纳洛酮联合麝香注射液治疗大面积脑梗塞的疗效观察

目的应用纳洛酮联合麝香注射液与单用纳洛酮或麝香注射液对大面积脑梗塞的临床疗效进行比较.方法将133例伴有意识障碍的大面积脑梗塞患者随机分为治疗组(纳洛酮联合麝香注射液组)、对照1组(纳洛酮组)、对照2组(麝香组),对3组患者治疗后的意识状态好转的起效时间及15天后神经功能缺损评分、临床疗效的总有效率进行比较.结果治疗组与对照1组及对照2组间意识状态好转的起效时间、神经功能缺损评分、临床疗效的总有效率比较均有显著性差异(P＜0.05,P＜0.01,P＜0.05).结论纳洛酮联合麝香注射液治疗大面积脑梗塞比单用纳洛酮或麝香注射液效果更理想,且无明显的不良反应.     

依达拉奉联合醒脑静注射液治疗急性脑出血的临床效果研究

目的探讨依达拉奉联合醒脑静注射液治疗急性脑出血的临床疗效。方法急性脑出血患者63例随机分为观察组和对照组,观察组（31例）给予依达拉奉联合醒脑静注射液治疗,对照组（32例）单用醒脑静注射液治疗,比较两组显效率及神经功能缺损评分。结果观察组显效率74．2％高于对照组的40．6％（P〈0．01）;两组治疗后神经功能缺损评分较治疗前均明显下降;观察组治疗后神经功能缺损评分低于对照组（P〈0．01）。结论依达拉奉联合醒脑静注射液治疗急性脑出血疗效优于单用醒脑静注射液治疗。     

穴位注射醒脑静联合纳洛酮治疗高血压脑出血84例临床分析

目的探讨穴位注射醒脑静联合静脉滴注纳洛酮治疗高血压脑出血（HICH）的临床效果。方法选择高血压脑出血患者84例为研究对象,随机分为两组,各42例。对照组给予常规治疗,观察组在常规治疗基础上给予穴位注射醒脑静联合静脉滴注纳洛酮治疗。观察两组治疗10 d后神经功能恢复情况及治疗效果。结果观察组总有效率为92.86%,高于对照组的73.81（P〈0.05）。观察组治疗后神经功能缺损程度评分低于同组治疗前及对照组治疗后（P〈0.01）。结论常规治疗基础上给予穴位注射醒脑静联合静脉滴注纳洛酮治疗HICH疗效显著,可改善神经功能,提高治疗效果,值得临床推广。     

纳洛酮联合醒脑静治疗高血压性脑出血的临床疗效观察

目的：观察纳洛酮联用醒脑静治疗高血压性脑出血的临床疗效及对血肿的影响。方法根据随机数字表法将120例高血压性脑出血患者分为对照组、纳洛酮组、醒脑静组和联合治疗组,每组30例。对照组采用常规方法治疗,纳洛酮组、醒脑静组和联合治疗组在此基础上加用纳洛酮、醒脑静和两种药物联合治疗。观察并比较患者治疗前和治疗后第3、7、15和30天的血肿量、脑水肿指数、神经功能缺损评分。结果在治疗前和治疗后第3天,对照组、纳洛酮组、醒脑静组和联合治疗组间血肿量、脑水肿指数和神经功能缺损评分比较差异均无统计学意义（均P＞0.05）;在治疗后第7、15和30天,对照组、纳洛酮组、醒脑静组和联合治疗组间血肿量、脑水肿指数和神经功能缺损评分比较差异均有统计学意义（均P＜0.05）。联合治疗组血肿量、脑水肿指数和神经功能缺损评分较纳洛酮组和醒脑静组显著低于对照组（均P＜0.05）。结论纳洛酮联用醒脑静治疗高血压性脑出血可以更好地促进血肿吸收,减轻脑水肿,改善神经功能缺损。     

醒脑静与纳洛酮治疗高血压脑出血的疗效及安全性评价

目的探讨醒脑静与纳洛酮联合治疗高血压脑出血微创血肿清除术后的疗效及安全性。方法 102例高血压脑出血患者分为观察组52例,给予醒脑静与纳洛酮联合治疗,对照组50例,给予纳洛酮治疗。比较两组患者总体疗效,治疗前、后神经功能缺损评分(GCS)、日常生活能力(ADL)以及安全性。结果治疗后两组在总体疗效、神经功能缺损评分以及ADL分级方面比较,观察组均显著优于对照组(P<0.05)。结论纳洛酮与醒脑静联用治疗高血压脑出血疗效确切,能改善患者神经功能缺损评分、日常生活能力,减少患者死亡率,安全性好。     

