纤维支气管镜肺泡灌洗治疗老年支气管扩张合并感染30例研究

目的分析应用支气管镜肺泡灌洗治疗老年支气管扩张合并感染的临床效果。方法选取我院2014年5月至2017年5月收治的支气管扩张合并感染患者60例随机分为观察组和对照组各30例,对照组行吸氧、扣背咳痰、抗生素等常规治疗,观察组在对照组治疗基础上行纤维支气管镜下肺泡灌洗,比较两组治疗后的临床效果。结果观察组临床治疗总有效率明显高于对照组(c2=10.42,P0.01),治疗后观察组血氧指标改善优于对照组(P0.05),患者住院时间和费用明显少于对照组(P0.01),治疗后半年内观察组就诊次数明显少于对照组(P0.05)。结论在纤维支气管镜下行肺泡灌洗治疗老年支气管扩张合并感染临床疗效显著,患者住院时间和费用减少,值得在临床上推广使用。     

电子支气管镜肺泡灌洗治疗老年支气管扩张合并感染60例疗效观察

目的探讨采用电子支气管镜肺泡灌洗治疗老年支气管扩张合并感染的临床效果。方法随机选取2014年4月至2015年11月解放军第159中心医院收治的老年支气管扩张患者120例,均合并感染,采用随机数字表法将其分为对照组和观察组,其中对照组行常规治疗,观察组在此基础上结合电子支气管镜肺泡灌洗,比较两组患者的临床疗效。结果观察组的临床症状缓解时间、炎症因子和血气水平改善结果均明显优于对照组(P<0.05)。结论对老年支气管扩张合并感染者进行电子支气管镜肺泡灌洗,可有效促进患者临床症状和肺换气功能的改善,对于控制病情发展具有十分积极的作用,建议在临床进一步推广。     

纤维支气管镜灌洗治疗支气管扩张合并感染的临床分析

目的 探讨对支气管扩张合并感染患者应用纤维支气管镜支气管肺泡灌洗治疗的临床效果.方法 随机选取支气管扩张合并感染患者100例,并将其分为对照组与观察组,每组各50例.对照组患者接受常规治疗,观察组患者在常规治疗基础上应用纤维支气管镜支气管肺泡灌洗,对比两组患者临床疗效及不良反应.结果 观察组患者临床治疗总有效率为94.0％,相对于对照组患者临床治疗总有效率78.0％有显著优越性,对比存在统计学意义（P＜0.05）;两组患者均未出现严重不良反应.结论 对支气管扩张合并感染患者应用经纤维支气管镜肺泡灌洗治疗方案具有安全高效的优点,取得令人满意的治疗效果,且不会出现严重不良反应,值得临床推广.     

支气管肺泡灌洗治疗支气管扩张合并感染临床分析

目的探讨使用支气管肺泡灌洗治疗支气管扩张合并感染的疗效。方法选取2009年8月～2012年1月收治的支气管扩张合并感染的66例患者为研究对象。随机将患者分为两组,对照组采用常规治疗,实验组给予支气管肺泡灌洗治疗,观察对比治疗效果。结果实验组治疗总有效率为96.97%,对照组治疗总有效率为81.82%,实验组总有效率更高,与对照组比较差异有统计学意义,P<0.05。结论对支气管扩张合并感染患者给予支气管肺泡灌洗,可以提高治疗效果,值得临床应用。     

纤支镜肺泡灌洗治疗支气管扩张并感染疗效分析

目的 探讨经纤维支气管镜在常规治疗基础上支气管肺泡灌洗治疗支气管扩张并感染的临床效果.方法 将支气管扩张伴感染的104例患者为支气管肺泡灌洗组与常规治疗组,支气管肺泡灌洗组在常规抗感染的基础上,通过纤支镜向病变部进行支气管肺泡灌洗,常规治疗组采用常规治疗,观察临床治疗效果.结果 对于支气管扩张合并感染患者,支气管肺泡灌洗,能明显提高疗效,其有效率明显优于常规治疗组;在常规治疗基础上加用支气管肺泡灌洗,能明显缩短恢复时间.结论 支气管肺泡灌洗结合常规治疗,可提高支气管扩张治疗并感染的临床效果,值得推广.     

