山莨菪碱联合垂体后叶素治疗肺结核大咯血

目的研究肺结核大咯血时山莨菪碱（654—2）联合应用垂体后叶素的临床疗效。方法将113例肺结核大咯血患者随机分为两组，垂体后叶素（对照组）55例，山莨菪碱联合应用垂体后叶素（治疗组）58例。分别观察总有效率、显效率。结果对照组、治疗组总有效率分别为：72．73％、91．38％，显效率分别为40．00％、77．59％。差异具有统计学意义（P〈0．01）。结论山莨菪碱联合应用垂体后叶素能明显提高肺结核大咯血的止血疗效。     

垂体后叶素联合酚妥拉明治疗肺结核大咯血的临床研究

目的 探讨垂体后叶素联合酚妥拉明治疗肺结核大咯血的临床效果及安全性.方法 将我科2010年1月至2012年12月收治的40例肺结核所致的大咯血患者随机分成两组,每组患者均无垂体后叶素相关禁忌症.A组:垂体后叶素+止血合剂(酚磺乙胺,氨甲苯酸,维生素K1).B组:垂体后叶素+酚妥拉明+止血合剂.观察两组的止血疗效及不良反应.结果 B组止血疗效明显优于A组(P＜0.05),B组不良反应较A组少.结论 垂体后叶素联合酚妥拉明治疗肺结核大咯血较单用垂体后叶素止血效果好,并发症少,是一种安全有效的止血方法,值得临床推广.     

立止血联合垂体后叶素治疗肺结核咯血疗效观察

目的：观察立止血联合垂体后叶素治疗肺结核咯血的临床疗效。方法：将128例肺结核咯血病例随机分成两组,均给予小剂量垂体后叶素2U／h,静滴8—12h,每天1次,出血停止后停用。在此基础上,治疗组应用立止血1kU肌注,1kU静推,每日1次,连用3d。观察两组的疗效及药物副作用。结果：治疗组有效率92．2％,对照组有效率62．S％;治疗组止血时间（1．54±0．65）d,明显短于对照组（2．31±0．91）d,两组比较有非常显著差异（P〈0．01）。治疗组未见明显不良反应,对照组不良反应发生率为40．62％。结论：立止血联合垂体后叶素治疗肺结核咯血是一种安全可行、高效迅速、使用方便的止血方法。     

普鲁卡因联合肾上腺色腙治疗肺结核大咯血疗效观察

目的观察普鲁卡因联合肾上腺色腙治疗肺结核大咯血的临床疗效和不良反应。方法 108例大咯血的肺结核患者随机分为对照组和治疗组两组。对照组53例患者用垂体后叶素,治疗组55例患者用普鲁卡因联合肾上腺色腙,观察两组治疗48小时后的疗效。结果对照组有效率为81.13%,治疗组有效率为96.36%,治疗组止血效果明显优于对照组,统计有明显差异（P〈0.05）,对照组不良反应显著高于治疗组。结论普鲁卡因联合肾上腺色腙治疗肺结核中大量咯血疗效比垂体后叶素止血效果好,不良反应少,可在临床推广应用。     

立止血联合垂体后叶素治疗肺结核咯血临床疗效

目的为提高肺结核大咯血病人的疗效,观察立止血联合垂体后叶素治疗肺结核咯血疗效。方法将80例初治肺结核咯血患者随机分为治疗组和对照组。治疗组40例用立止血和垂体后叶素,对照组40例用垂体后叶素。疗程5d,比较2组疗效。结果治疗组的显效率为85%,显著高于对照组的60%（P〈0.01）。治疗组的总有效率为97.5%,也显著高于对照组的80.0%（P〈0.05）。结论立止血和垂体后叶素联合治疗大咯血病人,中西药结合能显著提高止血作用,缩短出血时间,减少出血,无明显副作用。     

垂体后叶素辅助治疗肺结核大咯血的疗效观察

目的 观察垂体后叶素辅助治疗肺结核大咯血的临床疗效及其不良反应.方法 牡丹江医学院红旗医院将48例肺结核大咯血患者用数字表随机法分为两组,对照组（24例）仅采用常规止血治疗,观察组（24例）则在对照组基础上加用垂体后叶素治疗.观察和比较两组患者的临床疗效和不良反应.结果 观察组治疗总有效率（87.5%）显著高于对照组（66.7%）（P〈0.05）;观察组止血时间明显较对照组缩短（P〈0.05）;垂体后叶素治疗期间未出现严重不良反应.结论 垂体后叶素治疗肺结核大咯血疗效显著,值得临床推广应用.     

106例老年肺结核并咯血的治疗体会

目的探讨老年肺结核并咯血的有效治疗方法。方法将106例老年肺结核并咯血患者随机分为两组，治疗组55例采用垂体后叶素与酚妥拉明交替静脉滴注，对照组51例单独应用垂体后叶素或酚妥拉明。结果治疗组第1周、第2周的临床有效率明显高于对照组。结论老年肺结核并咯血采用垂体后叶素与酚妥拉明交替静脉滴注止血效果较好。     

老年肺结核并咯血的治疗探讨

目的：探讨老年肺结核并咯血的有效治疗方法。方法：将86例老年肺结核并咯血患者随机分为两组,治疗组44例采用垂体后叶素与普鲁卡因交替静脉滴注,对照组42例单独应用垂体后叶素或普鲁卡因。结果：治疗组1周、2周的临床有效率明显高于对照组。结论：老年人肺咯血采用垂体后叶素与普鲁卡因交替静脉滴注止血效果较好。     

垂体后叶素联合654—2治疗大咯血疗效观察

目的观察垂体后叶素联合654—2（山莨菪碱）治疗大咯血的治疗效果。方法将40例大咯血患者随机分为垂体后叶素联合654-2组（治疗组）19例和垂体后叶素组（对照组）21例,分别观察止血总有效率及止血起效时间。结果治疗组和对照组总有效率分别为89．47％和66．74％,止血起效时间治疗组明显短于对照组（7．7±1．5）h、（16．8±3．3）h。具有显著性差异（均为P〈0．01）。结论联合应用垂体后叶素和654-2能明显提高大咯血的治疗效果。     

肺结核大咯血及其窒息的救治

目的 探讨肺结核大咯血及其窒息的救治。方法 186例肺结核合并大咯血病人根据不同治疗方法分为三组：对照组单用脑垂体后叶素组（A组）、脑垂体后叶素伍用止血环酸组（C组），观察组脑垂体后叶素伍用地塞米松组（B组），观察四组止血效果。结果 脑垂体后叶素伍用地塞米松组治疗肺结核大咯血的疗效优于单用脑垂体后叶素组、脑垂体后叶素伍用止血环酸组，经统计学处理有显著差异（P〈0．05）。结论 肺结核合并大咯血窒息的成功经验在于充分重视咯血窒息先兆及时救治。     

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.     

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.     

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.