培哚普利与卡托普利对原发性高血压患者24小时血压的影响

目的：比较培哚普利与卡托普利对６４ 例原发性高血压患者降压效应及２４ 小时血压的影响。方法：６４ 例原发性高血压患者随机分组接受培哚普利（４ － ８ｍｇ／ｄ） 和卡托普利（３７ ．５ － ７５ ．０ｍｇ／ｄ）（ 各３２ 例） 治疗４ 周,运用２４ 小时动态血压监测血压变化情况。结果：培哚普利和卡托普利均能显著降低血压,彼此之间降低偶测血压的幅度无显著差异。培哚普利能显著降低夜间舒张压和清晨醒后的高峰期血压。结论：培哚普利可每日服１ 次,控制２４ 小时血压及清晨醒后的高峰期血压优于卡托普利。     

氯沙坦与培哚普利治疗老年轻、中度高血压病的疗效研究

目的：比较氯沙坦和培哚普利治疗老年轻、中度高血压的临床疗效与不良反应。方法：88例老年轻、中度高血压患，随机分为氯沙坦组（A组n=42)口服氯沙坦50－100mg，每日一次，培朵普利组（B组n=46)；口服培哚普利4－8mg，每日一次，持续12周，分别观察两组治疗前后偶测血压、24小时动态血压、血脂、血尿酸变化，记录不良反应。结果：①两组治疗前后的降压有效率和降压幅度比较无显性差异（有效率P＞0．05，收缩压下降幅度P＞0．05，舒张压下降幅度P＞0．05）；②氯沙坦和培哚普利能同样降低老年高血压病人各时点及24小时、日间、夜间的平均SBP、DBP、和血压负荷。③两降低的谷／峰比满意，氯沙坦降压的SBP和DBP T／P比分别为68．3％和79．7％，培哚普利分别为68．4％和79．8％；④氯沙坦组治疗后血尿酸明显下降（P＜0．01），而培哚普利组治疗前后血脂与血尿酸值比较无显性差异（P＞0．05）；⑤培哚普利组咳嗽发生率为6．5％，氯沙坦组无一例出现咳嗽反应。结论：氯沙坦和培哚普利治疗老年轻、中度高血压具有同样的降压效果，氯沙坦的主要优点是咳嗽发生率低，能明显降低血尿酸。     

氯沙坦与培哚普利治疗急性心肌梗死泵功能不全近期疗效观察

目的：评价氯沙坦对急性心肌梗死泵功能不全患者的治疗作用。方法：７９例急性心肌梗死并泵功能不全患者随机分为氯沙坦组（Ａ组）和培哚普利组（Ｂ组）,在按急性心肌梗死基本治疗方案的基础上,Ａ组加用氯沙坦５０ｍｇ,每日１次,Ｂ组加用培哚普利２～４ｍｇ,每日１次。观察４周。结果：氯沙坦治疗急性心肌梗死患者泵功能不全与培哚普利相似,减少心律失常发生率的作用及不良反应优于培哚普利组。结论：氯沙坦是治疗急性心肌梗死     

氯沙坦与苯那普利治疗轻,中同血压病的疗效比较

目的：比较氯沙坦与苯那普利治疗轻、中度高血压病的疗效及安全性。方法：随机将７７例轻、中度高血压病患者分为２组。每日服氯沙坦５０ｍｇ（３１例）或苯那普利１０ｍｇ（４６例）治疗４周。１周后舒张压≥９０ｍｍＨｇ者每日加服吲哒帕胺２．５ｍｇ。结果：两组各有１例因头昏、眩晕,苯那普利组有５例因咳嗽治疗未满１周而停止观察。第１、２周末氯沙坦疗效不及苯那普利（Ｐ〈０．０５）。４周后两种药物均能有效降低血压（Ｐ〉     

