幽门螺杆菌感染与缺铁性贫血临床研究

目的探讨幽门螺杆菌感染与缺铁性贫血的关系。方法选择伴慢性胃炎的IDA患者82例(观察组)和慢性胃炎无贫血患者60例(对照组)行快速尿素酶试验,内镜下组织病理检查;观察组中,Hp阳性患者70例随机分为A、B、C3组,A组(30例)给予硫酸亚铁和抗Hp治疗,B组(20例)给予硫酸亚铁和安慰剂治疗,C组(20例)给予抗Hp治疗;观察治疗前后患者的血红蛋白、红细胞计数、平均红细胞容积、网织红细胞、血清铁、血清铁蛋白等血液学指标的变化情况。结果观察组82例中70例Hp阳性,对照组60例中43例Hp阳性,两组间差异有显著性(P<0.01);观察组中A、C组与B组比较,治疗前后血液学指标改变及疗效差异有显著性(P<0.05)。结论Hp感染与IDA有一定相关性,抗Hp加铁剂是治疗Hp感染相关性缺铁性贫血的有效方法。     

青少年幽门螺杆菌相关性缺铁性贫血临床研究

目的:探讨幽门螺杆菌(helicobacter phyori,Hp)感染与青少年缺铁性贫血(iron deficiency anemia,IDA)的关系。方法:选择伴慢性胃炎的IDA患者82例(观察组)和慢性胃炎无贫血患者60例(对照组),均行快速尿素酶试验,内镜下组织病理检查;观察组Hp阳性患者随机分为A、B、C3组,A组给予硫酸亚铁和抗Hp治疗,B组给予硫酸亚铁和安慰剂治疗,C组给予抗Hp治疗;观察治疗前后患者的血红蛋白(Hb)、红细胞计数(RBC)、平均红细胞容积(MCV)、网织红细胞(Ret)、血清铁(SI)、血清铁蛋白(SF)等血液学指标的变化。结果:观察组82例中70例Hp阳性,对照组60例中43例Hp阳性,两组间差异有显著意义(P<0.01);观察组中A、C组与B组比较,治疗前后血液学指标改变及疗效差异有显著意义(P<0.05)。结论:Hp感染与青少年IDA有一定相关性,抗Hp加铁剂是治疗Hp感染相关性缺铁性贫血的有效方法。     

幽门螺杆菌感染与缺铁性贫血的相关性研究

目的观察IDA伴Hp阳性慢性胃炎患者抗Hp加铁剂治疗前后实验室检测指标的变化及疗效，探讨幽门螺杆菌（Hp）感染与缺铁性贫血（IDA）形成的相关性及其临床意义。方法将62例IDA伴Hp阳性慢性胃炎患者，分为四组（A、B、C、D组）。A组给予补铁及Hp根除治疗，B组仅Hp根除治疗，C组仅补铁治疗，D组中医药辨证治疗胃炎。检测治疗前后其血红蛋白浓度及血清铁、总铁结合力、铁蛋白水平，并对Hp、胃蛋白酶活性、胃酸进行检测。结果缺铁性贫血伴慢性胃炎患者幽门螺杆菌感染率较高，联合补铁及抗Hp治疗效果显著。结论幽门螺杆菌感染可造成或加重机体铁营养不良，在治疗IDA的过程中应注意清除Hp感染。     

幽门螺杆菌感染与缺铁性贫血的相关性研究

目的观察IDA伴Hp阳性慢性胃炎患者抗Hp加铁剂治疗前后实验室检测指标的变化及疗效,探讨幽门螺杆菌(Hp)感染与缺铁性贫血(IDA)形成的相关性及其临床意义。方法将62例IDA伴Hp阳性慢性胃炎患者,分为四组(A、B、C、D组)。A组给予补铁及Hp根除治疗,B组仅Hp根除治疗,C组仅补铁治疗,D组中医药辨证治疗胃炎。检测治疗前后其血红蛋白浓度及血清铁、总铁结合力、铁蛋白水平,并对Hp、胃蛋白酶活性、胃酸进行检测。结果缺铁性贫血伴慢性胃炎患者幽门螺杆菌感染率较高,联合补铁及抗Hp治疗效果显著。结论幽门螺杆菌感染可造成或加重机体铁营养不良,在治疗IDA的过程中应注意清除Hp感染。     

幽门螺杆菌对成人缺铁性贫血治疗影响的临床研究

目的 研究幽门螺杆菌（HP）对HP阳性的缺铁性贫血治疗的影响.方法 以62例HP阳性的慢性胃炎引起的缺铁性贫血（IDA）为对象.随机分为两组,A组（31例）给予抗HP加铁剂治疗,B组（31例）给予单纯铁剂治疗,动态观察两组的血液学和铁代谢指标变化.结果 A组外周血的血红蛋白（HGB）、平均红细胞体积（MCV）、平均红细胞血红蛋白含量（MCH）以及血清铁（SI）和血清铁蛋白（SF）恢复明显比B组快,尤其以储存铁SF在治疗后期（60d）的恢复更为明显（P＜0.01）.结论 在治疗HP阳性的慢性胃炎引起的IDA过程中,抗HP治疗能明显提高铁剂的治疗效果.     

