透明质酸钠关节腔注射治疗膝骨关节炎疗效观察

目的观察透明质酸钠膝关节腔注射对不同程度膝骨关节炎的治疗效果,探究透明质酸钠对膝骨关节炎的适用范围。方法将118例膝骨关节炎患者（共145膝）按照HSS（Hospitl for Special Surgery）膝关节评分分为优、良、中、差四组,进行膝关节腔透明质酸钠注射治疗,分别于治疗前及治疗后3、6、12个月进行HSS膝关节评分。结果 HSS评分优、良组治疗后3、6、12个月比治疗前评分提高（P〈0.05）,HSS评分中、差组治疗前后评分差异无统计学意义（P〉0.05）。结论轻、中度膝骨关节炎通过透明质酸钠膝关节腔注射治疗,具有积极的治疗效果,重度骨关节炎应用透明质酸膝治疗无明显疗效。     

富血小板血浆与透明质酸钠关节腔内注射治疗膝骨关节炎的疗效观察

目的探讨富血小板血浆与透明质酸钠关节腔内注射治疗膝骨关节炎患者的疗效。方法 2016年4月至2018年4月期间,将本院于收治的膝骨关节炎患者40例作为研究资料,随机分组,对照组采用透明质酸钠关节腔内注射治疗,观察组采用富血小板血浆关节腔内注射治疗,各20例,观察两组疗效,比较关节功能改善情况。结果对照组治疗有效率60.00%与对观察组90.00%比较偏低,P0.05;治疗前和治疗后2个月膝关节功能评分比较无明显差异,P 0.05;治疗后5个月和10个月膝关节功能评分明显降低,且改善程度均显著优于对照组,P 0.05。结论在膝骨关节炎患者治疗中采用富血小板血浆关节腔内注射治疗利于促使改善不良症状,促使膝关节功能逐渐恢复,获得良好的治疗效果。     

川芎嗪关节腔内注射对膝骨关节炎的治疗作用

目的：探讨川芎嗪关节腔内注射对膝骨关节炎的治疗作用。方法：7l例膝骨关节炎患者随机分为两组,分别予盐酸川芎嗪注射液或透明质酸钠注射液膝关节腔内注射,每周1次,连续5周。随访3月。参照Lequesne骨关节炎严重性和活动性评估法制定观察表,分别对两组患者治疗前后Lequesne评分及疗效进行比较。结果：透明质酸钠组在治疗1周后Lequesne评分较治疗前有明显降低（P〈0．01）,川芎嗪组在治疗3周后Lequesne评分明显降低（P〈0．01）。治疗5周后,川芎嗪组总有效率为82．1％,透明质酸钠组总有效率为87．2％,两组疗效差异无统计学意义（P〉0．05）。两组在治疗过程中均未见明显的不良反应。结论：川芎嗪关节腔内注射对膝骨关节炎具有治疗作用,且无明显不良反应,但起效较慢。     

接骨膏外敷治疗膝骨关节炎临床观察

目的观察中药接骨膏外敷配合透明质酸钠注射治疗膝骨关节炎的临床疗效。方法将115例膝骨关节炎患者随机分为治疗组62例、对照组53例。两组病人膝关节腔均注射透明质酸钠（SH）,治疗组加用中药接骨膏膝关节局部外敷。按Lequesne标准进行膝骨关节炎严重性指数评估。结果接受治疗3周后,治疗组Lequesne评分明显低于对照组（P〈0.05）。结论中药接骨膏外敷联合SH关节腔注射治疗膝骨关节炎疗效优于单用SH;该治疗方法疗效确切,值得临床推广应用。     

医用臭氧联合透明质酸钠治疗膝骨关节炎临床疗效

目的 研究臭氧联合透明质酸钠治疗膝关节骨性关节炎临床效果.方法 62例患者随机分成两组,冶疗组31例,使用臭氧联合透明质酸钠膝关节腔内注射.对照组31例,口服阿法骨化醇软胶囊、美洛昔康并关节腔内注射透明质酸纳.对照两组疼痛及Lysholm膝关节评分变化,随访6个月评价临床疗效.结果 臭氧联合透明质酸钠治疗组有效率显著高于对照组(P<0.05).结论 关节腔内注射臭氧联合透明质酸钠治疗膝骨关节炎,能明显缓解膝关节症状,改善患膝功能,该方法 是一种简单、安全、有效的治疗方法.     

透明质酸钠联合金乌骨通胶囊治疗膝骨关节炎疗效分析

目的评价透明质酸钠关节腔内注射联合金乌骨通胶囊治疗膝骨关节炎的疗效。方法将120例膝骨关节炎患者随机分为观察组和对照组,各60例。观察组采用透明质酸钠注射液2mL关节腔内注射(每周1次,5次为1个疗程)联合口服金乌骨通胶囊(每次3粒,每日3次,服用12周)。对照组采用透明质酸钠注射液2mL关节腔内注射(每周1次,5次为1个疗程)。结果观察组和对照组疗程结束时,有效率分别为76.67%和60.00%,3个月为85.00%和66.67%,6个月为82.00%和65.00%,各阶段组间比较差异有统计学意义(P<0.05)。结论透明质酸钠注射液关节腔内注射联合口服金乌骨通胶囊治疗膝骨关节炎有效和可靠。     

