孟鲁司特治疗毛细支气管炎急性期的疗效观察

目的探讨孟鲁司特治疗呼吸道合胞病毒（RSV）毛细支气管炎急性期的临床疗效。方法将49例非重度RSV毛细支气管炎患儿随机分为Ⅰ、Ⅱ组,Ⅰ组为对照组,采用毛支常规治疗;Ⅱ组在常规治疗的基础上加用白三烯拮抗剂孟鲁司特4 mg/d.观察患儿咳嗽、气促、肺部哮鸣音消失天数。结果加用孟鲁司特治疗组患儿咳嗽、气促、肺部哮鸣音消失天数都比常规治疗组短,且有显著差异（P〈0.01）。结论 RSV毛细支气管炎加用孟鲁司特可有效改善临床症状并缩短住院时间。     

孟鲁司特治疗不同病原感染后毛细支气管炎的临床疗效观察

目的:探讨孟鲁司特对不同病原感染毛细支气管炎后气道高反应的疗效是否一致,明确病原种类对孟鲁司特疗效的影响程度.方法:将150例2006年1月～2007年12月在我院儿科住院且符合毛细支气管炎纳入标准的患儿,采用ELISA方法检测血清病原20项后分成呼吸道合胞病毒(RSV)组与非RSV组,均给予综合常规治疗加服孟鲁司特7 d,比较两组临床疗效、平均住院天数、γ-干扰素(IFN-γ)、白介素4(IL-4)、治疗前后血清免疫球蛋白E(IgE)、嗜酸细胞阳离子蛋白(ECP)的变化及半年内反复喘息次数及哮喘发生率.结果:非RSV组感染后毛细支气管炎早期使用孟鲁司特的临床疗效与RSV组无显著性差异,两组内除腮腺炎病毒、柯萨奇病毒外治疗前后血清IgE水平、ECP的变化均有显著性差异,组间无显著性差异.两组细胞因子除百日咳杆菌、腮腺炎病毒、柯萨奇病毒外IFN-γ、IL-4水平均无显著性差异.随访6个月后RSV组发生哮喘5例,非RSV组有13例发生哮喘,经卡方检验两组哮喘发生率差异无统计学意义(P>0.05).结论: 孟鲁司特可以减轻非RSV感染后毛细支气管炎的临床症状,改善其所激发的气道高反应,降低毛细支气管炎后哮喘发生率;非RSV感染后毛细支气管炎的细胞因子水平的变化与RSV感染后一致;病原种类对孟鲁司特疗效的影响不大.     

孟鲁司特钠辅助治疗毛细支气管炎的临床评价

目的：评价孟鲁司特钠辅助治疗毛细支气管炎的有效性和安全性。方法将100例毛细支气管炎患儿随机分为观察组与对照组,每组50例,均予相同的对症综合治疗,观察组加用孟鲁司特钠辅助治疗3个月。出院后随访半年,对比2组临床症状（喘憋、咳嗽、哮鸣音）消失时间、住院时间、出院后3个月及6个月疾病复发率。结果观察组的临床症状消失快,住院时间短,临床治疗总有效率高,复发率低。口服孟鲁司特钠未出现明显不良反应,不影响治疗。结论孟鲁司特钠辅助治疗毛细支气管炎,可有效改善临床症状,总有效率高,住院时间短,复发率低,安全性高,值得临床推广应用。     

孟鲁司特钠治疗小儿毛细支气管炎54例疗效观察

目的观察孟鲁司特钠治疗患儿毛细支气管炎的临床效果。方法将100例毛细支气管炎患儿随机分为观察组54例,在综合治疗的基础上采用口服孟鲁司特钠进行干预;对照组46例患儿进行常规综合治疗,比较治疗后两组患儿的症状、体征、病情进展等情况。结果观察组治疗总效率为96.3%(52/54例),对照组的总有效率为80.43%(37/46例),两组比较差异有显著性(P<0.05);观察组咳嗽消失时间(4.92±1.86)d、喘憋消失时间(3.03±1.02)d、哮鸣音消失时间(3.58±1.21)d、湿啰音消失时间(4.06±1.16)d等明显低于对照组(P<0.05)。结论口服孟鲁司特钠对毛细支气管炎进行干预治疗,可缩短患儿病程,减轻喘憋程度,缩短住院时间及治愈过程,可作为临床治疗患儿毛细支气管炎的一种有效方法。     

孟鲁司特治疗毛细支气管炎20例

目的探讨呼吸道合胞病毒(RSV)性毛细支气管炎感染中的半胱氨酰白三烯(Cys-LT)受体拮抗剂孟鲁司特治疗毛细支气管炎的疗效情况。方法2007年10月～2009年6月入住我院的毛细支气管炎50例,患儿平均年龄为9个月,其中20例作为治疗组(孟鲁司特组)和30例对照组(常规治疗组)。结果治疗组(孟鲁司特)治愈患儿疗程,主要症状(咳嗽、气促、喘息),体征(肺部啰音)消失时间差异均有统计学意义。结论Cys-LT受体拮抗剂治疗控制炎症反应的双通道,减轻RSV毛细支气管炎的继发肺部症状。     

