依达拉奉对急性脑梗死患者血清c反应蛋白的影响

目的通过分析依达拉奉对急性脑梗死患者血清C反应蛋白（CRP）水平的影响及患者预后脑神经功能缺损状况,探究其临床药用价值。方法178例急性脑梗死患者随机均分成两组,对照组行基础治疗,观察组除基础治疗外加用依达拉奉,分别对两组患者治疗前及治疗后7d、14d血清CRP水平及神经功能缺损情况对比分析。结果两组患者疗程结束后血清CRP水平及神经功能缺损情况较治疗前差异均有统计学意义（P〈0．05）,7d时观察组血清CRP水平明显低于对照组（P〈0．01）,14d时治疗组神经功能缺损情况明显低于对照组（P〈0．01）。结论依达拉奉可有效地降低急性脑梗死患者血清CRP水平及神经功能损伤程度,改善患者预后机体机能。     

依达拉奉对急性脑梗死患者高敏C反应蛋白及预后的影响

目的探讨依达拉奉对急性脑梗死(ACI)患者高敏C反应蛋白(hsCRP)含量及预后影响。方法选择ACI患者72例,随机分为治疗组与对照组各36例,在常规治疗的基础上,治疗组予依达拉奉30 mg静脉滴注,每日2次;对照组予奥拉西坦4.0 g静脉滴注,每日1次,疗程7 d。检测血清hsCRP、神经功能缺损和日常生活能力。结果治疗组在治疗后第7、14天hsCRP水平明显低于对照组(P<0.05);第7、14天欧洲脑卒中评分量表评分高于对照组,第7、14、30、90天日常生活活动量表评分均高于对照组(P<0.05)。结论依达拉奉可明显减轻ACI患者炎性反应,改善缺损神经功能和日常生活能力。     

依达拉奉联合低分子肝素治疗急性脑梗死及对血清CRP的影响

目的观察依达拉奉与低分子肝素联合治疗对急性脑梗死的疗效及血清C反应蛋白的影响。方法将我院收治的100例急性脑梗死患者随机分为2组,对照组给予血栓通注射液和胞磷胆碱注射液治疗,连用14d;治疗组应用依达拉奉注射液（连用14d）和低分子肝素（连用7d）治疗,治疗前后分别评估其临床疗效和神经功能缺损积分,同时用免疫比浊法测定2组患者的血清CRP水平。结果治疗组其神经功能缺损积分优于对照组（P〈O．05）,总有效率明显高于对照组（P〈0．01）,治疗组与对照组相比CRP水平明显降低（P〈0．05）。结论依达拉奉与低分子肝素联合治疗对急性脑梗死疗效显著,且有效降低急性脑梗死患者血清CRP水平,对脑梗死病情恢复和预后具有重要意义。     

依达拉奉治疗ATCI患者对血清C反应蛋白和病灶体积的影响

目的 探讨依达拉奉治疗动脉粥样硬化性血栓性脑梗死（ATCI）患者对血清C反应蛋白（CRP）和病灶体积的影响。方法 选择发病48小时内的ATCI患者96例，按性别、年龄、头颅CT病灶体积和部位、临床神经功能缺损程度无明显差异患者进行配对，计48对分治疗组和对照组，治疗组给予依达拉奉注射液30mg静脉滴注，2次／d，共14d，同时给予维脑路通、阿司匹林作为基础治疗；对照组除依达拉奉外，余均同治疗组。采用免疫散射速率比浊法测定96例ATCI患者治疗前及治疗后第5天、第10天、第15天血清CRP浓度，治疗前及第5天、第15天查头颅CT。结果 依达拉奉治疗组患者治疗后血清CRP浓度明显低于对照组，差异有显著意义（P〈0．05），病灶体积明显小于对照组，差异有显著意义（P〈0．05）。结论 现有临床证据表明，依达拉奉有降低动脉粥样硬化性血栓性脑梗死患者血清CRP浓度，缩小病灶体积的作用。     

依达拉奉对急性脑梗死血清神经元特异性烯醇化酶的影响

目的：观察依达拉奉注射液对急性脑梗死患者血液中神经元特异性烯醇化酶（NSE）的影响，探讨依达拉奉注射液的脑保护作用。方法：利用酶联免疫吸附法检测35例脑梗死患者依达拉奉注射液治疗过程中血清中NSE浓度，记录神经功能缺损评分、评定临床疗效。并与对照组进行比较。结果：依达拉奉注射液治疗第3d时，治疗组患者血液中NSE浓度即明显下降，低于对照组，神经功能缺损评分亦明显少于对照组（P〈0．01）。21d时依达拉奉组神经功能改善的总有效率为62．86％，常规治疗组为34．29％。结论：依达拉奉注射液对急性脑梗死的神经元有保护作用，能有效改善急性脑梗死患者的神经功能缺损。     

