中西医结合治疗腹泻型肠易激综合征疗效观察

目的观察中西医结合治疗中重度腹泻型肠易激综合征的临床疗效。方法 80例中重度腹泻型肠易激综合征患者随机分为两组,对照组口服匹维溴铵及双歧三联活菌胶囊,治疗组在对照组治疗基础上加服气滞胃痛颗粒,8周后观察评估其症状积分的变化。结果治疗组总有效率优于对照组(P0.05),治疗组除排便满意度项目外,其余症状及症状总分均较对照组显著减轻(P0.05)。结论气滞胃痛颗粒联合得舒特及双歧三联活菌胶囊治疗腹泻型肠易激综合征疗效显著。     

川黄口服液联合乳果糖治疗津亏血少型便秘型肠易激综合征40例临床疗效观察

目的:观察川黄口服液联合乳果糖治疗津亏血少型便秘型肠易激综合征的临床疗效。方法:40例便秘型肠易激综合征的患者随机分两组。对照组乳果糖口服,治疗组在此基础上加用川黄口服液治疗,疗程4周。结果:治疗后治疗组总有效率优于对照组。在起效时间上,治疗组在各周总有效率均优于对照组。结论:川黄口服液联合乳果糖治疗津亏血少证便秘型肠易激综合征效果更好,起效更快,值得在临床推广。     

黛力新联合莫沙必利、乳果糖治疗便秘型肠易激综合症

目的：观察黛力新（氟哌噻吨美利曲辛）联合莫沙必利、乳果糖治疗便秘型肠易激综合征的临床效果。方法将63例便秘型肠易激综合征的患者随机分为两组,治疗组给予莫沙必利、乳果糖联合黛力新治疗,对照组仅给予莫沙必利及乳果糖。于治疗4周时记录临床症状观察结果,对比两组疗效及不良反应。结果治疗组便秘症状明显改善,总有效率93.9%,伴随症状改善率96.7%,均明显高于对照组（P 〈0.05）。不良反应无差异。结论黛力新联合莫沙必利、乳果糖治疗便秘型肠易激综合征安全有效。     

气滞胃痛颗粒联合匹维溴铵治疗腹泻型肠易激综合征临床研究

目的:气滞胃痛颗粒联合匹维溴铵治疗腹泻型肠易激综合征临床效果。方法:选择2016.2-2018.2我院收治的108例腹泻型IBS者为研究对象。依照治疗方式,将其分为2组,每组54例。对照组使用匹维溴铵,观察组使用气滞胃痛颗粒,分析结果。结果:观察组治疗有效率为64.81%,观察组为92.59%。和对照组相比,观察组治疗有效率明显较高,P0.05.治疗前,两组临床症状积分无明显差异,P0.05。治疗后,患者相关症状积分明显改善,就改善程度来讲,相较于对照组,观察组的积分降低更为显著,P0.05。结论:对于腹泻型肠易激综合征者,使用气滞胃痛颗粒联合匹维溴铵治疗,安全性强,能全面降低不良反应发生率,消除患者不良症状,值得进一步推广。     

西比灵联合谷维素治疗肠易激综合征84例

目的　研究观察西比灵联合谷维素治疗肠易激综合征 (IBS)的临床疗效。方法　将 136例肠易激综合征患者分为两组 ,对照组 (5 2例 )采用乳酸菌素、维生素B1 口服 ;治疗组 (84例 ) ,以西比灵联合谷维素进行治疗。结果　治疗组总有效率 85 .71% ,对照组总有率 5 0 % ,治疗组疗效明显高于对照组 (P<0 .0 1) ,且治疗组腹泻型、便秘型、腹泻便秘交替型与对照组同型疗效相比 ,均有显著性差异 (P <0 .0 1) ,但治疗组腹泻型和腹泻便秘交替型的疗效高于便秘型IBS患者 (P <0 .0 1)。结论　西比灵联合谷维素治疗肠易激综合征可在多层面多方面发挥作用 ,尤适用于腹泻型和腹泻便秘交替型患者     

