尿激酶血管内灌注介入治疗下肢深静脉血栓形成

目的 探索下肢深静脉血栓形成介入溶栓治疗的疗效。方法 对9例下肢深静脉血栓形成患者行介入治疗，利用溶栓导管将大量尿激酶灌注到血栓内或血栓形成远端，进行直接溶栓治疗。结果 9例患肢肿胀与疼痛均完全消失，3周后彩色多普勒复查，下肢静脉完全通畅8例，部分通畅1例，无效0例；所有患者溶栓过程中均未出现肺动脉栓塞症状。结论 利用介入技术将大量尿激酶灌注到血栓内或血栓形成远端，治疗下肢深静脉血栓形成疗效高、疗程短。     

骨科创伤术后患者并发下肢深静脉血栓的临床观察

目的：探讨骨科创伤术后患者并发下肢深静脉血栓的临床特点及其干预措施。方法：随机选取我院2010年2月～2013年9月期间收治的确诊为下肢深静脉血栓的骨科创伤术后患者60例,将其随机平均分配为试验组和对照组,其中对照组患者采用常规药物治疗,试验组患者在对照组患者的治疗基础上给予其超声消融介入治疗,对比2组患者的临床效果。结果：试验组患者的下肢深静脉血栓消失时间及临床治疗效果明显优于对照组患者,差异具有显著性（P＜0．05）。结论：在常规治疗基础上,给予骨科创伤术后并发下肢深静脉血栓患者超声消融等积极治疗,有助于改善患者的临床症状,促进患者术后恢复,具有十分积极的临床意义。     

下肢深静脉血栓形成HR分型对介入溶栓疗效的价值分析

目的探讨下肢深静脉血栓形成MR1分型对介入溶栓疗效的价值分析。方法收集我院20092012年80例下肢深静脉血栓形成病者资料进行回顾分析,所有患者均通过MRI检查确定血栓的急性、亚急性、慢性分型,并于48小时内进行DsA介入溶栓治疗。结果80例下肢深静脉血栓形成的MRl分型：急性42例,介入溶栓完全再通率为95．24％;亚急性23例,介入溶栓完全复通率为78．26％;慢性15例,介入溶栓完全复通率为60．0O％。MRI血栓分型与DsA溶栓复通疗效比较差异有统计学意义（X2=13．79,P〈0．005）。培论下肢深静脉血栓形成MRl分型,可作为DsA介入溶栓的量化指标之一,对临床治疗方案的选择有十分重要的指导意义,是值得推广。     

创伤后下肢深静脉血栓形成的临床特点和治疗

目的：探讨创伤后下肢深静脉血栓形成（deep venous thrombosis，DVT）的临床特点与治疗方法；方法：回顾性分析2001年1月——2005年1月49例（年龄33—72岁，平均53岁）创伤后下肢深静脉血栓形成患者临床资料；结果：全组损伤严重度评分（ISS）为19．54±9．65．下肢无创伤组27例，手术取栓7例。死亡1例，溶栓治疗20例；随访16例（1～5年），症状复发率分别为12．5％、30％、37．5％、33．3％、40％。下肢有创伤组22例。2例因股静脉损伤行手术治疗，溶栓治疗20例；随访15例（1～5年），症状复发率分别为6．7％、14．3％、15．4％、18．2％、25％。结论：创伤后下肢深静脉血栓形成多见于严重创伤患者，应接有无下肢合并伤分为二种类型。合并下肢损伤者溶栓治疗效果良好；及早诊断是挽救肢体、减少远期并发症的关键。     

介入腔内溶栓综合治疗下肢深静脉血栓形成35例分析

目的探讨下肢深静脉血栓形成（DVT）行介入腔内溶栓、抗凝综合治疗的疗效。方法35例DVT在数字减影血管造影（DSA）下放置下腔静脉滤器,腔内导管直接插入静脉血栓处,冲击、持续注入尿激酶溶栓,术后患肢末端静脉输注尿激酶溶栓,联合静脉抗凝综合治疗。结果35例患者,25例血栓完全消失,7例血栓部分残留,3例无改变;治疗结束时肢体健患侧周径差明显缩小;总治愈率达91．4％;与对照组比较有显著性差异（P〈0．01）。治疗过程中未出现严重并发症。结论采用介入腔内溶栓综合治疗DVT疗效好而且安全。     

尿激酶不同途径应用对下肢深静脉血栓的疗效观察

目的 观察不同途径应用尿激酶溶栓对下肢深静脉血栓的疗效及其安全性。方法 72例下肢深静脉血栓形成患者随机分成两组：A组40例，按常规输液途径应用尿激酶溶栓；B组32例，从患肢足背静脉输入，并在踝上l0cm扎止血带。结果 两组超声检查总有效率分别为97．5％和100．0％，统计学结果无显著性差异（P＞0．05）。结论 常规途径应用尿激酶溶栓安全、方便、有效。     

