程度不显著;尼尔雌醇治疗后CGRP上升,ET-1下降。提示雌激素对血管内皮细胞有一定效应,这可能是其心血管保护作用的重要机制之一。     

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.