Twin block式阻鼾器与Silensor阻鼾器初戴后患者耐受性的比较

目的 比较Twin block式阻鼾器与Silensor阻鼾器初戴后患者耐受性的差异,以及对患者睡眠的影响.方法 选择首都医科大学附属北京同仁医院口腔科应用Twin block式阻鼾器或Silensor阻鼾器治疗的阻塞性睡眠呼吸暂停综合征(OSAS)患者87例,男56例,女31例；平均年龄51岁.发予记录表格,采用目...     

阻鼾器治疗阻塞性睡眠呼吸暂停综合征的临床研究

目的:评价阻鼾器治疗呼吸暂停综合征的临床疗效。方法:我院口腔科和呼吸科共同协作,对16例阻鼾器治疗呼吸暂停综合征(OSAS)患者治疗前后分别进行多导夜间睡眠监测检查,比较治疗前后睡眠呼吸紊乱指标的变化。结果:①阻鼾器治疗呼吸暂停综合征的客观有效率为87.5%。②患者的主观症状明显改善,戴用矫正器后,AHI(即平均每小时呼吸暂停和低通气次数)平均由37.62±25.42/h降至8.92±12.92/h;最低血氧饱和度由72.39±11.46%提高到82.15±9.08%。结论:经过一年的治疗观察,我们设计的阻鼾器,感觉舒适,无创伤,容易接受,对呼吸暂停综合征方面的治疗起到明显的推动。     

Silensor阻鼾器的制作和应用

目的:探讨Silensor阻鼾器的制作方法和临床应用体会。方法:根据50例患者打鼾和阻塞性睡眠呼吸暂停低通气综合征(OSAS)的程度制作Silensor阻鼾器并配戴6～12个月,测血压、血糖、血脂、体重,并拍头颅定位侧位片,观察疗效。结果:50例患者中,5例放弃配戴Silensor阻鼾器,其余45例睡眠质量提高,OSAS症状减轻。结论:简化和创新制作的Silensor阻鼾器经济实用、省时省力、临床应用效果良好。     

SILENSOR-阻鼾器治疗阻塞性睡眠呼吸暂停低通气综合征的疗效观察

目的：介绍SILENSOR-阻鼾器的制作方法、适应症并对其进行临床疗效观察。方法：制作SILENSOR-阻鼾器治疗已被确诊为阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者，通过多导睡眠图监测观察治疗效果。结果：SILENSOR-阻鼾器治疗阻塞性睡眠呼吸暂停低通气综合征取得满意效果，使呼吸紊乱指数下降50％以上。结论：SILENSOR-阻鼾器与牙列外形非常贴和，保证了阻鼾器在口内的固位效果，间接带动舌体前移扩大舌后气道，有效消除睡眠呼吸暂停，明显改善患者的睡眠质量，使患者临床症状得到明显改善。     

防鼾器治疗阻塞性睡眠呼吸暂停综合征的临床研究

目的　对防鼾器治疗阻塞性睡眠呼吸暂停综合征 (OSAS)患者的疗效进行观察。方法　对 9例确诊OSAS的患者佩戴防鼾器治疗 ,通过夜间多导睡眠仪图观察治疗后效果。结果　夜间多导睡眠仪图显示低通气指数 (HI)、呼吸暂停指数 (AI)和呼吸紊乱指数 (AHI)明显降低 (P <0 0 5 )。结论　防鼾器对治疗阻塞性睡眠呼吸暂停综合征有一定疗效。     

Silensor阻鼾器治疗阻塞性睡眠呼吸暂停综合征临床观察

目的探讨Silensor阻鼾器对阻塞性睡眠呼吸暂停综合征(OSAS)的临床疗效。方法对17例确认为阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome,OSAS)患者佩带阻鼾器治疗,并在佩带前后用CT扫描观察患者上气道截面积的变化,同时采用夜间多导睡眠仪监测低通气指数(HI)、呼吸暂停指数(AI)和呼吸紊乱指数(AHI),观察临床治疗效果。结果观察对象上气道截面积均有增大,最小值从0.82cm2增加到1.70cm2;口咽上部截面积平均值由1.04cm2增加到1.93cm2;夜间多导睡眠仪图显示各项指标均较治疗前明显降低,差异具有统计学意义(P<0.05)。结论Silensor阻鼾器可使咽喉的空间扩大,空气流动的速度减慢,对治疗阻塞性睡眠呼吸暂停综合征有一定疗效。     

