盐酸曲美他嗪和硝酸异山梨酯在稳定性劳力型心绞痛治疗中的分析

目的 探讨盐酸曲美他嗪和硝酸异山梨酯治疗稳定性劳力型心绞痛的临床效果.方法 210例稳定性劳力型心绞痛患者按照数字分组法分为观察组和对照组,各105例.两组患者均给予综合常规治疗.对照组加用硝酸异山梨酯治疗,观察组在对照组基础上加用盐酸曲美他嗪治疗.两组均连续治疗2个月.结果 观察组显效率73.3%和总有效率93.3%均显著高于对照组的显效率59.0%,总有效率82.9%,比较差异差异具有统计学意义(P<0.05),治疗期间未见明显药物不良反应;观察组心率,DBP,SBP,LVEF和LVEDD的改善程度均显著大于对照组(P<0.05).结论 盐酸曲美他嗪和硝酸异山梨酯联合治疗稳定性劳力型心绞痛,具有更高的治疗效果,且不会明显增加治疗风险,值得临床考虑.     

曲美他嗪与硝酸异山梨酯治疗稳定性劳力型心绞痛效果观察

目的 探讨曲美他嗪与硝酸异山梨酯对稳定性劳力型心绞痛的治疗效果,以及其临床应用安全性。方法 选取该院自2010年1月—2014年1月收治的184例稳定性劳力型心绞痛患者进行分析研究,根据不同用药品种,随机分为A组和B组两组,每组92例,A组采用曲美他嗪片进行治疗,B组采用硝酸异山梨酯片进行治疗。观察两组患者临床治疗效果以及后期患者恢复情况。结果 A组患者治疗总有效率为96.74%,B组患者治疗总有效率为83.70%,两组患者在治疗效果上存在差异有统计学意义（P〈0.05）。两组患者在治疗后,各项临床指标都有明显改善,差异有统计学意义（P〈0.05）,但A组患者改善情况明显优于B组,差异有统计学意义（P〈0.05）。A组患者不良反应发生率仅为4.35%,A组患者不良反应发生率明显低于B组,差异有统计学意义（P〈0.05）。结论 曲美他嗪与硝酸异山梨酯对于稳定性劳力型心绞痛有着良好的治疗效果,能有效改善患者心肌缺血症状,减轻心肌损害,改善患者各项临床症状指标,相比起来,曲美他嗪对于治疗稳定性劳力型心绞痛有更好的临床疗效,患者康复治疗效果更佳明显,而且患者耐受性较好,值得临床推广应用。     

单硝酸异山梨酯联合曲美他嗪治疗冠心病心绞痛疗效观察

目的:观察单硝酸异山梨酯联合曲美他嗪治疗冠心病心绞痛的临床疗效。方法:选择稳定性劳力型心绞痛患者105例,随机分为治疗组52例和对照组53例。治疗组用单硝酸异山梨酯20mg,口服,2次/d,同时口服曲美他嗪20mg,3次/d。对照组单用单硝酸异山梨酯20mg,口服,1次/d,两组连续观察4周。记录症状、体征及不良反应,每周复查心电图2次。4周后进行疗效评定。结果:两组心绞痛疗效比较,治疗组优于对照组(P<0.05)。两组心电图疗效比较显效率差异显著(P<0.05)。总有效率治疗组优于对照组,差异显著(P<0.01)。结论:单硝酸异山梨酯与曲美他嗪联合应用治疗冠心病心绞痛疗效较好,值得推广应用。     

曲美他嗪治疗冠心病心绞痛的疗效评价

目的 观察曲美他嗪治疗冠心病心绞痛的效果。方法 将62例冠心病心绞痛患者随机分成观察组31例，曲美他嗪、硝酸异山梨酯、美托洛尔等治疗，对照组31例，予硝酸异山梨酯、美托洛尔等治疗，疗程均为4周，观察用药前后心绞痛发作情况、心电图ST－T改变、心功能及血压、心率的变化。结果 观察组与对照组均能减少心绞痛发作，心电图缺血性ST－T及心功能改善，两组比较差异有显著性（P＞0.05)。结论 曲美他嗪对冠心病心绞痛有较好的疗效。     

