硫酸镁合盐酸氟桂利嗪防治蛛网膜下腔出血后脑血管痉挛的疗效观察

目的:观察硫酸镁合氟桂利嗪防治蛛网膜下腔出血(SAH)后脑血管痉挛(CVS)的疗效.方法:将SAH患者88例,随机分为观察组和对照组各44例,.对照组采用脱水、止血等常规疗法;治疗组在常规疗法基础上加用25(硫酸镁60ml加生理盐水250ml,静脉滴注,1次/d;14天后停用,盐酸氟桂利嗪40mg,qn,po.采用经颅多普勒(TCD)检测SAH患者脑动脉的收缩峰速度,观察各组CVS发生的情况.结果:治疗组预防蛛网膜下腔出血后脑血管痉挛疗效于对照组显著改善(P<0.01),观察组总有效率高于对照组(P<0.05),且无明显不良反应。结论:硫酸镁合氟桂利嗪防治SAH后CVS疗效好而且安全。     

理疗联合氟桂利嗪治疗中重度颈椎曲度异常青少年头痛40例

目的 :观察理疗联合盐酸氟桂利嗪治疗中、重度颈椎曲度异常青少年头痛的疗效和安全性。方法 :对 80例中、重度颈椎曲度异常青少年头痛患者随机分为两组 ,对照组每晚睡前服氟桂利嗪 5mg ,治疗组在此基础上加理疗 ,每天 1次。结果 :治疗 4周后治疗组总有效率 95 .0 % ,痊愈率 5 7.5 % ;对照组总有效率 72 .5 % ,痊愈率 17.5 % ,两组差异有显著性 (P <0 .0 0 5 )。结论 :理疗联合氟桂利嗪是治疗中、重度颈椎曲度异常青少年头痛安全有效的方法     

氟桂利嗪治疗椎-基底动脉供血不足临床观察

目的 :观察氟桂利嗪对椎 基底动脉供血不足 (VBI)的治疗效果。方法 :对 2 5 0例VBI患者应用氟桂利嗪治疗 ,观察疗效及不良反应 ,并与对照组比较。结果 :氟桂利嗪治疗组显效率为 70 .80 % ,总有效率为 97.2 0 % ;对照组显效率为 15 .0 0 % ,总有效率为 85 .0 0 %。两组比较有非常显著差异 (P <0 .0 1) ,治疗组疗效较对照组更佳。结论 :氟桂利嗪能显著改善VBI患者的脑循环 ,改善临床症状 ,不良反应少 ,是治疗VBI安全有效的药物     

通心络联合氟桂利嗪治疗颈性眩晕60例

目的　观察通心络联合氟桂利嗪对颈性眩晕的疗效。方法　颈性眩晕 6 0例 ,观察组30例口服通心络 4粒每日 3次 ,氟桂利嗪 5mg每日 1次 ;对照组 30例 ,口服氟桂利嗪 5mg每日 2次。 2组疗程均为 10周。结果　随访 3个月 ,治疗组总有效率 (93.3% )明显高于对照组 (76 .7% )(P <0 .0 5 )。结论　通心络加氟桂利嗪治疗颈性眩晕效果优于单用氟桂利嗪。     

都梁软胶囊联合氟桂利嗪预防治疗慢性每日头痛的临床研究

目的 比较都梁软胶囊联合氟桂利嗪与单独使用氟桂利嗪治疗慢性每日头痛的疗效.方法 将64例临床确诊为慢性每日头痛的患者随机分为两组,都梁软胶囊联合氟桂利嗪组(治疗组)32例,单用氟桂利嗪组(对照组)32例.治疗组给予都梁软胶囊每次3粒,每日3次,口服;氟桂利嗪5～10mg,每晚睡前服.对照组给予氟桂利嗪5～10mg,每晚睡前服.两组均连续治疗12周.比较两组患者治疗前后的头痛严重程度、持续时间以及不良反应情况.结果 治疗组总有效率为84.39％,较对照组65.62％,差异有显著性(P<0.05);在头痛程度的缓解上优于对照组(P<0.05).结论 都梁软胶囊联合氟桂利嗪可改善慢性每日头痛患者的头痛发作程度,减少头痛的持续时间.     

