地塞米松鼓室内灌注对耳鸣患者的耳鸣情况影响

目的分析地塞米松鼓室内灌注对耳鸣患者的听力影响。方法选取我院2015年1月至2017年1月期间收治的60例主观性耳鸣患者,随机分A、B对照组。A组使用地塞米松鼓室内灌注法对患者进行治疗;B组患者采用血管扩张配合营养药对患者进行治疗;对照组仅口服营养神经药进行治疗。结果治疗结束后,A组总有效率明显高于B组和对照组,组间差异显著,具有统计学意义(P0.05);B组与对照组治疗有效率无明显差异,无统计学意义(P0.05)。结论针对主观性耳鸣患者的治疗,地塞米松鼓室内灌注糖皮质激素能有效改善患者听力,有效率较高,值得临床推广应用。     

甲基强的松龙鼓室内灌注对主观性耳鸣的疗效观察

目的:观察鼓室内灌注甲基强的松龙对主观性耳鸣的疗效。方法:选择病史在1个月以上已接受过药物治疗或未治疗的主观性耳鸣患者50例(60耳),观察组鼓室灌注甲基强的松龙,同时口服扩血管药及维生素;对照组除不行鼓室灌注外,其余治疗同观察组。所有患者在治疗前、治疗结束时均分别行纯音测听和耳鸣问卷调查。结果:治疗结束时,观察组与对照组耳鸣治疗有效率分别为62.50%、35.71%,两组总有效率比较差异有统计学意义(χ2=4.286,P0.05)。结论:鼓室内灌注糖皮质激素治疗主观性耳鸣是有效的,可作为常规药物治疗无效患者的另一种治疗选择。     

鼓室内注射地塞米松治疗突发性聋的疗效观察

目的:观察鼓室内注射地塞米松治疗突发性聋的效果。方法:70例(82耳)突发性耳聋患者随机分为鼓室给药组(A组,44耳)和全身给药组(B组,38耳),鼓室给药组鼓室内注射地塞米松,全身给药组静脉滴注地塞米松,治疗20天后复查听力,比较治疗效果。结果:鼓室给药组(A组)36耳有效,无效8耳,总有效率81.8%;全身给药组(B组)23耳有效,15耳无效,总有效率60.5%。A组疗效明显高于B组(P<0.05)。结论:鼓室内注射地塞米松治疗突发性聋比全身性给药安全有效。     

前列腺素E1脂微球载体制剂治疗主观性耳鸣的疗效观察

目的:探讨前列腺素E1脂微球载体制剂(PGE1)治疗主观性耳鸣的疗效.方法:将主观性耳鸣患者随机分为两组,治疗组33例(35耳)应用PGE1进行治疗,对照组32例(33耳)应用罂粟碱进行治疗,两组均辅以神经营养等药物.结果:治疗组患耳治疗后总有效率94.3%,对照组患耳治疗后总有效率66.6%,两组统计学处理差异有显著意义(P＜0.05).结论:前列腺素E1脂微球载体制剂(PGE1)不失为一种治疗主观性耳鸣的有效方法,且早期治疗显得较为重要,应及早给予静脉给药.     

鼓室内灌注醋酸泼尼松龙和地塞米松治疗主观性耳鸣的疗效

目的：分析在主观性耳鸣患者的治疗中,鼓室内灌注醋酸泼尼松龙与地塞米松的应用疗效。方法：选取2014年1月至2015年1月在我院门诊治疗的80例主观性耳鸣患者为研究对象,将所选患者随机均分为对照组与干预组,对照组患者接受鼓室内灌注地塞米松治疗,干预组患者则接受鼓室内灌注醋酸泼尼松龙治疗,对比两组患者的临床治疗效果。结果：干预组患者的临床治疗效果要明显好于对照组患者,两组患者的临床治疗效果经对比后存在统计学差异（P＜0．05）。结论：在主观性耳鸣患者的治疗中,鼓室内灌注醋酸泼尼松龙的治疗效果较好,值得推广。     