依达拉奉对急性脑梗死患者血清基质金属蛋白酶9表达的影响

目的探讨依达拉奉治疗急性脑梗死患者的疗效及对血清基质金属蛋白酶9（matrix metalloproteinase-9,MMP-9）蛋白表达的影响。方法选择发病24h内的急性脑梗死患者50例,按照随机数字表法分为对照组和治疗组（各25例）。两组患者视病情轻重及并发症给予对症治疗,其中治疗组联合应用依达拉奉30mg静脉滴注,2次/d,疗程14天。采用Western blot测定两组患者治疗前及治疗后第3天、第7天血清基质金属蛋白酶9蛋白表达,观察两组患者治疗前及治疗后第14天时临床神经功能缺损程度评分。结果治疗组治疗后第3、7天血清MMP-9蛋白表达与对照组比较差异有统计学意义（t3d=10.231,t7d=25.212,P〈0.01）。治疗组患者治疗后14天时神经功能缺损评分明显低于对照组（t=3.077,P〈0.05）。结论依达拉奉改善急性脑梗死患者神经功能的作用,可能与其降低血清中MMP-9蛋白水平有关。     

依达拉奉治疗急性脑梗死临床观察

目的：观察依达拉奉注射液治疗急性脑梗死的疗效及安全性。方法：选择起病48h以内的病例50例，随机分为依达拉奉治疗组和常规治疗组，治疗组在常规治疗组的基础上给予依达拉奉30mg加0．9％氯化钠50ml，每日2次静脉滴注，7d后改为每日1次静脉滴注，总疗程14d。治疗前、治疗后第7d、14d、21d对患者进行神经功能缺损评分。结果：依达拉奉治疗组与常规治疗组的神经功能恢复第7d差异显著（P〈0．05），在第14d、第21d差异更显著（P〈0．01）。结论：依达拉奉注射液是治疗急性脑梗死安全有效的药物之一。     

局部亚低温联合依达拉奉治疗急性大面积脑梗死

目的研究局部亚低温联合依迭拉奉治疗急性大面积脑梗死的临床疗效及其对血液超敏c反应蛋白（hs—CRP）水平的影响。方法发病24h内入院的大面积脑梗死患者84例,随机分为观察组和对照组各42谯。两组给予了长达拉奉静脉滴注14a,观察组加用32-34℃的低温治疗72h,两组患者分别于入院的,治疗了a1及14d后进行神经功能缺损评分及临床疗效评定,并测定hs—CRP水平。结果观察组及对照组治疗14d后神经功能缺损评分、hs—CRP水平分别与治疗前比较,差异有统计学意义（P〈0．05）;观察组与对照组治疗7d、14d后的神经功能缺损评分及hs—CRP水平比较,差异有统计学意义（P〈0．05）。结论局部亚低温联合依达拉奉治疗大面积脑梗死能取得更佳疗效,是值得进一步研究并应用于临床的治疗手段。     

依达拉奉对急性脑梗死患者神经元特异性烯醇化酶水平的影响

目的 探讨依达拉奉对急性脑梗死患者神经元特异性烯醇化酶(neuron specific enolase,NSE)水平的影响.方法 选择78例经CT或MRI确诊的发病在48 h内的脑梗死患者随机分为依达拉奉组和常规治疗组,分别于治疗前,治疗后第7、14、21天检测两组患者的血清NSE水平,并对两组患者的神经功能缺损程度进行评分.结果 治疗前两组患者血清NSE水平间差异无统计学意义(P＞0.05);依达拉奉组治疗后第7、14、21天的NSE水平与常规治疗组相应时间的NSE水平比较差异均有统计学意义(P＜0.05).治疗前两组患者神经功能缺损评分比较差异无统计学意义(P＞0.05);依达拉奉组治疗后第7、14、21天的神经功能缺损评分与常规治疗组相应时间的评分比较差异均有统计学意义(P＜0.05).结论 依达拉奉可以显著降低急性脑梗死患者血清NSE水平,能有效改善急性脑梗死患者的神经功能缺损.     

依达拉奉治疗急性脑梗死的疗效观察

目的观察依达拉奉注射液治疗急性脑梗死的临床效果。方法选择发病后72小时以内的急性脑梗死患者60例，随机分为治疗组和对照组，每组30例，观察两组治疗前后神经功能缺损（ESS）评分及日常生活活动（ADL）量表记分的变化。治疗组采用依达拉奉30mg加入生理盐水100ml静脉滴注，2次／天，共14天，同时给予对照组基础治疗。结果治疗组治疗后神经功能缺损评分减少值显著高于对照组（P〈0．001），总有效率和治疗后日常生活活动量表评分亦显著高于对照组（P〈0．01）。结论依达拉奉治疗急性脑梗死能有效改善发病早期的脑梗死患者近期的神经功能缺损和日常生活能力。     

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.     

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.