卡托普利联合硝苯地平治疗高血压30例疗效评估

目的探讨卡托普利联合硝苯地平治疗高血压的临床疗效。方法 60例高血压患者均符合2005年中国高血压病防治指南的诊断标准,随机分为观察组和对照组各30例,观察组给予卡托普利,同时口服硝苯地平控释片,对照组仅给予硝苯地平,观察比较2组的临床疗效及血压的改变情况。结果治疗组的总有效率为93.3%,明显高于对照组的总有效率60.0%,经统计学处理,2组总有效率比较,差异有显著性（χ2=8.363,P〈0.05）。2组患者的收缩压和舒张压治疗后均较治疗前显著下降（P〈0.05）,且治疗后治疗组组对照组相比,降压效果经统计学分析,差异有显著性（P〈0.01）。结论卡托普利联合硝苯地平治疗高血压治疗比单用卡托普利或硝苯地平更有效。     

硝苯地平联合卡托普利治疗原发性高血压46例的疗效比较

目的探讨硝苯地平联合卡托普利治疗原发性高血压的临床疗效。方法 92例高血压患者随机分为观察组和对照组各46例,观察组给予卡托普利起始剂量为6.25mg/次,3次/d。同时口服硝苯地平控释片20mg,每日2次。对照组仅给予硝苯地平10mg,2次/d。结果观察组与对照组的总有效率比较,治疗4周后,2组血压均较治疗前血压呈显著性下降。结论硝苯地平联合卡托普利治疗原发性高血压疗效好,值得临床推广和应用。     

硝苯地平联合卡托普利治疗原发性高血压的临床疗效分析

目的：观察卡托普利配合硝苯地平治疗原发性高血压的临床疗效。方法对我院2012年—2014年收治的154例原发性高血压患者的临床资料进行回顾性分析，并将其分为研究组与对照组，每组77例。对照组给予卡托普利，研究组则给予卡托普利配合硝苯地平治疗。治疗8周后对2组患者的疗效进行评价。结果研究组不仅在治疗总有效率上显著高出对照组，且治疗过后的舒张压与收缩压也优于对照组，组间差异具有统计学意义（P<0.05）。结论卡托普利配合硝苯地平用于治疗原发性高血压效果更优，值得在临床中推广应用。     

硝苯地平缓释片联合依那普利治疗老年冠心病合并高血压患者的临床效果

目的：探讨硝苯地平缓释片和依那普利联合用药治疗老年冠心病合并高血压的临床效果。方法：选取我院2013年1月－2015年12月收治的80例老年冠心病合并高血压患者,随机分为对照组和实验组,每组各40例,对照组采用硝苯地平缓释片进行治疗,研究组在对照组治疗基础上给予依那普利。比较2组患者的临床治疗情况。结果：实验组患者显效20例,有效17例,无效3例,总有效率为92．5％;对照组患者显效12例,有效18例,无效10例,总有效率为75．0％;两组总有效率比较差异有统计学意义（P＜0．05）;治疗前2组患者各项指标比较差异无统计学意义（P＞0．05）。治疗后,实验组患者采取联合用药后,收缩压（SBP）和舒张压（DBP）水平均下降幅度大于对照组,差异有统计学意义（P＜0．05）。结论：采用硝苯地平缓释片联合依那普利治疗老年冠心病合并高血压,临床疗效显著,患者预后较好。     

硫酸镁与硝苯地平联合方案治疗妊娠高血压综合征的临床效果

目的：探讨硫酸镁与硝苯地平联合方案治疗妊娠高血压综合征的临床效果。方法：选取2011年7月～2014年6月于本院进行治疗的48例妊娠高血压综合征患者,分为对照组24例和观察组24例,对照组患者单纯给予硫酸镁进行治疗,观察组患者采用硫酸镁与硝苯地平联合方案进行治疗,对比观察2组患者治疗的临床效果。结果：对照组和观察组患者治疗的总有效率分别为79．17％和95．83％,观察组显著优于对照组,P＜0．05表示有显著性差异,有统计学意义。结论：硫酸镁与硝苯地平联合方案治疗妊娠高血压综合征的临床效果显著,值得临床广泛推广应用。     

