贝那普利联合氨氯地平对高血压患者降压效果、血压变异性及心功能的影响

目的:探讨贝那普利联合氨氯地平对高血压患者降压效果、血压变异性(BPV)及心功能的影响。方法:选取2015年2月～2018年12月期间西安交通大学医学院附属三二〇一医院收治的131例高血压患者,根据随机数字表法分为对照组(n=65)和研究组(n=66),对照组患者给予氨氯地平治疗,研究组在对照组基础上联合贝那普利治疗。比较两组患者治疗后的降压效果、BPV以及心功能指标,记录两组患者治疗期间不良反应情况。结果:两组患者治疗4个月后收缩压(SBP)、舒张压(DBP)均下降,且研究组低于对照组(P0.05)。两组患者治疗4个月后24 h收缩压变异性(24hSBPV)、白天收缩压变异性(dSBPV)、24h舒张压变异性(24hDBPV)、白天舒张压变异性(dDBPV)均下降,且研究组低于对照组(P0.05),而夜间收缩压变异性(nSBPV)、夜间舒张压变异性(nDBPV)比较差异无统计学意义(P0.05)。两组患者治疗4个月后A峰速度、A/E峰值均下降,且研究组低于对照组(P0.05)。两组患者治疗4个月后E峰速度、EF值均升高,且研究组高于对照组(P0.05)。两组不良反应发生率比较无差异(P0.05)。结论:贝那普利联合氨氯地平治疗高血压患者的降压效果确切,可有效改善患者BPV及心功能,且安全性较好。     

不同性别急性心肌梗死合并心衰患者院内治疗及一年随访情况的比较

目的:比较不同性别急性心肌梗死(Acute Myocardial Infarction,AMI)合并心衰患者住院期间院内治疗方式、一年随访用药依从性及心血管不良事件发生情况。方法:收集我院2014年10月至2015年6月收治的136例急性心肌梗死合并心衰患者,分析和比较不同性别患者入院时的临床特征、住院期间治疗方式、一年随访过程中用药依从性以及心血管不良事件发生率的差异。结果:本研究共入组136例急性心肌梗死合并心衰患者,其中男性患者70(51.47%)例,女性66(48.53%)例。男性患者具有吸烟史、饮酒史的比例显著高于女性患者(62.86%vs 28.79%,P=0.001;35.71%vs 10.61%,P=0.001),但具有糖尿病史的比例明显低于女性(35.71%vs 53.03%,P=0.042);男性患者住院期间接受溶栓或经皮冠状动脉介入(Percutaneous Coronary Intervention,PCI)治疗的比例明显高于女性(62.86%vs 45.45%,P=0.042);男性患者一年随访期间出现胸痛、卒中的比例低于女性(11.43%vs 24.24%,P=0.050;2.86%vs 12.12%,P=0.050);但出血事件的发生率高于女性(10.00%vs 0%,P=0.014)。结论:男性急性心肌梗死合并心衰患者住院期间接受溶栓或PCI治疗的比例明显高于女性;一年随访过程中出现胸痛、卒中事件率低于女性,但出血事件的发生率高于女性。     

宫腹腔镜联合治疗输卵管阻塞性不孕症的疗效及在不同年龄及阻塞类型中疗效差异

目的:探讨宫腹腔镜联合治疗输卵管阻塞性不孕症的临床治疗效果及在不同年龄及阻塞类型中的疗效差异。方法:选取2013年2月至2015年2月间我院收治的70例输卵管性不孕症患者,按照随机数字表法分为两组,对照组(n=35例)行宫腔镜引导下的输卵管疏通术,观察组(n=35例)在对照组治疗方案上联合腹腔镜治疗,比较两组的临床治疗效果,同时比较宫腹腔镜联合对不同年龄段以及不同阻塞类型患者的临床治疗效果。结果:观察组输卵管通畅情况优于对照组(Z=-2.207,P=0.027);观察组输卵管再通率高于对照组[82.86%vs 60.00%],差异有统计学意义(x2=4.480,P=0.034)。两组治疗后并发症发生率无差异(P0.05)。观察组治疗后1年总妊娠率高于对照组[82.86%vs 57.14%],差异有统计学意义(P0.05);宫内妊娠率高于对照组[80.00%vs51.43%],差异有统计学意义(P0.05)。年龄≤30岁组与年龄30岁组患者输卵管再通率、总妊娠率、宫内妊娠率无差异(P0.05)。壶腹部或伞部阻塞患者输卵管再通率、总妊娠率、宫内妊娠率均高于间质部阻塞患者和峡部阻塞患者,差异有统计学意义(P0.05)。结论:宫腹腔镜联合治疗输卵管阻塞性不孕症具有较好的疗效,且输卵管再通率和妊娠率得到明显提高,术后并发症也较少,并且对输卵管壶腹部或伞部阻塞的术后再通率效果最好。     

