颅内血肿微创清除术治疗高血压脑出血36例体会

目的对高血压引起的脑出血通过微创技术行颅内血肿清除术的临床疗效进行评价。方法将2010年7月-2012年4月因高血压性脑出血住院的36例患者纳入本研究,并随机分为试验组(微创手术组)18例和对照组(内科保守治疗组)18例,不同方法治疗后,观察其临床疗效,并评价其生活自理能力。结果微创手术组总有效率94.4%,保守治疗组总有效率72.2%,微创手术组较保守治疗组在总有效率和生活自理能力评分都有明显优势(P<0.05)。结论对于高血压引起的脑出血患者,可通过微创手术清除颅内血肿,且疗效较好。     

微创手术与传统保守治疗高血压脑出血的临床疗效比较

目的：评价微创手术与传统保守治疗高血压性脑出血的疗效,选择最佳治疗方案,提高救治成功率,改善患者生活质量。方法：对152例高血压性脑出血患者随机分为两组,治疗组采用微创技术清除血肿,对照组单纯行保守治疗,分别观察两组的临床疗效。结果：治疗组患者的治疗总有效率为94.7%,死亡率为5.3%;对照组患者的治疗总有效率为76.3%,死亡率为23.7%。治疗组患者的总有效率明显高于对照组,死亡率明显低于对照组（P〈0.01）。结论：微创手术治疗高血压性脑出血较单纯保守治疗效果好,且能明显提高疗效、降低病死率、促进神经功能的恢复。     

高血压脑出血患者实施微创手术治疗的效果观察

目的探讨微创术及保守治疗高血压脑出血的临床治疗效果。方法将100例高血压脑出血患者按其家属选择及患者情况分为对照组和观察组各50例,对照组给予保守治疗,观察组给予微创术治疗,观察比较两组患者的病死率和临床疗效。结果对照组病死率明显高于观察组,差异具有统计学意义(P<0.01);观察组总有效率88%明显优于对照组,差异有统计学意义(P<0.01)。结论微创手术治疗高血压脑出血可降低患者病死率,提高临床疗效,值得临床推广。     

高血压脑出血微创术与保守治疗效果的比较研究

目的:探讨微创术及保守治疗高血压脑出血的临床治疗效果。方法:将120例高血压脑出血患者随机分为对照组和观察组各60例,对照组给予保守治疗,观察组给予微创术治疗,对比分析2组死亡率和临床疗效。结果:观察组死亡率11.67%明显少于对照组的31.67%,差异有高度统计学意义(P<0.01);观察组总有效率81.67%明显优于对照组的48.33%,差异有高度统计学意义(P<0.01)。结论:微创手术治疗高血压脑出血可降低患者死亡率,提高临床疗效,且其操作技术简单,值得临床推广应用。     

微创清除术治疗高血压脑出血的临床效果观察

目的探讨微创清除术治疗高血压脑出血的临床疗效。方法回顾我院2008年1月～2010年1月收治的120例高血压脑出血患者临床资料,分析微创清除术治疗高血压脑出血（观察组）近期临床疗效,并与内科保守治疗（对照组）的疗效进行对比分析。结果观察组总有效率为85.3%,对照组总有效率为51.1%,两组相比（p〈0.05）有统计学意义。观察组并发症发生总数及死亡率明显低于对照组,两组相比（p〈0.05）有统计学意义。结论微创清除术治疗高血压脑出血创伤小、疗效好,并发症少,是目前临床治疗高血压脑出血的一种较佳方法。     

微创术治疗高血压性脑出血的临床疗效分析

目的分析微创术治疗高血压性脑出血的临床疗效。方法将90例高血压性脑出血患者随机分为微创组和保守组,各45例。微创组术前根据CT定位穿刺部位及深度,局麻下行穿刺吸出血肿液体并引流;保守组采用内科保守治疗。于治疗前及治疗28d后对两组患者进行神经功能缺损程度评分,评价两组疗效。结果微创组治疗总有效率为82.22%(37/45);保守组总有效率为53.33%(24/45)。微创组总有效率明显高于保守组(P<0.01)。结论微创术治疗高血压性脑出血具有创口小,损伤轻,可在较短时间内有效清除血肿,解除占位效应,预后较好。     

微创治疗高血压性脑出血30例临床分析

目的: 探讨微创治疗高血压性脑出血的方法和临床效果.方法: 选取2015/6-2016/6于我院收治的60例高血压性脑出血患者,将其随机均分成观察组和治疗组,对照组30例患者实施保守治疗,观察组30例患者实施微创手术治疗,观察并对照二者疗效差异.结果: 接受微创手术治疗的观察组患者的治疗总有效率明显高于接受保守治疗的对照组患者,二者差异有统计学分析意义(P<0.05).结论: 微创治疗高血压性脑出血有着显著的应用价值,显著提高患者预后,值得推广.     

高血压性脑出血开颅手术与微创清除术的临床疗效分析

目的:分析高血压性脑出血临床治疗的效果,积累最佳治疗方案经验。方法:共收录2011年10月-2012年10月,在我院接受治疗的30例高血压性脑出血患者的资料,对其临床治疗效果进行回顾性分析。30例平均分为两组,n=15例,对照组为开颅手术,观察组为微创手术,治疗后60d,对两组患者疗效实施综合评估。结果:观察组治疗效果明显优于对照组,观察组总有效率93.3%(1例无效),对照组80.0%(3例无效)。结论:临床治疗高血压性脑出血,应积极推广微创手术治疗。     

颅内血肿微创清除术治疗高血压脑出血89例疗效分析

目的：探讨临床颅内血肿微创清除术治疗高血压脑出血临床疗效,为临床治疗与手术提供依据。方法选取该院2015年1月-2016年1月收治的高血压性脑出血的患者178例,随机分为对照组和治疗组各89例,对照组采用传统开颅手术治疗,治疗组采用颅内血肿微创清除术治疗,观察两组治疗效果。结果治疗组临床疗效总有效率为95.50%,对照组临床疗效总有效率为67.42%,治疗组的临床疗效明显高于对照组患者,P<0.05,说明差异有统计学意义。结论采用临床颅内血肿微创清除术治疗高血压脑出血,患者临床症状明显改善,患者神经功能明显改善,极大地提高了脑出血的治疗效果,减少了死亡率,减轻了致残率,提高了患者的生存质量,而且方法简单,易操作,创伤小,值得临床推广应用。     

颅内微创穿刺引流术治疗高血压脑出血疗效观察

目的:评价软通道微创介入技术在高血压脑出血穿刺引流中的应用价值.方法:40例天幕上脑出血患者随机分为微创组及对照组各20例,微创组使用软通道颅内血肿微创穿刺针进行穿刺引流,对照组使用药物保守治疗,比较两种治疗方法疗效.结果:微创组的总有效率较对照组要高,而且微创组病死率也明显低于对照组.结论:软通道颅内血肿微穿刺针治疗高血压脑出血,疗效优于保守治疗,并具有损伤小、见效快等优点,值得进一步推广应用.     

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.