奥美拉唑对急性脑血管病并发应激性溃疡出血17例疗效观察

<正> 我院近四年来,应用奥美拉唑治疗17例急性脑血管病并发应激性溃疡出血患者,取得了较好的疗效,现报道如下。 1.临床资料 一般资料 奥美拉唑组17例,为1993～1997年的住院病人,其中男12例,女5例,年龄26～79岁,平均60.72岁,脑出血11例,脑梗死6例。对照组20例,为1985～1992年资料完整的住院病人,其中男14例,女6例,年龄32～81岁,平均58.56岁,脑出血13例,脑梗死7例,采用西米替丁治疗。 急性脑血管病并发应激性溃疡出血诊断标准:(1)有急性脑血管病存在;(2)既往无溃疡病史;(3)在急性脑血管病发生后1～7天内发生上消化道出血。     

去甲肾上腺素联合奥美拉唑镁治疗脑血管病应激性溃疡出血患者的效果

目的:观察去甲肾上腺素联合奥美拉唑镁治疗脑血管病应激性溃疡出血患者的效果。方法:回顾性分析2018年1月至2020年5月该院收治的86例脑血管病应激性溃疡出血患者的临床资料,按治疗方案不同分为研究组和对照组各43例。对照组予以奥美拉唑镁治疗,研究组予以去甲肾上腺素联合奥美拉唑镁治疗。比较两组疗效、不良反应发生率、治疗前后胃蛋白酶水平、胃液pH值和视觉模拟评分法(VAS)评分。结果:研究组治疗总有效率为97.67%(42/43),高于对照组的81.40%(35/43),差异有统计学意义(P<0.05);治疗后,两组VAS评分和胃蛋白酶水平均降低,且研究组低于对照组,两组胃液pH值均升高,且研究组高于对照组,差异有统计学意义(P<0.05);两组不良反应发生率均为2.33%。结论:去甲肾上腺素联合奥美拉唑镁治疗脑血管病应激性溃疡出血患者效果显著,能提高胃液pH值,降低胃蛋白酶水平,缓解疼痛,且安全性良好。     

奥美拉唑治疗急性脑出血并发应激性溃疡的临床观察

1　目的应激性消化道溃疡出血是急性脑出血常见并发症之一 ,可使病情进一步加重 ,治疗上亦较困难。为探讨急性脑出血并发应激性溃疡出血的治疗方法 ,我院应用奥美拉唑静推对急性脑出血并发应激性溃疡患者进行临床疗效观察。2　方法对 6 0例急性脑出血并应激性溃疡出血患者随机分组 ,观察组 30例 ,对照组 30例。观察组用奥美拉唑 4 0mg,静推 ,2 /d ,疗程 3d ,对照组用西咪替丁 80 0mg加入葡萄糖 2 5 0ml,静滴 ,1/d ,疗程 3d。疗效判定 :①显效 :4 8h内无呕血 ,血压、脉搏保持稳定 ,排便间隔时间延长或柏油样便减少或颜色变淡 ;②有效 :72h内…     

脑出血后应激性溃疡的分析

目的探讨脑出血后应激性溃疡与出血部位、出血量的关系。分析早期使用奥美拉唑对应激性溃疡的预防。方法对98例急性脑出血患者进行随机分组，按出血部位、出血量比较应激性溃疡的发生率，A组使用奥关拉唑，B组不使用奥美拉唑。如B组出现消化道出血后加用奥美拉唑。结果脑出血后应激性溃疡与脑出血的出血部位、出血量有关。结论早期使用奥美拉唑可降低应激性溃疡的发生率且副作用少。     

洛赛克治疗急性脑血管病并发应激性溃疡疗效观察

我科 3年来共收治急性脑血管病并发应激性溃疡 40例 ,随机分为两组 ,治疗组应用洛赛克治疗 ,对照组应用西米替丁治疗 ,现将结果报道如下。1　资料与方法1.1　一般资料40例急性脑血管病并发应激性溃疡出血患者 ,均系本科1996 - 0 1～ 1999- 0 8的住院病人。其中男 2 8例 ,女 12例。年龄 40～ 70岁 ,平均年龄 5 7.8岁。脑出血 30例 ,脑梗死 9例 ,脑栓塞 1例。诊断标准 :①均有引起应激性溃疡出血的原发病存在 (急性脑血管病 ) ;②既往无消化性溃疡的病史 ;③在急性脑血管病发病后 1～ 5ｄ内出现上消化道出血。1 .2　给药方法治疗组 :洛赛克首…     

