奥曲肽与垂体后叶素治疗EVB的疗效比较

目的　比较奥曲肽与垂体后叶素治疗食管静脉曲张破裂出血 (EVB)的临床疗效。方法　将 93例食管静脉曲张破裂出血的患者随机分为 2组 ,奥曲肽组予奥曲肽 10 0 μg静注 ,继以 2 5μg/h的速度持续静滴 ,维持 4 8h ;垂体后叶素组予垂体后叶素 0 .2～ 0 .4u/min持续静滴 2 4h ,血止后减半量维持 2 4h。观察 2组的临床疗效及不良反应。结果　奥曲肽组总有效率为 81.3% ,止血时间为 9.2 8± 7.4 0h ;垂体后叶素组总有效率为 60 % ,止血时间约为 2 6.50± 19.82h ,两组比较 ,有显著差异。结论　奥曲肽治疗食管静脉曲张破裂出血疗效快、止血率高 ,且副作用少 ,比垂体后叶素优越 ,但价格较贵 ,对经济条件好的患者提倡使用该药     

奥曲肽和垂体后叶素治疗急性消化道出血的疗效观察

目的观察奥曲肽治疗急性消化道大出血的疗效。方法奥曲肽治疗组60例，先用奥曲肽针0.1mg静脉滴注，后以50μg／h微泵维持，维持48～72h；垂体后叶素对照组42例，以垂体后叶素针10U／h加硝酸甘油针0.4mg／h微泵维持48～72h。结果奥曲肽治疗组总有效率91．6％，明显优于垂体后叶素对照组的52.4％。结论奥曲肽是治疗急性消化道大出血的有效药物。     

垂体后叶素与国产奥曲肽治疗上消化道大出血的疗效观察

目的 观察垂体后叶素与国产奥曲肽对上消化道大出血的疗效及不良反应.方法 回顾性分析48例上消化道大出血病例,其中14例应用垂体后叶素,剂量为0.2-0.4U/m i n.34例应用国产奥曲肽,首诊给予奥曲肽0.1m g静脉注射,后25u g/h维持.48例均联合应用质子泵抑制剂(PPI)奥美拉唑治疗,奥美拉唑40mg静脉注射,每12小时1次;两组患者均用药3～4d.结果 国产奥曲肽组总有效率达88.25%,垂体后叶素组总有效率为57.14%,两组比较差异有统计学意义 (P<0.05).结论 垂体后叶素与国产奥曲肽联合奥美拉唑治疗上消化道大出血均可有效止血,但垂体后叶素临床不良反应较奥曲肽明显增多,因垂体后叶素价格较低,基层仍在应用.     

垂体后叶素治疗肝硬化并上消化道大出血疗效观察

目的：观察垂体后叶素治疗肝硬化合并上消化道大出血的疗效。方法随机将80例患者分为治疗组40例和对照组40例,同时运用奥美拉唑8 mg/h持续静滴。治疗组使用生理盐水加入奥曲肽0.3 mg,按50μg/h持续微量泵泵入及生理盐水加入垂体后叶素48 U,按0.4 U/min持续静滴;对照组使用生理盐水加入奥曲肽0.3 mg,按50μg/h持续微量泵泵入,观察时间24 h。结果治疗组总有效率92.5%,对照组为80.0%,2组比较差异具有统计学意义（P〈0.05）。结论在肝硬化合并上消化道大出血的治疗中,联合应用垂体后叶素是止血的有效措施之一。     

奥曲肽与垂体后叶素治疗食管胃底静脉曲张破裂出血疗效比较

目的　比较奥曲肽与垂体后叶素治疗食管胃底静脉曲张破裂出血的临床效果。方法　将我科 12 4例食管胃底静脉曲张破裂出血的住院患者分为A组 76例 ,应用奥曲肽治疗 ;B组 48例 ,应用垂体后叶素治疗。比较其有效率、止血率、止血时间、输血量、再出血率及药物副作用等。结果　A组显效率为 68% ,总有效率为 87% ;B组显效率为2 9 % ,总有效率为 62 % ;两组 6h内止血率分别为 5 8% ,17% ,2 4h内止血率分别为 86%和 71% ;平均止血时间分别为(5 61± 3 93 )h和 (14 2 9± 5 81)h ;平均输血量分别为 (4 2 3± 5 0 )ml和 (5 72± 78)ml。以上数据两组间比较差异均有显著性。结论　奥曲肽对食管胃底静脉曲张破裂出血的治疗效果确切 ,近期疗效明显优于垂体后叶素 ,而且使用方便 ,副作用少 ,可作为治疗该病的理想药物     

