异氟醚和硝普钠联合用药行控制性隆压的临床应用

将３６例脑肿瘤芬除患者随机分为两组，Ⅰ且单纯用硝普钠，Ⅱ组用异氟醚＋硝普钠，混一平均动脉压（ＭＡＰ）、心率（ＨＲ）、硝普钠用量、血压反跳现象。结果发现，两组在降压期间同一时段的ＭＡＰ、ＨＲ无显著差异；Ⅰ组硝普钠用量明显多于Ⅱ组（Ｐ〈０．０１）；Ⅰ组出现４例血压反跳现象，Ⅱ组无１例（Ｐ〈０．０１）。     

硝普钠联合多巴胺治疗急性心力衰竭的效果观察

目的：探讨硝普钠联合多巴胺治疗急性心力衰竭的效果。方法：抽签法选择 ２０１７－０６ ～ ２０１８－１２ 期 间我院收治的急性心力衰竭病人 １２０ 例，随机数表法分为观察组和对照组。对照组在常规对症治疗的基础上加 用硝普钠，观察组在对照组治疗基础上加用多巴胺，观察两组治疗效果。结果：治疗后，两组 ＣＶＰ、ＣＯ、ＨＲ 水平 均明显改善，优于治疗前，与治疗前比较，Ｐ＜０．０５；ＣＶＰ、ＣＯ、ＨＲ 水平治疗后组间比较，差异不显著，均 Ｐ＞０．０５；治 疗后观察组 ＬＶＥＦ 水平高于对照组，ＣＲＰ 水平低于对照组，ＢＮＰ 水平低于对照组，组间比较，均差异显著，均 Ｐ＜ ０．０５；治疗后，对照组的舒张压和收缩压分别为９３．１±１０．９ｍｍＨｇ、１６２．８±９．５ｍｍＨｇ，观察组的舒张压和收缩压分别 为７９．６±５．６ｍｍＨｇ、１３２．９±６．８ｍｍＨｇ，观察组优于对照组，Ｐ＜０．０５。结论：硝普钠联合多巴胺治疗急性心力衰竭可 有效控制血压，增加心排血量，治疗效果显著。     

硝普钠治疗难治性心衰及其对血浆一氧化氮、内皮素-1的影响

为探讨硝普钠治疗难治性心衰后血浆一氧化氮（ＮＯ）及内皮素１（ＥＴ１）的变化。在综合治疗的基础上加用硝普钠治疗难治性心衰５８例，应用分光光度法及放免法测定治疗前后血浆ＮＯ及ＥＴ１的变化。结果：与治疗前相比，有效组血浆ＮＯ水平明显升高（Ｐ＜００１），ＥＴ１明显下降（Ｐ＜００１）；无效组ＮＯ、ＥＴ１无明显变化（Ｐ＞００５）；心功能明显改善总有效率８７９３％。结果提示：ＮＯ、ＥＴ１是观察心衰治疗效果的重要指标之一。     

乌拉地尔治疗恶性高血压的临床观察

目的 观察乌拉地尔、硝普钠治疗恶性高血压的降压效果。方法 24例恶性高血压患者随机分成二组，一组经静脉给予乌拉地尔；另一组经静脉给予硝普钠作为对照，进行血压监测，观察二组的治疗效果，以了解乌拉地尔能否达到治疗恶性高血压的最初目标(数分钟至2h内平均动脉压下降不超过25％，以后的2～6h血压降至160／100mmHg以下)。结果 乌拉地尔、硝普钠可显著降低恶性高血压患者的收缩压、舒张压，二组给药10min时与给药前比较，其血压差异具有高度显著性(P＜0．01)。二种药物疗效比较差异无显著性(P＞0．05)，皆能达到治疗的最初目标。结论 乌拉地尔对恶性高血压有显著疗效，能达到治疗的最初目标。     

侧脑室微量注射硝普钠对大鼠痛阈的影响

实验采用辐射热作为伤害性刺激，以浅麻状态下大鼠甩尾潜伏期为痛阈指标，观察了侧脑室微量注射硝普钠及注射硝普钠与血红蛋白混合液对大鼠痛阈的影响。结果表明，选用１ｍｇ／ｍｌ硝普钠，注入后即刻甩尾潜伏期有明显缩短，２ｍｉｎ达高峰（３６．２％，Ｐ〈０．０５）；以硝普钠与血红蛋白的混合液注入，甩尾潜伏期无显著变化。提示：硝普钠在高位中枢对伤害性刺激有易化作用，其作用是通过一氧化氮实现的。     

