丹红注射液联合高压氧治疗对脑梗死患者神经细胞因子的影响

目的：观察丹红注射液联合高压氧治疗对脑梗死患者神经细胞因子的影响。方法将120例急性脑梗死患者随机分为丹红注射液联合高压氧治疗的观察组和高压氧治疗的对照组,疗程8周。观察两组患者治疗前后的神经细胞因子水平和神经功能评分情况,并分析两者的相关性。结果观察组患者治疗后的神经营养因子（NTF）和神经生长因子（NGF）含量高于对照组（P＜0.05）,神经功能缺损评分量表（CSS）评分和卒中量表（NIHSS）评分低于对照组（P＜0.05）,且神经细胞因子含量与神经功能评分呈负相关。结论丹红注射液联合高压氧治疗有助于改善脑梗死患者的神经功能、增加神经细胞因子含量,且两者具有相关性。     

四海之腧取穴法结合康复训练治疗脑梗死恢复期的临床观察

目的：观察四海之腧取穴法配合康复训练治疗脑梗死恢复期的临床疗效。方法将60例患者随机分为治疗组和对照组各30例,两组患者均接受基础治疗,治疗组采取四海之腧取穴法结合常规康复训练,对照组采用常规针刺结合康复训练,1个月为1个疗程,治疗3个疗程后,观察治疗前后上下肢 Fugl-Meyer 评分、NIHSS 评分变化情况。结果与治疗前相比,两组治疗1个月、2个月和3个月后 Fugl-Meyer 评分、NIHSS 评分均有所改善(P<0.05或 P<0.01),且治疗组各项指标均显著优于对照组,尤以治疗组治疗3个月后疗效为最佳(P<0.01)。结论“四海之腧”取穴法结合康复训练的治疗方式可更好地改善脑梗死恢复期患者的运动功能障碍和神经功能缺损情况,疗效确切,值得临床推广应用。     

针灸联合药物治疗对脑梗死康复期神经细胞因子分泌及氧化应激状态的影响

目的:探讨针灸联合药物治疗对脑梗死康复期神经细胞因子分泌及氧化应激状态的影响。方法:选取在我校附属医院接受治疗的脑梗死康复期患者118例,随机分为对照组及观察组各59例。对照组接受常规药物治疗,观察组接受针灸联合药物治疗。对比两组治疗前后血清中神经营养因子、神经损伤因子、氧化应激指标等含量的差异。结果:治疗前,两组血清中神经营养因子、神经损伤因子、氧化应激指标含量比较,差异无统计学意义(P>0.05)。治疗后,观察组患者血清中神经营养因子IGF-1、BDNF、NGF的含量高于对照组;神经损伤因子S-100β、NSE、GFAP、UCH-L1的含量低于对照组;氧化应激指标MDA、AOPPs、LHP的含量低于对照组,SOD、GSH-Px的含量高于对照组(P<0.05)。结论:脑梗死康复期患者接受针灸联合药物治疗,可有效优化神经功能并减轻神经损伤,抑制全身氧化应激反应。     

卒中单元对急性脑梗死患者神经功能缺损程度的影响

目的:观察卒中单元模式急性脑梗死患者神经功能缺损程度的影响。方法:30例急性脑梗死患者随机分成A、B组。在进行常规治疗的基础上,A组给予神经内科常规药物治疗,B组在给予神经内科常规药物治疗时,在患者神经症状、生命体征平稳后48 h内进行规范的康复训练。治疗前及治疗后第15天、第30天、第75天,依据欧洲卒中评分量表(ESS)评定患者神经功能缺损程度。结果:2组患者第30天和第75天的ESS均较治疗前改善,其中B组治疗后ESS评分明显高于A组(P<0.05)。结论:卒中单元能够明显提高急性脑梗死患者神经功能。     

