止遗方联合艾灸治疗下焦虚寒型小儿遗尿症临床研究

目的:观察止遗方联合艾灸治疗下焦虚寒型小儿遗尿症(nocturnalenuresis,NE)的临床疗效。方法:80例NE患儿随机分为观察组和对照组各40例。观察组给予止遗方免煎颗粒口服,每天2次,联合艾灸关元、中极、足三里、三阴交等穴位,每天1次;对照组给予醋酸去氨加压素(弥凝片)睡前口服,每次0.2 mg,赖氨肌醇维生素B12口服液,每次10 m L,每天2次。连续治疗1个月,随访6个月。观察两组患儿临床疗效、血清维生素B12和抗利尿激素(antidiuretic hormone,ADH)水平,并比较治疗过程中不良反应和治疗后复发情况。结果:观察组有效率显著优于对照组(P0.05),两组患儿治疗前后血清维生素B12水平比较有显著性差异(P0.05),两组比较,差异无统计学意义(P0.05);治疗后观察组患儿血清ADH高于对照组,两组比较,差异有统计学意义(P0.05);观察组不良反应率、复发率显著低于对照组(P0.01)。结论:止遗方联合艾灸治疗NE疗效确切,不良反应率和复发率低。     

止遗温胆汤结合推拿疗法治疗小儿遗尿病肝经湿热证的疗效观察

目的观察止遗温胆汤结合推拿疗法治疗小儿遗尿病肝经湿热证的临床疗效及复发情况。方法将符合纳入标准的64例患儿随机分为治疗组和对照组,各32例。治疗组口服止遗温胆汤结合推拿疗法,对照组单纯推拿疗法;观察两组患儿治疗3个月后的临床疗效,患儿尿床、性情急躁、睡眠觉醒障碍和夜梦纷纭临床症状复常率,并在停药后随访3个月内复发情况,统计复发率。结果治疗后治疗组总有效率为96.67%,对照组总有效率为86.20%,两组比较差异有统计学意义(P0.05);治疗后治疗组患儿尿床、性情急躁、睡眠觉醒障碍和夜梦纷纭临床症状的复常率均高于对照组,差异有统计学意义(P0.05);治疗组治疗3个月后患儿复发率低于对照组,差异有统计学意义(P0.05)。结论止遗温胆汤结合推拿疗法治疗小儿遗尿病肝经湿热证临床疗效显著,并能改善患儿尿床、性情急躁、睡眠觉醒障碍和夜梦纷纭等症状,且复发率低于单纯推拿疗法,值得临床推广应用。     

运用苗医刘氏小儿推拿治疗小儿遗尿临床观察

目的:探讨苗医刘氏小儿推拿治疗小儿遗尿下元虚寒型的临床疗效。方法:将48例下元虚寒型遗尿患儿随机分成治疗组和对照组各24例,治疗组采用刘氏小儿推拿疗法,对照组口服中药治疗;治疗后1个月,分别评价两组临床疗效。结果:对照组有效17例(70.8%),无效7例(29.2%);治疗组有效23例(95.8%),无效1例(4.2%);治疗组总有效率优于对照组,差异具有统计学意义(χ2=5.4,P<0.05)。结论:苗医刘氏小儿推拿治疗下元虚寒型小儿遗尿的临床疗效优于口服中药组,并具有简、便、易、廉的优点,值得推广应用。     