抗骨质增生胶囊治疗膝骨性关节炎临床研究

目的:通过对配合口服抗骨质增生胶囊和仅透明质酸钠(HA)注射液关节腔内注射治疗膝骨关节炎(KOA)临床疗效的比较,客观评价抗骨质增生胶囊治疗膝骨关节炎的疗效。方法:将80例膝骨关节炎患者,随机分为观察组和对照组,每组40例。观察组口服抗骨质增生胶囊且膝关节内注射透明质酸钠液,对照组仅给予膝关节内透明质酸钠注射液,测得各组患者治疗前、治疗后1周、治疗后1个月的JOA评分,进行比较。并在治疗1个疗程后1周和1个月观察两组疗效。结果:观察治疗组疗效明显高于对照治疗组(P0.05),具有显著意义。观察组治疗前后总体疗效比较(P≤0.05),有显著意义。单项症状比较(P0.05)具有显著性差异。结论:两组在早期治疗膝骨关节炎方面都有良好的疗效,且治疗后10周随访也有较好的疗效维持。但配合抗骨质增生胶囊口服治疗膝骨关节炎,具有安全、更有效、方便和廉价诸多优点,有临床推广应用价值。     

局部与关节腔内注射治疗膝骨关节炎临床观察

目的探讨局部痛点联合关节腔内注射治疗膝骨关节炎的临床疗效及不良反应。方法将膝骨关节炎患者96例随机分成3组：A组予膝关节周围压痛点注射配制药液治疗;B组予膝关节腔内注射透明质酸钠治疗;C组予局部痛点注射联合透明质酸钠关节腔内注射治疗,3组均为每周1次,连续4次。结果4周后,c组HSS评分明显高于A、B组（P〈0．05）,C组VAS评分明显低于A、B组（P〈0．05）;A、B、C组膝关节AROM度数均高于治疗前（P〈0．05）。结论曲安奈德局部注射联合透明质酸钠关节腔内注射治疗能更有效地缓解膝骨关节炎疼痛,但在改善关节活动度方面并无明显优势。     

透明质酸钠关节腔内注射对膝骨性关节炎患者关节滑液中细胞因子水平的影响及疗效观察

目的 探讨透明质酸钠关节腔内注射对膝骨性关节炎(OA)患者关节滑液中细胞因子水平的影响及疗效观察.方法 70例膝关节OA患者随机分为透明质酸钠组和对照组.透明质酸钠组予以关节腔内注射透明质酸钠2.5 mL/次,每周1次,连用4周.对照组予以口服芬必得胶囊0.3 g,2次/d,连用4周.结果 治疗4周后,透明质酸钠组关节滑液中IL-1、IL-6和IL-8水平下降的幅度明显优于对照组(P＜0.05);透明质酸钠组的临床总有效率明显优于对照组(x2=7.65,P＜0.01),药物不良反应的发生率明显低于对照组(x2=6.29,P＜0.05).结论 透明质酸钠关节腔内注射治疗膝关节OA疗效确切,安全性较好,作用与降低关节滑液中IL-1、IL-6和IL-8水平相关.     

唑来膦酸联合透明质酸钠治疗绝经后骨质疏松合并膝骨关节炎的临床效果分析

目的 探究唑来膦酸联合透明质酸钠治疗绝经后骨质疏松(PMOP)合并膝骨关节炎(OA)的临床效果。 方法 收集2009年5月—2014年4月在金华市中心医院治疗并自愿参加本研究的105例PMOP合并膝OA的临床资料,随机分为唑来膦酸组和对照组,2组患者均采用膝关节腔内注射透明质酸钠,对照组在此基础上采用鲑鱼降钙素、钙剂、阿仑膦酸钠及骨化三醇等传统抗骨质疏松治疗,唑来膦酸组在对照组基础上采用唑来膦酸注射液5 mg配合0.9%生理盐水或5%葡萄糖溶液稀释后静脉滴注,每年1次。记录2组患者治疗前和治疗后3、6、12个月WOMAC评分、Lysholm膝关节评分、疼痛VAS评分、BMD以及血清β-CTX、BGP、B-ALP水平。 结果 唑来膦酸组患者治疗后WOMAC评分、Lysholm膝关节评分、疼痛VAS评分及BMD明显优于对照组(P＜0.05),2组患者治疗后WOMAC评分、Lysholm膝关节评分、疼痛VAS评分及BMD均较治疗前有很大改善(P＜0.05),治疗后12个月唑来膦酸组血清β-CTX、B-ALP、BGP水平低于治疗前(P＜0.05),对照组患者治疗12个月后血清β-CTX、BGP、B-ALP与治疗前差异无统计学意义(P＞0.05),唑来膦酸组与对照组血清β-CTX、B-ALP、BGP水平差异有统计学意义(P＜0.05)。 结论 唑来膦酸联合透明质酸钠治疗PMOP合并膝OA能明显改善患者骨代谢状态,抑制骨吸收,提高患者骨密度及膝关节功能,减轻膝关节疼痛,提高患者生活质量,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.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

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.     

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.