瑞舒伐他汀钙片与蒲参胶囊降脂疗效比较

目的:观察瑞舒伐他汀钙片与蒲参胶囊降脂效果差别。方法:将确诊的高血脂患者随机分为2组:瑞舒伐他汀组42例,每晚服瑞舒伐他汀钙10mg;蒲参胶囊,每次4粒,每日3次;疗程8周。比较2组降脂效果,同时观察治疗期间不良事件。结果:2组治疗前后血脂水平变化比较与同组治疗前相比,治疗后TC、TG、LDL-C均有明显下降(P<0.05),HDL—C明显升高(P<0.05)。2组治疗8周后总有效率比较,TC、LDL-C总有效率瑞舒伐他汀组优于蒲参胶囊组,TG总有效率蒲参胶囊组优于瑞舒伐他汀组,有明显差异(P<0.05);HDL—C总有效率2组无明显差异(P>0.05).治疗期间2组不良反应均轻微。结论:瑞舒伐他汀对TC,LDL-C降低优于蒲参胶囊,蒲参胶囊对于TG的降低疗效优于瑞舒伐他汀钙片。     

蒲参胶囊治疗原发性高脂血症的多中心随机平行对照临床试验

目的进一步评价蒲参胶囊治疗原发性高脂血症的临床疗效.方法多中心随机平行对照临床试验.448例原发性高脂血症患者被随机分为两组:治疗组336例,服用蒲参胶囊;对照组112例,服用脂必妥片;两组疗程均为4周.主要疗效指标为总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL-C)和高度脂蛋白(HDL-C).结果蒲参胶囊能使TC平均降低0.6246mmol/L,TG平均降低1.5343mmol/L,LDL-C平均降低0.5764mmol/L,HDL-C平均升高0.4406mmol/L;其中蒲参胶囊降低TG的疗效优于对照组(P＜0.005).结论蒲参胶囊对原发性高脂血症患者(尤其是TG升高者)有较好的调脂作用.     

辛伐他汀联合蒲参胶囊治疗高脂血症的临床探讨

目的:探讨辛伐他汀联合蒲参胶囊治疗高脂血症的临床疗效。方法:选取我院收治的46例高脂血症患者作为研究对象,采用随机数字表法分为观察组和治疗组,观察组(n=23)给予单独辛伐他丁胶囊治疗,治疗组(n=23)给予辛伐他汀联合蒲参胶囊治疗,观察两组治疗后空腹血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白-胆固醇(HDL-C)、低密度脂蛋白-胆固醇(LDL-C)的水平以及不良反应发生情况对比临床疗效。结果:治疗组TC、TG、HDL-C、LDL-C的改善效果显著优于观察组,比较差异有统计学意义(P0.01);不良反应发生率均为4.35%,比较差异无统计学意义(P0.05)。结论:辛伐他汀联合蒲参胶囊能更更有效的改善高脂血症,临床疗效显著,不会增加不良反应,安全性高,值得在临床上大量推广使用。     

阿托伐他汀钙联合降脂通脉胶囊治疗高脂血症临床观察

目的 观察阿托伐他汀钙联合降脂通脉胶囊治疗高脂血症的疗效与安全性.方法 将80例高脂血症患者随机分为两组.治疗组40例,降脂通脉胶囊,3粒/次,3次/d口服,并于每晚睡前口服阿托伐他汀钙20mg.对照组40例,每晚睡前口服阿托伐他汀钙20 mg.两组均以4周为一个疗程,共持续8周.观察服药前及服药后第4、8周末血脂指标（TC、TG、LDL-C、HDL-C）、肝肾功能、肌酸激酶及不良反应.结果 两组患者治疗前血脂水平无明显差异（P＞0.05）.用药后两组患者TC、TG和LDL-C水平较用药前均明显降低,且8周后降低更显著（P均＜0.05）;与对照组比较,治疗组用药4周及8周末TC、TG和LDL-C均显著降低（P均＜0.05）;治疗后两组HDL-C水平均不同程度升高,且8周后更显著（P均＜0.05）,但两组间无明显差异（P＞0.05）;治疗组总有效率为90.00％（36/40）,显著高于对照组的67.50％（27/40）,差异有统计学意义（P＜0.05）;治疗期间两组均未观察到明显不良反应.结论 阿托伐他汀钙联合降脂通脉胶囊有明显降低TC、TG、LDL-C和升高HDL-C的作用,且不良反应轻微,使用安全.     