70 岁以上老年原发性肝癌患者临床特点

目的:探讨70岁以上高龄原发性肝癌患者临床表现、诊治方法和预后特点。方法:回顾性研究我院2000～2010年间70例原发性肝癌患者(PLC)临床资料,比较两组患者(≥70岁,高龄组;和<70岁,低龄组)的临床特点和预后。结果:≥70岁患者36例(51.4%),<70岁34例(48.6%)。与低龄组相比,高龄组心脏病(50.0%vs 17.6%)和糖尿病(41.7%vs 14.7%)显著增高(P=0.004-0.012);而乙型病毒性肝炎感染率低(50.0%vs 88.2%,P=0.016),发病时平均肿瘤直径小(3.4±2.3cm vs 5.8±4.4cm,P=0.02)。两组男性发病率、饮酒、脑血管病、首发症状和体征、肝硬化、肿瘤位置、肿瘤形态、AFP、发病时Child分级、组织学类型两组无显著差异(P>0.05)。总体(59,84.3%)以肝动脉化疗栓塞(TACE)治疗为主,平均治疗3.2±3.1次,两组接受TACE治疗患者和次数无差异。平均随访28.9月,生存分析显示两组死亡率(63.9%vs 58.8%,p=0.66)和中位生存时间(25.5月vs 20.5月,P=0.88)无显著差异。结论:≥70岁高龄PLC患者有较高的心脏病和糖尿病合并率,但多数可耐受系统性TACE治疗,从而有效延长老年患者的平均生存时间。     

TAC方案联合西黄丸对Ⅲ期乳腺癌患者P53, HER-2及TOPⅡ水平的影响

目的:研究TAC方案联合西黄丸对Ⅲ期乳腺癌患者P53、HER-2、TOPⅡ影响。方法:回顾性分析2014年3月至2016年2月在本院进行治疗的ⅡI期乳腺癌患者78例,根据治疗方法分为对照组和观察组。对照组患者采用TAC方案治疗,观察组患者采用TAC方案联合西黄丸治疗。评价两组患者的临床疗效、治疗前和治疗后P53基因(P53)、人表皮生长因子受体-2(HER-2)、拓扑异构酶Ⅱ(TOP-Ⅱ)表达情况,以及雌激素水平。结果:观察组总有效率显著高于对照组(P0.05)。观察组和对照组的P53水平比较无显著性差异(P0.05)。观察组HER-2、TOP Ⅱ阳性表达率显著低于对照组(P0.05)。治疗后,观察组促黄体生成素(LH)、促卵泡生成素(FSH)水平显著高于对照组(P0.05),血清雌酮(E1)、雌二醇(E2)水平显著低于对照组(P0.05)。结论:TAC方案联合西黄丸治疗ⅡI期乳腺癌可有效改善患者雌激素水平,降低HER-2及TOPⅡ阳性表达率,值得推广应用。     

单囊胚移植在新鲜移植周期与冻融移植周期中的应用比较

目的:探讨新鲜移植与冻融移植对单囊胚移植妊娠结果的影响。方法:回顾性分析2013~2015年在海军总医院行单囊胚移植的324例患者,其中新鲜移植组周期数为133例、冻融移植组周期数为191例,比较2组患者基本条件、临床妊娠率、流产率、分娩率等指标。结果:新鲜移植组和冻融移植组的患者基本条件中,除了囊胚级别(1.6±0.5 vs 1.9±0.4)、D5囊胚比例(100%vs 94.27%)、获卵数(17.5±5.2 vs 21.6±9.9)有显著性差异外(P0.01),其余无显著性差异(P0.05);新鲜周期移植组临床妊娠率低于冻融移植组(51.13%vs 62.30%),具有显著性差异(P0.05);流产率(17.65%vs 19.33%)、分娩率(42.10%vs 49.21%)无统计学差异(P0.05)。结论:冻融移植周期中单囊胚移植可取得比新鲜移植周期更高的临床妊娠率。     

