纳美芬、神经节苷脂与高压氧联合治疗急性一氧化碳中毒迟发性脑病的临床研究

目的探讨纳美芬、神经节苷脂与高压氧联合治疗急性一氧化碳中毒迟发型脑病(DEACMP)的临床疗效.方法收治急性一氧化碳中毒迟发性脑病患者160例,随机分为对照组和治疗组各80例.对照组给予对症支持治疗、高压氧治疗及神经节苷脂,治疗组在对照组的基础上给予纳美芬治疗,观察两组患者的临床疗效.结果治疗组的治愈率及总有效率明显高于对照组,治疗组BBS评分明显高于对照组,而Barthel评分明显低于对照组.上述结果差异均具有统计学意义(P<0.05).结论纳美芬、神经节苷脂与高压氧联合治疗急性一氧化碳中毒迟发型脑病疗效显著,可明显改善患者的运动功能障碍和精神障碍,值得在临床广泛推广.     

依达拉奉联合高压氧治疗急性一氧化碳中毒致迟发性脑病的临床观察

目的探讨依达拉奉联合高压氧治疗急性一氧化碳中毒致迟发性脑病的临床疗效。方法选取急性一氧化碳中毒致迟发性脑病患者80例,随机均分为2组（n=40）。对照组给予高压氧等综合治疗,观察组在对照组基础上加用依达拉奉,记录资料并进行回顾性分析。结果观察组总有效率大于对照组,差异有统计学意义（P〈0.05）;观察组无明显不良反应,未影响治疗。结论依达拉奉联合高压氧治疗急性一氧化碳中毒致迟发性脑病安全、有效,值得临床推广应用。     

高压氧治疗急性一氧化碳中毒迟发性脑病的临床疗效观察

目的：探讨高压氧治疗急性一氧化碳中毒迟发性脑病的临床疗效。方法：将我院2008年1月-2010年1月间收治的102例急性一氧化碳中毒迟发性脑病患者随机分为观察组和对照组,每组51例,对照组患者给予常规内科治疗,观察组患者在此基础上加用高压氧治疗,比较两组患者的临床疗效。结果：观察组患者治疗后的MMSE评分、MQ评分以及ADL评分均较对照组患者有显著改善,组间差异有统计学意义（P〈0．05）。观察组患者治疗后,痊愈41例,显效4例,好转3例,无效3例,治疗总有效率为94．1％,显著高于对照组患者的78．4％,治疗总有效率组间差异有统计学意义（P〈O．05）。结论：采用高压氧治疗急性一氧化碳中毒迟发性脑病,临床疗效确切,能够显著改善患者的临床症状及神经功能,值得临床进一步推广使用。     

一氧化碳中毒迟发脑病治疗体会

目的探讨高压氧联合椎管内注药治疗一氧化碳中毒迟发性脑病的疗效。方法人选50例一氧化碳中毒迟发性脑病患者随机分成两组,观察组在常规治疗基础上应用椎管内注药治疗,治疗前后分别对患者进行脑电图、临床疗效分析。结果常规治疗后临床症状明显改善,脑电图也较治疗前明显改善。临床症状的改善与疗程和脑电图的好转有相关性,观察组较对照组疗效显著,有统计学差异（P〈0,05）。结论高压氧联合椎管内注药治疗一氧化碳中毒迟发性脑病疗效显著,脑电图对临床诊断和治疗有指导意义。     

高压氧治疗一氧化碳中毒迟发性脑病的效果及护理体会分析

目的研究高压氧治疗一氧化碳中毒迟发性脑病的效果及护理体会。方法选取2016年1月至2018年5月我院收治的一氧化碳中毒迟发性脑病患者34例,随机将其分为对照组和观察组,各17例。对照组给予常规综合治疗,观察组在对照组基础上给予高压氧治疗,对比两组治疗效果。结果观察组治疗总有效率显著高于对照组(P0.05)。结论采用高压氧治疗一氧化碳中毒迟发性脑病能显著改善脑细胞功能,避免患者留下后遗症,疗效确切,值得推广。     

