西洛他唑联合前列地尔治疗2型糖尿病下肢血管病变临床疗效观察

目的观察西洛他唑联合前列地尔注射液治疗糖尿病下肢血管病变疗效。方法将50例糖尿病下肢血管病变的患者随机分为治疗组25例和对照组25例。治疗组给予西洛他唑联合前列地尔注射液治疗,对照组给予西洛他唑治疗,治疗15d,比较两组治疗前后临床症状、血流动力学参数及下肢动脉血流动力学变化。结果两组患者治疗后上述指标均改善,但治疗组总有效率明显高于对照组（P〈0．01）,治疗组足背动脉血流量和血管踝臂指数（ABI）高于对照组（P〈0．05）,凝血因子工低于对照组（P〈0．05）。结论西洛他唑联合前列地尔注射液治疗糖尿病下肢血管病变较单用西洛他唑疗效更佳。     

指压穴位操对老年2型糖尿病合并下肢血管病变患者的影响

目的探讨指压穴位操对老年2型糖尿病合并下肢血管病变患者双下肢的血液流速及生活质量的影响。方法将110例老年2型糖尿病合并下肢血管病变患者随机分为对照组和观察组各55例,对观察组患者双下肢进行指压穴位操干预,对照组实施自主随意活动,观察期1年。结果观察组患者踝肱指数(ABI)、足背动脉平均血流速度高于对照组(P 0. 05),两组糖化血红蛋白(HbA1c)水平比较,差异无统计学意义(P 0. 05)。观察组患者生活质量(A-DQOL量表)总分及各维度评分明显低于对照组(P 0. 05)。结论指压穴位操能够改善老年2型糖尿病合并下肢血管病变患者的下肢血液流速及生活质量。     

贝前列素钠对老年2型糖尿病合并下肢血管病变患者疗效及血清TNF－α、sICAM－1的影响

目的：观察贝前列素钠对老年2型糖尿病合并下肢血管病变患者的临床疗效及血清肿瘤坏死因子－α（TNF－α）、可溶性细胞间粘附分子－1（sICAM－1）的影响。方法：选择老年2型糖尿病合并下肢血管病变患者160例,分为对照组（80例）和观察组（80例）。两组均给予常规药物控制血糖。对照组：阿司匹林肠溶片75 mg,口服,qd。观察组：贝前列素钠,40μg,口服,tid。6个月后观察疗效,采用ELISA法检测治疗前后血清TNF－α、sICAM－1。结果：观察组总有效率高于对照组（P＜0．05）;对照组治疗前后血清TNF－α、sICAM－1无明显变化（P＞0．05）;而观察组治疗后血清TNF－α、sICAM－1均明显低于治疗前及对照组治疗后水平（P＜0．05）。结论：贝前列素钠对老年2型糖尿病合并下肢血管病变有较好疗效,能明显降低血清TNF－α、sICAM－1的表达。     

初发2型糖尿病老年患者下肢血管病变的危险因素观察

目的探讨初发2型糖尿病老年患者下肢血管病变的危险因素,以避免严重并发症的发生。方法将60例初发2型糖尿病老年患者,根据下肢动脉血管超声结果分为正常组、轻度病变组、中度病变组三组,观察各组间体质量指数（BMI）、血压、总胆固醇、甘油三酯、高密度脂蛋白胆固醇（HDL—C）、低密度脂蛋白胆固醇（LDL—c）、糖化血红蛋白（HbAlc）等的变化。结果初发的2型糖尿病老年患者中合并下肢血管病变的患病率为18．3％。初发2型糖尿病老年患者合并轻度下肢血管病变者,其体质量指数、收缩压、总胆固醇、低密度脂蛋白及糖化血红蛋白等指标较正常组明显升高,差异有统计学意义（P〈0．05）;合并中度下肢血管病变者体质量指数、收缩压、舒张压、总胆固醇、低密度脂蛋白及糖化血红蛋白等指标较正常组明显升高,差异有统计学意义（P〈0．05）。与伴有轻度下肢血管病变者相比,患有中度下肢血管病变者舒张压、总胆回醇和糖化血红蛋白明显升高。差异有统计学意义（P〈0．05）。结论初发的2型糖尿病老年患者具有体质量指数、血压、总胆固醇、低密度脂蛋白、糖化血红蛋白等升高明显的特点。应及早采用彩色多普勒超声筛查下肢动脉病变,以早期发现糖尿病周围血管病变,早期干预治疗,从而减少糖尿病足的发病率和致残率,节省医疗费用。     

前列地尔联合舒血宁治疗下肢血管病变的疗效

目的 探讨前列地尔联合舒血宁治疗2型糖尿病双下肢血管病变的临床效果.方法 将40例糖尿病合并下肢血管病变患者,随机分为治疗组及对照组.对照组给予前列地尔注射液(凯时)10 U加生理盐水10 ml静脉注射,每日1次,治疗组在应用前列地尔注射液同时联合舒血宁20 ml加0.9% NaCl注射液250 ml静点,每日1次,3周为一疗程,治疗前后比较症状和足背动脉血流量.结果 前列地尔注射液治疗2型糖尿病双下肢血管病变疗效确切,但联合舒血宁治疗疗效更佳(P<0.05).临床症状及足背动脉血流各项治疗后均有显著改变,两组差异具有统计学意义,且不良反应少.结论 前列地尔注射液联合舒血宁治疗能改善2型糖尿病患者合并下肢血管病变的症状及血流动力学状态.     