思连康联合思密达治疗腹泻型肠易激综合征的临床疗效观察

目的:观察思连康联合思密达治疗腹泻型肠易激综合征(IBS)的临床疗效。方法:将63例腹泻型IBS患者随机分为两组,治疗组32例,采用口服思连康加思密达治疗4周;对照组31例,采用口服匹维溴胺治疗4周,比较两组治疗效果。结果:治疗组总有效率93.7%,对照组总有效率71%,两组比较差异有统计学意义(P<0.05)。结论:思连康联合思密达口服治疗腹泻型IBS疗效确切,且无任何不良反应,值得临床广泛使用。     

便秘型肠易激综合征60例临床观察

目的探讨马来酸曲美布汀联合乳果糖治疗便秘型肠易激综合征(IBS)的疗效。方法随机将60例便秘型ISB分为治疗组和对照组,治疗组给予马来酸曲美布汀0.2口服每日3次,共4周,乳果糖7.5～15ml,口服每日1次,共4周。对照组给予马来酸曲美布汀0.2口服每日3次,共4周。结果两组间腹痛缓解情况在第1周末和第2周末的比较差异无显著性(P>0.05),而在第四周末两组比较差异有显著性(P<0.05),而粪便性状和排便频率在第1、2、4周末,两组比较差异有显著性(P<0.05)。结论马来酸曲美布汀联合乳果糖治疗便秘型IBS较单用马来酸曲美布汀疗效显著,不失为一种治疗便秘型IBS的良好选择。     

马来酸曲美布汀联合补脾益肠丸治疗腹泻型肠易激综合征疗效观察

目的:探讨马来酸曲美布汀联合补脾益肠丸治疗腹泻型肠易激综合征疗效观察.方法:选择120例腹泻型肠易激综合征患者,随机分成两组,治疗组60例用马来酸曲美布汀胶囊联合补脾益肠丸,对照组60例用马来酸曲美布汀胶囊.采用马来酸曲美布汀和补裨益肠丸合用(A组)对比马来酸曲美布汀(B组)治疗腹泻型IBS,观察两组药物对IBS的治疗疗效及不良反应.结果:总有效率治疗组86.7%,对照组68.3%,两组比较有显著性差异(P<0.05).结论:马来酸曲美布汀联合补脾益肠丸治疗腹泻型肠易激综合征安全有效.     

黛力新联合培菲康治疗不同类型肠易激综合征疗效观察

目的观察黛力新联合培菲康治疗不同类型的肠易激综合征的疗效和安全性评估。方法将近2年来我院消化内科确诊为肠易激综合征患者,分成两组,治疗组为联合用药黛力新联合培菲康口服。对照组给予单药培菲康口服,比较疗效两组差异。同时比较观察肠易激综合征腹泻型和便秘型在黛力新和培菲康联合治疗中疗效差异。结果联合用药组(治疗组)治疗肠易激综合征总有效率85.9%,单用药(对照组)培菲康的总有效率67.9%,联合治疗组总有效率明显优于单用培菲康对照组(P<0.05),两组患者均未发现明显的不良反应。在黛力新联合培菲康治疗肠易激综合征患者中,腹泻型肠易激综合征总有效率优于便秘型的总有效率,两组有显著性差异(P<0.05)。结论黛力新联合培菲康治疗肠易激综合征疗效明显安全,以腹泻型肠易激综合征疗效更为明显。     

复方谷氨酰胺联合培菲康治疗腹泻型肠易激综合征临床观察

目的观察复方谷氨酰胺肠溶胶囊联合口服双歧杆菌、嗜酸乳杆菌、肠球菌三联活菌胶囊(培菲康)治疗腹泻型肠易激综合征的临床疗效。方法选择符合条件的在滁州市第二人民医院消化内科门诊治疗的78例腹泻型肠易激综合征患者,随机分为两组。A组40例:口服复方谷氨酰胺肠溶胶囊3粒,3次/d,培菲康胶囊3粒,2次/d;B组38例:口服培菲康胶囊3粒,2次/d。疗程4周,观察两组临床症状改善情况。结果 A组主要症状改善总有效率为95%、显效率为80%,B组总有效率为69%、显效率为45%。两组临床疗效比较差异有统计学意义(P<0.05)。两组均未发现明显不良反应。结论复方谷氨酰胺肠溶胶囊联合培菲康胶囊治疗腹泻型肠易激综合征安全、有效。     

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.