醒脑静治疗高血压脑出血45例临床疗效观察

目的：观察醒脑静注射液治疗高血压性脑出血的临床疗效。方法：将45例出血量30～50ml的高血压性脑出血患者随机分为醒脑静治疗组25例和常规治疗对照组20例。治疗组加醒脑静注射液20ml静脉滴注。结果：醒脑静治疗高血压性脑出血的总有效率为96％,明显高于常规治疗组的70％,差异有显著性（P〈0．05）;醒脑静治疗后病人意识恢复时间平均为27．6h,较常规治疗组意识恢复时间平均38．7h缩短,两者相比差异具有显著性（P〈0．05）。醒脑静治疗组再出血3例（占7．1％）,对照组再出血6例（占15．7％）,两者相比差异有显著性（P〈0．05）。结论：醒脑静注射液的合用,显著提高了总有效率、显效率,病人日常生活能力、神经功能缺损恢复程度明显提高,致残率和再出血率亦明显降低。     

醒脑静注射液辅佐血肿清除术治疗高血压性脑出血的临床观察

目的:探讨醒脑静注射液辅佐血肿清除术治疗高血压性脑出血的临床疗效。方法:将80例出血量≥30ml的高血压性脑出血患者随机分为治疗组42例和对照组38例。两组均在常规治疗基础上进行早期颅内血肿微创清除术。治疗组加醒脑静注射液20ml静脉滴注。结果:治疗组总有效率、显效率、日常生活能力、治疗后神经功能缺损程度评分、平均催醒时间与对照组比较均有显著性差异(P<0.05)。结论:醒脑静注射液辅佐血肿清除术治疗高血压性脑出血能明显提高总有效率和显效率,提高神经功能缺损恢复程度及患者的日常生活能力,缩短昏迷时间。     

醒脑静注射液辅佐血肿清除术治疗高血压性脑出血的临床观察

目的探讨醒脑静注射液辅佐血肿清除术治疗高血压性脑出血的临床疗效。方法将80例出血量≥30ml的高血压性脑出血患者随机分为治疗组42例和对照组38例。两组均在常规治疗基础上进行早期颅内血肿微创清除术。治疗组加醒脑静注射液20ml静脉滴注。结果治疗组总有效率、显效率、日常生活能力、治疗后神经功能缺损程度评分、平均催醒时间与对照组比较均有显著性差异(P<0.05)。结论醒脑静注射液辅佐血肿清除术治疗高血压性脑出血能明显提高总有效率和显效率,神经功能缺损恢复程度,提高患者的日常生活能力,缩短昏迷时间。     

依达拉奉联合醒脑静治疗高血压性脑出血术后并发脑梗死的临床疗效观察

目的观察联合应用依达拉奉和醒脑静治疗高血压性脑出血术后并发脑梗死的临床疗效。方法将60例高血压性脑出血术后并发脑梗死患者随机分为对照组和观察组,对照组在常规疗法的基础上给予醒脑静注射液,观察组在对照组的基础上再联合应用依达拉奉注射液。治疗前后对患者进行格拉斯哥昏迷评分（GCS）和神经功能缺损评分（NDS）并作比较,同时观察两组患者的治疗有效率和不良反应发生率。结果治疗后,所有患者的GCS评分和NDS评分均显著降低（P〈0.01）,且观察组的评分低于对照组（P〈0.05）;对照组的总有效率为50%,观察组的总有效率为76.7%,差异具有统计学意义（P〈0.01）;两组患者在治疗后均未见明显的不良反应。结论依达拉奉联合醒脑静治疗高血压性脑出血术后脑梗死效果优于单一用药,有效改善脑梗死患者的手术预后。     

醒脑静治疗脑出血伴意识障碍100例观察

目的观察脑出血伴意识障碍患者应用醒脑静的临床疗效。方法将100例脑出血伴意识障碍患者随机分为治疗组、对照组,治疗组以醒脑静注射液加西医常规治疗,对照组为西医常规治疗;通过Glasgow昏迷计分法（GCS）及神经功能缺损程度评分比较两组治疗前后临床疗效。结果治疗后治疗组总有效率明显高于对照组,其治疗后神经功能缺损程度评分改善优于对照组,GCS评分亦明显提高。结论常规治疗基础上配合醒脑静注射液治疗脑出血伴意识障碍对意识障碍改善,神经功能缺损均有较显著疗效。     

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.     

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.