国产与进口酒石酸美托洛尔治疗原发性高血压的疗效与经济比较

目的比较国产与进口酒石酸美托洛尔片治疗原发性高血压的疗效及经济。方法50例原发性高血压患者分成观察组和对照组。对照组给予进口酒石酸美托洛尔片治疗：观察组给予国产酒石酸美托洛尔片治疗。结果观察组总有效率80．00％与对照组84．00％比较,差异无统计学意义（P〉0．05）。两组原发性高血压患者均未见严重不良反应。国产酒石酸美托洛尔片价格低于进口酒石酸美托洛尔片。结论国产与进口酒石酸美托洛尔片治疗原发性高血压患者均疗效可靠、安全,但是国产药更经济实惠。     

国产缬沙坦逆转原发性高血压左心室肥厚60例疗效观察

目的比较国产和进口缬沙坦逆转原发性高血压左心室肥厚（LVH）的疗效及安全性。方法选择原发性高血压伴LVH患者118例,随机分为两组,治疗组60例口服国产缬沙坦,对照组58例口服进口缬沙坦。剂量均为80mg,qd。6个月为1个疗程,观察治疗前后血压、左心室肥厚超声心动图指标变化,并监测血、尿常规、肝肾功能等指标,记录不良反应。结果两组均能降低血压,治疗前后差异显著（P〈0.01）,两组相比差异无显著意义（P〉0.05）;两组均能逆转原发性高血压伴LVH,治疗前后差异显著（P〈0.05）,两组相比差异无显著意义（P〉0.05）;两组心率无明显变化;在整个观察期间,两组药物不良反应发生率相比差异无显著意义（P〉0.05）。结论国产和进口缬沙坦治疗原发性高血压伴LVH均能在降低血压的同时,使LVH发生逆转,且不影响心率,不良反应少。     

ARB类药物对高血压患者HRV的影响

目的 探讨ARB类药物对高血压患者心率变异性HRV的影响.方法 入选112例中、重度高血压患者,给予加服缬沙坦胶囊80-160mg Qd共12周;另选同期108例中、重度高血压患者给予加服ARB类药物之外的其他降压药作为对照组.观察高血压患者治疗前后HRV的变化.结果 随访12周后,与治疗前比较,高血压患者血压下降,HRV升高.结论 ARB类药物能改善高血压患者的心率变异性.     

替米沙坦治疗原发性高血压的临床疗效观察

目的:分析研究替米沙坦治疗原发性高血压的临床效果及安全性。方法:将82例轻中度原发性高血压患者随机分成观察组50例和对照组32例,观察组患者给予替米沙坦治疗,对照组患者给予缬沙坦治疗,观察记录两组患者临床疗效及不良反应情况。结果:观察组有效率为96.00%,显著高于对照组的84.38%(P0.05);在24 h血压均值、日间血压均值及夜间血压均值方面,两组治疗前后差异均有统计学意义(P0.05),但两组间比较,差异无统计学意义(P0.05)。结论:替米沙坦对原发性高血压具有明显的降压作用,且不良反应发生率低,值得应用。     

缬沙坦联合氨氯地平治疗高血压患者的疗效观察

目的:探讨缬沙坦联合氨氯地平治疗原发性高血压患者临床疗效和安全性。方法:应用随机数字表法将我社区门诊治疗的96例原发性高血压患者分为对照组和观察组,每组各48例,对照组给予贝那普利联合氨氯地平治疗,观察组则给予缬沙坦联合氨氯地平治疗,治疗12周,比较两组患者临床疗效和药物不良反应发生情况。结果:治疗12周,观察组坐位收缩压和坐位舒张压均明显低于对照组,有显著性差异(P<0.05),对照组治疗总有效率(97.92%)明显高于观察组的(87.50%),有显著性差异(P<0.05),且对照组药物不良反应发生率无显著性差异(P>0.05)。结论:缬沙坦联合氨氯地平治疗原发性高血压临床疗效确切,临床疗效优于贝那普利联合氨氯地平,两种方案在药物不良反应上有各自特点,可根据患者的具体情况选择药物治疗方案。     

