不同方法治疗早发型子痫前期的临床疗效分析

目的:探讨不同治疗方法对早发型子痫前期的临床疗效。方法:抽取来本院就诊的96例发型子痫前期孕妇,随机分为三组,硫酸镁组、硫酸镁+LMWH组、硫酸镁+LMWH+SM组,每组各32例。通过观察三组妊娠结局、血压变化、APTT值、新生儿情况等来判断三组的临床疗效。结果:三组患者血压、APTT值的治疗前后比较,差异均有统计学意义(P0.05);硫酸组的新生儿窒息发生率最高达62.5%,存活率最低只有87.5%,与其他两组比较差异均有统计学意义(P0.05)。三组患者的治疗时间及新生儿体重两两比较,均无明显差异。结论:硫酸镁+低分子肝素+丹参联合治疗早发型子痫前期效果最佳,值得临床推广应用。     

比较早发型子痫前期2种期待治疗方法对妊娠结局的影响

目的：比较早发型子痫前期2种期待治疗方法的妊娠结局差异。方法选取202例早发型子痫前期患者,随机均分为对照组和观察组（n=101）,对照组给予硫酸镁治疗,观察组给予硫酸镁联合丹参和低分子肝素治疗。比较2组患者终止妊娠孕周、母婴并发症发生率和围生儿死亡率的差异。结果观察组终止妊娠孕周时间显著长于对照组（P<0.05）;观察组低蛋白血症、胎儿窘迫和肝功能损害等母婴并发症发生率显著低于对照组（P<0.05）;观察组围生儿死亡率为2.0%,显著低于对照组的9.9%（P<0.05）。结论硫酸镁联合丹参和低分子肝素治疗早发型子痫前期疗效确切,较单独应用硫酸镁效果好,可显著延长妊娠时间,降低母婴并发症及围生儿死亡率。     

解痉抗凝治疗早发型子痫前期的疗效分析

目的:探讨解痉抗凝治疗早发型子痫前期的临床效果。方法:选择早发型子痫前期患者72例,将患者随机分为观察组和对照组,每组各38例。对照组38例患者给予常规的硫酸镁治疗,而观察组38例患者给予硫酸镁联合低分子肝素治疗。观察两组患者的血压变化情况、妊娠结局以及新生儿结局进行对比分析。结果:观察组剖宫产率、新生儿窒息率、胎儿窘迫、胎盘早剥发生率明显低于对照组,差异有统计学意义(P<0.05);两组患者均有不同程度的血压下降。结论:硫酸镁联合低分子肝素解痉抗凝治疗早发型子痫前期能够显著疏通微循环,改善胎盘功能,保护肾功能,改善母婴结局,降低并发症发生,安全可靠,值得临床推广应用。     

低分子肝素联合硫酸镁对早发型重度子痫前期患者并发症的预防效果

目的:探讨低分子肝素联合硫酸镁治疗早发型重度子痫前期患者的临床效果。方法:选择2015年2月—2017年8月在我院治疗的早发型重度子痫前期患者50例,随机分为两组,每组25例。对照组采用硫酸镁治疗,观察组采用低分子肝素联合硫酸镁治疗,比较两组动脉压、24h尿蛋白定量及并发症发生情况。结果:治疗后,观察组动脉压水平、24h尿蛋白定量均低于对照组,差异有统计学意义(P<0.05);观察组并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论:低分子肝素联合硫酸镁治疗早发型重度子痫前期患者,可有效改善其动脉压水平及24h尿蛋白定量,利于减少并发症的产生。     

硫酸镁联合低分子肝素治疗早发型子痫前期的临床分析

目的：分析硫酸镁联合低分子肝素治疗早发型子痫前期对新生儿与母亲结局的影响。方法：选取我院2012年1月一2013年6月65例早发型子痫前期孕妇资料进行分析,其中35例给予硫酸镁联合低分子肝素治疗,另外30例仅给予硫酸镁治疗,观察两组治疗后血压、血脂及尿量,同时比较两组新生儿及产妇结局。结果：联合组SBP、DBP、TG、HDL、尿量均低于硫酸镁组,联合组产后出血1例,剖宫产率为22．86％;产妇结局明显好于硫酸镁组,联合组无1例新生儿死亡,胎儿窘迫发生率明显低于硫酸镁组,两组比较差异有显著性（P〈O．05）。结论：硫酸镁联合低分子肝素治疗早发型子痫前期较之单用硫酸镁疗效更好,对保障母婴安全、提高预后、降低产后并发症具有积极作用。     

