微粒化纯化黄酮制剂治疗下肢静脉性溃疡的临床研究

目的评价微粒化纯化的黄酮制剂(爱脉朗)治疗下肢静脉性溃疡的疗效.方法2003年5月～2003年11月,48例下肢静脉功能不全溃疡患者随机分为治疗组和对照组,观察腿部沉重感、夜间腿部痉挛及疼痛等各项症状,并测定溃疡最大径.结果6周和12周,治疗组腿部沉重感、夜间腿部痉挛及疼痛评分较治疗前明显降低(P＜0.05);对照组症状与入组前无统计学差异(P＞0.05).治疗组6周后溃疡最大径平均缩小(0.53±0.94)cm,12周时缩小(1.02±0.96)cm,较治疗前明显减小(P＜0.05),其中3例观察期内溃疡愈合;对照组则无明显变化(P＞0.05).结论微粒化黄酮制剂是治疗慢性下肢静脉功能不全肢体溃疡的安全、有效的药物.     

地奥司明与消脱止-M治疗下肢静脉功能不全中的临床观察

目的观察地奥司明与消脱止-M在治疗下肢静脉功能不全的临床疗效。方法将115例CVI患者随机分为2组,治疗组采用地奥司明治疗,对照组予消脱止-M治疗,疗程均为30d。结果用药后7d、15d、30d,2组间各时间症状体征评分比较,地奥司明组在沉重感、小腿痉挛、腿部肿胀评分均较治疗前降低,差异有统计学意义(P0.01),2组在缓解小腿疼痛上,差异无统计学意义(P0.05)。用药后2组各时间节点的患肢周径和溃疡面积均明显缩小(P0.05),组间比较差异无统计学意义。结论地奥司明与消脱止-M在治疗下肢静脉功能不全中,地奥司明明显优于消脱止-M,值得临床推广。     

草木犀流浸液片治疗下肢慢性静脉功能不全

目的研究草木犀流浸液片对下肢慢性静脉功能不全的疗效。方法符合入选标准的慢性下肢静脉功能不全患者60例口服草木犀流浸液片，每次3片，每日3次，疗程60d。服药前、服药后20d、服药后30d按评分标准评价沉重感、疼痛、夜间小腿痉挛、腿部肿胀等症的程度。结果服药后20d、30d，患者沉重感、夜间小腿痉挛、腿部肿胀等明显缓解。结论应用草木犀流浸液片可以明显缓解下肢慢性静脉功能不全患者的临床症状和体征。     

逆行置管溶栓治疗急性髂股静脉血栓形成的对照研究

目的探讨经健侧股静脉穿刺逆行置溶栓导管治疗急性髂股静脉血栓形成的效果。方法对27例B型超声明确诊断为急性髂股静脉血栓患者,分为经对侧股静脉穿刺逆行置管溶栓组(A组)12例和全身静脉溶栓组(B组)15例。对2组患者患肢周径缩小值、远期瓣膜功能进行观察比较。结果治疗14d下肢周径缩小值,A组为(3.4±0.8)cm,B组为(2.8±0.8)cm,差异无统计学意义(P>0.05);治疗6个月后,经光电容积描记法(PPG)评价深静脉瓣膜功能,A组静脉充盈时间(VRT)为(22.2±3.5)s,B组为(16.6±4.1)s,差异有统计学意义(P<0.05)。结论经健侧股静脉穿刺置溶栓导管治疗急性髂股静脉血栓形成可有效改善深静脉瓣膜功能,降低静脉血栓后遗症发生率。     

中成药脉管复康片治疗下肢静脉性溃疡疗效观察

目的:观察纯中药制剂脉管复康片治疗慢性下肢静脉性溃疡(chronic venous leg ulcer,CVLU)的疗效。方法:选取58例于2012年4月至2014年5月在我院治疗的单纯下肢慢性静脉功能不全合并下肢静脉性溃疡的患者,将其随机分为治疗组及对照组进行药物和弹力袜的疗效对比观察。结果:经过脉管复康片治疗后患者肢体肿胀及行走沉重感改善明显,治疗组患者各期肢体溃疡的愈合时间与对照组比较,明显缩短(P<0.05),溃疡平均愈合率明显大于对照组。结论:脉管复康片能有效促进静脉性溃疡的愈合。     