分析我院门诊ACEI和ARB类抗高血压药物的应用效果

目的分析我院门诊ACEI和ARB类抗高血压药物的应用效果。方法选取2017年1月至2018年12月我院收治的210例高血压患者,将其随机分为两组,其中105例服用ACEI类抗高血压药物,记为对照组,105例服用ARB类抗高血压药物,记为观察组,对比两组患者的疗效效果、不良反应与副作用情况。结果 ACEI和ARB类抗高血压药物均能有效降低患者的血压水平,两组患者治疗后的血压水平差异无统计学意义(P0.05),观察组的不良反应和副作用发生率低于对照组,差异有统计学意义(P0.05)。结论 ACEI和ARB类抗高血压药物均能有效降低高血压患者的血压水平,其中ARB类抗高血压药物引发不良反应与副作用的几率更低,值得推广。     

缬沙坦联合血塞通片治疗老年轻中度高血压的临床观察

目的 观察缬沙坦联合血塞通片治疗老年轻中度高血压的疗效.方法 96例符合轻中度高血压病患者随机分为对照组和观察组各48例,对照组给予缬沙坦80mg,1次/d,4周为1个疗程;观察组给予缬沙坦80mg,1次/d,联合血塞通片0.1g,3次/d,疗程与对照组相同.比较两组患者用药各项指标改善情况.结果 对照组有效率79.2%(38/48),观察组有效率95.8%(46/48),治疗前后两组血压值差异有统计学意义(P＜0.05).心电图ST-T变化疗效比较对照组有效率45.8%(22/48),观察组有效率70.8%(34/48),两组比较差异有统计学意义(P＜0.01).结论 缬沙坦联合血塞通治疗老年轻中度高血压心电图ST-T变化疗效比较满意,安全、不良反应少.     

缬沙坦联合氨氯地平治疗老年高血压的疗效分析

目的:探讨缬沙坦联合氨氯地平治疗老年高血压的疗效。方法:选取300例老年高血压患者,按照1∶1比例将患者实施平分,观察组与对照组各150例,对照组单独采用氨氯地平治疗,观察组采用氨氯地平联合缬沙坦治疗,比较两组治疗效果、血压变化情况及患者出现的不良反应。结果:观察组患者98.67%的治疗有效率与对照组90.67%的治疗有效率比较,差异有统计学意义(P<0.05);治疗前,两组血压水平比较差异无统计学意义(P>0.05);不同方式治疗后,观察组血压水平较对照组下降更显著,差异有统计学意义(P<0.05);观察组不良反应发生率为4.00%,显著低于对照组的12.67%,差异有统计学意义(P<0.05)。结论:给予老年高血压患者缬沙坦联合氨氯地平治疗后,取得的治疗效果显著,患者血压水平得以明显降低,且并发症少,疾病得以良好预后。     

大剂量缬沙坦对老年高血压合并肾病患者的疗效及肾功能的影响

目的:探究大剂量缬沙坦对老年高血压合并肾病患者的疗效及肾功能的影响.方法:选择2014年9月～2016年6月本院收治的老年高血压合并肾病患者86例为研究对象,依入院顺序分为观察组和对照组,两组患者接受缬沙坦导入治疗后,观察组患者给予大剂量缬沙坦,对照组维持原导入剂量.测定两组患者治疗前后血压指标及肾功能指标,并进行对比.结果:治疗前两组患者血压对比,差异不显著(P>0.05);治疗后两组血压均较治疗前下降,且观察组下降水平优于对照组,差异显著(P<0.05);治疗前两组肾功能指标对比,差异不显著(P>0.05);治疗后均有改善,观察组改善幅度优于对照组,差异显著(P<0.05).结论:给予老年高血压合并肾病患者大剂量缬沙坦治疗,可有效降低血压,改善肾功能.     

缬沙坦联合苯磺酸氨氯地平片治疗高血压患者的临床疗效分析

目的观察高血压患者应用缬沙坦、苯磺酸氨氯地平片联合治疗的临床效果。方法以随机的方式选取2016年1月至12月在门诊进行高血压治疗的60例患者作为本次调查的对象。按照随机的方式分成两组,对照组和实验组每组各30例。对照组给予患者苯磺酸氨氯地平片治疗。实验组给予患者缬沙坦、苯磺酸氨氯地平片联合治疗。观察对照组和实验组临床治疗效果。结果对照组不良反应发生率高于实验组,但两组之间无明显差异(P0.05)。结论在高血压临床治疗中,可采取缬沙坦联合氨氯地平药物治疗方式,治疗效果显著。     

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.