下肢静脉造影的临床应用价值

目的：探讨下肢静脉造影在下肢静脉疾病中的临床应用价值。方法收集我院自2011年3月～2013年7月怀疑有下肢静脉疾病的患者378例613条肢体,均行下肢静脉顺行性造影,对造影结果总结分析。结果613条下肢静脉造影表现中,下肢深静脉瓣膜功能不全349条（56.93％）,下肢浅静脉瓣膜关闭不全166条（27.08％）,左髂总静脉压迫综合征59条（9.62％）,深静脉血栓形成30条（4.89％）,下肢深静脉血栓形成后综合征7条（1.14％）,正常静脉2条（0.33％）。结论下肢静脉造影对下肢静脉疾病的病因诊断、临床治疗有重要的应用价值。     

免碘过敏试验使用复方泛影葡胺行静脉肾盂造影检查分析

目的探讨免碘过敏试验使用76％复方泛影葡胺在静脉肾盂造影（IVP）的临床应用情况。方法2008年共1230名患者常规做静脉肾盂造影时免碘过敏试验静脉推注40ml76％复方泛影葡胺并全程观察患者的反应。结果在所有患者中仅有2例出于安全考虑改用非离子型对比剂,有52例出现轻中度过敏反应,发生各症状的人数与在2007年同时期行碘过敏试验阴性后IVP出现过敏反应症状比较无显著性差异。结论在做好预防和抢救措施的前提下进行免碘过敏试验静脉肾盂造影是安全可行的。     

低浓度水性碘子宫输卵管造影在不孕症中的应用价值

目的探讨低浓度水性碘施行子宫输卵管造影（HSG）在不孕症中的临床应用价值。方法1546例不孕症患者均采用38％泛影葡胺施行子宫输卵管造影检查，观察其结果。结果1546例患者子宫及输卵管显影满意，宫腔异常166例（10．7％），双侧输卵管通畅322例（20．8％），通而不畅856例（55．4％），输卵管阻塞368例（23．8％），淋巴及静脉逆流48例（3．1％），轻度不良反应72例（2．1％）。结论低浓度水性碘施行子宫输卵管造影在不孕症的诊断中有重要临床应用价值，同时具有一定的临床治疗作用，值得推广应用。     

泛影葡胺静脉肾盂造影不良反应的观察及护理

对３５９例碘过敏试验阴性患者行静脉肾盂造影。结果表明，碘过敏试验阴性，患者使用泛影葡胺后仍有出现不良反应的可能，此类反应多在静注药物开始３ｍｉｎ内出现。文章对此类不良反应的预防，提出相关护理措施，以确保静脉肾盂造影检查的成功。     

泛影葡胺静脉肾盂造影不良反应的观察及护理

对359例碘过敏试验阴性患者行静脉肾盂造影。结果表明，碘过敏试验阴性，患者使用泛影葡胺后仍有出现不良反应的可能，此类反应多在静注药物开始3min内出现。文章对此类不良反应的预防，提出相关护理措施，以确保静脉肾盂造影检查的成功。     

9例子宫输卵管造影碘油逆流分析

９例子宫输卵管造影碘油逆流分析林薇（广西区南溪山医院放射科桂林市５４１００２）关键词子宫；输卵管；造影；碘油子宫输卵管造影术中的造影剂逆流问题（即碘油进入间质及血管）应引起重视。我院１９８７年以来行子宫输卵管造影的１６５例中逆流９例（占５．５％），静...     

肝癌患者碘油—化疗药物乳剂栓塞化疗后剧烈寒战23例临床分析

目的;分析肝癌患者肝动脉碘油－化疗的药物乳剂栓塞化疗后出现剧烈寒战,发热的原因,探讨其预防及治疗措施。方法：观察69例肝癌患者（肝癌组）116例次肝动脉数字减影血管造影（DSA）造影及碘油－化疗药物乳剂栓塞化疗和38例肺癌患者（肺癌组）76例次支气管动脉灌注化疗后的反应。结果：肝癌组术后寒战发生率19．8％,肺癌组术后无一例发生寒战（P＜0．01）,肝癌组发生寒战得肝动战与碘油及肝内存在肝动脉－肝静脉兼有关。     

DSA在胸部检查中的应用

1造影检查方法 1．1造影前的准备 （1）碘过敏试验其方法有几种：口服试验，结膜试验，口含试验，皮内试验，静脉碘试验，通常以静脉法碘试验常用。     

碘造影剂过敏反应的预防及处理

含碘造影剂如泛影葡胺、优维显、欧乃派克等，因其显影清晰，毒副作用少，易于吸收与排泄，广泛应用于放射科四肢血管造影、静脉肾盂造影、胆道造影等检查中。碘造影剂过敏反应是造影检查过程中最严重的不良反应，轻者影响病人的身心健康，重者危及病人的生命。现将造影剂过敏反应的预防和处理报告如下。     

子宫输卵管碘油造影诊断分析

目的 探讨子宫输卵管碘油造影的诊断。方法 对39例资料较完整的子宫输卵管碘油造影患者的X线片进行分析。结果 正常5例（12．82％），宫腔异常3例（7．69％），单侧输卵管不通12例（30．77％），双侧输卵管不通7例（17．95％），输卵管通而不畅7例（17．95％），造影剂逆流5例（12．82％）。结论 子宫输卵管碘油造影是行之有效且简便实用的诊断技术。     

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.