沙美特罗丙酸氟替卡松治疗支气管哮喘的临床观察

目的对支气管患者应用沙美特罗丙酸氛替卡松粉吸入剂治疗后的临床效果进行分析。方法将26例确诊为支气管哮喘患者给予糖皮质激素和长效β2受体激动剂的复方制剂舒利迭（沙美特罗／氟替卡松）吸入治疗。每次1吸,每天2次,连用12周,治疗后对临床疗效．肺功能指标进行比较。结果26例患者哮喘明显改善,第一秒用力呼气量占预计值百分比,用力呼气峰流速,都得到了明显的改善。患者无不良反应。结论沙美特罗丙酸氟替卡松钠可以明显改善支气管哮喘症状。     

地龙提取液对哮喘患者肺功能的影响

为探讨地龙提取液对急性哮喘患者肺功能的影响，观察了４０例哮喘患者用药前后用力肺活量、第一秒用力呼气量及第一秒用力呼气量与肺活量比值的变化；结果表明：用药后用力肺活量、第一秒用力呼气量显著提高，差异有高度显著性（Ｐ＜０．００１），第一秒用力呼气量与肺活量比值无明显改变（Ｐ＞０．０５），提示地龙提取液可明显改善急性哮喘患者的肺通气功能。     

糖皮质激素治疗吸烟与非吸烟哮喘患者疗效的对比研究

目的探讨糖皮质激素治疗吸烟与非吸烟哮喘患者的疗效。方法选择2010年3月至2012年3月北京大学深圳医院呼吸科收治的支气管哮喘患者180例作为研究对象,根据病史资料将患者分为吸烟组和非吸烟组,观察治疗后两组患者的疗效以及生活质量的相关指标。结果吸烟组患者第一秒用力呼气量(FEV1)、第一秒用力呼气量占用力肺活量百分率(FEV1/FVC)、最大呼气流量(PEF)增加值以及卡氏行为状态评分表(KPS)评分、躯体功能、心理功能、社会功能、认知功能和总体生活质量评分均显著低于非吸烟组;吸烟组患者PEF昼夜变异率以及哮喘发作次数均显著高于非吸烟组(P<0.05)。结论吸烟会降低气道功能,影响患者的生活质量,降低糖皮质激素治疗的效果。     

不同药物治疗支气管哮喘的疗效对比研究

目的：对比分析不同药物治疗支气管哮喘的临床疗效,为该病的临床治疗提供依据。方法：选择2008年1月-2010年6月在我院住院治疗的支气管哮喘患者56例作为研究对象,根据不同的药物治疗方法将所有患者随机分为观察组和对照组,其中观察组28例给予沙美特罗/氟替卡松复方制剂舒利迭雾化吸入,对照组28例单用吸入糖皮质激素布地奈德粉吸入剂,治疗4周后,观察吸入前后临床症状变化及肺功能FEV1（第一秒用力呼气容积）,FVC（用力呼气肺活量）,PEFR（用力呼气峰流速）等指标。结果：治疗4周后观察组支气管哮喘症状及肺功能较治疗前明显改善（P〈0.01）,肺功能有效率观察组和对照组分别为71%、46%（P〈0.05）。结论：舒利迭相比于单用糖皮质激素布地奈德粉改善哮喘患者的症状及肺功能更快、更安全有效,值得临床推广应用。     

沙美特罗替卡松治疗支气管哮喘32例疗效分析

目的观察沙美特罗替卡松治疗支气管哮喘的疗效。方法将32例确诊为支气管哮喘的患者给予沙美特罗替卡松治疗,每日2次,经准纳气吸入,连续使用8周,自身对照观察用药前后肺功能：用力呼气峰流速、用力呼气肺活量、第一秒用力呼气容积及临床症状变化。结果用沙美特罗替卡松治疗后肺功能及支气管哮喘症状计分都有明显的改善（P〈0.01）。结论沙美特罗替卡松治疗支气管哮喘疗效显著,不良反应小。     

支气管哮喘病人的临床护理

目的 探讨支气管哮喘病人的临床护理方法.方法 作超声雾化吸入治疗支气管哮喘病人46例,与慢性咽炎病人(对照组)30例比较,并测定其肺功能.结果 通过临床效果观察,及同时作雾化吸入治疗前后第1秒用力呼气容积(FEV1),它们治疗前后的比值≥26.92%(正常≤15%).第1秒用力呼气容积与用力肺活量的比值(FEV1/FVC)≤70%(正常≥70%)[1].结论 使用超声雾化吸入治疗慢性支气管哮喘病人,尤其急性发作的病人其效果并不显著,建议慎用.     

