苯那普利与心痛定治疗原发性高血压的比较观察

目的：比较苯那普利与心痛定治疗高血压的疗效和安全性。方法：将129例原发性高血压患者随机分为苯那普利组65例，用苯那普利5－10mg,PO,qd；心痛定组64例，以心痛定10－20mg,PO,q8h,2组疗程均为4wk。结果：治疗4wk后，2组血压下降差别均有非常显著意义（P＜0．01），苯那普利组的总效率为91％，心痛定组为92％，2组疗效差别无显著意义（P＞0．05）。苯那普利与心痛定均无严重不良反应。结论：苯那普利与心痛定治疗原发性高血压疗效均好，较安全。     

苯那普利和赖诺普利治疗轻中度高血压病的效果观察

苯那普利和赖诺普利均为含羧基类血管紧张素转移酶抑制剂 (ＡＣＥⅠ )的制剂。本文探讨二种药物对高血压疗效及心肌重量指数的影响。1　对象和方法1 1　对象　苯那普利组及赖诺普利组各 30例。两组患者 ,性别、高血压病程、治疗前基础血压和心率均无显著性差异。 (见表 1 )表 1　两组病人的基础情况 (ｘ-±ｓ)苯那普利组赖诺普利组性别 (男∶女 ) 16∶1414∶16年龄 (岁 ) 5 9 8± 10 3 5 7 0± 9 72高血压病程 (年 ) 6 75± 7 987 36± 7 5 3收缩压 2 2 7± 1 912 3 2± 2 0 1舒张压 12 5± 1 5 112 5± 1 41心率 (次 /分 ) 87 5± 1…     

福辛普利治疗原发性高血压46例临床疗效观察

目的:观察福辛普利治疗原发性高血压临床疗效。方法:原发性高血压(轻、中度)46例服用福辛普利10mg/天,观察4周。服药2周降压不明显者,加服吲哒帕胺2.5mg/天。同期选择原发性高血压患者24例服用苯那普利10mg/天,作为对照组。结果:福辛普利组在治疗前、治疗第2周后、治疗第4周后的收缩压分别是(187±16)mmHg、(171±14)mmHg和(159±13)mmHg,舒张压分别是(95.2±5.1)mmHg、(90.6±4.9)mmHg和(84.3±6.3)mmHg;苯那普利组在治疗前、治疗第2周后、治疗第4周后的收缩压分别是(184±20)mmHg、(170±16)mmHg和(159±14)mmHg,舒张压分别是(93.9±7.2)mmHg、(89.2±5.9)mmHg和(83.4±4.8)mmHg,两组的收缩压和舒张压在治疗前后无统计学差异(P<0.05)。结论:轻、中度高血压患者,福辛普利是一安全的降压药物,与其他ACEI类制剂比较,可减少咳嗽的发生。     

氨氯地平与苯那普利对老年原发性高血压的疗效比较

目的比较氨氯地平与苯那普利对老年原发性高血压的治疗作用.方法入选轻中度原发性高血压病 人随机分为两组,氨氯地平组39例,口服氨氯地平5mg每日1次;苯那普利组36例,口服苯那普利每日10mg,上午7 点服用;每日1次,治疗结束时对两组病人服药前后比较血压.结果治疗高血压,氨氯地平起效慢,苯那普利起效 较快,但副反应均小.结论长效制剂氨氯地平、苯那普利治疗老年高血压疗效确切,服用方便,副作用少,可作为 老年高血压病人的首选药物之一.     

缬沙坦与苯那普利逆转左室肥厚效应及耐受性安全性的比较

目的:比较缬沙坦和苯那普利治疗原发性高血压患者的耐受性、安全性及左室肥厚逆转效应。方法:67例原发性高血压伴左室肥厚(LVH)患者随机分为缬沙坦和苯那普利组,分别服用缬沙坦80mg/d~160mg/d,苯那普利10mg/d~20mg/d。治疗6个月后,观察降压疗效比较治疗前后超声心动图指标。结果:应用缬沙坦和苯那普利后均有显著的降压和逆转效应。缬沙坦族具有良好的耐受性,未见干咳现象,苯那普利组干咳发生率8.5%。结论:缬沙坦治疗原发性高血压安全有效,逆转左室肥厚效应明显且耐受性好。     

伊贝沙坦与吲达帕胺联合治疗高血压效果及安全性

目的:观察伊贝沙坦与吲达帕胺联合治疗原发性高血压的效果及安全性。方法:高血压60例被随机分为观察组和对照组(各30例),分别给予伊贝沙坦150mg和吲达帕胺2.5mg每天晨服,或苯那普利10mg和吲达帕胺2.5mg每天晨服,疗程均为12周。结果:治疗后两组血压均有明显下降,伊贝沙坦由治疗前的171.2±17.5/105.3±10.5mmHg降至125.1±15.0/80.5±8.2mmHg,苯那普利由治疗前的170.4±17.6/104.5±10.2mmHg降至124.5±14.4/80.5±8.5mmHg。与治疗前比较P均<0.01。但组间比较差异无显著性(P>0.05)。对照组服药后出现咳嗽6例,观察组未发现明显不良反应。结论:伊贝沙坦与吲达帕胺联用能安全有效地降低高血压,其疗效与苯那普利和吲达帕胺联用后的疗效相似,但副作用明显小于后者,是合理用药的理想组合。     

