高压氧对冠心病患者内皮细胞保护作用的临床研究

目的:研究高压氧对冠心病患者内皮细胞的保护作用。方法:选取64例经冠脉造影确诊的冠心病患者,随机分成高压氧组和对照组(各32例),进行对照研究。对照组按冠心病常规药物治疗,高压氧组在常规治疗基础上加用高压氧治疗。比较两组患者治疗前后心绞痛发作次数、持续时间、心电图改善情况;检测内皮素-1(ET-1)、一氧化氮(NO)水平和循环内皮细胞(CEC)数。结果:高压氧组治疗1个疗程后,心绞痛发作和心电图均改善,ET-1水平及CEC数较对照组显著下降(P<0.05),NO水平较对照明显上升(P<0.05)。结论:高压氧能够明显减少心绞痛发作的时间,减少发作次数,改善冠心病患者心电图,对患者的内皮细胞具有明显的保护作用。     

曲美他嗪治疗不稳定型心绞痛临床疗效观察

目的评价曲美他嗪对心绞痛缺血心肌的保护作用。方法选取不稳定型稳定心绞痛患者60例随机分为治疗组和对照组,治疗组在常规治疗的基础上给予曲美他嗪20mg每日3次口服,治疗期间心绞痛发作给予舌下含化硝酸甘油片,记录每天心绞痛发作次数及程度、硝酸甘油的消耗量,两组均以2周为1个疗程。结果曲美他嗪能够减少心绞痛发作次数和硝酸甘油的消耗量。结论曲美他嗪能作为冠心病心绞痛的常规治疗药物。     

曲美他嗪治疗不稳定型心绞痛临床疗效观察

目的观察曲美他嗪对不稳定型心绞痛的治疗效果。方法78例不稳定型心绞痛患者,随机分治疗组与对照组。治疗组在对照组基础上加服曲美他嗪20mg,1d3次,口服,观察3个月。观察用药前后心绞痛发作情况,心电图变化。结果治疗组心绞痛发作次数减少,程度减轻,心电图缺血改善。结论曲美他嗪可作为治疗心绞痛的常规用药。     

曲美他嗪治疗老年人冠心病心绞痛疗效观察

目的评价曲美他嗪在治疗老年人冠心病心绞痛中的临床疗效及安全性.方法采用分组对照的方法,103例冠心病心绞痛患者随机分为治疗组和对照组,对照组常规给予硝酸脂类及抗凝药物,治疗组在常规治疗同时加用曲美他嗪,比较两组心绞痛发作次数、程度、硝酸甘油用量、心电图变化等指标.结果治疗组总有效率90.4%高于对照组(62.7%)(P＜0.05),并无明显不良反应.结论曲美他嗪与硝酸甘油合用,能减轻心绞痛发作次数,减少硝酸甘油用量,改善临床症状,安全有效.     

曲美他嗪治疗冠心病心绞痛合并糖尿病患者疗效观察

目的探讨曲美他嗪对冠心病合并糖尿病患者的临床治疗效果。方法84例冠心病合并糖尿病患者随机分为观察组和对照组,对照组采用常规方法治疗,观察组在常规治疗的基础上加用曲美他嗪,比较两组治疗效果。结果治疗组加用曲美他嗪后心绞痛发作次数、心绞痛持续时间和硝酸甘油用量均明显下降,而且无明显不良反应,血糖稳定。结论曲美他嗪可明显改善心功能,减少心绞痛发作频率、心绞痛持续时间和硝酸甘油用量,安全有效。     

盐酸曲美他嗪治疗冠心病稳定性心绞痛的临床效果评价

目的：分析盐酸曲美他嗪治疗冠心病稳定性心绞痛的临床效果。方法：100例冠心病稳定性心绞痛患者随机分为对照组和治疗组,对照组采用长效硝酸甘油缓释剂和阿司匹林治疗,治疗组在对照组基础上加用盐酸曲美他嗪治疗。结果：治疗后,治疗组患者心绞痛平均每周发作次数、平均每次发作时间、心电检查 ST 段情况改善显著优于对照组（P ＜0.05）。结论：盐酸曲美他嗪治疗冠心病稳定性心绞痛的临床效果显著。     

