5-氨基水杨酸治疗溃疡性结肠炎的临床观察

目的观察氨基水杨酸（5-ASA）治疗溃疡性结肠炎（UC）的疗效与安全性。方法对2004年6年至2009年4月确诊的溃疡性结肠炎48例患者,随机分为治疗组（5-ASA）与对照组柳氮磺胺吡啶（SHSP）组分别为26例与22例。5-ASA组给予5-ASA3～4g/d;SASP组给予SASP4-6g/d,2组均于治疗前及疗程6周复查结肠镜评估疗效。结果5ASA治疗UC6周后有效率与SASP组无显著差异（P〉0.05）显效率与SASP组差异有显著性（P〈0.05）;药物不良反应如恶心,肝功能损害明显低于SASP组。结论5-ASA为治疗UC安全有效不良反应明显减少的药物。     

昆明市10家医院炎症性肠病患者临床资料分析

目的：回顾性调查昆明市住院的炎症性肠病（IBD）患者,了解该市近年来 IBD 患者临床资料特点。方法选取该市10家三级综合医院,调查2007年1月至2013年12月住院符合 IBD 诊断的1029例患者的性别、年龄、病程、症状等人口资料及诊断、治疗、转归等情况。结果本组资料显示,该市近7年 IBD 住院病例数有逐年上升的趋势。1029例 IBD 患者中溃疡性结肠炎（UC）患者853例,克罗恩病（CD）患者157例,未定型 IBD 患者19例。本组 IBD 患者男女比例为1．23∶1．00,IBD 患者平均发病年龄为（47．93±16．78）岁,UC 患者的发病高峰年龄为40～60岁,CD 患者发病高峰年龄为20～40岁,以病程小于5年的患者居多;本组 IBD 患者城镇人口多于农村人口;UC 住院病例明显多于 CD ,住院 IBD 患者疾病严重程度以中度为主。 UC 临床类型以慢性复发型（64．4％）为主,CD 以狭窄型（41．2％）和炎症型（51．0％）为主。 IBD 主要症状有腹泻（91．0％）、腹痛（84．6％）、血便（79．4％）等;肠外表现（6．1％）和并发症（10．6％）少见。辅助确诊手段主要为结肠镜（97．7％）及病理检测（29．2％）。结肠镜检查显示 UC 以直肠和乙状结肠病变为主,CD 以回盲部及回肠末端为主。治疗以氨基水杨酸类和类固醇激素为主,较少患者应用免疫抑制剂。单纯内科治疗总有效率达92．4％,病死率0．4％。结论该市 IBD 发病数近年有逐渐增加的趋势,发病患者以中青年为主,疾病严重程度以中度为主,UC 临床类型以慢性复发型为主,CD 以狭窄型和炎症型为主,肠外表现及并发症较少。治疗以氨基水杨酸类及类固醇激素为主,并且需要长期维持治疗。     

10年间溃疡性结肠炎住院患者临床特征和治疗方式演变

目的 探讨过去10年间溃疡性结肠炎（UC）住院患者临床特征和治疗方式的演变。方法 通过航天中心医院病案管理系统收集2003年1月-2012年12月住院诊断为UC患者的临床资料,记录患者一般资料、临床特征（临床类型、疾病分期、严重程度及病变范围）、治疗方式。比较前5年（2003-2007年）和后5年（2008-2012年）患者一般资料、临床特征和治疗方式的演变。结果 共纳入115例患者,发病高峰年龄段分别为20～29岁（17例,占14.8%）及50～69岁（52例,占45.2%）。前5年纳入患者49例,后5年纳入患者66例,前、后5年患者病程比较,差异有统计学意义（Z=-2.522,P＜0.05）。115例患者临床类型以初发型为主,占55.6%（64/115）;疾病分期多处于活动期,占93.9%（108/115）;严重程度以轻、中度为主,占81.5%（88/108）;病变范围以广泛结肠型为主,占51.3%（59/115）。115例患者均行内科药物治疗,其中应用氨基水杨酸制剂者97例（84.3％）,包括单用水杨酸偶氮磺胺吡啶（SASP）者33例（28.7％）,单用5-氨基水杨酸（5-ASA）者55例（47.8％）,SASP+5-ASA者9例（7.8％）;局部保留灌肠者80例（69.6％）。前、后5年患者微生态制剂、止泻药使用率和局部保留灌肠治疗率比较,差异有统计学意义（χ2=4.000、3.997、4.054,P＜0.05）。结论 20～29岁及50～69岁是UC的发病高峰年龄段,初发型、轻中度活动期、广泛结肠型多见,病变范围呈扩大化,氨基水杨酸制剂仍是治疗UC的主要药物,微生态制剂、局部保留灌肠逐渐应用于治疗。     

