双歧杆菌三联活菌联合维生素D干预对PCOS患者肠道菌群及内分泌的影响

目的 探讨双歧杆菌三联活菌联合维生素D对多囊卵巢综合征（polycystic ovarian syndrome,PCOS）患者肠道菌群及内分泌的影响。方法 选取2020年10月至2021年12月于台州市立医院就诊的152例PCOS患者,根据随机数字表法将其分为维生素D组和联合组,每组各76例。两组患者均给予饮食干预,联合组患者采用双歧杆菌三联活菌联合维生素D治疗,维生素D组患者给予维生素D治疗。比较两组患者治疗前后的肠道菌群、催乳素（prolactin,PRL）、促卵泡激素（follicle stimulating hormone,FSH）、黄体生成素（luteinizing hormone,LH）、空腹胰岛素（fasting insulin,FINS）、空腹血糖（fasting blood glucose,FBG）、肠道生态评分和胃肠道症状评定量表（gastrointestinal symptom rating scale,GSRS）评分。结果 干预后,两组患者的乳酸杆菌、双歧杆菌、FSH水平均显著高于本组干预前,大肠杆菌、肠球菌、PRL、LH、FINS、FBG水平及肠道生态评分、GSRS评分均显著低于本组干预前（P<0.05）,且联合组患者的乳酸杆菌、双歧杆菌、FSH水平均显著高于维生素D组,大肠杆菌、肠球菌、PRL、LH、FINS、FBG水平及肠道生态评分、GSRS评分均显著低于维生素D组（P<0.05）。结论 使用双歧杆菌三联活菌联合维生素D治疗可显著改善PCOS患者的肠道菌群及内分泌状况,促进患者的身体恢复,效果较为理想     

双歧杆菌对2型糖尿病大鼠血浆酪酪肽和胰岛素抵抗的影响

目的观察双歧杆菌对2型糖尿病（T2DM）大鼠血浆酪酪肽（PYY）和胰岛素抵抗指数（HOMA-IR）的影响。方法30只周龄为9周SD雄性大鼠链脲佐菌素（STZ）造模后,根据双歧杆菌灌胃剂量分成4组:正常对照组（N组）、糖尿病组（T2DM组）、高剂量组和低剂量组,双歧杆菌连续灌胃6周后,测所有大鼠空腹血糖（FBS）,处死后取血浆检测PYY、糖化血红蛋白（HbA1c）、空腹胰岛素（FINS）、血脂,计算HOMA-IR,比较4组大鼠上述指标的差异。结果高剂量组和低剂量组HbA1c、FBS、FINS、HOMA-IR和三酰甘油低于T2DM组（P < 0.01）,但高于N组（P < 0.05~P < 0.01）;高剂量组和低剂量组PYY高于T2DM组（P < 0.01）,但低于N组（P < 0.01）,高剂量组和低剂量组上述指标差异均无统计学意义（P>0.05）,PYY和HOMA-IR呈负相关（r=-0.783,P < 0.01）。结论双歧杆菌可以降低T2DM大鼠HbA1c、FBS、FINS、TG和HOMA-IR,升高PYY。     

金仁陈子方对小鼠脾虚模型肠道菌群的影响研究

目的 观察金仁陈子方对脾虚证小鼠模型肠道菌群的影响,评价其对肠道微生态调节的作用.方法 昆明种小鼠,分成5组,即正常对照组、脾虚模型对照组、阳性药对照妈咪爱组、金仁陈子方高剂量组、金仁陈子方低剂量组.以苦寒泻下中药大黄造成脾虚模型小鼠,灌胃给药7天后,选用厌氧及需氧菌选择性培养基测定粪便标本中代表性菌种：肠杆菌、肠球菌、产气荚膜梭菌、双歧杆菌、和乳酸杆菌数量.结果 脾虚模型组小鼠肠道双歧杆菌（P＜0.01）、乳酸杆菌（P＜0.05）等厌氧菌含量显著下降.给予金仁陈子方灌胃后这两种厌氧菌含量均恢复正常（P＜0.05）,大肠杆菌（P＜0.01）、肠球菌（P＜0.01）、产气荚膜梭菌（P＜0.05）在造模完成时含量显著上升,灌胃金仁陈子方之后大肠杆菌（P＜0.01）、肠球菌（P＜0.05）、产气荚膜梭菌（P＜0.01）含量显著低于模型组.结论 脾虚证小鼠肠道双歧杆菌、乳酸杆菌菌群异常低下,肠杆菌、肠球菌、产气荚膜梭菌含量显著增加,金仁陈子方可通过扶植肠道有益菌、抑制有害菌,从而调节肠道微生态,对脾虚泄泻的恢复有重要影响.     

