阿罗格皮肤点刺试验及脱敏治疗在变应性鼻炎中的临床意义

目的:探讨阿罗格皮肤点刺试验及脱敏治疗在变应性鼻炎中的临床意义。方法:用阿罗格19种点刺原液进行皮肤点刺试验,组胺液为阳性对照、生理盐水为阴性对照;并对变应原为螨阳性者进行脱敏治疗。结果:在210例变应性鼻炎患者中对螨Ⅱ和螨I变应原呈阳性反应者分别为50.5%和28.6%;对10种变应原的阳性反应在0.4%和6.2%之间;对其余7种变应原的反应均为阴性。对变应原为螨阳性者使用阿罗格标准抗原进行脱敏治疗,疗效满意。结论:阿罗格皮肤点刺试验为变应性鼻炎的特异性脱敏治疗提供可靠依据,也为治疗后的疗效评定提供客观指标;阿罗格是治疗变应性鼻炎的有效药物。     

阿罗格变应原皮肤点刺在变应性鼻炎诊断中的意义

目的探讨阿罗格变应原皮肤点刺试验在变应性鼻炎中的临床意义。方法应用阿罗格点刺试液对800例变应性鼻炎患者进行皮肤点刺试验,按年龄将800例患者分为〈10岁、11～20岁、21～30岁、31～40岁、41～50岁、〉50岁六个年龄段,分别计算皮肤点刺试验阳性率,并进行统计学处理。结果在800例变应性鼻炎患者中,对粉尘螨和屋尘螨变应原呈阳性反应分别占79.8%及73.5%、狗上皮为42.0%,食物组以小虾多见,为47.3%,其余12种变应原阳性反应分别占1.3%～15.0%。结论阿罗格变应原皮肤点刺试验为变应性鼻炎的诊断提供有力的依据,为特异性脱敏治疗提供可靠的客观指标,具有方便安全、操作简单、假阳性少、多种变应原可同时检测、特异性高等优点。     

变应性鼻炎脱敏治疗的疗效与安全性

目的：探讨阿罗格（NHD）标准化花粉变应原疫苗,皮下免疫疗法治疗中一重度变应性鼻炎的疗效。方法：对6例季节性变应性中一重度花粉变应性鼻炎患者采用阿罗格点刺液进行标准化皮肤点刺试验检测过敏原,并采用长效变应原混悬液进行脱敏治疗2年,对脱敏治疗效果进行评价。结果：皮肤点刺试验结果,6例患者对艾蒿阳性率为100％,对其他25种变应原有不同的阳性率,经过2年的治疗,达到使患者在7～9月份接触到有关致敏原后,也不产生症状或症状减轻之目的。结论：花粉变应性鼻炎患者采用长效变应原试剂皮下注射进行特异性免疫治疗,具有良好的安全性,可作为季节性变应性鼻炎的一种常规治疗方法,值得在临床上推广应用。     

阿罗格长效变应原脱敏治疗变应性鼻炎的疗效观察

目的：分析阿罗格（NHD）变应原脱敏治疗变应性鼻炎的疗效。方法：对72例常年性变应性鼻炎患者采用阿罗格点刺液行标准化皮肤点刺试验检测过敏原,并采用长效变应原混悬液进行脱敏治疗2年,对脱敏治疗效果进行评价。结果：皮肤点刺试验结果：72例患者对粉尘螨、屋尘螨阳性率为100．00％,对其他25种变应原有不同的阳性率。长效变应原制剂脱敏治疗72例患者,单纯吸入性变应原过敏患者46例,治疗总有效率为82．61％;吸入性变应原合并有食物性变应原过敏的患者26例,治疗总有效率为80．77％,两组疗效差异无统计学意义（P〉0．05）。结论：长效变应原制剂脱敏治疗是变应性鼻炎安全有效的治疗方法,可作为常年性变应性鼻炎的一种常规治疗方法,在临床上推广应用。     

新疆伊犁地区343例变应性鼻炎患者变应原分布分析

目的:了解新疆伊犁地区变应性鼻炎变应原分布状况.方法:选用30种变应原点剌液对343例变应性鼻炎患者进行皮肤点刺试验.结果:变应原皮肤点刺试验阳性反应343例,阳性率100％.主要变应原以葎草、户尘螨、粉尘螨、蒿属的阳性率最高.结论:伊犁地区变应性鼻炎的主要变应原为葎草、户尘螨、粉尘螨、蒿属.变应原皮肤点刺试验安全、快速、特异性强,可作为筛查和寻找变应原的重要监测手段.     

