复方皂矾丸联合环孢菌素A治疗慢性再生障碍性贫血的研究

目的:探讨进一步提高慢性再生障碍性贫血(CAA)疗效的方法.方法:采用同期随机对照研究方法,比较复方皂矾丸联合环孢菌素A(CsA)与单用雄激素治疗CAA的疗效.结果:复方皂矾丸联合CsA治疗CAA有效率为85.0 %,明显高于单用雄激素对照组的44.4 %.治疗有效者骨髓BFU-E、CFU-E、CFU-GM数量恢复较好.结论:复方皂矾丸联合CsA是治疗CAA的有效方法之一.     

复方皂矾丸与雄激素联合治疗慢性再生障碍性贫血

目的:为探索复方皂矾丸联合雄激素治疗慢性再生障碍性贫血(CAA)的疗效及有关实验指标的变化。方法:采用随机对照研究方法,比较单用雄性激素与雄激素联合复方皂矾丸治疗CAA的疗效。结果:雄激素联合复方皂矾丸治疗组有效率91.23%,明显高于单用雄激素对照组(58.16%);治疗组中外周血单个核细胞(PBMNC)对正常人CFU-GM免疫抑制作用阳性者有效率与阴性者比较差异有显著性(P<0.05)。结论:复方皂矾丸联合雄激素治疗CAA优于单用雄激素治疗,PBMNC对正常人CFU-GM产率的抑制试验可作为联合用药的一个指标,治疗有效者骨髓造血功能恢复更为完全。该方案治愈率高,副作用小,患者可以耐受。     

复方皂矾丸联合环孢菌素A治疗慢性再生障碍性贫血的研究

目的 :探讨进一步提高慢性再生障碍性贫血 (CAA)疗效的方法。方法 :采用同期随机对照研究方法 ,比较复方皂矾丸联合环孢菌素 A(Cs A)与单用雄激素治疗 CAA的疗效。结果 :复方皂矾丸联合 Cs A治疗 CAA有效率为85 .0 % ,明显高于单用雄激素对照组的 4 4 .4 %。治疗有效者骨髓 BFU - E、CFU - E、CFU- GM数量恢复较好。结论 :复方皂矾丸联合 Cs A是治疗 CAA的有效方法之一。     

环孢霉素A联合康力龙治疗慢性再生障碍性贫血疗效观察

目的 :探讨环孢霉素A(CsA)加康力龙对慢性再生障碍性贫血 (CAA)的疗效。方法 :慢性再障 (CAA) 36例 ,用环孢霉素A(CsA) +康力龙治疗 16例 ,单用康力龙治疗 2 0例 ,观察两组疗效及对疗效和一些相关因素进行比较。结果 :CsA +康力龙有效率为 93.8% ,高于单用康力龙组的 5 5 .0 % (P <0 .0 5 )。CsA +康力龙组的骨髓增生度及外周血网织红细胞的恢复优于单用康力龙组。结论 :CsA +康力龙治疗CAA优于单用康力龙 ,是更有效的治疗CAA的方案。     

环孢素A联合康力隆治疗慢性再生障碍性贫血

目的 观察环孢素A(CsA)联合康力隆治疗慢性再生障碍性贫血(CAA)的临床疗效.方法 将78例CAA患者随机分为2组,治疗组49例,采取CsA联合康力隆治疗,对照组29例采取单药康力隆治疗.持续用药治疗6个月后,观察治疗后的临床疗效、血常规变化、不良反应,进行比较分析.结果 治疗组总有效率为91.8%,对照组为65.5%,两组比较,CsA联合康力隆的疗效明显高于单药康力隆的疗效.结论 CsA联合康力隆对CAA有较好的临床疗效,优于单用康力隆治疗.     

硝呋太尔制霉素和甲硝唑治疗细菌性阴道病的临床效果比较

目的探讨甲硝唑片联合硝呋太尔制霉菌素阴道栓治疗外阴阴道细菌病的临床效果.方法选取2010年2月~2012年2月期间在我院妇产科接受治疗的细菌性阴道病患者120例,随机分为研究组和对照组各60例.研究组采用硝呋太尔制霉素联合甲硝唑进行治疗;对照组单用硝呋太尔制霉菌素进行治疗,对比两组患者的临床疗效.结果治疗后,对照组的总有效率为80.00%,研究组的总有效率为93.33%,差异有统计学意义(P<0.05).研究组起效时间为(3±2)d,复发率为11.67%,对照组起效时间为(7±2)d,复发率为33.33%,研究组患者起效时间相比对照组显著缩短,复发率相比对照组显著降低,差异均有统计学意义(P<0.05).结论甲硝唑片联合硝呋太尔制霉菌素阴道栓治疗细菌性阴道炎,安全、有效,具有临床应用价值.     

