丙酸倍氯米松气雾吸入治疗儿童哮喘急性发作的效果观察

目的观察丙酸倍氯米松气雾剂治疗儿童哮喘急性发作的效果。方法50例患儿分为两组,观察组(30例)给予丙酸倍氯米松气雾剂、全乐宁雾化吸入;对照组(20例)给予静脉滴注地塞米松、全乐宁雾化吸入。观察用药前、后患儿症状体征(呼吸困难、咳嗽、喘息、喘鸣音)的改善情况及消失天数。结果观察组症状体征改善分数明显优于对照组(P<0.01),症状体症消失时间比对照组明显缩短(P<0.05或0.01)。结论支气管扩张剂雾化吸入联合丙酸倍氯米松气雾吸入,治疗儿童哮喘急性发作效果显著。     

普米克令舒混悬液治疗毛细支气管炎的效果观察

①目的　观察普米克令舒混悬液治疗毛细支气管炎的效果。②方法　将 48例病儿随机分为治疗组(n =2 8)与对照组 (n =2 0 ) ,治疗组雾化吸入普米克令舒混悬液和全乐宁雾化溶液 ,对照组单独使用全乐宁雾化溶液。观察两组病儿用药后症状、体征 (呼吸困难、咳嗽、喘息、哮鸣音 )改善情况及消失时间。③结果　治疗组治疗后 6h各症状体征评分的改善分数为 :呼吸困难 1 .2 0 ,咳嗽 1 .1 0 ,喘息 1 .50 ,哮鸣音 1 .40 ;对照组分别为 0 .90 ,0 .80 ,0 .90 ,0 .80 ;治疗组各症状体征改善分数明显优于对照组 (t=9.84～ 1 4 .2 9,P <0 .0 5)。治疗组喘息减轻时间(2 .2 0± 1 .2 0 )d ,哮鸣音消失时间 (3 .60± 1 .68)d ,对照组分别为 (4.30± 1 .44)d和 (6 .0 8± 1 .74)d ,治疗组较对照组病程明显缩短 (t=3 .2 2 ,4.97,P <0 .0 5)。④结论　普米克令舒雾化混悬液和全乐宁雾化溶液联合治疗毛细支气管炎效果明显     

普米克雾化吸入联合多素茶碱治疗儿童哮喘性疾病临床观察

目的:探讨普米克雾化吸入联合多素茶碱治疗儿童哮喘性疾病的疗效。方法:将符合标准的78例哮喘患儿随机分为多素茶碱治疗组40例和对照组38例,在常规治疗基础上,治疗组静脉滴注多素茶碱5 mg/(kg·d),对照组静脉滴注氨茶碱3~5 mg/(kg·d),观察两组患儿症状、体征消失时间和不良反应的发生率。结果:治疗组总有效率为97.5%,对照组总有效率为68.4%,治疗组咳嗽、气喘、肺部哮鸣音消失时间及住院天数比对照组明显缩短(P<0.05)。结论:普米克雾化吸入联合多素茶碱治疗儿童哮喘性疾病疗效确切,能有效控制哮喘症状及体征,缩短病程,提高治愈率,治疗安全、有效。     

布地奈德联合特布他林雾化吸入治疗毛细支气管炎80例疗效观察

目的探讨布地奈德联合特布他林雾化吸入治疗毛细支气管炎的疗效。方法160例毛细支气管炎患儿随机分为治疗组与对照组各80例。治疗组:布地奈德混悬液0.5mg加特布他林雾化液2.5mg放入氧气驱动雾化装置,雾化吸入,每天2次,连用5～7d。对照组:氢化可的松静脉滴注每次5mg/kg,每天2次,连用5～7d。观察两组喘息、咳嗽、哮鸣音好转情况及不良反应。结果治疗组总有效率高于对照组,差异有显著统计学意义(P<0.01)。喘息消失、咳嗽消失、肺部哮鸣音消失时间及平均住院时间治疗组与对照组比较明显缩短,差异有统计学意义(P<0.05)。结论布地奈德联合特布他林雾化吸入治疗毛细支气管炎可增强疗效,缩短病程,提高治愈率,安全有效,简单易行。     

普米克令舒与特布他林联合雾化吸入治疗毛细支气管炎

目的探讨普米克令舒联合特布他林雾化液雾化吸入治疗毛细支气管炎的疗效。方法 62例毛细支气管炎患儿随机分为治疗组与对照组各31例,治疗组予普米克令舒每次1 mL（含布地奈德0.5 mg）和特布他林雾化液2.5 mg/mL联合雾化吸入,每天2次;对照组予地塞米松2 mg、糜蛋白酶5 mg和生理盐水2 mL,每天2次,每次吸入时间为10 min-15 min.观察2组咳嗽、气促、哮鸣音和肺部啰音消失时间及不良反应。结果治疗组与对照组患儿气促缓解,哮鸣音消失,肺部啰音消失,咳嗽消失时间比较差异有显著性意义（P〈0.01）。结论普米克令舒联合特布他林雾化吸入治疗毛细支气管炎能增强疗效,缓解症状,缩短病程,提高治愈率,是安全、有效、简便的治疗方法。     

