内镜下药物注射治疗消化性溃疡并出血26例

目的观察内镜下注射治疗联合药物治疗及单纯药物治疗对消化性溃疡并活动性出血患者的疗效。方法采用随机分组将58例经内镜证实有活动性消化道出血患者分为两组，即注射组和药物组。两组患者均以制酸荆治疗，注射组另予1：10000肾上腺素液在渍疡周围注射。结果注射组和药物组比较，有效率，再出血率，手术率，止血时间及住院时间差异均有显著性。结论内镜下药物注射止血治疗消化性溃疡并活动性出血疗效明显优于单纯药物治疗，是其首选治疗方法。     

消化性溃疡活动性出血诊断和治疗分析

目的：对消化性溃疡活动性出血案例进行分析和研究，找出最有效的治愈方法。方法：结合2008年5月-2012年5月在本院进行治疗的80名消化性溃疡活动性出血患者的临床治疗资料，依据治疗方式不同分为两组：药物治疗40例，内镜下注射止血联合药物治疗40例，分析和比较两组的治愈效果差异。结果：采用内镜注射止血联合药物治疗的患者中出血停止者28例，且有效率为90%；只接受药物治疗患者，出血停止者15例，总有效率为70%。结论：采用内镜下注射止血联合药物治疗的方法能够更有效地治愈消化性溃疡活动性出血。     

联合应用肾上腺素和双极电凝与单独应用双极电凝治疗出血性消化性溃疡疗效比较:一项随机对照研究

对于可能发生出血的高危消化性溃疡患者而言,与药物相结合的内镜治疗被认为是标准的治疗方法。本研究比较了注射肾上腺素和双极电凝联用,与单独应用双极电凝治疗高危消化性溃疡出血患者之间的差异。2000年1月至2002年12月,内镜下证实有出血(活动性出血或可见血管)的消化性溃疡患者被随机分为两组。试验组(n=58)在注射肾上腺素后使用电凝治疗,对照组(n=56)仅应用电凝治疗。主要评价指标为:初次止血率和出血复发率。其他评价指标包括:是否需要外科手术来控制出血、是否需要输血、住院时间(d)和30d内的死亡率。联合治疗组的初始止血率明显较高(…     

胃镜下注射去甲肾上腺素联合静注奥美拉唑治疗消化性溃疡活动性出血

目的 探讨胃镜下注射去甲肾上腺素联合静注奥美拉唑治疗消化性溃疡活动性出血的疗效.方法 将67例无严重并发症的消化性溃疡活动性出血患者随机分为两组,在一般治疗的基础上,A组34例,用胃镜下注射去甲肾上腺素联合静注奥美拉唑治疗,B组33例,用静注奥美拉唑联合应用立止血治疗.结果 A组患者再出血率、手术率明显低于B组(P＜0.05);止血时间、住院天数A组明显短于B组(P＜0.05 );两组输血量及住院总费用无明显差异(P＞0.05).结论 胃镜下注射去甲肾上腺素联合静注奥美拉唑治疗消化性溃疡活动性出血的疗效明显优于静注奥美拉唑联合应用立止血,住院总费用未见明显增加,是治疗消化性溃疡活动性出血的首选方法 .     

镜下注射联合静注奥美拉唑治疗消化性溃疡活动性出血的疗效观察

目的探讨胃镜下注射去甲肾上腺素联合静注奥美拉唑治疗消化性溃疡活动性出血的疗效。方法将102例病情大致相似且无严重并发症的消化性溃疡活动性出血患者随机分为A、B、C三组,在一般治疗的基础上,A组采用镜下注射去甲肾上腺素联合静注奥美拉唑治疗,B组采用静注奥美拉唑联合应用立止血治疗,C组采用静注奥美拉唑联合口服去甲肾上腺素治疗。结果A组患者再出血率、手术率、止血时间、住院天数明显低于B组和C组(P<0.05),三组输血量及住院总费用无明显差异(P>0.05)。结论镜下注射去甲肾上腺素联合静注奥美拉唑治疗消化性溃疡活动性出血的疗效明显优于静注奥美拉唑联合应用立止血或静注奥美拉唑联合口服去甲肾上腺素,住院总费用未见明显增加,可作为治疗消化性溃疡活动性出血的首选方法。     

