静脉注射维拉帕米或普罗帕酮治疗阵发性室上性心动过速的对比研究

目的：观察静脉注射维拉帕米或普罗帕酮治疗阵发性室上性心动过速（PSVT）的疗效。方法：静脉注射维拉帕米治疗35例78例次PSVT,并与普罗帕酮治疗31例59例次PSVT对比观察。结果：维拉帕米组总例次终止率为89．7％,普罗帕酮组总例次终止率为88．7％。两组疗效、终止PSVT发作的心电图形式等无显著性差异（P＞0．05）。普罗帕酮组2例较长时间窦性停博,1例致Ⅲ度房室传导阻滞（AVB）,3例中2例死亡。结论：房室结折返性心动过速（AVNRT）应用维拉帕米复律优于普罗帕酮（P＜0．05）。普罗帕酮副作用较大。     

对比分析维拉帕米与普罗帕酮治疗阵发性室上性心动过速的临床疗效

目的比较维拉帕米与普罗帕酮治疗阵发性室上性心动过速(PSVT)的临床疗效。方法将该院确诊并收治的74例PSVT患者按随机原则分为维拉帕米治疗组和普罗帕酮治疗组,每组患者各37例,观察两组患者窦性心律恢复时间,比较两组患者的临床疗效。结果普罗帕酮组患者用药后窦性心律恢复时间为(7.3±2.8)min,明显少于维拉帕米组的(10.6±2.4)min(P0.05);普罗帕酮组患者治疗总有效率为94.59%,显著高于维拉帕米组的78.38%(P0.05)。结论普罗帕酮治疗PSVT的总体疗效优于维拉帕米,可作为临床治疗的首选药物在临床推广应用。     

普罗帕酮与维拉帕米治疗阵发性室上性心动过速的疗效对比

目的对比分析普罗帕酮与维拉帕米治疗阵发性室上性心动过速（PSVT）的疗效及不良反应。方法选择2008年1月至2010年10月在我科收治的88例PSVT患者,随机分为2组：普罗帕酮组（45例）给予普罗帕酮70mg加入生理盐水20ml中缓慢静脉推注;维拉帕米组（43例）给予维拉帕米5～10mg加入20ml生理盐水缓慢静脉推注。观察、比较2组患者治疗效果及不良反应。结果普罗帕酮组与维拉帕米组转复率分别为84.4%和95.3,2组比较差异无统计学意义（P〉0.05）;普罗帕酮组平均转复时间明显长于维拉帕米组（P〈0.05）;2组不良反应发生率比较差异无统计学意义（P〉0.05）。结论维拉帕米与普罗帕酮均可有效终止PSVT,维拉帕米治疗效果更佳,但应注意其并发症的发生。     

药物治疗阵发性室上性心动过速的对比研究

目的比较静脉注射三磷酸腺苷（ATP）、普罗帕酮和维拉帕米在终止阵发性室上性心动过速（PSVT）发作的疗效及安全性。方法符合条件的PSVT患者随机分ATP组27例、普罗帕酮组27例和维拉帕米组27例,分别经静脉ATP、普罗帕酮、维拉帕米推注,记录给药后和给药期间临床和心电图状况。结果 ATP组转复成功率为85.2%、普罗帕酮组81.5%、维拉帕米组88.9%,相比较维拉帕米组转复成功率最高。ATP组起效更快,P〈0.001。ATP组、普罗帕酮组和维拉帕米组的不良反应发生率分别为25.9%、22.2%、22.2%,3组比较差异无统计学意义（P〉0.05）。整体试验未发生严重不良事件。结论三磷酸腺苷、普罗帕酮和维拉帕米均是治疗PSVT有效、安全的药物。     

维拉帕米与普罗帕酮治疗阵发性室上性心动过速临床疗效分析

目的:比较普罗帕酮(心律平)及维拉帕米(异搏定)治疗阵发性室上性心动过速(PSVT)的疗效,评价其安全性。方法:将94例PSVT患者随机分为普罗帕酮组和维拉帕米组,普罗帕酮组48例,给予首剂普罗帕酮70 mg,加葡萄糖液20 ml静脉滴注;维拉帕米组46例,给予首剂维拉帕米5 mg,加10～20 ml葡萄糖液或者生理盐水静脉滴注。结果:普罗帕酮组有效率93.8%,维拉帕米组有效率91.3%,两组有效率比较,差异无统计学意义(P>0.05);普罗帕酮组不良反应率6.25%,维拉帕米组不良反应率10.8%,差异有统计学意义(P<0.05)。结论:普罗帕酮和维拉帕米对阵发性室上性心动过速均有效,从有效率、不良反应等全面考虑认为,普罗帕酮可作为治疗PSVT的首选药物治疗,而维拉帕米因不良反应大于普罗帕酮,可作为一线治疗药物。     