胞二磷胆碱联合高压氧治疗一氧化碳中毒临床疗效观察

目的观察胞二磷胆碱联合高压氧治疗急性一氧化碳中毒的临床疗效。方法 35例急性一氧化碳中毒患者随机分成两组,治疗组18例,常规＋胞二磷胆碱治疗（2-4周高压氧＋必要的糖皮质激素＋维生素＋30d胞二磷胆碱口服,0.2g/次,3次/d）,对照组17例,常规治疗（2-4周高压氧＋必要的糖皮质激素＋维生素）,对住院时间、入出院智能评分、神经伤残功能评分、随访迟发性脑病发病率等指标进行比较。结果两组住院时间无差异,P〉0.05,出院智能评分治疗组优于对照组,P〈0.05,神经伤残功能评分好于对照组,P〈0.05,随访迟发性脑病发病率明显低于对照组,P〈0.01。结论胞二磷胆碱联合高压氧治疗能明显改善一氧化碳中毒患者高级神经功能受损及减少迟发性脑病的发生。     

高压氧联合依达拉奉治疗一氧化碳中毒迟发性脑病的疗效观察

目的观察高压氧联合依达拉奉治疗一氧化碳(CO)中毒迟发性脑病(DEACMP)的临床效果。方法选取80例CO中毒迟发性脑病患者,随机分成两组,对照组40例给予常规治疗和高压氧治疗,实验组40例在常规治疗和高压氧治疗基础上加用依达拉奉治疗,经过2个疗程后,比较两组患者的临床疗效、智力水平测试分(HDS)、脑电图(EEG)等指标变化。结果治疗后,实验组的疗效优于对照组(P<0.001);两组智力水平量表评分均显著升高(P<0.01),实验组比对照组升高更明显(P<0.001);实验组脑电图恢复正常10例(25.0%),对照组脑电图恢复正常3例(7.5%),两组比较差异有统计学意义(P<0.05)。结论高压氧与依达拉奉联合应用可有效改善一氧化碳中毒迟发性脑病症状,是一组安全有效的辅助治疗药物,值得临床推广应用。     

一氧化碳中毒迟发性脑病的护理体会

目的：都可喜联合高压氧对一氧化碳中毒有特效。本实验旨在研究都可喜联合高压氧治疗一氧化碳中毒迟发性脑病的护理体会;方法：我院从2001年3月-2006年3月五年间共收治216例一氧化碳中毒迟发性脑病患者,均给予都可喜联合高压氧治疗和良好的护理,观察病情改善情况;结果：除2例无明显变化外,其余均在3个月内好转或痊愈。结论：都可喜联合高压氧对一氧化碳中毒迟发性脑病疗效确切,良好的护理可促进病情好转。     

依达拉奉联合高压氧对一氧化碳中毒迟发性脑病的预防作用

目的观察依达拉奉联合高压氧治疗对一氧化碳中毒迟发性脑病的预防作用。方法收集我院急性一氧化碳中毒中重度患者163例,分为依达拉奉+高压氧(MCI)组(76例)和高压氧对照组(87例),所有患者给予高压氧及支持治疗的同时,MCI组静脉加用依达拉奉治疗,观察治疗效果。结果 MCI组一氧化碳中毒迟发性脑病(DEACMP)阳性患者8例(10.53%),对照组DEACMP患者21例(24.14%),MCI组DEACMP发生率显著低于对照组(P<0.01),差异有统计学意义。MCI组DEACMP阳性病例的NIHSS评分和Barthel指数评分分别为(3.48±1.03)和(75.16±25.92),对照组则分别为(4.49±1.51)和(53.74±17.60),MCI组发生DEACMP的患者NIHSS评分和Barthel指数评分显著高于对照组(P<0.05)。结论依达拉奉联合高压氧和单纯应用高压氧相比,能降低一氧化碳中毒患者迟发性脑病的发生。     

纳洛酮、依达拉奉与高压氧联用治疗急性一氧化碳中毒迟发型脑病的临床研究

目的探讨纳洛酮、依达拉奉与高压氧联用治疗急性一氧化碳中毒迟发型脑病的临床疗效。方法 182例一氧化碳中毒迟发型脑病（DEACMP）患者随机分为对照组和治疗组,对照组患者行高压氧、脑复新与纳洛酮治疗,治疗组患者行高压氧、依达拉奉与纳洛酮治疗。比较两组患者的临床疗效、运动功能和生活满意度评分。结果治疗组的痊愈率明显高于对照组,无效率明显低于对照组,而总有效率明显高于对照组,治疗后两组患者BBS评分明显比治疗前升高,而Barthel评分明显降低;治疗组BBS评分明显高于对照组,而Barthel评分明显低于对照组,治疗组SF-36各项评分明显高于对照组。上述结果差异均具有统计学意义（P〈0.05）。结论纳洛酮、依达拉奉与高压氧联用治疗急性一氧化碳中毒迟发型脑病疗效显著,不良反应少,可明显改善患者的运动功能障碍和精神障碍,值得临床推广。     

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.     

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.     

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.