乳杆菌活菌胶囊联合甲硝唑治疗细菌性阴道病的临床疗效

目的观察乳杆菌活菌胶囊联合甲硝唑局部用药治疗细菌性阴道病的临床疗效。方法 228例病例随机分为三组,观察组76例,对照组A 76例,对照组B 76例。观察组在阴道放置甲硝唑片0.4g,每晚1次,连用7d后再在阴道放置乳杆菌活菌胶囊l粒,每晚1次,连用5d;对照组A口服甲硝唑片0.4g,每天2次,连用7d后再在阴道放置乳杆菌活菌胶囊l粒,每晚1次,连用5d;对照组B在阴道放置甲硝唑片0.4g,每晚1次,连用7d。观察治疗后三组总有效率、药物不良反应及复发情况。结果三组患者的总有效率比较差异无统计学意义(92.11%vs 93.42%vs 90.79%)(χ2=0.362,P0.05);3个月后复发情况,观察组与对照组A比较差异无统计学意义(14.47%vs 13.16%)(χ2=0.055,P0.05),对照组B分别与观察组及对照组A比较差异均有统计学意义(34.21%vs 14.47%;34.21%vs 13.16%)(χ21=8.038,P0.01;χ22=9.318,P0.01);治疗后药物不良反应,观察组与对照组B比较差异无统计学意义(2/76 vs 1/76)(χ2=0,P0.05),对照组A分别与观察组及对照组B比较差异均有统计学意义(10/76 vs 2/76;10/76 vs 1/76)(χ21=4.433,P0.05;χ22=6.272,P0.05)。结论乳杆菌活菌胶囊联合甲硝唑局部用药治疗细菌性阴道病疗效快,副反应小,有利于恢复阴道微生态平衡,预防复发。     

肾衰宁胶囊联合血液透析对慢性肾功能衰竭患者肾功能及血液流变学的影响

目的:探讨肾衰宁胶囊联合血液透析对慢性肾功能衰竭患者肾功能及血液流变学的影响。方法:选取中国医科大学本溪中心医院于2015年1月-2017年9月期间收治的慢性肾功能衰竭患者80例为研究对象。根据随机数字表法将患者分为对照组(n=40)与研究组(n=40),两组患者均给予血液透析治疗,研究组在此基础上联合使用肾衰宁胶囊治疗,疗程均为3个月。观察并比较两组患者治疗3个月后临床疗效及不良反应发生情况,比较两组患者治疗前、治疗3个月后血肌酐(Scr)、尿素氮(BUN)、肾小球滤过率(eGFR)水平及全血高切黏度、全血低切黏度、血浆黏度、红细胞比容。结果:研究组患者总有效率为92.50%(37/40),高于对照组的67.50%(27/40),差异有统计学意义(P0.05)。两组患者治疗3个月后Scr、BUN水平较治疗前降低,且研究组低于对照组(P0.05);而两组患者治疗3个月后eGFR水平较治疗前升高,且研究组高于对照组(P0.05)。研究组患者治疗3个月后的全血高切黏度、全血低切黏度、血浆黏度以及红细胞比容均低于对照组(P0.05)。对照组不良反应发生率为7.50%,与研究组的10.00%比较差异无统计学意义(P0.05)。结论:肾衰宁胶囊联合血液透析对慢性肾功能衰竭患者有较好的治疗效果,能够改善患者肾功能状况,同时稳定患者血液流变学,并且安全性较好。     

肝动脉化疗栓塞联合射频消融对中晚期肝癌患者血清肿瘤活性因子、肝功能和预后的影响

目的:探讨肝动脉化疗栓塞(TACE)联合射频消融(RFA)对中晚期肝癌患者血清肿瘤活性因子、肝功能和预后的影响。方法:选取2012年2月～2016年6月期间我院收治的中晚期肝癌患者103例,根据随机数字表法将患者分为对照组(n=51)和研究组(n=52),对照组患者给予RFA治疗,研究组给予TACE联合RFA治疗,比较两组临床总有效率,比较两组治疗前后肝功能、血清肿瘤活性因子水平,统计两组患者并发症情况和预后。结果:治疗后研究组临床总有效率为53.85%(28/52),高于对照组患者的33.33%(17/51)(P0.05)。两组患者治疗后总胆红素(TBIL)、丙氨酸转氨酶(ALT)、氨基酸转氨酶(AST)较治疗前降低(P0.05),但两组治疗后TBIL、ALT、AST比较差异无统计学意义(P0.05)。两组患者治疗后甲胎蛋白(AFP)、糖类抗原199(CA199),基质金属蛋白酶(MMP)均较治疗前降低,且研究组低于对照组(P0.05)。两组患者并发症发生率比较无差异(P0.05)。研究组患者治疗后1年、2年复发率低于对照组,生存率高于对照组(P0.05)。结论:TACE联合RFA治疗中晚期肝癌,疗效确切,可有效降低血清肿瘤活性因子水平,未加重肝功能损伤,且可改善患者的预后。     