四川省357例溃疡性结肠炎住院病例回顾分析

目的　回顾性调查我省住院溃疡性结肠炎(UC)患者的诊断、治疗及逐年就诊情况,探讨近年住院病例UC的特点。方法　全省选取5个大型医院,调查1990～2 0 0 3年期间住院诊断为UC的患者,重新审定入组病例,并填写统一的调查表,调查表内容包括患者的诊断、治疗及逐年就诊情况和同期内镜检出率。结果　筛出住院UC患者共3 5 7例,其中男女之比为1.76∶1,年龄12～77(平均46±14 .2 )岁,97.8%UC患者为活动期,以中度(4 2 .7%)和重度(2 9.4%)为主。初发型(3 7.8%)和慢性复发型(4 8.5 %)多见。主要表现为腹泻、腹痛、血便。治疗上以SASP/ 5ASA (69.2 %)和类固醇激素(4 9.0 %)为主。单纯内科治疗总有效率达87.6%,其中8例(2 .2 %)患者行手术治疗,死亡4例(1.1%)。结论　本组住院UC患者以中重度为主,主要为慢性复发型,结肠镜及粘膜活检对诊断有重要意义。综合治疗效果好,预后较好,手术率、病死率及癌变率均较国外报道低。     

中、重型溃疡性结肠炎176例临床诊疗分析

目的评价中、重型溃疡性结肠炎的临床特点及疗效。方法回顾性分析176例中、重型溃疡性结肠炎住院患者的诊疗资料。结果中、重型溃疡性结肠炎患者病变以左半结肠炎型常见，且以初发型及慢性复发型为主。控制急性发作主要药物为糖皮质激素。药物治疗中型、重型溃疡型结肠炎有效率分别为97．3％（144／148）、89．3％（25／28），外科手术率10．7％（3／28）。肠外并发症发生率8．5％（15／176），结肠息肉发生率26．1％（46／176），癌变率2．3％（4／176）。结论正确系统应用糖皮质激素治疗中、重型溃疡性结肠炎疗效显著，但应定期复查结肠镜。     

思密达和5-氨基水杨酸肠溶片治疗溃疡性结肠炎疗效观察

目的 观察思密达和5-氨基水杨酸（5-ASA）肠溶片治疗轻、中度活动期溃疡性结肠炎（UC）临床资料。方法选择70例轻、中度活动期UC患者，随机分成治疗组和对照组，治疗组服思密达和5-ASA肠溶片，对照组服5-ASA肠溶片，疗程6周。结果治疗组总有效率91．9％，对照组总有效率78．8％，两组差异有统计学意义（P〈0．05）。结论思密达配伍5-ASA肠溶片治疗UC较单用5-ASA疗效高，可推广应用。     

中西医结合治疗慢性非特异性溃疡性结肠炎128例

为观察自拟中药保留灌肠加柳氮磺胺吡啶（SASP）口服治疗慢性非特异性溃疡性结肠炎（UC）的疗效,将238例UC患者,随机分成治疗组128例采用自拟中药保留灌肠加SASP口服,对照组110例用SASP加思密达口服治疗。治疗组完全缓解率为43．0％,显效率为25．0％,总有效率为89．06％;对照组分别为27．3％、20．9％和70．91％。两组完全缓解率、显效率、总有效率差异有统计学意义。结果表明采用自拟中药保留灌肠加SASP口服治疗UC有较好的疗效。     

活动期溃疡性结肠炎临床疗效评价

目的:分析溃疡性结肠炎(UC)活动期的临床疗效及治疗转归,评价预后相关因素。方法:回顾性分析我院128例住院患者的病例资料,记录临床表现及诊疗经过,对柳氮磺吡啶(SASP)或5-氨基水杨酸(5-ASA),糖皮质激素,免疫抑制剂,灌肠,外科手术等治疗方法的疗效进行评价。结果:活动期UC患者中,轻度占25.0%(32/128),中度占53.9%(69/128),重度占21.1%(27/128);SASP或5-ASA是控制症状的主要药物,对于中度UC患者,联合用药治疗效果较为理想。而发病年龄轻、结肠病变范围大、低血红蛋白、大便以血为主、低血清白蛋白、病变伴有溃疡是提示疗效差的相关因素。结论:对于UC病变处于活动期时,应及时评估病情严重程度,选择疗效相对较好的治疗方案,并分析影响疗效相关因素。     

思密达加5-氨基水杨酸对溃疡性结肠炎的疗效

目的观察思密达和5-氨基水杨酸（5-ASA）联合灌肠对溃疡性结肠炎（UC）的疗效。方法选择UC患者73例，随机分成治疗组（37例）和对照组（36例），治疗组给予思密达6g和5-ASA1g保留灌肠，每日1次，共3周，对照组给予5-ASA1g保留灌肠，每日1次，共3周。结果治疗组总有效率91．9％，对照组总有效率72．2％，2组差异有统计学意义（P〈0．05）。结论思密达和5-ASA联合灌肠治疗UC较单用5-ASA灌肠治疗疗效高。     

141例溃疡性结肠炎住院病例分析

目的：研究溃疡性结肠炎（UC）患者的临床特征。方法：收集141例UC患者的相关资料,分析其临床特点。结果：141例患者临床症状多数有腹痛、腹泻、脓血便等,结肠镜检查示病变呈连续性、弥散性分布,病变范围直肠、乙状结肠占20.5%,左半结肠占29.8%,全结肠占34.7%。临床分型以初发型及慢性复发型为主,治疗上根据病情轻重予5-ASA类药物和（或）激素及灌肠治疗,缓解率高。结论：发病率逐年增加,临床表现较典型,住院患者以全结肠及左半结肠多见,目前以内科药物保守治疗为主。     

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.