血必净注射液对脓毒性休克患者心肌损伤的治疗作用

目的探讨血必净注射液对脓毒性休克患者心肌损伤的治疗作用。方法选27例伴有心肌损伤的脓毒性休克患者随机分为对照组（n=13例）和治疗组（n=14例）。对照组常规给予抗感染、液体复苏抗休克、免疫及营养支持等常规治疗;治疗组除了给予常规治疗外,另给予血必净注射液50ml＋0．9％生理盐水100ml静脉点滴,2次／d,连用7d。观察两组治疗前后心肌损伤标志物肌钙蛋白I的变化。结果治疗组与对照组相比,心肌损伤标志物肌钙蛋白I水平明显降低（P〈0．01）。结论血必净注射液能有效改善脓毒性休克患者的心肌损伤。     

血必净辅助治疗脓毒性休克的临床疗效观察

目的探讨血必净注射液辅助治疗脓毒性休克患者的临床疗效。方法将我院收治的脓毒性休克患者46例随机分为观察组和对照组,各23例。所有患者均行常规治疗,观察组在此基础上加用血必净注射液静脉滴注治疗。结果治疗7d后,两组慢性健康状况评分系统II(APACHE II)评分和多脏器功能障碍综合征(MODS)评分均显著下降(P0.01),观察组下降幅度较对照组大(P0.01)。结论血必净注射液辅助治疗脓毒性休克疗效显著。     

血必净注射液在脓毒性休克患者中的效果观察

目的:观察与分析血必净注射液在脓毒性休克患者中的效果。方法:选取2016年7月-2017年4月本院诊治的58例脓毒性休克患者为观察对象,将其随机分为对照组(常规脓毒性休克治疗)29例和观察组(常规脓毒性休克治疗加血必净注射液)29例。比较两组患者的临床总有效率、病死率及治疗前后的氧合指数、乳酸水平、微循环指标。结果:观察组的临床总有效率高于对照组(P<0.05),病死率低于对照组(P<0.05),治疗前两组的氧合指数、乳酸水平及微循环指标差异无统计学意义(P>0.05),而治疗后观察组的氧合指数、乳酸水平及微循环指标均好于对照组(P<0.05)。结论:血必净注射液在脓毒性休克患者中的效果较好,可显著改善患者的氧供与微循环状态。     

血必净注射液治疗脓毒性休克的临床研究

目的探讨血必净注射液治疗脓毒性休克的临床价值。方法选取2009年3月-2012年3月我院52例脓毒性休克患者,观察使用血必净注射液(观察组33例)与未使用血必净注射液(对照组19例)患者的临床疗效及预后情况。结果治疗后观察组HR、体温及WBC明显低于对照组,两组患者治疗后AST、ALT、BUN及Cr水平均有明显下降,观察组治疗72h后AST、ALT、BUN及Cr水平均明显低于对照组;两组患者治疗后PaO2、PaCO2及PaO2/FiO2水平均有明显上升,观察组水平明显高于对照组(P<0.05);观察组死亡率9.1%,明显低于对照组的47.7%。结论血必净注射液治疗脓毒性休克具有菌、毒、炎症介质并治的作用,对降低死亡率、改善预后有积极意义。     

血必净注射液治疗缺氧性肺动脉高压患者的临床研究

目的：探讨血必净注射液治疗缺氧性肺动脉高压的临床疗效。方法：将43例缺氧性肺动脉高压患者随机分为血必净注射液组（22例）和对照组（21例）,两组均给予常规基础治疗,血必净注射液组加用血必净注射液,对照组加用硝苯地平,连续治疗20 d,两组治疗前后测定肺动脉平均压及体循环平均压,并行血气分析及监测血液流变学指标,评价两组治疗前后临床症状、体征积分及疗效,并观察两组不良反应发生情况。结果：治疗后两组肺动脉平均压均较治疗前明显降低（t=3.471、3.050,P〈0.01）,血必净注射液组肺动脉平均压较对照组下降更明显（t=2.302,P〈0.05）;两组治疗前后体循环平均压均无明显变化（P〉0.05）。两组治疗后PaO2及PaCO2均显著改善,血必净注射液组治疗后PaO2及PaCO2较对照组改善显著（P〈0.05）;两组血液流变学指标治疗后均较治疗前有明显改善（P〈0.05）。两组治疗后临床症状、体征积分较治疗前均有明显改善（t=4.582,P〈0.01;t=2.137,P〈0.05）,血必净注射液组较对照组改善更显著（t=3.524,P〈0.01）,且血必净注射液组疗效明显优于对照组（χ2=2.642,P〈0.05）。两组治疗后均未出现明显不良反应。结论：血必净注射液能有效降低缺氧性肺动脉高压患者的肺动脉平均压,改善其临床症状,并改善血液流变学指标,临床疗效较好,值得推广应用。     

