乌拉地尔治疗高血压急症的疗效观察

目的:观察静脉注射剂乌拉地尔对高血压急症的疗效。方法:选择89例高血压急症女性患者,静脉使用乌拉地尔治疗,并记录用药后5min、0.5h、1h、2h、4h、6h、12h及24h血压及心率。结果:89例患者在用药后5min内血压明显下降,收缩压由(218.2±14.7)mmHg降至(201±13.3)mmHg(1mmHg=0.133kPa),P<0.01,舒张压由(119.3±6.7)mmHg降至(109.7±5.4)mmHg,P<0.01。显效率100%。仅有2例出现头晕,但可耐受。结论:静脉使用乌拉地尔降低血压起效迅速、疗效肯定、使用安全、简单、副作用轻微,可作为高血压急症的首选药。     

乌拉地尔治疗老年高血压急症

目的 :观察乌拉地尔治疗老年高血压急症的降压作用。方法 :对 47例高血压急症患者给予乌拉地尔 12 .5～ 2 5mg加生理盐水 10ml稀释后 3～ 5分钟内静注 ,必要时 10分钟后再重复注射 1次 ,然后将 5 0mg乌拉地尔加入 2 5 0ml液体中以 0 .1～ 0 .4mg/min速度静滴 ,观察用药后 5min、15min、30min、1h、2 4h血压、心率变化 ,同时记录用药量、临床表现和不良反应。结果 :给药后 5min血压开始下降 (P <0 .0 5 ) ,至 6 0min降至理想血压 (P <0 .0 1) ,总有效率 10 0 %。心率随血压下降而减慢 (P <0 .0 5 )。结论 :乌拉地尔降压作用迅速而平稳 ,剂量容易掌握 ,不良反应少 ,可以作为老年高血压急症的首选降压药     

乌拉地尔治疗高血压急症的疗效观察

目的观察静脉注射剂乌拉地尔对高血压急症的疗效.方法选择89例高血压急症女性患者,静脉使用乌拉地尔治疗,并记录用药后5min、0.5h、1h、2h、4h、6h、12h及24h血压及心率.结果89例患者在用药后5min内血压明显下降,收缩压由(218.2±14.7)mmHg降至(201±13.3)mmHg(1mmHg=0.133kPa),P＜0.01,舒张压由(119.3±6.7)mmHg降至(109.7±5.4)mmHg,P＜0.01.显效率100%.仅有2例出现头晕,但可耐受.结论静脉使用乌拉地尔降低血压起效迅速、疗效肯定、使用安全、简单、副作用轻微,可作为高血压急症的首选药.     

乌拉地尔静脉注射治疗高血压急症的疗效观察

目的：观察乌拉地尔静脉注射治疗高血压急症的疗效及安全性。方法：22例高血压急症患者静脉注射乌拉地尔25mg(5min内）、随后以100－200μg/min静滴维持，观察用药前后血压、心率变化。结果：用药后5min血压明显下降，30min达到高峰并维持稳定，有效率100％，心率无明显变化。结论：乌拉地尔治疗高血压急症降压效果确切，副作用少，不影响心率。     

盐酸乌拉地尔治疗高血压急症40例临床疗效及安全性的观察

目的:评估盐酸乌拉地尔治疗高血压急症的临床疗效及安全性。方法:选取本院2010年12月1日～2011年11月31日1年内急诊及ICU重症高血压患者40例,其中男性26例,女性14例,给予盐酸乌拉地尔静滴或静推等治疗,观察用药后15、30、60、120 min的血压,心率变化及不良反应。结果:与用药前比较,用药后15、30、60、120 min的收缩压,舒张压明显下降,差异有统计学意义(P<0.05)。用药前后,心率略减慢,有差异但无统计学意义。其中有3例有头晕及恶心等不良反应,均能耐受。治疗后27例显效,12例有效,1例无效。结论:乌拉地尔治疗高血压急症疗效快,显效率高,不良反应轻微,可作为高血压急症的首选用药。     

