口腔粘膜白斑的临床治疗分析

目的探讨口腔粘膜白斑的临床治疗方法及效果。方法将河北省承德市口腔医院牙周科收治80例口腔粘膜白斑患者按照随机数字法分为两组。对照组患者给予综合治疗,观察组给予综合+CO2激光手术治疗,观察两组的临床效果和不良反应情况。结果观察组总有效率92.5%,对照组总有效率为80.0%,对照组和观察组的数据比较,差异有统计学意义(P<0.05);对照组不良反应发生率和观察组不良反应发生率比较,差异无统计学意义(P>0.05)。结论临床中口腔粘膜白斑患者应用综合+CO2激光手术治疗是可行的,效果显著,不良反应少,值得临床中应用。     

药物综合疗法治疗甲亢合并2型糖尿病效果观察

目的：观察药物综合疗法治疗甲状腺功能亢进（甲亢）合并2型糖尿病（T2DM）的临床效果。方法选择46例甲亢合并 T2DM患者,随机分为两组,各23例。对照组给予甲巯咪唑联合二甲双胍治疗,观察组给予甲巯咪唑、二甲双胍联合胰岛素综合治疗。比较两组治疗总有效率和血糖水平以及不良反应发生率的差异。结果观察组治疗总有效率为95．65％,高于对照组的69．57％（ P ＜0．05）;观察组各时段血糖水平均低于对照组（ P ＜0．01）;两组均无严重不良反应发生,不良反应发生率无统计学差异（ P ＞0．05）。结论甲巯咪唑、二甲双胍联合胰岛素药物综合疗法治疗甲亢合并T2DM效果确切,能有效控制血糖,且无严重不良反应,值得临床推广应用。     

阿奇霉素不同用药方式治疗支原体肺炎患儿临床效果研究

目的：进行小儿支原体肺炎治疗中阿奇霉素不同用药方式效果的探讨。方法：选择我院2015年6月至2016年5月收治144例支原体肺炎患儿,将其随机平均划分为观察组和对照组。两组患者均接受化痰、平喘、止咳治疗,在此基础上对照组患者接受常规阿奇霉素治疗,观察组患者接受阿奇霉素序贯疗法治疗,治疗,进行两组患者治愈率和不良反应发生率的对比。结果：观察组具有91．8％的治疗有效率,对照组具有72．3％的治疗有效率,观察组治疗有效率明显高于对照组,两组数据差异存在统计学意义,P＜0．05。观察组具有11．2％不良反应发生率,对照组具有30．5％不良反应发生率,观察组不良反应发生率明显对于对照组,两组数据差异存在统计学意义,P＜0．05。结论：在小儿支原体肺炎治疗中阿奇霉素序贯疗法疗效显著,并其能够有效降低不良反应的发生,具有较高的临床推广价值。     

碳酸氢钠溶液用于雾化吸入后口腔护理预防真菌感染的效果观察

目的:观察碳酸氢钠溶液用于雾化吸入后口腔护理预防真菌感染的效果。方法:选择行雾化吸入治疗的78例呼吸道疾病住院患者,随机分为对照组(39例)和观察组(39例)。两组患者均给予糖皮质激素(布地奈德)雾化吸入治疗,雾化吸入后,观察组采用碳酸氢钠溶液进行口腔护理,对照组采用生理盐水进行口腔护理,对比两组口腔真菌感染、黏膜白斑及溃疡的发生率。结果:观察组口腔真菌感染发生率(7. 69%)显著低于对照组(20. 51%),差异有统计学意义(P <0. 05);观察组口腔黏膜白斑发生率(5. 13%)和口腔溃疡发生率(2. 56%)均显著低于对照组(15. 38%;15. 38%),差异有统计学意义(P <0. 05)。结论:雾化吸入后采用碳酸氢钠溶液进行口腔护理,可有效降低口腔真菌感染发生率。     

奥硝唑与甲硝唑治疗滴虫阴道炎的临床疗效对比分析

目的：对奥硝唑与甲硝唑治疗滴虫阴道炎病症的临床效果进行分析。方法：选取我院2015年3月～2016年3月收治的100例滴虫阴道炎患者为研究对象,依据患者治疗方式的差异将其分为对照组与观察组,各50例。其中,对照组给予奥硝唑治疗,观察组患者给予甲硝唑治疗,1个疗程之后,对两组患者的治疗疗效进行比较,并且记录不良反应发生状况。结果：对照组总有效率高于观察组,差异具有统计学意义,即为P＜0．05。对照组发生胃肠道反应7例,头晕2例,皮疹0例,不良反应发生率为18．0％;观察组患者发生胃肠道反应26例,头晕6例,皮疹1例,不良反应发生率为66．0％。两组不良反应发生率比较,差异具有统计学意义,即为P＜0．05。结论：在滴虫阴道炎治疗过程中,相比于甲硝唑,奥硝唑的疗效更加确切,治愈率更高,安全性更好,不良反应发生率也更加低。     

