纳洛酮联合醒脑静治疗急性乙醇中毒的观察

目的:观察纳洛酮、醒脑静联合治疗急性乙醇中毒的疗效。方法:选择急性乙醇中毒患者,随机分成治疗组和对照组,其中治疗组予以纳洛酮1.2 mg加NaCl溶液100 ml静脉滴注,联合醒脑静30 ml加5%葡萄糖或NaCl溶液250 ml静脉滴注,而对照组只用纳洛酮1.2 mg加NaCl溶液100 ml静脉滴注,其他治疗相同。结果:纳洛酮联合醒脑静治疗急性乙醇中毒,患者症状迅速缓解,明显优于对照组(P<0.05)。结论:纳洛酮联合醒脑静治疗急性乙醇中毒疗效显著。     

纳络酮治疗急性重度乙醇中毒51例临床观察

目的 观察纳洛酮注射液治疗急性重度乙醇中毒的临床效果.方法 将102例急性重度乙醇中毒患者随机分成治疗组与对照组,每组各51例.对照组给予常规性基础治疗,治疗组在对照组的基础上予以纳洛酮注射液0.4mg～0.8mg缓慢静脉注射,必要时30分钟后重复给药.比较两组之间的疗效.结果 治疗组起效时间、催醒时间、症状消失时间均明显短于对照组(P<0.O1).结论 应用纳洛酮注射液治疗急性重度乙醇中毒疗效显著,安全可靠.     

高渗葡萄糖注射液加呋塞米治疗急性乙醇中毒的疗效观察

目的:观察高渗葡萄糖注射液加呋塞米治疗急性乙醇中毒的疗效.方法:将急性乙醇中毒26例分为两组.治疗组13例.用高渗葡萄糖注射液加呋塞米治疗.对照组13例用纳洛酮治疗.结果:治疗组13例均在45分钟内清醒,对照组45分钟内清醒2例.结论:高渗葡萄糖注射液加呋塞米治疗急性乙醇中毒有明显疗效.     

纳洛酮治疗肺性脑病疗效观察

目的:观察纳洛酮治疗肺性脑病临床疗效及安全性.方法:将入选的62例患者随机分为治疗组及对照组,治疗组在综合治疗基础上给予盐酸纳洛酮0.8mg加入5%葡萄糖20ml缓慢静脉注射,然后2.0mg加入5%葡萄糖250ml静滴,每天纳洛酮总剂量4mg,直至神志清醒.对照组在综合治疗基础上给予肺脑合剂+5%葡萄糖250ml+地塞米松5mg+氨茶碱0.25g+尼可刹米1.125g静脉滴注,每12小时1次.结果:治疗后,治疗组总有效率(81.25%)显著高于对照组(46.67%)(P＜0.01).治疗过程中无不良反应发生.结论:纳洛酮治疗肺性脑病临床疗效确切、安全.     

盐酸纳洛酮治疗急性乙醇中毒74例临床观察

目的探讨盐酸纳洛酮治疗急性乙醇中毒的临床疗效.方法将148例急性乙醇中毒患者随机分为两组,对照组74例患者给予常规治疗,治疗组74例患者在常规治疗的基础上加用盐酸纳洛酮静脉注射,将两组患者的临床疗效进行对比分析.结果对照组的总有效率为77%,治疗组的总有效率为98.6%;治疗组的疗效明显优于对照组,两组比较差异具有统计学意义,P<0.01.结论盐酸纳洛酮治疗急性乙醇中毒可迅速缓解患者的症状,因其简单易行、安全有效、无明显副作用,值得临床广泛应用.     

