静脉使用胺碘酮治疗心力衰竭并快速心房纤颤的疗效观察

目的对比研究胺碘酮与毛花甙C治疗心力衰竭并快速心房纤颤的疗效。方法选择各种心脏病引起的心力衰竭并快速心房纤颤患者48例,随机分为两组:胺碘酮组25例,给予胺碘酮负荷量150 mg静注后,以0.8~1mg/min维持静脉点滴,依心室率情况调节胺碘酮剂量。毛花甙C组23例,近1周未用洋地黄者,以毛花甙C 0.4 mg静脉注射,近1周口服地高辛者,以毛花甙C 0.2 mg静脉注射,依见效情况调节剂量。观察复律情况、心室率及心功能的变化。结果胺碘酮组与毛花甙C组用药前心室率分别为(150±18)次/min和(148±20)次/min,用药后心室率分别为(81±12)次/min和(102±14)次/min。胺碘酮组用药平均起效时间为(14±10)min,而毛花甙C组用药平均起效时间为(30±5)min。胺碘酮组治疗有效19例,有效率76.0%;毛花甙C组治疗有效14例,有效率为60.9%。转为窦性心率:胺碘酮组10例,毛花甙C组7例。结论静脉使用胺碘酮治疗心力衰竭并快速心房纤颤疗效迅速、安全、有效。     

静脉使用胺碘酮治疗心力衰竭并快速心房纤颤的疗效观察

目的对比研究胺碘酮与毛花甙C治疗心力衰竭并快速心房纤颤的疗效.方法选择各种心脏病引起的心力衰竭并快速心房纤颤患者48例,随机分为两组胺碘酮组25例,给予胺碘酮负荷量150 mg静注后,以0.8～1mg/min维持静脉点滴,依心室率情况调节胺碘酮剂量.毛花甙C组23例,近1周未用洋地黄者,以毛花甙C 0.4 mg静脉注射,近1周口服地高辛者,以毛花甙C 0.2 mg静脉注射,依见效情况调节剂量.观察复律情况、心室率及心功能的变化.结果胺碘酮组与毛花甙C组用药前心室率分别为(150±18)次/min和(148±20)次/min,用药后心室率分别为(81±12)次/min和(102±14)次/min.胺碘酮组用药平均起效时间为(14±10)min,而毛花甙C组用药平均起效时间为(30±5)min.胺碘酮组治疗有效19例,有效率76.0%;毛花甙C组治疗有效14例,有效率为60.9%.转为窦性心率胺碘酮组10例,毛花甙C组7例.结论静脉使用胺碘酮治疗心力衰竭并快速心房纤颤疗效迅速、安全、有效.     

胺碘酮治疗心房纤颤快速心室率128例体会

目的探讨静脉注射胺碘酮治疗心房纤颤快速心室率的方法。方法选择心房纤颤心室率大于100次/min患者128例,静脉注射胺碘酮150mg,时间大于10min,15min未转为窦性心律者,重复首次剂量一次,15min后若仍未转复者,以1mg/min静滴6h,继之以0.5mg/min,以静脉输液泵控制速度静滴,24h未转复者停用。结果24h内转复窦性心律者90人(70%);用药后1h内心室率平均下降30次/min;Q-T间期延长者无1例发生严重心律失常,未诱发或加重心功能不全,无恶性心律失常发生,不良反应小,症状轻微。结论静脉注射胺碘酮治疗心房纤颤快速心室率安全有效。     

胺碘酮治疗急性心肌梗死并心房颤动的临床研究

目的探讨胺碘酮治疗急性心肌梗死并心房颤动的临床疗效与安全性。方法急性心肌梗死并心房颤动60例分两组,治疗组予以胺碘酮治疗(胺碘酮组),对照组予以普罗帕酮治疗(普罗帕酮组),观察24h内心房颤动转复率、转复后30d内窦性心律维持率及副作用。结果胺碘酮组转复率86.7%,转复后窦性心律维持率76.7%,普罗帕酮组转复率80.0%,转复后窦性心律维持率40%。结论胺碘酮治疗AMI并发AF临床疗效良好、安全性高,值得临床推广应用。     

静脉用胺碘酮治疗阵发性房颤30例

目的:观察静脉应用胺碘酮对阵发性心房颤动的作用。方法:30例器质性心脏病阵发性心房颤动患者,首剂静脉注射150mg,10分钟内注入,继之以0.5mg/分维持静脉泵入,15分钟未转复为窦性心律且心室率仍快者,追加静脉注射150mg。结果:5例10分钟转复,21例5小时后转复,4例10小时后转复。用药期间,未见缓慢性心律失常、低血压、心衰加重、心绞痛加重及QT间期延长等不良反应。结论:静脉用胺碘酮治疗阵发性心房颤动安全有效。     

