稳心颗粒联合美托洛尔治疗慢性肺心病合并心律失常的临床疗效

目的：观察稳心颗粒联合美托洛尔治疗慢性肺心病合并心律失常的临床疗效。方法：选取该院慢性肺心病合并心律失常患者60例,分为对照组和观察组,对照组接受美托洛尔常规对症治疗,观察组接受稳心颗粒联合美托洛尔治疗,观察两组临床疗效及不良反应情况。结果：观察组临床总有效率明显高于对照组（P ＜0．05）,不良反应发生率明显低于对照组（P ＜0．05）。结论：稳心颗粒联合美托洛尔治疗慢性肺心病合并心律失常临床疗效显著,不良反应少,可推广临床应用。     

胺碘酮联合美托洛尔治疗老年冠心病并发心律失常的临床观察

目的:探讨胺碘酮联合美托洛尔治疗老年冠心病并发心律失常的临床治疗效果。方法:选择在我院确诊为老年冠心病并发心律失常患者作为研究对象46例,分为两组,对照组患者23例、实验组患者23例;对照组患者采用胺碘酮进行临床治疗,实验组患者采用胺碘酮联合美托洛尔进行临床治疗,对比分析两组患者临床治疗效果。结果:实验组患者临床治疗有效率高于对照组患者,且实验组患者心律失常改善情况也优于对照组患者,两组患者各数据之间存在差异,具有统计学意义,P0.05。两组患者不良反应发生率,差异不明显(P0.05)。结论:对老年冠心病并发心律失常患者采用胺碘酮联合美托洛尔治疗,有效地提升患者临床治疗有效率,具有临床推广价值。     

不同部位急性心肌梗死并发心律失常的临床诊治措施分析

目的分析对不同部位急性心肌梗死并发心律失常患者的有效治疗方法。方法选择我院在2年内收治的120例急性心肌梗死并发心律失常患者,按照治疗方法分为对照组(60例,常规治疗)和观察组(60例,根部发病部位进行治疗),比较两组治疗效果。结果观察组的心律恢复率明显高于对照组,心律失常复发率明显低于对照组,差异有统计学意义(P0.05)。结论根据急性心肌梗死并发心律失常发病部位实施相应治疗可取得更好疗效。     

美托洛尔治疗慢性肺心病心力衰竭临床分析

目的探讨小剂量美托洛尔在慢性肺心病心力衰竭治疗中的应用。方法将72例慢性肺心病心衰患者随机分成两组,其中对照组35例,给予常规治疗;治疗组37例,给予常规治疗加小剂量美托洛尔辅助治疗,观察治疗前后心功能变化。结果治疗组在心功能改善方面,较对照组有更多的改善（P〈0.05）。结论美托洛尔治疗慢性肺心病心力衰竭能明显改善患者心功能,延缓肺心病心衰的进展。     

步长稳心颗粒与美托洛尔联用治疗心律失常临床效果观察

目的:探讨步长稳心颗粒联合美托洛尔治疗心律失常临床疗效。方法:选取120例心律失常患者的临床资料,随机分为治疗组和对照组各60例,两组患者均应用美托洛尔治疗,治疗组患者加用步长稳心颗粒,比较两组患者的临床疗效。结果:治疗组患者心律失常控制好,与对照组患者比较,差异有统计学意义(P<0.05)。结论:步长稳心颗粒联合美托洛尔能较好的控制患者的心律失常,效果满意,值得在临床推广。     

卡托普利 美托洛尔 稳心颗粒治疗心律失常

目的观察卡托普利、美托洛尔配合步长稳心颗粒治疗心律失常的疗效。方法将120例心律失常患者随机分为治疗组与对照组,治疗组服用卡托利片、美托洛尔片、步长稳心颗粒。对照组：口服胺碘酮片。结果治疗组总有效率为90%,对照组总有效率为60%（P〈0.05）,差异具有统计学意义。结论心律失常是临床常见病症,目前心律失常的药物治疗无明显进展,临床常用的抗心律失常药物同时也有致心律失常的作用,用卡托普利、美托洛尔配合步长稳心颗粒治疗心律失常作用显著,副作用少,值得临床推广。     

