地高辛血药浓度监测及分析

目的分析地高辛血药浓度监测结果,为临床合理用药提供参考依据。方法采用荧光免疫偏振法监测使用地高辛的72例患者血药浓度,对监测结果进行比较分析。结果 0.5-2.0μg/L为地高辛安全有效血药浓度,共监测72例,其中在有效血药浓度范围内共50例（占69.44%）,低于治疗浓度下限的共9例（占12.50%）,高于治疗浓度上限的共13例（占18.06%）。结论由于地高辛安全范围窄,个体差异大,故应对使用地高辛的患者进行血药浓度监测,并制订个体化给药方案,为临床安全、有效、合理地使用地高辛提供依据。     

地高辛的血药浓度监测及分析

目的：为地高辛（Digoxin）的临床合理用药提供参考。方法：应用荧光偏振免疫分析法（FPIA）测定血药浓度，对结果作综合分析。结果：共监测121例，其中在有效治疗血药浓度范围内的为82例（占67．8％），小于0．5μg/L的为21例（占17．3％），大于2．0μg/L的为18例（占14．9％），中毒表现为13例（占10．7％）。结论：口服地高辛有必要加强血药浓度监测，特别是老年患者的血药浓度监测，并结合临床表现和用药特点进行分析，达到保证临床疗效，减少毒性反应发生的目的。     

地高辛血药浓度监测1039例分析

地高辛是临床常用的强心甙之一，其治疗有效浓度范围为0．8－2．0ng／ml。本文总结分析了用快速血药浓度检测仪（TDX）测定的地高辛血浓病例1039例，其中测定结果低于0．8ng／ml395N，占38．0％，高于2．0ng／ml135例，占13．0％，出现中毒症状有40例，占0．4％，同时结合临床监测结果进行分析探讨。     

108例口服地高辛患者血药浓度监测结果分析

目的 对本院2007～2010年地高辛血药浓度监测结果进行回顾性分析,为临床合理用药提供参考.方法 采用放射免疫法对108例口服地高辛的患者进行血药浓度的监测,并对结果进行统计、分析.结果 地高辛血药浓度在有效治疗浓度0.5～2.0 ng/mL的有69例(63.9%);低于有效治疗浓度的有32例(29.6%);高于有效...     

LC- MS法检测血液透析对尿毒症伴心力衰竭患者地高辛血药浓度的影响

目的：研究尿毒症伴心力衰竭患者血液透析治疗中体内地高辛血药浓度的变化情况,为临床合理用药提供参考。方法以液相色谱-质谱（LC- MS）法测定10例尿毒症伴心力衰竭患者体内地高辛血药浓度的变化情况。结果地高辛血药浓度在0.2~8.0ng/ml范围内呈现良好线性关系,平均回收率98.36%~104.35%,日内和日间精密度＜5.00%;给药8h后的地高辛浓度均在有效范围内;血液透析后的4~8h,地高辛浓度出现“反跳”现象,用平均升高30.00%左右。结论对于血液透析患者的地高辛浓度监测是必要的,需要实行个体化给药。LC- MS法快速、简便、准确,适用于临床血药浓度监测。     

106例地高辛血药浓度监测及结果分析

目的通过对患者地高辛血药浓度监测结果的分析,为临床合理用药提供参考。方法使用荧光免疫偏振法监测106例患者使用地高辛的血药浓度,根据监测结果进行统计并分析其影响因素。结果在106例监测结果中,共有40例在0.8~2.0μg/L的治疗浓度范围内,占37.74%;有41例血药浓度<0.8μg/L,占38.68%;有25例血药浓度>2.0μg/L,占23.69%。共有28例出现中毒症状,占26.40%。结论对使用地高辛患者进行血药浓度监测,制定个体化给药方案,为临床安全、有效、合理使用强心苷类药物提供依据。     

临床药师干预对地高辛血药浓度监测及个体化用药的影响分析

目的：探讨临床药师针对性干预措施对地高辛治疗患者血药浓度的影响。方法：将2017年6月-2018年6月采用地高辛治疗的患者分为高浓度组(血药浓度>2.0 ng/mL)与对照组(0.8 ng/mL<血药浓度≤2.0 ng/mL)，分析引起地高辛血药浓度升高的主要危险因素。选取2019年7月-2020年7月使用地高辛治疗的患者160例，随机分为干预组和非干预组，各80例，均进行血药浓度监测，其中干预组针对危险因素进行干预，非干预组仅给予常规用药指导，分析两组患者血药浓度差异及地高辛中毒发生率。结果：高龄、合并肾功能障碍、联合使用β受体阻滞剂、噻嗪类利尿剂、抗凝药物为引起地高辛血药浓度水平升高的危险因素，差异有统计学意义(P<0.05)。干预组有效血药浓度范围占比高于非干预组，差异有统计学意义(P<0.05)；干预组血药浓度偏高患者占比低于非干预组，差异有统计学意义(P<0.05)；两组地高辛中毒发生率比较，差异无统计学意义(P>0.05)。结论：临床药师针对性干预及个体化用药指导能维持地高辛有效血药浓度，对临床合理安全使用地高辛具有积极意义。     

地高辛血浓度监测及其临床意义

临床上使用地高辛治疗时,易发生过早中毒,但多少剂量为安全剂量又因各人不一,因此需监测其血药浓度而选择最佳剂量。为此,我们对38例临床使用地高辛治疗者,测定其他高辛血药浓度及其与中毒关系,并与35例正常人血待地高辛物质浓度比较,结果报道于下。！问斥资料1．l对象：临床使用地高辛治疗组（不简称地高辛组）：38例,男29例,女9例;年龄15－68岁。原发病：风湿性心脏病ZI例,肺心病！0例,冠心病5例,心衰2例。正常组：35例,为经作检健康人．心、肺等无严重疾患,肝肾功能正常,旨未医用地高辛类药物。1．2他高辛协药浓度测定…     

间歇维持量地高辛治疗老年心力衰竭60例疗效分析

目的：观察间歇维持量地高辛治疗老年心力衰竭患者的疗效。方法：对60例患者给予间歇维持量地高辛0．25mg，隔日1次口服，连服4周．观察患者症状，必要时测地高辛血药浓度。结果：显效75％（45／60）．总有效率88％（53／60），无效率12％（7／60），中毒率8％（5／60）。结论：老年心力衰竭患者采用间歇维持量疗法具有疗效佳、不良反应少、申毒发生率较低的优点。     

丙戊酸钠血药浓度监测对指导儿童癫痫病治疗的临床意义

目的：评价丙戊酸钠的血药浓度与剂量对治疗儿童癫痫病患者临床疗效的影响。方法：给576例儿童癫痫病患者长期口服丙戊酸钠，剂量为15～60mg／（kg·d），并进行血药浓度监测。利用SPSSIO．0统计软件对治疗结果产生的数据进行处理。结果：丙戊酸钠的有效浓度范围为50-100μg／ml，中毒浓度〉100μg／ml，观察组中癫痫完全被控制186例，好转331例，总有效率为89．76％。不同个体服用同等剂量丙戊酸钠后，稳态血药浓度差异有统计学意义（P〈0．05）。结论：测定丙戊酸钠的血药浓度对治疗儿童癫痫病的临床疗效有显著意义。临床监测其血药浓度十分必要。     

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.