苯那普利联合倍他乐克治疗充血性心力衰竭疗效观察

目的 观察洛汀新、倍他乐克联合治疗充血性心力衰竭患者的临床疗效、死亡率及病残率。方法 将169例慢性充血性心力衰竭患者随机分为治疗组90例及对照组79例，两组患者均给予常规治疗，治疗组在常规治疗基础上，给予洛汀新5-10mg／d；倍他乐克6．25-100mg/d，治疗0．5～2年。治疗6个月后心脏超声复查。对治疗终点的临床疗效进行评价。结果 治疗组患者心率减慢，心功能改善，超声心动图复查显示左室舒张末期内径及左房内径缩小，左室射血分数增高，随访2年其死亡率及病残率明显低于对照组。结论 慢性充血性心力衰竭患者长期服用洛汀新加倍他乐克可改善心功能，提高生存率，改善患者生存质量。     

小剂量美托洛尔治疗慢性充血性心力衰竭疗效观察

①目的 探讨小剂量美托洛尔治疗慢性充血性心力衰竭的疗效。②方法 96例慢性充血性心力衰竭患者随机分为观察组与对照组。对照组应用利尿剂、血管紧张素转换酶抑制剂、地高辛、硝酸酯类等治疗；观察组在对照组治疗基础上应用美托洛尔，起始量6．25mg，2次／d，口服，1周后增至12．5mg，2次／d，口服。③结果 治疗6个月后，两组心功能均有明显改善，总有效率对照组为72.9％，观察组为91．6％。观察组心功能改善更加明显（P〈0．05）。④结论 小剂量美托洛尔治疗慢性充血性心力衰竭疗效满意。     

厄贝沙坦联合倍他乐克在慢性充血性心力衰竭中的应用

目的探讨厄贝沙坦联合倍他乐克联合应用治疗慢性充血性心力衰竭的，临床疗效。方法选择80例慢性充血性心衰竭住院患者，随机分为治疗组（40例）和对照组（40例），在心力衰竭常规治疗的基础上，治疗组给予倍他克6．25mg／d与厄贝坦75mg／d。结果治疗16周后治疗组心力衰竭患者心功能分级改善显著，总有效率95％，无效2例占5％；对照组总有效率70％，无效12例占30％。两组比较总有效率有差异显著（p〈0．05）。结论厄贝沙坦联合倍他乐克治疗慢性充血性心力衰竭能显著提高临床疗效，并且未增加副反应。     

倍他乐克治疗充血性心力衰竭患者的临床疗效观察

目的：观察倍他乐克治疗充血性心力衰竭患者临床疗效。方法：将60例充血性心力衰竭患者在常规治疗1－2周后加服倍他乐克。结果：60例中显效38．3％，有效50％，无效11．7％，临床总有效率88．3％。结论：倍他乐克能显著改善充血性心力衰竭患者的心功能。     

倍他乐克治疗慢性充血性心力衰竭临床分析

目的：探讨倍他乐克治疗慢性充血性心力衰竭疗效。方法：30例慢性充血性心力衰竭患者均经临床确诊超声心动图反x线心脏三位片,在用传统的强心、利尿、扩血管治疗的基础上加用倍他乐克。结果：倍他乐克使慢性充血性心力衰竭患者的心率减慢、心功能改善、射血分数提高,总有效率迭76．2％。结论：倍他乐克治疗慢性充血性心力衰竭有效．可明显改善心功能和临床症状．提高生活质量,从小剂量开始,严密观察心率、血压及临床症状,逐渐增加到最大耐茔剂量是非常安全的．     

小剂量倍他乐克治疗慢性充血性心力衰竭36例报道

目的探讨小剂量倍他乐克治疗慢性充血性心力衰竭的疗效。方法采用小剂量倍他乐克治疗慢性充血性心力衰竭36例，疗程2～3周；并与常规治疗的36例同一类型心力衰竭进行对照，两组发病年龄、心力衰竭分级均具有可比性（P〉0．05）。结果治疗组心力衰竭改善有效率达86．1％，对照组达63．9％，两组比较有统计学差异（P〈0．05）。结论小剂量倍他乐克治疗慢性充血性心力衰竭疗效高，副作用小，能明显改善心力衰竭患者的心功能，可作为治疗慢性充血性心力衰竭的首选药物之一。     

倍他乐克治疗慢性心力衰竭临床疗效观察

目的观察倍他乐克治疗慢性充血性心力衰竭（CHF）患者的疗效。探讨β-阻滞剂在CHF中的作用。方法将108例CHF患者在应用常规治疗的基础上加服倍他乐克，从12．5mg每天两次开始，直到目标剂量每天75mg，治疗6个月。观察内容为患者临床症状和体征，心功能（NYHA分级），左室射血分数，左室舒张末内径，运动耐量治疗前后的变化。结果倍他乐克可使心功能、左室射血分数提高，左室舒张末内径减少，明显改善运动耐量。结论倍他乐克可改善心功能提高生命质量。     

倍他乐克治疗慢性充血性心力衰竭疗效观察

目的：探讨倍他乐克在慢性充血性心力衰竭中的疗效。方法：选择56例慢性充血性心力衰竭患者,随机分为两组．治疗组在常规应用强心、利尿、扩血管药物的基础上,加用倍他乐克。2个月后观察患者心功能、心率的变化,评估其临床疗效。结果：应用倍他乐克后心力衰竭患者心功能分级显著改善,心率明显降低。结论：在常规抗心力衰竭药物治疗基础上加用倍他乐克可明显改善慢性心力衰竭患者的心功能。     

倍他乐克治疗慢性充血性心力衰竭37例疗效观察

目的:探讨倍他乐克治疗慢性充血性心力衰竭的临床疗效及副作用。方法:将收治的慢性充血性心力衰竭73例随机分为治疗组(37例)和对照组(36例),两组均给予常规抗心衰治疗,治疗组加用倍他乐克6.25m g/d始,缓慢加量至有效剂量达25~50m g/d,8周为一疗程,观察症状、体征及心率和心功能改善状况。结果:治疗组患者症状和体征消失及改善率、心率降低和心功能改善率明显优于对照组(P<0.01)。结论:倍他乐克可作为治疗病情稳定的慢性充血性心力衰竭患者的首选药物之一。     

美托洛尔对慢性充血性心力衰竭的治疗价值

目的：探讨美托洛尔在慢性充血性心力衰竭治疗中的临床价值，并进一步评估。方法：对40例慢性充血性心力衰竭患者在常规应用强心剂、利尿剂、扩血管剂及血管紧张素转换酶抑制剂治疗1周后，效果不佳者加用美托洛尔6．25～50mg，2次/d，治疗15d，观察患者心功能改善情况。结果：美托洛尔联合常规用药治疗慢性充血性心力衰竭40例疗效显著，总有效率达90％。结论：美托洛尔必须与强心剂、利尿剂、扩血管剂及血管紧张素转换酶抑制剂等联合应用，这样治疗慢性充血性心力衰竭疗效更显著，但不应单独使用。     

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.