肾康注射液与前列地尔联合治疗糖尿病肾病的疗效观察

目的:探讨肾康注射液联合前列地尔治疗糖尿病肾病的临床疗效.方法:选用70例2型糖尿病肾病患者随机分为两组,每组各35人,两组均采用基础治疗.对照组在基础治疗上给予加用川芎嗪治疗,治疗组在基础治疗上加用肾康注射液、前列地尔注射液治疗,观察两组治疗前后肾功能、尿蛋白、血脂的变化.结果:治疗组能显著降低Scr、BUN、Ccr、TC、TG,与治疗前相比差异有统计学意义(P均<0.05),与对照组之间治疗后也有显著差异(P<0.05);对照组治疗后Scr、BUN、Ccr、TC、TG与治疗前相比差异并无统计学意义;两组的24小时尿蛋白排泄量均较治疗前明显降低,差异有统计学意义(P<0.05),但是治疗组较对照组无明显差异.结论:肾康注射液和前列地尔联合能延缓DN慢性肾衰竭的进展,临床疗效满意值得进一步研究.     

前列地尔联合丹红注射液治疗早期糖尿病肾病的临床研究

目的探究前列地尔联合丹红注射液治疗早期糖尿病肾病的疗效观察。方法选取我科住院的早期糖尿病肾病患者71例,分为观察组和对照组。其中对照组患者给予静点前列地尔治疗,观察组在此基础上加用丹红注射液静点,比较观察组与对照组患者的临床治疗效果。结果观察组与对照组治疗总有效率分别为91.43%与66.67%。观察组疗效优于对照组,差异有统计学意义(P0.05)。临床相关指标分析:治疗前两组指标差异无统计学意义(P0.05)。治疗后各指标值均好转,与治疗前相比差异有统计学意义(P0.05),且观察组患者与对照组治疗后各指标值比较差异有统计学意义(P0.05)。结论前列地尔联合丹红注射液治疗早期糖尿病肾病临床效果显著,可有效改善患者尿蛋白,降低血脂水平,改善肾功,值得大力推广并应用。     

氯沙坦联合前列地尔治疗糖尿病肾病临床观察

目的:探讨氯沙坦联合前列地尔治疗糖尿病肾病的疗效.方法:纳入糖尿病肾病患者80例,随机分观察组和对照组各40例.观察组在基础治疗同时,加用氯沙坦和前列地尔治疗;对照组采用基础治疗加氯沙坦治疗.比较两组治疗前后检测空腹血糖(FBG)、尿蛋白定量(UAER)、血肌酐(Scr)、收缩压(SBP)、舒张压(DBP).结果:治疗后观察组和对照组SBP和DBP均明显低于治疗前,差异有明显统计学意义(P＜0.05);观察组和对照组自身治疗后UAER与治疗前比较均明显降低(P＜0.05);观察组治疗后UAER明显低于对照组(P＜0.05).结论:氯沙坦联合前列地尔治疗糖尿病肾病,能有效降低患者的血压、减少尿蛋白,保护肾功能,延缓肾功能恶化.     

前列地尔联合丹红对早期糖尿病肾病患者肾功能及血清炎症因子水平的影响

目的：：探讨前列地尔联合丹红对早期糖尿病肾病患者肾功能及血清炎症因子水平的影响,寻找理想的治疗方式。方法：选择80例早期糖尿病肾病患者,随机分为观察组和对照组各40例,两组患者均给予常规治疗,对照组加用丹红注射液,观察组在对照组基础上加用前列地尔注射液,比较两组患者治疗前后血尿素氮(BUN)、血肌酐(SCr)、β2微球蛋白(β2－MG)、24h尿蛋白定量(24h Upro)、尿白蛋白排泄率(UAER),以及血清白细胞介素－6(IL－6)、白细胞介素－18(IL－18)、肿瘤坏死因子－α( TNF－α)、超敏C反应蛋白( hs－CRP )。结果：治疗前,两组患者BUN、SCr、24h Upro、β2－MG、UAER及血清IL－6、IL－18、TNF－α、hs－CRP 水平相似相似,差异无统计学意义(P>0.05);治疗后,两组患者BUN、SCr、24h Upro、β2－MG、UAER及血清IL－6、IL－18、TNF－α、hs－CRP 水平较本组治疗前均下降,但是观察组下降幅度更显著,差异有统计学意义( P<0.05)。结论：前列地尔联合丹红可以有效改善早期糖尿病肾病患者肾功能,降低炎性因子水平,临床疗效显著,安全性高。     

