小儿尸检临床及病理对照分析

目的 评价分析小儿尸检36例的结果。方法 对比36例小儿尸检病历的临床及病理诊断。结果 36例小儿尸检中，新生儿尸检17例，临床诊断基本符合5例，临床诊断不符9例，待诊3例；28天－2岁12例，临床诊断基本符合9例，临床诊断不符1例，待诊2例；2－12岁7例，临床诊断基本符合2例，临床诊断不符1例，待诊4例。结论 分析表明，尸检是帮助临床医师提高诊治水平的重要手段。     

福建邵武地区伤寒临床变迁（71例临床分析）

福建邵武地区伤寒临床变迁（７１例临床分析）陈国关键词：肠伤寒病，肥达氏反应，氯霉素为提高对不典型伤寒病例的认识，本文对７１例伤寒患者作一临床分析，并探讨其临床特点。１临床资料１．１一般资料男性３５例，女性３６例，其中工人２９例，农民２５例，其他１８例...     

糖尿病合并脑中风的临床护理体会

目的：探讨糖尿病合并脑中风的临床护理措施及效果。方法选取我院收治的132例糖尿病合并脑中风患者，并对其临床资料进行回顾性分析。结果本组132例患者经常规治疗及针对性临床护理干预后临床治愈72例，显效35例，有效23例，无效2例，治疗总有效率为98.48%。结论给予糖尿病合并脑中风患者针对性的临床护理干预，可有效提高治疗效果，值得临床推广应用。     

胃溃疡的饮食护理

胃溃疡是临床内科常见病，多发病，近年来采用合理、规范的饮食、护理，胃溃疡患者取得满意的临床疗效，现总结报告如下。 1临床资料：选取胃溃疡患者56例，其中男36例，女20例；25∽35岁15例，36∽46岁25例；47岁以上者16例；病程1∽12年。本组56例患者中，临床治愈45例，好转9例，无效2例。     

应用针灸疗法治疗甲状腺机能亢进症的疗效观察

目的：探讨分析应用针灸疗法治疗甲状腺机能亢进症的临床疗效。方法：选取2011年5月～2012年5月间我院收治的患有甲状腺机能亢进症的患者114例作为研究对象，将其随机分为对照组（57例）和治疗组（57例），为对照组患者进行常规药物治疗，为治疗组患者进行针灸治疗，观察对比两组患者的临床疗效，并将对比的结果及两组患者的临床资料进行回顾性的分析。结果：在治疗组57例患者中，临床疗效判定等级为痊愈的患者有34例，临床疗效判定等级为显效的患者有19例，临床疗效判定等级为有效的患者有3例，临床疗效判定等级为无效的患者有1例，治疗的总有效率为98.2%；在对照组57例患者中，临床疗效判定等级为痊愈的患者有16例，临床疗效判定等级为显效的患者有28例，临床疗效判定等级为有效的患者有8例，临床疗效判定等级为无效的患者有5例，治疗的总有效率为91.2%。治疗组患者的临床疗效明显优于对照组患者，差异显著（P＜0.05），具有统计学意义。结论：应用针灸疗法治疗甲状腺机能亢进症的临床疗效显著，值得在临床上推广应用。     

应用临床路径对脑卒中合并吞咽困难患者进行护理的效果观察

目的：探讨分析应用临床路径(CNP)对脑卒中合并吞咽困难患者进行护理的临床效果。方法：选取2011年11月～2013年8月间我院收治的脑卒中合并吞咽困难患者60例作为研究对象，按照入院时间的不同（以2012年8月份为界）将其分为对照组（30例）和观察组（30例），为对照组患者进行常规护理，为观察组患者进行临床路径护理，观察对比两组患者吞咽功能的恢复情况，并将对比的结果及两组患者的临床资料进行回顾性的分析。结果：在观察组30例患者中，临床疗效判定等级为痊愈的患者有3例，临床疗效判定等级为明显好转的患者有4例，临床疗效判定等级为好转的患者有17例，临床疗效判定等级为无效的患者有6例，治疗的总有效率为80.00%；在对照组30例患者中，临床疗效判定等级为痊愈的患者有1例，临床疗效判定等级为明显好转的患者有2例，临床疗效判定等级为好转的患者有14例，临床疗效判定等级为无效的患者有13例，治疗的总有效率为56.67%。观察组患者的临床疗效明显优于对照组患者，差异显著(P＜0.05)，具有统计学意义。结论：应用临床路径对脑卒中合并吞咽困难患者进行护理的临床效果显著，值得在临床上推广应用。     