单硝酸异山梨酯片与盐酸曲美他嗪片联合治疗慢性稳定型心绞痛的药效学研究

目的：探讨慢性稳定型心绞痛应用盐酸曲美他嗪片与单硝酸异山梨酯片治疗的药效学。方法选择2014年1月—2015年2月我院收治的慢性稳定型心绞痛患者60例,按治疗用药不同分为对照组和试验组各30例,对照组给予单硝酸异山梨酯治疗;试验组给予单硝酸异山梨酯联合盐酸曲美他嗪片治疗。观察2组患者临床疗效以及心电图疗效。结果试验组临床疗效为93.33%,明显高于对照组的76.67%,比较差异有统计学意义（P<0.05）;试验组治疗后心电图改善率为90.00%,明显高于对照组的73.33%,差异有统计学意义（P<0.05）。结论在慢性稳定型心绞痛患者应用盐酸曲美他嗪片联合单硝酸异山梨酯片治疗,不仅能够减少其发病次数,且持续时间较长,临床疗效显著,值得推广应用。     

曲美他嗪和辅酶Q10治疗稳定性劳力型心绞痛的对比研究

目的:对比研究曲美他嗪和辅酶Q10治疗稳定性心绞痛的疗效。方法:选择108例稳定性劳力型心绞痛,随机分成曲美他嗪组54例,辅酶Q10组54例,两组常规治疗(阿司匹林联合单一的硝酸酯制剂或β阻滞剂或钙通道阻滞剂)相同,曲美他嗪组给予曲美他嗪20mg,每天三次口服,辅酶Q10组给予辅酶Q1020mg,每天三次口服,疗程均为12周。观察临床疗效指标改善情况。结果:曲美他嗪组心绞痛及心电图改善分别为94.4%和68.5%,辅酶Q10组分别为88.9%和59.3%。组间比较差异有显著意义(P<0.05)。结论:曲美他嗪治疗稳定性劳力型心绞痛的疗效优于辅酶Q10。     

曲美他嗪治疗稳定劳力型心绞痛的疗效观察

目的主要对稳定劳力型心绞痛患者临床应用曲美他嗪的效果进行分析。方法选择72例心绞痛患者,随机分两组,36例接受曲美他嗪加常规治疗为治疗组,36例接受肠溶阿斯匹、美托洛尔、单硝酸异山梨酯、辛伐他汀等常规治疗为对照组,共4周。结果治疗组治疗效果明显优于对照组(P0.05),总有效率差异有统计学意义。结论在以肠溶阿斯匹、美托洛尔、单硝酸异山梨酯的常规治疗方案上加用曲美他嗪的治疗稳定劳力型心绞痛,能更好的改善心肌供血,增加心肌供能,减少心肌耗氧,改善心绞痛临床症状,是常规治疗方法外的一种选择。     

联合低分子肝素治疗不稳定型心绞痛51例疗效观察

目的 探讨曲美他嗪联合低分子肝素治疗不稳定型心绞痛的临床疗效.方法 选择笔者所在医院2007年5月～2009年5月不稳定型心肌梗死患者101例,随机分为观察组和对照组.其中对照组只给予硝酸异山梨酯片、美托洛尔、阿司匹林、降脂药等,同时皮下注射低分子肝素5000 U,每天1次,连用5 d.有变异型心绞痛发作者可给予地尔硫卓.治疗组在对照组治疗基础上给予曲美他嗪20 mg口服,每天3次,连续服用14 d.结果 观察组的总有效率为94.1%,对照组的总有效率为74.0%,两组总有效率比较,差异有统计学意义(P<0.05).结论 曲美他嗪联合低分子肝素治疗不稳定型心绞痛临床效果显著,值得临床借鉴.     

曲美他嗪治疗老年人稳定性心绞痛疗效观察

目的观察曲美他嗪对稳定性心绞痛的疗效及安全性。方法95例老年稳定性心绞痛患者按自愿分为2组,治疗组50例,对照组45例,对比观察曲美他嗪的抗心绞痛作用及24 h心电图心肌缺血负荷改善情况。结果抗心绞痛治疗组显效率84.0%,对照组62.2%,2组比较有显著差异(P<0.05);心肌缺血总负荷在治疗3~6个月后明显改善,2组对比有明显差异(P<0.01);未发现有特别不良反应。结论曲美他嗪治疗稳定性心绞痛安全有效。     

曲美他嗪治疗老年冠心病患者的临床疗效观察

目的探讨曲美他嗪治疗老年冠心病的临床疗效。方法将80例已经使用β受体阻滞剂和阿司匹林肠溶片等常规规治疗有仍有心绞痛发作的老年患者随机分为观察组(40例)和对照组(40例),观察组在常规治疗基础上加用曲美他嗪片,对照组在常规治疗基础上加用硝酸异山梨酯片,治疗3月,统计分析比较两组患者的临床疗效。结果观察组心肌缺血指标(每月心绞痛发作次数、每次发作时间、ST段下移幅度)、临床疗效均显著优于对照组(P<0.05)。结论曲美他嗪治疗老年冠心病具有疗效确切、安全性高等特点。     

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.