硫酸镁加酚妥拉明治疗哮喘急性发作116例疗效分析

目的探讨硫酸镁注射液与酚妥拉明对慢性支气管炎、支气管哮喘、慢性肺心病所致哮喘急性发作的疗效。方法将167例患者随机分为硫酸镁注射液加酚妥拉明治疗的观察组与常规治疗的对照组。观察组116例,对照组51例。两组均予氨苄青霉素或舒他西林抗感染,治疗组予硫酸镁注射液3～5g加酚妥拉明10mg于5%葡萄糖溶液100mL中缓慢静滴;对照组予氨茶碱、地塞米松常规治疗。两组皆每日1次,7～14d为一疗程。结果两组总有效率分别为93.97%和80.39%。治疗组的综合疗效明显优于对照组(P<0.01)。结论硫酸镁注射液加酚妥拉明对于慢性支气管炎、支气管哮喘、慢性肺心病所致的哮喘急性发作具有较好疗效。亦适用于慢性肺心病,因其具有抗心律失常、改善心功能、纠正心衰等作用。     

酚妥拉明、硫酸镁与法莫替丁联合治疗重度支气管哮喘63例疗效观察

目的观察酚妥拉明、硫酸镁加法莫替丁注射液治疗重度支气管哮喘的疗效。方法选择重度支气管哮喘急性发作患者87例,随机分成两组。对照组24例予西医常规治疗,治疗组63例在对照组治疗基础上加用酚妥拉明10mg、硫酸镁2.5g、法莫替丁40mg静滴。观察两组疗效及治疗前后肺活量（VC）、用力肺活量（FVC）和1s用力呼气量（FEV1）的变化。结果两组总有效率分别为96.8%和79.2%,治疗组疗效优于对照组（P（0.01）。治疗组治疗后肺功能明显改善,治疗前后比较VC分别为（1.79±0.39）L和（2.51±0.65）L,（P（0.01）;FVC分别为（1.91±0.51）L和（2.41±0.66）L,（P（0.01）;FEV1分别为（0.93±0.75）L和（1.42±0.39）L,（P（0.01）。与对照组相比有显著统计学意义（P〈0.01）。结论在常规疗法的基础上加用酚妥拉明、硫酸镁和法莫替丁注射液可提高治疗重度支气管哮喘的疗效。     

紫外线照射,充氧自血回输治疗慢性肺心病急性发作（附30例报告）

近年来，我们用紫外线照射、充氧自血回输疗法（UVB）治疗慢性肺心病急性发作30例，经对照比较，疗效满意，报告如下。60例慢性肺心病急性发作患者均为我院住院病人，符合1980年全国第三次肺心病专业会议诊断标准。随机分为两组：观察组（常规综合治疗加UVB）30例，男18例，女12例，年龄46～78岁，平均62．3岁。原发病：慢性支气管炎23例，支气管哮喘5例，支气管扩张2例。对照组（常规综合治疗）30例，男16例，女14例，年龄41～74岁，平均60．7岁。原发病：慢性支气管炎24例，支气管哮喘4例，支气管扩张与肺结核各1例。治疗方法：①观察…     

酚妥拉明联合硫酸镁治疗慢性肺心病的疗效观察

目的：探讨酚妥拉明联合硫酸镁治疗慢性肺心病的疗效。方法：150例慢性肺心病患者随机分为2组各75例,治疗组在常规治疗的基础上加用酚妥拉明和硫酸镁,对照组常规治疗。结果：治疗组总有效率92.0%,对照组77.3%。两组比较差异有显著性（P〈0.01）。结论：酚妥拉明联合硫酸镁治疗慢性肺心病疗效确切,值得临床推广应用。     

硫酸镁注射液治疗支气管哮喘急性发作期临床观察

目的:支气管哮喘是临床上常见病、多发病,反复发作,急性发作期中、重度患者不及时控制可危及生命.方法:选择支气管哮喘患者118例,随机分为两组.对照组56例,给予上氧、应用支气管舒张药、抗炎等常规治疗.治疗组62例,在常规治疗的基础上加用25%硫酸镁注射液25～50mg/(kg·日),加入5%葡萄糖注射液250ml静脉滴注,滴速为20～35滴/分.5%硫酸镁溶液5ml泵雾化吸入.结果:治疗组能很好地缓解症状,解除患者痛苦,硫酸镁有明显舒张支气管作用,效果优于对照组,两组比较有显著性差异.结论:硫酸镁注射液在治疗支气管哮喘的临床应用中有明显效果.     