下肢深静脉血栓手术取栓与介入溶栓的疗效比较

目的：探讨下肢深静脉血栓碎栓溶栓与介入溶栓的临床疗效。方法：回顾性分析我院2006年6月~2010年3月收治的64例下肢深静脉血栓患者临床资料。根据我院采用的治疗方法不同,将其分为对照组和观察组。对照组40例给予碎栓溶栓,观察组24例给予介入溶栓治疗。比较两组的临床疗效、并发症及住院时间。随访1年后,比较两组的复发率和后遗症。结果：与对照组相比,观察组的治愈率和总有效率高于对照组（62.50%vs 37.50%,95.83%vs 82.50%）,差异均有高度统计学意义（χ2=53.94、90.65,均P〈0.01）,无效率及并发症发生率低于对照组（4.17%vs 17.50%,9.38%vs 37.50%）,差异均有高度统计学意义（χ2=22.95、37.28,均P〈0.01）,观察组的住院时间和复发率低于对照组[（7.9±3.8）d vs（15.3±5.9）d,0 vs 12.50%],差异均有统计学意义（t=2.854,χ2=12.96;均P〈0.05）。结论：介入置管溶栓术治疗下肢深静脉血栓,临床疗效显著,并发症少,复发率低,值得在基层医院推广应用。     

下肢深静脉血栓介入溶栓治疗中开展围术期护理干预的效果

目的：评价下肢深静脉血栓介入溶栓治疗中开展围术期护理干预方案的临床有效性。方法：采取随机法选择该院2014年4月至2015年12月接收的66例下肢深静脉血栓患者,随机分成2个组：Ⅰ组共33例,接受介入溶栓治疗＋围术期护理干预;Ⅱ组共33例,接受介入溶栓治疗＋围术期一般护理,观察两组入选患者疗效及预后情况,并进行客观比对。结果：所有入选患者均配合完成护理工作,Ⅰ组住院时长（14.95±4.00）d,Ⅱ组（27.06±4.15）d,且Ⅰ组并发症发生几率比Ⅱ组低,Ⅰ组护理效果有优势（P ＜0.05）。结论：在下肢深静脉血栓介入溶栓治疗中,开展围术期护理干预方案具有可行性,可促进患者康复,建议推广。     

瑞替普酶治疗下肢深静脉血栓的疗效观察

目的：探究瑞替普酶治疗下肢深静脉血栓形成的临床效果。方法选取2010年2月～2013年11月来濮阳市人民医院进行下肢静脉血栓治疗的患者40例为研究对象，根据治疗方法的不同，将所有患者分为治疗组与对照组（n=20）。2组患者均行静脉造影，治疗组给予重组人组织型纤溶酶原激酶衍生物18 mg＋40 mL氯化钠溶液静脉滴注，时间控制在1 h，12 h后重复给药1次。对照组给予尿激酶30万U＋40 mL氯化钠注射液静脉滴注，时间控制在1h，每日3次，待患者血栓消融后进行DSA检查，对比2组患者治疗后血管的通畅度、溶栓所需的时间、并发症的发生情况。结果2组患者经治疗后比较大腿径减少（t=22.0000，P=0.0000）；小腿径减少（t=10.3975，P=0.0000）；溶栓时间、经溶栓后纤维蛋白原、治疗后血管通畅度一级、二级比较差异均有统计学意义（t=4.9948，P=0.0000；t=3.7210，P=0.0006；χ2=5.4444，P=0.0196；χ2=4.1786，P=0.0409），三级比较差异无统计学意义。穿刺点出血的治疗组2例，对照组3例，经压迫后未再出血；血尿的治疗组0例，对照组2例。无其他严重不良反应发生。结论使用瑞替普酶治疗双下肢静脉血栓，血管的通畅度良好，溶栓的速度较快，且无严重不良反应发生。     

外周静脉加压溶栓联合医用弹力袜治疗下肢深静脉血栓形成护理研究

目的对下肢深静脉血栓形成护理及治疗两种不同方法的分析研究证明,外周静脉加压溶栓联合医用弹力袜治疗较常规外周静脉溶栓治疗有更好的疗效和预后。方法将本院2008年3月－2009年12月住院治疗的54例下肢深静脉血栓形成患者随机分成常规静脉治疗组和外周静脉加压溶栓联合医用弹力袜治疗组,通过两组患者的症状缓解时间、出院一年后血栓形成后遗症出现率的比较分析,研究两种治疗疗效的差异。结果外周静脉加压溶栓联合医用弹力袜治疗组患肢疼痛、水肿、皮肤色斑等症状开始出现缓解的时间在（3±1．2）天,各种症状完全消失的时间在（6．8±2．3）天,较常规治疗组缓解时间明显提前（P〈0．05）;出院1年后患肢出现血栓形成后遗症的比率为（11±1．3）％,较常规治疗组明显降低（P〈0．05）。结论外周静脉加压溶栓联合医用弹力袜治疗及护理较常规外周静脉溶栓治疗及护理有较好的疗效及临床预后。     

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.     

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.     

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.