高血压脑出血93例外科疗效探讨

目的：探讨高血压脑出血的外科治疗方法和疗效。方法：对93例高血压脑出血患者的临床资料进行分析。结果：存活55例(59．2％)，其中生活自理12例，生活部分自理42例，植物生存1例；死亡38例(40．8％)。结论：高血压脑出血应严格把握手术适应证。     

高血压性脑出血外科治疗134例临床分析

目的 探讨高血压性脑出血压外科治疗的适应症、手术时机及影响疗效的因素。方法 对１９９２～１９９８年行外科手术治疗的１３４例高血压性脑出血的临床资料进行回顾性分析。结果 本组１３４例中存活１０２例（７６．１％）,其中痊愈的３８例（２８．３％）,生活能自理３２例（２３．８％）,生活不能自理者２８例（２０．８％）,植物生存４例（２．９％）;死亡３２例（２３．９％）。结论 脑出血引起中线结构移位大于５ｍｍ     

内外科治疗高血压脑出血96例的临床疗效对比观察

目的：探讨高血压脑出血的治疗方法。方法：外科开颅手术清除血肿与内科保守治疗的对比观察。结果：外科治疗组病死率为19％，内科治疗组病死率25.9％。结论：高血压脑出血外科开颅手术清除血肿优于内科保守治疗，可降低病死率及提高病人的生存质量。     

高血压性脑病的临床诊治分析

目的：探讨高血压脑出血外科治疗效果，以提高对此疾病的认识和诊断水平。方法：对69例高血压脑出血患者外科手术治疗的临床资料进行回顾性统计分析。结果：本组69例高血压脑出血患者中，死亡13例，存活56例，其中按日常生活能力（ADL）标准判定：完全恢复工作14例（20．3％），生活自理30例（43．4％），生活半自理7例（10．1％），卧床不起3例（4．3％），植物生存2例（2．9％）。结论：高血压脑出血的治疗过程中实施何种术式需根据患者病情和头颅CT扫描结果适当选择。术后综合处理，加强护理，治疗并发症，防治并发症是降低死亡率的重要保证。     

手术治疗高血压脑出血患者的临床效果

目的探讨手术治疗高血压脑出血患者的临床效果,提高高血压脑出血患者的治疗效果和生活质量。方法选取吉林省舒兰市人民医院收治的90例高血压性脑出血患者,随机分成两组,对照组采用内科保守疗法,试验组采用颅内血肿清创术。结果试验组高血压性脑出血患者的总有效率（88．9％）明显高于对照组的总有效率（77．8％）（t=2．826,P=0．038）。结论手术治疗高血压性脑出血患者的临床疗效明显好于内科保守疗法的临床疗效,手术治疗有利于减少患者的痛苦,提高患者的生活质量。     

微创手术治疗高血压脑出血的临床应用

目的探讨微创手术治疗高血压脑出血的疗效。方法84例高血压脑出血尽早行血肿穿刺引流和（或）侧脑室穿刺引流，术后用尿激酶溶血引流治疗。结果再出血4例（4．8％），恢复良好41例（48．8％），致残30例（35．7％），死亡9例（10．7％）。结论微创手术治疗治疗高血压脑出血，疗效确切，尽早使用此法治疗，能明显降低病死率及病残率。     

微创颅内血肿清除术治疗高血压性脑出血的疗效分析

目的：探讨微创颅内血肿清除术（以下简称微创）在神经内科治疗高血压性脑出血的疗效．方法：对自2001年6月至2005年2月间在本科用微创治疗的112例高血压性脑出血与1999年2月至2001年5月间用内科方法治疗的118例高血压性脑出血进行疗效分析．比较内科保守治疗与微创治疗的疗效．结果：内科治疗组与微创治疗组在嫡情分级（GCS评分）、出血量上无显著差异．微创治疗组的治愈率（80．3％）高于内科治疗组（59．7％），病残率（19．7％）低于内科治疗组（40．3％），死亡率（19．6％）亦明显低于内科治疗组（51．7%）．结论：微创治疗高血压性脑出血较单纯内科保守治疗效果显著，该技术创伤小、效果好，在神经内科开展此项治疗，对提高高血压性脑出血患者的生存率．降低死亡率和提高生存患者的生存质量效果显著，值得推广．     

微创清除治疗急性高血压脑出血近期疗效观察

目的：探讨颅内血肿微创清除术治疗急性高血压脑出血的近期疗效，方法：手术组50例给予微创颅内血肿清除术，对照组30例予常规内科治疗，比较两组总有效率，死亡率及不同时期神经功能缺损程度评分的减少值，结果：手术组总有效率为86％，对照组为53％（X^2＝26，P＜0．005）；手术组病死率与对照比较明显降低，神经功能缺损评分明显减少（P＜0．05）。结论：颅内血肿微创清除术是治疗急性高血压脑出血，尤其是超早期高血压脑出血的较好方法。     

颅内血肿微创穿刺清除术治疗高血压性脑出血562例临床分析

目的：探讨颅内血肿微创穿刺清除术治疗高血压性脑出血的临床疗效。方法：采用对比分析的方法，观察颅内血肿微创穿刺清除术（治疗组）与内科保守（对照组）治疗高血压性脑出血患者的临床疗效。结果：治疗组的治愈率20．1％和总有效率71．7％明显高于对照组的11．3％和47．3％，病死率12．8％明显低于对照组的39．2％。结论：颅内血肿微创穿刺清除术是治疗高血压性脑出血的一种积极有效的方法。     

微创颅内血肿清除术治疗高血压性脑出血65例疗效观察

目的 报告65例微创颅内清除术治疗高血压性脑出血的经验。方法 分析65例高血压脑出血行微创颅内血肿清除术的治疗方法、手术结果及相关处理、并发症等。结果 9例死亡，手术病死率13．8％，随访3个月-6个月，良好34例（52．3％）．轻残16例（24．6％），重残6例（9．2％）。结论 微创颅内血肿清除术治疗高血压性脑出血方便、快捷、创伤小、疗效好。     

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.