益母草注射液联合催产素用于剖宫产患者中预防产后出血及术后子宫复旧的临床观察

目的:观察益母草注射液配伍催产素预防剖宫产产后出血及术后子宫复旧的的效果.方法:将400例剖宫产随机分为观察组及对照组,每组200例,观察组胎儿娩出后,宫体肌注益母草注射液40mg,催产素10IU,静滴催产素10IU;对照组胎儿娩出后,宫体注射催产素10IU,静滴催产素10IU;观察两组术中及产后2小时的出血量、产后出血例数及术后子宫复旧情况.结果:观察组产后出血例数及产后2小时出血量明显少于对照组,术后子宫复旧观察组明显好于对照组,P＜0 05有显著差异.结论:益母草注射液配伍催产素预防剖宫产产后出血及促进术后子宫复旧效果显著,用药安全简单,无不良反应.     

剖宫产术中应用催产素对血流动力学的影响

我们选择性对300例在硬膜外麻醉下行剖宫产术时，胎儿娩出后以不同途径和速度应用催产素对产妇血流动力学改变、临床反应及子宫收缩效果进行了观察和比较，旨在探讨：①不同途径和速度使用催产素对产妇血流动力学的改变及临床反应；②不同途径、同等剂量对产妇子宫收缩的效果观察。     

米索用于择期剖宫产预防产后出血临床效果分析

目的 观察米索用于择期剖宫产预防产后出血的效果.方法 选本院70例择期剖宫产,随机分三组,第一组和第二组24例均用①切开皮肤时口服嚼米索200 ug.②胎盘胎膜娩出,宫腔擦拭干净后放入米索200 ug.第二组在胎儿娩出后加催产素20 u,子宫肌层注射.第三组在胎儿娩出后子宫肌肉注射催产素20u 静滴催产素20 u.三组观察术中术后2小时出血量.结果 ①②比较无显著差异P＞0.05.①②比较有极显著差异P＜0.01.结论 米索促进宫缩,强于催产素,能较好预防择期剖宫产术后出血,用药方便安全.     

米索用于择期剖宫产预防产后出血临床效果分析

目的 观察米索用于择期剖宫产预防产后出血的效果.方法 选本院70例择期剖宫产,随机分三组,第一组和第二组24例均用①切开皮肤时口服嚼米索200 ug.②胎盘胎膜娩出,宫腔擦拭干净后放入米索200 ug.第二组在胎儿娩出后加催产素20 u,子宫肌层注射.第三组在胎儿娩出后子宫肌肉注射催产素20u+静滴催产素20 u.三组观察术中术后2小时出血量.结果 ①②比较无显著差异P＞0.05.①②比较有极显著差异P＜0.01.结论 米索促进宫缩,强于催产素,能较好预防择期剖宫产术后出血,用药方便安全.     

米索前列醇在预防产后出血中的应用

目的：观察米索前列醇用于预防产后出血的效果。实验设计为完全随机设计。方法：选择有产后出血高危因素的产妇480例，其中经阴分娩240例，剖宫产240例，随机分为米索前列醇组及催产素组。米索前列醇组经阴分娩者在胎儿娩出后，剖宫产者在术中打开腹膜时口服米索前列醇600μg；催产素组经阴分娩者在胎儿娩出后臀部肌注射催产素20IU，剖宫产者在胎儿娩出后宫底肌注射催产素20IU，再静脉滴注催产素20IU。以上两组观察术中及术后2小时内出血量。结果：米索前列醇在预防产后出血方面优于催产素，且用药方便、安全。     

比较产科疤痕子宫行剖宫产术中应用卡贝缩宫素和催产素对术中出血及子宫肌层厚度的临床分析

目的：观察比较产科高危妊娠疤痕子宫行剖宫产术中应用卡贝缩宫素和催产素对术中出血量及子宫肌层厚度方面的差异。方法：采用回顾性分析疤痕子宫妊娠产妇100名,在腰硬联合麻醉下剖宫产术,分为卡贝缩宫素组和催产素组2组各50名,胎儿娩出后,1组给予静脉注射卡贝缩宫素100μg,另1组给予静脉输入催产素20u,比较2组术中出血量及子宫肌层厚度。结果：卡贝缩宫素组比催产素组术中出血量明显减少,同时子宫肌层厚度明显增厚,（P＜0．05）。结论：卡贝缩宫素在高危妊娠疤痕子宫手术中应用后术中出血量明显减少,子宫肌层厚度明显增厚,从而减少产后出血量,避免产后宫缩乏力导致的产后大出血,值得临床使用、推广。     

