糖尿病合并高血压患者降压用药情况调查分析

目的 了解糖尿病高血压患者的用药现状,分析其降压药物使用情况,为合理治疗提供依据. 方法 将入选病例分为观察组(高血压合并糖尿病)和对照组(未合并糖尿病),回顾性调查两组患者降压药物使用情况,包括降压药的使用种类、频率及联合用药情况. 结果 观察组降压治疗方案中使用较多的是血管紧张素转换酶抑制荆(ACEl)和血管紧张素II受体阻断药(ARB),其平均服用降压药物种类要显著多于对照组(P<0.05). 结论 对于糖尿病高血压患者,应综合分析患者的危险水平、降压疗效、对临床终点事件的影响、治疗的依从性和安全性及经济状况等,构建合理的治疗方案.     

糖尿病合并高血压患者降压用药情况调查分析

目的 了解糖尿病高血压患者的用药现状,分析其降压药物使用情况,为合理治疗提供依据.方法 将入选病例分为观察组(高血压合并糖尿病)和对照组(未合并糖尿病),回顾性调查两组患者降压药物使用情况,包括降压药的使用种类,频率及联合用药情况.结果 观察组降压治疗方案中使用较多的是血管紧张素转换酶抑制剂(ACEI)和血管紧张素Ⅱ受体阻断药(ARB),其平均服用降压药物种类要显著多于对照组(P＜0.05).结论 对于糖尿病高血压患者,应综合分析患者的危险水平、降压疗效、对临床终点事件的影响、治疗的依从性和安全性及经济状况等,构建合理的治疗方案.     

糖尿病合并高血压患者降压用药情况调查分析

目的 了解糖尿病高血压患者的用药现状,分析其降压药物使用情况,为合理治疗提供依据.方法 将入选病例分为观察组(高血压合并糖尿病)和对照组(未合并糖尿病),回顾性调查两组患者降压药物使用情况,包括降压药的使用种类,频率及联合用药情况.结果 观察组降压治疗方案中使用较多的是血管紧张素转换酶抑制剂(ACEI)和血管紧张素Ⅱ受体阻断药(ARB),其平均服用降压药物种类要显著多于对照组(P＜0.05).结论 对于糖尿病高血压患者,应综合分析患者的危险水平、降压疗效、对临床终点事件的影响、治疗的依从性和安全性及经济状况等,构建合理的治疗方案.     

高血压急诊患者降压药物应用的临床分析

目的 探讨高血压急诊降压药物的使用情况、治疗效果和存在的问题,旨在积累高血压的防治经验,提高高血压的控制率;方法回顾性分析2008年12月至2011年12月我院急诊诊治的高血压患者684例的临床资料;结果 684例患者需静脉使用降压药物如:硝酸甘油、硝普钠、或者酚妥拉明的占32.5%;口服降压药物治疗,治疗率为92.8%,控制率为91.7%.采用单药治疗283例(41.1%),采用2种以上抗高血压药物治疗401例(58.9%),单药控制率为86.7%,2种药控制率为94.7%,3种药控制率为96.4%,4种药控制率为98.6%,联合用药的控制率明显高于单药治疗.联合治疗中以钙拮抗剂和β受体阻滞剂使用率最高.收缩压控制理想<140mmH g的患者收缩压平均为(124.6±6.5)mmH g,明显低于控制不良组(154.2±8.6)mmH g,差异非常显著(P<0.01);舒张压控制理想(<90mmHg)的患者平均为(74.8±6.2)mmHg,明显低于控制不良组(96.4±8.8)mmHg,差异非常显著(P<0.01);结论高血压急诊治疗时应根据具体情况确定治疗降压目标,以保护靶器官,防止急性心血管事件的发生.     

我院门诊高血压患者用药情况分析

目的了解门诊高血压患者的药物使用情况。方法查阅2013年1月—6月我院门诊高血压患者治疗药物处方1 500张,统计分析抗高血压药的使用情况及临床医师对高血压病的治疗方案是否合理。结果钙离子通道阻滞剂、血管紧张素转换酶抑制剂、血管紧张素Ⅱ受体拮抗剂、β-受体阻滞剂、利尿剂等几类为常用降压药物,单种药物治疗占40.80%,联合2种以上药物治疗占59.20%。左旋氨氯地平、依那普利、氯沙坦在同类药物中使用率最高。结论我院医师对门诊高血压患者的治疗基本合理,但高血压治疗水平与药物合理联合应用还有待于提高,应用长效抗高血压药及合理联合使用降压药物是当今高血压治疗的主要发展方向。     