环孢素A联合治疗重型再生障碍性贫血的临床研究

目的 探讨环孢素A( CsA )联合大剂量免疫球蛋白和雄激素治疗重型再生障碍性贫血(SAA)的临床疗效和不良反应.方法 28例重型再生障碍性贫血患者随机分为观察组和对照组,对照组用大剂量免疫球蛋白(HD-IVIG)和雄激素治疗,观察组在对照组治疗的基础上加用 CsA 3~5 mg/(kg·d),分两次口服,疗程不少于6~12个月.结果 两组患者经治疗后观察组总有效率为75%,对照组总有效率为50%,两组比较,差异有统计学意义(P<0.05).结论 CsA联合HD-IVIG和雄激素治疗重型再生障碍性贫血是有效的治疗方案,其不但安全可靠,且不良反应少,值得临床推广应用.     

再生障碍性贫血60例临床分析

目的探讨60例再生障碍性贫血（AA）患者临床发病特点、疾病诊断类型及临床治疗效果。方法回顾性分析9年间确诊的60例AA患者的临床资料。结果 60例AA患者治疗总有效率为53.3%（32/60）,其中SAA患者治疗有效率36%,CAA治疗有效率65.7%,（χ^2=5.17,P〈0.05）。雄激素治疗组23例,有效8例,占34.9%。雄激素＋CsA治疗组37例,有效24例,占64.9%（χ^2=5.16,P〈0.05）。SAA单用雄激素治疗组8例,有效1例,占12.5%;环孢素（CsA）＋雄激素治疗组17例,有效8例,占47.1%;CAA单用雄激素治疗组15例,有效7例,占46.7%;雄激素＋CsA治疗组20例,有效16例,占80%。用雄激素治疗组患者出现肝功能损害6例（26.1%）。雄激素联合CsA治疗组患者出现肝功能损害8例,肌酐、尿素氮升高4例（10.8%）,此外,出现牙龈增生肿胀3例（8.1%）,多毛及四肢感觉异常者各1例。结论免疫介导机制为再障主要发病机制之一,雄激素联合CsA应用为治疗AA的有效方法,但对于SAA治疗效果较差,如有条件应该尽早进行造血干细胞移植或给予抗胸腺细胞球蛋白/抗淋巴细胞球蛋白（ATG/ALG）治疗。     

环孢霉素A联合康力龙治疗慢性再生障碍性贫血

目的 探讨环孢霉素A（CsA)加康力龙对慢性再生障碍性贫血（CAA）的疗效。方法 慢性再障（CAA）36例，用环孢霉素A（CsA)＋康力龙治疗16例，单用康力龙治疗20例，观察两组疗效，对疗效和一些相关因素进行比较。结果 CsA＋康力龙有效率为93.75%，高于单用康力龙组的55％（P＜0.05，有显差异）。CsA 康力龙组的骨髓增生度及外周血网织红细胞的恢复优于单用康力龙组。结论 CsA 康力龙治疗CAA优于单用康力龙，是更有效的治疗CAA的方案。     

激素联合免疫球蛋白治疗吉兰-巴雷综合征患者的临床疗效观察

目的:观察激素联合免疫球蛋白治疗吉兰-巴雷综合征患者的临床疗效。方法:选取吉兰-巴雷综合征患者54例,随机分为对照组和观察组,每组各27例。对照组患者仅给予常规综合治疗,观察组患者在此基础上同时开展激素联合免疫球蛋白(丙种球蛋白)治疗,比较两组患者的起效时间、预后疗效及生活能力等指标。结果:观察组患者临床起效时间为(1.6±1.3)d,住院时间为(25.4±3.0)d,治疗总有效率为88.8%,均显著好于对照组,具有统计学意义(P<0.05)。结论:在常规综合治疗基础上采用激素联合免疫球蛋白治疗吉兰-巴雷综合征患者的疗效优于单纯常规综合治疗疗效。     

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.