双歧杆菌对脾虚小鼠肠道菌群的调整作用

目的：观察双歧杆菌对大黄致脾虚小鼠肠道菌群的调整作用。方法：大黄致脾虚造模型法和粪菌群定量检测法,结果：在大黄造模组小鼠肠道菌群中,双歧杆菌、类杆菌和乳酸杆菌的数量下降,大肠杆菌的数量上升（P＜0.05）,经灌服双歧杆菌制剂（108／ml,1ml/天）一周后,以上各菌群数量恢复正常。结论：服用双歧杆菌制剂有改善机体牌虚证的作用。     

比较多黏菌素和阿米卡星治疗急性出血坏死性肠炎对患者肠道菌群的影响

目的 比较多黏菌素和阿米卡星治疗急性出血坏死性肠炎(AHNE)对患者肠道菌群的影响。方法选取本院就诊的80例AHNE患者,随机分为多黏菌素组和阿米卡星组。多黏菌素组给予多黏菌素治疗,阿米卡星组给予阿米卡星治疗。比较两组治疗前、后肠道菌群变化。结果治疗后1、3、5和7天,两组患者乳酸杆菌、双歧杆菌、厌氧菌/需氧菌、双歧杆菌/肠杆菌比值较治疗前均升高,而肠球菌和肠杆菌水平较治疗前均降低(P＜0.05),并且多黏菌素组患者乳酸杆菌、双歧杆菌、厌氧菌/需氧菌、双歧杆菌/肠杆菌比值高于阿米卡星组,而肠球菌水平和肠杆菌水平低于阿米卡星组(P＜0.05)。结论多黏菌素和阿米卡星治疗急性出血坏死性肠炎可调节患者肠道菌群平衡,并且多黏菌素优于阿米卡星。     

先天性肛门直肠畸形患儿术后肠道菌群变化的前瞻性研究

目的：前瞻性研究先天性肛门直肠畸形（anorectal malformation,ARM）患儿术后肠道菌群变化的情况。方法：实时荧光定量PCR法检测分析21名先天性ARM组患儿10日龄（出院前1 d）、1月龄和3月龄~4月龄时粪便中3种主要菌群数量,并与日龄匹配的21名对照组正常婴儿菌群数量进行比较。结果：（1）10日龄,先天性ARM组双歧杆菌与大肠杆菌数量的比值（bifidobacteria/escherichia coli,B/E）<1,大肠杆菌数量较双歧杆菌高和乳酸杆菌高（P=0.021和P=0.004）,且乳酸杆菌数量较对照组高（P=0.001）。（2）1月龄,先天性ARM组B/E较10日龄增高（P=0.030）,B/E>1,双歧杆菌数量增高（P=0.001）,高于自身大肠杆菌、乳酸杆菌数量和对照组双歧杆菌数量（P=0.001、P<0.001和P=0.004）,乳酸杆菌数量亦较对照组高（P<0.001）。（3）3月龄~4月龄,先天性ARM组乳酸杆菌数量较1月龄时降低（P=0.005）,与对照组无统计学差异（P=0.571）,双歧杆菌数量较对照组高（P=0.004）。（4）3月龄~4月龄,连续服用益生菌患儿肠道双歧杆菌数量显著高于对照组婴儿（P=0.013）,未连续补充者肠道双歧杆菌数量和对照组婴儿相比无统计学差异（P=0.032）。结论：（1）10日龄,先天性ARM患儿以大肠杆菌数量占优势,乳酸杆菌数量亦高,较正常对照组婴儿肠道大肠杆菌和双歧杆菌数量均占优势的定植状况不同。（2）1月龄和正常对照组婴儿一样,双歧杆菌成为患儿肠道优势菌,而乳酸杆菌数量仍居高。（3）3月龄~4月龄,患儿肠道乳酸杆菌数量下降至正常对照组水平,菌群状态接近正常婴儿。（4）患儿1月龄后连续补充益生菌制剂至3月龄~4月龄能够使肠道保持高水平的双歧杆菌数量。     

利拉鲁肽对超重、肥胖2型糖尿病患者内脏脂肪的影响

［摘要］ 目的观察利拉鲁肽对胰岛素联合二甲双胍治疗血糖控制不佳的超重、肥胖2型糖尿病（type 2 dabetes mellitus,T2DM）患者胰岛素抵抗及内脏脂肪的影响。 方法筛选超重、肥胖T2DM患者80例,糖化血红蛋白（glycated hemoglobin,HbA1c）符合(7%≤HbA1c≤11％),随机分成2组,胰岛素联合二甲双胍组（对照组）、胰岛素联合二甲双胍的基础上加用利拉鲁肽（利拉鲁肽组）,治疗24周,观察治疗前后体重（body weight,WT）、腰围（waist circumference,WC）、体重指数（body mass index,BMI）、空腹血糖（fasting plasma glucose,FPG）、总胆固醇（total lesterol,TC）、三酰甘油（triglyceride,TG）、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、高密度脂蛋白胆固醇（high density lipoprotein cholesterol,HDL-C）、HbA1c、空腹胰岛素（fasting insulin,FINS）、胰岛素抵抗指数（insulin resistance index,HOMA-IR）及内脏脂肪面积（visceral fat area,VFA）的变化。 结果治疗后,对照组FPG、TC、TG、LDL-C、HbA1c、FINS、HOMA-IR较治疗前均降低,HDL-C升高,差异有统计学意义（P＜0.05）;利拉鲁肽组WT、WC、BMI、 FPG、HbA1c、TC、TG、LDL-C、FINS、HOMA-IR、VFA较治疗前均降低,HDL-C升高,差异有统计学意义（P＜0.05）。治疗后,利拉鲁肽组WT、WC、BMI、VFA较对照组均降低（P＜0.05）。利拉鲁肽组与每日应用胰岛素剂量比对照组减少（P＜0.05）。VFA降低与WT、WC、BMI降低呈正相关（P＜0.05）。 结论利拉鲁肽应用于超重、肥胖2型糖尿病患者不仅可以降低血糖还可以减轻体重,改善胰岛素抵抗,减少内脏脂肪,具有临床获益。     

