蔗糖铁联合促红细胞生成素对维持性血液透析病人肾性贫血疗效评价

目的 探讨观察蔗糖铁联合促红细胞生成素对维持性血液透析病人肾性贫血的疗效.方法 按照随机数字表法将135例患者随机分为观察组（67例）和对照组（68例）,所有患者均给予促红细胞生成素治疗,观察组患者采用蔗糖铁治疗,对照组患者采用琥珀酸亚铁治疗.结果 治疗后观察组Hb、Hct、SF、TSAT等指标均与对照组差异有统计学意义（P＜0.05）;观察组不良反应发生率（1.49％）显著低于对照组（7.35％）,P＜0.05.结论 蔗糖铁联合促红细胞生成素联合治疗维持性血液透析病人肾性贫血的疗效确切,不良反应轻微,值得临床借鉴.     

重组人促红细胞生成素在老年人围术期应用的临床观察

目的：评价重组人促红细胞生成素在老年入围术期中应用的安全性及临床价值.方法：选择我院骨科60岁以上老年择期手术患者60例,将相同的手术或估计失血量相当的患者随机分成促红素组（A组）和非促红素组（B组）,A组于术前5天起隔日皮下注射重组人促红素150U/kg,用至术后第五天,B组未用促红素.两组在围术期均以相同的方法扩容及补充铁剂等造血原料.结果：A组患者术后恢复期的红细胞（RBC）、血红蛋白（HGB）、红细胞压积（HCT）均高于B组,A组患者的贫血状况明显轻于B组,在整个围术期对异体血的需求方面,A组少于B组.结论：重组人促红细胞生成素应用于老年手术患者,可有效促进患者围术期自身红细胞的生成,促进术后贫血状况的恢复,有效减少异体血的需求,加快康复,是一种安全有效的围术期用药.     

生血宁片治疗维持性血液透析患者肾性贫血的临床观察

目的:观察生血宁片改善规律维持性血液透析尿毒症肾性贫血患者的铁代谢及其与促红细胞生成素协同作用的临床疗效.方法:选择我院血液净化中心规律维持性血液透析尿毒症肾性贫血患者60例为研究对象,随机分为生血宁组和琥珀酸亚铁组,每组30例.生血宁组口服生血宁片,琥珀酸亚铁组口服琥珀酸亚铁片.两组患者均按照肾性贫血治疗指南中建议剂量个体化联合应用促红细胞生成素治疗.16周后对两组患者进行临床疗效观察,详细记录治疗前和治疗后两组患者的血红蛋白、红细胞比容、血清铁蛋白、转铁蛋白饱和度等指标变化,同时监测两组患者治疗中出现的不良反应.结果:治疗16周后两组患者的血红蛋白、红细胞比容、血清铁蛋白、转铁蛋白饱和度与治疗前比较均有增高,差异具有统计学意义(P<0.05);但生血宁组治疗后血红蛋白、红细胞比容、血清铁蛋白、转铁蛋白饱和度明显高于琥珀酸亚铁组,差异具有统计学意义(P<0.05).与琥珀酸亚铁组比较,生血宁组不良反应发生较少.结论:与琥珀酸亚铁组比较,生血宁能更有效补充尿毒症肾性贫血患者所需的铁剂,且生血宁不良反应少,安全性好.     

促红细胞生成素在老年转子间骨折治疗中的应用

目的 评价促红细胞生成素在老年股骨转子间骨折治疗中应用的临床意义和安全性.方法 选取80例行闭合复位髓内钉内固定术治疗的股骨转子间骨折患者,随机分为2组:EPO组(40例)人院后立即开始使用促红细胞生成素(EPO),采用皮下给药.对照组(40例)不给予EPO处理,其他同EPO组.比较2组术前、术后1d、3d、5d时血红蛋白(Hb)、红细胞压积(Hct),以及术后血压、血小板和输血情况.结果 本研究中,EPO组和对照组比较,两组患者在术前ASA分级、骨折类型、伤前活动度、血红蛋白水平、红细胞压积、合并基础疾病数量、血压和血小板情况方面比较无统计学差异(P＞0.05).术前1d和术后5d的血红蛋白,术前和术后红细胞压积,术后的血压和血小板均无统计学差异(P＞0.05).两组比较,术后1d和术后3d的血红蛋白,总失血量,平均输血量和输血率具有统计学差异(P＜0.05).结论 围手术期应用促红细胞生成素治疗老年股骨转子间骨折患者,可以早期动员红细胞,改善患者术后贫血程度,降低输血量,未发现明显有关的不良反应.     

静脉铁剂与促红细胞生成素治疗髋关节置换术前贫血患者的效果观察

目的:观察静脉铁剂与促红细胞生成素治疗髋关节置换术前贫血患者的临床效果。方法:选择行髋关节置换术伴缺铁性贫血(ASAⅠ~Ⅲ级)患者100例,男性Hb<120 g/L,女性<110 g/L;其中,男性58例,女性42例。将患者分为研究组和对照组,每组各50例。研究组患者术前2周至术后1周皮下注射促红细胞生成素100 IU/kg,每周3次;并静脉输注蔗糖铁200 mg,每周2次。对照组患者未注射静脉铁剂与促红细胞生成素。术前和术后,检测两组患者的血红蛋白(Hb)和红细胞压积(Hct),并比较两组患者贫血治疗的效果,异体输血及恢复情况。结果:术前、术后1 d、术后1周和2周,研究组患者的Hb和Hct均高于对照组,两组患者的术中失血量无明显差异;研究组患者的异体输血率、输血量、发热、肺部感染等并发症均低于对照组(P<0.05)。结论:髋关节置换术前贫血患者予以静脉铁剂与促红素治疗有利于提高其围术期血红蛋白,减少异体输血,降低发热及肺部感染发生率。     

