曲美他嗪在缺血性心肌病心力衰竭治疗中的疗效评价

目的研究曲美他嗪治疗缺血性心肌病心力衰竭的临床疗效。方法选择72例缺血性心肌病患者,随机分为治疗组和对照组各36例,治疗组在常规治疗心力衰竭的基础上加曲美他嗪30mg,每日3次口服。对照组常规应用抗心力衰竭治疗,疗程为3个月,观察两组治疗前后左心室收缩末期内径(ESD)、舒张末期内径(EDD)、收缩末期容积(ESV)、舒张末期容积(EDV)、短轴缩短分数(FS)、每搏量(SV)、左心室射血分数(LVEF)、6 min步行距离。结果治疗组与对照组均能有效地治疗缺血性心肌病心力衰竭,两组治疗前后的自身比较显示ESV、FS、SV和LVEF均有统计学意义(P<0.05);治疗前两组比较差异无统计学意义;经过3个月的治疗后,组间比较显示治疗组的ESD、ESV、FS、SV和LVEF较对照组有进一步的改善(P<0.05),两组均未发现与药物相关的不良反应。结论曲美他嗪能有效改善缺血性心肌病患者的心功能,值得临床推广应用。     

曲美他嗪治疗缺血性心肌病心力衰竭的临床观察

目的 用6分钟步行试验和多普勒超声心动图评价曲美他嗪辅助治疗缺血性心肌病心力衰竭的疗效。方法 选取116例因缺血性心肌病而导致慢性心力衰竭患者（纽约心脏病学会分级Ⅱ～Ⅳ级）。采用随机、单盲试验,将病人分为两组,曲美他嗪组60例,采用常规治疗及口服曲美他嗪,每次20mg,每日3次;对照组56例,采用常规治疗,疗程3个月,观察两组治疗前后左心室收缩末期内径、左心室舒张末期内径、左室收缩末期容积、左心室舒张末期容积、左心室射血分数、心搏出量、短轴缩短分数、6分钟步行距离。结果用药3个月后,组间比较显示曲美他嗪组的、左心室收缩末期内径、左心室收缩末期容积、射血分数、心搏出量,短轴缩短分数及6分钟步行距离较常规治疗组有进一步的改善。结论在常规治疗缺血性心肌病心力衰竭的基础上加用曲美他嗪可以进一步改善患者的心脏收缩功能,提高患者的运动耐量,耐受性良好。     

曲美他嗪治疗缺血性心肌病心力衰竭37例疗效观察

目的 探讨曲美他嗪对缺血性心肌病(ICM)心力衰竭患者心功能的影响.方法 选取74例ICM心力衰竭患者,37例服用曲美他嗪片20 mg,3次/d;常规治疗组37例.疗程均为3个月,分别采用多普勒超声心动图对其测量治疗前后EDD、EDV、ESD、ESV、FS、SV、LVEF,并观测治疗前、后6 min步行距离, 评价心脏收缩功能及运动耐量的改善情况.结果 入选时两组资料有可比性.用药3个月后,曲美他嗪组的ESD、ESV、FS、SV、LVEF及6min步行距离较常规治疗组明显改善.常规治疗组除去失访1例,因心力衰竭的加重再住院13例(占35.1%).曲美他嗪组因心力衰竭的加重再住院4例(占10.8%).结论 曲美他嗪可以改善患者的心脏收缩功能,提高患者的运动耐量,降低再住院率,患者耐受良好.     

曲美他嗪治疗缺血性心肌病心力衰竭的疗效评价

目的评价曲美他嗪治疗缺血性心肌病心力衰竭的临床疗效。方法采用随机、单盲对照及组间对照，将103例缺血性心肌病心力衰竭患者分为曲美他嗪组（试验组，53例），服用曲美他嗪20mg，3次／天；常规治疗组（对照组，50例），疗程均为6个月，观察两组治疗前后临床疗效、左室射血分数（LVEF）、左室舒张末期内径、左室收缩末期内径及6min步行距离。结果试验组治疗前后自身比较LVEF、6min步行距离等相关参数均有显著改善（P〈0．05），治疗后组间比较示试验组进一步提高患者LVEF、6min步行距离等，差异有显著性（P〈0．05）；未发现与药物相关的不良反应。结论曲美他嗪与其他常规药物联用能进一步改善缺血性心肌病患者心功能，值得临床推广应用。     

曲美他嗪对缺血性心肌病患者左心功能及Q-T间期离散度的影响

目的探讨曲美他嗪对缺血性心肌病患者左心功能及Q-T间期离散度的影响。方法将我院2011年1月~2013年12月诊治的68例缺血性心肌病患者随机分为对照组与曲美他嗪组,每组34例,对照组患者给予常规抗缺血性心肌病治疗,曲美他嗪组在常规治疗基础上加用曲美他嗪口服进行治疗,疗程6个月,分别观察两组患者的左心功能指标和Q-T离散度指标的变化,并进行比较分析。结果曲美他嗪组患者左室舒张末期内径(LVEDD)、左室射血分数(LVEF)、左室舒张末期容积(LVEDV)、左室短轴缩短率(LVFS)及每博输出量(SV)显著优于对照组(P<0.05);与对照组相比,曲美他嗪组Q-T间期离散度及心率校正Q-T间期(QTcd)显著下降,差异具有统计学意义(P<0.05)。结论曲美他嗪治疗可显著改善缺血性心肌病患者左心功能,缩短Q-T间期离散度。     