曲美他嗪在稳定型心绞痛治疗中的临床应用

目的：评价曲美他嗪治疗稳定型心绞痛的疗效。方法将我院65例明确诊断为稳定型心绞痛的患者随机分为对照组33例和治疗组32例,对照组给予硝酸酯类、β受体阻断剂、他汀类、阿司匹林、血管紧张素转换酶抑制剂等基础治疗;治疗组在对照组基础上加用曲美他嗪,疗程均为4个月。治疗前后检查心电图,记录心绞痛发作次数、每次心绞痛发作的时间以及治疗前后血压、心率变化。结果2组患者临床疗效有显著性差异（P〈0.05）,治疗组患者治疗后心绞痛发作次数、持续时间均较对照组显著降低（P〈0.01）。结论曲美他嗪用于稳定型心绞痛的辅助治疗,有助于提高治疗效果,值得临床应用。     

曲美他嗪治疗不稳定型心绞痛的疗效分析

目的观察曲美他嗪与传统药物相结合治疗对冠心病不稳定型心绞痛患者心肌缺血的保护作用。方法将40例冠心病不稳定型心绞痛患者随机分成两组,曲美他嗪治疗组20例,除用硝酸酯类、β-阻滞剂、钙拮抗剂等常规治疗外,加用曲美他嗪20 mg,每日3次口服。对照组20例接受常规传统药物治疗,连续观察4周。观察两组患者心绞痛发作次数、心电图缺血性ST-T的疗效及血压、心率的变化。结果治疗组心绞痛发作次数较对照组明显减少,两组比较P〈0.05,动态心电图缺血性ST-T改善的疗效明显好于对照组,P〈0.05,而两组的心率、血压变化无明显差异。结论曲美他嗪作为一种影响代谢的药物,对改善心肌缺血有良好的效果,且方法简便,疗效显著,安全可靠,易于接受。     

盐酸曲美他嗪联合培朵普利辅助治疗冠心病心绞痛100例临床观察

目的：观察盐酸曲美他嗪联合培朵普利辅助治疗冠心病心绞痛时心绞痛发作的次数。方法：采用随机分组对照比较100例冠心病心绞痛患者在常规治疗基础上口服盐酸曲美他嗪10mg，每日3次，培朵普利4mg，每日1次或普通治疗15d，观察治疗前后心绞痛发作次数的改变。结果：治疗15d后显示治疗组冠心病心绞痛发作次数较治疗前明显减少（P〈0．05）。结论：盐酸曲美他嗪联合培朵普利口服可减少冠心病、心绞痛患者发作次数。     

益心康泰胶囊联合曲美他嗪治疗老年不稳定型心绞痛

目的：研究益心康泰胶囊联合曲美他嗪对老年不稳定型心绞痛患者的临床疗效。方法将66例老年不稳定型心绞痛患者随机分为对照组和益心康泰胶囊与曲美他嗪联合治疗组,每组33例。对照组只给予常规抗心绞痛药物治疗,联合治疗组在给予常规抗心绞痛药物治疗的同时,另给予益心康泰胶囊与曲美他嗪。疗程为1个月。观察治疗前后药物对患者心绞痛症状、心电图 ST-T、血小板聚集率及内皮细胞功能的影响。结果联合治疗组临床疗效总有效率87.9%,高于对照组的69.7%（P ＜0.05）;联合治疗组心电图总有效率优于对照组（P ＜0.05）;血小板聚集率明显降低（P ＜0.05）;ET-1明显降低,NO 及 FMD 明显升高（P ＜0.05）。结论益心康泰胶囊联合曲美他嗪可改善患者心绞痛症状,通过抗血小板聚集、保护内皮功能损伤发挥治疗老年不稳定型心绞痛的作用。     

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.