低分子肝素钙治疗急性脑梗死的临床观察

目的 观察低分子肝素钙在脑梗死疾病中的临床疗效.方法 将80例脑梗死住院病人随机分为低分子肝素钙治疗组及对照组,对照组采用常规疗法,治疗组在常规疗法的基础上加用低分子肝素钙,治疗后10 d及21d进行神经功能缺损评分的比较分析.结果 低分子肝素钙组与对照组治疗前后神经功能缺损恢复情况比较,差异有显著性.结论 低分子肝素钙可显著改善进展性卒中的预后,值得临床进一步研究及推广.     

丹参川芎嗪注射液联合低分子肝素钙治疗进展性卒中30例

目的:观察丹参川芎嗪注射液与低分子肝素钙治疗进展性卒中的疗效.方法:将60例患者随机分为治疗组和对照组,两组均予常规治疗,治疗组采用丹参川芎嗪注射液及低分子肝素钙治疗,对照组仅予低分子肝素钙治疗.两组均连续治疗14 d后评定临床疗效,神经功能缺损评分,血液流变学的变化.结果:治疗组总有效率为90%,对照组为70%,两组比较有统计学意义(P<0.05).两组治疗后第7天、第14天时神经功能缺损均较治疗前改善明显(P<0.05),且治疗组优于对照组(P<0.05).结论:丹参川芎嗪注射液联用低分子肝素钙治疗进展性卒中疗效优于单用低分子肝素钙.     

氯吡格雷联合低分子肝素钙治疗进展性脑梗死临床观察

目的观察氯吡格雷联合低分子肝素钙治疗进展性脑梗死的疗效及安全性。方法将50例急性进展性脑梗死患者随机分为对照组25例和治疗组25例,对照组给予口服氯吡格雷及其他常规治疗,疗程14d;治疗组在对照组治疗基础上加用低分子肝素钙,皮下注射,q12h,疗程10d。观察两组治疗前后神经功能缺损评分(NDS)、血小板(PLT)及凝血功能的变化。结果治疗组显效率高于对照组,差异有显著性意义(P<0.05);治疗后治疗组NDS低于对照组,差异有显著性(P<0.01);治疗组治疗前后PLT及凝血功能均无明显变化;用药过程中均无出血并发症发生。结论氯吡格雷联合低分子肝素治疗进展性脑梗死安全有效。     

巴曲酶联合低分子肝素钙预防进展性卒中的效果

目的 探讨巴曲酶联合低分子肝素钙预防进展性卒中的效果。方法 将起病在72h内的57例脑梗死病人随机分为巴曲酶联合低分子肝素钙治疗组（治疗组）和低分子肝素钙治疗组（对照组）。治疗组在常规治疗的基础上加用巴曲酶,第1天10BU,第3、5天各5BU静脉滴注,同时用低分子肝素钙0．4mL,每日2次腹部皮下注射,连续7d。对照组在常规治疗的基础上只加低分子肝素钙。治疗前后检测凝血活酶时间（PT）、凝血酶时间（TT）、活化部分凝血活酶时间（APTT）、血浆纤维蛋白原,并对治疗前、治疗后4周神经功能缺损进行评分。结果 治疗组1例而对照组7例发生进展性卒中,两组比较差异有显著性（Х^2=4．97,P〈0．05）;治疗组治疗后血浆纤维蛋白原降低,TT、PT、APTT轻度延长,但均在正常范围内。结论 巴曲酶联合低分子肝素钙治疗能降低进展性卒中的发生率,有利于进展性卒中的病人神经功能的恢复。     

依达拉奉联合低分子肝素钙治疗进展性脑梗死的临床观察

目的探讨依达拉奉联合低分子肝素钙治疗进展性脑梗死的疗效。方法将70例进展性脑梗死患者随机分为两组,治疗组在常规治疗的基础上用依达拉奉30mg加入0.9%的盐水中静脉滴注,2次/日,连用14d;同时联合低分子肝素钙5000U皮下注射,1次/12h,连用7d。对照组在常规治疗的基础上加用低分子肝素钙5000U皮下注射,1次/12h,连用7d。于治疗前及治疗14d后分别进行临床疗效及神经功能缺损评分。结果两组于治疗前后神经功能缺损评分均有下降,治疗组与对照组相比,有显著性差异（P〈0.05）。结论依达拉奉联合低分子肝素钙治疗进展性脑梗死疗效显著,有助于患者神经功能缺损的恢复。     

