还原型谷胱甘肽对酒精性肝纤维化的保护作用

目的探讨还原型谷胱甘肽对酒精性肝纤维化的保护作用。方法将96例酒精性肝纤维化患者随机分为对照组和治疗组各48例,对照组采用甘草酸二胺治疗,治疗组采用还原型谷胱甘肽治疗,对两组患者治疗前后肝功能和肝纤维化指标进行比较分析。结果两组患者治疗后TBIL、ALT和AST等肝功能指标,以及LN、HA和C-Ⅳ等肝纤维化指标均有所下降,且与对照组相比,治疗组各指标均明显降低,差异具有统计学意义(P0.05)。结论采用还原型谷胱甘肽对酒精性肝纤维化进行保护,其疗效确切,效果显著,是酒精性肝纤维化患者较为理想的治疗药物之一。     

丹红注射液联合异甘草酸镁对乙型肝炎肝硬化失代偿期患者的临床疗效及对肝功能、肝纤维化的影响

目的:探讨丹红注射液联合异甘草酸镁对乙型肝炎肝硬化失代偿期患者的临床疗效及对肝功能、肝纤维化的影响。方法:选取乙型肝炎肝硬化失代偿期患者88例。按照随机数字表法将其分为对照组和病例组,各44例。患者均给予常规对症支持治疗,对照组给予异甘草酸镁注射液,病例组在对照组基础上给予丹红注射液。比较两组临床疗效、肝功能指标(ALT、AST、TBIL、ALB)、肝纤维化指标(HA、LN、PCⅢ、Ⅳ-C)、影像学指标等。结果:病例组总有效率为95.45%,高于对照组的81.82%,差异有统计学意义(X~2=4.062,P=0.044);治疗后,两组各项肝功能指标、肝纤维化指标、影像学指标均较治疗前好转(P0.05),且病例组ALT、AST、TBIL、HA、LN、PCⅢ、Ⅳ-C、门静脉内径、脾静脉内径、脾脏厚度均低于对照组,ALB高于对照组,差异均有统计学意义(P0.05)。结论:丹红注射液联合异甘草酸镁治疗乙型肝炎肝硬化失代偿期患者能明显改善肝功能,减轻肝纤维化程度,提高临床疗效,值得临床推广。     

异甘草酸镁注射液治疗70例慢性乙型肝炎疗效观察

目的:探讨慢性乙型肝炎采用异甘草酸镁注射液进行治疗的临床效果。方法:将140例慢性乙型肝炎患者随机分为研究组和对照组,各70例。研究组给予异甘草酸镁注射液治疗,对照组给予复方甘草酸苷注射液治疗。比较两组患者的临床疗效。结果:研究组临床疗效明显优于对照组,差异有统计学意义(P<0.05);两组患者治疗后TBIL、ALT、AST均明显改善,差异有统计学意义(P<0.05),其中研究组改善程度明显优于对照组,差异有统计学意义(P<0.05)。结论:慢性乙型肝炎采用异甘草酸镁注射液进行治疗效果显著,能有效改善患者肝功能,并发症少,值得临床推广应用。     

异甘草酸镁在胃肠道肿瘤肝转移化疗时保护肝作用的临床研究

目的:探讨异甘草酸镁在胃肠道肿瘤肝转移化疗时的护肝作用。方法:将60例胃肠道肿瘤肝转移患者随机分为两组,研究组采用异甘草酸镁辅助化疗治疗,对照组采用还原型谷胱甘肽辅助化疗治疗,观察两组不良反应及肝功能变化。结果:研究组肝功能损害发生率为6.7%(2/30)较对照组26.7%(8/30)明显低(P<0.05);治疗前两组间TBIL、ALT、AST无明显差异(P>0.05),第6周期化疗后ALT、AST两组间有明显差异(P<0.05);研究组患者第2、4、6周期化疗后与化疗前比较,TBIL、ALT、AST无明显差异(P>0.05);而对照组患者第2、4、6周期化疗后与化疗前比较TBIL无明显差异(P>0.05),对照组第6周期化疗后ALT、AST较治疗前有明显差异(P<0.05)。结论:异甘草酸镁辅助胃肠道肿瘤肝转移化疗时护肝作用较好。     

异甘草酸镁与复方甘草酸苷治疗慢性肝炎的疗效对比研究

目的对比分析慢性肝炎患者采用异甘草酸镁和复方甘草酸苷治疗后的临床效果。方法选择2014年9月~2015年12月期间我院收治的103例慢性肝炎患者进行回顾性分析,按照治疗方法分为两组,研究组52例,采用异甘草酸镁治疗,对照组51例,采用复方甘草酸苷治疗,比较两组患者的临床疗效及肝功能。结果研究组的总有效率明显高于对照组,差异有统计学意义(P0.05);治疗后两组ALT、TBIL、AST均较治疗前有明显降低,PA较治疗前有明显升高,差异有统计学意义(P0.05);研究组治疗后ALT、TBIL、AST显著低于对照组,PA显著高于对照组,差异有统计学意义(P0.05)。结论异甘草酸镁及复方甘草酸苷在慢性肝炎的治疗方面均有较好的效果,但是异甘草酸镁与复方甘草酸苷比较更有优势,值得在临床推广应用。     