湖北省荆州地区变应性鼻炎及相关变应性疾病变应原皮试结果分析

目的应用标准化变应原检测初步探讨荆州地区变应性鼻炎的变应原分布情况。方法采用阿罗格变应原皮肤点刺液,对拟诊为变应性鼻炎及相关变应性疾病(主要为哮喘)的820例患者行皮肤点刺试验。结果变应原阳性率为64.15%。荆州地区最主要的变应原为屋尘螨(58.41%)、粉尘螨(55.37%)、豚草花粉(10.00%)、艾蒿花粉(9.15%)。结论本研究变应原检测结果可为荆州地区变应性鼻炎及相关变应性疾病的预防及免疫治疗提供指导。     

儿童变应性鼻炎过敏原测试临床分析

目的 通过检测儿童变应性鼻炎的变应原,为临床诊断、预防和治疗变应性鼻炎提供依据.方法 应用阿罗格点刺液对门诊变应性鼻炎患者320例行皮肤点刺试验以判定其主要过敏原.结果 320例患者阳性检出率92.5%,其中屋尘螨、粉尘螨的阳性检出率分别是88.5%和88.2%.变应原反应最强烈的是屋尘螨,其次是粉尘满、烟曲霉、特异青霉、动物毛Ⅰ.有31.8%的患儿有2种以上的过敏原存在.结论 屋尘螨、粉尘螨是本次调查儿童变应性鼻炎最主要和反应最强烈的过敏原,而防治方案是回避和免疫治疗.     

江苏省南通地区变应性鼻炎1200例变应原调查研究

目的:探讨江苏省南通地区变应性鼻炎患者变应原分布情况。方法:采用变应原皮肤点刺试验(skin prick test,SPT)检测在我院门诊拟诊为变应性鼻炎的1200例南通地区患者的变应原及75例健康大学生志愿者的变应原。结果:1200例患者中,有1098例出现阳性反应,阳性率为91.5%;其中粉尘螨和屋尘螨阳性检出率最高,分别为88.92%和85.25%,2种以上变应原阳性反应率为84.67%(1016/1200)。75名健康大学生对照组变应原阳性反应者为2例(2.67)%,二者比较差异有统计学意义。结论:江苏省南通地区变应性鼻炎患者中最常见变应原为尘螨;变应原皮肤点刺试验法是一种安全、简便、快速、有效的辅助诊断变应性鼻炎的方法,具有重要临床价值。     

陕西铜川地区570例变应性鼻炎患者变应原谱分析

目的:了解陕西省铜川地区变应性鼻炎患者变应原分布状况,为预防、临床诊断和治疗提供有效的科学依据。方法:选取铜川市人民医院耳鼻喉头颈外科2010年3月至2013年5月确诊为变应性鼻炎的570例患者作为研究对象,均进行特异性皮肤点刺试验,统计过敏反应情况及阳性率,分析变应原分布情况。结果:570例变应性鼻炎患者中,阳性反应526例,阳性率为92.3%,其中男性354例(67.3%),女性172例(32.7%)。变应原阳性率较高的为冷空气、柳絮类、花粉类,阳性率依次为61.7%、58.2%、57.6%。结论:铜川地区变应性鼻炎的主要变应原为冷空气、柳絮类、花粉。现阶段特异性皮肤点刺试验主要用于寻找变应原和临床基础筛查的检测,并为变应性鼻炎的诊治提供科学依据。     

变应性鼻炎皮肤点刺试验与护理体会

目的：探讨阿罗格点刺试验,临床诊断变应性鼻炎及护理体会方法：对672例患者临床应用皮肤点刺试验经验总结。结果：我区变应性鼻炎的发生与季节性变应源密切相关。结论：变应原皮肤点刺试验因其结果可靠,剂量控制严格,安全系数高,痛苦小,病人易于接受,成为目前该类疾病的首推诊断方法。     

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.     

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.     

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.