357例老年单纯收缩期高血压患者的降压治疗

目的：了解住院老年单纯收缩期高血压人群的治疗现状及达标率，探讨治疗合理性。方法：回顾性调查357例住院老年单纯收缩期高血压患者降压治疗情况，评估治疗效果。结果：各类常用降压药物使用频率分别为：钙离子拮抗药（CCB）64.15%，血管紧张素转换酶抑制药（ACEI）32.77%，利尿药26.33%，β受体阻断药（BB）25.77%，血管紧张素Ⅱ受体阻断药（ARB）23.81%，α受体阻断药4.20%。单剂药物治疗方案占42.86%，联合药物治疗方案占57.14%，其中不含利尿药的联合药物治疗组合占40.62%，含利尿药的联合药物治疗组合占16.53%。收缩压达标率为67.79%。舒张压≤70 mmHg发生率为26.89%，其中8例发生心肌缺血事件。结论：合理的降压药物和治疗方案的选择能够提高老年单纯收缩期高血压患者的达标率。努力达标的同时，应避免过度降低舒张压。     

糖尿病合并高血压患者降压用药情况调查分析

目的了解糖尿病高血压患者的用药现状，分析其降压药物使用情况，为合理治疗提供依据。方法将入选病例分为观察组（高血压合并糖尿病）和对照组（未合并糖尿病），回顾性调查两组患者降压药物使用情况，包括降压药的使用种类、频率及联合用药情况。结果观察组降压治疗方案中使用较多的是血管紧张素转换酶抑制荆（ACEI）和血管紧张素Ⅱ受体阻断药（ARB），其平均服用降压药物种类要显著多于对照组（P〈0．05）。结论对于糖尿病高血压患者。应综合分析患者的危险水平、降压疗效、对临床终点事件的影响、治疗的依从性和安全性及经济状况等，构建合理的治疗方案。     

药物基因检测在我院高血压患者中的应用效果

目的:分析我院老年病科高血压患者人群的五类降压药物敏感性,通过药物基因检测技术个体化选择降压药物,为高血压患者提供个体化精准药物治疗方案。方法:选取2019年1月—2020年4月在我院老年病科住院的68例初发高血压患者,其中32例患者进行药物基因检测,通过筛选降压药物基因敏感性靶点给予降压药物,36例患者按照指南经验性给予降压药物。比较2组降压药物的临床疗效。采用t检验比较2组患者年龄、体质量指数、肝肾功能、血压水平、心率。采用χ~2检验比较2组间性别、给药后2周血压达标率的差异。结果:研究组32例患者中,对钙通道阻滞剂类敏感性强的占62.5%,对β受体阻滞剂类敏感性强的占50.0%,对血管紧张素转换酶抑制剂敏感性强的占37.5%,对血管紧张素Ⅱ受体拮抗剂敏感性强的占87.5%,对利尿剂敏感性强的占37.5%。给药后2周血压达标率,研究组(100.00%)高于对照组(72.22%)。2组间不良反应率的差异无统计学意义。结论:通过药物基因检测技术,个体化精准的给予降压药物,有利于高血压患者更快更好的控制血压。     

高血压脑卒中二级预防方式及应用价值评析

目的：研究高血压脑卒中二级预防方式及应用价值。方法：纳入社区2014年1月－2014年12月高血压脑卒中病情稳定患者100例并根据随机数字表法分为两组。ACEI 组采用以 ACEI 为基础的降压治疗,CCB 组采用以长效 CCB 为基础的降压治疗。观察1年,比较两组患者脑卒中复发率、其他心血管事件发生率;联合利尿剂使用率、两种以上药物联合使用率;入组时和1年后患者收缩压、舒张压的差异。结果：CCB 组脑卒中复发率显著低于 ACEI 组,P＜0．05;两组其他心血管事件发生率相似,P＞0．05;CCB 组、ACEI 组联合利尿剂使用率、两种以上药物联合使用率相似,P＞0．05;入组时两组收缩压、舒张压相似,P＞0．05;1年后两组患者收缩压、舒张压均有所降低,P＜0．05。结论：高血压脑卒中二级预防中应用长效CCB 和 ACEI 均有一定效果,但长效 CCB 可更好预防脑卒中复发,值得推广。     

降压药物在老年高血压病患者中的应用分析

目的 分析老年高血压病患者使用降压药物的情况.方法 选择2008年1月-2010年1月我院门诊治疗的原发性老年高血压患者900例,分析其降压药物的应用情况.结果 ①老年高血压患者收缩压控制理想(<140mmHg)的占51%,舒张压控制率优于收缩压控制率;②降压药物使用由高到低依次是:钙离子阻滞剂、血管紧张素转化酶抑制剂、-受体拮抗剂、血管紧张素II受体阻滞剂(ARB)、利尿剂、直接舒张血管平滑肌药;③踝部水肿、低血钾、干咳、心动过缓、体位性低血压等为其主要副作用.结论 老年高血压病降压药物使用基本符合规范,部分患者存在药物不良反应.     

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.