奥曲肽与垂体后叶素治疗食管胃底静脉曲张破裂出血的疗效比较

目的　比较奥曲肽与垂体后叶素治疗食管胃底静脉曲张破裂出血的疗效。方法　将 97例食管胃底静脉曲张破裂出血的住院患者随机分为奥曲肽治疗 (观察 )组 49例及垂体后叶素对照组 48例 ,分别比较两组显效率、总有效率、止血率、止血时间、输血量、再出血率及副作用等。结果　观察组显效率为 67 3 % ,总有效率为 85 7% ;对照组显效率为 2 5 0 % ,总有效率为 60 4% ;两组 6h内止血率分别为 61 2 %和 18 8% ,2 4h内止血率分别为 79 6%和 60 4% ;平均止血时间分别为 ( 6 42± 3 95 )h和 ( 15 94± 6 93 )h ;平均输血量分别为 ( 4 67± 63 )ml和 ( 5 93± 78)ml ;再出血率分别为16 3 %和 3 9 6% ;副作用发生率分别为 12 2 %和 3 5 4%。以上数据两组间比较差异有显著性 (P <0 0 5 )。结论　奥曲肽对食管胃底静脉曲张破裂出血的止血效果明显优于垂体后叶素 ,而且使用方便 ,副作用少 ,是内科治疗肝硬化食管胃底静脉曲张破裂出血的首选药物     

奥曲肽、垂体后叶素治疗食管胃底静脉曲张破裂出血的疗效对照

目的探讨奥曲肽、垂体后叶素2种药物对治疗食管、胃底静脉曲张破裂出血的疗效。方法奥曲肽、垂体后叶素常规剂量对该病的治疗,观察其24小时止血率和平均止血时间。结果奥曲肽24小时止血率为813%,平均止血时间为58±36小时。垂体后叶素24小时止血率为611%,平均止血时间为127±54小时。结论奥曲肽近期止血效果较确切,疗效明显优于垂体后叶素,而且使用方便,副作用小。     

奥曲肽联合垂体后叶素治疗肝硬化并上消化道出血31例临床疗效观察

目的：探讨奥曲肽联合垂体后叶素治疗肝硬化并上消化道出血的疗效。方法：给予患者奥曲肽0.1 mg＋0.9%氯化钠溶液20 ml缓慢静注,完毕立即接通奥曲肽0.2 mg＋0.9%氯化钠溶液500 ml滴入,结束后再接通垂体后叶素30 U＋5%葡萄糖溶液500 ml以3 U/h静滴,24 h连续输入,记录患者的生命指征、呕血和便血、液体进出量及必要的实验室检查。结果：止血成功22例,出血控制率为71.0%,平均止血时间（10.37±5.56） h。结论：奥曲肽联合垂体后叶素治疗肝硬化并上消化道出血,效果满意,值得临床推广应用。     

奥曲肽联合西米替丁治疗上消化道大出血的疗效观察

目的 观察奥曲肽治疗上消化道大出血的疗效.方法 将我院近年来收住的上消化道大出血的患者50例,随机分为2组,治疗组予奥曲肽联合西米替丁,对照组予垂体后叶素联合西米替丁,观察2组止血效果.结果 治疗组总有效率为85.6%,显著高于对照组(70.7%),且不良反应少.结论 奥曲肽治疗上消化道大出血疗效确切,安全可靠.     

奥曲肽治疗上消化道大出血的临床观察

目的观察奥曲肽治疗上消化道大出血的疗效。方法将我院近年收治的上消化道大出血患者58例,随机分为两组,治疗组予奥曲肽,对照组予垂体后叶素,观察两组止血效果。结果治疗组显效率为62.1%,总有效率93.1%,均显著高于对照组(6.9%和65.5%,p<0.01),且不良反应少。结论奥曲肽治疗上消化道大出血疗效确切,安全可靠。     

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.