白三烯受体拮抗剂治疗咳嗽变异性哮喘临床分析

目的 探讨白三烯受体拮抗剂治疗咳嗽变异性哮喘的临床效果.方法 选择2009年1月～2011年1月期间收治的68例咳嗽变异性哮喘患者为研究对象,随机分为观察组和对照组,对照组给予β2受体激动剂盐酸丙卡特罗口服溶液治疗,观察组在对照组的基础上给予白三烯受体拮抗剂孟鲁司特钠口服,治疗3个月后观察两组患者在显效率、无效率及治疗总有效率方面的差异,评价治疗效果.结果 观察组的显效率及治疗总有效率均显著高于对照组,无效率显著低于对照组,P<0.05,具有统计学差异.结论 孟鲁司特是临床上常用的白三烯受体拮抗剂,用于咳嗽变异性哮喘的治疗,效果较好,并且不良反应少,患者耐受性好,可作为咳嗽变异性哮喘的常规用药.     

孟鲁司特钠联合丙卡特罗对儿童咳嗽变异性哮喘的影响

目的：探讨孟鲁司特钠联合丙卡特罗对儿童咳嗽变异性哮喘（CVA）的影响。方法将70例CVA患儿随机分为2组各35例,观察组予给予孟鲁司特钠联合丙卡特罗,对照组予酮替酚联合丙卡特罗,观察2组治疗情况。结果观察组症状改善时间（4.9±1.4）d,症状消失时间（6.8±1.8）d,明显短于对照组（P<0.01）。观察组总有效率94.3%（33/35）,明显高于对照组（P<0.05）。随访6个月,2组CAV复发率差异有统计学意义（P<0.05）。结论孟鲁司特钠联合丙卡特罗治疗儿童CVA起效快,疗效好,复发率低。     

小儿咳嗽变异性哮喘临床治疗分析

目的:分析白三烯受体拮抗剂孟鲁司特在治疗小儿咳嗽变异性哮喘方面的临床效果。方法:将80例3～10岁咳嗽变异性哮喘患儿随机分为两组。观察组40例给予盐酸丙卡特罗、酮替芬联合孟鲁司特咀嚼片治疗;对照组40例给予盐酸丙卡特罗联合酮替芬治疗。比较两组患儿的临床疗效及6个月内的复发情况。结果:观察组患儿治疗的总有效率显著高于对照组(P<0.05),且其复发率显著低于对照组患儿(P<0.05)。结论:孟鲁司特在治疗小儿咳嗽变异性哮喘方面疗效确切,且复发率低,值得在临床上推广应用。     

孟鲁司特钠在变异性哮喘中的应用

目的探讨白三烯受体拮抗剂孟鲁司特钠在变异性哮喘（CVA）中的应用。方法将112例CVA患者随机分为对照组与治疗组,对照组予口服β2受体激动剂联合吸入糖皮质激素（ICS）,治疗组予口服β2受体激动剂联合白三烯受体桔抗剂孟鲁司特钠,治疗共4周,随访3个月。比较两组治疗前后咳嗽症状评分、疗效及不良反应。结果对照组与治疗组治疗前咳嗽症状评分比较差异无统计学意义（P〉0．05）;两组治疗后咳嗽症状评分、总有效率、不良反应比较差异无统计学意义（P〉0．05）。结论孟鲁司特钠与β2受体激动剂联合应用能有效控制CVA症状,孟鲁司特钠能够达到ICS的临床效果,且不良反应少,可以作为治疗CAV的一线用药。     

盐酸丙卡特罗联合酮替芬治疗儿童咳嗽变异性哮喘的效果

目的：分析盐酸丙卡特罗口服溶液联合酮替芬治疗儿童咳嗽变异性哮喘的临床效果。方法选取108例咳嗽变异性哮喘患儿,按照数字表法随机分为研究组和对照组2组。对照组54例患儿予以单纯酮替芬口服,1片/次,2次/d（早晚各1次）;研究组54例患儿予以盐酸丙卡特罗口服溶液联合酮替芬治疗,酮替芬用法同对照组,盐酸丙卡特罗口服溶液口服,用量根据患儿实际年龄调整,2次/d,2组患儿疗程均为2周。分析2组患儿治疗效果及复发情况。结果对照组患儿咳嗽缓解时间、咳嗽消失时间分别为（8.3±4.9）d、（13.6±4.3）d,长于研究组（5.6±2.2）d、（9.3±2.8）d （P<0.05）;3个月后复发率18.52%明显高于研究组1.85%,差异有统计学意义（P<0.05）。结论儿童咳嗽变异性哮喘应用盐酸丙卡特罗口服溶液与酮替芬联合疗法的临床效果显著,有效降低患儿复发率情况。     

