盐酸氨溴索不同给药方式对分泌性中耳炎疗效对比研究

目的：比较盐酸氨溴索耳内镜下鼓膜穿刺给药及鼻内镜引导下咽鼓管给药治疗分泌性中耳炎的效果。方法：分泌性中耳炎患者96例,随机分为对照组和观察组各48例。在常规治疗的临床上,对照组予以盐酸氨溴索耳内镜下鼓膜穿刺给药,观察组予以盐酸氨溴索鼻内镜引导下咽鼓管给药。比较两组患者的临床疗效、鼓室压、语频气导听阈和不良反应。结果：对照组总有效率为83.34%,明显低于观察组的95.84%,差异有统计学意义（P<0.05）;治疗后对照组鼓室压-109.85±32.18 daPa,语气导听阈37.18±15.90 dB,观察组鼓室压-87.18±25.09 daPa,语频气导听阈48.94±16.28 dB,均较治疗前升高,差异均有统计学意义（P<0.05）,但观察组与对照组比较,升高幅度更明显,差异均有统计学意义（P<0.05）;疑似药物不良反应观察组出现3例（6.25%）,对照组出现2例（4.17%）,差异无统计学意义（P>0.05）。结论：盐酸氨溴索鼻内镜引导下咽鼓管给药治疗分泌性中耳炎,较耳内镜下鼓膜穿刺给药疗效更为显著,可明显提高鼓室压及语气导听阈,未增加不良反应发生率。     

咽鼓管球囊扩张术对慢性分泌性中耳炎的疗效

目的探讨咽鼓管球囊扩张术对慢性分泌性中耳炎的治疗效果。方法选择2018年1—8月信阳市第四人民医院收治的70例慢性分泌性中耳炎患者,根据随机数表法分为对照组和观察组,各35例。对照组接受鼓膜置管术治疗,观察组接受咽鼓管球囊扩张术治疗。术前和术后6个月分别测试患者的纯音听阈均值,统计患者并发症发生情况。结果术后6个月,两组纯音听阈均值均较治疗前降低,且观察组低于对照组,差异有统计学意义(均P<0.05)。观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论咽鼓管球囊扩张术治疗慢性分泌性中耳炎效果显著,可有效促进患者听力水平恢复,减少并发症的发生,效果高于鼓膜置管术。     

经鼻内镜腺样体切除术后对儿童分泌性中耳炎听力的影响

目的观察经鼻内镜腺样体切除术对儿童分泌性中耳炎听力的影响。方法回顾性分析25例儿童腺样体肥大伴分泌性中耳炎经鼻内镜腺样体切除的效果。结果手术后1月、3月分泌性中耳炎25例（36耳）的治疗有效率分别为81.2%和100%;11例（21耳）纯音测听检查听力下降患儿术前和术后低频平均听阈上升（P〈0.05）。结论切除肥大的腺样体对治疗分泌性中耳炎听力恢复具有积极影响。     

低温等离子腺样体消融联合BDET术治疗慢性分泌性中耳炎患儿的疗效及对炎症应激和咽鼓管功能的影响

目的 探索低温等离子腺样体消融联合咽鼓管球囊扩张术（BDET）治疗慢性分泌性中耳炎（OMSC）疗效及对炎症应激和咽鼓管功能的影响。方法 选取2019年1月—2022年6月该院耳鼻喉科就诊的慢性分泌性中耳炎106例为研究对象，随机分为观察组（n=53）和对照组（n=53）。对照组给予低温等离子腺样体消融术治疗，观察组同时进行BDET术治疗，比较二组患儿治疗后总有效率、不良反应及复发率，比较二组患儿治疗时手术时间、术中出血量、鼓膜愈合时间、术后中耳积液时间，以及手术前后肿瘤坏死因子-α(TNF-α)、白细胞介素-10(IL-10)、白细胞介素-6(IL-6)、咽鼓管功能评分（ETS）和咽鼓管功能障碍评分（ETDQ-7）。结果 治疗后，观察组总有效率（98.11%）高于对照组（86.79%）(P<0.05)；观察组手术时间、鼓膜愈合时间、术后中耳积液时间均短于对照组，术中出血量少于对照组（P<0.05）；手术1个月后，观察组血清TNF-α、IL-10、IL-6水平均低于对照组（P<0.05）；手术1个月后，观察组ETS评分高于对照组，ETDQ-7评分低于对照组，咽鼓管压力小...     