抗幽门螺杆菌感染在治疗缺铁性贫血中的临床价值

目的探讨抗幽门螺杆菌（HP）感染在缺铁性贫血（IDA）治疗中的临床价值。方法将伴有HP阳性慢性胃炎的IDA患者116例随机分成A、B两组,A组给予铁剂联合HP根除治疗;B组仅予补铁治疗。观察两组患者治疗前后红蛋白（Hb）、血清铁（SI）、血清铁蛋白（SF）等血液学指标的变化。结果 A组的治疗效果明显优于B组,差异有统计学意义（P〈0.05）。结论抗HP加铁剂是治疗HP感染相关性IDA的有效方法,具有重要临床价值。     

幽门螺杆菌感染相关性缺铁性贫血60例临床分析

目的了解幽门螺旋杆菌（HP）感染对缺铁性贫血（IDA）发病的影响,观察抗HP治疗对改善贫血的效果。方法采用13C呼气试验检测105例IDA患者的幽门螺杆菌并对HP阳性患者行根除HP治疗,观察其血红蛋白上升情况及其他血液学指标的变化。结果本组60例HP检测阳性患者中,抗HP治疗后HP转阴52例,转阴率86.7%;HP根治的患者有35例（67.3%）贫血纠正,SF恢复正常。治疗后血液学指标有不同程度的改善。结论幽门螺杆菌感染可能是缺铁性贫血的一个致病因素,以HP阳性慢性胃炎作为惟一病因的IDA患者,根除HP可治愈IDA;对于临床上缺铁原因不明的IDA患者,应该注意检测HP感染的情况,给予有效的抗HP治疗。     

抗幽门螺杆菌感染治疗中青年缺铁性贫血89例临床分析

目的探讨幽门螺杆菌（HP）感染在中青年缺铁性贫血（IDA）中的重要性。方法选择98例伴慢性胃炎IDA患者中HP感染的89例随机分为A、B两组,A组给予铁剂联合HP根除治疗,B组仅予补铁治疗,观察治疗前后患者的血红蛋白（Hb）、血清铁（SI）、血清铁蛋白（SF）等血液学指标的变化。结果补铁联合抗HP治疗较单纯补铁治疗效果好,差异有统计学意义（P〈0.05）。结论HP感染与中青年IDA关系密切,抗HP加铁剂是治疗HP感染相关性IDA的有效方法。     

慢性胃炎伴缺铁性贫血抗幽门螺杆菌治疗65例临床观察

目的:探讨抗幽门螺杆菌(HP)对慢性胃炎伴缺铁性贫血(IDA)患者的疗效。方法:选择IDA伴HP感染阳性的慢性胃炎病人65为观察组,慢性胃炎而无贫血70例为对照组,均行快速尿素酶试验,内镜下组织病理学检查;分别统计观察组与对照组HP感染率;将观察组为两组,A组:抗HP治疗加铁剂治疗,B组:单用铁剂。结果:观察组65例中59例HP阳性,对照组70例中54例HP阳性,两者之间差异有显著性(P<0.01);A组Hb、SI、SF8周、12周后明显升高,治疗前后比较差异有显著性(P<0.01);B组三项指标升高不明显,治疗前后比较差异无显著性(P>0.05)。结论:Hp感染与IDA有密切关系,抗Hp治疗可加快Hb上升,增加铁贮存量。抗HP加铁剂是治疗Hp相关性贫血的有效方法。     

根除幽门螺杆菌在缺铁性贫血治疗中的临床意义

目的探讨幽门螺杆菌(Hp)感染与缺铁性贫血(IDA)的关系及根除Hp治疗的临床意义。方法选取2010年6月至2016年8月我院门诊及住院的缺铁性贫血患者237例,进行14C尿素呼气试验,将其分为Hp+组及Hp-组。Hp+组患者又随机分为A、B、C 3组,A组给予铁剂治疗,B组给予根除Hp治疗,C组给予铁剂+根除Hp治疗,Hp-组给予铁剂治疗。比较各组治疗前后血液学指标及Hp根治情况,并观察疗效。结果治疗两周时,C组及Hp-组网织红细胞水平明显高于治疗前(P<0.05),A、B组较治疗前无明显变化(P>0.05);治疗8周时,4组血红蛋白、血清铁、血清铁蛋白均高于治疗前(P<0.05),总铁结合力较治疗前下降(P<0.05)。C组、Hp-组血红蛋白、血清铁、血清铁蛋白水平及总铁结合力与其他两组比较差异有显著性(P<0.05)。结论 Hp感染与IDA高度相关,在常规补铁治疗的同时进行根除Hp治疗可显著提高临床疗效。     

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.