化瘀通络汤联合低分子肝素钙治疗进展性脑梗死临床研究

目的:探究化瘀通络汤联合低分子肝素钙治疗进展性脑梗死的临床疗效。方法:将进展性脑梗死患者116例,随机分为治疗组和对照组。两组均给予降血脂、降血糖、降血压、抗血小板等常规治疗,同时皮下注射0.4 m L低分子肝素钙,每日2次。治疗组在观察组基础上加服化瘀通络汤,连续治疗7 d,统计分析两组治疗后临床有效率、神经功能缺损程度及不良反应等。结果:治疗组有效率为96.6%,对照组有效率为84.5%,两组比较差异有统计学意义(P0.05)。两组患者治疗后神经功能缺损程度及日常生活能力均较治疗前改善明显(P0.05),且治疗组明显优于对照组(P0.05),两组患者治疗过程中均未发现药物相关不良反应。结论:化瘀通络汤联合低分子肝素钙可显著改善进展性脑梗死患者神经功能和生活能力,疗效显著,同时无明显不良反应。     

依达拉奉联合低分子肝素治疗进展性卒中的疗效观察

目的观察依达拉奉联合低分子肝素治疗进展性卒中的疗效。方法对140例急性进展性卒中的患者随机分为依达拉奉联合低分子肝素治疗组（n=70）和低分子肝素对照纽（n=70）。治疗组在常规治疗的基础上加用依达拉奉30mg加入生理盐水100ml中静滴,2次／d,连用14d,同时给予低分子肝素5000U腹部皮下注射2次／d,连用7d。对照组在常规治疗的基础上只加用低分子肝素。于治疗前及治疗第14d分别进行临床疗效及神经功能缺损评分。结果两组于治疗前后神经功能缺损评分、临床疗效均有改善,治疗组总有效率90．00％,对照组总有效率75．71％,治疗组改善更明显,与对照组相比有显著性差异（P〈0．01）。结论依这拉奉联合低分子肝素治疗进展性卒中疗效确切,不良反应少,值得推广。     

尤瑞克林联合低分子肝素钙治疗进展性脑梗死疗效观察

目的:探讨尤瑞克林联合低分子肝素钙治疗进展性脑梗死的临床疗效和安全性。方法:选择94例给予改善循环、抗血小板聚集等常规治疗仍出现进展性脑梗死患者,随机分为联合治疗组(尤瑞克林+低分子肝素钙)32例、低分子肝素钙组31例、和对照组(常规治疗组)31例。于治疗前、治疗14天后进行临床神经功能缺损程度评分与日常生活活动能力量表评分,观察3组临床疗效,并监测不良反应。结果:联合治疗组神经功能缺损的治疗效果最好,低分子肝素钙组次之,对照组恢复最差,3组间比较有统计学差异。且无明显不良反应。结论:尤瑞克林联合低分子肝素钙对进展性脑梗死具有较好的治疗效果。     

低分子肝素钙注射液治疗急性期脑梗死临床体会

目的观察低分子肝素钙注射液治疗急性期脑梗死的临床疗效。方法急性期脑梗死病人226例,对照组126例予常规治疗,治疗组120例在常规治疗基础上予低分子肝素钙注射液5000u日二次皮下注射,治疗10天后观察神经功能缺损评分并评价临床疗效,治疗前后检测纤维蛋白原、凝血相（INR）、红细胞刚性指数,观察不良反应。结果治疗前后神经功能缺损评分差值二组间差异有非常显著性（P〈0.01）;而纤维蛋白原、凝血相（INR）、红细胞刚性指数二组间差异无显著性（P〉0.05）。结论低分子肝素钙注射液治疗急性期脑梗死预防血栓进展、不受时间窗限制、对凝血指标无明显影响、安全性好、副作用小,治疗效果明显优于常规对照组。     

醒脑开窍针刺法配合低分子肝素钙治疗进展性脑梗塞效果观察

目的:分析醒脑开窍针刺法配合低分子肝素钙治疗进展性脑梗塞效果.方法:选取2017年1月—2018年12月期间在河南大学第一附属医院就诊的进展性脑梗塞患者200例作为本次研究对象,将其分为对照组(n=100)和观察组(n=100),对照组行低分子肝素钙治疗,观察组行醒脑开窍针刺法配合低分子肝素钙治疗,观察两组患者的神经功能缺损评分、BI指数评分、凝血功能指标变化.结果:治疗后观察组患者的神经功能缺损评分为(9.30±0.82)分、BI指数评分为(56.72±5.48)分,相比较于对照组,差异有统计学意义(P<0.05);治疗后观察组患者的PLT为(211.03±19.94)×109/L、PT为(14.92±1.35)s、APTT为(34.57±3.26)s,相比较于对照组,差异有统计学意义(P<0.05).结论:进展性脑梗塞患者接受醒脑开窍针刺法配合低分子肝素钙治疗,对减少神经功能损伤、提高生活质量、改善凝血功能具有良好的效果,值得推广应用.     

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.