综合疗法治疗输卵管堵塞的临床疗效分析

目的：研究分析综合疗法治疗输卵管堵塞的临床疗效。方法：选择该院2014年2月至2015年2月接收的输卵管堵塞患者84例作为研究对象，将患者分为两组，观察组和对照组，均为42例，观察组患者应用综合疗法进行治疗，对照组应用常规方法进行治疗，对两组治疗效果和安全性进行比较分析。结果：观察组患者治疗有效率高于对照组（P ＜0．05）；观察组患者不良反应发生率与对照组差异不大（P ＞0．05）。结论：综合疗法治疗输卵管堵塞的临床疗效较理想，可有效提高妊娠率，值得推广应用。     

四联疗法治疗幽门螺杆菌阳性消化性溃疡的临床疗效分析

目的：分析研究四联疗法治疗幽门螺杆菌阳性消化性溃疡的临床疗效。方法：回顾性分析2012年2月～2013年2月期间在我院治疗的46例幽门螺杆菌阳性消化性溃疡患者的临床资料。将46例患者随机分为治疗组和对照组各23例,治疗组给予四联疗法治疗,对照组给予三联疗法治疗,观察两组临床疗效及不良反应。结果：治疗组Hp根除率为91．30％（21/23）,对照组Hp根除率为78．26％（18/23）,两组Hp根除率比较差异有统计学意义（P＜0．05）;治疗4周后,治疗组临床疗效明显优于对照组（P＜0．05）;治疗组不良反应发生率明显低于对照组（P＜0．05）。结论：四联疗法具有溃疡愈合迅速、Hp根除率高、不良反应小、疗程短等优点,易于被患者接受,值得临床推广应用。     

甲巯咪唑联合心得安治疗甲亢的临床疗效探析

目的：探析甲巯咪唑联合心得安治疗甲亢的临床疗效。方法：将80例甲亢患者随机分为观察组和对照组，给予观察组甲巯咪唑联合心得安治疗，给予对照组单纯甲巯咪唑治疗，对比两组的治疗效果和不良反应发生情况。结果：观察组的治疗总有效率为95．00％，高于对照组的77．50％，且差异较大，P ＜0．05。另外，观察组和对照组的不良反应发生率（分别为7．50％和2．50％）差异较小，P ＞0．05。结论：给予甲亢患者甲巯咪唑联合心得安治疗效果显著，能有效提高治疗总有效率，且不良反应较少，值得推广。     

克莫司软膏治疗糜烂型口腔扁平苔藓效果分析

目的探讨他克莫司软膏治疗糜烂型口腔扁平苔藓的临床效果。方法选择口腔科就诊的糜烂型口腔扁平苔藓患者80例,将其随机分成观察组和对照组,每组40例。观察组给予他克莫司软膏治疗;对照组应用氟轻松软膏治疗;均2次／d涂于患处,疗程均为8周。观察比较两组的临床疗效、不良反应发生率及复发率。结果观察组总有效率为90．0％,对照组为67.5％,两组总有效率比较差异有统计学意义（P〈0．05）。两组不良反应发生率和复发率比较（70.0％VS30.0％,7．5％vsf7．5％）,差异均有统计学意义（均p〈0.05）。结论他克莫司软膏治疗糜烂型口腔扁平苔藓具有良好的临床疗效,不良反应少,复发率低。     

交感型颈椎病综合治疗的临床研究

目的：探讨超短波、牵引、α受体拮抗剂、运动疗法综合治疗交感型颈椎病的近期和远期效果。方法：将80例患者随机分为治疗组和对照组，治疗组采用超短波、牵引、运动治疗、α受体拮抗剂；对照组采用超短波、牵引、电脑中频、药物治疗。观察两组患者治疗后的即时疗效和6个月的复发率。结果：治疗12d后评定疗效，治疗组治愈率为65．0％，对照组治愈率为40．0％，）（Χ^2=5．01，治疗组近期疗效优于对照组（P〈0．05）。治疗后6个月随访时评定，治疗组35例为治愈和显效患者，未发现复发病例；而对照组30例中于6个月内有5例复发，Χ^2=4．19，6个月后的复发率治疗组明显低于对照组（P〈0．05）。结论：超短波、牵引、仅受体拮抗剂、运动治疗综合疗法对交感型颈椎病患者有较好的近期和远期效果，适用于交感型颈椎病患者。     

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.