食管心房调搏和普罗帕酮治疗室上性心动过速疗效比较

目的比较食管心房调搏和普罗帕酮在治疗阵发性室上性心动过速(PSVT)中的临床疗效.方法食管心房调搏组44例,用S1S1刺激超速抑制或S1S2程序期前刺激终止PSVT.普罗帕酮组46例,用普罗帕酮70mg溶于20ml液体中静注,如无效则间隔20～40分钟后重复注入70mg,最大剂量用至210mg.结果食管心房调搏终止PSVT有效率为81.8%,普罗帕酮组终止PSVT有效率为82.6%,两组间比较无显著性差异(P＞0.05).结论食管心房调搏治疗PSVT安全、有效、不良反应少.     

普罗帕酮、毛花甙丙转复围术期室上性心动过速比较

对比分析围术期普罗帕酮和毛花甙丙转复阵发性室上性心动过速(PSVT)的疗效.方法:将PSVT患者随机分为普罗帕酮组(Ⅰ组)和毛花甙丙组(Ⅱ组),分别静脉注射普罗帕酮70～120 mg和毛花甙丙0.4～0.6 mg,连续观察心率、心律及血压的变化 .结果:60例患者,PSVT病程0～13.5年,Ⅰ组成功率为90.6%,Ⅱ组成功率为75.0%(P＞0.05).两组转复成功时间差异也无显著性(P＞0.05).结论:在围术期转复PSVT治疗中,普罗帕酮和毛花甙丙一样,有效、安全 .     

普罗帕酮与维拉帕米终止阵发性室上性心动过速的疗效观察

目的 对比分析普罗帕酮与维拉帕米终止阵发性室上性心动过速的疗效.方法 对86例室上速患者随机选择普罗帕酮或维拉帕米注射剂静脉推注以终止室上速发作,记录有效转复率及平均恢复窦性心律时间并进行对比分析.结果 普罗帕酮组的转复率较维拉帕米组低,平均转复时间较维拉帕米组延长,差异有统计学意义(P＜0.05).结论 维拉帕米是终止阵发性室上性心动过速的更有效药物.     

三磷酸腺苷与维拉帕米治疗PSVT的对比研究

目的:比较静脉注射三磷酸腺苷(ATP)和维拉帕米终止阵发性室上性心动过速(PSVT)的疗效及安全性.方法:符合条件的PSVT患者44例随机分为ATP组(21例)和维拉帕米组(23例),分别经静脉给予ATP和维拉帕米,观察两组的疗效、从用药到PSVT终止的时间和不良反应.结果:ATP组转复成功率为85.7％,与维拉帕米组(82.6％)比较差异无统计学意义(P＞0.05).ATP组从用药到PSVT终止的时间为(41.2±17.9)s,显著短于维拉帕米组(921.6±603.4)s(P＜0.01).ATP组和维拉帕米组不良反应发生率分别为26.8％和23.3％,两组比较差异无统计学意义(P＞0.05);两组均未出现窦性停搏等严重心律失常.结论:ATP治疗PSVT有效、安全,与维拉帕米转复成功率相似,但起效快.     

普罗帕酮和维拉帕米治疗阵发性室上性心动过速临床疗效分析

目的:对比普罗帕酮和维拉帕米对阵发性室上性心动过速(PSVT)的治疗效果及副作用。方法:将我院急诊阵发性室上性心动过速患者68例,随机分成普罗帕酮组和维拉帕米组。普罗帕酮组给予普罗帕酮70mg静脉椎注(10min推完),若无效,继续用普罗帕酮140mg缓慢静脉滴注(30滴/min)。维拉帕米组给予维拉帕米5~10mg静椎。结果:普罗帕酮和维拉帕米对PSVT的治疗效果差异无统计学意义(P>0.05),维拉帕米副作用较普罗帕酮高(P<0.05)。结论:治疗PSVT应首选普罗帕酮,维拉帕米可作为一线药物,但应注意其副作用。     

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.