心先安佐治婴幼儿急性毛细支气管炎观察及护理

目的探讨心先安在治疗婴幼儿急性毛细支气管炎中的临床疗效及护理方法.方法112例急性毛细支气管炎患儿随机分为治疗组及对照组,在相同的基础治疗条件下,治疗组应用心先安每次2～5 mg/kg,静滴,每天2次.结果治疗组痊愈41例(73.2%),好转10例(17.9%),无效5例(8.9%),总有效91.1%.对照组痊愈34例(60.7%),好转8例(14.3%),无效14例(25%),总有效75%.两组相比差异显著(x2=5.13,P＜0.05).结论心先安佐治婴幼儿急性毛细支气管炎疗效确切,且安全、可靠.细致的观察和护理是治疗成功的关键之一.     

环磷腺苷葡胺治疗76例病毒性心肌炎的疗效观察

目的观察环磷腺苷葡胺治疗76例病毒性心肌炎的临床疗效。方法76例病毒性心肌炎患者随机分为治疗组及对照组,对照组予维生素C、能量合剂等常规治疗,治疗组在常规治疗基础上给予环磷腺苷葡胺180 mg加入5%葡萄糖250 ml静滴,每日1次。结果治疗组痊愈28例(73.68%),好转7例(18.42%),无效3例(7.89%),总有效率为92.10%;对照组痊愈16例(42.10%),好转11例(28.95%),无效11例(28.95%),总有效率为71.05%;两组相比,痊愈率和总有效率差异有统计学意义(P<0.05)。治疗组治疗后心搏出量(SV)、每分钟输出量(CO)、心排血指数(CI)及射血分数(EF)有明显改善,与治疗前比较,差异有统计学意义(P<0.05);与对照组比较,差异有统计学意义(P<0.05)。结论环磷腺苷葡胺治疗病毒性心肌炎疗效确切,且安全、可靠。     

急性病毒性心肌炎80例综合治疗的疗效观察

目的 评价在常规治疗基础上应用1，6-二磷酸果糖（FDP），心先安，黄芪注射液联合治疗急性病毒性心肌炎的疗效。方法 80例急性病毒性心肌炎病人按入院顺序随机分为两组，对照组40例在青霉素，维生素C、病毒唑抗感染及抗病毒治疗基础上辅助加用GIS（10%GS500ml,RI8u-12u，氯化钾1g-1.5g)静滴，1次/天，连用2周，治疗组40例在常规治疗基础上加用FDP5g-10g入注射用水50ml-100ml静滴，1次/天；心先安90mg-150mg，黄芪注射液20ml-40ml入5%GS250ml中缓慢静滴，1次/天，连用1周-2周为1疗程，观察临床症状，体征，心电图，心功能等改变情况。结果 对照组40例显效14例，有效13例，无效12例，死亡1例，总有效率67.5%；治疗组40例显效25例，有效14例，无效1例，总有效率92.9%。经Ridit分析法检验两组疗效差别显。结论 FDP、心先安，黄芪注射液治疗急性病毒性心肌炎能有效预防心衰，减少心律失常发生率，且无任何副作用。是一种安全，有效的治疗方法，值得临床推广。     

中西医结合治疗急性病毒性心肌炎45例疗效观察

目的探讨中西医结合治疗急性病毒性心肌炎的疗效和可行性。方法将77例急性病毒性心肌炎患者随机分为治疗组(45例)和对照组(32例)。对照组:单纯应用西医综合疗法;治疗组在西医治疗的基础上加用黄芪注射液和丹参注射液。比较两组的疗效。结果治疗组:45例中,治愈35例,好转8例,无效2例,总有效率95.56%;对照组:32例中,治愈17例,好转6例,无效9例,总有效率71.88%。两组总有效率比较有统计学意义(χ2=8.56,P<0.01)。结论中西医结合治疗急性病毒性心肌炎明显优于单纯西药治疗。     

