通心络联合氯吡格雷对不稳定型心绞痛患者血管内皮功能和炎性因子的影响

目的探讨通心络胶囊联合硫酸氢氯吡格雷对不稳定型心绞痛患者血管内功能和炎性因子的影响。方法 80例不稳定型心绞痛患者随机分为对照组、研究组各40例。2组均常规应用氯吡格雷、低分子肝素钙、钙离子拮抗剂、β受体阻滞剂等冠心病的规范治疗;研究组在规范治疗基础上加服通心络胶囊3粒,3次/d。检测治疗前及治疗4、8周后2组患者一氧化氮(NO)、内皮素-1(ET-1)、肿瘤坏死因子-α(TNF-α)、白介素-1(IL-1)、白介素-6(IL-6)水平变化。结果 2组患者治疗前NO、ET-1、TNF-α、IL-1、IL-6水平比较差异均无统计学意义(P>0.05)。与治疗前比较,2组患者治疗4、8周后NO均明显升高(P<0.05),ET-1、TNF-α、IL-1、IL-6均明显降低(P<0.05)。与对照组比较,研究组治疗后4、8周后NO水平明显升高(P<0.05),ET-1、TNF-α、IL-1、IL-6水平明显降低(P<0.05)。治疗4、8周后研究组总有效率明显高于对照组(分别为90.0%、95.0%和72.5%、77.5%,P<0.05)。结论通心络胶囊联合硫酸氢氯吡格雷能明显改善不稳定型心绞痛患者血管内皮功能,提高不稳定型心绞痛临床治疗效果。     

通心络胶囊联合氟桂利嗪治疗慢性脑供血不足性头晕患者的疗效评价

目的:评价通心络胶囊联合氟桂利嗪治疗慢性脑供血不足性头晕患者的临床疗效.方法:选取2017年10月—2019年10月兰考第一医院慢性脑供血不足性头晕患者167例,按随机数字表法分研究组(n=84)和对照组(n=83).对照组采用氟桂利嗪治疗,研究组采用通心络+氟桂利嗪治疗.比较两组总有效率、治疗前后血液流变学指标(血浆黏度、纤维蛋白原、红细胞压积)水平、不良反应发生率.结果:研究组总有效率为96.43％(81/84),高于对照组79.52％(66/83)(P<0.05);治疗后两组血浆黏度、纤维蛋白原、红细胞压积水平均明显降低,研究组低于对照组(P<0.05);治疗后两组BA平均血流速度均明显提高,研究组高于对照组(P<0.05);两组不良反应发生率比较无明显差异(P>0.05).结论:通心络胶囊联合氟桂利嗪治疗慢性脑供血不足性头晕患者的临床疗效显著,可有效改善患者血液流变学状态,同时保证治疗安全性.     

通心络对缺血性心脏病血液流变学的影响临床分析

目的：观察通心络对缺血性心脏病血液流变学的影响。方法：50例缺血性心脏病合并高黏血症应用通心络治疗,设50例常规治疗为对照组。对照两组血液流变学的变化。结果：红细胞压积、全血比黏度、还原黏度、红细胞电泳、纤维蛋白原治疗前后均有差异（P〈0．05或0．01）。结论：通心络对冠心病高黏血症效果显著。     

通心络胶囊对不稳定型心绞痛患者血管内皮功能的影响

目的 探讨通心络胶囊对不稳定型心绞痛(UAP)患者血管内皮功能的影响.方法 100例UAP患者,随机分为常规组(西医常规治疗)和通心络组(西医常规加通心络治疗),观察治疗前和治疗1个月后血清内皮素(ET)、一氧化氮(NO)、血管性假血友病因子(vWF)、可溶性血管细胞粘附分子-1(sVCAM-1)、可溶性细胞间粘附分子-1(sVCAM-1)的变化,并应用多普勒超声诊断仪测定肱动脉血流介导的血管扩张变化率(FMD).结果 与治疗前比较,治疗后两组患者血清vWF、ET水平均明显下降(P<0.01),NO水平和FMD 均升高(P<0.05或P<0.01);通心络组血清sVCAM-1水平显著下降(P<0.01),而常规组血清sVCAM-1水平无明显变化(P>0.05).治疗后通心络组血清vWF、ET、sVCAM-1水平均低于常规组(P<0.01),NO水平和FMD 高于常规组(P<0.01).结论 通心络可通过降低血清ET、vWF和部分细胞粘附分子水平,提高NO水平等途径改善血管内皮功能,提高临床疗效.     

