急性心肌梗死致心脏骤停复苏后的溶栓治疗

目的：探讨急性心肌梗死合并心脏骤停患者心肺复苏后溶栓的效果。方法：对2003年3月至2009年3月间救治的96例急性心肌梗死所致心脏骤停行心肺复苏的37例患者,行心肺复苏后静脉溶栓治疗,观察疗效。结果：37例行溶栓治疗,存活31例,占83.78%,死亡6例,占16.22%;59例未行静脉溶栓治疗,存活32例,占54.24%;死亡27例,占45.76%。两组存活率比较差异有统计学意义（P﹤0.05）。结论：急性心肌梗死合并心脏骤停患者在心肺复苏后进行溶栓治疗,可明显提高患者的复苏成功率,并能改善患者的生活质量。     

急性心肌梗塞心肺复苏后溶栓治疗

目的　探讨急性心肌梗塞心肺复苏后溶栓治疗的可行性、必要性及预后。方法　急性心肌梗塞并发心脏骤停的患者 2 2例。治疗组 13例 ,心肺复苏后即刻静脉予尿激酶 12 0～ 2 0 0万U、链激酶 150万 U或 rt- PA50 mg溶栓治疗 ,部分行冠状动脉造影检查。对照组 9例 ,在心肺复苏后予除溶栓外的积极抢救治疗。结果　治疗组 13例中 11例复苏后溶栓再通 ,占 84 .6。住院死亡 3例 ( 2 0 .1% )。 9例随访 3.3± 1.5( 1～ 6)年 ,3例死亡。对照组心肺复苏 4 8小时后无一例存活。两组急救存活率有显著性差异 ( P<0 .0 0 1)。结论　在没有条件实行急诊血管重建的医院 ,急性心肌梗塞心肺复苏后溶栓治疗能明显提高其住院存活率     

急性心肌梗死心跳骤停患者心肺复苏后静脉尿激酶溶栓疗效观察

目的：探讨急性心肌梗死（AMI）心跳骤停患者心肺复苏（CPR）后静脉尿激酶溶栓临床疗效观察。方法：AMI并发呼吸心跳骤停CPR成功患者11例。随机分为治疗组5例,心肺复苏后即刻静脉给予尿激酶150万U,30分内静脉注射;对照组6例,在心肺复苏后予除静脉溶栓外的积极抢救治疗。结果：治疗组的自主循环、自主呼吸恢复例数,24小时存活例数和出院存活例数明显高于对照组,自主循环恢复时间、自主呼吸恢复时间明显短于对照组。结论：AMI患者心肺复苏后进行溶栓治疗,能明显提高患者的自主循环、自主呼吸恢复率、24小时存活率、出院存活率,缩短自主循环、自主呼吸恢复时间,且不增加继发出血发生率。     

急性心肌梗死心肺复苏后行静脉溶栓治疗的临床观察

目的：探讨急性心肌梗死心肺复苏后的静脉溶栓治疗临床疗效。方法回顾分析发生急性心肌梗死,经心肺复苏救治成功后的52例患者（复苏时间小于10 min）,30例复苏后经家属同意给予静脉溶栓治疗（溶栓组）,另外22例给予常规治疗措施,并未溶栓（对照组）。比较2组冠脉再通率以及临床疗效。结果溶栓组30例患者治疗后冠状动脉再通19例（63.33%）,对照组再通3例（13.64%）,2组再通率比较,差异有统计学意义（P<0.05）;溶栓组临床疗效良好17例,良好率为56.67%,优于对照组的13.64%（P<0.05）;溶栓组死亡2例,死亡率6.67%,低于对照组的36.36%,差异有统计学意义（P<0.05）。结论急性心肌梗死心肺复苏成功后给予静脉溶栓治疗冠脉再通率高、临床疗效好,值得临床推广。     

心肺复苏过程中静脉溶栓救治急性心肌梗死临床分析

目的:总结心肺复苏过程中加用尿激酶溶栓救治急性心肌梗死患者的临床效果。方法:对在我院急诊科及ICU病房中发生心跳骤停的6例心梗患者,在心肺复苏过程中加用尿激酶溶栓治疗。结果:6例患者中5例复苏后存活(包括1例脑死亡病例),1例抢救无效于急诊室死亡。结论:对急性心肌梗死并发心跳骤停的患者,在心肺复苏过程中,应积极尽快溶栓治疗,而不应等待自主心跳恢复后再溶栓,以争取时间,最大限度地提高抢救成功率。     