纳络酮联合醒脑静在抢救急性意识障碍中的治疗作用研究

目的探讨纳洛酮联合醒脑静在抢救急性意识障碍中的疗效。方法根据病因不同,将急性意识障碍分为:急性乙醇中毒、急性镇静催眠药中毒、急性脑血管意外、中暑、急性一氧化碳中毒。其中急性乙醇中毒患者70例、急性镇静催眠药中毒患者60例、中暑患者30例、急性脑血管意外患者50例、急性一氧化碳中毒患者46例。采用前瞻随机、对照的方法,随机分为两组:一组为治疗组、一组为对照组。治疗组在常规治疗的基础上应用纳洛酮0.4￣1.2mg静脉注射,联合醒脑静10￣20ml静脉滴注。对照组给予常规治疗。结果治疗组较对照组明显缩短意识障碍时间,提高疗效。结论纳洛酮联合醒脑静在抢救急性意识障碍中的治疗作用较常规方法有显著疗效。值得推广。     

不同剂量纳洛酮治疗急性酒精中毒104例效果观察

目的:探讨使用不同剂量的纳洛酮治疗急性酒精中毒的临床疗效。方法:将酒精中毒104例按照随机数字表法分为对照组(54例)和观察组(50例)。在常规治疗的基础上,对照组给予常规剂量纳洛酮,观察组应用纳洛酮0.8mg加入5%葡萄糖盐水注射液20ml静脉注射,用纳洛酮4.8mg加入5%葡萄糖盐水注射液500ml静脉滴注。结果:观察组和对照组患者疗效相似(P>0.05),观察组不良反应发生率较对照组高(P<0.05)。结论:常规剂量治疗急性酒精中毒疗效显著,降低治疗费用。     

纳洛酮治疗急性乙醇中毒72例体会

目的:观察纳洛酮治疗急性乙醇中毒的临床疗效。方法:选择140例急性乙醇中毒患者,随机将患者分为观察组72例和对照组68例,两组患者均常规治疗。观察组在以上治疗基础上给予纳洛酮注射液0.4～1.6mg加入25%葡萄糖注射液60ml静脉推注,必要时每隔半小时重复给药,直到患者清醒为止。结果:两组患者全部治愈出院,无任何后遗症。观察组的症状缓解时间及症状消失时间均明显优于对照组(P<0.01)。结论:纳络酮能有效解除急性乙醇中毒的症状,缩短症状缓解时间和消失时间,是治疗乙醇中毒的理想药物。     

纳洛酮治疗急性乙醇中毒60例疗效观察

目的:观察纳洛酮治疗急性乙醇中毒的临床疗效。方法:将条件基本相同者60例急性乙醇中毒病例随机分成两组,治疗组30例用纳洛酮治疗;对照组30例用利尿、输液、补充维生素等治疗。对比两组的治疗效果,重点对症状消失时间进行对照。结果:治疗组比对照组显效时间、症状减轻时间、症状消失时间明显缩短,差异有统计学意义(P<0.01)。结论:纳洛酮治疗急性乙醇中毒见效快、简便、疗效确切、不良反应少,是救治急性乙醇中毒的理想药物。     

纳洛酮联合天麻素治疗急性脑梗死的疗效观察

目的探讨纳洛酮联合天麻素治疗急性脑梗死的临床疗效。方法将急性脑梗死患者随机分为两组,治疗组86例采用纳洛酮针1.6 mg加入5%葡萄糖注射液250 mL(或0.9%的氯化钠注射液250 mL)静滴,联合天麻素针600 mg静滴,1次/d,15 d为1个疗程;对照组86例采用胞二磷胆碱针1.0 g加入5%葡萄糖注射液250 mL(或0.9%的氯化钠注射液250 mL)静滴,联合葛根素针0.4 g静滴,1次/d,15 d为1个疗程。采用欧洲脑卒中量表(ESS)和日常生活能力量表(ADL)进行评分及判断疗效。结果治疗组总有效率为96.51%,对照组为74.42%,治疗组疗效优于对照组(P<0.05);两组治疗后ESS及ADL评分较治疗前均明显改善(P<0.05)。结论纳洛酮联合天麻素治疗急性脑梗死疗效明显并有效改善神经功能,值得临床推广。     

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.