瑞芬太尼用于剖宫产术全身麻醉对母婴的影响

目的探讨瑞芬太尼用于剖宫产术全身麻醉对母婴的影响。方法将42例采用全身麻醉行剖宫产术产妇分为2组,各21例。A组在胎儿麻醉诱导前输注血浆靶浓度为5g/L的瑞芬太尼,切开皮肤后停止,胎儿取出后继续输注;B组在胎儿娩出后静脉注射芬太尼5g/kg。观察产妇血流动力学的变化,胎儿娩出后1、5minApgar评分和脐动脉血气。结果 A组产妇血流动力学较B组平稳,新生儿1minApgar评分低于B组（0.05）,5minApgar评分与B组比较差异无统计学意义（〉0.05）。结论瑞芬太尼用于剖宫产术全身麻醉诱导,产妇血流动力学稳定,但对新生儿有短暂性的呼吸抑制。     

腰硬联合麻醉下剖宫产术中左侧斜卧位对产妇血流动力学的影响

目的：观察腰硬联合麻醉下剖宫产术中体位变化对产妇血流动力学的影响。方法将40例ASAⅠ～Ⅱ级拟行剖宫产术的产妇分为A、B两组,每组20例,于剖宫产术中分别采用平卧位和左侧斜卧15°位。分别于入室后5 min、腰硬联合麻醉时侧卧位后3 min、麻醉后3 min、切皮即刻、胎儿娩出后3 min、手术结束时点记录产妇心输出量、每搏量、心率、平均动脉压、总外周阻力、胸腔液体含量。结果两组产妇总输液量、升压药用量、心率、胸腔液体含量无明显差异;心输出量、每搏量组内各时比较点差异有统计学意义（P＜0.05）,但组间比较差异无统计学意义（P＞0.05）;麻醉后A组血压、总外周阻力下降较B组明显（P＜0.05）。结论腰硬联合麻醉剖宫产术围术期血流动力学波动较大,主要发生在麻醉后及胎儿娩出前后,需要及时准确的监测以指导治疗。术中采取左侧斜卧位,配合恰当的容量治疗及麻醉管理,可减少低血压的发生。     

米索前列醇预防剖宫产术后出血的疗效观察

目的 选择有产后出血高危因素的51例剖宫产者,分为米索前列醇+催产素组及催产素组.米索前列醇+催产素组26例,胎儿娩出后即舌下含服米索前列醇400μg,再静脉滴注催产素20 IU.催产素组25例,胎儿娩出后即宫体肌内注射催产素10IU,再静脉滴注催产素20 IU.以上两组观察术中及术后2小时内出血量.结果 术中及术后2小时平均出血量,米索前列醇+催产素组为180±55.8m l;催产素组为275±70.7m l.米索前列醇+催产素组与单用催产素组比较,两组差异有极显著性(P＜0.01).结论 加用米索前列醇促进子宫收缩作用强于单用催产素,能较好地预防剖宫产术后出血,且用药方便、安全.     

欣母沛预防宫缩乏力性产后出血的临床观察

目的观察欣母沛用于预防宫缩乏力性产后出血的效果。方法选择360例有宫缩乏力性产后出血高危因素的产妇,随机分为实验组和对照组,比较两组产后2h及24h出血量、产后出血发生率。实验组：在胎儿娩出后,宫体注射欣母沛250μg;对照组：于胎儿娩出后宫体注射催产素20IU,同时静脉滴注催产素20IU。结果实验组比对照组产后2h及产后24h平均出血量减少,差异均有统计学极显著意义（P〈0．01）,实验组产后出血发生率明显少于对照组,差异有统计学极显著意义（P〈0．01）。结论欣母沛比催产素能更有效地预防宫缩乏力性产后出血。     

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.     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.