中西医结合治疗慢性肾小球肾炎38例疗效观察

目的 观察中西医结合治疗慢性肾小球肾炎疗效.方法 76例患者随机分成治疗组和对照组各38例,对照组予西医常规治疗方法,治疗组在对照组基础上给予中药治疗,治疗3个月后观察24 h尿蛋白定量、尿红细胞数、血肌酐、血尿素氮变化情况.结果 治疗组总有效率92.1％,明显高于对照组65.8％(P＜0.05);治疗组治疗前后及治疗后与对照组比较,24 h尿蛋白定量、尿红细胞数有明显降低(P＜0.01);肌酐有明显降低(P＜0.05).结论 中西医结合治疗慢性肾小球肾炎有明显优势.     

中药山红合剂治疗慢性肾小球肾炎的临床研究

目的观察中药山红合剂治疗慢性肾小球肾炎的临床疗效。方法将108例慢性肾小球肾炎患者随机分为两组,对照组38例予西医常规治疗,治疗组70例在对照组治疗基础上加用中药山红合剂。治疗12周后比较两组临床疗效及相关实验室检查指标的改善情况。结果治疗组总有效率为97.1%,对照组总有效率为76.3%,治疗组疗效优于对照组（P〈0.05）;两组在改善血肌酐、血尿素氮、尿蛋白、血红蛋白指标方面比较,差异有统计学意义（P〈0.05）,治疗组优于对照组;两组治疗后尿红细胞计数较治疗前均降低,与本组治疗前比较差异均有统计学意义（P〈0.05）,治疗组尿红细胞计数低于对照组,且两组治疗后组间比较差异有高度统计学意义（P〈0.01）。结论中药山红合剂治疗慢性肾小球肾炎临床疗效较好,能改善相关实验室检查指标。     

前列地尔治疗慢性肾小球肾炎的临床分析

目的：探讨前列地尔治疗慢性肾小球肾炎的临床效果。方法将64例慢性肾小球肾炎患者进行分组,按照门诊就诊顺序分为2组,各32例。对照组给予内科常规治疗,观察组在内科治疗基础上给予前列地尔治疗,观察2组患者24小时尿蛋白定量、血肌酐、血尿素氮、尿红细胞计数,并对2组患者的治疗效果进行临床分析和比较。结果治疗前,2组各指标差异无统计学意义;治疗后观察组血肌酐（132.41±24.32）μmol/L、血尿素氮（10.23±2.34）mmol/L、尿红细胞计数（16.2±7.4）个/HP,与对照组比较,差异有统计学意义（P＜0.05）。观察组总有效率93.75%显著高于对照组62.5%,差异有统计学意义（P＜0.05）。结论应用前列地尔治疗慢性肾小球肾炎临床效果显著,总有效率明显高于常规内科治疗措施,明显提高患者生命质量。     

肾复康Ⅱ号胶囊治疗慢性肾小球肾炎的疗效观察

目的观察肾复康Ⅱ号胶囊治疗脾肾气虚兼血瘀证慢性肾小球肾炎的临床疗效及安全性。方法将60例患者随机分为治疗组和对照组。对照组采用西医一般常规治疗;治疗组在对照组治疗的基础上加用肾复康Ⅱ号胶囊。两组治疗8周后,观察患者尿常规、尿蛋白定性、尿红细胞定性、24h尿蛋白定量、血肌酐、尿素氮结果,中医症状及临床总疗效。结果治疗组临床总有效率优于对照组(P0.05);治疗组在降低患者尿蛋白定性、尿红细胞定性、24h尿蛋白定量方面优于对照组,但尚不能认为治疗组在改善尿素氮、血肌酐水平方面优于对照组;治疗组中医证候疗效优于对照组(P0.05);治疗组在改善中医临床症状方面明显优于对照组;两组试验过程中均未出现明显不良反应。结论肾复康Ⅱ号胶囊治疗慢性肾小球肾炎能够缓解患者临床症状,减少蛋白尿、血尿,保护肾功能,用药安全,疗效确切,值得进一步实验研究及临床推广。     

养肾汤治疗慢性肾小球肾炎的临床研究

目的：观察自拟养肾汤治疗慢性肾小球肾炎的临床疗效。方法：将62例慢性肾小球肾炎患者随机分为两组,对照组30例予西医常规治疗,治疗组32例在对照组治疗基础上加用养肾汤。治疗8周后比较两组临床疗效和相关生化指标的改善情况。结果：两组临床综合疗效比较差异有统计学意义（P〈0．05）,治疗组优于对照组;两组在改善血肌酐（Scr）、血尿素氮（BUN）、尿蛋白（Upro）、血红蛋白（Hb）和尿红细胞计数（URBC）指标方面比较,差异有统计学意义（P〈0．05或P〈O．01）,治疗组优于对照组。结论：养肾汤治疗慢性肾小球肾炎有较好的临床疗效。     

复方α-酮酸治疗慢性肾病蛋白尿的疗效分析

目的:探讨复方α-酮酸治疗慢性肾病蛋白尿的临床疗效。方法:选择60例蛋白尿患者,随机分为对照组和治疗组各30例。两组患者常规治疗:低蛋白饮食,氯沙坦钾及利尿剂治疗;治疗组加服复方α-酮酸片。疗程12周观察治疗前后24h尿蛋白定量、血清白蛋白、肌酐、尿素氮、肾小球滤过率及临床疗效情况。结果:两组患者24h尿蛋白定量、血清白蛋白、肌酐、尿素氮及肾小球滤过率均较治疗前显著改善;治疗组24h尿蛋白定量、尿素氮、肌酐水平均明显低于对照组(P<0.05),而血清白蛋白水平、GFR水平和治疗后总有效率均明显高于对照组,有统计学差异(P<0.05)。结论:复方α-酮酸可以有效控制慢性肾病患者的蛋白尿显著提高血清白蛋白水平并延缓慢性肾脏病的进展。     