银翘散加减治疗小儿风热犯心型病毒性心肌炎临床观察

目的:观察小儿病毒性心肌炎中医治疗临床疗效并分析其机制。方法:将58例病毒性心肌炎患儿随机分为治疗组和对照组,每组各29例,两组均给予一般治疗,治疗组患儿在其基础上给予中药银翘散,并随证加减;对照组给予肌肉注射干扰素、口服辅酶Q10及维生素E,疗程均为4周,疗程结束后观察两组患儿临床疗效及心肌酶谱改善效果。结果:治疗组总有效率(93.1%)显著高于对照组总有效率(75.9%),治疗组心肌酶谱改善效果显著好于对照组,两组差异对比均有统计学意义(P<0.05)。结论:银翘散加减治疗小儿风热犯心型病毒性心肌炎,疗效确切,可广泛应用于临床。     

心先安佐治婴幼儿急性毛细支气管炎观察及护理

目的：探讨心先安在治疗婴幼儿急性毛细支气管炎中的临床疗效及护理方法。方法：112例急性毛细支气管炎患儿随机分为治疗组及对照组，在相同的基础治疗条件下，治疗组应用心先安每次2～5mg／kg，静滴，每天2次。结果：治疗组：痊愈41例（73．2％），好转10例（17．9％），无效5例（8．9％），总有效91．1％。对照组痊愈34例（60．7％），好转8例（14．3％），无效14例（25％），总有效75％。两组相比差异显著（x^2=5．13，P〈0．05）。结论：心先安佐治婴幼儿急性毛细支气管炎疗效确切，且安全、可靠。细致的观察和护理是治疗成功的关键之一。     

中西医结合治疗儿童病毒性心肌炎疗效观察

目的探讨中药黄芪注射液治疗儿童病毒性心肌炎的临床疗效.方法将120例患儿分成治疗组60例,对照组60例.治疗组除常规治疗基础上加用黄芪注射液,每日一次,连用21天.结果治疗组显效36例(60%),有效20例(33%),无效4例(7%);对照组60例,显效8例(13%),有效36例(60%),无效16例(27%).2组治疗效果差异有统计学意义(P<0.05).结论加用黄芪注射液治疗科提高小儿病毒性心肌炎的疗效,值得推广.     

参麦注射液治疗68例小儿病毒性心肌炎的临床疗效观察

目的 探讨参麦注射液治疗小儿病毒性心肌炎的临床疗效.方法 回顾性分析笔者所在医院68例小儿病毒性心肌炎患儿的病例资料,所有患儿均应用参麦注射液进行治疗,2周为1个疗程.结果 68例患儿,治愈63例(92.6%),有效3例(4.4%),无效2例(2.9%),总有效率为97%.所有患儿均未发生明显不良反应.结论 参麦注射液治疗小儿病毒性心肌炎疗效肯定,值得临床推广.     

黄芪治疗儿童病毒性心肌炎疗效观察

目的 探讨黄芪注射液治疗儿童病毒性心肌炎的临床疗效.方法 将住院患病毒性心肌炎的患儿随机分成治疗组和对照组,对照组采用常规治疗,治疗组在常规治疗基础上加用黄芪注射液.结果 治疗组30例,显效18例(60%),有效10例(33%),无效2例(7%);对照组30例,显效4例(13%),有效18例(60%),无效8例(27%),两组结果经χ2检验,χ2=3.92,P＜0.05,治疗组明显优于对照组.结论 黄芪注射液可显著提高治疗病毒性心肌炎的疗效,值得推广.     

黄芪注射液联合病毒唑治疗小儿病毒性心肌炎临床疗效观察

目的:观察黄芪注射液联合病毒唑治疗小儿病毒性心肌炎的临床疗效。方法:选择78例病毒性心肌炎患儿,随机分为观察组和对照组,各39例。在常规治疗基础上,对照组给予单纯病毒唑治疗,观察组给予黄芪注射液联合病毒唑治疗。比较两组患者心肌酶谱值改善情况、治疗效果和不良反应发生情况。结果:观察组心肌酶谱值改善较对照组明显。对照组患儿治疗总有效率为74.36%,观察组患儿治疗总有效率为92.31%;观察组治疗总有效率明显高于对照组,差异具有统计学意义(P<0.05)。两组患者治疗过程中均未出现严重药物不良反应。结论:黄芪注射液联合病毒唑治疗小儿病毒性心肌炎效果较好,可有效降低心肌酶谱值,安全性高。     

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.