米非司酮配伍雷公藤多甙治疗子宫肌瘤的远期疗效观察

目的 观察米非司酮配伍雷公藤多甙治疗子宫肌瘤的远期疗效.方法 将90例子宫肌瘤患者,随机分为3组.组1,雷公藤多甙组30例,每天口服雷公藤多甙40rag,连服3个月;组2,米非司酮组30例,每天口服米非司酮25mg,连服3个月;组3,联合用药组(米非司酮+雷公藤多甙)30例,每天口服米非司酮10mg+雷公藤多甙20mg,连服3个月.比较3组治疗期间和停药3个月时的子宫及肌瘤体积和月经恢复情况.结果 三组患者临床症状均有明显改善.以子宫肌瘤缩小25.0%以上为有效,组1有66.7%,组2有73.3%,组3有93.3%,三组比较差异有统计学意义(P<0.05).停药3个月时组3的月经改善情况和子宫肌瘤变化优于组1和组2.结论 米非司酮配伍雷公藤多甙治疗子宫肌瘤远期疗效较单用米非司酮或雷公藤多甙更为安全有效,值得在临床推广应用.     

米非司酮联合桂枝茯苓胶囊治疗子宫肌瘤的临床疗效分析

目的米非司酮联合桂枝茯苓胶囊治疗子宫肌瘤的临床疗效。方法选取2004年1月至2008年1月在本院确诊为子宫肌瘤患者136例,随机分为两组,分别给予单纯米非司酮和米非司酮联合桂枝茯苓胶囊进行治疗。米非司酮组每次睡前口服25mg,每天1次,连服3个月。联合用药组在服用米非司酮的基础上每次口服桂枝茯苓胶囊4粒,每天3次,连服3个月。治疗前后监测血中激素水平及子宫肌瘤大小。结果用药后两组患者的临床症状均减轻或消失,子宫肌瘤缩小,不良反应发生率无显著性差异,但激素水平差异明显,联合用药组停药后短时间内月经完全恢复正常,临床疗效和远期疗效优于单纯米非司酮组。结论米非司酮联合桂枝茯苓胶囊能提高子宫肌瘤的治疗效果。     

米非司酮配伍消结安胶囊在子宫肌瘤治疗中的应用

目的:探讨米非司酮配伍消结安胶囊治疗子宫肌瘤的临床疗效。方法:回顾性分析我院136例子宫肌瘤患者的治疗史,一组口服米非司酮片,另一组口服米非司酮片加消结安胶囊。随访观察两组疗效,并比较两组间疗效差异。结果:两组患者临床症状均有改善,子宫及子宫肌瘤体积均缩小,米非司酮配伍消结安治疗后子宫肌瘤体积缩小更明显(P<0.05),有效率为92.65%,较单纯用米非司酮的有效率高(P<0.05)。联合用药明显改善贫血症状,可延缓子宫肌瘤的复发。结论:米非司酮配伍消结安胶囊治疗子宫肌瘤患者效果明显,值得在临床推广应用。     

米非司酮联合桂枝茯苓胶囊治疗子宫肌瘤疗效分析

目的:研究米非司酮联合桂枝茯苓胶囊治疗子宫肌瘤的临床疗效。方法:122例子宫肌瘤患者随机分为两组,对照组每次口服米非司酮10 mg,每天1次,连服3个月。观察组每次口服米非司酮10 mg,每天1次,同时口服桂枝茯苓胶囊4粒,每天3次,连服3个月。治疗前后监测血中激素水平及子宫肌瘤大小。结果:用药后两组患者的临床症状均减轻或消失,血红蛋白上升,子宫肌瘤平均体积均明显缩小,血清性激素水平明显下降,观察组疗效明显优于对照组(P<0.05)。结论:米非司酮联合桂枝茯苓胶囊能降低子宫肌瘤的复发率,提高治疗效果。     