胺碘酮与美托洛尔联合治疗老年冠心病并发心律失常患者的临床体会

目的探讨胺碘酮与美托洛尔联合治疗老年冠心病并发心律失常患者的临床价值。方法本次研究对象选取2016年5月～2018年5月我院收治的100例老年冠心病并发心律失常患者,按照接受药物治疗的不同分为对照组和实验组两组,对照组患者接受单纯胺碘酮治疗,实验组患者接受胺碘酮联合美托洛尔治疗,对两组患者的治疗效果进行对比分析。结果实验组的临床总有效率较对照组患者高,组间比较差异有统计学意义(P0.05)。治疗前,两组老年冠心病并发心律失常患者OTc间期变化情况、ORS波时限、PR间期以及焦虑和抑郁评分的比较,差异无统计学意义(P0.05);治疗后,两组患者上述指标比较,差异有统计学意义(P0.05)。两组患者的不良反应发生率比较,差异无统计学意义(P0.05)。结论老年冠心病并发心律失常患者接受胺碘酮联合美托洛尔治疗后的临床效果显著,心理状态良好,围术期的各项指标也显著改善,值得临床推广。     

观察琥珀酸美托洛尔缓释片治疗心梗后室性心律失常的临床疗效

目的对琥珀酸美托洛尔缓释片在心梗后室性心律失常中的应用效果进行评价。方法研究参与对象为心梗后室性心律失常患者166例,均为我院2016年7月份至2017年7月份收治。采用抽签法分成两组各83例,对照组予以常规治疗;实验组同时取琥珀酸美托洛尔缓释片治疗。观察两组患者的治疗情况,对两组患者的临床疗效以及指标变化予以记录、分析和比较。结果实验组的总有效率与对照组比较相对更高,数据差异显示(P0.05),有统计学意义;实验组的QTd、QTcd与对照组比较改善情况相对理想,数据差异显示(P0.05),有统计学意义;实验组的不良反应率与对照组比较相对更低,数据差异显示(P0.05),有统计学意义。结论对心梗后室性心律失常患者实施琥珀酸美托洛尔缓释片治疗,对患者心功能改善有积极意义,疗效确切。     

静脉注射美托洛尔治疗心绞痛并发急性心力衰竭疗效观察

目的:观察静脉注射美托洛尔治疗心绞痛并发急性心力衰竭的疗效.方法:选取我院2009年7月~2014年7月收治的60例心绞痛并发急性心力衰竭患者作为研究对象.60例患者均符合的诊断标准.将这60例患者随机分成对照组和观察组,每组有30例患者.对照组只采用常规治疗,观察组再静脉注射美托洛尔.对比两组治疗效果.结果:观察组心绞痛并发急性心力衰竭患者的治疗总有效率高达93.30%,显著优于对照组(P<0.05).结论:针对心绞痛并发急性心力衰竭患者,采用常规治疗和静脉注射美托洛尔的方式联合治疗,能够取得明显的治疗效果.     

卡维地洛治疗扩张型心肌病并发心律失常60例的疗效评价

目的评价卡维地洛治疗扩张型心肌病并发心律失常的临床疗效。方法我院收治的120例扩张型心肌病并发心律失常患者随机分为两组,A组60例予以常规治疗,B组60例在常规治疗的基础上服用卡维地洛进行治疗,比较两组疗效及早搏次数。结果 B组总有效率为91.7%,明显高于A组的76.7%(P0.05);两组治疗后早搏次数的对比具有统计学差异(P0.05)。结论扩张型心肌病并发心律失常患者服用卡维地洛的疗效确切,值得临床借鉴和推广。     

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.     

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.