静脉应用胺碘酮转复急性心房颤动的疗效观察

目的:观察静脉应用胺碘酮转复急性心房颤动的有效性和安全性。方法:将28例发生于48h以内的急性心房颤动患者予胺碘酮150m g稀释后在10~15m in内静脉注射,继而以1m g/m in速度经微量泵静脉输入维持6h,再以0.5m g/m in速度维持18h,转复窦性心律后停用。结果:25例患者均在静脉用胺碘酮后24h内转复为窦性心律,转复率为89.2%。2例合并低血压,经同时静脉滴注多巴胺后血压恢复正常。1例出现窦性心动过缓,停药后恢复正常心率。结论:静脉内使用胺碘酮可安全有效地转复新近发生的快速心房颤动。     

静脉注射胺碘酮治疗心房纤颤快速心室率的临床评价

目的观察静脉注射胺碘酮治疗心房纤颤快速心室率的疗效。方法 32例心房纤颤心室率〉100次/min的患者,20min静推胺碘酮150mg,观察10min,未转为窦性心律者再次20min静推胺碘酮150mg,仍未转复者则以1.0mg/min静滴6h,之后改为0.5mg/min静滴18h,转为窦性心律者则随时终止静滴胺碘酮。结果 24h内转为窦性心律者33例（92%）,转为窦性心律时间10min～23h,平均6.9h;转为窦性心律的药物剂量为150～900mg,平均406mg.无严重心律失常发生,未诱发或加重心功能不全。结论静脉注射胺碘酮治疗心房纤颤快速心室率疗效确切、安全。     

胺碘酮联合培哚普利对初发性心房颤动复律后窦性心律维持的影响

观察静脉注射胺碘酮对初发性心房颤动伴快心室反应的转复效果以及口服胺碘酮联合培哚普利对心房颤动转复后远期窦性心律的维持。将89例患者随即分为胺碘酮组(n=48例)和胺碘酮加培哚普利组(n=41例)。观察静注胺碘酮对房颤终止的效果。48小时内转复率70.8%。胺碘酮加培哚普利组对房颤复律后窦性心律的维持,左房内径缩小均明显优于胺碘酮组(P<0.05)。结论胺碘酮联合培哚普利对初发性房颤复律后窦性心律的维持优于胺碘酮组,对左房扩大的延缓及心功能改善均有一定作用。     

静脉用乙胺碘呋酮治疗老年人快速心房纤颤的临床评价

目的观察静脉用乙胺碘呋酮治疗老年人心房纤颤并快速心室率的疗效及副作用。方法45例新发老年心房纤颤患者,心室率大于100次/min。静脉推注(10 min)乙胺碘呋酮150 mg,观察10 min,未转为窦性心律者再次推注(10 min)150 mg,仍未转复者则0.5~1.0 mg/min静脉滴注24 h,转为窦性心律者则随时终止滴注。结果24 h内转复为窦性心律者38例(84.4%),其中30 min内转复者7例(15.6%),0.5~10 h转复者27例(60%),10 h以上转复4例(8.9%)。转复为窦性心律的药物剂量150~1000 mg,平均为460 mg。用药后30 min及1、6、24 h与用药前比心室率均明显下降(P<0.005),无严重心律失常发生,未诱发或加重心功能不全。结论静脉用乙胺碘呋酮治疗老年人心房纤颤快速心室率疗效确切、安全。     

静脉注射伊布利特转复心房扑动或心房颤动14例疗效分析

目的:比较伊布利特与胺碘酮转复心房扑动(AFL)或心房颤动(AF)的临床疗效。方法:将符合入选标准的27例AFL或AF患者随机分为伊布利特组14例,给予伊布利特注射液1 mg于10 min内静脉注射(静注);如无效10 min后再给予1 mg静注。胺碘酮组13例,给予胺碘酮注射液150 mg于15 min内静注;如无效10 min后再给予75 mg静注。观察转复为窦性心律的例数及时间。结果:伊布利特组转复为窦性心律的时间短于胺碘酮组(P0.05);伊布利特组与胺碘酮组分别有11例与6例在给药后0～30 min内转复为窦性心律;分别有3例与2例在给药后30～90 min内转复为窦性心律,总转复率分别为100.0%和61.54%。2组差异无统计学意义(P=0.167)。结论:伊布利特是一种快速、安全、有效的新型抗心律失常药物,为AFL或AF转复为窦性心律提供了新的选择。     

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.