重组人脑利钠肽对急性呼吸窘迫综合征患者血管外肺水及预后的影响

目的探讨重组人脑利钠肽(rhBNP)对急性呼吸窘迫综合征(ARDS)患者血管外肺水及预后的影响。方法选择2013年1月～2015年12月在我院ICU治疗的急性呼吸窘迫综合症患者110例,按随机数字表法分为对照组50例与治疗组60例。对照组给予常规ICU治疗(肺保护性通气策略),治疗组在此基础上加用重组人脑利钠肽治疗,分析比较两组患者血管外肺水指数(EVLWI)、肺活量(VC)以及肺总量(TLC)水平。结果两组患者治疗前的EVLWI指标比较,差异无统计学意义(P0.05);治疗后,治疗组的EVLWI指标为(10.42±2.35)ml/kg,对照组为(14.51±3.14)ml/kg,两组比较差异有统计学意义(t=7.804,P0.05)。两组患者的VC、TLC水平比较,治疗前均无统计学意义(均P0.05);治疗后,治疗组的VC指标为(3673.72±413.56)ml,对照组为(3045.34±435.15)ml,差异有统计学意义(t=7.749,P0.05);TLC指标比较,治疗组为(3892.63±504.73)ml,对照组为(3573.46±516.93)ml,两组比较差异有统计学意义(t=3.266,P0.05)。结论 rhBNP应用于ARDS患者能有效改善血管外肺水指数,提升患者肺功能,改善患者预后情况。     

六种藓类植物茎的比较解剖学研究

通过对6种藓类植物,即褶叶青藓(Brachythecium salebrosum(Web.et Mohr.)B.S.G.)、湿地匐灯藓(Plagiomnium acutum(Lindb.)Kop.)、侧枝匐灯藓(Plagiomnium maximoviczii(Lindb.)Kop.)、大凤尾藓(Fissidensnobilis Griff.)、大羽藓(Thuidium cymbifolium(Doz.et Molk.)B.S.G.)和大灰藓(Hypnum plumaeforme Wils.)嫩茎和老茎的石蜡切片和显微观察发现,同一藓类植株的嫩茎和老茎,茎结构稳定,不同种藓类植物茎横切面具有不同特征.植物体茎横切面形状、表层细胞的层数、细胞大小和细胞壁厚薄、皮层细胞大小和形状、中轴的有无以及比例等特征可以作为藓类植物的分科分类依据之一.     

Cause of Senescence of Nine Sorts of Flowers

The levels of endogenous phytohormones and respiratory rate in nine sorts of flowers such as Cymbidium faberi Rolfe, Nopalxochia ackermannii Kunth and others were investigated both at full bloom and senescence and meanwhile the effect of exogenous phytohormones on prolonging the blossoms and promoting ethylene production were tested. There is a high content of endogenous ethylene in all the long-lived flowere, about 3–16 folds higer than the short-lived ones. There is a high level of ABA at full blooming flowers of short-lived flowers, in which there is no or only some cytokinins in it, but the ratio of CTK (6BA+zeatin)/ABA is smaller(l.7). The endogenous ABA reached a much higher level at senescence in all nine sorts of flowers, so it is reasonable to consider that it is ABA which plays an important role of regulation in controlling flower's senescence. There is a much higher level of GA3 and zeatin in the long-lived flowers which is not demonstrated in the shortlived ones. The respiratory rate is one of the factors controtling the longevity of flowers, but it does not play a decided role. Application of 6BA and zeatin prolongs distinctly orchid’s longevity, however exogenous IAA through the promotive action on ethylene production, evidently extends the longevity of the flowers of the Nopalxochia ackermannii Kunth.     