氯沙坦和福辛普利降压、降尿酸作用的临床观察

目的比较氯沙坦和福辛普利的降压疗效及两者对高血压伴高尿酸血症的影响。方法将88例原发性高血压伴高尿酸血症患者随机分成2组,分别给予氯沙坦50mg／d和福辛普利10mg／d治疗,疗程6周,观察2组治疗前后血压和血尿酸的变化。结果2组治疗后收缩压、舒张压均较治疗前下降（P〈0．05）,氯沙坦组治疗后较治疗前血尿酸水平明显降低（P〈0．05）,福辛普利组治疗后较治疗前血尿酸水平差异无统计学意义（P〉0．05）。结论氟沙坦和福辛普利降压疗效相似,氯沙坦除降压外。还可降低血尿酸水平,对高血压伴高尿酸血症患者应首选氯沙坦。     

培哚普利与卡托普利治疗高血压病的疗效比较

目的 观察新型血管紧张素转换酶抑制剂培哚普利对高血压的疗效。方法 １２０例高血压病病人随机分成两组,分别用培哚普利２￣４ｍｇ／ｄ和卡托普利１２．５￣２５ｍｇ／ｄ进行治疗,运用偶测血压（ＣＢＰ）及２４ｈ动态血压监测（ＡＢＰＭ）来评价疗效。结果 ＣＢＰ监测培哚普利组显效率５３．３％,总有效率９０．０％,卡托普利组的显效率５１．７％,总有效率８１．７％,两组疗效相近。但ＡＢＰＭ培呆普利组显效率３１．３％     

福辛普利治疗原发性高血压效果观察

为比较福辛普利与卡托普利的降压效果与安全性,将６０例原发性高血压患者随机分为福辛普利组和卡托普利组治疗３个月。结果：福辛普利和卡托普利降压的总有效率分别为９０％和８６７％（Ｐ＞００５）,动态血压监测福辛普利有效率为９３３％,卡托普利为７０％（Ｐ＜００５）。福辛普利谷峰比：收缩压６９％,舒张压６２％。认为福辛普利治疗原发性高血压安全有效,具有２４ｈ稳定降压的效果     

培哚普利治疗老年Ⅰ～Ⅱ级高血压病的临床疗效和安全性

目的：对老年Ⅰ～Ⅱ级高血压病（45例）和非老年Ⅰ～Ⅱ级高血压病（43例）应用培哚普利治疗并进行比较。方法：88例高血压病患者均服用培哚普利,老年组：2～4mg;非老年组4～8mg：每日1次,疗程4周。主要观察两组降压疗效。结果：两组在治疗后均有显著的降压效果（P〈0．01）,但是两组之间的降压总有效率和降压幅度均无显著性差异（P〉0．05）。治疗过程中未发现任何严重不良反应事件。结论：培哚普利治疗老年Ⅰ～Ⅱ级高血压病的疗效较好而且安全。     

苯那普利与卡托普利治疗肾性高血压的疗效对比

目的：比较苯那普利与卡托普利治疗肾性高血压的降压效应与安全性。方法：８４例肾性高血压患者随机接受苯那普利（１０～２０ｍｇ／ｄ）与卡托普利（３７．５～７５．０ｍｇ／ｄ）治疗４周。结果：苯那普利与卡托普利的降压总有效率在偶测血压监测时分别为９２．５％和９０．５％，两组降压疗效比较无显著性差异（Ｐ〉０．０５），两组治疗前后血压比较均有显著性差异（Ｐ〈０．００１），但两组之间降压幅度比较无显著性差异（Ｐ〉     

培哚普利与硝苯吡啶治疗高血压病的对比研究

以随机，单盲，组间，平行对照的方式，用培哚普利对高血压病患者进行了为期２周的治疗观察，并与钙拮抗硝苯吡啶进行了对比。培哚普利剂量４－８，ｇ／ｄ，每日一次服用，硝苯吡啶为３０－７０ｍｇ／ｄ，每日三次服用。通过７０例的观察显示；两药的降压有效率无明显差异，两药皆能减轻左心室的肥厚，但培哚普利优于硝苯吡啶。     

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.