非洛地平缓释片与硝苯地平片治疗高血压病疗效比较

目的比较非洛地平缓释片与硝苯地平片治疗原发性高血压病的疗效.方法选择门诊轻、中度高血压病人84例.随机分为两组,其中42例(男性30例,女性12例.年龄51±7岁)用非洛地平缓释片 5~10mg.po,qid x 4wK治疗.另42例(男32例,女10例,年龄 50a±s6a)用硝苯地平片10mg,Po,Tid或中qidX4wk治疗.结果非洛地平组降压总有效率95.2% ,与硝苯地平组对90.5%相比,差别有显著性意义(P<0.05).不良反应发生率非洛地平组14%,与硝苯地平组23.8%比较,差别有显著性意义(P＜0.01).结论非洛地平缓释片对高血压病的疗效优于硝苯地平片.     

苯那普利联合小剂量双氢克尿噻治疗高血压疗效观察

目的：探讨苯那普利与小剂量双氢克尿噻联合治疗高血压疗效其对代谢的影响。方法：48例高血压病患者随机分为两组，苯那普利组：苯那普利5-10mg，每日1次或两次口服；苯那普利联用双氢克尿噻组：苯那普利10mg加服双氢克尿噻12.5mg，每日1次。两组均治疗8周，治疗前后测基础血压、空腹血糖、血脂、血尿酸、血钾、血肌酐以及治疗前后24小时动态血压检测。结果：（1）苯那普利联合小剂量双氢克尿噻组较单用苯那普利组降压总有效率明显提高，24小时动态血压负荷下降显著改善。（2）两组治疗前后对代谢无明显改变。结论：苯寻普利联合小剂量双氢克尿噻治疗高血压优于单用苯那普利组，并且对代谢夫明显影响。     

氯沙坦与苯那普利治疗老年慢性心功能不全的研究

目的　观察氯沙坦与苯那普利对老年慢性心功能不全 (CHF)的作用 ,探讨两者在老年CHF治疗中的地位。方法　共 13 5例患者入选 ,年龄均大于 60岁 ,心功能在Ⅱ～Ⅳ级之间 ,经心脏彩色多普勒超声检查证实左室射血分数在 5 0 %以下。在原有抗心力衰竭的基础上随机分入氯沙坦组 (2 5～ 5 0mg d)以及苯那普利组 (5～ 10mg d)。在治疗前及治疗后第 1、3、7、12周查血钾、肾功能及心电图。治疗前及治疗后第 12周时测定患者心脏结构和功能的变化。结果　苯那普利组和氯沙坦组治疗后第 12周时LVEDD(5 .97± 0 .41vs 6.3 6± 0 .43 ;5 .91± 0 .44vs 6.3 2± 0 .41)、LVEF(3 6.4± 4.3vs 3 0 .2± 4.9;3 7.8± 5 .1vs 2 9.7± 4.6)、CO(4 .62± 1.95vs 3 .3 5± 1.67;4.67± 1.82vs 3 .2 8± 1.72 )较入院时明显改善。但两组之间相比无显著差异。苯那普利组患者中共有 16例 (2 3 .19% )出现咳嗽、高钾血症、皮疹、局部血管神经性水肿等不良反应 ,氯沙坦组中仅有 1例 (1.5 % )患者出现低血压。结论　 (1)氯沙坦及苯那普利均可以在一定程度上逆转老年CHF患者的左室重构 ,但两组之间相比无显著差异。 (2 )服用氯沙坦患者中咳嗽等不良反应发生率要明显低于苯那普利 ,耐受良好。     

非洛地平与苯那普利治疗原发性高血压并左心室肥厚效果观察

目的:评价非洛地平与苯那普利治疗原发性高血压并左心室肥厚(LVH)的效果。方法:64例原发性高血压并左心室肥厚患者随机分为2组,每组32例。非洛地平组(F组)给予非洛地平5~10mg/d,苯那普利组(B组)给予苯那普利10~20mg/d,每d1次,疗程24周。2组在治疗前、后分别进行偶测血压、24h动态血压和超声心动图检查。结果:治疗后2组血压均显著降低,2组间偶测血压降幅差异无统计学意义(P>0.05),而24h平均血压、白昼及夜间血压F组降幅大于B组(P<0.05)。2组治疗后室间隔厚度、左心室后壁厚度、左心室心肌质量及左心室质量指数均较治疗前降低(P<0.01),且B组降幅大于F组(P<0.05)。结论:2药均能有效降压和逆转左心室肥厚,非洛地平总体降压幅度大于苯那普利,而苯那普利在逆转左心室肥厚方面略优于非洛地平。     

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.     

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.     

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.