超声心动图对扩张性心肌病患者左室舒张功能的评价

目的：为评价超声心动图对扩张心肌病患者左室舒张功能的诊断价值。方法：用超声心动图和放射性核素显像对２０例ＤＣＭ和患者和２０例同龄正常人的左室舒张功能进行对照分析。结果;ＤＣＭ组左室舒张功能ＲＮＶ指标峰充盈率明显降低,同对照组比较差异有显著性;超声指标二尖瓣血流频谱早期充盈峰速度,晚期充盈峰速度,ｖＡ／Ｖｅ等参数对照组比较无明显差异,表现为“正常”。     

52例轻中度高血压病24小时动态血压参数与左室舒张功能的相关分析

目的：探讨动态血压监测在临床应用中的价值。方法：对５２ 例轻、中度高血压病（ Ｅ Ｈ）患者和３０ 例正常人进行 ２４ ｈ 动态血压监测（ Ａ Ｂ Ｐ Ｍ）,同时应用多普勒超声心动图测定其左室舒张功能（ Ｌ Ｖ Ｄ Ｆ）,并对两者参数进行相关性分析。结果： Ｅ Ｈ 组舒张晚期最大血流速度（ Ｐ Ｖ Ａ）、舒张晚期血流速度时间积分（ Ａｉ）及 Ｐ Ｖ Ａ／ Ｐ Ｖ Ｅ比值增大,舒张早期血流速度时间（ Ｅｔｉｍ ｅ） 延长、 Ｅ峰充盈分数（ Ｅ Ｆ Ｆ）变小, Ａ 峰充盈分数（ Ａ Ｆ Ｆ）增大, Ｉ Ｖ Ｓ Ｔ、 Ｐ Ｗ Ｔ、 Ｌ Ｖ Ｍ、 Ｌ Ｖ Ｍ Ｉ增加, Ｌ Ａ Ｄ 扩大,均与对照组相差显著（ Ｐ＜ ０．０５～０．０１）。其中日间、夜间 Ｓ Ｂ Ｐ及其负荷值均与 Ｉ Ｖ Ｓ Ｔ、 Ｐ Ｗ Ｔ、 Ｌ Ｖ Ｍ Ｉ、 Ｐ Ｖ Ａ　 Ｐ Ｖ Ｅ 具有较好的相关性（ｒ＝ ０．３１～０．６３）。结论： Ｅ Ｈ 患者早期出现 Ｌ Ｖ Ｄ Ｆ 异常; Ａ Ｂ Ｐ Ｍ 在评价 Ｅ Ｈ 心脏靶器官损害方面有更好的预测价值。     

高血压病患者的收缩压和舒张压与左心功能相关关系的研究

为了解收缩压（ＳＢＰ）、舒张压（ＤＢＰ）分别与左室收缩及舒张功能的相关关系，应用诊所血压及超声心动图方法观察３７４例高血压病患者。发现其收缩压与舒张早期充盈峰值流速（ＥＰＦＶ）呈明显负相关（Ｐ＜０．０５），与心房收缩期充盈峰值流速（ＡＰＦＶ）及Ａ／Ｅ比值呈明显正相关（Ｐ＜０．０５及０．０１）；舒张压与心输出量（ＣＯ）呈明显负相关（Ｐ＜０．０１），与舒张功能指标无相关关系。单纯性收缩期高血压组血清总胆固醇水平明显高于舒张期高血压组（Ｐ＜０．００１）。多元逐步回归分析显示在排除众多因素以后，收缩压与Ａ／Ｅ比值呈明显正相关（Ｐ＜０．０５），舒张压与年龄、ＣＯ呈明显负相关（Ｐ均＜０．０１）。结果提示：高血压病患者收缩压主要影响左室舒张功能，舒张压主要影响左室收缩功能     

甲状腺功能亢进性心脏病患者^131I治疗后左室心功能的二维多普勒超 …

目的：观测＾１３１碘治疗后甲状腺功能亢进性心脏病（甲亢心）患者二维多普勒超声心动图的变化。方法：运用多普勒超声心动图测定１１９例女性亢心患者＾１３１碘治疗前后的左室心功能参数。结果：与治疗前相比,＾１３１碘治疗后左室ＬＶＥＤＤ、ＬＶＥＳＤ、ＬＶＥＤＶ及ＨＲ降低（Ｐ〈０．０５）,ＳＶ及ＥＦ升高（Ｐ〈０．０１）;同时,ＰＶＥ、ＰＶＥ／ＰＶＡ及ＭＥＦ增加（Ｐ〈０．０１）,ＰＶＡ及ＣＥ／ＣＡ降低（Ｐ〈０．     

