兰索拉唑三联疗法治疗幽门螺旋杆菌感染十二指肠溃疡

目的：观察兰索拉唑、克拉霉素、阿莫西林短程三联疗法治疗幽门螺旋杆菌（HP）感染十二指肠溃疡的愈合率和根除率。方法：HP阳性的十二指肠溃疡病人135例,分为两组,观察组85例,以兰索拉唑30mg、克拉霉素500mg、阿莫西林1000mg,每天2次口服,治疗10天;对照组50例,以雷尼替丁150mg、阿莫西林1000mg、甲硝唑400mg,每天2次口服,治疗10天,疗程结束后4周复查十二指肠溃疡的愈合率和根除率。结果：观察组溃疡的愈合率为93％,HP的根除率为93％,对照组溃疡的愈合率为74％,HP的根除率为70％。结论：兰索拉唑、克拉霉素、阿莫西林三联短程疗法治疗HP阳性十二指肠溃疡明显优于对照组,是满意的选择之一。     

兰索拉唑短程三联治疗幽门螺杆菌的疗效观察

目的：观察兰综拉唑联用克拉霉素及阿莫西林一周对幽门螺杆菌（HP）感染的十二脂肠溃疡病人疗效,方法：将83例胃镜正镜证实有HP感染十二指肠溃疡病人随机分成两组,A组30例,口服兰索拉唑30mg,阿莫西林500mg,克拉霉素500mg,用法每天二次,疗程一周,B组53例,口服兰索拉唑30mg,每天一次,阿莫西林500mg,甲硝唑200mg,每天四次,疗程两周,治疗四周后复查胃镜了解溃疡愈合及HP根除率,结果：HP根限率A组96．7％,高于B组77．4％（P＜0．05）,溃疡愈合率A组93．3％,与B组92．5％相似（P＞0．05）。溃疡愈合率A组93．3％,与B组92．5％相似（P＞0．05）,结论：兰索拉唑联用克拉素及阿莫西林一周是目前较理想根除HP治疗方案。     

兰索拉唑四联治疗Hp阳性DU36例疗效观察

目的观察兰索拉唑、果胶铋、克拉霉素、阿莫西株短程四联疗法根除凼门螺旋杆茸（Hp）和治疗十二指肠溃疡（Du）临床疗效。方法36例确诊为Hp阳性十二指肠球部溃疡的患者,予以四联治疗：兰索拉唑30mg、克拉霉素500mg、阿莫西林1000mg,均每天2次口服,果胶铋150mg,每天3次口服,共治疗2周,疗程结束后复查十二指肠溃疡的愈合率和幽门螺旋杆菌根除率。结果溃疡的愈合率为91％,Hp的根除率为94％。结论兰索拉唑,果胶铋、克拉霉素,阿莫西林四联疗法治疗Hp阳性的十二指肠溃疡具有溃疡愈合迅速,Hp根除率高,症状缓解迅速,不良反应少,依从性良好。     

含铋剂四联疗法作为幽门螺杆菌根除失败后补救治疗方案的临床研究

目的探讨含铋剂四联疗法作为幽门螺杆菌（Hp）根除失败后补救治疗方案的疗效及安全性。方法选择首次Hp根除治疗失败的180例非溃疡性消化不良患者,随机分为A、B两组,每组90例,A组予兰索拉唑肠溶胶囊＋胶体次枸橼酸铋＋阿莫西林＋左氧氟沙星治疗14d。B组予兰索拉唑肠溶胶囊＋胶体次枸橼酸铋＋阿莫西林＋呋喃唑酮治疗14d。治疗结束至少停药4周后复查14C尿素呼气试验确定HP根除率,对Hp根除率进行意向性分析（ITT）和符合方案分析（PP）比较,同时评估疗效及安全性。结果A、B两组HP根除率分别为：11Tr87-8％（79／90）,PP90．8％（79／87）;ITT85．6％（77／90）,PP89．5％（77／86）,组间差异均无统计学意义（P〉0．05）。结论左氧氟沙星或呋喃唑酮联合阿莫西林两种抗生素的含铋剂四联疗法可用于首次根除Hp失败后的补救治疗。     

四联疗法治疗胃溃疡并幽门螺杆菌感染的临床疗效观察

目的观察左氧氟沙星、阿莫西林、枸橼酸铋钾、兰索拉唑的四联疗法治疗胃溃疡并幽门螺杆菌（HP）感染的疗效。方法经胃镜及快速尿素酶试验确诊的胃溃疡并HP阳性63例患者分为治疗组和对照组,治疗组给予左氧氟沙星、阿莫西林、枸橼酸铋钾、兰索拉唑治疗;对照组给予阿莫西林、克拉霉素、兰索拉唑治疗,疗程均为10 d,并比较两组治疗效果,观察两组患者HP根除率、胃溃疡总有效率及不良反应。结果治疗组31例,HP根除28例,根除率为90.3%;对照组32例,HP根除23例,根除率为71.9%,两组间根除率比较差异无统计学意义（χ2=3.475.0,P〈0.05）;治疗组溃疡治愈总有效30例（96.7%）,对照组溃疡治愈总有效30例（93.8%）,两组间总有效率比较差异无统计学意义（χ2=0.0,P〉0.05）。结论左氧氟沙星、阿莫西林、枸橼酸铋钾、兰索拉唑的四联疗法对HP的根除效果优于标准三联疗法,价格低廉,副作用少,安全性高,患者依从性好。     