通心络胶囊联合胰岛素强化治疗对2型糖尿病患者血管内皮功能的影响

目的观察通心络胶囊联合胰岛素强化治疗对2型糖尿病(T2DM)患者血管内皮功能的影响。方法选取南阳市第一人民医院2017年2月至2018年4月收治的124例T2DM患者,采用随机数表法分为对照组和观察组,各62例。对照组接受胰岛素强化治疗,观察组在对照组基础上接受通心络胶囊治疗。对比两组治疗前后血糖指标[空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)]、血管内皮功能指标[内皮素-1(ET-1)、一氧化氮(NO)、内皮依赖性舒张功能(EDD)、内皮非依赖性舒张功能(EID)]水平。结果治疗后,两组FPG、2 h PG、HbA1c水平均低于治疗前,且观察组均低于对照组,差异有统计学意义(均P<0.05)。治疗后,两组ET-1水平均低于治疗前,NO、EDD、EID水平均高于治疗前,且观察组ET-1水平低于对照组,NO、EDD、EID水平均高于对照组,差异有统计学意义(均P<0.05)。结论通心络胶囊联合胰岛素强化治疗T2DM患者,能降低血糖,促进血管内皮功能恢复。     

通心络联合芪苈强心胶囊对慢性充血性心力衰竭患者血管内皮功能的影响

目的探究通心络联合芪苈强心胶囊对慢性充血性心力衰竭(CHF)患者血管内皮功能的影响。方法选取2015年2月至2016年9月商丘市第一人民医院收治的慢性充血性心力衰竭患者60例为研究对象,使用随机数表法分为观察组和对照组,各30例。对照组在常规治疗基础上使用芪苈强心胶囊,观察组在常规治疗基础上接受通心络联合芪苈强心胶囊联合治疗。将两组患者血管内皮功能、心功能、治疗效果进行对比。结果两组治疗后NO均有上升,VEGF、ET-1均有下降,观察组改善幅度均优于对照组,差异有统计学意义(P<0.05);观察组治疗后心功能指标LVEF、LVEDD、SV、CO水平均优于对照组,差异有统计学意义(P<0.05);观察组治疗总有效率96.67%明显高于对照组的73.33%,差异有统计学意义(P<0.05)。结论通心络联合芪苈强心胶囊能够显著改善慢性充血性心力衰竭患者血管内皮功能及心功能,疗效显著。     

通心络治疗脑梗死的疗效及对血液流变学的影响

目的探讨通心络治疗脑梗死的疗效及对血液流变学的影响。方法将2008年12月～2010年6月期间在我院住院的脑梗死患者64例,随机分为治疗组和对照组各32例,对照组给予常规治疗,治疗组在对照组的基础上应用通心络胶囊,疗程14d,比较两组的疗效及对全血黏度、血浆黏度、纤维蛋白原、刚性指数、红细胞压积等血液流变学指标的影响。结果治疗组总有效率93.34%(28/30),对照组总有效率70.00%(21/30),两组总有效率比较,χ2=5.364,P0.05。治疗组治疗后全血高、低切黏度、血浆黏度、红细胞压积、血小板聚集指数、纤维蛋白原含量与治疗前比较明显降低(P0.05或P0.01);两组治疗后全血高、低切黏度、血浆黏度、血小板聚集指数、纤维蛋白原含量比较,差异有统计学意义(P0.05)。结论通心络治疗脑梗死的疗效确切,能明显改善微循环,降低血液黏滞度,值得临床推广。     