急性心肌梗死患者心肺复苏后静脉溶栓临床疗效观察

目的观察急性心肌梗死患者心肺复苏后静脉溶栓的临床疗效。方法回顾分析我院2002年1月至2010年12月就诊的60例急性心肌梗死患者心肺复苏术后行静脉溶栓（观察组）治疗和同期60例急性心肌梗死患者心肺复苏后未行静脉溶栓（对照组）治疗的临床疗效,比较两组再通率、死亡率及30d内两组临床特征的变化情况。结果两组比较,观察组再通18例,再通率为26.67%;对照组再通3例,再通率为5.00%,观察组再通率明显高于对照组（P〈0.05）,治疗后30d内临床特征变化情况观察组治疗后情况比对照组佳,观察组总有效率为58.33%,高于对照组的30.00%,两组比较差异有统计学意义（P〈0.05）。结论急性心肌梗死患者心肺复苏后行静脉溶栓治疗安全有效,临床疗效明显优于急性心肌梗死心肺复苏后不行静脉溶栓治疗的患者,值得临床推广。     

急性心肌梗死患者心肺复苏后静脉溶栓临床疗效观察

目的观察急性心肌梗死（AMI）患者心肺复苏后静脉溶栓的临床疗效。方法选取河南科技大学第三附属医院2008年2月至2011年2月入诊的60例急性心肌梗死患者心肺复苏后静脉溶栓（观察组）,与同期60例急性心肌梗死患者心肺复苏后不行静脉溶栓（对照组）临床疗效进行比较,比较两组再通率、病死率及并发症发生率。结果两组比较,观察组并发症发生率（13．3％）明显低于对照组（48．3％）。观察组再通47例,再通率为78．3％;对照组再通11例,再通率18．3％。观察组病死率（8．3％）明显低于对照组（35．0％）,两组比较差异有统计学意义（P〈0．05）。结论急性心肌梗死患者心肺复苏后行静脉溶栓临床疗效明显优于急性心肌梗死患者心肺复苏后不行静脉溶栓治疗。     

急性心肌梗死心肺复苏后溶栓治疗的临床观察

目的：探讨急性心肌梗死（AMI）患者心肺复苏（CPR）后静脉溶栓的临床效果。方法选取我院2005年1月-2012年3月就诊的急性心肌梗死并发心搏骤停复苏成功41例患者,随机分为治疗组20例（溶栓组）,对照组21例（常规组）。比较2组患者梗死血管再通率、病死率、出血率。结果与常规组相比溶栓组梗死血管再通率明显提高（P〈0.05）,2组出血发生率无明显差异（P〉0.05）,溶栓组无死亡病例。结论 AMI患者心肺复苏后溶栓治疗安全有效。     

急性心肌梗死心肺复苏术后溶栓的临床研究

目的观察急性心肌梗死（AMI）心肺复苏术后溶栓治疗的有效性和安全性。方法将63例ST段抬高伴心脏骤停心肺复苏成功的AMI患者,根据是否获得溶栓治疗,随机分为溶栓组和对照组。溶栓组31例,对照组32例。两组患者心肺复苏成功后,均给予扩张冠状动脉或抗休克治疗、抗心律失常、脑保护等对症处理,溶栓组给予尿激酶静脉溶栓。结果溶栓纽23例血管再通,对照组4例血管再通,溶栓组患者血管再通率明显高于对照组（P〈0．01）;住院4周平均心脏事件发生率明显低于对照组（P〈0．05）;溶栓组住院4周死亡1例,对照组住院4周死亡9例,病死率明显低于对照组（P〈0．05）;两组患者出血发生率差异无统计学意义（P〉0．05）。结论AMI患者心肺复苏术后行溶栓治疗安全有效。     

门冬氨酸钾对急性心肌梗死溶栓后再灌注心律失常的作用

目的观察急性心肌梗死溶栓后门冬氨酸钾镁对再灌注心律失常的作用。方法62例急性心肌梗死柱院患者随机分观察组30例、对照组32例。62例均行溶栓治疗,对照组予常规治疗;观察组予常规治疗＋门冬氨酸钾镁表静脉滴注,两组同时用心电监护或动态心电图监测。结果62例急性心肌梗死患者中有38例发生再灌注后心律失常．其中观察组14例,占22．6％;对照组24例,占38．7％。两组差异有显著性（P〈0．05）。结论急性心肌梗死早期补门冬氨酸钾镁能隆低再灌注心律失常的发生率。     

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.