速可平内镜下喷洒治疗急性期消化胃溃疡临床观察

目的：探讨蝎毒制剂－速可平（SV）对急性期消化性胃溃疡（APU）的治疗效果。方法：46例APU患者随机分组，治疗组23例采用速可平内镜下喷洒溃疡面，对照组23例单用洁维乐凝胶内镜下喷洒溃疡面。结果：2组治疗后主症及胃粘膜结构积分有明显改善（P＜0．05）；溃疡周边胃粘膜血流量治疗后均有显著的改善（P＜0．05），且治疗组较对照组改善更明显（P＜0．05）；治疗组胃溃疡治疗显效率及总有效率分别为56．5％和91．5％，与对照组26．0％和69．5％相比，差异有显著性（P＜0．01或P＜0．05）。结论：SV能迅速改善APU患者的症状和体征，促进溃疡的愈合，能有效改善溃疡周边胃粘膜血流量，无明显的副作用。     

内镜下清创术治疗胃溃疡疗效观察

目的　观察内镜下病灶清创对溃疡病的治疗作用。方法　对 78例经内镜和病理确诊为胃溃疡病人 ,分别采用内镜下病灶清创并于病灶表面喷洒 10 %枸橼酸铋钾溶液加口服丽珠得乐 (治疗组 )和口服雷尼替丁加丽珠得乐 (对照组 )治疗 ,于第 2周及第 4周及第 8周复查胃镜 ,观察溃疡病灶的变化。结果　治疗组 5 2例 2周、4周及 8周治愈率分别为 5 3 8%、82 7%及 88 5 % ,对照组 2 6例 4周及 8周治愈率为 68 4%及 76 9% ;治疗组中溃疡病灶 <0 5cm的 17例全部治愈 ,0 5～ 0 9cm的治愈率为 91 3 % ,而>1 5cm则无效 ,治疗效果与病灶大小呈负相关 (R =0 45 5 ,P <0 0 5 )。结论　内镜下溃疡病灶清创术加病灶表面喷洒加口服枸橼酸铋钾对胃溃疡疗效十分满意 ,且方法简单易于操作 ,内镜检查时一次完成 ,无副作用 ,是一种很有前途的治疗方法。     

世居高原居民吸鼻烟与胃粘膜损害

目的　研究世居高原居民吸鼻烟与胃粘膜损害的关系。方法　观察 2 16例长期吸鼻烟世居高原的藏族居民 ,同时选择 163例不吸鼻烟的藏族健康人作对照组 ;受观察者均作胃镜检查 ,取胃粘膜活检送病理检查 ,同时查幽门螺杆菌 (HP)。结果　吸鼻烟组消化性溃疡 (PU)、糜烂性胃炎 (EG )内镜检出率分别为 2 5 %、3 1 0 2 % ,明显高于对照组的7 3 6%、7 2 % (P均 <0 .0 0 1) ;胃溃疡 (GU)多于十二指肠溃疡 (DU) ,吸鼻烟组GU∶DU是 16 3 3∶1,对照组是 2 67∶1。吸鼻烟组胃癌内镜检出率为 7 4% ,对照组未发现胃癌 ;吸鼻烟组GU位于胃底、胃体分别为 3 4 69%、42 86% ,溃疡面积大 ,多发性溃疡多。吸鼻烟组患GU的危险性是对照组的 5 8倍 ,OR =5 .8(P <0 .0 0 2 ) ;患EG的危险性是对照组的 2 6倍 ,OR=2 .6(P <0 .0 0 2 )。每日吸烟草指数与GU、EG呈正相关 ,r分别 =0 .986、0 .981(P均 <0 .0 0 2 )。吸鼻烟组胃粘膜HP检出率为 3 7 0 3 % ,低于对照组的 79 75 % (P <0 .0 0 1) ,PU、慢性胃炎HP检出率分别为 3 1 48%、3 6 71% ,低于对照组的 75 %、81 13 % (P <0 .0 0 1)。结论　长期吸鼻烟藏族居民GU、DU、EG及胃癌内镜检出率高 ,胃粘膜HP感染率低     

