平阳霉素局部注射治疗小儿体表血管瘤286例分析

目的:总结平阳霉素瘤体内注射治疗小儿体表血管瘤的临床疗效.方法:根据患儿年龄、病变部位等不同,使用不同浓度、剂量的平阳霉素治疗单纯性、混合性血管瘤286例.1次未愈者,2周重复注射1次,2～5次为1个疗程.结果:286例患儿326个瘤体,经6个月至1年的随访,治愈率47.6%,显效率29.7%,总有效率89.9%.结论:本方法疗效可靠,不良反应少,适合小儿体表草莓状血管瘤、混合性血管瘤的使用.     

平阳霉素和地塞米松治疗颌面部海绵状血管瘤

目的 探讨平阳霉素加地塞米松瘤体内注射治疗小儿颌面部海绵状血管瘤疗效。方法对20例小儿颌面部海绵状血管瘤患者行平阳霉素加地塞米松瘤体内注射治疗。结果随访1年，20例中治愈15例（75％），有效4例（20％），好转1例（5％）。结论 平阳霉素加地塞米松瘤体内注射治疗小儿颌面部海绵状血管瘤疗效较好。     

平阳霉素局部注射治疗小儿体表血管瘤286例

目的总结平阳霉素瘤体内注射治疗小儿体表血管瘤的临床疗效。方法根据患儿年龄、病变部位等不同,使用不同浓度、剂量的平阳霉素,治疗单纯性、混合性和海绵状血管瘤286例。1次未愈者,2周重复注射1次,2—5次为1个疗程。结果286例患儿326个瘤体,经6个月～2年的随访,治愈率55．5％,显效率31．3％,总有效率86．8％。结论本方法疗效可靠,不良反应少,适合小儿体表单纯性、混合性、海绵状血管瘤的使用。     

小儿体表特殊位置血管瘤局部注射平阳霉素的治疗体会

目的：探讨采用平阳霉素行小儿体表特殊位置血管瘤局部注射的疗效。方法：将平阳霉素8mg用生理盐水3mL～5mL溶解，以皮试针头分点刺入瘤体回抽有血后可注药至瘤体苍白和肿胀为准。间隔2周～3周复诊，根据治疗效果决定是否再次注射，总药量不超过40mg。结果：65例患儿经平阳霉素注射治疗随访3个月～1年，治愈率78．4％，显效率12．3％，总有效率90％。全身不良反应轻微。结论：平阳霉素局部注射治疗小儿体表特殊位置血管瘤疗效确切，副作用小，安全可靠。     

成人体表血管瘤瘤体内注射平阳霉素疗效评定

目的 探讨平阳霉素瘤体内注射治疗成人体表血管瘤的效果。方法 对２７例成人不同部位的体表血管瘤。采用平阳霉素瘤体内注射。结果 平阳霉素瘤体内注射对成人头面颈部海绵状及混合性血管瘤效果较好,对其它类型的血管瘤以及躯干和四肢的任何类型血类瘤效果较差。结论 平阳霉素瘤体内注射对成人仅适用于头面部海绵状及混合性血管瘤,其它类型及其它部位的体表血管瘤不宜选用。     

小儿体表血管瘤的治疗及疗效分析

目的 探讨各年龄层次、各种类型血管瘤、各类治疗方法与疗效的关系.方法 回顾并随访188例10岁以下小儿体表血管瘤,对其疗效进行分析.结果 3岁以内的体表血管瘤患儿治疗效果明显优于年龄较大的患儿;毛细血管瘤的有效率为93.3%,明显高于其他类型血管瘤;口服激素的有效率为64.3%,注射平阳霉素的有效率为83.8%,注射沙培林的有效率为87.5%,手术切除的有效率为90.1%.结论 小儿体表血管瘤需及早治疗;毛细血管瘤的治疗效果较其他类型的血管瘤显著;口服激素、局部注射平阳霉素、沙培林及手术切除治疗均有效.     

不同方法治疗小儿体表血管瘤的疗效对比研究

目的:观察比较平阳霉素局部注射、复方夏枯草搽剂外用及平阳霉素局部注射联合复方夏枯草搽剂外用治疗小儿体表血管瘤临床疗效。方法:我院血管瘤门诊2003～2011年收治小儿体表血管瘤795例,分别采用平阳霉素局部注射、复方夏枯草搽剂外用及平阳霉素局部注射联合复方夏枯草搽剂外用治疗。其中:①注射组包括草莓型236例,混合型130例;②外用组包括草莓型168例,混合型103例;③联合组包括草莓型90例,混合型68例。结果:注射组中草莓型有效率79.7%,混合型有效率69.2%;外用组草莓型有效率80.4%,混合型有效率76.7%;联合组中草莓型有效率88.9%,混合型有效率82.4%。结论:不同的治疗方法对小儿体表血管瘤的疗效不同,其中平阳霉素局部注射联合复方夏枯草搽剂外用治疗效果较好,治愈率最高。     

平阳霉素治疗小儿体表血管瘤1658例临床疗效观察与护理

目的平阳霉素瘤内注射治疗小儿体表血管瘤的临床疗效观察与护理配合。方法回顾分析我科1997年1月。2008年1月以平阳霉素注射治疗小儿体表血管瘤1658例的临床资料,分析其临床疗效及护理方法。结果经过6．12个月（平均10．83个月）随访,总有效率为97．09％,不同类型血管瘤总有效率,差异具有统计学意义,海绵状血管瘤疗效最好,依次为草莓状血管瘤,混合性血管瘤,葡萄酒色斑痣疗效最差。本组发生局部溃破54例,发热有418例,过敏性休克3例。结论平阳霉素治疗小儿体表血管瘤是一种简便、安全有效的方法,易为患者接受。注射前应告知患者相关注意事项,注射后应积极评估应用平阳霉素引起的不良反应并对症治疗,及早防治各项并发症的发生,以提高治疗效果。     

铜针留置结合平阳霉素注射治疗小儿海绵状血管瘤35例

目的 观察铜针留置结合平阳霉素注射治疗小儿海绵状血管瘤的效果,总结治疗经验.方法 对35例小儿体表海绵状血管瘤采用铜针留置结合平阳霉素注射治疗,根据Acharer分级标准评价治疗效果.结果 35例患儿随访3～16个月,优23例,良11例,中1例,优良率为97.14%.结论 铜针留置结合平阳霉素注射治疗小儿海绵状血管瘤疗效确切,方法安全、简单.     

平阳霉素瘤内注射治疗体表血管瘤(附25例报告)

目的:总结平阳霉素瘤内注射治疗25例体表血管瘤的疗效.方法:25例体表血管瘤患者,其中男13例,女12例,年龄3个月至56岁,均为海绵状血管瘤.平阳霉素按8 mg/60 kg剂量(成人一次不超过8 mg) 生理盐水4 ml 2%利多卡因1 ml 11 000肾上腺素0.1 ml向瘤体内注射.结果:治愈率84%(21/25),好转率16%(4/25),总有效率为100%,经3～30个月随访无复发.25例中有21例注射后出现低度发热,经过对症处理恢复正常;无局部组织溃烂、肺炎样症状及肺纤维化现象;出现过敏性休克1例,经抢救后脱险.结论:平阳霉素为治疗体表血管瘤的优选方案.     

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.