丁苯酞软胶囊治疗急性脑梗死的临床疗效及其对患者炎性反应的影响

目的观察丁苯酞软胶囊治疗急性脑梗死的临床疗效及其对患者神经功能、炎性反应的影响。方法选择张家口市第一医院和河北北方学院附属第三医院2016年1月至2016年10月收治的急性脑梗死患者100例,依据治疗方案分为对照组和治疗组,每组50例。对照组患者入院后给予抗血小板聚集、他汀类药物等常规治疗,治疗组患者在对照组治疗基础上给予丁苯酞软胶囊口服,于治疗1周时采集2组患者肘静脉血,检测血清C反应蛋白(CRP)、白细胞介素-6(IL-6)水平及血小板聚集率;比较2组患者治疗4周时神经功能缺损评分(NIHSS),采用改良Rankin评分评价2组患者治疗3个月时神经功能恢复情况。结果治疗前2组患者血清CRP、IL-6水平及血小板聚集率比较差异均无统计学意义(P>0.05);治疗1周时2组患者血清CRP、IL-6水平及血小板聚集率均较治疗前显著下降(P<0.05),且治疗组患者治疗1周时血清CRP、IL-6水平及血小板聚集率显著低于对照组(P<0.05)。治疗4周时治疗组患者NIHSS评分显著低于对照组(P<0.05);治疗3个月时治疗组患者Rankin评分显著低于对照组(P<0.05);治疗组患者治疗总有效率显著高于对照组(χ~2=13.22,P<0.05)。结论丁苯酞软胶囊可显著降低急性脑梗死患者机体炎性反应,改善并恢复神经功能缺损,且疗效显著。     

小牛血清去蛋白注射液治疗脑梗死疗效观察

目的探讨小牛血清去蛋白注射液治疗脑梗死的临床效果。方法将90例脑梗死患者采用随机数字表法分为观察组和对照组,每组45例。对照组患者给予常规治疗,观察组患者在常规治疗的基础上给予小牛血清去蛋白注射液治疗,治疗周期为2周。观察2组患者治疗前后全血黏度、血浆黏度、血小板聚集率、上下肢Fugl-Meyer评估(FMA)评分、美国卫生研究院卒中量表(NIHSS)评分及日常生活活动(ADL)评分。结果治疗前,2组患者全血黏度、血浆黏度、血小板聚集率、上下肢FMA评分、NIHSS评分及ADL评分比较差异均无统计学意义(P>0.05);治疗后2组患者各指标与治疗前比较差异均有统计学意义(P<0.05)。治疗后,观察组患者上下肢FMA评分、ADL评分高于对照组(P<0.05),NIHSS评分、全血黏度、血浆黏度及血小板聚集率均低于对照组(P<0.05,P<0.01)。治疗后观察组患者总有效率高于对照组(P<0.05)。2组患者均无明显不良反应。结论小牛血清去蛋白注射液可改善脑梗死患者血液流变学相关指标,促进患者神经功能恢复,减少神经功能缺损,且无明显不良反应。     

五虎化栓丸对急性脑梗死患者神经功能康复的影响

目的:研究五虎化栓丸对急性脑梗死患者神经功能的影响.方法:将156 例急性脑梗死患者采取抽签的方法,分为3 组,最后综合组48 例、中药组49 例、康复组47 例进入统计分析.在神经内科常规治疗的基础上,康复组进行神经功能的康复训练,中药组加用自制药物五虎化栓丸,综合组应用五虎化栓丸+神经功能的康复训练,均跟踪观察60 天,评价神经功能恢复情况,观察治疗前、治疗后60 天的神经功能缺损、FMA 及Barthel 评分.结果:中药组治疗后60 天神经功能缺损评分与治疗前和康复组比较有显著差异性(P<0.05 或P<0.01),治疗后60 天FMA 评分和Barthel 评分与治疗前和康复组比较也有显著性差异(P<0.05 或P<0.01);中药组与综合组间疗效也有明显差异,综合组疗效优于中药组,(P<0.05).结论:五虎化栓丸对急性脑梗死患者神经功能康复有显著促进作用,如结合早期康复训练效果更好.     

