左卡尼汀联合促红细胞生成素治疗维持性血透患者贫血的临床观察

目的观察左卡尼汀联合促红细胞生成素（r-HEpo）对维持性血透患者（MHD）贫血的疗效及对促红细胞生成素剂量的影响。方法将55例维持性血透贫血患者随机分为两组,均在血液透析治疗后皮下注射r-HEpo,剂量100～150u/kg,分为2～3次注射,当Hb≥100g/L,RBC压积（Hct）≥30后逐渐减量,治疗组每次透析后予以左卡尼汀1.0iv,疗程三月。结果两组Hb、Hct较治疗前均有所提高（P〈0.01）,治疗组较对照组提高更明显（P〈0.05）,治疗组促红细胞生成素维持量少。结论左卡尼汀联合促红细胞生成素能提高维持性血透患者贫血的治疗疗效,减少促红细胞生成素的用量。     

左旋肉毒碱和蔗糖铁对血透患者贫血氧化应激的影响

目的 研究左旋肉毒碱和蔗糖铁对维持性血液透析（MHD）患者贫血及氧化应激的影响.方法 选择MHD合并贫血的患者40例,随机分为实验组和对照组,各20例.实验组给予左旋肉毒碱＋蔗糖铁＋促红素,对照组给予蔗糖铁＋促红素.分别测定治疗前及治疗后2个月及4个月血红蛋白（Hb）、红细胞压积（Hct）、血清铁蛋白（SF）、转铁蛋白饱和度（TSAT）及丙二醛（MDA）、超氧化物歧化酶（SOD）的水平.结果 2组治疗4个月后贫血指标（Hb、Hct、SF、TSAT）均有明显改善,治疗4个月后对照组MDA较治疗前明显升高（P＜0.05）、SOD明显降低（P＜0.05）,实验组4个月后MDA与治疗前比较有上升趋势,但差异无统计学意义（P＞0.05）,SOD明显上升（P＜0.05）.结论 左旋肉毒碱和蔗糖铁对维持性血液透析患者贫血有明显治疗作用,左旋肉毒碱可缓解蔗糖铁引起的氧化应激反应.     

左卡尼汀对改善维持性血液透析患者营养不良及微炎症状态的临床研究

目的：观察静脉注射左卡尼汀对维持性血液透析患者（MHD）营养状态及微炎症状态指标的影响。方法：选择透析龄超过3月的MHD患者40例,随机分为治疗组22例,对照组18例。治疗组每次结束透析时静脉注射左卡尼汀1 g,对照组注射等量生理盐水,治疗3个月,分别检测治疗前后MHD患者的白蛋白（Alb）、前白蛋白（PA）、血红蛋白（Hb）、身体质量指数（BMI）、C反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）和白介素-6（IL-6）水平变化。结果：治疗组Alb、PA、Hb和BMI水平均较治疗前明显上升（P〈0.05）,而CRP、TNF-α和IL-6水平均较治疗前明显下降（P〈0.05）;对照组Alb、PA、Hb、BMI、CRP、TNF-α和IL-6治疗前后差异无统计学意义（P〉0.05）。结论：左卡尼汀能改善MHD患者营养不良及微炎症状态。     

左旋卡尼汀对维持性血液透析患者微炎症、贫血和心功能的影响

目的：观察左旋卡尼汀对维持性血液透析（MHD）患者微炎症、贫血和心功能的影响,探讨左旋卡尼汀对MHD患者的治疗作用。方法：选择已排除急性感染及其他活动性疾病、透析龄超过6个月的MHD患者42例,随机分为治疗组（22例）和对照组（20例）。每次透析结束后,治疗组给予静脉注射左旋卡尼汀2g,对照纽注射等量的生理盐水。观察治疗前及治疗4个月后患者炎症介质、营养状况、贫血和心脏结构与心功能。结果：与治疗前相比,治疗组的超敏C反应蛋白（Hs．CRP）、白介素（IL-6）显著下降,血红蛋白（Hb）、红细胞压积（Hct）显著升高,左心室收缩末内径（LVDs）,左心室射血分数（LVEF）明显改善;与对照组比较,治疗组的Hs-CRP、IL-6、Hb、Hct、LVDs、左心室舒张末内径（LVDd）、LVEF差异显著。结论：左旋卡尼汀可改善MHD微炎症状态、贫血和心功能,可作为MHD患者的一种长期治疗药物。     

左卡尼汀和蔗糖铁对血液透析患者肾性贫血氧化应激的干预作用

目的研究左卡尼汀和蔗糖铁对血液透析患者肾性贫血及氧化应激的影响。方法 80例血液透析患者随机分为对照组（单用蔗糖铁）和治疗组（左卡尼汀＋蔗糖铁）,两组各40例。分别测定两组治疗前及治疗后3、6月贫血指标（Hb、Hct、SF、TSAT）和氧化应激指标（AOPP、MDA）的水平。结果①两组透析患者的贫血指标均低于正常值,AOPP、MDA明显升高。②两组治疗3个月时AOPP、MDA较前增加但无统计学意义（P〉0.05）。两组患者共有75人贫血指标达标。③治疗6个月时对照组MDA、AOPP与治疗前比较明显升高（P〈0.05）,治疗组有上升的趋势（P〉0.05）,治疗组EPO剂量低于对照组（P〈0.05）。结论左卡尼汀和蔗糖铁对血透患者肾性贫血有明显的治疗效果,蔗糖铁加重患者的氧化应激（OS）,而左卡尼汀对OS有明确的缓解作用。     