福多司坦联合支气管镜下肺泡灌洗治疗老年支气管扩张合并感染患者的疗效

目的分析福多司坦联合支气管镜下肺泡灌洗治疗老年支气管扩张合并感染患者的临床疗效。方法选取我院2017年1月～2019年5月收治的老年支气管扩张合并感染患者60例,依照随机数字表法分为对照组和研究组各30例。对照组行支气管镜下肺泡灌洗治疗,研究组行福多司坦联合支气管镜下肺泡灌洗治疗,分别比较两组患者的炎性因子水平、痰液性状评分、肺功能指标、临床治疗效果及并发症发生情况。结果治疗后,研究组患者的IL-10、hs-CRP、TNF-α等炎性因子水平低于对照组,差异有统计学意义(P0.05);研究组患者的MD、MP等痰液性状评分高于对照组,MVP评分低于对照组,差异有统计学意义(P0.05);治疗后,研究组患者的FEV1、FVC肺功能指标优于对照组,差异有统计学意义(P0.05);研究组患者的临床总有效率高于对照组,差异有统计学意义(P0.05);研究组患者的并发症发生情况少于对照组,差异有统计学意义(P0.05)。结论在临床治疗老年支气管扩张合并感染的过程中,采用福多司坦联合支气管镜下肺泡灌洗治疗有助于改善炎症反应,减少痰液分泌,提升临床疗效的同时还能降低恶心呕吐、出血、心律失常等并发症的发生风险。     

纤维支气管镜肺泡灌洗治疗支气管扩张合并感染85例疗效观察

目的:观察纤维支气管镜肺泡灌洗治疗支气管扩张合并感染的疗效。方法:将85例支气管扩张合并感染患者以简单随机抽样法分为对照组(n=42)和研究组(n=43),对照组给予常规治疗,研究组在对照组基础上采用纤维支气管镜肺泡灌洗治疗,比较两组患者的疗效。结果:治疗前两组患者的PaO_2、PaCO_2及PaO_2/FiO_2等各项血气水平及hs-CRP、TNF-α等炎性因子水平比较均无显著性差异(P>0.05),治疗后两组PaO_2、PaO_2/FiO_2均明显升高,PaCO_2及hs-CRP、TNF-α水平均明显降低,且研究组上述指标均明显优于对照组(P<0.05)。研究组患者发热、咳嗽、咳痰及肺部湿罗音等症状消失时间和住院时间均明显短于对照组(P<0.05)。结论:在常规治疗基础上采用纤维支气管镜肺泡灌洗治疗支气管扩张合并感染的疗效优于单纯常规治疗疗效。     

支气管镜下肺泡灌洗术联合头孢哌酮舒巴坦治疗支气管扩张合并感染的疗效

目的 探讨支气管镜下肺泡灌洗术联合头孢哌酮舒巴坦治疗支气管扩张合并感染的疗效.方法 120例病例随机分为观察组和对照组各60例,两组患者均给予常规基础治疗,对照组加用头孢哌酮舒巴坦静脉滴注,观察组在上述治疗的基础上加用支气管镜下肺泡灌洗术,比较两组临床治疗效果.结果 观察组治疗总有效率达95.00％,高于对照组的81.67％ （P＜0.05）.治疗后,两组患者血气分析、肺功能指标、EsR、CRP均比治疗前有改善（P＜0.05）,但观察组改善更明显（P＜0.05）.结论 支气管镜下肺泡灌洗术联合头孢哌酮舒巴坦治疗支气管扩张合并感染的疗效确切,值得临床推广.     

支气管肺泡灌洗术治疗老年脑卒中合并肺部感染的临床价值

目的 探讨支气管肺泡灌洗术治疗老年脑卒中合并肺部感染的临床价值.方法 对50例老年脑卒中合并肺部感染患者按卒中类型、意识障碍程度、基础疾病及感染细菌种类随机分为治疗组与对照组,治疗组在敏感抗生素等治疗的基础上应用纤维支气管镜行支气管肺泡灌洗术治疗,对照组仅敏感抗生素等治疗.结果 治疗组与对照组的平均住院日分别为l4.3 d和21.6d(P<0.01),治疗组与对照组的总有效率分别为84%,32%(P<0.01).结论 应用纤维支气管镜行支气管肺泡灌洗术治疗老年脑卒中并肺部感染疗效显著,值得临床推广应用.     

纤维支气管镜下肺泡灌洗对支气管扩张合并感染的临床疗效

目的探讨纤维支气管镜下肺泡灌洗在支气管扩张合并感染中的应用价值。方法选取2015年11月至2018年11月于郸城县人民医院就诊的112例支气管扩张合并感染患者,按照随机数表法分为对照组和研究组,每组56例。对照组患者接受常规治疗,包括吸氧、抗菌药物、营养支持、纠正水电解质紊乱等。研究组患者在对照组基础上接受纤维支气管镜肺泡灌洗治疗。两组均治疗2周。比较两组临床疗效和治疗前后血气指标。结果对照组和研究组治疗总有效率分别为82.14%(46/56)、82.14%(53/56),研究组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。治疗后,两组患者SaO_2、PaO_2及PaO_2/FiO_2较治疗前增高,研究组患者SaO_2、PaO_2及PaO_2/FiO_2均高于对照组,差异有统计学意义(均P<0.05)。结论纤维支气管镜下肺泡灌洗治疗支气管扩张合并感染,可有效改善患者血气指标,提高疾病治疗效果。     

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.