白三烯受体拮抗剂治疗小儿咳嗽变异性哮喘临床观察

目的观察白三烯受体拮抗剂治疗小儿咳嗽变异性哮喘的疗效。方法将130例小儿咳嗽变异性哮喘病例分成对照组和观察组,观察组采用盐酸丙卡特罗治疗,对照组采用孟鲁司特钠与盐酸丙卡特罗联合治疗,观察2组治疗效果。结果观察组患儿的治疗总有效率显著高于对照组,差异有统计学意义（P〈0.05）。结论白三烯受体拮抗剂治疗小儿咳嗽变异性哮喘效果十分理想,值得临床推广应用。     

宣肺止嗽合剂辅助治疗儿童咳嗽变异性哮喘临床观察

咳嗽变异性哮喘(cough variant asthma,CVA)是以干咳为主要症状的支气管哮喘,多表现为反复发作的咳嗽症状,严重影响患儿身心健康,给家庭及社会带来巨大的精神和经济负担.目前临床常用糖皮质激素、β受体激动剂、抗胆碱能药物进行治疗,孟鲁司特钠为白三烯受体拮抗剂,可抑制气道平滑肌中白三烯多肽的活性,从而预防...     

孟鲁司特联合盐酸丙卡特罗治疗咳嗽变异性哮喘疗效观察

目的：观察孟鲁司特联合盐酸丙卡特罗治疗咳嗽变异性哮喘（CVA）的疗效。方法：100例咳嗽变异性哮喘患者随机分为观察组和对照组各50例,观察组采用孟鲁司特联合盐酸丙卡特罗治疗,对照组仅用盐酸丙卡特罗（美普清）治疗,观察两组治疗效果。结果：观察组总有效率明显高于对照组,两组比较,差异有统计学意义（χ2=19.569,P〈0.05）。结论：孟鲁司特联合盐酸丙卡特罗治疗CVA疗效确切,值得临床推广。     

孟鲁司特钠联合盐酸丙卡特罗对咳嗽变异性哮喘患儿血清TGF-β1、IL-8水平的影响观察

目的观察孟鲁司特钠联合盐酸丙卡特罗对咳嗽变异性哮喘(CVA)患儿血清转化生长因子β1(TGF-β1)、白介素-8(IL-8)水平的影响。方法选取CVA患儿108例,随机分为对照组及观察组,各54例。对照组予盐酸丙卡特罗治疗,观察组在对照组基础上联合孟鲁司特钠治疗。比较两组疗效及不良反应发生率,观察患儿TGF-β1、IL-8水平变化。结果观察组临床总有效率高于对照组(P<0.05),两组不良反应发生率无明显差异(P>0.05)。治疗后两组TGF-β1水平较治疗前上升,IL-8水平较治疗前下降(P<0.05),且观察组较对照组改善显著(P<0.05)。结论孟鲁司特钠联合盐酸丙卡特罗治疗CVA效果良好且安全性较高,可有效改善患儿TGF-β1及IL-8水平。     

药物联合治疗对小儿咳嗽变异性哮喘的疗效分析

目的:探讨分析采取孟鲁司特联合盐酸丙卡特罗治疗小儿咳嗽变异性哮喘的临床疗效。方法:选择咳嗽变异性哮喘患儿100例,随机分为观察组与对照组,每组50例,观察组采取孟鲁司特联合盐酸丙卡特罗治疗,对照组采取盐酸丙卡特罗治疗,比较两组患者的临床疗效。结果:观察组总有效率为94%,对照组总有效率为72%,观察组总有效率明显高于对照组,差异有统计学意义(P<0.05)。结论:采取孟鲁司特联合盐酸丙卡特罗治疗小儿咳嗽变异性哮喘的疗效很好,可以有效的治疗小儿咳嗽变异性哮喘,有效的缓解咳嗽症状。     

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.