多普勒超声心动图评价肺动脉高压病人左心室舒张功能

目的：探讨肺动脉高压（ＰＨ）对左心室舒张功能（ＬＶＤＦ）的影响及其发生机理。方法：用彩色多普勒超声心动图结合右心导管检测观察２８例继发有ＰＨ先心病（ＣＨＤ）病人的ＬＶＤＦ，并与２０例无ＰＨ的ＣＨＤ病人对比分析。结果：继发有ＰＨ的病人二尖瓣口血流频谱Ａ峰流速（ＡＶ）、速度时间积分（ＡＶＩ）较对照组明显增高（Ｐ＜０．０５～０．０１），Ｅ峰流速（ＥＶ）、速度时间积分（ＥＶＩ）无明显改变（Ｐ＞０．０５），ＡＶ／ＥＶ、ＡＶＩ／ＥＶＩ增大（Ｐ＜０．０１），左室等容舒张期（ＬＩＶＲＴ）延长（Ｐ＜０．０５），且肺动脉压与ＡＶ／ＥＶ比值成中等相关（ｒ＝０．４１８９～０．４２４６，Ｐ＜０．０１）。结论：ＰＨ可致ＬＶＤＦ减退，并推测其机理可能与ＰＨ所引起的室间隔运动异常、肥厚、两室间充盈的相互影响及左室三维几何形态的改变等因素有关。     

应用PDE观察足月新生儿窒息后对右心功能的影响

本文应用脉冲多普勒超声心动图（ＰＤＥ）对测量２０例足月新生儿窒息后，肺动脉瓣和三尖瓣血流参数。结果表明ＭＶ、ＤＴ、ＤＣ、ＭＰＧＤ、ＴＲ和ＰｅａｋＥ与２０例正常足月新生儿对照组间差异非常显著（Ｐ＜０．０１）；ＰＶ、ＡＴ、ＡＣ、ＰＰＧＤ、ＲＰＥＰ／ＡＴ与对照组差异显著（Ｐ＜０．０５）。捉示窒息婴儿右心收缩和舒张功能受损。     

二维和多普勒超声评价原发性高血压患者左心房功能的变化

应用多普勒超声（ＰＤＥ）结合二维超声（２－ＤＥ）方法对８６例原发性高血压患者和３５例正常对照者左室舒张期充盈各部分血流特征进行分析。发现高血压患者左房最大容积（ＰＶＡ）、房缩前容积（Ａｉ）、左房射血（ＡＥＶ）大于对照组（Ｐ＜０．０１），而房缩前左室充盈显著下降（Ｐ＜０．０５）。其中快速充盈期充盈容量与正常对照组无明显差异；仅在管道容积部分减少，这些变化在重度心肌增重组更明显（Ｐ＜０．０５），Ａｉ和ＡＥＶ与ＬＶＭＩ呈正相关（Ｐ＜０．０５）。提示高血压心脏房缩前左室充盈受损，表现为ＣＶ的降低；而左房收缩排血量的增加补充左室充盈的不足，维持心排血量的相对稳定。     

彩色多普勒超声心动图评价左室舒张功能的指标及其分析

目的：本文分析用彩色多普勒超声心动图诊断的左室舒张功能异常９８例，以了解其诊断价值。方法：以舒张早期快速充盈血流速度（ＶＥ）、舒张晚期心房收缩血流速度（ＶＡ）、二者比值（Ｅ／Ａ）、舒张早期快速充盈减速度（ＥＤＣ）及二尖瓣前叶ＥＦ斜率（ＥＦＶ）为测量参数。结果：Ｅ／Ａ、ＥＤＣ及ＥＦＶ的异常率分别为７５．５％、６３．３％有７２．４％。结论：这些参数是评价左室舒张功能有用的指标，彩色多普勒超声心动图对评     

超声心动图自动边缘检测技术评价扩张型心肌病患者左心功能

目的：探讨超声心动图自动边缘检测（ＡＱ）技术评价扩张心肌病（ＤＣＭ）患者左心功能的临床应用价值。方法用ＨＰＶｓｏｎｏｓ２５００型彩色多普勒超声诊断仪，启动ＡＱ系统自动检测心内膜边缘，测量左室舒张末期容积（ＥＤＶ）、收缩末期容答（ＥＳＶ）、射血分数（ＥＦ）、峰值充盈率（ＰＦＲ）、峰值排空率（ＰＥＲ）、峰值充盈时间（ＴＰＥＲ）。结果：ＥＤＶ（１３０．０５±２８．０９）ｍｌ、ＥＳＶ（９３．８３±１９．０     

多普勒超声对高血压病左室舒张功能的研究

本文应用多普勒超声对５２例高血压病患者和３０例正常人的左室舒张功能进行了研究。结果表明：１、Ⅰ期高血压左空舒张功能开始减退。ＰＶＥ、ＰＶＡ、ＥＰＳＳ同正常组比较有显著性差异（Ｐ＜０．０１）。２、Ⅱ期较Ⅰ期高血压患者左室舒张功能减退更明显。ＰＶＥ、ＰＶＡ、ＥＩ、ＡＩ、ＥＰＳＳ较正常组有显著性差异（Ｐ＜０．０５），同时，两期高血压患者上述指标亦有显著性差异（Ｐ＜０．０５）。３、ＰＶＥ、ＰＶＡ、ＥＰＳＳ可作为高血压病左室舒张功能受损及其程度的敏感指标。     

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.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

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.     

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.