链霉蛋白酶联合医用胃镜胶在无痛胃镜检查前胃腔准备中的应用效果观察

目的观察链霉蛋白酶联合医用胃镜胶在无痛胃镜检查前胃腔准备中的应用效果。方法选取行无痛胃镜检查的患者1890例,采用随机数字表法分为3组。3组患者检查前胃腔准备方法不同,链霉蛋白酶+医用胃镜胶组（648例）患者应用链霉蛋白酶+医用胃镜胶+复方盐酸利多卡因胶浆,医用胃镜胶组（630例）应用医用胃镜胶+复方盐酸利多卡因胶浆,对照组（612例）单用复方盐酸利多卡因胶浆。观察并比较3组患者胃镜视野清晰度与早期胃癌检出率。结果3组患者胃镜视野清晰度比较差异有统计学意义（P＜0.05）,组间两两比较差异亦均有统计学意义（均P＜0.05）。链霉蛋白酶+医用胃镜胶组、医用胃镜胶组和对照组患者胃镜视野优良率分别为86.6%、70.5%、27.3%,链霉蛋白酶＋医用胃镜胶组患者胃镜视野清晰度优于医用胃镜胶组,医用胃镜胶组患者胃镜视野清晰度优于对照组。链霉蛋白酶+医用胃镜胶组、医用胃镜胶组、对照组患者早期胃癌检出率分别为0.46%（3/648）、0.32%（2/630）、0.16%（1/612）,差异无统计学意义（P＞0.05）。结论患者无痛胃镜检查前服用链霉蛋白酶联合医用胃镜胶可明显提高胃镜视野清晰度,且对早期胃癌的检出率无不良影响,值得临床推广应用。     

链霉蛋白酶对上消化道内镜检查胃内清晰度的效果观察

目的:评价行胃镜检查的患者使用链霉蛋白酶后胃腔内的清晰度,探讨链霉蛋白酶协助胃镜检查的有效性。方法:收集胃镜检查的100例患者,分为试验组(给药链霉蛋白酶)和对照组(给药Na Cl溶液),分别比较其胃腔内的清晰度评分。结果:试验组使用链霉蛋白酶后胃内清晰度明显较对照组为高。结论:链霉蛋白酶能有效提高胃内清晰度,可作为检查前的辅助手段。     

链霉蛋白酶在胃镜检查中的应用价值

目的 探讨链霉蛋白酶在胃镜检查中的应用价值.方法 将204例接受胃镜检查的患者分为实验组和对照组.对照组在胃镜检查前服用盐酸利多卡因胶浆,实验组服用盐酸利多卡因胶浆及链霉蛋白酶.观察两组胃内视野清晰度及不良反应.比较实验组中不同链霉蛋白酶服药时间患者的胃内视野清晰度.结果 实验组胃内视野清晰度的有效率73.96％ (71/96),高于对照组的41.67％(45/108),差异有统计学意义(P＜0.05);两组不良反应发生率比较,差异无统计学意义(P＞0.05).实验组按胃镜检查前服用链霉蛋白酶的时间分为服药时间＜ 20 min的患者48例,服药时间≥20 min的患者48例,其胃镜检查视野清晰度的有效率比较,差异无统计学意义(P＞0.05).结论 胃镜检查前联合应用链霉蛋白酶及盐酸利多卡因胶浆,可明显提高胃内视野的清晰度,且无明显不良反应,安全性较高.     

链霉蛋白酶对胶囊内镜检查图像及病变检出率的影响

目的 探讨链霉蛋白酶对胶囊内镜检查图像清晰度及病变检出率的影响.方法 将100例需要行胶囊内镜的患者,随机分为实验组(链霉蛋白酶组)及对照组(空白组),两组患者检查前1天晚上均口服复方聚乙二醇电解质散行肠道准备,次日上午胶囊内镜检查前,实验组患者口服链霉蛋白酶,对照组行空白试验,比较两组患者胶囊内镜检查图像的气泡量、肠道清晰度及病变检出率,评价两种方法的效果.结果 在中上段小肠,实验组的气泡量及肠道清洁度均较对照组改善,差异具有统计学意义(P<0.05),在下段小肠,差异无统计学意义.从全段小肠综合来看,实验组的肠道清洁度较对照组改善,差异具有统计学意义(P<0.05),但在气泡量方面,差异无统计学意义.对于两组患者小肠病变检出率来说,虽然实验组的阳性率较高,但差异无统计学意义.结论 胶囊内镜检查前服用链酶蛋白酶能一定程度上改善胶囊内镜检查时的肠道清洁度,减少泡沫量,从而对提高病变的检出率有帮助.     

链霉蛋白酶应用于胃镜检查的效果观察

目的探讨链霉蛋白酶在胃镜检查中的应用效果。方法将接受胃镜检查的270例患者按随机数字表法分为2组:试验组129例,检查前30min口服链霉蛋白酶和碳酸氢钠的混合液50mL,并于检查前10min口服盐酸利多卡因胶浆10mL;对照组141例,检查前10min口服盐酸利多卡因胶浆10mL。胃镜检查时分别对胃底、胃体上部、胃体下部、胃窦的黏膜清晰度进行评分,比较2组萎缩性胃炎及伴有肠上皮化生检出率。结果试验组胃底、胃体上部、胃体下部、胃窦黏膜以及总黏膜清晰度评分分别为(1.81±0.88)、(1.53±0.72)、(1.29±0.50)、(1.47±0.71)、(6.09±1.87)分,对照组分别为(2.48±0.67)、(2.37±0.80)、(2.31±0.78)、(2.12±0.83)、(9.23±2.39)分,试验组各部位及总胃黏膜评分均显著低于对照组,差异有统计学意义(P<0.001)。试验组对萎缩性胃炎及伴有肠上皮化生检出率显著高于对照组(17.8%比10.6%,P<0.05)。结论链霉蛋白酶能有效提高胃镜检查时胃黏膜清晰度,有利于胃黏膜微小病变的发现。 更多还原     