阻鼾器治疗阻塞性睡眠呼吸暂停综合征疗效观察

目的探讨阻鼾器是否为阻塞性睡眠呼吸暂停综合征(OSAS)简便,有效治疗方法.方法28例经多导睡眠图(PSG)确诊,并符合治疗条件的OSAS患者,用由加热变性的高分子塑料注塑成形的阻鼾器治疗,对比治疗4周前、后PSG结果并询问主观症状变化.结果该组病例接受阻鼾器治疗后,客观有效率为82%,睡眠呼吸暂停指数AI、低通气指数HI和平均呼吸暂停时间降低,最低血氧饱和度(SaO2)提高,鼾声指数降低与治疗前比较,差异均有显著性(P＜0.05或P＜0.01).临床症状均有不同程度改善或消失.初用时上下颌肌肉酸痛,多数患者2,3 d后适应.结论阻鼾器可以成为OSAS的一个治疗方法,效果肯定,且制作简便,患者痛苦小.     

压膜式阻鼾器治疗阻塞性睡眠呼吸暂停低通气综合征

目的探讨压膜式阻鼾器治疗阻塞性睡眠呼吸暂停低通气综合征的临床效果。方法对我院2012年10月—2013年10月收治的48例阻塞性睡眠呼吸暂停低通气综合征患者予以压膜式阻鼾器治疗,对患者疗效进行观察分析。结果 48例患者治疗总有效率为87.5%,患者治疗后睡眠呼吸紊乱指数较治疗前显著减小,平均呼吸暂停时间、最长呼吸暂停时间均较治疗前显著缩短,最低血氧饱和度较治疗前显著升高,差异均具有统计学意义（P〈0.05）。结论压膜式阻鼾器治疗阻塞性睡眠呼吸暂停低通气综合征临床效果显著,能明显改善患者临床指征,值得临床推广应用。     

阻鼾器结合中药治疗OSAHS疗效观察

目的:观察阻鼾器结合中药治疗OSAHS的临床效果。方法:将30例OSAHS轻度、中度患者随机分成两组,每组15例,对照组给予阻鼾器治疗,治疗组在应用阻鼾器的基础上加用中药(补中益气汤、二陈汤、丹参饮加减)治疗,采用多导睡眠仪监测(PSG)患者治疗前后呼吸暂停低通气指数(AHI)、呼吸暂停指数(AI)、低通气指数(HI)和LSaO2指数变化,并进行问卷调查。结果:①临床疗效方面治疗后治疗组总有效率为93.3%,对照组为73.3%,治疗组疗效明显高于对照组;②主观症状方面治疗组的有效率为86.6%,对照组为66.6%;③治疗有效OSAHS患者呼吸暂停低通气指数、呼吸暂停指数和低通气指数分别降低85.46%、79.27%、53.79%(P<0.01),夜间最低血氧饱和度明显升高(P<0.01),患者睡眠质量均有明显改善,鼾声均消失或明显减轻,治疗组作用优于对照组(P<0.05)。结论:阻鼾器结合中药治疗轻度、中度OSAHS疗效明显。     

口腔矫治器治疗OSAS的疗效观察

目的 :评价矫治器治疗阻塞性睡眠呼吸暂停综合症 (OSAS)的疗效。方法 :18例经呼吸科确诊的OSAS患者 ,男14例 ,女4例 ,平均年龄 (54.2±7.9)岁,体重指数为 (29.6±3.9)kg/m2,呼吸紊乱指数 (AHI)为48土12,使用多导睡眠图仪 (PSG)和核磁共振成像 (MRI)测量患者的呼吸变量和头影变量。结果 :患者呼吸紊乱指数 ,呼吸暂停指数 ,低通气指数和血氧饱和度使用前后有显著性改善。结论 :矫治器是治疗OSAS的一种有效方法。     

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.