白芨和三七联合奥美拉唑和克拉霉素治疗胃溃疡70例疗效观察

目的 :观察白芨和三七在治疗胃溃疡中的作用。方法 :1 36例经胃镜证实为活动性胃溃疡病人分为对照组 6 6例 ,给予常规治疗 (奥美拉唑 2 0mgqd早餐前 5min ,克拉霉素 2 5 0mgqid) ;联合治疗组 70例 ,在常规治疗基础上 ,三餐前半小时口服白芨粉剂 5 .0gtid ,三七粉剂 5 .0gtid。 4周后复查胃镜。结果 :联合治疗组的胃溃疡治愈率为 94 .3% ,对照组 80 .3% ,P <0 .0 5。结论 :白芨和三七起到保护溃疡面、减轻其炎性反应、促进溃疡组织再生和修复作用。     

慢性肺心病胃粘膜病变50例分析

目的 :观察慢性肺心病人胃粘膜病变情况。方法 :用纤维胃镜观察肺心病患者 5 0例并与同期非肺心病患者 5 0例作对比 ,并取活组织作病理检查。结果 :肺心病组胃粘膜弥漫性充血水肿发生率及胃体、底部点片状糜烂、出血发生率明显高于对照组 (P <0 0 1) ,胃溃疡、十二指肠溃疡、十二指肠球炎发生率亦明显高于对照组 (P <0 0 1或P <0 0 5 )。结论 :慢性肺心病患者胃粘膜损害发生率高 ,治疗时应注意保护胃粘膜     

3-氧-乙酰-11-脱氧甘草次酸铝抗大鼠实验性胃溃疡作用机制

目的　探讨 3-氧 -乙酰 - 11-脱氧甘草次酸铝 (aluminum 3-oxo -acetyl- 11-deoxogly cyrrhetinate,ADA)对实验性大鼠胃溃疡的保护作用机制。 方法　采用Shay结扎法、醋酸法复制大鼠胃溃疡模型 ,分别测定给药后胃粘液PGE2 含量及胃粘膜血流量 (GMBF) ,并对结果进行统计分析。结果　ADA5 0mg·kg-1,10 0mg·kg-1与对照组相比 ,能显著增加胃内游离粘液和胃壁粘液量及胃壁内PGE2 含量(P <0 .0 1)。连续以ADA灌胃能显著增加胃粘膜血流量 (P <0 .0 1)。结论　ADA的抗溃疡作用与增加胃粘液量 ,促进PGE2 分泌及增加GMBF有关     

柴疏四君汤联合艾灸在脾胃虚弱胃溃疡患者中的临床对照研究

目的探讨柴疏四君汤联合艾灸对脾胃虚弱胃溃疡患者的影响。方法选取2016年7月—2018年3月期间的126例脾胃虚弱胃溃疡患者,随机分为对照组63例和治疗组63例,其中对照组给予柴疏四君汤治疗,治疗组给予柴疏四君汤联合艾灸治疗,两组均治疗4周。观察两组患者治疗前后血清炎性因子水平、胃肠动力、免疫状态、临床疗效及内镜疗效。结果治疗后两组患者血清炎性因子水平与治疗前比较均明显降低(P 0. 05),且治疗组降低程度明显大于对照组(P 0. 05)。治疗后两组患者胃肠动力与治疗前比较均明显改善(P 0. 05),且治疗组改善程度明显好于对照组(P 0. 05)。治疗后两组患者免疫状态与治疗前比较均明显改善(P 0. 05),且治疗组改善程度明显好于对照组(P 0. 05)。治疗组临床有效率96. 8%(61/63)治疗效果明显好于对照组临床有效率82. 5%(52/63)(P 0. 05)。治疗组内镜疗效有效率95. 2%内镜疗效明显高于对照组内镜疗效有效率81. 0%(P 0. 05)。结论柴疏四君汤联合艾灸治疗能够明显改善脾胃虚弱胃溃疡患者血清炎性因子、胃肠动力及免疫状态,疗效较好,值得在临床中推广应用。     