孟鲁司特治疗毛细支气管炎疗效评估

目的:探讨研究孟鲁司特治疗毛细支气管炎的疗效。方法:随机选取在我院60例毛细支气管患儿为研究对象,对照组30例患儿给予常规综合治疗,实验组30例在对照组的基础上加用孟鲁司特钠治疗,2周后记录两组患儿喘息、咳嗽持续次数及时间以及住院时间等,比较两组患儿的临床治疗效果。结果:实验组30例患儿喘息、咳嗽的发作次数较治疗前有明显减少。实验组30例患儿治疗效果比对照组30例患儿治疗效果更为显著,实验组总有效率为93.3%明显高出对照组总有效率76.6%。结论:孟鲁司特钠可以提高毛细支气管炎的临床治疗效果,缩短患儿的住院时间,改善患儿咳嗽、喘息症状,具有一定的临床推广价值。     

毛细支气管炎应用氨溴特罗口服液联合孟鲁司特治疗的临床疗效

目的探讨分析毛细支气管炎应用氨溴特罗口服液联合孟鲁司特治疗的临床疗效。方法回顾性分析2016年2月至2017年3月我院接治的104例毛细支气管炎患儿的临床记录资料。结果治疗组的总有效率为92.31%,喘憋消失时间为(3.31±0.72)d,咳嗽消失时间为(4.09±0.47)d,哮鸣音消失时间为(5.14±0.38)d,湿啰音消失时间为(3.65±0.92)d,均优于对照组,差异均具统计学意义(P0.05)。结论毛细支气管炎应用氨溴特罗口服液联合孟鲁司特治疗的临床疗效显著,值得临床应用。     

孟鲁司特治疗呼吸道合胞病毒毛细支气管炎的疗效观察

目的：观察孟鲁司特（顺尔宁）治疗呼吸道合胞病毒毛细支气管炎的临床疗效及预后。方法：对符合诊断标准的90例呼吸道合胞病毒毛细支气管炎儿童随机分为孟鲁司特治疗组52例和对照组38例。所有患儿均为首次发病,两组患儿均采用综合治疗,治疗组加用口服孟鲁司特4mg/次,1次/d,共用4周。观察两组患儿临床症状、恢复情况、住院天数,并对所有病例随访3个月,观察各组患儿喘息的复发率。结果：孟鲁司特治疗组较对照组症状缓解天数、住院天数明显缩短,差异有统计学意义（P〈0.05）。出院随访3个月,喘息复发次数明显减少,差异有统计学意义（P〈0.05）。结论：呼吸道合胞病毒毛细支气管炎加用孟鲁司特治疗可有效改善患儿临床症状并缩短住院时间,降低呼吸道合胞病毒感染后喘息的复发率。     

孟鲁司特治疗小儿毛细支气管炎的临床效果研究

目的:探讨孟鲁司特治疗小儿毛细支气管炎的临床效果。方法:选取小儿毛细支气管炎患儿80例,随机分为对照组和观察组,各40例。对照组患儿采取常规的临床治疗,观察组患儿在常规对症治疗和护理的同时采用孟鲁司特口服治疗,对比2组患儿的临床治疗效果以及相关指标。结果:观察组患儿的临床治疗有效率为95.0%,高于对照组的75.0%（P<0.05）;观察组患儿的毛细支气管炎相关临床症状缓解时间及哮鸣音、湿啰音消失时间均显著少于对照组（P<0.01）,观察组患儿在治疗后半年的喘息复发率明显低于对照组（P<0.01）。结论:在小儿毛细支气管炎的临床治疗中结合孟鲁司特口服治疗能够显著改善临床治疗效果,快速缓解临床症状和体征,降低喘息病症的复发率。     

孟鲁司特治疗婴幼儿毛细支气管炎42例疗效观察

目的观察孟鲁司特辅佐治疗婴幼儿毛细支气管炎的临床疗效及喘息反复发生情况.方法选择84例6个月~2岁毛细支气管炎患儿,随机分为治疗组和对照组.对照组给予特步他林、布地奈德、溴化异丙托品联合雾化吸入,抗感染等常规治疗,治疗组在此基础上加用孟鲁司特每天4mg口服1月.结果治疗组临床症状减轻时间住院时间与对照组无显著性差异(P>0.05),治疗组复发率与对照组有显著性差异( P<0.01).结论孟鲁司特对婴幼儿毛细支气管炎后反复喘息有一定预防作用,值得临床推广.     

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.