鼻内镜下咽鼓管球囊扩张术与鼓膜置管术治疗老年慢性分泌性中耳炎的效果比较

目的比较鼻内镜下咽鼓管球囊扩张术与鼓膜置管术治疗老年慢性分泌性中耳炎的效果。方法选取2015年11月至2017年11月项城市第一人民医院收治的90例老年慢性分泌性中耳炎患者,根据随机数表法分为置管组与扩张组,各45例。给予置管组鼓膜置管术治疗,给予扩张组鼻内镜下咽鼓管球囊扩张术治疗。比较两组患者术前、术后6个月咽鼓管功能[咽鼓管功能障碍症状评分量表(ETDQ-7)评分]、捏鼻鼓气难度[捏鼻鼓气法(Valsalva)评分],记录两组临床疗效,统计术前、术后6个月纯音听阈均值(PTA)。结果术后6个月,两组ETDQ-7、Valsalva评分均较术前降低,且扩张组ETDQ-7、Valsalva评分均低于置管组,差异有统计学意义(均P<0.05)。扩张组治疗总有效率为93.33%(42/45),高于置管组的73.33%(33/45),差异有统计学意义(P<0.05)。术后6个月,扩张组PTA低于置管组,差异有统计学意义(P<0.001)。结论与鼓膜置管术相比,鼻内镜下咽鼓管球囊扩张术治疗老年慢性分泌性中耳炎效果显著,可改善患者咽鼓管功能,降低捏鼻鼓气难度及PTA。     

不同手术联合方案对慢性分泌性中耳炎患者PTA及ABG的影响

目的 探讨不同手术联合方案对慢性分泌性中耳炎患者纯音气导听阈(PTA)及气-骨导差(ABG)的影响.方法 选取2018年2月至2019年8月本院收治的慢性分泌性中耳炎患者68例,按随机对照原则分为对照组(n=34,54耳)与观察组(n=34,53耳).对照组采用腺样体消融术联合鼓膜切开置管术治疗,观察组在对照组基础上联合咽鼓管球囊扩张术治疗.比较两组治疗效果、PTA及ABG、咽鼓管功能及并发症情况.结果 观察组治疗有效率(98.11％)高于对照组(85.19％),差异有统计学意义(P<0.05);术后,观察组PTA、ABG均低于对照组,差异有统计学意义(P<0.05);术后6个月、1年,观察组各时间点咽鼓管功能障碍问卷(ETDQ-7)评分均低于对照组,差异有统计学意义(P<0.05);两组术后并发症发生率比较差异无统计学意义.结论 腺样体消融术联合鼓膜切开置管术及咽鼓管球囊扩张术治疗慢性分泌性中耳炎,能有效提高患者术后咽鼓管功能,且安全性高,值得临床推广运用.     

鼻内镜下咽鼓管置管术与鼓膜切开置管术治疗分泌性中耳炎疗效对比分析

目的探讨鼻内镜下咽鼓管置管术与鼓膜切开置管术治疗分泌性中耳炎疗效对比分析。方法选取2015年2月-2017年3月我院收治的68例分泌性中耳炎患者,随机分为对照组34例与观察组34例,对照组患者采用鼓膜切开置管术治疗,观察组患者使用鼻内镜下咽鼓管置管术进行治疗,对比两组患者治疗后临床疗效及不良反应。结果 (1)对比两组患者临床疗效:观察组34例患者治疗总有效率97.06%显然高于对照组82.35%,差异显著,具有统计学意义(P0.05);(2)对比两组患者术后并发症情况:观察组34例患者术后并发症发生率5.88%显然低于对照组29.41%,差异显著,具有统计学意义(P0.05)。结论采用鼻内镜下咽鼓管置管术对分泌性中耳炎患者实施治疗,其疗效显然优于鼓膜切开置管术,且患者并发症较少,值得临床推广。     

