急性冠状动脉综合征与血清骨保护素的相关性研究进展

急性冠状动脉综合征（ACS）是冠状动脉急性严重狭窄或闭塞引起急性心肌缺血或坏死的一组临床综合征,包括不稳定型心绞痛（UA）、非ST段抬高及ST段抬高型急性心肌梗死（AMI）。     

不稳定型心绞痛患者的护理

不稳定型心绞痛（unstable angina,UA）是指介于稳定性心绞痛与急性心肌梗塞（acute myocardial infarction,AMI）、心脏猝死之间的一种临床状态,包括除稳定性心绞痛以外的其他各型心绞痛^[1]。UA曾被称为中间型冠状动脉综合征、急性冠状动脉机能不全、进行性或强性心绞痛、心肌梗死前心绞痛、冠状动脉衰竭等。UA既可逆转为稳定型心绞痛,     

心绞痛患者冠状动脉造影与血管内超声的对比分析

目的：应用选择性冠状动脉造影和血管内超声（IVUS）对心绞痛患者的冠状动脉病变进行临床对比分析。方法：对125名有典型心绞痛的患者进行选择性冠状动脉造影和血管内超声检测,按心绞痛性质分为稳定型心绞痛组（SA组）和不稳定型心绞痛组（UA组）,比较两组患者冠状动脉狭窄程度、斑块形态和性质的差异。结果：冠状动脉造影显示的病变血管及狭窄程度两组比较差异无统计意义,但是血管内超声显示,UA组病变以脂质斑块多见,SA组病变则以纤维斑块和钙化斑块多见,UA组病变自发性内膜撕裂和血栓形成的比例明显高于SA组。结论：IVUS对于不稳定型心绞痛患者的冠状动脉粥样硬化斑块病变特点的诊断明显优于冠状动脉造影,对冠状动脉介入手术方案的选择至关重要。     

不稳定型心绞痛的诊断与治疗进展

不稳定型心绞痛（UA）是急性冠状动脉（冠脉）综合征的一种，是介于稳定型心绞痛（SA）和急性心肌梗塞（AMI）之间的一种状态。UA的病变复杂，临床表现多种多样，且预后具有多方向性，既可演变为SA，也可恶化为AMI或缺血性摔死。近年来，对UA的发生机制有了进一步的认识，UA的诊断和治疗也取得了较大进展。IUA的发生机制UA临床病情的不稳定性主要取决于其冠脉局部病变本身的不稳定性。一般认为，各种因素引起粥样斑块的纤维帽出现溃疡或破裂，胶原纤维或脂质核暴露，引起血小板及凝血系统激活等一系列瀑布似反应，造成冠脉内血栓…     

冠心病药物治疗的进展

冠心病是由于冠状动脉粥样硬化引起血管狭窄和（或）血管痉挛,导致心肌氧耗与氧供间失衡引起心肌缺血缺氧。临床表现为稳定型心绞痛、不稳定型心绞痛,可发展为急性心肌梗死（ＡＭＩ）甚至猝死。多数病人有典型的心绞痛,但也有相当部分病人无明显胸痛,而仅表现为胸部不...     

单硝酸异山梨酯治疗不稳定型心绞痛的观察与护理

不稳定型心绞痛（unstablangina,UA）是稳定性心绞痛与急性心肌梗死（AMI）和心脏性猝死之间的一种临床状态,包括除稳定性心绞痛以外的其它各型心绞痛,既可逆转为稳定型心绞痛,也可能迅速进展为AMI,甚至心脏猝死。UA曾被称为中问型冠状动脉综合征、急性冠状动脉机能不全,进行或强性心绞痛、心肌梗死前心绞痛、加速型心绞痛、冠状动脉衰竭、濒临心肌梗死前综合征等。     

疏血通注射液治疗不稳定型心绞痛33例疗效观察

不稳定型心绞痛（UA）是介于稳定型心绞痛与急性心肌梗死之间的一组严重的、具有潜在危险的急性冠状动脉综合征，其发生过程千变万化，若不及时处理，部分病例可发展为急性心肌梗死或猝死，必须积极给予干预治疗。我院2005年7月至2007年8月采用疏血通注射液治疗UA患者33例，取得满意效果，现报告如下。     

阿托伐他汀片治疗不稳定型心绞痛42例疗效观察

不稳定型心绞痛（UA）属于急性冠状动脉综合征（ACS）ST段无抬高的一类，是介于稳定型心绞痛与急性心肌梗死之间的一组常见的临床综合征。治疗目标是解除心绞痛症状、预防心肌梗死和防止死亡。我院2007年7月2010年7月采用阿托伐他汀治疗不稳定型心绞痛患者84例，疗效满意，现报告如下。     

低分子肝素钙联合阿托伐他汀治疗不稳定型心绞痛100例疗效观察

不稳定型心绞痛（UA）是介于稳定型心绞痛与急性心肌梗死（AMI）之间的一组综合征，是急性冠状动脉综合征（ACS）的一种。以往单用抗凝药物，但是效果不佳，近年研究发现其发病机制与不稳定斑块导致局部白色血栓形成有关。我们联合应用低分子肝素钙和阿托伐汀治疗不稳定型心绞痛100例，现报告如下。     

“稳定的”不能稳定型心绞痛患者的血管狭窄进展和冠状动脉意外

在临床中，不稳定型心绞痛提示冠状动脉疾病已发生了进展。狭窄进展主要是由于斑块破裂和冠状动脉内血栓形成，这可导致间歇性血管闭塞。近来的研究也显示了在不稳定性心绞痛患者中，复合性血管狭窄预示着后期的不稳定性。然而，在不稳定型心绞痛中，当证实了严重的病变之后，通常快速地施行经皮透照血管成形术（PTCA）或冠状动脉旁道手术（CABG）。所以，大多数不稳定型冠状动脉病变的自然病程进展就无法确定了。在这种情况下，血管造影形态学的应用价值仍是一种预测。特别是，对于复合狭窄的形态是否是常规内科治疗不稳定型心绞痛患者…     

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.