阿托伐他汀与洛伐他汀治疗高脂血症的疗效观察

目的:比较观察阿托伐他汀与洛伐他汀治疗高脂血症的疗效。方法:60例高脂血症患者随机分为A、B两组,在常规低脂膳食基础上,A组服用阿托伐他汀10mg,B组服用洛伐他汀20mg,均每日1次,疗程6周。检测两组患者治疗前后的血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)水平的变化。结果:服药6周末与治疗前相比:两组的TC、TG、LDL-C均显著下降(P<0.01),HDL-C均明显上升(P<0.05),但以A组更为显著。结论:阿托伐他汀和洛伐他汀均为高效、安全的降脂药物,但阿托伐他汀的降脂效果更为显著。     

尿毒清联合黄葵延缓早期慢性肾衰竭进展的临床研究

目的 观察尿毒清颗粒联合黄葵延缓早期慢性肾衰竭进展的临床疗效。方法 116例确诊为早期慢性肾衰竭的患者随机分为对照组（58例）和治疗A组（28例）、B组（30例）;分别给予爱西特、尿毒清及尿毒清联合黄葵治疗,于治疗前、治疗8周后分别检测患者血肌酐(Scr)、内生肌酐清除率(Ccr)、尿素氮(BUN)、24 h尿蛋白定量、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)。结果 3组治疗8周后,A、B组与治疗前相比,各指标均有显著性差异(P<0.05);A、B组与对照组24 h尿蛋白定量、TC、TG、HDL-C、LDL-C有统计学差异(P<0.05,P<0.01),A、B 2组比较,P<0.05。3组临床疗效比较,A、B与对照组比,P<0.05,A、B 2组比较,P<0.05。结论 尿毒清颗粒联合黄葵通过减少尿蛋白排出、调节血脂、降低血肌酐、尿素氮等多个影响肾功能恶性进展的可逆因素的干预,较爱西特更能延缓早期慢性肾衰竭的进展。     

阿托伐他汀联合苯扎贝特治疗高脂血症临床疗效观察

目的:观察阿托伐他汀联合苯扎贝特治疗混合性高脂血症的疗效及安全性。方法:混合性高脂血症80例,随机分为2组:联合组晨起口服苯扎贝特200 mg,晚上睡前服用阿托伐他汀10mg;对照组单用阿托伐他汀10mg,每晚一次顿服。观察两组用药8周后血脂水平变化及不良反应情况。结果:治疗8周后于治疗前相比联合组总胆固醇(TC),甘油三酯(TG),低密度脂蛋白(LDL-C)显著降低(P<0.01),高密度脂蛋白(HDL-C)明显升高(P<0.05);对照组TC,LDL-C明显降低,(P<0.05)。两组间比较:联合组TG,TC,LDL-C显著降低,(P<0.01),HDL-C水平明显升高(P<0.01)。两组不良反应无明显统计学差异。总有效率联合组为77.5%,对照组为67.5.0%,有显著性差异(P<0.01)。结论:阿托伐他汀联合苯扎贝特给药对混合性高脂血症的疗效确切。但应注意掌握适应症和服药方法,尽可能减少联合用药引起的不良反应。     

降脂通脉胶囊联合阿托伐他汀钙治疗混合型高脂血症疗效观察

目的：探讨中药降脂通脉胶囊与阿托伐他汀钙联合应用对混合型高脂血症的临床疗效。方法：将2009年10月～2010年10月我院60例混合型高脂血症患者随机分为A、B两组,A组单服阿托伐他汀钙片,B组联合服用降脂通脉胶囊及阿托伐他汀钙片。服药前和服药后30 d检测空腹血清总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）以及相关的谷丙转氨酶（ALT）及肌酸激酶（CK）。结果：A、B两组均能明显降低血清TC、LDL-C,组间比较差异无统计学意义（P〉0.05）,而TG疗效B组明显优于A组（P〈0.001）。结论：降脂通脉胶囊联合阿托伐他汀钙片能更安全、更有效地纠正混合型脂质代谢紊乱。     

清浊化脂胶囊治疗高脂血症80例临床观察

目的:探讨清浊化脂胶囊对高脂血症的治疗作用。方法:将121例高脂血症患者分为治疗组80例和对照组41例,分别给予清浊化脂胶囊和舒降之治疗。治疗前后观察胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)含量及血液流变学指标变化。结果:治疗组治疗前后TC、TG、LDL-C含量及Apoa/ApoB比值均有明显改善,总有效率为87.5%,与舒降之组比较无明显差异;血液流变学各项指标的改善情况与舒降之组比较P<0.05和P<0.01。服药期间未见明显不良反应。结论:清浊化脂胶囊治疗高脂血症疗效肯定,无明显不良反应。     

辛伐他汀和血脂康治疗高脂血症的临床观察

目的:观察辛伐他汀和血脂康治疗高脂血症的临床疗效。方法:选择62例高脂血症患者,随机分为2组,治疗组182例,辛伐他汀10mg/d,1次/d加血脂康胶囊0.6g/次,2次/d,疗程8周,对照组180例,仅口服辛伐他汀10 mg/次,1次/d,晚上服用,疗程8周;用药前后检测血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C),甘油三酯(TG),高密度脂蛋白胆固醇(HDL-C),C反应蛋白(CRP)浓度。结果:治疗组总有效率98.35%,对照组总有效率87.22%,2组比较有显著性差异(p<0.05)。两组治疗后TC、TG、LDL-C均明显降低,HDL-C均明显升高,比治疗前差异有显著性意义(p<0.05)。2组各项指标比较无显著性差异(p>0.05)。2组治疗前后CRP比较有显著性差异(p<0.05)。结论:辛伐他汀联合血脂康治疗高脂血症比单独辛伐他汀治疗效果更好。     

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.