尿激酶联合阿魏酸钠治疗慢性肾小球肾炎临床分析

目的探讨尿激酶联合阿魏酸钠治疗慢性肾小球肾炎的临床疗效。方法对照组采用西医常规治疗,治疗组加用尿激酶和阿魏酸钠,3个疗程后观察疗效。结果总有效率治疗组为93.11%,对照组为67.56%,比较有显著性差异（P〈0.01）;血肌酐、尿素氮、尿沉渣红细胞计数、尿24h蛋白定量治疗前比较均无显著性差异,治疗后治疗组均明显优于对照组（P〈0.05或P〈0.001）。结论尿激酶联合阿魏酸钠治疗慢性肾小球肾炎可起到抗凝、溶解血栓和拮抗内皮素对肾血管的双重保护作用,安全有效,值得临床推广使用。     

肾康注射液联合还原型谷胱甘肽治疗慢性肾脏病疗效观察

目的 观察肾康注射液联合还原型谷胱甘肽治疗慢性肾脏病（chronic kidney disease,CKD）的疗效。方法 将70例CKD患者随机分为对照组（34例）及治疗组（36例）。治疗组主要予以常规治疗,对照组在治疗组基础上加用肾康注射液联合还原型谷胱甘肽静脉滴注,疗程均为4周。观察两组临床疗效以及治疗前后血尿素氮（blood urea nitrogen, BUN）、血清肌酐（serum creatinine, SCr）、估算的肾小球滤过率（estimated glomerular filtration rate, eGFR）、胱抑素C（cystatin C, Cys-C）水平。结果 两组临床疗效的分布比较,差异具有统计学意义（P＜0.05）,治疗组的临床疗效优于对照组。治疗组治疗后BUN、SCr、Cys-C水平较治疗前明显下降（P＜0.05）,eGFR水平明显升高（P＜0.05）;治疗组治疗前后BUN、SCr、Cys-C、eGFR差值与对照组比较,差异均有统计学意义（P＜0.05）。结论 肾康注射液联合还原型谷胱甘肽治疗慢性肾脏病疗效显著。     

肾康注射液联合还原型谷胱甘肽治疗慢性肾脏病的疗效观察

目的：观察肾康注射液联合还原型谷胱甘肽治疗慢性肾脏病（chronic kidney disease,CKD）的疗效。方法：70例慢性肾脏病患者随机分为对照组及治疗组,分别为34例,36例,治疗组主要予以西医常规治疗,对照组加肾康注射液联用还原型谷胱甘肽静滴,每天一次,疗程均为4周。观察2组治疗前后总有效率、血尿素氮（BUN）、血肌酐（SCr）、估算的肾小球滤过率（eGFR）、胱抑素C（Cys-C）,并进行评价分析。结果：观察疗程结束后,治疗组的临床疗效明显高于对照组（P＜0.05）,两组治疗前BUN、SCr、Cys-C、eGFR水平比较,差异无统计学意义（P＞0.05）,治疗组治疗后BUN、SCr、Cys-C水平较治疗前明显下降（P＜0.05）,eGFR水平明显升高（P＜0.05）,对照组治疗后BUN、SCr、Cys-C、eGFR水平比较无明显改变（P＞0.05）,治疗组治疗前后BUN、SCr、Cys-C、eGFR的差值大于对照组（P＜0.05）。结论：肾康注射液联合还原型谷胱甘肽治疗慢性肾脏病疗效佳。 关键词：肾康注射液,还原型谷胱甘肽,慢性肾脏病,疗效观察     

基于创新中医理论辨证施治慢性肾脏疾病的临床研究

目的 探索在中医理论辩证原则下使用辨证施治对比中成药配合西药治疗慢性肾脏疾病的临床疗效。方法 纳入同期门诊慢性肾脏疾病患者共225例,其中纳入接受了常规西药加中成药治疗患者170例作为对照组,纳入接受常规西药治疗配合中医理论"肾痿"治疗的患者55例作为治疗组。比较两组患者的治疗结局,并采用多元线性回归分析影响治疗结局的因素。结果 治疗组和对照组的基线数据在年龄 （P<0.01）、肾功能分期构成 （P=0.007）和蛋白尿程度 （P<0.01）上差异有统计学意义,但采用多元线性回归后,尚不认为性别、年龄、蛋白尿程度对治疗结局产生影响。治疗组对肌酐和尿素的降低优于对照组 （P<0.001）,两组对尿酸的影响差异无统计学意义 （P=0.475）。治疗组和对照组对尿蛋白 （P=0.058）和尿红细胞 (P=0.577)的影响无差异,对尿白细胞的影响亦不明显 （P=0.01）。治疗组相比对照组治疗后更多患者出现了估算肾小球滤过率上升 （P<0.001）。采用多元线性回归确定对治疗结局有统计学意义的影响因素为治疗方法分组 （P<0.001）和肾功能进展分期 （P=0.008）。相比于肾功能分期 （标准化回归系数0.165）,分组 （标准化回归系数0.395）对治疗结局的影响更大。结论 常规西药治疗配合中医理论的"肾痿"辨证施治可以改善慢性肾脏疾病患者的肾小球滤过率,在肾功能分期严重的患者中更为明显,且疗效优于常规西药加中成药治疗。     

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.