前列地尔、缬沙坦、肾消方三者联合治疗糖尿病肾病的疗效及对肾功能的影响

目的探讨前列地尔、缬沙坦及肾消方联合治疗糖尿病肾病的疗效及对肾功能的影响。方法选取2017年3月～2018年3月我院住院治疗的糖尿病肾病100例。全部患者根据治疗方法不同分为观察组和对照组,每组50例,两组患者均予控制饮食、运动及皮下注射胰岛素等方法将血糖控制在正常水平。两组均予"肾消方"。对照组患者予缬沙坦胶囊80 mg,每天1次,治疗4周;观察组同时加用前列地尔注射液10μg静注,每天1次,连续治疗4周。治疗后比较两组的临床疗效以及两组患者治疗前后Scr、BUN、UAER水平的变化情况。结果治疗后,观察组患者显效率64.0%、无效率4.0%,总有效率96.0%,对照组患者显效率40.0%、无效率22.0%,总有效率78.0%,两组临床疗效比较差异具有显著性(P0.05)。治疗前,观察组患者的Scr、BUN、UAER水平与对照组比较,差异无显著性(P0.05),治疗后,观察组患者的Scr为(121.6±28.0)μmol/L、BUN为(8.7±1.9)mmol/L、UAER水平为(86.1±12.9)mg/24 h,对照组患者的Scr为(180.6±13.9)μmol/L、BUN为(11.5±2.2)mmol/L、UAER水平为(174.3±16.5)mg/24 h,观察组患者上述各指标分别显著低于对照组,组间比较差异有显著性(P0.05)。结论前列地尔、缬沙坦及肾消方联合治疗糖尿病肾病疗效确切,且能明显改善患者的肾功能,值得临床推广和应用。     

丹红注射液联合前列地尔注射液治疗慢性肾脏病的临床效果研究

目的探讨丹红注射液联合前列地尔注射液在慢性肾脏病患者中的临床治疗效果。方法取2015年1月~2016年10月医院收治的慢性肾脏病患者50例,随机数字法分为对照组(n=25)和观察组(n=25)。对照组采用常规方法治疗,观察组联合丹红注射液、前列地尔注射液治疗,采用酶联免疫吸附试验检测两组治疗前、后肾功能及尿蛋白水平,比较两组临床疗效。结果两组治疗后2周的临床疗效率比较差异有统计学意义(P0.05);观察组治疗后2周的BUN、SCr水平低于对照组(P0.05);观察组治疗后血红蛋白水平高于对照组(P0.05);两组治疗后2周的安全性比较差异无统计学意义(P0.05)。结论慢性肾脏病患者在常规方法基础上联合丹红注射液、前列地尔注射液治疗效果理想,能改善患者肾脏水平,安全性较高,值得推广应用。     

前列地尔联合黄芪治疗糖尿病肾病35例疗效观察

目的:观察前列地尔注射液联合黄芪注射液治疗糖尿病肾病患者蛋白尿和改善肾功能的临床疗效。方法:将60例2型糖尿病合并糖尿病肾病～期患者随机分成治疗组35例,对照组25例,分别给予前列地尔注射液联合黄芪注射液治疗和丹参注射液治疗;14d后观察24h尿蛋白定量(24hU-P)、血浆白蛋白(ALB)、血肌酐(Scr)、血尿素氮(BUN)、内生肌酐清除率(Ccr)的变化。治疗前后各查1次,记录数据进行组内及组间比较。结果:两组蛋白尿均显著下降,治疗组较对照组更显著。两组血ALB均有上升,治疗组有显著性差异,对照组无显著性差异。两组肾功能比较,治疗组Scr、BUN、Ccr明显改善有显著性差异,对照组无显著性差异。结论:前列地尔联合黄芪可显著降低糖尿病肾病的蛋白尿,改善和保护肾功能,使用安全,不良反应少。     