兰索拉唑三联疗法治疗消化性溃疡合并Hp感染的疗效观察

目的观察兰索拉唑三联疗法治疗幽门螺杆菌（Hp）及治疗十二指肠溃疡的效果。方法66例十二指肠溃Hp阳性的患者分为三组A、B、C组，三组均先给予三联治疗一周．兰索拉唑30mg＋阿莫西林1g＋克拉霉素500mg。然后再继续单独给予B组兰索拉唑15mg，每日一次，连续一周，C组兰索拉唑15mg，每天一次，连续三周，于用药结束后第28天复查胃镜及检测Hp，井于用药后第28天对患者的上腹维．反酸等症状进行评估。结果58例完成全部治疗方案，8例失访。三组Hp根除率88.88％～94.73％，组间差异无显著性（P〉0.05）：溃疡愈合率83.33％～89.43％组间差异无显著性（P〉0.05）。症状积分改善情况三组间两两比较有显著性差异（P〈0.05）。结论三组方案均能有效地根除Hp和促进溃疡的愈合。     

兰索拉唑、呋喃唑酮、阿莫西林三联疗法治疗幽门螺杆菌相关性消化性溃疡的疗效观察

目的：观察兰索拉唑、呋喃唑酮、阿莫西林三联疗法对消化性溃疡（PU）的治疗效果及幽门螺杆菌（Hp）的根除效果。方法：对64例幽门螺杆菌阳性的消化性溃疡患者，随机分为治疗组及对照组。治疗组33例，给予兰索拉唑30mg，1次／d；呋哺唑酮100mg，3次／d；阿莫西林1000mg，2次／d，饭前服用1周。对照组31例，给予奥美拉唑20mg。2次／d；克拉霉素500mg。2次／d；阿莫西林1000mg，2次／d，饭前服用1周。停药4周后复查胃镜。结果：治疗组与对照组Hp根除率分别为90．9％、93．5％，差异无统计学意义（P〉0．05）；溃疡愈合率分别为93．9％、96．8％，差异无统计学意义（P〉0．05）。结论：兰索拉唑、呋喃唑酮、阿莫西林三联疗法具有药物剂量小、疗程短、疗效高、不良反应轻微、费用低等优点。值得基层医院推广应用。     

兰索拉唑四联疗法治疗幽门螺杆菌阳性十二指肠溃疡疗效观察

幽门螺杆菌(HP)感染与溃疡病、慢性胃炎密切相关,目前临床对根除HP的方案已达到共识,主要有两大类：一类是以铋剂为主,再加两种抗菌药的三联疗法,另一类是以质子泵抑制药(PPI)为主,再加两种抗菌素的新三联疗法。据外国报告PPI加上以铋剂为主的经典三联疗法HP根除率为95％～100％,因此我们应用兰索拉唑、枸橼酸铋钾、阿莫西林、甲硝唑对HP阳性的十二指肠溃疡(Du)患进行为期1周的四联疗法,取得满意疗效,现报道如下。     

雷贝拉唑四联疗法抗幽门螺杆菌的疗效观察

目的观察雷贝拉唑四联方案4日根除幽门螺杆菌（HP）的疗效。方法120例HP阳性患者随机分为治疗组（四联方案）和对照组（三联方案）各60例,治疗组口服雷贝拉唑10mg、雷尼替丁枸橼酸铋（RBC）350mg、阿莫西林1000mg、呋喃唑酮100mg,2次／d,共4d。对照组口服雷贝拉唑10mg、阿莫西林1000mg,呋喃唑酮100mg,2次／d,共7d。活动期溃疡抗HP治疗后继续服用雷贝拉唑10mg,1次／d,疗程2周。观察HP根除率、活动期溃疡和糜烂性胃窦炎的愈合率及副作用的发生率。结果治疗组和对照组按治疗意向（ITT）分析的根除率分别为83．33％、71．67％,按完成随访病例（PP）分析的根除率分别为94．55％、77．78％（P〈0．05）;两组对活动期溃疡愈合率差异元统计学意义（P〉0．05）;治疗组对糜烂性胃窦炎的愈合率显著高于对照组（P〈0．05）;副作用发生率分别为8．33％、11．67％（P〉0．05）。结论雷贝拉唑与RBC四联4日疗法是一种短程、高效、安全的根除HP的方法,值得进一步试用。     

枸橼酸铋钾、克拉霉素及替硝唑三联1周治疗幽门螺旋杆菌感染

目的：观察枸橼酸铋钾，克拉霉素及替硝唑三联1周根除幽门螺旋杆菌(Hp)的疗效，探索较理想的根除Hp方案，方法：Hp阳性的慢性胃炎或静止期十二指肠溃疡患者75例，随机分为二组：治疗组：枸橼酸铋钾220mg，克拉霉素250mg,替硝唑500mg，对照组：奥美拉唑20mg，克拉霉素250mg，替硝唑500mg，均为2次／d，共7d，观察记录Hp根除情况，临床症状改善情况及不良反应。结果：Hp根除率两组分别为84．2％，86．5％（P＞0．05），两组在消化道症状缓解率和不良反应出现率方面差异无显著性，不良反应均较轻微，不影响治疗。结论：枸橼酸铋 钾，克拉霉素及替硝唑三联1周治疗方案疗程短，疗效高，价格低，副反应轻微，是较理想的根除Hp的方案。     

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.     

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.     

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.