温肾益脾法配合推拿治疗小儿遗尿临床研究

目的:探讨温肾益脾法配合推拿治疗小儿脾气亏虚型遗尿的临床疗效与安全性。方法:选取脾气亏虚型遗尿症患儿74例,按随机数字表法分别对照组和研究组,每组37例,对照组予以盐酸甲氯芬酯胶囊口服,研究组在西医治疗基础上予以温肾益脾法配合推拿治疗,15 d为1个疗程,测定治疗后两组患儿血管升压素(antidiuretichormone,ADH)水平,记录临床症状,对比临床疗效、睡眠觉醒状况及不良反应发生情况。结果:与治疗前及对照组治疗后比较,两组患儿治疗后血浆ADH3降低,血浆ADH1升高,尿床、神疲乏力、食欲不振、便溏、自汗等中医证候积分降低,遗尿次数、残余尿量降低,膀胱容量升高,差异有统计学意义(P0.05);研究组睡眠觉醒水平优于对照组(P0.05);对照组有效率为70.27%,研究组有效率为91.89%,两组比较,差异有统计学意义(P0.05);两组均无明显不良反应。结论:温肾益脾法配合推拿治疗小儿脾气亏虚型遗尿疗效确切,可改善临床症状,提高夜间ADH水平,安全性好。     

小儿推拿联合艾灸、穴位贴敷治疗小儿遗尿的临床疗效

目的:探讨小儿推拿联合艾灸、穴位贴敷治疗小儿遗尿的临床效果。方法:选取2020年3月—2022年3月贵州航天医院收治的遗尿患儿80例为观察对象,根据随机数字表法分为对照组与观察组,各40例。对照组给予艾灸配合穴位贴敷治疗,观察组在对照组基础上给予小儿推拿治疗。比较两组治疗效果、中医证候评分、复发率。结果:观察组治疗总有效率高于对照组,差异有统计学意义(P=0.040)。治疗后,两组患儿中医证候评分均降低,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组复发率低于对照组,差异有统计学意义(P=0.047)。结论:小儿推拿联合艾灸、穴位贴敷治疗小儿遗尿的效果显著,能够减少疾病复发,改善患儿临床症状。     

益气止遗汤治疗肺脾气虚型小儿遗尿症的临床疗效及对其膀胱功能的影响

目的 探讨益气止遗汤治疗肺脾气虚型小儿遗尿症(Nocturnal enuresis, NE)的临床疗效及对其膀胱功能的影响。方法 选取2021年9月—2022年9月期间苏州市中西医结合医院收治的肺脾气虚型小儿NE患儿69例,按随机数字表法分为对照组35例和治疗组34例。对照组给予憋尿训练和盐酸奥昔布宁片口服,治疗组采用憋尿训练联合益气止遗汤治疗。治疗12周后,观察比较两组患儿临床疗效、复发率及不良反应发生率,治疗前后评价每周遗尿次数、中医证候积分,检测功能性膀胱容量(Functional bladder volume, FBC)和残余尿量(Residual urine volume, RUV)。结果 治疗后两组患儿每周遗尿次数均较治疗前明显减少,差异有统计学意义(P<0.05);且治疗组每周遗尿次数明显低于对照组,差异有统计学意义(P<0.05)。治疗6周、3个月后,两组患儿中医证候评分均较治疗前明显降低,差异有统计学意义(P<0.05);且治疗组中医证候评分低于对照组,差异有统计学意义(P<0.05)。治疗后两组患儿FBC水平均较治疗前明显升高,RUV水平均较...     

补宫止漏Ⅰ号方治疗剖宫产后切口假腔的临床观察

目的 探讨补宫止漏Ⅰ号方治疗剖宫产后切口假腔(气血两虚证)的临床疗效,为补宫止漏Ⅰ号方的临床应用提供科学依据.方法 将60例剖宫产术后切口假腔患者随机分为补官止漏Ⅰ号方治疗组和妈富隆对照组,对两组临床疗效进行对比观察.结果 治疗3个疗程后,两组对缩小切口假腔面积均有疗效(P＜0.05),且治疗组优于对照组(P＜0.05);经期延长疗效治疗组愈显率为43.33％,对照组为16.67％,差异有统计学意义(P＜0.05);治疗组中医证候改善总有效率为80％,高于对照组的63.3％,差异有统计学意义(P＜0.05).结论 补宫止漏Ⅰ号方对于缩小剖宫产后切口假腔(气血两虚证)的面积、改善经期延长及中医证候等方面优于妈富隆组,且无不良反应,安全可靠,值得进一步研究.     

