糖尿病性下肢血管病变的诊断与治疗效果分析

目的 探讨分析糖尿病性下肢血管病变的治疗方法,总结其临床诊断标准与治疗效果.方法 选取我院2007年10月至2009年10月98例糖尿病性下肢血管病变患者,进行基础治疗34例,内科治疗25例,外科治疗12例,中医治疗27例,随访一月,记录治疗前后血脂变化及血液流变学变化情况,进行统计分析.结果 98例糖尿病性下肢血管病变患者中,基础治疗显效13例,有效17例,无效4例;内科治疗显效14例,有效10例,无效1例;外科治疗显效4例,有效6例,无效2例;中医治疗显效8例,有效15例,无效4例.结论 采取以中西医结合内科治疗为主,以外科手术治疗为辅的综合治疗手段,及早诊断,早期积极进行防治,能明显改善下肢的缺血症状,有效降低患肢的截肢率,提高患者的治愈率.     

氟哌啶醇治疗强直-阵挛性癫痫持续状态的临床分析

目的 探讨氟哌啶醇治疗强直-阵挛性癫痫持续状态的实际临床疗效.方法 选择自2000年5月～2011年9月收治强直-阵挛性癫痫持续状态患者56例,随机分为治疗组和对照组,治疗组27例,对照组29例.两组患者均给予传统药物治疗,治疗组在传统药物治疗的基础上,加用水合氯醛及氟哌啶醇治疗,详细观察统计两组患者惊厥控制情况,记录两组患者实际临床治疗效果.结果 治疗组27例患者中,治疗后1h控制惊厥14例,治疗后6h控制惊厥11例,治疗后12h控制惊厥1例,治疗后24h控制惊厥0例,治疗后48h控制惊厥0例,死亡1例;对照组29例患者中,治疗后1h控制惊厥5例,治疗后6h控制惊厥11例,治疗后12h控制惊厥9例,治疗后24h控制惊厥2例,治疗后48h控制惊厥1例,死亡1例.结论 氟哌啶醇治疗强直-阵挛性癫痫持续状态疗效显著.     

复发性口腔溃疡的临床诊治探析

目的:探讨复发性口腔溃疡的治疗方法。方法:选择91例复发性口腔溃疡患者,随机分为试验组48例,对照组43例。试验组采用相关中药的治疗方法,对照组采用甲硝唑和Vit B2的药物治疗,对比两组患者的治疗效果。结果:试验组治疗显效32例,有效15例,治疗无效1例;对照组治疗显效20例,有效12例,无效11例。结论:对复发性口腔溃疡的患者采用中医的治疗方法,治疗效果显著。     

中西医结合治疗妇产科术后低热症100例效果观察

目的:对中西结合治疗妇产科术后低热症的临床疗效进行观察和研究。方法:选择100例进行妇产科术后低热症治疗的患者资料进行研究和分析,将患者分为西医组、中医组和中西结合组三组,分别包括40例中西结合治疗患者,30例西医治疗患者和30例中医治疗患者,比较和分析三组患者的治疗效果。结果:西医组12例患者基本治愈,7例患者治疗显效,7例患者治疗有效,4例患者治疗无效,治疗显效率为63.3%。中医组12例患者基本治愈,11例患者治疗显效,5例患者治疗有效,2例患者治疗无效,治疗显效率为53.3%。中西医结合组25例患者基本治愈,12例患者治疗显效,2例患者治疗有效,1例患者治疗无效,治疗显效率为92.5%。中医组、西医组与中西医结合组治疗效果差异具有统计学意义(P<0.05)。结论:中西结合治疗妇产科术后低热症能够取得更加理想的治疗效果,值得被推广和应用到临床治疗中去。     

针药结合治疗原发性痛经

目的：明确针灸结合中药治疗原发性痛经的疗效。方法：将82例患者随机分为3组,治疗1组28例全部采用针灸加中药汤剂治疗;治疗2组27例单纯采用中药汤剂辨证论治;对照组27例采用止痛片进行治疗。结果：治疗1组的显效率、有效率高于治疗2组和对照组。治疗1组治愈21例,显效5例,有效1例,无效1例。治疗2组治愈10例,显效7例,有效6例,无效2例。对照组治愈9例,显效7例,有效5例,无效6例。结论：采用针药结合的方法治疗原发性痛经有较好的效果。     

