塞利洛尔与阿替洛尔治疗高血压的对照研究

目的观察塞利洛尔治疗原发性高血压的降压疗效并与阿替洛尔进行比较。方法采用多中心、随机、双盲、平行对照法，入选21～60岁血压为(160～200)mmHg/(95～114)mmHg(1mmHg=0.133kPa)的原发性高血压病人240例进行8周的观察，随机服用塞利洛尔100～400mg/d或阿替洛尔25～100mg/d。结果塞利洛尔组(114例)血压从(163.9±20.3)mmHg/(105±11.3)mmHg降至(139.1±17.2)mmHg/(86.0±7.3)mmHg；阿替洛尔组(112例)血压从(164.5±20.0)mmHg/(104.0±8.1)mmHg降至(138.2±17.4)mmHg/(84.2±8.3)mmHg。控制24h血压，塞利洛尔较阿替洛尔为佳。结论β受体阻滞剂塞利洛尔是一种有效而安全的降压药，比阿替洛尔有更好的控制24h血压的作用，推荐剂量为100～300mg/d。     

氯沙坦降压疗效及对尿酸和蛋白尿的影响

目的探讨高血压治疗中氯沙坦对血压、蛋白尿和尿酸的影响.方法观察30例高血压患者服用氯沙坦(50mg/d)治疗8周后血压、尿蛋白、血尿酸及肌酐的变化.结果氯沙坦治疗8周后,血压明显下降,从161.66±17.52/97.42±6.70mmHg降至137.33±14.81/87.30±8.53mmHg(1mmHg=0.133kPa,P＜0.001);尿酸从457.76±108.77μmol/L降至405.91±90.11μmol/L(P＜0.001);蛋白尿从2210.26±1969.8mg/24h降至1895±2447.97mg/24h(P＜0.001);血肌酐变化不显著(P＞0.05).结论氯沙坦对高血压患者具有良好的降压作用,同时兼有降尿酸、降尿蛋白的作用.     

卡托普利与硝苯地平治疗老年人高血压疗效比较

目的 观察血管紧张素转换酶抑制剂卡托普利和钙离子拮抗剂硝苯地平对老年高血压的疗效。方法对80例60岁以上的高血压患者随机分为两组,每组各40例,分别用卡托普利25～37.5mg/d和硝苯地平15～30mg/d进行治疗。结果 卡托普利组血压从(170±18)/(88±9)mmHg降至(132±13)/(80±9)mmHg,P<0.01;硝苯地平组血压从(173±19)/(88±8)mmHg降至(129±15)(79±8)mmHg,P<0.01,两组疗效相近。结论 卡托普利与硝苯地平治疗老年人高血压疗效肯定,均未发生体位性低血压。     

莫索尼定与氨氯地平治疗轻中度原发性高血压的对比研究

目的:评价莫索尼定对轻中度原发性高血压的疗效和安全性。方法:采用随机、双盲、对照的研究方法,选择舒张压在95~114mmHg,年龄为18~75岁的59例患者,分别口服莫索尼定0.2 mg/d(A组)或氨氯地平5mg/d(B组),观察和分析前者的降压疗效及其安全性。结果:服药2周后两组血压均明显下降,至8周末时,A组血压从(156.93±11.52)/(99.93±4.07)mmHg降至(137.48±8.70)/(87.83±4.56)mmHg;B组血压从(156.43±11.38)/(100.43±4.03)mmHg降至(134.63±⒍26)/(85.47±4.81)mmHg(P<0.0 1)。A组和B组总有效率分别为86.21%和100.00%,而两组间差异无显著性意义。不良反应轻微,两组发生率分别为13.79%和10.00%,差异无显著性意义。结论:莫索尼定可有效地降低轻中度原发性高血压患者的血压,且不良反应轻微,安全性较好。     

塞利洛尔治疗原发性高血压40例疗效观察

β受体阻滞剂在治疗高血压、心绞痛中已广泛应用于临床,近期我们应用第3代β受体阻滞剂、塞利洛尔治疗原发性高血压40例,取得了较好的降压效果。现报告如下。1　对象与方法1.1　对象　　按照ＷＨＯ标准确诊原发性高血压Ⅰ～Ⅱ期病人40例,其中男24例,女16例。平均年龄(56.0±6.8)岁,病程(8.59±8.31)年,平均血压ＳＢＰ(163.1±18.8)ｍｍＨｇ(1ｍｍＨｇ=0.133ｋＰａ)、ＤＢＰ(102.6±5.6)ｍｍＨｇ。1.2　方法　　采用开放自身前后对照的方法。所有患者用药前均服用安慰剂2周,并停服其他降压药,血压仍保持在Ⅰ～Ⅱ期水平者。然后服用塞利洛尔10…     