Photoregulation of seed germination of wild-type and of an aurea-mutant of tomato

Seed germination of an aurea mutant of tomato ( Lycopersicon esculentum Mill.) is promoted by continuous irradiation with red, far-red or long-wavelength far-red (758 nm) light as well as by cyclic irradiations (5 min red or 5 min far-red/25 min darkness). Far-red light applied immediately after each red does not change the germination behaviour. Seed germination of the isogenic wild-type, cv. UC-105, is promoted by continuous and cyclic red light while it is inhibited by continuous and cyclic far-red light and by continious 758 nm irradiation. Far-red irradiation reverses almost completely the promoting effect of red light. The promoting effect (in the aurea mutant) and the inhibitory effect (in the wild-type) of continuous far-red light do not show photon fluence rate dependency above 20 nmol m⁻² s⁻¹. It is concluded that phytochrome controls tomato seed germination throgh low energy responses in both the wild type and the au mutant. The promoting effect of continuous and cyclic far-red light in the au mutant can be attributed to a greater sensitivity to P_fr.     

龙胆科药用植物化学成分的研究现状

龙胆科植物在我国的分布范围很广,且多数为药用植物,其多数种属的药用植物,至今其化学成分尚未被系统研究。综述了目前龙胆科药用植物的化学成分的研究现状及一般提取方法,对近年来发现的环烯醚萜及裂环烯醚萜类化合物进行了总结,为本科药用植物的更深入研究提供了参考。     

The effects of glutamine of the maintenance of embryogenic cultures of Cryptomeria japonica

Summary Embryogenic tissues of sugi (Cryptomeria japonica) were induced on a modified Campbell and Durzan (CD) medium containing 1 μM 2,4-dichlorophenoxyacetic acid (2,4-D) and 600 mg l⁻¹ glutamine, and subcultured in the medium of the same composition for over 1 yr. This resulted in a mixed culture of embryogenic and non-embryogenic cells. When embryogenic cells were isolated and cultured independently, their capacity to form embryogenic aggregates was lost. Thus, the non-embryogenic cells present within a mixed culture system were essential to the formation of embryogenic aggregates. When embryogenic tissues were isolated and cultured independently on a high glutamine-containing (2400 mg l⁻¹) medium, dry weights and endogenous levels of glutamine increased, and the tissue could generate a large number of embryogenic aggregates. Amino acid analysis of embryogenic and non-embryogenic cells from the maintenance culture indicated a higher level of glutamine was present in the latter. The high endogenous level of glutamine in the non-embryogenic portion of mixed cell masses may be the supplier of glutamine for maintaining the embryogenic property of the tissues.     

Specificity of action of piperidylcholine derivatives as substrates of cholinesterases of various origin

The review deals with study of enzymologic properties of a novel highly specific acetylcholinesterase substrate, N-(β-acetoxyethyl) piperidinium iodomethylate (“piperidylcholine”), and its 30 derivatives that were tested as effectors of cholinesterases of mammals and various species of Pacific squids. It was proven for the first time that responsible for specificity of action was structure of cyclic ammonium grouping of the alcohol part of molecule of the ester substrate. Analysis of specificity is performed based on enzymatic hydrolysis parameters—activity of catalytic center of cholinesterases and bimolecular constant of the reaction rate that are determined at optimal and low substrate concentrations. Among the specially synthesized group of thioester compounds there is revealed one more highly specific acetylcholinesterase substrate—N-(β-acetoxyethyl) piperidinium.     

Interconnection of parameters of regulation system of lipid peroxidation and of morphophysiological parameters of mouse liver

A complex analysis of seasonal fluctuations of the mean group parameters of the system of regulation of lipid peroxidation has been performed in liver of Balb/c mice. Association of lipid characteristics and morphophysiological parameters is studied in the Balb/c mouse liver. An inter-connection is revealed between the liver index and the amount of lysoforms of phospholipids, the scale and character of the interconnection differing essentially depending on proportion of phos-phatidylcholine in mouse liver phospholipids.     

真菌类遗传学分析的知识结构教学

本文以认知结构理论为指导,讨论了真菌类遗传分析与高等动植物遗传分析的内在联系,认为利用这种内在联系进行教学可收到好的效果并说明了作者的具体教学过程。 Abstract:In the paper, the relationship between genetic analysis of Fungi and genetic analysis of high animal and plant was discussed.A good results were obtained when we adopted this method in the teaching.