系统性康复训练联合迈之灵片治疗宫颈癌患者同步放化疗后下肢淋巴水肿

目的 探讨系统性康复训练联合迈之灵片治疗宫颈癌同步放化疗后下肢淋巴水肿的临床疗效.方法 61例接受同步放化疗治疗后发生下肢淋巴水肿的宫颈癌患者按接受治疗方式的不同分为治疗组和对照组,治疗组接受髋关节全范围运动训练和手法淋巴引流按摩为主的系统性康复训练并联合迈之灵片治疗,对照组接受肿瘤科常规护理和迈之灵片治疗,观察两组患者在治疗前和治疗3个月后下肢沉重感、疼痛、麻木和功能障碍等主观不适情况,下肢周径变化和淋巴水肿分级上的疗效差异.结果 两组患者接受治疗3个月后,治疗组和对照组的下肢深重感、疼痛、功能障碍评分分别为1.96 ±0.66和2.47±0.57、1.59 ±0.49和2.00±0.61、0.90±0.46和1.51±0.73,上述三个主观指标治疗组均优于对照组(P＜0.05),治疗组小腿周径(32.38±4.40)cm较对照组(34.78±5.19)em明显缩小(P＜0.05),但两组在麻木感、大腿周径和总体淋巴水肿分级上无明显差异.结论 系统性康复训练联合迈之灵片可以有效地治疗宫颈癌患者同步放化疗后的下肢淋巴水肿.     

尿激酶治疗下肢深静脉血栓形成42例

对42例下肢深静脉血栓形成患者(左侧33例,右侧9例),从患肢静脉推注尿激酶50～100万U,再滴注尿激酶50万U,疗程7～14d,进行溶栓治疗。治疗后,患肢大小腿平均周径较治疗前明显缩小,大小腿患、健肢周径差治疗后较治疗前分别缩小2.0±0.8cm,4.2±2.0cm(P<0.01)。治疗过程中,1例出现皮肤瘀紫和肉眼血尿,其余均未出现严重并发症。     

Angiojet机械血栓清除术在急性下肢深静脉血栓中的应用

目的：分析Angiojet机械血栓清除术在急性下肢深静脉血栓(DVT)中的应用效果。方法：选择我院于2020年1月—2021年1月收治的急性下肢深静脉血栓患者87例，以随机数字法将其分为研究组(n=44)、对照组(n=43),研究组给予Angiojet机械血栓清除术，对照组给予置管溶栓治疗，对比组间症状缓解情况、患肢周径差异、血清指标以及复查效果。结果：研究组溶栓时间、住院时间短于对照组，尿激酶总量低于对照组，差异显著(P<0.05)。组间治疗前DD、FIB水平无差异(P>0.05);治疗后研究组DD、FIB水平均低于对照组(P<0.05)。组间治疗前大腿周径差、小腿周径差对比差异不显著(P>0.05);治疗后，研究组大腿周径差、小腿周径差均小于对照组，差异显著(P<0.05)。研究组术后血栓清除率高于对照组，但组间对比差异不显著(P>0.05)。研究组1年通畅率高于对照组，1年内血栓复发率低于对照组，差异有统计学意义(P<0.05)。组间治疗前Villalta评分对比差异不显著(P>0.05);治疗后，研究组Villalta评分低于对照...     

顺行溶栓治疗下肢深静脉血栓35例临床分析

目的:探讨顺行静脉溶栓治疗深静脉血栓形成的临床疗效。方法:对35例(43条肢体)深静脉血栓形成患者,按照下肢深静脉顺行造影的原理,选择患者的足背浅静脉将50万IU尿激酶(UK)加压快速静脉推注,随后按50万IU/12h静脉滴入,持续3d,改为25万IU静注,静脉滴入不变,7d为1疗程;治疗期间皮下注射低分子肝素,1次/12h。结果:所有患者临床症状及体征均有改善,肢体周径膝上15cm处缩小6.0±1.73cm,膝下l0cm处缩小4.5±1.30cm,治疗后较治疗前有极显着性差异(P<0.01),经患肢静脉顺行造影,近期再通率达79.1%。结论:顺行静脉溶栓治疗下肢深静脉血栓形成方法简便、安全有效。     

早期康复干预对下肢骨折术后肢体肿胀恢复的影响

目的:探讨早期康复干预对下肢骨折术后肢体肿胀治疗的效果。方法:将84例下肢骨折术后肢体肿胀患者随机分为两组(观察组42例,对照组42例)。观察组依据病因分为:创伤性软组织肿胀、静脉源性、淋巴回流障碍性和骨筋膜室综合征组,采取个性化处理方式,同时进行早期康复干预;对照组采用个性化处理和常规的功能锻炼。在治疗前、治疗后第7、14天和3个月时进行疗效比较。结果:观察组经个性化治疗加早期康复干预后,在治疗后第7、14天的有效率比对照组高(P<0.05);患肢周径缩小较对照组明显(P<0.05);治疗3个月后两组无显著性差异(P>0.05)。结论:早期康复干预加个性化治疗缩短了下肢骨折术后肢体肿胀的恢复时间,短期疗效较为显著。     

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.