糖络方联合弥可保治疗2型糖尿病周围神经病变的临床观察

目的观察益气养阴活血通络之糖络方联合弥可保治疗2型糖尿病周围神经病变的疗效。方法将65例患者随机分成治疗组（中西药组）和对照组（西药组）,均在西药降血糖基本达标的同时,对照组单纯口服弥可保,治疗组口服弥可保的基础上加用糖络方内服,治疗8周。结果总有效率及治疗后证候积分比较,治疗组优于对照组,差异有统计学意义（P〈0．05）;治疗后肌电图比较,治疗组优于对照组,差异有统计学意义（P〈0．01）。结论益气养阴活血通络之糖络方联合弥可保治疗2型糖尿病周围神经病变疗效优于单用弥可保,是治疗该病的有效方剂之一。     

益气养阴活血法治疗糖尿病周围神经病变60例

目的观察益气养阴活血法治疗糖尿病周围神经病变的临床疗效。方法随机将120例患者分为益气养阴活血法治疗组60例和肌注维生素B12、口服维生素B1片对照组60例。结果治疗组总有效率92%,对照组74%,治疗组疗效优于对照组（P〈0.05）。结论益气养阴活血法治疗糖尿病周围神经病变较单纯西药治疗效果好。     

注射用冻干丹参治疗糖尿病周围神经病变62例

目的观察注射冻干丹参对糖尿病周围神经病变的疗效。方法治疗组62例采用注射用冻干丹参配合西药治疗，并与单用西药50例对照治疗进行疗效对比观察。结果治疗组总效率为90.3％，对照组为58．0％，p〈0．01（x^2=24．397）在神经传导速度变化方面，两组治疗前后自身及两组治疗后比均较有显著提高（p〈0．05和p〈0．01）；在改善血液流变学方面，治疗组治疗后较治疗前改善有显著性p〈0．01，治疗后两组比较亦有显著性差异（p〈0．05和p〈0．01），但对照组自身比较p〉0．05。结论冻干丹参注射液治疗糖尿病周围神经病变疗效确切。     

依帕司他联合弥可保治疗糖尿病周围神经病变的疗效观察

目的：探讨依帕司他联合弥可保治疗糖尿病周围神经病变的疗效。方法：把58例患者随机分为两组,对照组30例应用弥可保,治疗组28例应用依帕司他联合弥可保。结果：治疗组总有效率85．7％,显效率25．O％;对照组总有效率66．66％,显效率13．33％,治疗组明显优于对照组（P〈0．05）。两组治疗后正中神经、腓总神经和腓浅神经的感觉神经传导速度（SNCV）和运动神经传导速度（MNCV）与治疗前比较有明显提高,差异有显著性（P〈0．01）;而两组之间比较,则差异无显著性。结论：依帕司他联合弥可保治疗糖尿病神周围经病变效果良好。     

中西医结合治疗糖尿病周围神经病变疗效观察

目的：观察中西医结合治疗糖尿病周围神经病变的疗效。方法：将106例患者随机分两组，对照组53例采用西药甲钴胺片（弥可保）、维生素B1片、地巴唑片治疗；治疗组53例在对照组治疗基础上加用中药口服。结果：总有效率，治疗组94．34％，对照组79．25％，治疗组疗效明显优于对照组（P〈0．05）。结论：中西医结合方法治疗糖尿病周围神经病变临床疗效满意。     

益气温阳活血方药治疗糖尿病周围神经病变疗效观察

目的观察益气温阳活血方药治疗糖尿病周围神经病变的疗效。方法将糖尿病周围神经病变患者61例随机分为两组，治疗组31例，对照组30例。其中治疗组在饮食控制及给予降糖药物治疗的同时加用温阳活血通络中药，对照组在同样条件下给予维生素B1 100mg和维生素B12 500mg，每天1次，肌肉注射。两组均以25天为1个疗程，然后评价两组疗效和神经传导速度。结果治疗组症状明显改善，总有效率90．6％，对照组总有效率17．9％，两组疗效具有显著性差异（P〈O．01），并且治疗组神经传导速度明显提高（P〈0．05）。结论温阳活血中药是治疗糖尿病周围神经病变的有效方药，值得推广。     

α硫辛酸治疗糖尿病周围神经病变临床观察

目的观察α硫辛酸联合弥可保治疗2型糖尿病周围神经病变的疗效,并评价其安全性和不良反应。方法将2型糖尿病周围神经病变患者122例随机分为两组。两组均给予基础治疗：胰岛素强化治疗、改善微循环、阿司匹林抗血小板及对症治疗。治疗组（观察组）给予α硫辛酸联合弥可保治疗,对照组给予弥可保治疗,疗程2周;比较2组治疗前后临床症状疗效、运动神经传导速度（MNCV）、感觉神经传导速度（SNCV）等指标变化。结果观察组和对照组治疗总有效率分别为79．0％和56．7％,差异有统计学意义（P〈0．05）,两组神经传导速度治疗后有不同程度改善,尤其以正中神经感觉及运动传导速度改善均明显,治疗前后差异有显著性（P〈0．01）,观察组与对照组比较,治疗后差异有统计学意义（P〈0．01）,各组治疗前后自身对照差异有统计学意义（P〈0．01）。结论α硫辛酸联合弥可保治疗2型糖尿病周围神经病变疗效优于弥可保单用,不良反应少,值得临床推广应用。     

自拟活血通络浴足方治疗2型糖尿病下肢周围神经病变35例

[目的]观察自拟活血通络浴足方治疗2型糖尿病下肢周围神经病变的临床疗效。[方法]将65例患者随机分为治疗组35例和对照组30例,在西药降血糖基本达标的基础上,对照组口服弥可保,治疗组用自拟活血通络浴足方浴足治疗,均治疗8周。[结果]治疗组临床总有效率为97.14%,对照组为76.67%,2组比较,差异有显著性意义(P<0.05)。2组治疗后腓神经感觉传导速度比较,差异有显著性意义(P<0.05)。[结论]活血通络方浴足治疗2型糖尿病下肢周围神经病变疗效优于口服西药,是治疗该病的有效方法之一。     

益气养阴通络法治疗糖尿病周围神经病变疗效观察

益气养阴通络法治疗103例糖尿病周围神经病变患者，取得较好疗效。治疗组52例，显效29例，有效19例。无效4例，总有效率91．2％，对照组总有效率68．3％，经X^2检验，差异有显著性意义，P〈0．05，治疗组优于对照组。提示益气养阴通络法可以改善肢体微循环，使受损的神经组织得到充分的营养并重新修复，从而取得良好的效果。     

中西医结合治疗糖尿病周围神经病变临床观察

目的：应用中医中药能改善糖尿病血管病变,减轻和治疗糖尿病性周围神经病变,观察中西医结合治疗糖尿病周围神经病变。方法：笔者近年来运用中医益气养阴活血法为主,中医理论以益气温经,活血通络为治则,结合胰岛素治疗糖尿病性周围神经病变。结果：治疗组总有效率86．7％,对照组53．33％,差异有非常显著性（P〈0．01）。结论：中医中药能改善糖尿病血管病变,减轻和治疗糖尿病性周围神经病变,体现了中西医结合治疗糖尿病周围神经病变的优势。     

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.