乌拉地尔和硝普钠治疗高血压急症的疗效观察

目的观察经微量泵静脉注射乌拉地尔和硝普钠治疗高血压急症的疗效。方法高血压急症84例随机分为乌拉地尔治疗组(n=43)和硝普钠对照组(n=41),两组经微量注射泵持续给药,盐酸乌拉地尔组:盐酸乌拉地尔100mg稀释于50ml生理盐水中微泵静脉注射,据血压调整速度。硝普钠组50mg加入5%葡萄糖50ml,0.25μg/kg·min开始,5min监测血压1次,据血压调整给药剂量;记录血压、心率、心电图等资料。结果盐酸乌拉地尔组43例(97.7%)显效,30min内收缩压从治疗前的(203.3±15.5)mmHg降至(167.2±16.4)mmHg(P<0.05),舒张压也显著下降[(124.6±13.9)mmHg∶(103.0±15.8)mmHg,P<0.05];两组显效率有显著差异(97.7%∶82.9%,P<0.05)。结论静脉应用盐酸乌拉地尔降血压疗效肯定,使用安全,副作用少,可作为高血压急症的首选药物。     

高血压患者行腹部急诊手术的麻醉处理

目的:探讨联合应用盐酸乌拉地尔和硝酸甘油治疗中重度高血压患者行上腹部全身麻醉急诊手术时控制血压的疗效和安全性。方法:ASA2~3级高血压患者25例,于诱导插管前及术毕拔管前,静注盐酸乌拉地尔,分别观察静注后至20 min时收缩压(SBP)、舒张压(DBP)、心率(HR)的变化。术中观察泵注硝酸甘油至60 min及停药后至30 min,SBP、DBP、HR的变化。结果:诱导插管前静注药物后2 min,SBP、DBP即显著下降,HR无明显改变,术毕拔管前静注药物后,SBP、DBP,显著下降,且维持至20 min。术中泵注硝酸甘油时,SBP、DBP显著下降,且维持至停药后30 min,而HR无显著改变。结论:联合应用乌拉地尔及硝酸甘油能有效控制血压,维持全麻诱导、拔管时血压、心率的平稳,维持术中血流动力学的稳定。     

乌拉地尔治疗高血压急症20例的疗效观察

1998年以来,我们用乌拉地尔治疗高血压急症20例,取得了较显著的降压效果,现报道如下。1　资料与方法11　一般资料　本组男性12例,女性8例。年龄45～72岁。均为高血压急症患者,其中高血压脑病15例,高血压危象4例,高血压性心脏病并急性左心衰1例。12　用药方法　乌拉地尔125～25ｍｇ用5%葡萄糖溶液10ｍＬ稀释后静注(3～5ｍｉｎ),必要时20ｍｉｎ后可重复1次。血压降至满意水平后将乌拉地尔50ｍｇ加入250ｍＬ葡萄糖液中以(01～02)ｍｇ/ｍｉｎ维持静滴,视患者血压水平调整输液速度,一般4～6ｈ后可用口服药物维持治疗。并同时根据高血压所致器官受…     

静脉应用乌拉地尔对老年高血压急症36例临床观察

目的观察静脉应用乌拉地尔对老年高血压急症的临床疗效.方法对36例老年高血压急症患者,采用乌拉地尔首次剂量25mg加入生理盐水20ml中静脉推注(时间＞15min),随后用100mg加入5%葡萄糖液或生理盐水250ml缓慢静滴,以10-30mg/h速度,根据血压调控滴速,连续心电监护,于用药前和用药后5、10、15、30 min及1、2、4、6h记录血压、心率及观察其不良反应.结果用药后5min时显效77.7%(28/36),30min时有效16.6%(6/36),总有效率94.4%.用药前后对比血压差异显著(P＜0.01),心率差异无显著变化(P＞0.05),未见明显不良反应.结论静脉应用乌拉地尔治疗老年高血压急症,起效快、降压平稳安全、疗效好,可作为急诊救治老年高血压急症的首选药物之一.     

乌拉地尔治疗老年人高血压急症首次剂量的选择

目的　观察乌拉地尔治疗老年人高血压急症的降压效果以及首次剂量的选择。方法　将 15 5例高血压急症患者随机分为两组 :A组 74例 ,将盐酸乌拉地尔首剂 2 5 0mg加入 0 9%氯化钠溶液 10ml中稀释后于 3～ 5min内静注。B组 81例 ,将乌拉地尔首剂 12 5mg加入 0 9%氯化钠溶液 10ml中稀释后于 3～ 5min内静注。观察两组患者用药前、用药后 30min血压、心率 (HR)的变化情况 ,同时记录用药量、临床表现和不良反应。结果　首次静脉注射2 5 0mg和 12 5mg的乌拉地尔疗效相当 ,而首次静脉注射 12 5mg组低血压发生率明显低于 2 5 0mg组 ,两组降压后心率降低不明显。结论　乌拉地尔降压作用迅速而平稳 ,不良反应少 ,常作为老年高血压急症的首选降压药 ,治疗的首次剂量以 12 5mg为宜。     

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.