丁苯酞对急性脑梗死患者血清白介素6的影响

目的：观察丁苯酞对急性脑梗死患者白介素6（IL-6）、超敏CRP、血小板聚集率的影响,探讨神经功能缺损与IL-6等的相关性。方法：80例急性脑梗死患者,随机分为治疗组（40例）和对照组（40例）,20名健康体检者作为正常对照组。治疗组和对照组均采用常规治疗,治疗组加用丁苯酞200 mg,每日3次口服,连用14 d。在治疗前和治疗后30 d对治疗组和对照组脑梗死患者进行NIHSS评分,治疗后3个月进行mRS评分以观察神经功能恢复情况。在治疗前和治疗后7 d测定超敏CRP、IL-6、血小板聚集率水平,同时对神经功能缺损评分与超敏CRP、IL-6、血小板聚集率的相关性进行分析。结果：治疗前治疗组和对照组的超敏CRP、IL-6、血小板聚集率水平均高于正常对照组,（P〈0.05）,治疗后7 d两组超敏CRP、IL-6、血小板聚集率水平均较治疗前下降,且治疗组的超敏CRP、IL-6、血小板聚集率水平较对照组下降更加明显,（P〈0.05）。治疗后两组的神经功能损伤程度评分均较治疗前明显下降,且与对照组相比,治疗组治疗后的评分较前下降更为显著（P〈0.05）。急性脑梗死患者NIHSS评分、mRS评分的下降与超敏CRP、IL-6及血小板聚集率的下降呈正相关（P〈0.05）。结论：丁苯酞通过减轻炎症反应和抑制血小板聚集以促进神经功能的恢复,对急性脑梗死早期有显著治疗作用。     

认知康复训练改善脑梗死恢复期患者神经和认知功能的作用

目的探讨认知康复训练改善脑梗死恢复期患者神经和认知功能的作用。方法选取脑梗死恢复期患者78例,将其分为康复组(n=39)和对照组(n=39)。两组均予以相同常规药物治疗,对照组在此基础上予以常规康复干预,康复组在对照组基础上予以认知康复训练干预,两组均干预16周。分别于干预前与干预16周后观察两组神经、肢体运动和认知功能变化。结果干预16周后,两组患者CSS评分与FMA评分较前分别明显下降或上升(P0.05或P0.01),且康复组变化幅度较对照组更明显(P0.05);两组MMSE评分和LOTCA评分均较前明显上升(P0.05或P0.01),且康复组上升幅度较对照组更明显(P0.05)。结论认知康复训练用于改善脑梗死恢复期患者可使得其神经和肢体运动功能早日好转,改善其认知功能。     

丁苯酞软胶囊联合低频rTMS在脑梗死恢复期患者中的应用效果

目的探讨丁苯酞软胶囊联合低频重复经颅磁刺激(rTMS)在脑梗死恢复期患者中的应用效果。方法选取2016年7月至2018年4月商丘市第一人民医院收治的97例脑梗死恢复期患者,采用随机数表法分为对照组和观察组。对照组48例,接发常规治疗方法。观察组49例,在常规治疗基础上加用丁苯酞软胶囊联合低频rTMS治疗。采用美国国立卫生研究院卒中量表(NIHSS)对两组患者治疗前后神经功能缺损程度进行评估;对两组患者血清C反应蛋白(CRP)水平进行比较;采用改良Fugl-Meyer运动功能量表(FMA)评估患者运动功能。结果治疗前两组患者NIHSS评分、血清CRP水平和FMA评分差异无统计学意义(均P>0.05),治疗后14 d观察组患者NIHSS评分及血清CRP水平均低于对照组,FMA评分高于对照组,差异有统计学意义(均P<0.01)。结论丁苯酞软胶囊联合低频rTMS疗法可改善脑梗死恢复期患者血清CRP水平,促进患者运动功能及神经功能的恢复。     

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.