焦虑情绪对老年高血压病患者左室肥厚的影响

目的探讨焦虑情绪对老年高血压病患者降压疗效及左室肥厚的影响.方法老年高血压病患者根据汉密顿焦虑量表(HAMA)测定,阳性分成2组(A、B组),A组38人;B组34人;阴性为C组35人.三组均口服氨氯地平降压治疗,每次5mg,每日1次,A组病例同时加用抗焦虑治疗,黛力新片10.5mg,每日1～2次.疗程均为6个月.结果 A、B、C三组降压有效率分别为89.47%、67.65%、82.86%,有显著差异.C组降压治疗后左心室重量指数(LVMI)显著下降,与B组相比LVMI的下降有显著差异,加用抗焦虑治疗后A组LVMI亦显著下降,与B组比较有显著差异.结论在伴有焦虑情绪的老年高血压病患者中,焦虑障碍可明显降低降压疗效,而抗焦虑治疗可以明显提高疗效,并且有助于改善伴有焦虑情绪的老年高血压病患者左室肥厚.     

抗焦虑治疗对老年高血压病患者血管内皮功能的影响

目的研究抗焦虑治疗对老年高血压病患者降压疗效以及血管内皮功能的影响. 方法高血压病患者予以汉密顿焦虑量表(HAMA)测定,量表测定为阳性的病例分为A、B两组,阴性患者作为 C组,均口服氨氯地平,A组病例同时加服黛力新片.疗程均为6个月.测定治疗前、后24h平均血压、汉密顿焦虑量表、一氧化氮(NO)、内皮素(ET)、血栓素(TXB2)、前列环素(PGI2). 结果 A、B、C三组降压有效率分别为89.47%、67.65%、82.86%;经降压治疗后各组ET、TXB2均显著下降,而A组ET、TXB2的下降较B组更为明显,有显著性差异;且A组治疗前后血浆NO水平有明显升高,与B、C二组相比有显著性差异. 结论伴有焦虑情绪的老年高血压患者加用抗焦虑治疗既能改善患者的焦虑情绪,又能增加降压药物的疗效,同时能减轻血管内皮功能的损伤.     

抗焦虑治疗对老年高血压病患者血管内皮功能的影响

目的 研究抗焦虑治疗对老年高血压病患者降压疗效以及血管内皮功能的影响。方法高血压病患者予以汉密顿焦虑量表(HAMA)测定，量表测定为阳性的病例分为A、B两组，阴性患者作为C组，均口服氮氯地平，A组病例同时加服黛力新片。疗程均为6个月。测定治疗前、后24h平均血压、汉密顿焦虑量表、一氧化氮(NO)、内皮素(ET)、血栓素(TXB2)、前列环素(PGI2)。结果 A、B、C三组降压有效率分别为89．47％、67．65％、82．86％；经降压治疗后各组ET、TXB2均显著下降，而A组ET、TXB2的下降较B组更为明显，有显著性差异；且A组治疗前后血浆NO水平有明显升高，与B、C二组相比有显著性差异。结论 伴有焦虑情绪的老年高血压患者加用抗焦虑治疗既能改善患者的焦虑情绪，又能增加降压药物的疗效，同时能减轻血管内皮功能的损伤。     

舍曲林治疗老年原发性高血压患者伴抑郁情绪的疗效

目的 研究舍曲林治疗对老年高血压病患者降压疗效的影响. 方法 老年高血压病患者予以汉密顿抑郁量表(HAMA)和抑郁自评量表(SDS)测定,对量表测定为阳性的病例按随机单盲法分为A、B2组,对量表评定为阴性患者作为C组,均口服硝苯地平,A组病例同时加服舍曲林片.疗程均为12个月. 结果 老年高血压合并抑郁患者在治疗前HAMD、SDS评分差异无显著性,经抗抑郁治疗后HAMD、SDS评分下降有显著差异(P＜0.01).A、B、C 3个组降压有效率分别为91.89%,、65.70%、80.00%.A组加用抗抑郁治疗后,∑ST显著下降,CI和LVEF明显增加,与B组比较有显著差异(P＜0.01). 结论 伴有抑郁情绪的老年高血压患者加用抗抑郁治疗可以改善患者的抑郁情绪,并且增加降压药物的疗效.     

舍曲林治疗老年原发性高血压患者伴抑郁情绪的疗效

目的研究舍曲林治疗对老年高血压病患者降压疗效的影响。方法老年高血压病患者予以汉密顿抑郁量表（HAMA）和抑郁自评量表（SDS）测定，对量表测定为阳性的病例按随机单盲法分为A、B2组，对量表评定为阴性患者作为C组，均口服硝苯地平，A组病例同时加服舍曲林片。疗程均为12个月。结果老年高血压合并抑郁患者在治疗前HAMD、SDS评分差异无显著性，经抗抑郁治疗后HAMD、SDS评分下降有显著差异（P〈0．01）。A、B、C3个组降压有效率分别为91．89％、65．70％、80．00％。A组加用抗抑郁治疗后，∑ST显著下降，CI和LVEF明显增加，与B组比较有显著差异（P〈0．01）。结论伴有抑郁情绪的老年高血压患者加用抗抑郁治疗可以改善患者的抑郁情绪，并且增加降压药物的疗效。     