胃复安联合氟桂利嗪治疗偏头痛30例

目的　了解胃复安联用氟桂利嗪对偏头痛的临床疗效。方法　将 60例偏头痛患者随机分为 2组 :治疗组 (3 0例 )用胃复安 15mgTid ,氟桂利嗪 5～ 10mg睡前口服 ;对照组 (3 0例 )用氟桂利嗪 5～ 10mg睡前口服 ,均以 14天为 1个疗程。 结果　治疗组痊愈率为 60 .0 % ,总有效率为 90 .0 % ,而对照组痊愈率为 3 0 .0 % ,总有效率为 5 6.7%。治疗组显著高于对照组 (P <0 .0 5或<0 .0 1)。结论　胃复安联用氟桂利嗪是治疗偏头痛安全有效的药物     

氟桂利嗪治疗颈性眩晕的临床观察

目的 观察氟桂利嗪治疗颈性眩晕的疗效。方法 采用随机单盲法对60例颈性眩晕患分为两组：30例口服氟桂利嗪5－10mg,每晚1次,为治疗组;30例口服谷维素30mg,每晚1次,为对照组。分别于24小时、72小时、1周观察临床症状变化。结果 治疗组总有效率达93％,治疗前后眩晕缓解情况与非治疗组对比有显性差异（P＜0．01）。结论 氟桂利嗪治疗颈性眩晕有效,且不良反应轻。     

氟桂利嗪与尼莫地平胶囊预防偏头痛的疗效及对血流动力学的影响

目的 对氟桂利嗪与尼莫地平胶囊(尼康普达)治疗偏头痛的疗效及其对血流动力学的改变进行对比研究.方法 将60例偏头痛患者随机分为氟桂利嗪组(30例):给予氟桂利嗪5 mg,睡前服用;尼康普达组(30例):给予尼康普达30 mg,3次/d,两组均连续服药12周,评价两组患者服药前后头痛情况、脑血流动力学改变及副作用.结果 治疗前两组患者头痛次数、头痛指数及大脑中动脉最大血流速度(MCAVs)间差别均无显著性意义(P＞0.05),治疗后两组患者上述各指标间差别均有显著性意义(P＜0.05).氟桂利嗪组和尼康普达组组内治疗前后头痛次数、头痛指数及MCAVs间差别均有显著性意义(P＜0.05).结论 氟桂利嗪与尼康普达均可预防偏头痛发作,氟桂利嗪能有效改善血管痉挛程度,预防偏头痛的发生.     

氟桂利嗪、顺铂对食管癌放射增敏作用的临床研究

目的　氟桂利嗪、顺铂与放射联合应用治疗食管癌 ,以观察氟桂利嗪、顺铂是否有放射增敏作用。方法　治疗组 :口服氟桂利嗪、静脉点滴顺铂、60 Co照射。对照组 :照射方法和技术同治疗组 ,不加用氟桂利嗪和顺铂。观察两组放射治疗结束时、放射治疗结束后 1个月、6个月的食管X线片变化 ,并观察放疗及氟桂利嗪、顺铂的急性毒副作用。结果　治疗组放疗组放射结束时、放射治疗结束后 1个月、6个月的食管X线片 1、2级分别为 4 8.0 %、5 4 .7%、5 0 .6 % ,而对照组同期食管X线片 1、2级分别为 2 6 .0 %、32 .0 %、2 8.0 % ,治疗组近期疗效显著优于对照组 (P <0 .0 5 )。但治疗组血液系统毒性、胃肠反应发生率与对照组比较有非常显著差异 (P <0 .0 0 1)。结论　氟桂利嗪、顺铂对食管癌的放射治疗有增敏作用 ,但有一定毒性 ,有待进一步完善     

元神安颗粒联合氟桂利嗪治疗偏头痛50例

目的观察元神安颗粒联合氟桂利嗪治疗偏头痛的疗效。方法将96例偏头痛患者随机分为2组,治疗组元神安颗粒加氟桂利嗪,对照组单用氟桂利嗪治疗,10天1疗程,3个疗程后观察疗效。结果治疗组对偏头痛患者的治愈率和总有效率明显高于时照组,两组有显著差异(P＜0．05)。结论元神安颗粒联合氟桂利嗪治疗偏头痛较单用氟桂利嗪疗效增高。     

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.