前列地尔在糖尿病肾病中应用的疗效观察

目的:研究前列地尔在糖尿病肾病中的应用价值。方法:选择92例糖尿病肾病患者,分为观察组与对照组,每组46例。在常规治疗基础上,给予对照组洛丁新片治疗,给予观察组前列地尔治疗,观察比较两组BUN、Scr、UAER、SBP、DBP变化情况。结果:经治疗,两组BUN、Scr、UAER、24h尿蛋白定量等指标均显著改善,与治疗前相比,差异有统计学意义(P<0.05);观察组各项指标改善程度优于对照组,组间差异有统计学意义(P<0.05)。结论:前列地尔可有效治疗糖尿病肾病,可在临床推广。     

前列地尔联合百令胶囊对早期糖尿病肾病患者肾功能和血清炎性因子的影响

目的:探讨前列地尔联合百令胶囊对早期糖尿病肾病患者肾功能和血清炎性因子的影响.方法:将84例早期糖尿病肾病患者随机分为观察组和对照组,每组各42例.两组均给予常规治疗,在此基础上,对照组采用前列地尔治疗,观察组则采用前列地尔联合百令胶囊进行治疗.连续治疗2周后,观察两组治疗前后24 h尿蛋白定量(24 h Upro)、血清肌酐(Scr)、血尿素氮(BUN)、尿白蛋白排泄率(UAER)、微球蛋白(β2-MG)等肾功能指标以及白细胞介素-6(IL-6)、白细胞介素-18(IL-18)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)等血清炎性因子水平的变化,并对两组临床疗效进行评价.结果:观察组总有效率明显高于对照组,差异具有统计学意义(P＜0.05);治疗后,两组24 h Upro、UAER、SCr、BUN、β2-MG等肾功能指标均较治疗前明显降低,且观察组各指标明显低于对照组,差异具有统计学意义(P＜0.05);治疗后,两组IL-6、IL-18、TNF-α、hs-CRP水平均较治疗前明显降低,且观察组各指标明显低于对照组,差异具有统计学意义(P＜0.05).结论:前列地尔联合百令胶囊治疗早期糖尿病肾病疗效显著,对患者肾脏具有很好的保护作用,且能有效降低其炎性因子水平,值得临床大力推广和应用.     

缬沙坦联合前列地尔治疗早期糖尿病肾病的效果及对患者肾功能及微炎症反应状态的影响研究

目的:探究缬沙坦联合前列地尔治疗早期糖尿病肾病对患者肾功能及微炎症反应状态的影响。方法:选取2017年1月-2019年4月本院收治的120例早期糖尿病肾病患者为研究对象,依据随机数字表法将其分为对照组与研究组,每组60例。对照组口服缬沙坦胶囊,研究组在对照组基础上联合前列地尔注射液治疗,比较两组治疗前后肾功能指标、微炎症相关指标变化情况,并比较两组治疗效果。结果:治疗后,两组24 h尿蛋白定量、Scr、UAER和BUN水平均低于治疗前,且研究组均低于对照组,差异均有统计学意义(P0.05)。治疗后,两组TNF-α、IL-6和IL-18水平均明显低于治疗前,且研究组均低于对照组,差异均有统计学意义(P0.05)。研究组治疗总有效率为91.67%,显著高于对照组的71.67%,差异有统计学意义(P0.05)。结论:缬沙坦联合前列地尔治疗早期糖尿病肾病,在显著改善肾功能的同时,可以有效降低微炎症相关指标水平,获得理想的治疗效果,值得推广使用。     

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.     

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.     

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.