鼻内镜下咽鼓管置管联合鼓室清窍汤冲洗治疗慢性分泌性中耳炎临床观察

目的?观察鼻内镜下咽鼓管置管联合鼓室中药液冲洗治疗慢性分泌性中耳炎(CSOM)的治疗效果。方法?将2012年9月-2014年3月期间就诊的80例CSOM 患者随机分成2组。实验组40例（61 耳）行经鼻内镜下咽鼓管置管联合鼓室清窍汤冲洗,每次2?mL,4～7?d。对照组40例（59耳）行鼓膜切开置管,置入管通常6~8 周后取出或自行掉落。术后随访6月,观察2组疗效。 结果?实验组治愈率为81.97%,总有效率为95.08%,优于对照组（64.41%、83.05%）,P<0.05。实验组并发症发生率为9.84%,低于对照组（28.81%）,P<0.05。实验组复发率为6.56%,低于对照组（20.34%）,P<0.05。结论?鼻内镜下咽鼓管置管联合鼓室清窍汤冲洗治疗慢性分泌性中耳炎,创伤小、疗效确切、副反应少、复发率低,值得临床推广。      

鼻内镜下经咽鼓管置管注药治疗慢性分泌性中耳炎

目的：探讨鼻内镜下经咽鼓管置管注药治疗慢性分泌性中耳炎的效果.方法：将我院近期收治的慢性分泌性中耳炎患者40例（40耳）,均为单侧,随机分为观察组和对照组各20例（20耳）,观察组给予鼻内镜下经咽鼓管置管灌药治疗,对照组给予显微镜下鼓膜切开置管术治疗.结果：观察组患者的有效率显著高于对照组,并发症的发生率显著低于对照组,两组比较,差异均具有统计学意义（P＜0.05）.结论：鼻内镜下经咽鼓管置管注药治疗慢性分泌性中耳交的效果显著,且操作简单,无严重并发症,是目前临床治疗慢性分泌性中耳炎的首选方法,值得临床推广应用.     

内镜下腺样体消融术与鼓膜置管治疗分泌性中耳炎伴腺样体肥大的临床疗效分析

目的：探讨内镜下腺样体消融术与鼓膜置管治疗分泌性中耳炎伴腺样体肥大的临床疗效及对患儿咽鼓管功能的影响。方法：选择2021年1—12月我院分泌性中耳炎伴腺样体肥大患儿100例为观察对象，依据随机抽签法将其分为两组，每组50例。对照组予以内镜下腺样体动力切割术联合鼓膜置管治疗，研究组予以内镜下腺样体消融术联合鼓膜置管治疗。比较两组临床疗效、治疗前后咽鼓管功能和鼻腔功能以及术后恢复情况。结果：研究组治疗总有效率为96.00%,高于对照组的84.00%(P<0.05);研究组术后鼻腔通气恢复时间、住院时间短于对照组，术后3个月听阈低于对照组(P<0.05);治疗前及治疗后3个月，两组咽鼓管功能比较差异均无统计学意义(P>0.05);治疗后3个月，研究组鼻腔容积(NCV)、鼻腔最小横截面积(NMCA)高于对照组，鼻腔阻力低于对照组(P<0.05)。结论：内镜下腺样体消融术与鼓膜置管治疗分泌性中耳炎伴腺样体肥大患儿效果显著，可提升治疗有效率，改善鼻腔功能，利于术后恢复，值得推广。     

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.