曲美他嗪治疗缺血性心肌病充血性心力衰竭疗效观察

目的：观察曲美他嗪联合常规疗法治疗缺血性心肌病充血性心力衰竭疗效。方法：76例患者分为观察组40例和对照组36例。对照组采用常规治疗,观察组在常规治疗基础上加曲美他嗪治疗。结果：观察组和对照组总有效率分别为92.5%和86.1%,显效率分别为62.5%和38.9%,2组显效率比较有显著差异（P〈0.05）：治疗后左室收缩末期内径（LVESD）、左室舒张末期内径（LVEDD）及左室射血分数（LVEF）变化情况观察组均优于对照组（P〈0.05）。结论：曲美他嗪配合常规疗法治疗缺血性心肌病充血性心力衰竭疗效满意。     

卡维地洛治疗缺血性心脏病心力衰竭及对QT离散度的影响

目的观察卡维地洛对缺血性心脏病心力衰竭的临床疗效及对QT离散度(QTd)和恶性室性心律失常发生的影响。方法选择128例缺血性心脏病心力衰竭患者随机分成卡维地洛治疗组和常规治疗组(每组64例)。监测治疗前及治疗6个月后6 min步行距离,每搏输出量(SV)及每分心输出量(CO);超声心动图监测左室射血分数(EF)、左室舒张末期内径(LVEDD)及左室收缩末期内径(LVESD);同时监测心功能、收缩压、舒张压及心率的变化;QTd及恶性室性心律失常。结果治疗6个月后,两组心功能均见明显改善。卡维地洛组6 min步行距离较常规治疗组明显改善;射血分数(EF)、每搏输出量(SV)及每分心输出量(CO)较常规治疗明显增加;左室舒张末期内径(LVEDD)及左室收缩末期内径(LVESD)较常规治疗组明显降低;收缩压、舒张压、心率及QTd较常规治疗组明显降低;恶性室性心律失常发生率明显降低。结论卡维地洛能显著改善缺血性心脏病心力衰竭,改善左室重构,使QTd缩短而减少恶性室性心律失常的发生。     

曲美他嗪治疗缺血性心肌病心力衰竭的疗效观察

目的观察曲美他嗪治疗缺血性心肌病心力衰竭的临床疗效。方法将106例缺血性心肌病心力衰竭患者随机分为对照组与观察组,53例对照组患者接受抗心衰常规治疗,53例观察组患者在常规治疗基础上加用曲美他嗪治疗,比较两组治疗后的临床疗效、6min内最大步行距离、左室射血分数（LVEF）、左心室收缩末期内径（LVESD）和左心室舒张末期内径（LVEDD）的变化。结果观察组临床治疗总有效率为90.5%,显著高于对照组的73.6%(P＜0.05),治疗后6min最大步行距离观察组患者比对照组显著提高(P＜0.01),观察组患者与对照组比较,LVEF的升高和LVESD、LVEDD的降低均差异显著具有统计学意义(P＜0.01)。结论曲美他嗪用于缺血性心肌病心力衰竭,可显著改善患者心功能,提高临床疗效,延长其生命,是一种安全有效的方法,值得临床推广。     

卡维地洛治疗缺血性心脏病心力衰竭及对QT离散度的影响

目的 观察卡维地洛治疗缺血性心脏病心力衰竭及对QT离散度(QTD)和恶性室性心律失常发生的影响.方法 62例缺血性心脏病心力衰竭患者随机分成卡维地洛治疗组和常规治疗组(每组31例).监测治疗前及治疗6个月后6min步行距离,每搏输出量(SV)及每分心输出量(CO);超声心动图监测左室射血分数(EF)、左室舒张末期内径(LEVDD)乏左室收缩末期内径(LVESD),同时监测心功能、收缩压、舒张压及心率的变化;QTd及恶性室性心律失常.结果 治疗个月后,两组心功能均未明显改善.卡维地洛组6min步行距离较常规治疗组明显改善;射血分数(EF)、每搏输出量(SV)及每分心输出量(CO)较常规治疗组明显增加;左室舒张末期内径(LEVDD)及左室收缩末期内径(LVESD)较常规治疗组月显降低;收缩压、舒张压、心率及QTd较常规治疗组明显降低;恶性室性心律失常检出率明显降低.结论 卡维地洛能显著改善缺血性心脏病心力衰竭,改善左室重塑,使QTd缩短而减少恶性室性心律失常的发生.     

卡维地洛治疗缺血性心脏病心力衰竭及对QT离散度的影响

目的 观察卡维地洛治疗缺血性心脏病心力衰竭及对QT离散度(QTD)和恶性室性心律失常发生的影响.方法 62例缺血性心脏病心力衰竭患者随机分成卡维地洛治疗组和常规治疗组(每组31例).监测治疗前及治疗6个月后6min步行距离,每搏输出量(SV)及每分心输出量(CO);超声心动图监测左室射血分数(EF)、左室舒张末期内径(LEVDD)乏左室收缩末期内径(LVESD),同时监测心功能、收缩压、舒张压及心率的变化;QTd及恶性室性心律失常.结果 治疗个月后,两组心功能均未明显改善.卡维地洛组6min步行距离较常规治疗组明显改善;射血分数(EF)、每搏输出量(SV)及每分心输出量(CO)较常规治疗组明显增加;左室舒张末期内径(LEVDD)及左室收缩末期内径(LVESD)较常规治疗组月显降低;收缩压、舒张压、心率及QTd较常规治疗组明显降低;恶性室性心律失常检出率明显降低.结论 卡维地洛能显著改善缺血性心脏病心力衰竭,改善左室重塑,使QTd缩短而减少恶性室性心律失常的发生.     

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.