蔗糖铁注射液联合重组人红细胞生成素治疗血液透析患者贫血的疗效观察

目的 探讨静脉用铁剂蔗糖铁(简称静脉组)和口服铁剂琥珀酸亚铁(简称口服组)分别联合重组人红细胞生成素治疗维持性血液透析患者肾性贫血的疗效和安全性.方法 采用同期随机对照研究.结果 治疗后静脉组和口服组血红蛋白、血清铁蛋白及红细胞压积较治疗前均有提高,静脉组血红蛋白上升幅度明显高于口服组,差异有统计学意义(P＜0.05),不良反应发生率低于口服组(P＜0.05).结论 静脉用蔗糖铁联合重组人红细胞生成素治疗维持性血液透析患者的肾性贫血安全有效.     

3种不同方法在双膝关节同期置换围手术期血液管理中的应用效果研究

目的:探讨3种不同方法在双膝关节同期置换围手术期血液管理中的应用效果。方法:选取2013年5月至2014年3月接受双膝关节同期置换手术治疗的患者37例,14例A组患者采用急性等容血液稀释联合术后自体血回收,11例B组患者采用单纯术后自体血回收,12例C组患者采用单纯术后引流管引流,比较三组患者术后急性失血量及异体血输注量。结果:三组患者术前、术后即刻、术后6h血红蛋白及红细胞比容有变化;A组急性失血量(145.30±37.60)m L、异体血输注量(721.80±186.30)m L与B组急性失血量(192.00±50.60)m L、异体血输注量(586.40±148.50)m L明显低于C组急性失血量(423.00±112.40)m L、异体血输注量(1076.10±286.40)m L,三组有显著性差异,差异具有统计学意义(P<0.05)。结论:急性等容血液稀释联合术后自体血回收及单纯术后自体血回收均可减少异体血输注,且前者减少术后急性失血量更有优势。     

左卡尼丁联合促红细胞生成素治疗肾性贫血的临床观察

目的 观察左卡尼丁联合促红细胞生成素(rhEPO)治疗维持性血液透析患者肾性贫血的疗效.方法 将40例维持性血液透析患者随机分成治疗组和对照组,每组各20例,均采用相同血液透析方式进行透析,且血透后每周给予重组人促红细胞生成素(rhEPO) 100～150 U/kg皮下注射,但治疗组每次透析结束后静脉注射左卡尼丁1 g,而对照组仅注射促红细胞生成素,疗程12周.结果 两组患者的血红蛋白(HB)、红细胞压积(HCT)较治疗前明显升高,治疗组优于对照组(P＜0.05);治疗组rhEPO用量较对照组少,两组比较差异有统计学意义(P＜0.05);治疗组不良症状发生率较对照组少,差异有统计学意义(P＜0.05).结论 左卡尼丁联合促红细胞生成素能显著提高尿毒症血液透析患者贫血的疗效,同时左卡尼丁能减少促红细胞生成素的用量,降低不良反应的发生率.     

回收式自体血回输应用于外科手术的临床观察

目的 观察回收式自体血回输应用于外科手术的临床效果.方法 对100例预计出血量大于500 mL的外科手术病人,采用自体血液回收机进行血液收集和回输(试验组);相同或类似手术100例单纯输注异体血(对照组).观察2组病人失血量、血液回收量、异体血输注量、输血反应、输血费用、血库日均供给手术病人血量.结果 试验组手术失血量(1 615.0±69.6)mL,血液回收输注量(823.3±67.6)mL,异体血输注量(316.3±58.4)mL;对照组手术失血量(1 628.0±715)mL,异体血输注量(803.5±77.4)mL,2组异体血输注量比较差异有统计学意义(P＜0.05).试验组病人输血反应发生率、输血费用和血库日均供给手术病人血量明显低于对照组(均P＜0.05).结论 回收式自体血回输应用于外科手术,安全可靠,可产生巨大的经济效益和社会效益.     

铁剂的不同给药途径对治疗维持性血液透析患者肾性贫血的疗效及安全性分析

目的:观察铁剂的不同给药途径对治疗维持性血液透析患者肾性贫血的疗效及安全性。方法:将68例在血透室行维持性血液透析治疗的患者随机分为对照组和观察组,每组各34例,观察组患者应用蔗糖铁联合重组人促红细胞生成素治疗,对照组患者应用琥珀酸亚铁联合促红细胞生成素治疗,共观察12周。分别记录两组患者治疗前及治疗12周后的Hb、Hct、SF、TSAT、Cr、BUN等指标。同时观察两组患者治疗期间不良反应发生率。结果:治疗后两组患者Hb、Hct、SF、TSAT均有所升高,且差异均具有统计学意义(P<0.05);但观察组患者的Hb、Hct、SF、TSAT的升高要显著高于对照组,不良反应发生率显著低于对照组。结论:静脉应用蔗糖铁联合促红素治疗肾性贫血效果优于口服琥珀酸亚铁联合促红素,且不良反应发生率较低,值得临床参考。     

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.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

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.