格列美脲与瑞格列奈治疗初发2型糖尿病的疗效对比

目的比较格列美脲和瑞格列奈治疗初发2型糖尿病的临床疗效。方法将60例初发2型糖尿病患者随机分为格列美脲组30例与瑞格列奈组30例,观察12周。治疗前后监测患者空腹血糖（FBG）、餐后2h血糖（2hPBG）、糖化血红蛋白（HbA1c）、空腹胰岛素（FINS）、餐后2h胰岛素（2hPINS）、空腹C肽（FCP）、餐后2hC肽（2hPCP）及体质指数（BMI）。同时了解治疗期间低血糖发生情况。结果两组治疗后FBG、2hPBG及HbA1c均明显下降（P〈0.05）,但诺和龙组治疗后2hPBG较格列美脲组降低更明显,两组间比较差异有统计学意义（P〈0.05）;治疗后两组间FBG、HbA1c、FINS、FCP之间比较差异无统计学意义（P〉0.05）。结论格列美脲和瑞格列奈用于治疗初发的2型糖尿病患者,能够保护胰岛β细胞功能,延缓糖尿病进程,疗效确切安全,均可以作为初发2型糖尿病患者的首选药物。     

糖尿病合并脑梗死患者血清HMGB1 水平及其意义

目的 观察糖尿病合并脑梗死患者血清高迁移率族蛋白B1（HMGB1）及其他血清指标水平,探讨血清HMGB1 与其他血清指标的关系。方法 选择该院糖尿病合并脑梗死患者60 例作为糖尿病合并脑梗死组,糖尿病患者60 例作为糖尿病组,健康体检者60 例作为对照组,收集3 组患者的临床资料、血清HMGB1 及其他血清指标水平。结果 糖尿病合并脑梗死组和糖尿病组患者血清HMGB1、高敏C 反应蛋白（hs-CRP）、空腹血糖（FBG）、糖化血红蛋白（HbA1c）、空腹胰岛素（FINS）、稳态胰岛素评价指数（HOMA-IR）、三酰甘油（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）水平高于对照组（P <0.05）,血清高密度脂蛋白胆固醇（HDL-C）水平低于对照组（P <0.05）,糖尿病合并脑梗死组患者血清HMGB1、hs-CRP、FBG、HbA1c、FINS、HOMA-IR、TG、TC、LDL-C 水平高于糖尿病组（P <0.05）,血清HDL-C 水平低于糖尿病组（P <0.05）。糖尿病合并脑梗死患者血清HMGB1 与血清hs-CRP、FBG、HbA1c、FINS、HOMA-IR、TG、TC、LDL-C 水平呈正相关（P <0.05）,与血清HDL-C 水平呈负相关（P <0.05）。多因素分析结果显示,FINS、HOMA-IR、TG、TC、LDL-C 是血清HMGB1 的影响因素（P <0.05）。结论 糖尿病合并脑梗死患者血清HMGB1 水平升高,血清HMGB1 与hs-CRP、血糖、血脂指标有关,FINS、HOMA-IR、TG、TC、LDL-C 是血清HMGB1 的影响因素。     

血清骨保护素与2型糖尿病及合并冠心病的关系

目的：探讨血清骨保护素（ OPG）与2型糖尿病及合并冠心病的关系。方法选择健康个体、2型糖尿病患者及2型糖尿病合并冠心病患者各30例。用ELISA方法测定OPG,生化法测定空腹血糖（ FPG）及糖化血红蛋白（HbA1c）,免疫化学发光法测定空腹胰岛素（FINS）,计算胰岛素敏感指数（ISI）及胰岛素抵抗指数（HOMA-IR）,并观察组间各指标的变化。结果2型糖尿病组及合并冠心病组血清OPG、FPG、HbA1c、HOMA-IR明显高于对照组（ P均＜0.01）,ISI明显低于对照组（ P＜0.01）。2型糖尿病合并冠心病组FINS显著高于对照组（ P＜0.05）。2型糖尿病组HbA1 c明显高于2型糖尿病合并冠心病组（ P＜0.01）。结论2型糖尿病及其合并冠心病患者血清OPG水平、血糖、胰岛素及HOMA-IR明显增高,2型糖尿病患者冠心病发生与血清OPG、血糖、胰岛素升高以及胰岛素抵抗有关,OPG作为心血管疾病的预测因子可能与胰岛素的影响有关。     

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…     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

Luo Lingjie''''s Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.