依帕司他联合弥可保治疗糖尿病周围神经病变的疗效观察

目的：探讨依帕司他联合弥可保治疗糖尿病周围神经病变的疗效。方法：把58例患者随机分为两组,对照组30例应用弥可保,治疗组28例应用依帕司他联合弥可保。结果：治疗组总有效率85．7％,显效率25．O％;对照组总有效率66．66％,显效率13．33％,治疗组明显优于对照组（P〈0．05）。两组治疗后正中神经、腓总神经和腓浅神经的感觉神经传导速度（SNCV）和运动神经传导速度（MNCV）与治疗前比较有明显提高,差异有显著性（P〈0．01）;而两组之间比较,则差异无显著性。结论：依帕司他联合弥可保治疗糖尿病神周围经病变效果良好。     

甲钴胺联合前列地尔与依帕司他治疗糖尿病周围神经病变的疗效观察

目的观察甲钴胺、前列地尔与依帕司他联合治疗糖尿病周围神经病变的疗效。方法将90例糖尿病周围神经病变患者随机分为观察组和对照组各45例,观察组用甲钴胺、前列地尔与依帕司他联合治疗,对照组用甲钴胺与前列地尔治疗。结果观察组总有效率为91．1％,对照组为75．6％,观察组疗效好于对照组（P〈0．05）。两组治疗后正中神经和腓总神经的运动传导速度、感觉传导速度均较治疗前明显提高（P〈0．01）,观察组比对照组提高的程度更显著（P〈0．01）。结论甲钴胺、前列地尔与依帕司他联合应用能提高糖尿病周围神经病变的疗效。     

依帕司它联合单唾液酸四己糖神经节苷脂治疗糖尿病周围神经病变疗效观察

目的：观察依帕司它联合单唾液酸四己糖神经节苷脂治疗糖尿病周围神经病变（DPN ）的临床疗效。方法将62例DPN患者随机分为对照组及试验组,每组31例。两组均给予单唾液酸四己糖神经节苷脂钠,试验组在给予单唾液酸四己糖神经节苷脂钠的基础上,加用依帕司他。两组疗程均为4周。比较两组疗效及治疗前后正中神经、腓总神经运动传导速度。结果试验组显效14例,有效12例,无效5例,有效率83．87％;对照组显效8例,有效9例,无效14例,有效率54．83％;试验组有效率优于对照组（ P ＜0．05）。两组治疗后正中神经、腓总神经传导速度均较治疗前改善（P ＜0．05）,试验组改善优于对照组（P ＜0．05）。两组治疗过程中均未发生明显不良反应。结论依帕司他联合单唾液酸四己糖神经节苷脂治疗DPN疗效优于单用单唾液酸四己糖神经节苷脂。     

通塞脉片联合依帕司他治疗糖尿病周围神经病变的疗效

目的观察通塞脉片联合依帕司他治疗糖尿病周围神经病变的疗效。方法将62例糖尿病周围神经病变患者随机分为治疗组和对照组（各3l例）,在常规糖尿病综合治疗的基础上对照组给予依帕司他片,治疗组在依帕司他片基础上加服通塞脉片。两组疗程均为8周,治疗结束后比较两组患者的神经传导情况及临床效果。结果经过8周治疗,治疗组总有效率（87 .10％）明显高于对照组（58 .06％）,差异有统计学意义（P〈0.05）,治疗组神经传导速度改善情况明显优于对照组（P〈0.05）。结论通塞脉片联合依帕司他治疗糖尿病周围神经病变的临床疗效显著,好于依帕司他单独用药。     

葛根素和依帕司他联合应用对糖尿病周围神经病变的临床疗效

目的使用葛根素与依帕司他联合治疗糖尿病周围神经病变患者,对其疗效进行评价。方法对我院2016年11月至2018年2月收治的104例糖尿病周围神经病变患者分组研究,参照组单纯使用依帕司他治疗,联合组给予葛根素与依帕司他治疗,对两组治疗结果进行比较。结果与参照组相比,联合组总有效率明显更高(P0.05);联合组神经传导速度增加比参照组更为明显(P0.05)。结论葛根素联合依帕司他治疗糖尿病周围神经病变效果理想,可增加其神经传导速度,值得应用。     