硝普钠治疗高血压伴有肺结核大咯血的疗效观察

目的：探讨快速、安全、高效的治疗高血压肺结核大咯血的止血药物的疗效。方法：对经分析９８例应用硝普钠与酚妥拉明静滴止血治疗效果。结果：硝普钠治疗有效率为９３．８％。酚妥拉明有效率为６１．２％，两组相比较差异有极显著性（Ｘ＾３＝１５．００５，Ｐ〈０．０１）。结论：硝普钠治疗高血压伴有肺结核大咯血具有疗效高、速度快、副作用少等特点。     

生脉注射液辅助治疗慢性肺心病初探

报告用华西牌生脉注射液辅助治疗慢性肺源性心脏病６０例疗效，并与６０例常规治疗组疗效进行比较。结果显示：治疗前两组第一秒率（ＦＥＶ（１．０）％）、动脉血氧分压（ＰａＯ＿２）、二氧化碳分压（Ｐａ－ＣＯ＿２）无显著性差异（Ｐ＞０．０５），治疗后生脉液组临床症状明显好转，ＦＥＶ（１．０）％、ＰａＯ＿２明显升高，与对照组比较有显著性差异（Ｐ＜０．０１，Ｐ＜０．０５），但ＰａＣＯ＿２无显著性差异（Ｐ＞０．０５）。     

硝苯啶对Ⅱ,Ⅲ期老年高血压病人动态血压的影响

分析３６例硝苯啶治疗后降压满意的Ⅱ、Ⅲ期老年高血压病人（ＨＰＥ）的动态血压（ＡＢＰ），结果显示：（１）治疗后两组ＡＢＰ参数除最低血压外均较治疗前显下降（Ｐ〈０．０５￣０．０１），组间比较Ⅲ期组舒张压、血压负荷值明显高于Ⅱ期组（Ｐ〈０．０５￣０．０１）；（２）治疗后两组ＡＢＰ昼夜节律与治疗前相似，提示：（１）短效硝苯啶用于ＨＰＥ仍有效、安全，特别是Ⅱ期ＨＰＥ；（２）硝苯啶对ＨＰＥ的ＡＢＰ昼夜节律无     

开博通、硝苯啶对原发性高血压患者血浆内皮素、肾素─血管紧张素─醛固酮系统的影响

本文对２４例原发性高血压（ＥＨ）患者随机分为应用升博通组及硝苯啶组，各１２例，均进行１４ｄ治疗，探讨这两种药物对血浆内皮素（ＦＴ）、肾素（ＰＲＡ）、皿管紧张素Ⅱ（ＡＴⅡ）及醛固酮（ＡＬＤ）系统、血压和心率的影响。结果表明：ＥＨ患者治疗前血浆ＦＴ、ＰＲＡ、ＡＴⅡ及ＡＬＤ浓度与正常对照组相比差异有显著性意义（Ｐ＜Ｏ．０１和Ｐ＜０．０５）．开博通组治疗后，血浆ＡＴⅡ、ＡＬＤ、血压及心率平均值与治疗前相比差异有显著性意义（Ｐ＜０．０１和Ｐ＜０．０５），ＦＴ和ＰＲＡ差异无显著意义（Ｐ＞０．０５）；硝苯啶组治疗后血浆ＥＴ、血压平均值与治疗前相比差异有极显著性意义（Ｐ＜０．０１）、ＡＴⅡ、ＡＬＤ虽有下降但差异无显著性意义（Ｐ＞０．０５），心率平均值增加（Ｐ＜０．０１）。以上两种药物从不同作用机制影响血管活性物质的皿浆浓度来降低血压，提示将此两种药物联合使用，呵更有效地发挥降压效果。     

动脉硬化性脑梗塞并发高血压患者脉压差变化及临床意义

目的探讨动脉硬化脑梗塞（脑梗塞）患者脉压差变化规律。方法对 ４４７例脑梗塞患者入院时血压及脉压差情况作回顾性分析。结果≥７５岁年龄组脉压差９ ３１±２６８ｋＰａ，较＜７５岁组８５３ ± ２．３３ ｋＰａ差异有极显著性（Ｐ＜０．０１），高血压病程≥１０年组脉压差９．１６１２．３６ ｋＰａ，较＜１０年组８．６３１２．５０ ｋＰａ亦有显著性差异（Ｐ＜０．０５），但不同性别间脉压差变化不大（Ｐ＞０．０５）。结论脑梗塞并发高血压患者无论男性或女性，其脉压差均增大。     

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.