异甘草酸镁、硫普罗宁治疗酒精性肝病的疗效对比

目的:观察异甘草酸镁、硫普罗宁治疗酒精性肝病疗效的差异。方法:38例酒精性肝病患者随机分为两组,对照组给予硫普罗宁保肝治疗,治疗组给予异甘草酸镁治疗。观察治疗前后患者临床症状、肝功能及肝纤维化指标的变化,同时观察两组药物不良反应。结果:治疗组患者治疗后临床症状改善更明显,ALT、TBIL和肝纤维化指标降低更显著且药物不良反应少。结论:异甘草酸镁更适合于酒精性肝病的治疗。     

还原型谷胱甘肽联合多烯磷脂酰胆碱治疗对酒精性肝病患者肝功能及肝纤维化指标的影响

目的 探讨还原型谷胱甘肽联合多烯磷脂酰胆碱治疗对酒精性肝病(ALD)患者肝功能及肝纤维化指标的影响.方法 ALD患者100例随机分为观察组和对照组,每组50例.两组均给予常规治疗,对照组给予还原型谷胱甘肽联合复方甘草酸苷治疗,观察组给予还原型谷胱甘肽联合多烯磷脂酰胆碱治疗.比较两组患者治疗前后肝功能指标及肝纤维化指标的变化.结果 两组患者治疗前AST、ALT、谷氨酰转肽酶(GGT)、TBIL及透明质酸(HA)、层黏蛋白(LN)、Ⅲ型前胶原(PⅢP)、Ⅳ型胶原(Ⅳ-C)水平比较,差异均无统计学意义(P>0.05),治疗后两组AST、ALT、GGT、TBIL、HA、LN、PⅢP、Ⅳ-C水平均低于治疗前,并且观察组患者低于对照组(均P<0.05).结论 还原型谷胱甘肽联合多烯磷脂酰胆碱能够显著改善ALD患者的肝功能和肝纤维化.     

异甘草酸镁与复方甘草酸苷治疗酒精性肝炎的疗效比较

目的比较异甘草酸镁与复方甘草酸苷治疗酒精性肝炎的临床效果。方法 100例酒精性肝炎患者被随机分为治疗组(50例)和对照组(50例)。两组均进行基础治疗。治疗组给予异甘草酸镁注射液150mg加入5%葡萄糖液250ml中静脉滴注,每日1次;对照组给予复方甘草酸苷160mg加入5%葡萄糖液250ml中静脉滴注,每日1次,疗程均为4周。观察两组患者治疗前后肝功能(ALT、AST、TBIL、PA、GGT)等指标变化情况。结果治疗后2周及4周,与对照组比较,治疗组ALT、GGT明显降低(P0.05),AST降低也显著(P0.05),PA明显升高(P0.05),4周后ALT、AST、TBIL、和PA的复常率则无统计学差异(P0.05)。结论与复方甘草酸苷比较,异甘草酸镁治疗酒精性肝炎对肝功能的改善效果更佳,值得临床推广应用。结论与复方甘草酸苷比较,异甘草酸镁治疗酒精性肝炎可快速改善肝功能,疗效显著,值得肯定。     

异甘草酸镁联合谷胱甘肽治疗脓毒血症合并肝功能损害的临床分析

目的:分析异甘草酸镁联合谷胱甘肽治疗脓毒血症合并肝功能损害临床疗效。方法:选择50例脓毒血症合并肝功能损害,随机分为对照组(25例)与观察组(25例),对照组采用谷胱甘肽,观察组在对照组基础上联合异甘草酸镁,对比两组TBIL、AST、ALT水平。结果:治疗后,观察组ALT、TBIL、AST水平明显低于对照组(P<0.05)。结论:对脓毒血症合并肝功能损害采用异甘草酸镁联合谷胱甘肽治疗,效果明显,能起到协同作用。     

恩替卡韦联合安络化纤丸治疗慢性乙型肝炎肝纤维化的效果观察

目的:观察恩替卡韦联合安络化纤丸治疗慢性乙型肝炎肝纤维化的效果。方法:选取68例慢性乙型肝炎肝纤维化患者作为研究对象,根据随机数字表法将其分为对照组和观察组各34例,对照组口服恩替卡韦治疗,观察组在对照组的基础上联合安络化纤丸治疗,两组均治疗14 d,比较两组乙型肝炎病毒(HBV)DNA阴转率、治疗前后血清肝纤维化指标[透明质酸(HA)、Ⅳ型胶原(C-Ⅳ)、层粘连蛋白(LN)、IU型前胶原(PCⅢ)]水平、肝功能指标[丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)]水平及不良反应发生率。结果:治疗后两组HBV-DNA阴转率与不良反应发生率比较,差异均无统计学意义(P>0.05);治疗前两组HA、C-Ⅳ、LN、PCⅢ的水平比较,差异无统计学意义(P>0.05),治疗后两组HA、C-Ⅳ、PCⅢ、LN水平明显低于治疗前,且观察组HA、C-Ⅳ、PCⅢ的水平明显低于对照组,差异均有统计学意义(P<0.05);治疗前两组ALT、AST水平比较,差异无统计学意义(P>0.05);治疗后两组ALT、AST水平均明显低于治疗前,且观察组低于对照组,差异均有统计学意义(P<0.05)。结论:恩替卡韦联合安络化纤丸治疗慢性乙型肝炎肝纤维化的效果优于单纯恩替卡韦治疗效果。     

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.