胰激肽原酶肠溶片治疗糖尿病周围神经病变的疗效评价

目的评价胰激肽原酶肠溶片治疗糖尿病性周围神经病变（DPN）的疗效。方法90例DPN患者分成观察组和对照组。对照组予以依帕司他治疗。观察组采用胰激肽原酶肠溶片联合依帕司他治疗。结果观察组总有效率为88．89％,高于对照组总有效率66．67％,具有显著差异（P〈0．05）。两组患者治疗后神经传导速度均有明显改善（P〈0．01）。治疗后,观察组腓总神经的感觉神经传导速度及运动神经传导速度优于对照组,具有显著差异（P〈0．05）。两组患者在治疗期间均未发现明显不良反应。结论胰激肽原酶肠溶片联合依帕司他治疗DPN患者疗效佳,而且也较安全。     

依帕司他片治疗糖尿病并发周围神经病变的临床疗效探讨

目的:观察糖尿病并发周围神经病变应用依帕司他片治疗的临床疗效。方法:采集我院内科2017年12月—2018年12月收治的80例糖尿病合并周围神经病变患者临床资料,按不同治疗方案分为两组,每组40例,对照组施予甲钴胺治疗,观察组在其基础予依帕司他片治疗,比较两组疗效、神经传导速度。结果:观察组治疗总有效率相较于对照组更高(P<0.05);观察组治疗后腓总神经运动支、腓总神经感觉支、正中神经运动支、正中神经感觉支相较于对照组速度均高(P<0.05)。结论:糖尿病并发周围神经病变用依帕司他片治疗的效果显著,能缓解下肢疼痛、麻木等神经病变症状,改善神经传导。     

依帕司他联合弥可保治疗糖尿病周围神经病变疗效观察

目的探讨依帕司他联合弥可保在治疗糖尿病周围神经病变中的临床价值和安全性。方法选择我院2007～2009年收治的糖尿病周围神经病变患者78例,随机分为观察组和对照组,每组各39例,对照组给予弥可保治疗,初始剂量0．5mg／次,1次,d,肌内注射,4周后改口服弥可保0．5mg／次,3次／d,服用8周;观察组在此基础上给予依帕司他片50mg／次,3次／d,疗程为12周。分别于治疗前后比较两组患者的神经传导速度、总症状积分（TSS）、下肢神经损害（NIS—LL）评分、神经症状改变（NSC）评分。结果观察组治疗后总有效率达92_3％,显著高于对照组（59．0％）（P〈0．05）：治疗12周后两组患者神经传导速度均有所改善（P〈0．05）,但观察组改善幅度显著好于对照组（P〈0．05）．且观察组在TSS、NSC和NIS—LL评分方面显著好于对照组（P〈0．05）。结论依帕司他联合弥可保治疗糖尿病周围神经病变效果显著,能有效改善患者周围神经病变症状,提升神经传导速度,且安全。     

依帕司他结合甲钴胺治疗糖尿病周围神经病变的临床效果观察

目的：探究依帕司他结合甲钴胺治疗糖尿病周围神经病变的临床效果。方法选取70例糖尿病周围神经病变患者,随机分为对照组和观察组,每组各35例,对照组进行常规治疗,观察组采用依帕司他结合甲钴胺治疗,将治疗结果进行对比。结果观察组的正中神经和腓总神经的感觉神经传导速度,治疗后得到显著改善,对照组治疗前后的神经传导速度无明显变化,2组比较差异具有统计学意义（P＜0.05）。观察组总有效率94.29%明显高于对照组68.57%,差异具有统计学意义（P＜0.05）。结论依帕司他结合甲钴胺治疗糖尿病周围神经病变能够有效的改善患者神经传导速度,治疗效果显著,值得在临床中借鉴和使用。     

依帕司他联合甲钴胺治疗糖尿病周围神经病变的临床观察

目的：探讨依帕司他联合甲钴胺治疗糖尿病周围神经病变（DPN）的临床疗效。方法：选择住院期间糖尿病合并神经病变患者80例,随机分为治疗组和对照组,每组各40例,均给予常规降血糖、调节血脂治疗。治疗组应用依帕司他联合甲钴胺治疗;对照组肌内注射维生素B,和维生素B12;2周为1个疗程,观察两组治疗前后的疗效变化。结果：治疗组疗效明显优于对照组,差异有统计学意义（P〈0．05）。治疗组治疗后正中神经与腓总神经的运动神经传导速度和感觉神经传导速度均优于治疗前,差异有统计学意义（P〈0．05）。结论：依帕司他联合甲钴胺治疗DPN疗效显著,值得临床推广使用。     

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.