益肾化瘀通络法治疗Ⅳ期糖尿病肾病临床观察

目的:观察益肾化瘀通络法治疗Ⅳ期糖尿病肾病(diabetic nephropathy,DN)的临床疗效。方法:将68例气阴两虚、瘀血阻络证DN患者随机分为治疗组(44例)和对照组(24例),对照组在控制饮食、运动治疗基础上给予常规西药降压、降糖治疗,治疗组患者在对照组疗法基础上口服益肾化瘀通络方。治疗后观察两组临床疗效,治疗前后分别检测两组24 h尿蛋白、尿白蛋白排泄率、空腹血糖、糖化血红蛋白A1c、血清胱抑素C及血脂水平。结果:两组临床疗效比较,差异无统计学意义(P0.05),治疗组在降低24 h尿蛋白、尿白蛋白排泄率、血清胱抑素C、甘油三脂、低密度脂蛋白胆固醇水平,升高高密度脂蛋白胆固醇水平方面显著优于对照组。结论:益肾化瘀通络法可降低Ⅳ期DN患者尿蛋白,促进肾小球滤过,调节血脂水平,从而延缓肾功能减退。     

百令胶囊治疗糖尿病肾病临床观察

目的 观察百令胶囊治疗糖尿病肾病的疗效。方法 选择我院门诊的糖尿病肾病患者86例，治疗组43例，为常规治疗的同时加百令胶囊6粒，2次/d，口服；对照组43例，仍常规治疗；两组均按常规糖尿病饮食，治疗4个月为一疗程。用药前后测定患者的24小时尿蛋白定量、血甘油三酯、空腹血糖、血尿素氮、血肌酐。结果 治疗前与治疗后24小时尿蛋白定量及血甘油三酯、血肌酐、尿素氮的变化有显著性差异（P〈0.05）。结论 百令胶囊可使糖尿病肾病患者尿白蛋白排泄下降（P〈0.01），并改善异常血脂代谢，对肾功能有保护作用，且无毒副作用，是协助治疗糖尿病肾病的有效药物。     

通心络联合缬沙坦治疗早期糖尿病肾病疗效观察

目的：观察通心络联合缬沙坦治疗早期糖尿病肾病的临床疗效。方法：48例早期糖尿病肾病患者随机分为治疗组24例,口服通心络3粒/次,每日3次,同时缬沙坦80mg/次,每晨1次口服;对照组24例,只口服缬沙坦80mg/（次·d）,疗程均为12周。测定两组患者治疗后24h尿白蛋白排泄率。结果：治疗组24h尿白蛋白排泄率明显低于对照组。结论：通心络联合缬沙坦治疗早期糖尿病肾病可有效降低尿蛋白。     

参芪降糖颗粒治疗糖尿病肾病80例临床观察

目的:观察中药参芪降糖颗粒治疗早期糖尿病肾病(DN)的临床疗效.方法:将糖尿病肾病患者80例双盲随机分为治疗组、对照组,两组患者均给予福辛普利10mg,1次/日,阿托伐他汀10mg,每晚1次,前列地尔注射液10μg+生理盐水250ml,1次/日静滴;治疗组予以参芪降糖颗粒口服,3个月后,比较两组患者尿白蛋白、空腹血糖、糖化血红蛋白、血肌酐、尿素氮和血脂的变化.结果:参芪降糖颗粒联合西药治疗糖尿病肾病,能有效降低尿蛋白、血脂、血糖、糖化血红蛋白,与对照组单用西药治疗后比较,有显著差异.结论:参芪降糖颗粒联合西药治疗糖尿病肾病疗效理想,值得在临床上推广应用.     

厄贝沙坦联合丹参酮ⅡA治疗糖尿病肾病临床疗效观察

目的:观察厄贝沙坦联合丹参酮ⅡA治疗糖尿病肾病的临床疗效。方法:将70例糖尿病肾病患者分为对照组和治疗组,两组均使用胰岛素和口服降糖药,严格控制血糖和血压在正常范围,对照组单纯使用厄贝沙坦,治疗组在此基础上给予丹参酮ⅡA,观察期间检测患者尿蛋白排泄率(UAER)、空腹血糖、肾功能及血脂,比较两组尿微量白蛋白排泄率和血液高凝状态。结果:治疗组疗效明显优于对照组(P0.05)。结论:厄贝沙坦联合丹参酮ⅡA对糖尿病肾病效果明显,值得临床推广应用。     

