口服山莨菪碱治疗婴幼儿轮状病毒肠炎疗效观察

目的探讨观察口服山莨菪碱辅助婴幼儿轮状病毒肠炎的临床疗效。方法222例患者随机分成两组，对照组（114例）采用补液、抗病毒、口服思密达、双歧杆菌、合理饮食、对症治疗；治疗组（108例）在上述治疗基础上加口服山莨菪碱片0．1—0．2mg／（kg·次），2次/d），两组疗程均为5～7d。结果治疗组108例中显效24例（22．2％），有效69例（63．9％），无效15例（13．9％），总有效率93％；对照组114例中，显效27例（23．7％），有效45例（39．5％），无效42例（36．8％），总有效率63．2％，治疗组与对照组比较差异有统计学意义（P〈O．05）。结论口服山莨菪碱片治疗婴幼儿轮状病毒肠炎有明显疗效。     

消旋卡多曲颗粒治疗婴幼儿轮状病毒性肠炎70例疗效观察

目的观察消旋卡多曲颗粒治疗婴幼儿轮状病毒性肠炎的疗效。方法将140例轮状病毒性肠炎患儿随机分为治疗组与对照组各70例，2组均给予补液、调整饮食、口服蒙脱石散等综合治疗，治疗组在此基础上给予消旋卡多曲颗粒口服，疗程3d。结果治疗组应用消旋卡多曲颗粒后，能显著缩短腹泻控制时闯和总病程，治疗组总有效率达92．9％，明显高于对照组72．9％，2组比较差异有统计学意义（P〈O．01）。结论消旋卡多曲颗粒治疗婴幼儿轮状病毒性肠炎疗效显著，无明显毒副作用，值得临床推广。     

口服补锌辅助治疗婴幼儿轮状病毒肠炎临床观察

目的观察口服补锌辅助治疗婴幼儿轮状病毒性肠炎的临床疗效,探讨其作用原理。方法将116例轮状病毒性肠炎婴幼儿随机分成治疗组和对照组,两组都给予常规治疗,治疗组加用口服补锌（葡萄糖酸锌）,观察其疗效。结果治疗组总有效率（82.8%）明显高于对照组（53.5%）,平均腹泻停止时间观察组较对照组明显缩短,差异均有显著性意义（x2=11.47,P〈0.01）。结论常规治疗的基础上进行补锌辅助治疗对轮状病毒肠炎患儿有明显的疗效。     

苍葛止泻灵治疗婴幼儿轮状病毒肠炎临床观察

目的：观察苍葛止泻灵治疗婴幼儿轮状病毒肠炎的临床疗效。方法：将190例婴幼儿轮状病毒肠炎（IRVE）的患儿随机分为苍葛止泻灵治疗组110例（其中湿热泄治疗组74例，寒湿泻治疗组36例），思密达对照组70例（其中湿热泻对照组40例，寒湿泻对照组30例，进行临床观察。结果：痊愈率湿热泻治疗组为866．49％，对照组为50．00％，2组结果有显著性差异（P＜0．01），同时在消除发热、上感症状、食欲不振以及轮状病毒转阴等方面治疗组均优于对照组。寒湿泻治疗组痊愈率为83．33％，对照组为80．00％，2组结果无显著性差异。但在上感症状、食欲不振以及轮状病毒转阴等方面治疗组均优于对照组。结论：表明苍葛止泻灵是治疗婴幼儿轮状病毒肠炎的有效方药。     

思密达＋利巴韦林保留灌肠治疗婴幼儿轮状病毒性肠炎

目的探讨思密达＋利巴韦林保留灌肠治疗婴幼儿轮状病毒性肠炎的疗效。方法200例轮状病毒性肠炎患儿随机分为对照组、思密达口服组、思密达＋利巴韦林保留灌肠组及利巴韦林组，在对照组常规治疗的基础上，思密达口服组给予思密达口服；思密达＋利巴韦林灌肠组将思密达3g＋利巴韦林10～15mg／（kg·d）溶于15mL生理盐水保留灌肠，1次／d，连用3d；利巴韦林组将利巴韦林10～15mg／（kg·d）溶于5％葡萄糖溶液中静脉滴注，1次／d；观察各组发热、呕吐、腹泻、脱水等临床表现消失时间，并比较疗效。结果治疗72h后对照组、思密达口服组、思密达＋利巴韦林保留灌肠组及利巴韦林组总有效率分别为59．6％、73．9％、91．4％及65．9％。其中思密达＋利巴韦林保留灌肠组总有效率均较其他三组高，差异有统计学意义（P〈0．01或P〈0．05）。思密达＋利巴韦林保留灌肠可明显缩短患儿退热、止吐、止泻及脱水纠正时间。结论在常规治疗基础上配合思密达＋利巴韦林保留灌肠治疗婴幼儿轮状病毒性肠炎比常规治疗及常规治疗配合口服思密达或静脉滴注利巴韦林效果好。     

