补中益气汤加减治疗慢性肾炎蛋白尿的临床效果观察

目的:观察补中益气汤加减治疗慢性肾炎蛋白尿的临床效果。方法:选取40例慢性肾炎蛋白尿患者作为研究对象,按随机数字表法将其分为对照组和观察组各20例,对照组给予盐酸贝那普利治疗,观察组在对照组的基础上联合补中益气汤加减辅助治疗,比较两组临床疗效、肾功能及蛋白尿复发状况。结果:观察组的治疗有效率为95.0%(19/20),明显高于对照组的70.0%(14/20),差异有统计学意义(P<0.05);治疗后观察组血尿素氮、血肌酐、24 h尿蛋白定量均明显低于对照组,差异有统计学意义(P<0.05);随访6个月,观察组复发率为0,明显低于对照组的21.4%(3/14),差异有统计学意义(P<0.05)。结论:与单用西药治疗相比,联合补中益气汤加减治疗慢性肾炎蛋白尿患者的效果更显著,可明显改善患者肾功能指标,降低复发率。     

科素亚联合洛丁新治疗早期糖尿病肾病的临床疗效

目的观察科素亚联合洛丁新治疗早期糖尿病肾病与单独使用科素亚或洛丁新治疗的临床疗效。方法 90例临床确诊为早期糖尿病肾病患者随机分成3组,A组30例为治疗组,采用科素亚联合洛丁新治疗;对照组B组30例用科素亚治疗;C组30例用洛丁新治疗。疗程均为3个月。观察3组治疗前后血压、血尿素氮（BUN）、肌酐（Cr）、24h尿蛋白定量及电解质等的变化。结果 3组的血压及24h尿蛋白均明显下降,尤其是A组上述作用更为显著。结论对早期糖尿病肾病患者而言,联合应用科素亚、洛丁新具有更好的肾脏保护作用。对延缓糖尿病肾病的发展,可能具有重要价值。     

厄贝沙坦联用肾炎康复片治疗慢性肾炎蛋白尿的疗效观察

目的:对慢性肾炎蛋白尿患者联合应用厄贝沙坦和肾炎康复片的临床治疗效果加以分析。方法:将商丘市第四人民医院收治的80例慢性肾炎且出现蛋白尿的患者,随机分为单用厄贝沙坦治疗的对照组和厄贝沙坦联合肾炎康复片治疗的观察组,每组患者40例。经2个月的治疗后,对比两组患者的治疗效果。结果:治疗前两组患者24 h尿蛋白含量比较未见明显差异(P>0.05),经2个月的治疗后,两组24 h尿蛋白含量明显减少,与治疗前相比均有统计学意义(P<0.05)。两组比较,观察组减少较对照组更为明显(P<0.05);同时对照组患者经2个月治疗后,8例达到显效,20例达到有效,总有效率为70.00%,而观察组12例达到显效,22例达到有效,总有效率为85.00%,经统计学比较,观察组治疗效果明显优于对照组(P<0.05)。结论:联合应用厄贝沙坦和肾炎康复片较单用厄贝沙坦能更有效地改善慢性肾炎蛋白尿患者的尿蛋白情况。     

厄贝沙坦联用肾炎康复片治疗慢性肾炎蛋白尿疗效观察

目的:对采用肾炎康复片与厄贝沙坦联合的方法对患有慢性肾炎蛋白尿的患者进行治疗的临床效果进行观察研究。方法:抽取68例患有慢性肾炎蛋白尿的患者病例,将其分为A、B两组,平均每组34例。分别采用肾炎康复片和肾炎康复片与厄贝沙坦联合进行治疗。结果:B组患者的临床治疗效果明显优于A组患者;该组患者在治疗前后的尿蛋白改善幅度明显大于A组患者;该组患者在治疗前后的血肌酐变化幅度明显小于A组患者;两组患者在治疗的过程中,均没有出现比较严重的并发症和不良反应现象。结论:采用肾炎康复片与厄贝沙坦联合的方法对患有慢性肾炎蛋白尿的患者进行治疗的临床效果十分理想。     

中药滋肾方联合中医护理对慢性肾炎患者肾功能和不良反应的影响

目的 探讨中药滋肾方联合中医护理对慢性肾炎患者肾功能和不良反应的影响。方法 选取2019年1月—2020年1月泉州市中医院收治的104例慢性肾炎患者作为研究对象,按随机数字表法将其分为常规组（实施常规药物治疗联合常规护理方法干预）和研究组（实施中药滋肾方联合中医护理方法干预）,每组52例。比较2组干预前后的肾功能指标[尿素氮（BUN）、24 h尿蛋白定量、血肌酐（SCr）]、诺丁汉健康量表（NHP）评分、中医证候积分（血尿、水肿、蛋白尿）,并对比2组治疗后的不良反应发生率。结果 干预前,2组的BUN、24 h尿蛋白定量、SCr水平和NHP评分、中医证候积分相比差异无统计学意义（P>0.05）;干预后,2组的BUN、24 h尿蛋白定量、SCr水平和NHP评分、中医证候积分均低于干预前,且研究组低于常规组（P<0.05）。研究组不良反应发生率（3.85%）与常规组（5.77%）对比无显著差异（P>0.05）。结论 慢性肾炎患者实施中医护理并配合中药滋肾方干预,可改善受损的肾功能,缓解水肿、血尿等临床症状,降低其中医证候积分,效果较为理想。     