还原型谷胱甘肽对2型糖尿病早期肾病患者尿清蛋白排泄率的影响

目的探讨还原型谷胱甘肽对2型糖尿病早期肾病患者尿清蛋白排泄率的影响。方法76例2型糖尿病早期肾病患者随机分为两组:治疗组38例患者口服还原型谷胱甘肽片(0.4g,3次/d);对照组38例患者口服安慰剂维生素B1(10mg,3次/d),两组患者均治疗3个月。比较两组患者治疗前后尿清蛋白排泄率(UAER)。结果治疗后两组患者UAER间差别有显著性意义(P<0.01),治疗后两组患者血压、肝肾功能、血糖、糖化血红蛋白及血脂间差别无显著性意义(P>0.05)。结论还原型谷胱甘肽能显著减少2型糖尿病早期肾病患者尿清蛋白的排泄,对2型糖尿病早期肾病具有治疗作用,且安全性好。     

乾坤丹Ⅵ号治疗糖尿病肾病62例疗效观察

目的观察乾坤丹Ⅵ号治疗早、中期糖尿病肾病的临床效果。方法将62例糖尿病肾病患者随机分为对照组和治疗组,所有患者均经基础治疗1周,然后对照组患者在基础治疗的基础上口服苯那普利10mg,1次/d,治疗组患者在基础治疗的基础上口服乾坤丹Ⅵ号,12g/次,3次/d,2个月为1疗程。观察两组患者治疗前及治疗2个疗程后空腹血糖、餐后2h血糖、糖化血红蛋白、血脂、血浆白蛋白水平和24h尿白蛋白、24h尿总蛋白含量。结果治疗后两组患者的空腹血糖、餐后2h血糖、糖化血红蛋白、胆固醇、三酰甘油、血浆总蛋白的水平间差别均无显著性意义(P>0.05);而24h尿白蛋白、24h尿总蛋白含量间差别有显著性意义(P<0.01)。结论乾坤丹Ⅵ号对延缓、阻止早、中期糖尿病肾病发展有一定疗效。     

祛痰通络汤治疗痰瘀阻络型糖尿病肾病临床观察

目的观察祛痰通络汤治疗痰瘀阻络型糖尿病肾病(DN)Ⅲ~Ⅳ期的临床疗效。方法将64例患者随机分为对照组和治疗组各32例。对照组给予低盐、低脂、优质低蛋白糖尿病饮食,单纯口服降糖药或合用胰岛素控制血糖,配合降压、降脂治疗。治疗组在此基础上口服祛痰通络汤,每日1剂,分早晚2次服用。两组均连续治疗2个月。结果两组患者治疗后24 h尿蛋白定量、肾功能、糖化血红蛋白、血脂较治疗前均有改善(P<0.05);其中治疗组中医症状积分、24 h尿蛋白定量、血脂较对照组改善更为明显(P<0.05);临床疗效比较,治疗组显效率优于对照组(P<0.05)。结论祛痰通络汤能降低痰瘀阻络型糖尿病肾病Ⅲ~Ⅳ患者尿蛋白,对其肾功能、血脂及临床症状均有改善作用。     

前列地尔联合洛汀新治疗糖尿病肾病的疗效观察

目的：探讨前列地尔联合洛汀新治疗早期糖尿病肾病的临床疗效。方法将该院收治的90例糖尿病早期肾病患者,随机分为观察组和对照组,每组各45例。两组均给予洛汀新10 mg,口服,1次/d;观察组再给予前列地尔注射液10μl加入0.9%氯化钠100 mL,静脉点滴。两组在控制血压、血糖、血脂等治疗方面相同,治疗14 d后,比较两组的血肌酐、空腹血糖、24 h尿蛋白、8 h尿白蛋白排泄率。结果治疗2周后,2组患者的尿蛋白、白蛋白、血肌酐均明显好转;其中,观察组血肌酐（113.97±14.53）μmol/L,尿蛋白（0.23±0.02）g/24 h,尿蛋白排泄率（72±31）μg/min;对照组治疗后的各数据为（127.2±10.11）μmol/L,（0.32±0.07）g/24 h,（136±36）μg/min;观察组和对照组相比,观察组的尿蛋白及白蛋白排泄率改善明显(P<0.05)。结论短期使用前列前列地尔联合洛汀新治疗老年糖尿病早期肾病疗效显著,可延缓糖尿病肾病的发生发展。     

厄贝沙坦联合疏血通治疗早期糖尿病肾病临床疗效观察

目的:观察厄贝沙坦联合疏血通治疗早期糖尿病肾病的临床疗效。方法:60例早期糖尿病肾病患者随机分为治疗组(30例)和对照组(30例),治疗组用厄贝沙坦75 mg口服,1次/d早晨空腹服用,疏血通8 ml加入生理盐水250 ml静脉滴注,每日一次;对照组只用厄贝沙坦75mg口服,1次/d早晨空腹服用;应用2周后观察尿微量白蛋白、肾功能、三酰甘油的变化。结果:2周后两组患者的尿微量白蛋白及三酰甘油均有所下降,但治疗组的指标下降更为明显(P<0.05),结论:厄贝沙坦联合疏血通治疗早期糖尿病肾病在减少尿微量白蛋白及血脂方面优势明显,故能延缓糖尿病肾病的发展。     

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.