缬沙坦治疗南方人原发性高血压病的疗效观察

目的通过开放试验,评价缬沙坦对治疗南方人高血压病的疗效和病人的耐受性.方法采用随机、单盲、安慰剂对照试验,测定30例南方原发性高血压患者降血压治疗(缬沙坦80～160mg/d,治疗8周)前后及30例安慰剂组的血压,并观察血压变化及相关指标.结果缬沙坦80～160mg,每日1次,可明显降低南方高血压病患者血压,缬沙坦组患者收缩压由治疗前(157.051±13.82)mmHg降至(126.85±10.60)mmHg,舒张压由治疗前(101.58±7.25)mmHg降至(87.00±10.25)mmHg,P＜0.05,安慰剂组治疗前后无明显变化.缬沙坦具有良好的安全性和耐受性.不良反应通常是轻微的、暂时的,不影响治疗.结论南方人原发性高血压病患者,每日1次服用缬沙坦80～160mg,可明显降低血压,且安全性良好,易于耐受.     

伊贝沙坦治疗老年人原发性高血压的疗效及对肾功能的影响

目的评估伊贝沙坦对老年高血压患者降压的效果及对肾功能的影响.方法选择36例病人,确诊原发性高血压,开始剂量为150mg/日,若经2周治疗后,舒张压仍超过90mmHg,则剂量加倍,疗程共8周,观察治疗前后血压及肾功能指标并进行比较.结果①8周治疗后血压均明显降低,收缩压从平均(165.5±13.7)mmHg降至(144.6±11.1)mmHg,舒张压从平均(101.3±7.1)mmHg降至(87.1±6.8)mmHg(P＜0.05).②患者尿β2-微球蛋白(β2-MG)从治疗前平均(0.312±0.072)mg/L降至(0.236±0.067)mg/L(P＜0.05);血β2-MG从治疗前平均(2.92±0.53)mg/L降至(2.41±0.48)mg/L;24小时尿蛋白定量从平均(0.32±0.05)g/L降至(0.20±0.02)g/L(P＜0.05);36例病人治疗前后血脂、血糖、肝功能检查无明显变化.结论伊贝沙坦有较好的抗高血压疗效,降压同时减少微量蛋白尿,保护肾功能,对血脂、血糖、尿酸以及肝功能无不良影响.     

不同时间服药对高血压病控制血压晨峰的疗效观察

目的:探讨降压药物联合使用,不同时间服药对高血压患者降压及控制血压晨峰的疗效。方法:对原发性高血压病64例患者随机分成两组:早晨顿服组32例,分次服用组32例,使用拉西地平4mg和厄贝沙坦/氢氯噻嗪162.5mg,治疗8周。治疗前后分别行24h动态血压监测,以观察降压疗效及血压晨峰值的变化。结果:治疗8周,早上顿服组与分次服用组服药后比较:(1)24h平均收缩压140.6±12.7 mmHg vs121.5±10.6 mmHg(P<0.01);(2)夜间平均收缩压125.4±10.6 mmHg vs110.4±9.8 mmHg(P<0.05),夜间平均压舒张压81.2±6.2 mmHg vs75.2±5.6 mmHg(P<0.05);(3)血压晨峰值36.8±6.2 mmHg vs22.4±5.3 mmHg(P<0.01)。结论:拉西地平和厄贝沙坦/氢氯噻嗪不同时间分次服用可平稳降低夜间血压,有效控制晨峰现象,减少心血管事件发生。     

依拉地平治疗原发性高血压

本报告了依拉地平（isradipine）治疗30例原发性高血压的临床效果及安全性。观察期限6周,结果显示依拉地平1.25mg,每日2次,有14例病人获得满意的疗效,卧位血压由165.5±3.2/100.9±2.9mmHg降至146.1±1.2/89.1±2.5mmHg。11例病人服用剂量增至2.5mg,每日2次,卧位血压降至148.6±4.1/91.5±2.2mmHg。3例加服马来酸依那普利10mg,每日2次,血压降至152.5±2.3/94.9±5.6mmHg。2例病人降压效果不明显。单用依拉地平治疗高血压总有效率为83.3%,副作用较少,并随用药时间的延长而消失。     

乌拉地尔治疗高血压急症的疗效观察

目的:观察静脉注射剂乌拉地尔对高血压急症的疗效。方法:选择89例高血压急症女性患者,静脉使用乌拉地尔治疗,并记录用药后5min、0.5h、1h、2h、4h、6h、12h及24h血压及心率。结果:89例患者在用药后5min内血压明显下降,收缩压由(218.2±14.7)mmHg降至(201±13.3)mmHg(1mmHg=0.133kPa),P<0.01,舒张压由(119.3±6.7)mmHg降至(109.7±5.4)mmHg,P<0.01。显效率100%。仅有2例出现头晕,但可耐受。结论:静脉使用乌拉地尔降低血压起效迅速、疗效肯定、使用安全、简单、副作用轻微,可作为高血压急症的首选药。     

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.