内镜注射肾上腺素与静注洛赛克治疗重症消化性溃疡出血的对比

目的　对比观察内镜注射肾上腺素与静脉注射洛赛克治疗重症消化性溃疡出血的疗效。方法　 6 1例重症消化性溃疡出血随机分成 2组 ,一组内镜注射 1:10 0 0 0肾上腺素 ,另一组静脉滴注洛赛克40mg ,每日 2次 ,同时给予输血、补液 ,均不用其他止血药。观察止血成功率、输血量、1周再出血率、急诊手术率。结果　内镜注射组 2 4h止血成功率 (86 .2 % )高于洛赛克组 (71.9% ) ,48h和 72h时二者相比无明显差别 ,输血量少于洛赛克组 ,1周再出血率、急诊手术率相似。结论　两种治疗对重症消化性溃疡活动性出血均有很好的止血效果 ,内镜注射止血更迅速 ,并可减少输血量     

消化性溃疡出血采用机械止血联合肾上腺素注射与单用肾上腺素注射对比:前瞻性随机试验

背景:在消化性溃疡出血时,对比机械止血联合肾上腺素注射与单用肾上腺素止血的有效性。方法:90例有活动性出血的或未见明显血管出血的消化性溃疡患者,被随机分配至机械止血(23例使用止血夹,22例采用胶圈套扎止血)联合肾上腺素注射止血组或单用肾上腺素止血组。结果:两组患者的基本变量相似。在两组中最初的止血率都达到97.8%(44/45)。所应用的止血夹及胶圈的平均数量分别为2.8(95%CI2.5～3.1)和1.1(95%CI1.0～1.2)。注射肾上腺素的平均量为19.9ml(95%CI19.3ml～20.5ml)。联合应用组再出血的发生率(2/44,4.5%)明显低于单用肾上腺素组(9/44…     

内镜下注射联合电凝治疗消化性溃疡出血的疗效分析

目的:观察内镜下注射联合电凝治疗消化性溃疡出血的疗效,总结临床应用经验。方法:选取收治消化性溃疡出血患者共计62例,按照随机数表法进行分组,对照组(共31例)给予内镜下注射治疗,观察组(共31例)给予内镜下注射联合电凝治疗,记录并比较两组的输血量、止血率、再出血率、中转手术率及住院天数。结果:两组的输血量、止血率、再出血率、中转手术率、住院天数比较,观察组显著优于对照组,差异有统计学意义(P<0.05)。结论:内镜下注射联合电凝治疗消化性溃疡出血的疗效优于单纯注射治疗,值得应用并推广。     

内镜下单纯注射与联合柔和电凝治疗消化性溃疡出血的对比研究

目的:比较内镜下单纯注射与联合柔和电凝治疗消化性溃疡出血的效果。方法:56例消化性溃疡出血患者,按性别、年龄、溃疡部位、内镜Forrest分级匹配随机分为单纯注射组和联合柔和电凝组各28例。单纯注射组:注射1∶10000肾上腺素盐水0.5~1ml,4~6点,直至出血停止,总量<10ml。联合电凝组:局部注射同单纯注射组,选择柔和电凝模式、能量25~30焦耳,每次电凝1~2秒,共2~4次,直至局部变白。结果:联合柔和电凝组与单纯注射组首次治疗止血率分别为100%、92.8%,再次治疗止血率分别为66.7%(2/3)、28.6%(2/7),总止血率分别为96.4%和75.0%;手术率分别为3.6%和25.0%。1周内再出血率为9.3%、19.3%,平均输血量1.4U、3.4U,平均住院日6.3天、8.8天。结论:内镜下联合柔和电凝治疗消化性溃疡出血优于内镜下单纯局部注射。可明显降低再出血发生率,缩短住院天数,减少输血量,是有效的非手术治疗方法。     

内镜下局部注射肾上腺素联合血凝酶治疗消化性溃疡出血的疗效分析

目的 探讨内镜下局部注射肾上腺素联合血凝酶治疗消化性溃疡出血的疗效和安全性。方法 胃镜确诊为消化性溃疡出血、 Forrest分级Ⅰa～Ⅱb的患者共213例,随机分为3组:单独注射血凝酶组 （70例）,单独注射肾上腺素组 （73例）,联合治疗组 （70例）。观察止血有效率、再出血率及不良反应。结果 联合用药较单独用药止血有效率增高 （P=0.017）,再出血率减少 （P=0.039）;且治疗后中上腹疼痛和收缩压增高、心率加快的发生率也较单独用药降低 （P<0.05）。结论 内镜下肾上腺素联合血凝酶局部注射治疗消化性溃疡出血较单独用药显示出更佳的止血效果及安全性。     

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.