盐酸甲氯芬酯胶囊联合醒脾养儿颗粒治疗小儿遗尿的临床疗效观察

目的:分析盐酸甲氯芬酯胶囊联合醒脾养儿颗粒治疗小儿遗尿症的临床效果,为临床推广提供科学依据。方法:选取于2020年5月至2022年7月我院收治的小儿遗尿患儿共148例,按照随机数法并根据治疗方法不同将入组患儿分为研究组和对照组,每组各74例。对照组给予口服盐酸甲氯芬酯胶囊治疗,研究组给予口服盐酸甲氯芬酯胶囊+醒脾养儿颗粒治疗,连续治疗4周。评价两组临床疗效并对比两组患儿治疗前后中医症候积分、遗尿次数、睡眠觉醒障碍评分、唤醒阈、膀胱容量以及尿渗透压和抗利尿激素(ADH)水平。记录治疗后3个月内两组患儿复发率。结果:研究组治疗总有效率(85.14%)高于对照组(64.86%);治疗后两组中医症候积分、两组遗尿次数、睡眠觉醒障碍评分以及唤醒阈指标均降低,且研究组低于对照组;治疗后两组膀胱容量、尿渗透压和ADH的浓度水平均增加,且研究组高于对照组,上述差异均有统计学意义(P<0.05)。随访3月,研究组复发率(8.11%)低于对照组(20.27%),该差异有统计学意义(P<0.05)。结论:醒脾养儿联合盐酸甲氯芬酯胶囊可以显著改善小儿遗尿的临床疗效并降低复发率,值得临床推广。     

推拿联合行为干预治疗儿童原发性夜间遗尿症临床观察

目的:观察推拿联合行为干预治疗儿童原发性夜间遗尿症的临床疗效。方法:将60例原发性夜间遗尿症患儿随机分为对照组和治疗组,每组各30例。对照组采用行为干预治疗,治疗组采用推拿联合行为干预治疗,疗程均为3个月。观察两组临床疗效、中医证候积分的变化情况及复发率。结果:治疗组临床总有效率为90.0%,对照组临床总有效率为66.7%,治疗组临床疗效明显优于对照组(P0.05);治疗前两组中医证候积分比较差异无统计学意义(P0.05),治疗后两组中医证候积分均较治疗前明显降低(P0.05),且治疗组优于对照组(P0.05); 2个月后,治疗组的复发率为11.1%,对照组为60.0%,治疗组明显低于对照组(P0.01)。结论:推拿联合行为干预治疗儿童原发性夜间遗尿症临床疗效良好,复发率低。     

抗利尿激素变化与新生儿水肿的相关性研究

目的:探讨新生儿水肿时体内抗利尿激素(ADH)的变化及其对临床治疗的指导意义?方法:选取本院2009年1月~2011年1月收治的新生儿窒息?败血症?肺炎等病程中出现水肿的40例患儿为治疗组,选取本科同期收住的20例新生儿羊水咽下患者作为对照组,治疗组按随机数字表随机分为利尿剂组和常规治疗组?治疗组于水肿时及水肿消退后,对照组于入院时采集静脉血检测血钠?血ADH值?记录常规治疗组与利尿剂组水肿持续的时间?结果:水肿组患儿水肿时血钠及血ADH值与对照组相比差异有统计学意义(P < 0.01),水肿消退后血钠及血ADH值与对照组相比差异无统计学意义(P > 0.05);水肿组患儿治疗前后自身血钠及ADH值有差异(P < 0.01)?利尿剂组水肿持续的时间短于常规治疗组,两组间病程比较差异有统计学意义(P < 0.05)?结论:新生儿水肿时,体内ADH增高,使用利尿剂能缩短水肿的持续时间?     

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.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

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.     

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.