左卡尼汀对老年维持性血液透析患者炎症、营养不良和贫血的影响研究

目的：探讨左卡尼汀（L-CN）对老年维持性血液透析（MHD）患者炎症、营养不良和贫血的影响。方法：46例老年MHD患者随机分为两组,对照组予常规治疗,观察组加用左卡尼汀,比较两组患者治疗前后血IL-6、hs-CRP、Alb、PAB、Hb、HCT等指标的差异。结果：治疗12周后,观察组患者血清IL-6、hs-CRP较治疗前显著下降,Alb、PAB、Hb、HCT显著上升,对照组Hb、HCT较治疗前显著上升,差异有统计学意义（P〈O．05）,但明显低于观察组,差异有统计学意义（P〈0．05）;对照组治疗后血IL-6、hs-CR及Alb、PAB与治疗前比较无统计学差异（P〉0．05）。结论：老年MHD患者普遍存在L-CN缺乏,L-CN治疗可以改善患者微炎症及营养不良状态,纠正肾性贫血．     

左卡尼汀对维持性血液透析患者营养及微炎症状态的影响

目的观察静脉注射左卡尼汀对维持性血液透析（MHD）患者营养及微炎症状态的影响。方法选择MHD时间〉6个月的患者68例,按随机数字表法分为两组,观察组35例每次透析结束后给予左卡尼汀静脉注射,并给予重细人促红细胞生成素、铁剂、叶酸等药物治疗,对照组33例不给予左卡尼汀,其他治疗与观察组相同。分别于治疗前及治疗后3个月检测两组患者胁、ALB、TC、TG、LDL-C、HDL-C等营养指标及超敏C反应蛋白（hs-CRP）、白细胞介素-6（IL-6）、白细胞介素-8（IL-8）、肿瘤坏死因子-α（TNF-α）等炎症指标。结果治疗后观察组血清IIb、虹卫水平均较治疗前明显上升（P〈0．05）,且明显高于对照组治疗后的水平（P〈0．05）;观察组治疗前后血清TC、TG、LDL-C、HDL-C水平均无明显变化（P〉0．05）,对照组治疗前后血清Hb、ALB、TC、TG、LDL-C、HDL-C水平均无明显变化（P〉0．05）。治疗后观察组hs-CRP、IL-15、IL-8、TNF-α均较治疗前明显下降（P〈0．05）,且明显低于对照组治疗后的水平（P〈0．05）;对照组治疗前后hs-CRP、IL-6、IL-8、TNF-α均未发生明显变化（P〉0．05）。结论左卡尼汀能明显改善MHD患者营养状况及微炎症状态。     

左卡尼汀联合促红素治疗维持性血液透析患者肾性贫血的临床观察

目的：探讨左卡尼汀联合促红素治疗维持性血液透析肾性贫血的临床疗效。方法：收集2012年1月-2013年1月在本院进行维持性血液透析肾性贫血患者90例,随机分成三组,分别为左卡尼汀联合促红素治疗组、左卡尼汀治疗组、促红素治疗组,每组30例。左卡尼汀治疗组在常规治疗基础上加用予左卡尼汀;促红素治疗组在常规治疗基础上加用EPO。左卡尼汀联合促红素治疗组在常规治疗加用左卡尼汀和EPO治疗。分析三组治疗1、6个月RBC、Hb、Hct情况。结果：三组治疗前与治疗后1、6个月RBC、Hb、Hct比较,差异均有统计学意义（P〈0.05）。治疗1、6个月后,左卡尼汀联合促红素治疗组RBC、Hb、Hct高于左卡尼汀治疗组和促红素治疗组（P〈0.05）;促红素治疗组RBC、Hb、Hct高于左卡尼汀治疗组（P〈0.05）。结论：左卡尼汀联合促红素治疗维持性血液透析肾性贫血比单一药物治疗疗效佳。     

重组人促红素联合左卡尼汀注射液治疗肾性贫血的临床观察

目的观察重组人促红素联合左卡尼汀注射液治疗肾性贫血的临床疗效。方法将54例维持性血液透析的慢性肾衰肾贫血病人随机分为观察组和对照组。观察组采用重组人促红素联合左卡尼汀注射液进行治疗,对照组仅用重组人促红素进行治疗,对比两组的治疗效果。结果治疗后,两组患者的RBC、Hct和Hb都有明显的升高(P0.05);治疗后观察组的RBC、Hct、Hb水平明显优于对照组(P0.05);观察组患者每周平均重组人促红素用量少于对照组(P0.05)。结论在重组人促红素的基础上联合左卡尼汀注射液能明显提高对肾性贫血的疗效,并减少并发症发生,值得临床推广。     

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.