内镜下止血联合艾司奥美拉唑治疗消化性溃疡并出血的效果分析

目的:探讨内镜下止血联合艾司奥美拉唑治疗消化性溃疡并出血的效果.方法:选取2018年2月—2020年1月就诊于廉江市人民医院的160例消化性溃疡并出血患者,按随机数字表法分为两组,每组各80例.参考组行单一艾司奥美拉唑治疗,试验组行内镜下止血与艾司奥美拉唑联合治疗.比较两组临床疗效、再出血率、止血时间、住院时间、输血量、胃液pH值及不良反应发生情况.结果:试验组治疗总有效率高于参考组,再出血率、输血量低于参考组,止血时间、住院时间短于参考组,差异有统计学意义(P<0.05);两组治疗后24 h胃液pH值较治疗前明显升高,且试验组胃液pH值高于参考组,差异有统计学意义(P<0.05);两组不良反应发生率相比,差异无统计学差异(P>0.05).结论:消化性溃疡并出血患者接受内镜下止血联合艾司奥美拉唑治疗安全性较高,能缩短止血时间,减少再出血发生与输血量,提高胃液pH值,缩短住院时间.     

奥美拉唑与脑卒中相关性肺炎的关系研究

目的探讨无法进食经鼻饲的急性脑卒中患者给予奥美拉唑后胃液pH值、胃腔细菌定植情况以及对应激性消化道溃疡、卒中相关性肺炎（SAP）的影响。方法90例患者依据奥美拉唑应用时间随机分为三组,每8小时抽取胃液,测pH值及潜血试验。留取胃液、深部痰行细菌培养。结果三组胃液pH值、各组SAP发生率差异有统计学意义：三组应激性溃疡的发生率差异无统计学意义。90例患者中31例发生胃腔细菌定植,三组差异有统计学意义。胃腔细菌定植患者pH值与无细菌定植患者胃液pH值差异有统计学意义;发生胃腔细菌定植细菌主要为革兰阴性杆菌;17例SAP患者痰细菌培养主要为革兰阴性杆菌。17例SAP患者pH值与非SAP患者胃液pH值差异有统计学意义;急性脑卒中鼻饲患者,应用奥美拉唑时间延长,胃液pH增加,胃腔细菌定植增多,SAP发生率增加,应激性溃疡发生率下降。结论对于急性脑卒中患者应选择应用奥美拉唑时间,需监测胃液pH值,使胃液pH值保持适当范围。     

泮托拉唑与奥美拉唑治疗消化道溃疡合并出血的疗效评价

目的：观察泮托拉唑与奥美拉唑治疗消化道溃疡合并出血的临床效果。方法选择2014年9月—2016年4月在我院接受治疗的消化道溃疡合并出血患者90例作为研究对象,随机分为观察组和对照组各45例,分别接受泮托拉唑和奥美拉唑治疗,比较2组患者治疗前后的胃液pH值变化。结果治疗前2组患者胃液pH值比较差异无统计学意义（P>0.05）;治疗后观察组患者胃液pH值高于对照组,差异有统计学意义（P<0.05）。结论泮托拉唑治疗消化道溃疡合并出血效果优于奥美拉唑,值得临床推广应用。     

奥美拉唑对急性脑血管病应激性溃疡出血的预防作用

目的 比较西米替丁与奥美拉唑预防急性脑血管病并发应激性溃疡出血的效果。方法 186例急性脑血管病患者随机分成西米替丁对照组（93例）和奥美拉唑观察组（93例），观察住院期间消化道出血情况及病死率。结果 西米替丁组和奥美拉唑组并发应激性溃疡出血的发生率分别为19.4%和5.3%，西米替丁组病死率为11.8%。明显高于奥美拉唑组的3.2%。结论 奥美拉唑预防急性脑血管病并发应激性溃疡出血的效果明显优于西米替丁。     

国产泮托拉唑钠治疗脑出血并发应激性溃疡出血的疗效观察

我科于 1 999年 1月至 2 0 0 1年 8月应用国产泮托拉唑钠治疗脑出血合并应激性溃疡出血 31例 ,取得满意疗效 ,现报告如下 :1　资料与方法1 .1　一般资料　 61例急性脑出血并发应激性溃疡出血均为住院患者 ,符合 1 986年中华医学会第二次全国脑血管病学术会第 3次修订的诊断标准 ,经CT证实为急性脑出血 ,既往无消化溃疡病史 ,将 61例患者随机分为两组 ,治疗组 31例 (男 2 4例 ,女 7例 )年龄 43～ 74岁 ,其中呕血和黑便 2 1例 ,单纯性柏油便 1 0例 ,胃出血 45 0～ 1 2 0 0 ml,其中大脑皮层出血 3例 ,壳核出血 1 8例 ,丘脑出血 5例 ,脑室出血3…     

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.