通心络胶囊辅治腔隙性脑梗死合并血管性认知功能障碍患者疗效观察

目的观察通心络胶囊辅治腔隙性脑梗死(LI)合并血管性认知功能障碍(VCI)患者的疗效。方法纳入LI合并VCI患者68例,随机分成对照组、治疗组各34例,2组均给予常规治疗,治疗组加用通心络胶囊3粒口服,每天3次,疗程均为4个月,比较2组简易智能精神状态检查量表(MMSE)评分、日常生活能力(ADL)评分、纤维蛋白原(Fg)及血液流变学的改变。结果与治疗前比较,2组治疗后MMSE评分、ADL评分、Fg及血液流变学均有改善(P<0.05),且治疗组MMSE评分、ADL评分、Fg及还原黏度高切、还原黏度低切、红细胞聚集指数较对照组改善明显(P<0.05),而全血黏度高切、全血黏度低切差异无统计学意义(P>0.05)。治疗组发生不良反应5例(14.7%),对照组发生3例(8.8%),2组比较差异无统计学意义(P>0.05)。结论通心络胶囊不但可改善LI合并VCI患者的认知功能,而且可改善患者Fg、血液流变学,对LI合并VCI患者治疗具有一定的意义。     

黄芪仙灵脾汤联合活血通脉片对肾病综合征高凝血症患者CRP和TNF-α及血液流变学的影响

目的 探讨黄芪仙灵脾汤联合活血通脉片对肾病综合征高凝血症患者血清CRP、TNF-α及血液流变学的影响。 方法 收集2014年3月-2016年2月于浙江省台州医院住院或门诊治疗的肾病综合征高凝血症患者78例,按随机数字表法分为2组,每组39例,对照组采用强的松、低分子肝素钙治疗;观察组在此基础上采用黄芪仙灵脾汤联合活血通脉片治疗,共治疗2个月为1个疗程,对比2组间临床疗效,治疗前后血液流变学、CRP、TNF-α、NO、ET-1以及肾功能指标,同时记录不良反应事件。 结果 与治疗前比较,2组治疗后红细胞压积、红细胞聚集指数、全血黏度、血浆黏度降低,血清CRP、TNF-α、ET-1降低,血清NO升高,24 h Pro、BUN、Scr水平降低,总蛋白水平升高(均P<0.05);与对照组比较,观察组治疗后红细胞压积、红细胞聚集指数、全血黏度、血浆黏度较低,血清CRP、TNF-α、ET-1较低,血清NO较高,24 h Pro、BUN、Scr水平较低,总蛋白水平较高(均P<0.05);对照组不良反应发生率(17.95%)与观察组(23.08%)对比差异无统计学意义(P>0.05)。 结论 黄芪仙灵脾汤联合活血通脉片对肾病综合征高凝血症患者疗效确切,且不增加不良反应,与降低CRP、TNF-α,改善血管内皮和血液流变学相关。      

小柴胡汤为基础方加减对脑卒中后眩晕患者血液流变学指标影响

目的:探讨小柴胡汤为基础方加减对缺血性卒中后眩晕患者血液流变学指标的影响。方法:选取我院神经内科2014年1月—2015年6月收治的缺血性脑卒中后眩晕患者96例,按随机数字表法分组,分别为48例,对照组予以地芬尼多片治疗,研究组予以小柴胡汤为基础方加减治疗,两组共治疗2周为一疗程,采血测定血液流变学及内皮细胞功能指标,行多普勒超声检测,记录中医证候积分,同时对比临床疗效及并发症。结果:与治疗前比较,两组治疗后中医证候积分降低,治疗后Vm、Vp升高,PI、RI降低,治疗后全血黏度、血浆黏度、红细胞压积、纤维蛋白原降低,治疗后ET-1、TM降低,NO升高(P0.05);与对照组比较,研究组治疗后中医证候积分较低,Vm、Vp较高,PI、RI较低,全血黏度、血浆黏度、红细胞压积、纤维蛋白原较低,ET-1、TM较低,NO较高(P0.05);对照组有效率75.00%与研究组有效率91.67%数据对比,研究组高于对照组(P0.05)。结论:小柴胡汤为基础方加减对脑卒中后眩晕疗效确切,能提高血液流变学及TCD指标,改善血管内皮功能,值得推广。     

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.     

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.