探讨贝那普利联合百令胶囊治疗慢性肾炎的临床疗效

目的探析慢性肾炎患者用贝那普利、百令胶囊联合治疗的临床效果。方法纳入本院2015年至2017年期间收治并确诊为慢性肾炎患者的临床基线数据,从中选取200例,编序后以随机数字表将其分为常规组(用贝那普利治疗)与联合组(联合百令胶囊治疗),比较患者接受两种治疗手段后的疗效差异。结果 (1)两组患者临床疗效对比:联合组临床治疗总有效率显著高于常规组(P0.05);(2)两组患者临床指标对比:联合组患者治疗后24h尿蛋白定量、血肌酐、尿素氮指标显著优于常规组(P0.05);治疗期间患者均未发生药物引发的严重不适症状,顺利完成疗程。结论为慢性肾炎患者制定干预方案,可将贝那普利联合百令胶囊作为主要治疗手段,可有效平复相关临床症状,改善临床指标,安全性高,对慢性肾炎患者健康及生活质量均有积极的保障价值。     

环孢素A联合甲基泼尼松龙治疗特发性膜性肾病的临床效果

目的探讨环孢素A联合甲基泼尼松龙治疗特发性膜性肾病(IMN)的临床效果。方法选取2014年12月至2018年12月焦作市第二人民医院收治的94例IMN患者,依照治疗方案分为常规组和观察组,每组47例。常规组患者接受甲基泼尼松龙治疗,观察组患者接受环孢素A联合甲基泼尼松龙治疗。比较两组临床疗效及治疗前和治疗6个月肾功能[24小时尿蛋白定量、血清白蛋白(ALB)]、免疫功能(CD4~+/CD8~+、CD4~+)水平。结果观察组治疗总有效率[89.36%(42/47)]高于常规组[72.34%(34/47)],差异有统计学意义(P<0.05)。治疗6个月,两组24小时尿蛋白定量水平均低于治疗前,观察组24小时尿蛋白定量水平低于常规组,差异有统计学意义(均P<0.05)。治疗6个月,两组ALB水平均高于治疗前,观察组ALB水平高于常规组,差异有统计学意义(均P<0.05)。治疗6个月,观察组CD4~+和CD4~+/CD8~+水平均高于常规组,差异有统计学意义(均P<0.05)。结论采用环孢素A联合甲基泼尼松龙治疗IMN的效果显著,可有效改善患者的肾功能和免疫功能。     

科素亚、川芎嗪联合治疗糖尿病肾病疗效观察

目的 探讨科素亚、川芎嗪联合治疗糖尿病肾病疗效.方法 将52例糖尿病肾病患者随机分为对照组(口服科素亚)与治疗组(口服科素亚,同时加用川芎嗪注射液)观察其疗效.结果 两组治疗后血糖血压均较入院时明显好转(P＜0.05),但24h尿蛋白总量与脂代谢紊乱的改善方面,治疗组优于对照组(P＜0.05).结论 科素亚、川芎嗪联合治疗糖尿病肾病疗效较好.     

来氟米特治疗伴有中等量蛋白尿的慢性肾炎患者的疗效评价

目的评价来氟米特治疗伴有中等量蛋白尿的慢性肾炎患者的疗效。方法采用随机数表法选取我院于2015年7月至2018年7月收治的伴有中等量蛋白尿的慢性肾炎患者100例,盲分成两组,每组各占50例。对照组行常规激素治疗,实验组在此基础上联合来氟米特治疗,对两组患者在治疗前后的指标以及治疗效果予以对比。结果实验组疗效明显高于对照组,P0.05,差异有意义,两组在治疗前的24h尿蛋白跟血浆清蛋白差异的比较是无意义的,在治疗结束后,实验组的两组指标情况明显好于对照组,P0.05,差异有意义,但两组不良反应差异比较无意义。结论对于伴有中等量蛋白尿的慢性肾炎患者来说,在常规激素治疗的基础上加用来氟米特综合治疗,患者的疗效要更显著,而且不会产生严重毒副作用,也不会产生任何不良影响,值得临床大力推荐。     

开博通与科素亚联合治疗糖尿病肾病疗效观察

目的　研究开博通与科素亚联合应用和两者之一单用对糖尿病肾病的治疗作用。方法　 38例糖尿病肾病Ⅳ期患者随机分成 3组 ,观察组接受开博通和科素亚联合治疗 ;设置两个对照组 :开博通组 ,接受开博通治疗 ;科素亚组 ,接受科素亚治疗。观察期间每月检测一次尿蛋白定量、肾功能及血钾。 3组均给予基础治疗 ,即给予胰岛素和 (或 )口服降糖药 ,必要时加用钙拮抗剂等降血压药物 ,严格控制血糖与血压在正常范围。结果　随访治疗 0 5～ 1年 ,3组患者尿蛋白均有不同程度下降 ,观察组尿蛋白下降程度明显优于任一对照组 ,差异有显著性(P <0 0 5 )。两对照组之间降尿蛋白作用相似。所有病例均未发生高钾血症和肾功能恶化。结论　开博通与科素亚联合使用治疗糖尿病肾病的作用优于两者之一单独使用 ,有应用价值     

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.