卡托普利与硝苯地平联合治疗老年高血压患者的疗效观察

目的观察卡托普利联合硝苯地平治疗老年高血压患者的临床疗效。方法将95例高血压患者随机分为联合治疗组47例和对照组48例。联合治疗组采用卡托普利和硝苯地平联合治疗,对照组在仅用硝苯地平治疗。疗程均为8周。结果联合治疗组总有效率87.2%,对照组总有效率72.9%,2组疗效比较有显著性差异（P〈0.05）。与对照组治疗后比较,联合治疗组收缩期和舒张期血压明显降低（P〈0.05）。2组无严重并发症出现。结论卡托普利联合硝苯地平是治疗老年高血压患者一种安全有效的用药方法。     

硫酸镁及硫酸镁联合硝苯地平治疗妊高症效果对比

目的：对硫酸镁及酸镁联合硝苯地平治疗妊高症的临床效果进行探讨。方法：选取我院2013年5月－2014年5月收治的80例妊高症患者,随机分成治疗组与对照组,每组各40例,对照组患者给予硫酸镁治疗,治疗组患者给予硫酸镁联合硝苯地平治疗,比较两组患者的临床疗效。结果：治疗组与对照组患者的临床治疗总有效率分别为97．5％、77．5％,两组比较,差异具有统计学意义（P＜0．05）。结论：应用硫酸镁联合硝苯地平治疗妊高症具有较好的临床效果,因此值得临床推广及应用。     

卡托普利并硝苯地平缓释片治疗高血压病疗效观察

目的 观察、比较卡托普利和硝苯地平联用与卡托普利单用治疗高血压病的疗效。方法 106例高血压病患者，随机分为治疗组（54例）和对照组（52例），治疗组卡托普利和硝苯地平联用，对照组卡托普利单用，用药4周后进行疗效分析。结果 治疗组血压明显下降，总有效率达98．1％，对照组总有效率88．5％，P〈0．05。结论 卡托普利和硝苯地平联用治疗高血压病疗效显著。     

联合应用卡托普利和硝苯地平治疗原发性高血压的疗效观察

分析联合应用卡托普利和硝苯地平治疗原发性高血压的临床效果。方法：将2013年3月至2013年11月我院收治的100例原发性高血压患者随机分为对照组和治疗组，每组各50例患者。为对照组患者使用卡托普利进行治疗，为治疗组患者在使用卡托普利的基础上加用硝苯地平进行治疗，对比分析两组患者的临床疗效。结果：与对照组患者相比，治疗组患者在进行治疗后其收缩压和舒张压下降的幅度均较大，差异显著（P＜0.05），有统计学意义。在进行治疗后，两组患者的心率相比较差异不显著（P＞0.05），无统计学意义。在治疗组患者中，有37例患者显效，11例患者有效，2例患者无效，其治疗的总有效率为96%。在对照组患者中，有19例患者显效，20例患者有效，11例患者无效，其治疗的总有效率为78%。治疗组患者治疗的总有效率明显高于对照组患者，差异显著（P＜0.05），有统计学意义。结论：联合应用卡托普利和硝苯地平治疗原发性高血压的疗效确切，可在临床上推广应用。     

用硝苯地平缓释片联合缬沙坦片治疗高血压的疗效观察

目的：探讨用硝苯地平缓释片联合缬沙坦片治疗高血压的临床效果。方法：对2011年12月～2013年12月期间我院收治的200例高血压患者的临床资料进行回顾性研究。我们将这200例患者随机分为对照组和实验组，每组各有100例患者。我院对对照组患者使用缬沙坦片进行治疗。对实验组患者在使用缬沙坦片进行治疗的基础上（方法与对照组相同），加用硝苯地平缓释片进行治疗。治疗结束后，比较两组患者的治疗效果和两组患者治疗后血压控制的情况。结果：实验组患者治疗的总有效率为92.0%，对照组患者治疗的总有效率为75.0%，实验组患者治疗的总有效率明显高于对照组患者，两组相比差异具有显著性（P<0.05）。治疗结束后，两组患者的收缩压及舒张压均有所下降。实验组患者的收缩压及舒张压的下降幅度明显大于对照组的患者，二者相比差异具有显著性（P<0.05）。结论：用硝苯地平缓释片联合缬沙坦片治疗高血压的疗效确切，安全性高。该方法值得在临床上推广使用。     

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.