不同剂量山绿茶降压片逆转高血压左室肥厚的临床观察

目的 比较不同剂量山绿茶降压片与卡托普利逆转高血压病患者左室肥厚的临床效果.方法 将120例伴有左室肥厚的高血压病患者随机分为小剂量治疗组(A组,山绿茶降压片6片/d)、大剂量治疗组(B组,山绿茶降压片9片/d)、对照组(C组,卡托普利27.5～75 mg/d),治疗2周后,若血压结果≥160/95mmHg,则分别加用氢氯噻嗪12.5～25mg/d.总疗程共6个月,治疗前、后行24h动态血压监测和彩色多普勒,检测平均收缩压、平均舒张压及左室相关数据.结果 ①三组治疗前24h平均收缩压、平均舒张压差异无统计学意义(P＞0.05),三组治疗后与治疗前比较均显著性降低(P＜0.01),但治疗后三组间比较差异均无统计学意义.②三组治疗前LVMI均无显著性差异(P＞0.05),治疗后LVMI较治疗前均明显下降(P＜0.05或P＜0.01);三组间治疗后LVMI比较,B、C两组与A组比较均明显降低(P＜0.05),B、C组比较差异无统计学意义(P＞0.05).结论 山绿茶降压片作为一种降压药物,剂量大小与降压效应无关,但加大剂量可以逆转左室肥厚,作用与卡托普利相当,但副作用明显少于卡托普利组.     

老年高血压病患者动态血压与左室肥厚关系的临床意义

目的 分析老年高血压病患者动态血压参数与左室肥厚(LVH)关系的临床意义方法对120例老年(≥55岁)高血压病患者依据是否伴有左心室肥厚分为左室肥厚组(LVH)与不伴有左室肥厚(NLVH)组,进行24h动态血压(ABPM)检测.比较两组间动态血压参数与左室肥厚的关系结果 LVH组与不伴有LVH组比较,24hSBP、24hPP、dSBP、nSBP、BPF、BPL、LVMI差异有显著性(P<0.05);LVH组以非杓型血压为主,占73%,而不伴有LVH组,以杓型血压为主,占79%;(3)LVH组LVMI与24hSBP、24hPP、dSBP、nSBP、SBPL正相关(P<0.001),与SBPF、DBPF负相关(P<0.01)结论老年高血压病左室肥厚的发生与SBP、24hPP、SBPL和BPF相关.     

补肾活血汤对老年高血压病左室肥厚和内皮功能的影响

目的观察补肾活血汤对老年高血压病左室肥厚和内皮功能的影响。方法 100例患者按随机数字表法分为对照组和治疗组。对照组给予常规西药治疗,治疗组在对照组的基础上给予补肾活血汤治疗,3个月后比较两组患者中医证候疗效和降压疗效,心脏彩超检测室间隔厚度(IVST)、左心室后壁厚度(LVPWT)、计算左室重量指数(LVMI)等左室肥厚指标,检测血浆一氧化氮(NO)、内皮素(ET)、血管性假血友病因子(VWF)等血管内皮功能指标。结果临床中医证候疗效治疗组总有效率92%,优于对照组82%(P 0. 05)。降压疗效治疗组总有效率90%,优于对照组70%(P 0. 05)。治疗后治疗组左室肥厚相关指标IVST、LVPWT、LVMI均优于对照组(P 0. 05)。治疗后治疗组血管内皮功能相关指标NO、ET、VWF改善优于对照组(P 0. 05)。结论补肾活血汤治疗老年高血压病左室肥厚可降低中医证候积分、提高降压有效率、降低左室肥厚相关指标、改善血管内皮功能,有较好的临床疗效。     

卡托普利对高血压病人左室肥厚逆转作用的初步观察

为了评价卡托普利(C)对高血压性左室肥厚的影响,本文采用超声心动图观察了22例原发性高血压病人C治疗4个月前后的血压,IVST,PWT,LVDd,LVMI及EF的变化,结果治疗后血压显著下降(P<0.01),LVDd及EF变化不大,IVST,PWT及LVMI显著减少(P均<0.01),提示C在降压的同时可逆转左室肥厚,而左心功能不受损害。     

高血压患者胰岛素样生长因子-Ⅰ与左室肥厚的关系

目的 探讨原发性高血压患者血清胰岛素样生长因子I(IGF-I)水平与左心室肥厚(LVH)的关系.方法 61例原发性高血压患者根据心脏多普勒超声各项参数计算左心室重量指数(LVMI),分为A组26例:高血压无左室肥厚,B组35例:高血压并左室肥厚.将30例正常健康者列为C组.采取酶联免疫分析方法测定血清IGF-I水平,分析其相关性.结果 A组血清IGF-I高于C组(P<0.05),B组血清IGF-I高于A组(P<0.05),并显著高于C组(P<0.01);血清IGF-I与LVMI存在正相关(r=0.45.P<0.05).结论 循环血IGF-I水平与高血压及高血压合并左心室肥厚密切相关.参与了高血压病的发生发展,可能在高血压病心肌重构过程中起到了重要作用.     

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.     

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.