胰岛素泵联合前列地尔治疗糖尿病双下肢血管病变的疗效观察

目的:分析研讨采用胰岛素泵联合前列地尔治糖尿病双下肢血管病变的临床疗效。方法:本次研究中所研讨的32例患者均随机从2015年2月至2016年4月期间本院收治的糖尿病双下肢血管病变患者中筛选而出。32例患者随机分为对照组(16例)与研究组(16例),采用前列地尔治疗对照组患者,采用胰岛素泵联合前列地尔治疗研究组患者。对比两组疗效。结果:从两组患者治疗后下肢动脉血流量、内径指数上对比来看,研究组比对照组优,组间数据有统计学意义(P0.05)。研究组治疗总疗效93.75%比对照组81.25%明显要高,组间数据有统计学意义(P0.05)。结论:临床在治疗糖尿病双下肢血管病变可考虑给予胰岛素泵联合前列地尔治疗,疗效突出,可明显降低糖尿病疾病并发其他疾病的危险性。     

前列地尔配合常规治疗对糖尿病下肢血管病变患者炎症因子和氧化应激的影响

目的:探讨选择前列地尔联合常规疗法对糖尿病下肢血管病变患者炎症因子以及氧化应激的影响。方法:选取2015年12月-2017年9月本院收治的糖尿病下肢血管病变患者80例,通过数字奇偶法将其分为对照组和观察组,各40例。对照组采用常规治疗,观察组采用前列地尔+常规治疗,两组均治疗14 d。比较两组治疗前后的临床症状评分、踝肱指数(ankle brachial index,ABI)、氧化应激指标水平、炎症细胞因子水平、疼痛程度(VAS评分),观察两组治疗效果。结果:治疗后,观察组ABI高于对照组及治疗前,临床症状评分低于对照组及治疗前,比较差异均有统计学意义(P0.05);治疗后,观察组8-异前列腺素F_(2α)、氧化低密度脂蛋白水平均低于治疗前及对照组,超氧化物歧化酶高于治疗前及对照组,比较差异均有统计学意义(P0.05);治疗后,两组各炎症细胞因子水平比较,差异均无统计学意义(P0.05);治疗后,观察组疼痛程度评分低于对照组(P0.05);观察组总有效率为97.50%,高于对照组的72.50%(x~2=9.803 9,P=0.001 7)。结论:合理选择前列地尔+常规疗法对糖尿病下肢血管病变患者进行治疗,可以有效改善患者下肢血流以及临床症状表现,充分降低其氧化应激反应水平,但是针对患者体内炎性细胞因子无显著性影响。     

前列地尔联合疏血通治疗单纯型糖尿病视网膜病变的疗效观察

目的观察前列地尔联合疏血通治疗单纯型糖尿病视网膜病变的临床疗效。方法对33例单纯型糖尿病视网膜病变的患者用前列地尔联合疏血通治疗1个月，对照组32例常规治疗。观察治疗前后的眼底改善情况和D-二聚体含量的变化。结果治疗组的D-二聚体含量指标较治疗前降低（P〈0．01），对照组无明显变化（P〉0．05）。治疗组眼底病变改善和稳定者多于对照组，眼底病变恶化者少于对照组（P〈0．01）。结论前列地尔联合疏血通治疗单纯型糖尿病视网膜病变具有良好的临床疗效。     

α-硫辛酸注射液对2型糖尿病患者周围神经病变的疗效和安全性研究

目的：探析2型糖尿病患者周围神经病变应用α-硫辛酸注射液疗法的临床效果及安全性研究。方法入选我院2013年1月至2014年1月老年糖尿病周围神经病变84例,按治疗方式的不同分入观察组、对照组,每组42例。对照组进行治疗原发病、注射胰岛素和（或）服用降糖药疗法,观察组在对照组的基础上实施α-硫辛酸注射液疗法,治疗后比较两组患者的周围神经病变的症状评分（ TSS）情况及并发症情况。结果治疗后观察组的TSS评分情况显著优于对照组,差异具有统计学意义（ P＜0．05）;两组治疗后的并发症发生率分别为9．6％、26．3％,差异具有统计学意义（ P＜0．05）。结论2型糖尿病患者应用α-硫辛酸注射液疗法,临床效果确切,可显著改善患者麻木、感觉异常、刺痛等症状,可靠安全,值得临床推广。     

前列地尔联合甲钴胺治疗糖尿病周围神经病变的疗效

目的探讨前列地尔与甲钴胺联合治疗糖尿病周围神经病变的临床疗效。方法选择糖尿病周围神经病变患者60例,随机分为观察组和对照组各30例,观察组在常规治疗基础上给予前列地尔与甲钴胺联合治疗,对照组在常规治疗基础上仅给予甲钴胺治疗,比较两组患者的治疗情况。结果观察组和对照组的总有效率分别为100％和83．33％,观察纽疗效明显优于对照组,两组比较差异有统计学意义（P〈0．05）。结论前列地尔与甲钴胺联合治疗糖尿病周围神经病变效果显著,值得临床推广应用。     

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.