3％高渗盐水联合利巴韦林氧气雾化吸人治疗毛细支气管炎

①目的观察3％高渗盐水联合利巴韦林氧气雾化吸入治疗中、重度毛细支气管炎的疗效。②方法采取随机对照方法,将98例中、重度毛细支气管炎病例分成观察组52例和对照组46例。在常规治疗的基础上,观察组加用3％高渗盐水3．OmL＋利巴韦林注射液15mg／（kg·次）氧气雾化吸入,3次／d;对照组给予生理盐水3．OmL＋利巴韦林注射液15mg／（kg·次）氧气雾化吸入,3次／d。两组疗程均为7～10d。比较两组咳嗽、气喘、肺部喘鸣音消失时间、住院时间及不良反应。③结果两组患儿均痊愈,观察组在咳嗽、气喘、肺部喘鸣音消失时问、住院时间等方面均优于对照组（P〈0．05）。④结论3％高渗盐水联合利巴韦林氧气雾化吸入是治疗中、重度毛细支气管炎的一种有效方法,减少住院时间,降低治疗费用。     

普米克令舒联合万托林雾化吸入治疗毛细支气管炎的疗效观察

目的观察普米克令舒联合万托林雾化吸入治疗毛细支气管炎的治疗效果。方法80例毛细支气管炎患儿随机分为治疗组与对照组各40例。治疗组:普米克令舒每次1mL加万托林雾化液每次0.5mL,放入压缩雾化泵吸入,每天2次,连用5～7d。对照组:地塞米松静脉滴注每次0.2～0.5mg/kg,每天1次,连用5～7d。观察两组喘息、咳嗽、哮鸣音的好转情况及不良反应。结果治疗组总有效率高于对照组,有显著性差异(P<0.05)。喘息消失、咳嗽消失、肺部哮鸣音消失时间及平均住院时间,治疗组与对照组比较明显缩短,有显著性差异(P<0.05)。结论普米克令舒联合万托林雾化吸入治疗毛细支气管炎可增强疗效,缩短病程,提高治愈率,安全有效,值得临床推广应用。     

普米克令舒联合沐舒坦雾化吸入治疗毛细支气管炎疗效观察

目的:观察普米克令舒联合沐舒坦(盐酸氨溴索)吸入疗法对小儿毛细支气管炎的临床疗效。方法:随机抽样,把120例毛细支气管炎患者分为治疗组60例,对照组60例。治疗组给予普米克令舒液1m l(0.5m g),联合沐舒坦液1m l(7.5m g),加生理盐水至5m l雾化吸入治疗,2次/d,疗程5~7d。对照组应用糜蛋白酶4000U联合地塞米松1m g,加生理盐水至5m l雾化吸入治疗,2次/d,疗程同治疗组。结果:治疗组与对照组在咳嗽、喘憋、肺部罗音消失时间、住院天数方面经统计学处理,差异有显著性。结论:应用普米克令舒联合沐舒坦雾化吸入治疗,既扩张了支气管平滑肌,又促进了痰液的排出,改善了肺功能,具有疗程短、疗效好、副作用少等优点,易于推广。     

布地奈德联合特布他林雾化吸入治疗毛细支气管炎80例疗效观察

目的 探讨布地奈德联合特布他林雾化吸入治疗毛细支气管炎的疗效.方法 160例毛细支气管炎患儿随机分为治疗组与对照组各80例.治疗组布地奈德混悬液0.5mg加特布他林雾化液2.5mg放入氧气驱动雾化装置,雾化吸入,每天2次,连用5～7 d.对照组氢化可的松静脉滴注每次5mg/kg,每天2次,连用5～7 d.观察两组喘息、咳嗽、哮鸣音好转情况及不良反应.结果 治疗组总有效率高于对照组,差异有显著统计学意义(P＜0.01).喘息消失、咳嗽消失、肺部哮鸣音消失时间及平均住院时间治疗组与对照组比较明显缩短,差异有统计学意义(P＜0.05).结论 布地奈德联合特布他林雾化吸入治疗毛细支气管炎可增强疗效,缩短病程,提高治愈率,安全有效,简单易行.     

沙丁胺醇联合丙酸氟替卡松雾化吸入治疗儿童哮喘64例分析

目的探讨沙丁胺醇联合丙酸氟替卡松雾化吸入治疗儿童哮喘的临床效果。方法将延安市人民医院收治的64例哮喘患儿,随机分为两组。对照组采用常规对症支持治疗,观察组在对照组基础上给予沙丁胺醇联合丙酸氟替卡松雾化吸入治疗。分析两组治疗效果,主要临床症状、体征改善情况及不良反应发生情况。结果观察组总有效率显著高于对照组（P〈0．05）;观察组咳嗽消失时间,喘息消失时间,呼吸困难消失时间,肺部哮鸣音消失时间显著早于对照组（P〈0．05）;观察组末次治疗后60rainPEFB显著优于对照组（P〈0．05）。结论沙丁胺醇联合丙酸氟替卡松雾化吸入治疗儿童哮喘疗效可靠,安全方便,值得临床推广应用。     

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.