超声雾化吸入治疗慢性支气管哮喘的临床观察及护理

目的探讨超声雾化吸入治疗慢性支气管哮喘的临床观察及护理。方法作超声雾化吸入治疗支气管哮喘病人46例,与慢性咽炎病人(对照组)30例比较,并测定其肺功能。结果通过临床效果观察,及同时作雾化吸入治疗前后第1秒用力呼气容积(FEV1),它们治疗前后的比值≥26.92%(正常≤15%)。第1秒用力呼气容积与用力肺活量的比值(FEV1/FVC)≤70%(正常≥70%)[1]。结论使用超声雾化吸入治疗慢性支气管哮喘病人,尤其急性发作的病人其效果并不显著,建议慎用。     

30例丙酸氟替卡松吸入气雾剂治疗支气管哮喘疗效观察

目的探讨新型吸入型糖皮质激素丙酸氟替卡松治疗支气管哮喘的临床疗效。方法选取自2011年5月至2013年10月期间本院收治且确诊的30名支气管哮喘患者作为观察组,给予丙酸氟替卡松吸入气雾剂治疗,另选取同期就诊的40支气管哮喘患者作为对照组,给予布地奈德混悬液吸入治疗;治疗1个月后观察对比两组的日间及夜间症状评分、晨间呼气峰流速（mPEF）及第1秒用力呼气容积占预计值百分比（FEV1%per）。结果与对照组相比,观察组在日间症状评分、夜间症状评分及晨间呼气峰流速（mPEF）与第1秒用力呼气容积占预计值百分比（FEV1%per）方面均有改善,差异均具统计学意义（P〈0.05）。结论丙酸氟替卡松治疗支气管哮喘疗效显著、安全性高,是治疗哮喘药物的最佳选择之一。     

支气管哮喘患者FeNO测定与肺功能及外周血嗜酸性粒细胞的相关性研究

目的 探讨支气管哮喘患者FeNO测定与肺功能及外周血嗜酸性粒细胞的相关性。方法 选择2017年1月～2019年1月就诊于我院门诊或住院的哮喘急性发作期患者80例,按照哮喘控制检测(Asthma control detection,ACT)评分分为轻度组、中度组、重度组。同时,选取30位健康体检者作为健康对照组,哮喘组患者用药前完成哮喘控制检测。之后给予4周信必可都保治疗。观察三组患者治疗前后FeNo水平、外周血嗜酸性粒细胞比例、第1秒用力呼气量占预计值百分比,分析FeNo水平与其他指标的相关性。结果 三组患者在治疗前,FeNo水平、外周血嗜酸性粒细胞比例均高于对照组,第1秒用力呼气量占预计值百分比低于对照组,差异显著(P0.05);三组患者FeNo水平经治疗后,均得到明显改善,与治疗前对比,差异显著(P0.05);FeNo水平与第1秒用力呼气量占预计值百分比无明显相关性(P0.05),与外周血嗜酸性粒细胞比例表现呈正相关(P0.05)。结论 支气管哮喘患者FeNO测定与外周血嗜酸性粒细胞有明显的相关性,临床可根据其水平变化,辅助临床诊治。     

普米克令舒治疗支气管哮喘对患者肺功能的影响观察

目的探讨普米克令舒治疗支气管哮喘对患者肺功能的影响。方法回顾性分析2009年11月～2010年3月收治的81例支气管哮喘患者的临床资料,采用普米克令舒治疗,观察患者的肺功能改善情况。结果本组病例中显效37例,有效42例,无效2例,总有效率为97.5%。治疗后患者用力肺活量（FVC）、第1s用力呼气容积（FEV1）、1s秒率（FEV1/FVC）、用力呼出50%肺活量时呼气流量（FEF50%）、最大呼气流速（PEFR）均明显改善,与治疗前比较差异有统计学意义（P〈0.05）。结论普米克令舒治疗支气管哮喘疗效满意,能够明显改善患者的肺功能,值得临床推广使用。     

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.     

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.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.