血必净注射液对脓毒症患者应激反应的影响

目的探讨血必净对脓毒症患者应激指标C-反应蛋白（CRP）、血小板（PLT）的影响。方法将确诊为脓毒症的35例患者随机分成两组,对照组（n=15）患者给予抗生素、对症及常规营养支持治疗,如病情需要可给予脏器替代治疗,包括使用呼吸机和/或血液透析;血必净组（n=15）患者在对照组治疗的基础上加用血必净注射液100ml,静脉滴注,1次/12h,连用7d,对患者进行CRP、PLT测定,同时观察患者WBC的变化。结果治疗前后,血必净组C-反应蛋白、PLT水平间差别有显著性意义（P〈0.05）,治疗后与对照组间差别有显著性意义（P〈0.05）;治疗前后血必净组WBC数间差别有显著性意义（P〈0.05）,治疗后血必净组与对照组间差别无统计学意义。结论加用血必净注射液可显著降低脓毒症患者的应激反应。     

血必净注射液治疗危重型手足口病的临床疗效观察

目的观察血必净注射液治疗危重型手足口病的临床疗效。方法 20例危重型手足口病患儿随机分为治疗组和对照组,每组60例。两组均给予常规治疗,治疗组在常规治疗的基础上加用血必净注射液。观察两组患者的心率（HR）、呼吸频率（RR）、体温（T）、血常规白细胞总数（WBC）、中性粒细胞比例（n）及血清C反应蛋白（CRP）变化。结果治疗组T、RR、HR、WBC、n及CRP改善情况明显优于对照组（P〈0.01或P〈0.05）。结论血必净注射液治疗危重型手足口病有一定的临床疗效,值得临床推广。     

血必净注射液联合化疗治疗晚期恶性肿瘤的随机对照研究

目的：观察血必净注射液联合铂类方案治疗晚期癌症患者的疗效和毒性反应。方法：将91例晚期癌症患者随机分为联合组（46例,接受血必净注射液联合化疗）和对照组（45例,仅接受化疗）。两组的化疗均为含铂类联合方案。比较两组的近期疗效和急性毒副反应的差异。结果：两组的有效率差异无统计学意义（P〉0．05）。联合组的恶心、呕吐和腹泻的发生率分别为63．0％、41．3％和8．9％,分别明显低于对照组的86．7％、64．4％和24．4％（均P〈0．05）,疲乏和肾功能损害的发生率亦明显低于对照组（均P〈0．05）。两组的肝功能损害和骨髓毒性反应差异无统计学意义。联合组的KPS评分明显优于对照组（P〈0．05）。结论：中药制剂血必净注射液能明显降低肿瘤患者含铂类方案化疗的相关毒性反应,改善患者的生活质量。     

血必净注射液对心肺复苏患者凝血功能的影响

目的观察心肺复苏患者凝血功能的变化及血必净注射液的作用。方法将36例心肺复苏患者随机分为对照组和血必净组,每组18例。对照组给予常规心肺复苏综合治疗,血必净组在常规综合治疗基础上加用血必净注射液100ml,2次/d,连用7d。检测两组患者治疗前及治疗后1d、3d、7d血小板计数（PLT）、纤维蛋白原（FBG）、凝血酶原时间（PT）、凝血酶时间（TT）、活化部分凝血活酶时间（APTT）、D-二聚体（DD）、组织纤溶酶原激活物（TPA）和纤溶酶原激活物抑制物-1（PAI-1）的变化。结果治疗前两组患者凝血功能各指标差异无统计学意义（P〉0.05）。治疗后两组患者PT、TT、APTT延长,PLT、FBG、DD和PAI-1下降,TPA升高;治疗第7天时,血必净组凝血功能各指标改善程度明显好于对照组（均P〈0.05）。结论心肺复苏患者的凝血功能发生紊乱,血必净注射液对其有保护作用。     

血必净治疗急性呼吸窘迫综合征疗效评价

目的：观察血必净注射液对急性呼吸窘迫综合征（ARDS）患者的疗效。方法：根据急性呼吸窘迫综合征诊断标准选择40例病例随机分为两组，分别给予血必净加常规治疗（血必净组）和常规治疗（常规组），对两组细胞因子水平及转归进行比较。结果：血必净组患者的细胞因子水平、机械通气时间及死亡率均较常规组降低，差异有显著性意义（P〈0．05）。结论：血必净注射液可通过减轻炎症反应而显著降低ARDS的死亡率，是安全、有效的治疗方法。     

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.