硫酸镁与酚妥拉明复合注射液治疗肺心病难治性心力衰竭的疗效

目的:观察用硫酸镁与酚妥拉明复合注射治疗肺心病难治性心力衰竭(HF)的临床效果.方法:选择原发性难治性HF患者87例,将患者随机分为治疗组(47例)和对照组(40例),两组常规综合治疗相同,治疗组加用硫酸镁与酚妥拉明复合注射液静脉滴注,疗程7～10天后统计疗效.结果:治疗组和对照组的临床症状和体征改善的有效率分别为93.6%和75%,两组相比较差别有显著性(P<0.05).结论:使用硫酸镁与酚妥拉明复合注射液静脉滴注治疗肺心病难治性HF有显著疗效.     

痰热清注射液治疗慢性肺心病急性发作疗效观察

目的 观察痰热清注射液治疗慢性肺心病急性发作的临床疗效。方法 将86例慢性肺心病急性发作患者随机分为两组,对照组41例予西医常规处理,治疗组45例在对照组基础上加用痰热清注射液、复方丹参注射液、前列腺素E1;比较两组临床疗效和血气分析、血浆凝血酶原片断1＋2（F1＋2）及纤维蛋白原（Fg）的变化。结果 治疗组总有效率高于对照组;治疗组PaO2、PaCO2、F1＋2、Fg较对照组明显改善。结论 在西医常规处理基础上加用痰热清注射液、复方丹参注射液、前列腺素E1对慢性肺心病急性发作有明显治疗作用,且对血气分析及F1＋2、Fg有明显改善作用。     

复方丹参注射液、多巴胺、酚妥拉明联合治疗慢性肺心病并顽固性心衰72例疗效观察

目的观察在常规治疗基础上加用酚妥拉明、多巴胺、复方丹参注射液治疗慢性肺心病并顽固性心衰的疗效.方法将72例慢性肺心病顽固性心衰患者,随机分为两组,每组36例,两组均给予抗炎、平喘、祛痰、强心、利尿等常规治疗,在此基础上治疗组加用酚妥拉明、多巴胺、复方丹参注射液.结果治疗组总有效率(94.44%)明显高于对照组(66.67%),x2=8.87,P＜0.05.结论在常规治疗基础上加用酚妥拉明、多巴胺、丹参注射液治疗慢性肺心病顽固性心衰效果肯定,值得临床推广应用.     

酚妥拉明、多巴胺、硫酸镁联合治疗高原地区肺心病心功能不全26例疗效观察

目的:观察酚妥拉明、多巴胺、硫酸镁联合治疗高原地区肺心病心功能不全的疗效。方法:选择移居高原地区慢性肺心病心功能不全患者50例,随机分为治疗组26例,对照组24例,治疗组在综合治疗的基础上加用酚妥拉明、多巴胺、硫酸镁静脉滴注治疗,对照组在综合治疗的基础上只加用酚妥拉明静脉滴注治疗,两组均治疗两个疗程后统计疗效。结果:治疗组26例总有效率77%,对照组24例总有效率62.5%,两组相比较差别有显著性(P<0.05)。结论:酚妥拉明、多巴胺、硫酸镁联合治疗高原地区肺心病心功能不全有较好疗效。     

酚妥拉明与硫酸镁联合治疗重症支气管哮喘27例疗效观察

目的 :探讨酚妥拉明与硫酸镁治疗重症支气管哮喘的临床疗效及不良反应。方法 :对收治的重症支气管哮喘2 7例在常规治疗的基础上加用酚妥拉明及硫酸镁治疗 ,并与常规治疗组进行对照。结果 :酚妥拉明联合硫酸镁治疗重症支气管哮喘具有较好疗效。其显效及总有效率均优于对照组 (P <0 0 1) ,且无不良反应。结论 :重症支气管哮喘常规治疗的基础上加用酚妥拉明及硫酸镁治疗可提高疗效 ,值得推广应用     

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.