探讨米非司酮配伍内美通与长效GnRH-a治疗子宫肌瘤的比较

目的探讨米非司酮配伍内美通与长效促性腺激素释放激素（长效GnRH-a）治疗子宫肌瘤的临床效果及副作用。方法将200例确诊为子宫肌瘤患者,随机分为两组,GnRH-a组100例,每隔4周皮下注射长效GnRH-a3.75mg,共3次;米非司酮组100例,每天口服米非司酮12.5mg,同时口服内美通2.5mg,每周2次,连服3个月,治疗前后B超监测子宫体积、肌瘤体积;检测血红蛋白,肝肾功能,观察服药后的副反应。结果两组患者临床症状明显改善,血红蛋白上升。治疗期间所有病人均闭经。肌瘤明显缩小,GnRH-a组肌瘤平均体积缩小42.3%,米非司酮配伍内美通组肌瘤平均体积缩小56.2%。两组治疗效果相比,差别有显著性（P〈0.01）。停药后多数病人月经逐渐恢复,月经复潮时间以米非司酮配伍内美通组较迟,肌瘤复发以GnRH-a组较快。结论长效GnRH-a和米非司酮配伍内美通对治疗子宫肌瘤均安全有效,但米非司酮配伍内美通更有效。因停药后均易复发,适合于术前或围绝经期用药,无法完全替代手术治疗。     

米非司酮配伍甲基睾丸素治疗子宫肌瘤的临床观察

目的观察米非司酮配伍甲基睾丸素的临床效果。方法48例子宫肌瘤患者随机分成两组。A组:每天口服米非司酮12.5 mg;B组:每天口服米非司酮12.5 mg,同时口服甲基睾丸素5 mg,从月经周期第1天开始,连服3 个月。在治疗前后B超测量子宫及肌瘤体积;查血红蛋白、肝肾功能。结果两组患者治疗期间均闭经。平均血红蛋白上升。用药3个月后,两组子宫及肌瘤体积均缩小,B组子宫及肌瘤体积缩小更明显,两组之间差异有显著性(P<0. 01)。结论单用米非司酮及配伍甲基睾丸素治疗子宫肌瘤均有较好的临床效果,米非司酮配伍甲基睾丸素是更理想的方法。     

米非司酮治疗子宫肌瘤的效果分析

目的 探讨米非司酮治疗子宫肌瘤的效果。方法 自2001年1月～2003年3月采用米非司酮治疗子宫肌瘤82例,用药方法 从月经第5天开始口服米非司酮25mg,每晚1次,共30天,第31天至90天每晚服米非司酮12.5mg,3个月为一疗程,停药后待出现第二次转经再继续每天服用米非司槽12.5mg,连服3个月经周期。82例均服完2个疗程。结果 肌瘤完全消失19例,肌瘤缩小50例,总有效率为84.1％,子宫肌瘤平均体积缩小44.9％,未发现肌瘤体积增大者。无明显不良反应。结论 米非司酮是治疗子宫肌瘤较理想的一种方法。     

米非司酮与桂枝茯苓胶囊治疗子宫肌瘤的临床疗效分析

目的比较米非司酮和桂枝茯苓胶囊治疗子宫肌瘤的临床疗效。方法选择2004年1月至2006年1月在本院确诊为子宫肌瘤患者126例，随机分为两组，分别给予米非司酮和桂枝茯苓胶囊进行治疗。米非司酮组每次睡前口服25mg，每天1次，连服3个月。桂枝茯苓胶囊组每次口服4粒，每天3次，连服3个月。治疗前后监测血中激素水平及子宫肌瘤大小。结果用药后两组患者的临床症状均减轻或消失，子宫肌瘤缩小，临床疗效无差异。桂枝茯苓胶囊组未见不良反应，米非司酮组存在一定的不良反应，但降低雌激素作用明显。结论米非司酮与桂枝茯苓胶囊在治疗子宫肌瘤方面各有优势。     

米非司酮治疗子宫肌瘤临床疗效观察

目的 探讨米非司酮治疗子宫肌瘤的疗效.方法 对愿意接受米非司酮治疗的子宫肌瘤患者,每天口服米非司酮12.5 mg.4个月为一疗程,接受复查.结果 口服米非司酮可引起闭经、改善贫血;停药后月经复潮;可使经量减少、经期缩短;子宫体积和肌瘤体积缩小;部分更年期妇女用药后进入绝经期.结论 米非司酮是治疗子宫肌瘤的有效药物.     

米非司酮治疗子宫肌瘤65例临床观察

目的 探讨米非司酮治疗子宫肌瘤的临床效果.方法 65例确诊为子宫肌瘤患者,从月经来潮第1天开始口服米非司酮12.5mg/d,连服3个月为一疗程,用药一疗程后停药.用药前后以彩色多普勒超声测量子宫及肌瘤大小、测定血清雌二醇孕酮血常规肝功能.结果 治疗期间所有患者出现闭经,一疗程结束后,子宫体积及肌瘤平均体积缩小,E2、P水平亦有显著下降.停药随访一年,30例患者肌瘤增大.结论 米非司酮治疗子宫肌瘤有一定疗效,但停药后易复发.     

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.