二甲硅油在无痛胃镜中对上消化道黏膜表面清洁度的影响

目的 探讨无痛胃镜检查前口服二甲硅油对患者食管及胃黏膜表面清洁度的影响。方法 选择2021年6月至2022年3月于山东第一医科大学附属省立医院消化内镜室接受无痛胃镜检查的136例患者为研究对象，按照随机数字表法分为研究组（64例）和对照组（72例）。研究组患者于无痛胃镜检查前30min口服二甲硅油乳剂6ml和链蛋白酶20 000单位；对照组患者检查前仅口服链蛋白酶20 000单位。比较两组患者无痛胃镜检查中食管及胃黏膜表面的清洁度和黏膜病变活检情况。根据胃镜检查结果将136例患者分为胃黏膜集合细静脉的规则排列（regular arrangement of collecting venules,RAC）阳性组和RAC阴性组，分别在RAC阳性和阴性患者中比较研究组和对照组无痛胃镜检查中胃黏膜表面的清洁度及黏膜病变活检情况。结果 研究组食管黏膜及胃黏膜表面清洁度评分分别为（1.20±0.48）分和（3.64±0.74）分，均低于对照组的（2.26±0.75）分和（5.72±0.93）分，差异有显著性（P<0.01）。RAC阳性患者中，研究组胃黏膜表面清洁度评分为（3.59±0.78），...     

西甲硅油+糜蛋白酶联合运用在无痛胃镜检查中的价值观察

目的:观察西甲硅油+糜蛋白酶联合运用在无痛胃镜检查中的价值。方法:选取100例在我院进行无痛胃镜检查的患者(2013年6月~2016年6月期间)作为观察对象。使用数字表法将其简单随机分为两组,检查中分别给予西甲硅油(对照组)和西甲硅油+糜蛋白酶联合运用(观察组)。对比2组无痛胃镜检查患者胃镜检查的视野清晰度、检查时间、医生满意情况以及麻醉药用量。结果:观察组患者的胃镜检查视野清晰度、医生满意度均优于对照组,P0.05;胃镜检查时间、麻醉药用量低于对照组,P0.05。结论:西甲硅油+糜蛋白酶联合运用在无痛胃镜检查中可缩短检查时间,减少麻醉药的剂量。     

西甲硅油在胃镜检查中的祛泡作用

目的:探讨西甲硅油在胃镜检查中的祛泡作用。方法:将行胃镜检查的患者随机分为两组。检查前研究组予西甲硅油8ml 盐酸利多卡因胶浆10ml口服,对照组予盐酸利多卡因胶浆10ml口服。根据胃镜下视野清晰程度分成A、B、C、D 4级,记录每例患者检查时间。结果:服用西甲硅油组胃镜下视野清晰度明显高于对照组(P<0.05),检查时间显著少于对照组(P<0.01)。结论:应用西甲硅油能够明显提高视野清晰度,缩短检查时间,可作为胃镜检查前的常规辅助用药。     

无痛胃镜检查应用盐酸达克罗宁胶浆与二甲硅油乳剂的疗效研究

目的比较无痛胃镜检查应用盐酸达克罗宁胶浆与二甲硅油乳剂的效果。方法选取2018年9月至2019年5月鹤壁市人民医院收治的98例行无痛胃镜检查术患者,采用随机数字表法分为实验组50例和对照组48例。对照组术前口服二甲硅油乳剂;实验组术前口服盐酸达克罗宁胶浆。比较两组临床疗效、胃镜下不同部位黏膜视野清晰度和不良反应发生情况。结果实验组临床总有效率高于对照组(100.00%vs. 91.67%)(P<0.05)。实验组胃窦、胃角、胃体、胃底及食管黏膜视野清晰度评分高于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论无痛胃镜检查应用盐酸达克罗宁胶浆临床效果理想,其能够有效提高胃镜下不同部位的视野清晰度,且不增加患者的不良反应发生率。     

盐酸达克罗宁胶浆在无痛胃镜检查中应用分析

目的观察盐酸达克罗宁胶浆在无痛胃镜检查中的安全性。方法分析无痛胃镜检查患者194例的资料,观察组98例患者胃镜检查前10～15 min口服盐酸达克罗宁胶浆10 ml,对照组96例胃镜检查前不服用盐酸达克罗宁胶浆。分析两组患者在检查过程中不适程度、反应情况、血氧饱和度的变化。结果无痛胃镜检查过程中观察组患者呛咳、喉头痉挛、呼吸抑制、无意识躁动、血氧饱和度下降、难以耐受的发生率分别为39.8%、9.2%、4.1%、18.4%、10.2%、8.2%;对照组分别为5.2%、0、4.2%、6.3%、3.1%、1.0%(P<0.05);观察组在检查过程中感受不适的例数及程度均明显高于对照组(P<0.05)。结论盐酸达克罗宁胶浆在无痛胃镜检查中应用后患者不适反应大、安全性低。     

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.     

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.