癌性Lambert—Eaton肌无力综合征16例临床特点分析

目的癌性Lambert—Eaton肌无力综合征（LEMS）临床少见，此报道旨在增进临床对这一综合征的认识，提高LEMS的诊断水平。方法对16例LEMS患者的临床资料做回顾性分析。结果全组16例，男性12例，女性4例，发病年龄39—72岁，首发症状均为肢体无力，全部病例均行病理诊断，肺癌10例，乳腺癌3例，甲状腺癌2例，胃癌1例，肌无力症状早于癌症状出现的11例。13例抗癌治疗，症状消失或改善。结论LEMS临床误诊率较高，认识其，临床特点有利于早期诊断，及早发现潜在癌肿，临床医生，特别是神经内科医生应高度重视，以免延误治疗时机。     

应用抗生素序贯疗法治疗儿童急性呼吸道感染的疗效观察

目的：探讨分析应用抗生素序贯疗法治疗儿童急性呼吸道感染的临床疗效。方法：选取2012年8月～2013年11月间我院收治的急性呼吸道感染患儿100例作为研究对象，将其随机分为观察组（50例）和对照组（50例），采用常规疗法为对照组患儿进行治疗，采用抗生素序贯疗法为观察组患儿进行治疗，观察对比两组患儿的临床治疗效果，并将对比的结果及两组患儿的临床资料进行回顾性的分析。结果：在观察组50例患儿中，临床疗效判定等级为治愈的患儿有24例，临床疗效判定等级为显效的患儿有20例，临床疗效判定等级为有效的患儿有5例，临床疗效判定等级为无效的患儿有1例，治愈率为48%，治疗的总有效率为98%；在对照组50例患儿中，临床疗效判定等级为治愈的患儿有17例，临床疗效判定等级为显效的患儿有24例，临床疗效判定等级为有效的患儿有5例，临床疗效判定等级为无效的患儿有4例，治愈率为34%，治疗的总有效率为92%。观察组患儿的临床疗效明显优于对照组患儿，差异显著（P＜0.05），具有统计学意义。结论：应用抗生素序贯疗法治疗儿童急性呼吸道感染的临床疗效显著，值得在临床上进一步推广应用。     

应用高压氧疗法联合音乐疗法治疗急性脑梗塞的疗效观察

目的：探讨分析应用高压氧疗法联合音乐疗法治疗急性脑梗塞的临床疗效。方法：选取2011年1月至2013年12月间我院收治的急性脑梗塞患者92例作为研究对象，将其随机分为高压氧组（46例）和音乐组（46例），为高压氧组患者进行高压氧治疗，为音乐组患者在进行高压氧治疗的基础上联合音乐治疗，观察对比两组患者的临床疗效，并将对比的结果及两组患者的临床资料进行回顾性的分析。结果：经过一段时间的治疗，两组患者的日常生活能力均得到了明显的提高。在音乐组46例患者中，临床疗效判定等级为痊愈的患者有24例，临床疗效判定等级为显效的患者有12例，临床疗效判定等级为有效的患者有4例，临床疗效判定等级为无效的患者有0例，治疗的总显效率为78.26%；在高压氧组46例患者中，临床疗效判定等级为痊愈的患者有17例，临床疗效判定等级为显效的患者有12例，临床疗效判定等级为有效的患者有9例，临床疗效判定等级为无效的患者有2例，治疗的总显效率为63.04%。音乐组患者的临床疗效明显优于高压氧组患者，差异显著（P＜0.05），具有统计学意义。结论：应用高压氧疗法联合音乐疗法治疗急性脑梗塞的临床疗效显著，值得在临床上推广应用。     

产科出血性休克的临床治疗对策及其效果分析

目的探讨产科出血性休克的治疗对策及临床效果。方法选取2010年6月-2012年4月收治的100例产科出血性休克患者为研究对象，观察临床治疗效果。结果本组100例患者中94例患者经过及时抢救临床症状得到缓解，有2例患者临床采用子宫全切除术进行治疗，3例患者临床行子宫次全切除术治疗，1例患者因临床治疗无效而死亡。结论快速实施临床抢救，是提升患者存活率的重要途径。     

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.