内镜下止血夹联合静脉推注奥美拉唑治疗消化性溃疡并出血的效果评价

目的探讨内镜下止血夹联合静脉推注奥美拉唑治疗消化性溃疡并出血的临床效果。方法选取自2015年1月—2016年1月在我院消化科住院治疗消化性溃疡并出血患者90例,入院后随机分为两组,观察组患者50例,对照组患者40例,其中只进行静脉推注奥美拉唑治疗处理的患者为对照组;采用内镜下止血夹联合静脉推注奥美拉唑处理的患者为观察组。观察并比较两组患者治疗期间的止血时间、再出血情况和止血效果。结果观察组止血总有效率显著优于对照组,差异有统计学意义(P<0.05);观察组止血所用时间明显短于对照组,差异有统计学意义(P<0.05);观察组再出血率(8.00%)明显低于对照组(22.50%),但差异无统计学意义(P>0.05)。结论采用奥美拉唑和内镜下止血夹联合治疗消化性溃疡并出血效果优于单独使用静脉推注奥美拉唑,具有止血有效率高,止血时间短等优点,值得推广和使用。     

内镜下止血联合艾司奥美拉唑治疗消化性溃疡并出血的效果分析

目的:探讨内镜下止血联合艾司奥美拉唑治疗消化性溃疡并出血的效果.方法:选取2018年2月—2020年1月就诊于廉江市人民医院的160例消化性溃疡并出血患者,按随机数字表法分为两组,每组各80例.参考组行单一艾司奥美拉唑治疗,试验组行内镜下止血与艾司奥美拉唑联合治疗.比较两组临床疗效、再出血率、止血时间、住院时间、输血量、胃液pH值及不良反应发生情况.结果:试验组治疗总有效率高于参考组,再出血率、输血量低于参考组,止血时间、住院时间短于参考组,差异有统计学意义(P<0.05);两组治疗后24 h胃液pH值较治疗前明显升高,且试验组胃液pH值高于参考组,差异有统计学意义(P<0.05);两组不良反应发生率相比,差异无统计学差异(P>0.05).结论:消化性溃疡并出血患者接受内镜下止血联合艾司奥美拉唑治疗安全性较高,能缩短止血时间,减少再出血发生与输血量,提高胃液pH值,缩短住院时间.     

静脉滴注大剂量雷贝拉唑治疗消化性溃疡出血高危患者43例疗效分析

目的:观察内镜止血联合静脉滴注大剂量雷贝拉唑治疗消化性溃疡出血高危患者的临床疗效.方法:消化性溃疡出血高危患者86例随机分为观察组和对照组,每组43例患者.观察组患者给予内镜止血联合大剂量雷贝拉唑治疗,对照组患者给予内镜止血联合大剂量艾司奥美拉唑治疗.比较两组患者的止血治疗效果、止血时间、再出血发生率和不良反应情况.结果:两组患者治疗总有效率、72h后再出血发生率、不良反应发生率比较,差异无统计学意义(P>0.05);观察组中位止血时间为25.5h,明显短于对照组(P<0.05).结论:内镜止血联合静脉滴注大剂量雷贝拉唑治疗消化性溃疡出血高危患者的疗效与内镜止血联合大剂量艾司奥美拉唑的治疗效果相当,且能明显缩短止血时间,值得临床推广.     

不同剂量奥美拉唑联合内镜下止血治疗中低危消化性溃疡出血的效果比较

目的对比分析不同剂量奥美拉唑联合内镜下止血治疗消化性溃疡伴出血的临床效果。方法选取2017年12月至2018年11月登封市妇幼保健院收治的33例消化性溃疡伴出血患者,以随机数表法分为A组(17例)和B组(16例)。A组接受奥美拉唑20 mg联合内镜下止血治疗,B组接受奥美拉唑40 mg联合内镜下止血夹治疗。比较两组患者止血时间、住院时间及再出血发生情况。结果 A组总有效率为64.71%(11/17),B组总有效率为93.75%(15/17),B组总有效率高于A组,差异有统计学意义(P<0.05)。B组止血时间和住院时间均短于A组,差异有统计学意义(均P<0.05)。治疗过程中,A组发生再出血4例(23.53%),B组未发生再出血。B组再出血率低于A组,差异有统计学意义(P<0.05)。结论大剂量奥美拉唑联合内镜下止血治疗中低危消化性溃疡出血的临床效果显著,且可预防再出血的发生。     

胃镜下止血结合奥美拉唑治疗消化性溃疡50例疗效分析

目的探讨胃镜下止血结合奥美拉唑治疗消化性溃疡的临床疗效。方法选取2010年3月—2011年6月于该院就诊的消化性溃疡患者100例,随即分为观察组和对照组,每组各50例。对照组行口服去甲肾上腺素联合奥美拉唑治疗,观察组行胃镜下注射去甲肾上腺素联和奥美拉唑联合治疗,观察两组患者表现,对比分析两种治疗方法的临床疗效。结果观察组患者的止血时间、再出血率、手术时间、住院天数与对照组相比较,差异有统计学意义（P〈0.05）。结论胃镜下静脉注射去甲肾上腺素止血联合奥美拉唑治疗消化性溃疡疗效好。     

