中毒患者信息数据库的建立及其临床意义

目的 提高急救危重病领域中毒患者各项信息数据管理的质量和工作效率,使信息管理科学化、规范化.方法 应用Microsoft Office2000组件中的Access2000完成数据库的构建并进行中毒患者信息数据的录入、保存、检索查询和数理统计等工作.结果 成功构建中毒患者信息数据库并系统、规范地收集了急救部2007年173例各类中毒患者信息,在数据保存、检索查询和数据统计等方面发挥了重要作用.结论 应用Access2000数据库开发的中毒患者信息数据库系统具有简便易用、安全可靠、维护方便、有较强的通用性和一定拓展移植性等特点,大大提高了工作效率;应用Access2000建立数据管理系统是目前最简单实用的方法之一,适合医疗系统许多专科项目开发使用.     

应用Access2000编制医学疾病登记系统

目的 开发自动化实用、可靠、功能完善的医学疾病登记管理系统。材料与方法 应用计算机WindowXP操作系统,以Microsoft Ac-cess2000(简体中文版)数据库软件作为编辑软件,包括创建数据表、输入数据窗体及功能按钮,建立查询及打印报表,建立WORD文档模版。结果 本系统可完成医学疾病登记的编辑及打印、文档模板的打印、自由词查询及收入统计等功能。结论 本系统是目前对医学疾病登记资料管理计算机化的有效方法之一。     

烧伤外科临床资料数据库的建立与应用

目的：利用Microsoft Access 2000保存和管理烧伤外科患者的临床资料，并探讨其应用价值。方法：回顾烧伤科2001-2004年间167例危重烧伤患者病案资料，结合2004年中华医学会烧伤外科学会制定的烧伤诊断标准和临床治疗、科研的需要，以Microsoft．NET平台的C#语言构建数据库，应用Access 2000桌面数据库管理系统平台，以烧伤入院患者的病案记录和图片资料为数据来源，建立专科临床资料数据库。结果：数据库界面友好，运行稳定，与以往手工方法回顾病例比较，具有录入、查询快速准确的特点。结论：利用Access 2000建立烧伤外科数据库简单实用，对病案资料具有强大的处理能力，不仅方便病案的信息化管理，而且有利于临床诊疗、教学和科研，值得在临床上推广。     

医学网址大全数据库的建立及其应用

收集各种医学网络网址,应用Microsoft Access程序编制医学网址大全数据库,使其能在不同计算机网络上自动链接,随时为医务人员提供医学网址资料的快捷查询.     

周围血管疾病3D-CTA数据库的构建与评价

目的：建立周围血管疾病三维CT血管造影（3D-CTA）数据库,实现对周围血管疾病文字资料和图片档案的动态化管理。方法：以Microsoft Access 2003软件为基础制作动态病例资料表、输入窗体、查询窗体。将资料完整的周围血管疾病3D-CTA检查患者的临床资料和影像学资料录入数据库。结果：建立了单机版3D-CTA数据库。数据库主要由五个窗体组成：患者基本资料录入、检查技术、3D-CTA正常解剖与变异、疾病诊断、查询。结论：该数据库是一个完善的、实用的影像与临床相结合的周围血管疾病数据库。     

乳腺癌电子数据库的建立及临床应用

目的建立乳腺癌电子数据库,收集乳腺癌临床病理资料,为开展乳腺癌临床和基础研究提供信息平台。方法利用Microsoft Access数据库软件设计乳腺癌电子数据库,将2002年1月至2011年12月宁夏医科大学总医院肿瘤外科收治的所有乳腺癌患者的临床、病理资料输入数据库。结果成功建立了宁夏医科大学总院乳腺癌数据库,已收集1630例乳腺癌患者的临床病理资料。数据库具有输入数据方便、快捷、完整、可靠,数据统计、查询快速、准确的特点,可对病案实行信息化管理。结论乳腺癌数据库为乳腺癌患者的临床资料信息化管理提供了一种有用的工具。     

探讨连续性血液净化治疗ICU多脏器功能衰竭综合征患者的临床应用效果

目的探究连续性血液净化治疗对ICU多脏器功能衰竭综合征患者的病情的改善效果,以指导临床上应用连续性血液净化治疗ICU多脏器功能衰竭综合征。方法收集去年我院重症监护室中120例经连续性血液净化治疗的多器官功能障碍综合征患者的临床资料,包括在治疗前后反映各重要脏器功能的相关指标。通过统计学分析,总结治疗的效果。结果大多数患者经过连续性血液净化治疗后,反映各功能障碍脏器的功能指标均有不同程度的改善。通过统计学分析,得出:ICU多脏器功能障碍综合征患者在连续性血液净化前后治疗各项指标具有统计学差异。结论连续性血液净化治疗能较明显的减缓ICU多脏器功能障碍综合征患者病情的进展和有利于进一步的治疗,可不同程度的改善预后。     

老年性白内障手术资料数据库的建立

目的开发较为详细的白内障手术资料数据库,便于病例管理和科研。方法复习文献制定白内障手术资料登记表,应用Microsoft Access 2003数据库软件建立老年白内障患者手术资料数据库及其管理系统,并联网测试使用。结果我院干部病房老年白内障手术资料数据库初步建立,相关网络通道运行良好。结论医院白内障手术资料数据库的建立有利于科学和系统地收集白内障手术资料数据,为进一步统计分析奠定基础,并为白内障手术治疗研究提供依据。     

探析重症急性胰腺炎的连续性血液净化临床治疗

目的:分析并探讨连续性血液治疗方法在重症急性胰腺炎患者的临床治疗效果.方法:随机选取该院2015年6月至2016年6月接诊的38例重症急性胰腺炎患者,将其对半分为观察组与对照组,予对照组实施常规综合治疗,在实施常规综合治疗的基础上予观察组实施连续性血液净化治疗,3d后观察两组患者的血清生化指标和症状体征的变化情况.结果:实施连续性血液净化治疗后,患者血清生化指标水平相比治疗前明显改善,差异具有统计学意义(P＜0.05).结论:将连续性血液净化治疗用于急性胰腺炎患者临床治疗,能保护患者器官功能,有效缓解患者病情,值得在临床进行推广.     

连续性血液净化治疗难治性肺心病

目的评估连续性血液净化治疗难治性肺心病的可行性。方法 2010年1月至2011年4月在我院住院治疗的肺心病心衰患者46例,根据患者及其家属自愿原则,选择连续性血液净化治疗者21例为治疗组,拒绝连续性血液净化治疗者25例为对照组。对照组患者继续使用药物治疗,治疗组患者在原治疗方案基础上加用CVVH治疗,根据患者病情使用24～72h。对治疗组及对照组7d后死亡率进行比较,及对治疗组在治疗前、治疗后1d、3d、7d各项观察指标进行比较。结果选择连续性血液净化的患者死亡率远低于对照组。治疗组患者体征及各项观察指标在接受连续性血液净化治疗后1d即开始出现显著变化,治疗后3d变化更明显。治疗后7d与治疗后3d的各项指标比较差异无统计学意义。结论连续性血液净化治疗可以用于难治性肺心病的治疗,可以根据患者病情决定治疗时间,通常治疗3d达到稳定。     

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.