思密达联合妈咪爱治疗婴幼儿轮状病毒肠炎的疗效观察

目的探讨思密达联合妈咪爱治疗婴幼儿轮状病毒肠炎的临床效果。方法将58例轮状病毒性肠炎患儿随机成两组均给予常规治疗,治疗组加用思密达和妈咪爱口服。结果治疗组和对照组治疗6天总有效率分别为93．1％和72．4％,有显著性差异（p〈0．05）。结论思密达联合妈咪爱治疗小儿轮状病毒性肠炎有助于恢复肠道正常微生态和生理功能、安全有效。     

口服免疫球蛋白对轮状病毒肠炎患儿肠道SIgA分泌的影响

目的 了解口服免疫球蛋白对儿童轮状病毒肠炎的临床疗效,探究其对患儿肠道自身分泌型IgA(SIgA)生成的影响。方法 纳入本院确诊的轮状病毒肠炎患儿100例,采用随机对照试验方法分为两组（对照组和口服免疫球蛋白组）,每组50例患儿。在口服蒙脱石散和补液等基本治疗的基础之上,对照组予安慰剂口服,免疫球蛋白组予“抗轮状病毒鸡卵黄IgY”口服治疗。于治疗第1、3、5、7、9、11 d收集患儿大便,定期记录临床症状。采用放射免疫法定量检测大便SIgA水平,双抗体夹心酶联免疫法半定量检测大便轮状病毒排泄量。 结果 治疗1 d后,口服免疫球蛋白组患儿腹泻频次较对照组明显减轻（P<0.05）。口服免疫球蛋白组病程为（4.5±0.92） d,对照组为（5.8±1.68） d,两组差异有统计学意义（P=0.015）。口服免疫球蛋白组患儿大便中SIgA含量在各时间点均高于对照组（P<0.05),口服免疫球蛋白组大便SIgA含量倍增时间在第3 d,对照组在第5 d。口服免疫球蛋白组的大便轮状病毒排泄量在各时间点均低于对照组（P<0.05）。 结论 口服免疫球蛋白能促进机体自身SIgA生成,有益于肠道内轮状病毒的清除,从而快速缓解轮状病毒肠炎临床症状,缩短病程。     

激光液与654-2联合治疗轮状病毒性肠炎的疗效观察

目的：为评价激光辐射葡萄糖液（简称激光液）与６５４—２联合治疗轮状病毒所致婴幼儿腹泻的疗效。方法：用ＥＬＩＳＡ一步法检查大便轮状病毒阳性２岁以下的腹泻患儿１３２例，随机分为治疗组６３例（激光液与６５４—２联合治疗）和对照组６９例（常规治疗）。结果：治疗组总有效率９０．５％，明显高于对照组５２．２％，两者比较有显著意义（ｘ２＝３４．３６，Ｐ＜０．０１）。结论：激光液与６５４—２联合应用是治疗婴幼儿轮状病毒性肠炎安全有效的方法。     

思连康治疗婴幼儿轮状病毒肠炎206例临床分析

目的：探讨思连康治疗婴幼儿轮状病毒肠炎的疗效。方法：206例婴幼儿轮状病毒肠炎患儿随机分为两组,对照组给予静脉滴喜炎平注射液,口服思密达;治疗组在此基础上口服思连康（〈6个月,2次／d,每次1片;～1岁,2次／d,每次2片;～3岁,2～3次／d,每次2片）,观察两组的总有效率、止吐时间、退热时间、止泻时间和总疗程。结果：治疗组总有效率（92．5％）明显高于对照组（78．0％）,退热、止泻、总疗程较对照组明显缩短,差异均有统计学意义（P〈0．05）,两组止吐时间差异无统计学意义（P〉0．05）。结论：思连康对婴幼儿轮状病毒肠炎有良好的疗效,值得临床推广使用。     

消旋卡多曲颗粒治疗婴幼儿轮状病毒性肠炎的疗效观察

目的观察消旋卡多曲治疗婴幼儿轮状病毒性肠炎的疗效。方法我科2009年8月～2010年6月收治住院的122例符合收治标准的婴幼儿轮状病毒性肠炎患儿，随机分为两组，治疗组65例，常规治疗加用消旋卡多曲口服；对照组57例，常规治疗加用蒙托石散口服，两组在性别、年龄、体重、临床表现、病情轻重及常规检验等方面，均无显著性差异（P〉0．05）。结果尽管治疗组总有效率（59／65）为90．77％，高于对照组的（49／57）85．96％，两组间差异无统计学意义（P〉0．05）。然而，消旋卡多曲止泻时间出现早，还能明显缩短病程，两组间差异有统计学意义（P〈0．05）。结论消旋卡多曲治疗婴幼儿急性水样腹泻疗效确切，值得临床推广应用。     

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.     

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.