2(3)-叔丁基-4-羟基茴香醚对大鼠醋酸溃疡的治疗作用

目的 :观察 2 (3) 叔丁基 4 羟基茴香醚 [2 (3)tert butyl 4 hydroxyanisole ,BHA]对醋酸诱发大鼠胃溃疡的治疗作用。方法 :用 5 0 % (体积分数 )醋酸烧灼胃前壁浆膜面 1min ,制备大鼠胃溃疡模型。动物随机分为 3组 :BHA组、奥美拉唑组和对照组。测定指标包括 :溃疡指数、粘膜再生指数和溃疡底暴露减少指数。结果 :BHA组和奥美拉唑组溃疡指数分别为 (2 .98± 1.33)mm2 和 (2 .71± 1.45 )mm2 ,显著低于对照组 (5 .86± 1.6 9)mm2 (P <0 .0 1)。BHA组和奥美拉唑组溃疡粘膜再生指数分别为 (70 .1± 7.9) %和 (79.0± 8.1) % ,较对照组 (5 4.5± 7.3) %显著增加 (P <0 .0 0 1)。BHA组和奥美拉唑组的溃疡底暴露减少指数分别为 (6 0 .3± 13.4) %和 (6 8.2± 8.4) % ,较对照组 (46 .5± 7.9) %显著增加 ,P值分别小于 0 .0 5和 0 .0 1。但BHA组与奥美拉唑组相比 ,P值均大于 0 .0 5。结论 :BHA能促进醋酸诱发溃疡的愈合 ,其疗效与奥美拉唑相似。     

雷贝拉唑治疗消化性溃疡的临床研究

目的 :评价雷贝拉唑 10mg d在消化性溃疡治疗中的疗效及安全性 ,并与奥美拉唑 2 0mg d进行对比。方法 :采用随机对照临床研究 ,患者随机进入雷贝拉唑组 (治疗组 )或奥美拉唑组 (对照组 ) ,共有 10 2例病人完成治疗 ,其中治疗组 5 2例 ,对照组 5 0例 ;治疗组口服雷贝拉唑钠片每次 10mg ,每日 1次 ;对照组口服奥美拉唑胶囊每次2 0mg ,每日 1次。十二指肠球部溃疡 (DU)疗程 4周 ,胃溃疡 (GU)为 6周。结果 :两组治疗前后疼痛症状的改善及总的缓解率无明显差异 (P >0 .0 5 ) ,但服药第一天时治疗组的腹痛缓解率在DU和GU分别为 5 8%和 4 5 % ,明显高于对照组的 38%和 2 4 % (P <0 .0 5 ) ,其于各天内两组间无差异。十二指肠球部溃疡病人中 ,治疗组愈合率、有效率、总有效率分别为 91%、9%、10 0 % ,对照组分别为 87.9%、9%、97% ,两组间差异无显著性 (P均 >0 .0 5 ) ;胃溃疡病人中 ,治疗组愈合率、有效率、总有效率分别为 84 .2 %、10 .5 %、94 .7% ,对照组分别为 76 .5 %、17.6 %和 94 .1% ,两组间无显著性差异 (P均 >0 .0 5 ) ;治疗组和对照组不良反应发生率分别为 1.92 %和 2 % ,两组间无显著性差异 (P >0 .0 5 )。结论 :雷贝拉唑 10mg d能有效地治疗消化性溃疡 ,其腹痛总的缓解率、促进溃疡愈合的疗效、不     

溃疡散对大鼠实验性胃溃疡的保护机制

目的　研究溃疡散对实验性大鼠胃溃疡的保护作用机制。方法　Wistar大鼠 5 0只 ,随机分为 0 .5 %羧甲基纤维素钠组、西咪替丁 (0 .5 g·kg-1)阳性对照组、溃疡散 0 .35 g、0 .7g及 1.4g·kg-13个剂量组。给药 6d后采用幽门结扎法复制大鼠胃溃疡模型 ,分别测定胃液容量、胃酸含量、胃蛋白酶活性和胃壁粘液量。结果　溃疡散 0 .7g和 1.4g·kg-1组能明显减少胃液容量 (P <0 .0 5、P <0 .0 1)和降低胃总酸排出量 (P <0 .0 0 1) ;各剂量组均能显著降低胃蛋白酶活性 (P <0 .0 1)和增加胃壁粘液量 (P <0 .0 5 ) ;各种作用呈剂量依赖性。结论　溃疡散的抗溃疡作用与增强粘膜保护因素和减少对胃粘膜的损伤因素有关。     

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.