鼻咽癌放疗后分泌性中耳炎的临床观察

目的 分析鼻咽癌(NPC)放疗后分泌性中耳炎(OME)的发病机理,探索临床有效的综合治疗方法.方法 对35例(43耳)NPC放疗后OME患者,采用咽鼓管置管、冲洗并向鼓室注入地塞米松、α-糜蛋白酶、盐酸氨溴索混合药液,局部清理,治疗临近部位疾病,常规全身抗炎、营养神经、扩张血管、粘膜促排剂及皮质内固醇药物治疗.结果 所有患者治疗前均有耳鸣、耳闷感及听力下降等症状;鼓室导抗图均为B型或C型.治疗后耳鸣消失31耳(72.09％)、好转8耳(18.6％)、无效3耳(6.9％),总有效率为90.69％.耳闷感消失35耳(81.40％)、好转6耳(13.95％)、无效2耳(4.65％),总有效率为95.35％.声导抗检查鼓室压图A型23耳(53.49％)、As型16耳(34.88％);B型2耳(4.65％);C型3耳(6.9％).治疗后0、0.5、1.0、2.0 kHz气导听阈均值为(25.6±3.5) dBHL,而治疗前为(48.5±4.6) dBHL,其差异有统计学意义(P=0.001).结论 依据NPC放疗后OME的发病机理,有针对性地采取咽鼓管置管及注药冲洗等综合治疗手段,有利于咽鼓管功能的恢复,对提高NPC患者的生存质量具有重要意义.     

中耳灌注地塞米松治疗120例主观性耳鸣

主观性耳鸣是指在周围环境中无相应声源和电(磁)刺激源情况下,患者自觉耳内或颅内有声音的一种主观感觉.耳鸣给患者带来很大痛苦和烦恼.耳鸣的治疗方法很多,但疗效都不确定.近年来我们采用中耳灌注地塞米松加常规口服药物治疗主观性耳鸣患者,并与常规口服药物治疗患者进行对照观察,现报告如下.     

地塞米松鼓室内注射治疗突发性耳聋28例

目的:观察鼓室内注射地塞米松治疗突聋的临床效果。方法:对60例突发性耳聋患者,随机分为实验组28例(29耳),对照组32例(34耳)。两组均给予250ml生理盐水+血塞通0.5g、5%葡萄糖注射液+胞磷胆碱钠0.5g,静脉滴注。对照组给予地塞米松5¹0mg静滴。实验组给予地塞米松鼓室内注射,每次5mg/ml,0.510mg静滴。实验组给予地塞米松鼓室内注射,每次5mg/ml,0.5⁰.8ml。隔天1次,共5次。观察治疗前后两组患者的(500Hz、1000Hz、2000Hz、4000Hz)平均听阈。结果:实验组:治愈9例(9耳),有效14例(14耳),有效率79.31%。对照组:治愈8例(8耳),有效9例(10耳),有效率52.94%,两组有效率比较差异有统计学意义(P<0.05)。实验组未出现鼓室内感染、鼓膜穿孔和听力下降。结论:鼓室内注射地塞米松治疗突聋,尤其是不能耐受全身应用糖皮质激素及扩管药患者,是安全有效的。耳内镜下鼓室内注射能够确保定位精确,注射药物进入鼓室无流失,治疗效果良好。     

盐酸氨溴索治疗分泌性中耳炎疗效观察

目的观察盐酸氨溴索(沐舒坦)治疗分泌性中耳炎的疗效. 方法76例(81耳)分泌性中耳炎患者随机分二组,用药组40例,用沐舒坦针剂鼓室内注射并口服沐舒坦;对照组36例,用地塞米松和α-糜蛋白酶针剂混合液行鼓室内注射,比较治疗前后的临床症状、体征、纯音测听和鼓室图的变化情况. 结果治疗后2 ～3周随访,用药组中24例25耳显效,12例15耳有效,4例5耳无效,总有效率达88.9%.对照组中14例14耳显效,9例9耳有效,13例13耳无效,总有效率63.9%. 结论沐舒坦是治疗分泌性中耳炎的一种安全有效的药物.     

西比灵治疗耳鸣疗效观察

目的观察西比灵治疗耳鸣的临床效果。方法对142例（180耳）耳鸣患者，随机分成西比灵治疗组82例（104耳）和对照组60例（76耳）。治疗组用西比灵治疗；对照组用血管扩张药、神经营养药等治疗，对比观察两组疗效。结果西比灵治疗组有效率69．1％，两组疗效相比，其差异具有显著性。结论西比灵治疗功能性耳鸣临床效果较好。     

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.