加味麻杏石甘汤治疗小儿肺炎

目的：研究分析加味麻杏石甘汤治疗小儿肺炎的临床疗效。方法：在江苏省睢宁县中医院儿科收治的小儿肺炎患儿中随机挑选52例作为研究对象,并随机均匀分为两组,对照组接受常规的药物治疗,实验组在常规药物治疗的基础上以加味麻杏石甘汤进行治疗。结果：实验组患儿11例痊愈,9例治疗效果显著,5例治疗有效,1例治疗无效,治疗有效率96.2％。对照组患儿5例痊愈,9例治疗效果显著,8例治疗有效,4例治疗无效,治疗有效率为84.6％。结论：加味麻杏石甘汤治疗小儿肺炎,效果显著,具有临床推广价值。     

生长抑素治疗上消化道出血临床观察

目的探寻治疗上消化道出血疗效较好的方法。方法 40例上消化道出血病例随机分为2组,治疗组采用生长抑素（奥曲肽）配合基础治疗,对照组采用基础治疗。观察2组疗效。结果治疗组显效13例,有效6例,无效1例;对照组显效9例,有效5例,无效6例,治疗组疗效明显优于对照组。结论生长抑素配合基础治疗治疗上消化道出血较基础治疗效果更佳,可以作为临床上消化道出血治疗的首选。     

针药结合治疗原发性痛经

目的:明确针灸结合中药治疗原发性痛经的疗效。方法:将82例患者随机分为3组,治疗1组28例全部采用针灸加中药汤剂治疗;治疗2组27例单纯采用中药汤剂辨证论治;对照组27例采用止痛片进行治疗。结果:治疗1组的显效率、有效率高于治疗2组和对照组。治疗1组治愈21例,显效5例,有效1例,无效1例。治疗2组治愈10例,显效7例,有效6例,无效2例。对照组治愈9例,显效7例,有效5例,无效6例。结论:采用针药结合的方法治疗原发性痛经有较好的效果。     

重症急性胰腺炎综合治疗疗效分析

目的探讨治疗重症急性胰腺炎的方法,提高临床医生对该病的诊疗水平。方法回顾性分析我院5年来63例重症急性胰腺炎患者的相关临床资料,通过保守治疗共36例,其中转为手术治疗5例;内镜治疗共27例,其中转为手术治疗3例;手术治疗组共8例,分析相关治疗方法的临床应用价值。结果在本组63例重症急性胰腺炎患者中治愈52例,死亡11例;保守治疗组31例,治愈26例,死亡5例;内镜治疗组24例,治愈21例,死亡3例;手术治疗组8例,治愈5例,死亡3例。结论对于非胆源性所致重症急性胰腺炎,均应采用以保守治疗为主,必要时可考虑选择手术治疗;而对于胆源性所致重症急性胰腺炎,应尽可能早期行ERCP和（或）EST＋ENBD治疗,术后病情稳定后可酌情行腹腔镜胆囊切除术（LC）。     

绿色通道救治蛛网膜下腔出血126例的效果评价

目的:探讨绿色通道对蛛网膜下腔出血病因诊断及治疗方案选择的意义.方法:回顾性分析2007 年1月～2009 年12 月实施绿色通道对126 例蛛网膜下腔出血患者行急症CTA 或DSA 检查,确定病因,快速多学科会诊,制定治疗方案,并在治疗后3个月行日常生活能力Barthel 指数测评.结果:126 例蛛网膜下腔出血发现动脉瘤106 例,其中行栓堵治疗55 例,手术夹闭38 例,保守治疗13 例;治疗中及治疗后发生血管痉挛11 例,再出血6例,脑积水12 例,死亡6例.动静脉畸形8例,其中行栓堵治疗2例,手术治疗2例,保守治疗4例;治疗中及治疗后发生血管痉挛1例,再出血1例,脑积水1例,死亡1例.CTA 或DSA 未见明显异常者12 例,均采取保守治疗.治疗后3个月日常生活能力Barthel 指数测评明显改善.结论:医院多学科协作,开通绿色通道,可以在最短时间内明确蛛网膜下腔出血的原因,为病因治疗提供依据,可降低急性期死亡率,改善预后.     

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.