早发型子痫前期孕妇解痉抗凝治疗的临床研究

目的对比早发型子痫前期患者应用硫酸镁合并低分子肝素联合治疗与常规硫酸镁治疗的临床疗效。方法将64例早发型子痫前期患者随机分为2组,研究组应用硫酸镁+低分子肝素(4100U/d)治疗;对照组采用硫酸镁常规治疗。通过临床表现及实验室检查的变化判断疗效。结果两组患者在治疗前临床各项指标差异无统计学意义(P>0.05);两组治疗后平均动脉压与24小时尿蛋白均较治疗前下降(P<0.05),但组间差异无统计学意义(P>0.05);治疗后研究组的新生儿窒息率较对照组显著降低,差异有统计学意义(P<0.05)。结论硫酸镁联合低分子肝素治疗可明显改善早发型子痫前期患者新生儿的预后。     

早发型重度子痫前期抗凝解痉治疗效果及终止妊娠时机选择

目的探讨早发型重度子痫前期抗凝解痉治疗效果及终止妊娠时机选择。方法选择早发型重度子痫前期患者35例,随机分成3组,采取单用硫酸镁解痉、硫酸镁加复方丹参、硫酸镁加低分子肝素抗凝解痉3种治疗方案,通过对比疗效并探讨早发型重度子痫前期终止妊娠的时机。结果3组患者治疗前后比较发现血压降低,24h尿量增多,尿蛋白减少,PT、APTT增加,血小板减少,肝肾功能无明显变化,但仅收缩压、24h尿量和24h尿蛋白定量差异有统计学意义（P〈0．05）。3组分娩孕周差异有统计学意义（P〈0．05）,终止妊娠原因和新生儿出生体质量差异无统计学意义（P〉0．05）。结论复方丹参和低分子肝素均能有效控制患者症状,延长孕周,对母儿安全,而两者效果比较无明显区别。早发型重度子痫前期患者可在严密监护下适当延长孕周后终止妊娠,减少母儿不良结局的发生率。     

复方丹参注射液联合低分子肝素对早发型重度子痫前期疗效及安全性研究

目的探讨复方丹参注射液联合低分子肝素治疗早发型重度子痫前期的疗效与安全性。方法选取2014年7月至2016年5月期间收治的早发型重度子痫前期患者80例作为研究对象,随机数字法分为低分子肝素组27例、丹参组26例以及联合组27例。三组患者均采用常规方法治疗,在此基础上低分子肝素组加用低分子肝素钙注射液、丹参组加用丹参注射液,联合组则同时加用低分子肝素钙与丹参注射液治疗。比较三组患者血浆黏度、D-二聚体水平、胎龄延长时间、新生儿体重、死亡率、Apgar评分、并发症发生率等情况。结果三组患者治疗后血浆黏度、D-二聚体水平明显低于本组治疗前;联合组的血浆黏度、D-二聚体水平明显低于低分子肝素组和丹参组,差异均具有统计学意义(P0.05)。联合组的胎龄延长时间、新生儿体重、Apgar评分均明显高于低分子肝素组和丹参组,新生儿死亡率明显低于低分子肝素组和丹参组,差异均具有统计学意义(P0.05)。三组患者均未发生心力衰竭,联合组胎盘早剥、产后出血、低蛋白血症、视觉障碍的发生率均低于低分子肝素组和丹参组,但差异无统计学意义(P0.05)。结论复方丹参注射液联合低分子肝素治疗早发型重度子痫前期可有效改善母婴结局,安全性仍需大样本量进一步验证。     

低分子肝素钙联合硫酸镁对早发型重度子痫前期患者的疗效

目的观察低分子肝素钙联合硫酸镁对早发型重度子痫前期患者的疗效。方法选取河南科技大学附属许昌市中心医院2015年1月至2018年12月收治的200例早发型重度子痫前期患者,根据治疗方案分为两组,每组100例。常规组接受硫酸镁治疗,干预组接受低分子肝素钙联合硫酸镁治疗。比较两组治疗前、治疗7 d后血压、凝血四项及妊娠结局。结果治疗7 d后,干预组收缩压、舒张压、血浆FIB水平均低于常规组,APTT、TT、PT均长于常规组,差异有统计学意义(均P<0.05)。干预组不良妊娠结局出现率[17.00%(17/100)]低于常规组[35.00%(35/100)],差异有统计学意义(P<0.05)。结论低分子肝素钙联合硫酸镁可有效降低早发型重度子痫前期患者血压,改善患者凝血功能,减少不良妊娠结局的出现。     

丹参注射液与低分子肝素钙注射液联用治疗早发型重度子痫前期的临床分析

目的:探讨丹参注射液联合低分子肝素钙注射液用于早发型重度子痫前期病症的临床治疗效果。方法:选取2013年1月至2015年6月在我院进行早发型重度子痫前期病症治疗的58例患者随机分成观察组29例(参注射液联合低分子肝素钙注射液治疗)和对照组29例(常规治疗),对比两组的疗效。结果:经过治疗后,两组患者在24小时尿量、尿蛋白、新生儿Apgar评分、胎盘重量、胎龄、新生儿重量、新生儿死亡方面相比差异均具有显著性(P0.05)。结论:目前治疗早发型重度子痫前期病症的有效方法之一就是联合使用低分子肝素钙和复方丹参注射液,临床效果显著。     

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.