两种不同内镜下钛夹止血法治疗消化性溃疡出血的回顾性对比研究

目的对比分析两种不同内镜下钛夹止血法治疗消化性溃疡出血的疗效及再出血原因。方法选取2012年3月~2017年7月消化性溃疡出血患者152例,按时间顺序分为单用OLYMPUS钛夹组(A组)84例和内镜下肾上腺素注射联合新型可回收旋转组织钛夹组(B组)68例。对比分析两组间初次止血成功率、近期出血率、延迟出血率、再次止血成功率、钛夹使用数量、止血时视野清晰情况、再出血时血清白蛋白水平及钛夹开始脱落时间。结果 B组初次止血成功率高于A组(P0.001);A组近期出血率及延迟出血率均高于B组(P0.05);两组间再次止血成功率比较差异无统计学意义(P0.05);A组钛夹使用数量少于B组(P0.001);B组视野清晰情况优于A组(P=0.002);再出血时血清白蛋白水平两组间差异无统计学意义(P=0.635);B组钛夹开始脱落时间晚于A组(P0.001)。结论内镜下肾上腺素注射联合新型可回收旋转组织钛夹治疗消化性溃疡出血比单纯金属钛夹更有效,可保持治疗时视野清晰、精准而又充分地夹闭血管及重视患者术后处理,能提高患者内镜下止血成功率。     

内镜下止血术联合中药穴位贴敷治疗消化性溃疡出血的临床研究

目的：观察内镜下止血术联合中药穴位贴敷治疗消化性溃疡出血的临床效果。方法：选择2020年7月-2022年6月桂林市中西医结合医院收治的62例消化性溃疡出血患者,采用随机数字表法将其分为观察组（31例）和对照组（31例）。对照组采用内镜下止血术,观察组在对照组的基础上联合中药穴位贴敷。比较两组患者止血效果,临床指标（呕血消失时间、内镜止血时间、内镜止血成功率、黑便消失时间、住院时间、腹痛缓解时间）,再出血率及不良反应。结果：观察组止血总有效率高于对照组（P<0.05）。观察组呕血消失时间、黑便消失时间、住院时间、腹痛缓解时间均短于对照组（P<0.05）;两组内镜止血时间、内镜止血成功率比较,差异均无统计学意义（P>0.05）。观察组再出血率低于对照组（P<0.05）。两组均未见明显不良反应。结论：内镜下止血术联合中药穴位贴敷治疗消化性溃疡出血效果显著,能改善临床症状,有效降低患者术后的再出血率。     

内镜介入联合质子泵抑制剂三联疗法治疗消化性溃疡合并上消化道出血

目的 探讨内镜介入治疗联合质子泵抑制剂三联疗法治疗消化性溃疡合并上消化道出血(UGB)的临床疗效及安全性.方法 80例消化性溃疡伴出血患者随机分为治疗组和对照组,对照组采用泵抑制剂三联疗法(奥美拉唑+阿莫西林+克拉霉素)治疗,治疗组采用内镜下巴曲酶联合质子泵抑制剂三联疗法治疗.观察治疗后12、24、48小时止血情况和空腹胃液pH,治疗14天后评价疗效,记录不良反应.结果 治疗组临床疗效总有效率为97.5％,明显优于对照组(70.0％),差异有显著性.治疗后12、24、48小时治疗组止血率分别为75.0％、82.5％、97.5％,均显著高于对照组.治疗后12、24、48小时,治疗组和对照组空腹胃液pH显著高于治疗前水平,差异有显著性.两组均无严重不良反应发生.结论 内镜介入治疗后联合应用质子泵抑制剂三联疗法治疗消化性溃疡合并UGB安全可靠.     

中西医结合治疗消化性溃疡出血56例

目的观察消溃止血饮合奥美拉唑治疗消化性溃疡出血临床疗效。方法将112例消化性溃疡出血患者随机分为治疗组与对照组,治疗组给予消溃止血饮合奥美拉唑,对照组给予奥美拉唑合安络血、止血芳酸。疗程两周,观察大便隐血转阴率,主要症状改善率,溃疡愈合率及不良反应。结果治疗组大便隐血转阴率明显优于对照组(P<0.01),总有效率、主要症状改善率、溃疡愈合率两组间比较无显著性差异(P>0.05)。结论消溃止血饮合奥美拉唑治疗消化性溃疡有较好的疗效。     

48例奥美拉唑联合血凝酶治疗消化性溃疡出血的疗效观察

目的：观察奥美拉唑与血凝酶联合治疗消化性溃疡出血的临床疗效。方法从收治的消化性溃疡出血患者中抽取48例,将其随机分为2组,各24例。其中,对照组采用常规治疗,并利用奥美拉唑治疗;观察组在对照组基础上,外加血凝酶治疗,比较2组治疗效果。结果比较2组治疗总有效率,对照组为83.33%远低于观察组的91.67%,差异具有统计学意义（P<0.05）;观察组平均止血时间与再出血率均明显少于对照组,差异有统计学意义（均P<0.05）。结论利用奥美拉唑与血凝酶治疗消化性溃疡出血可取得显著疗效,起效迅速,不良反应少,具有良好的临床推广应用价值。     

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.     

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.     

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.