34例抗凝治疗对小儿肾病血液流变学的影响

对３４例原发性肾病综合征（ＩＮＳ）患儿抗凝治疗后的血液流变学改变及临床疗效进行了观察。结果显示，抗凝治疗后血液流变学指标中血浆比粘度、全血比粘度高切变、全血比粘度低切变、全血还原比粘度、纤维蛋白原、血沉均明显降低，与治疗前比较差异有极显著性（Ｐ＜０．０１）；与治疗对照组（治疗后）比较差异有显著性（Ｐ＜０．０１），Ｐ＜０．０５）。同时，临床症状明显改善，完全缓解率较对照组明显提高（Ｐ＜０．０５）。提示抗凝治疗对ＩＮＳ高凝状态有明显改善作用。     

光量子血疗对冠心病心绞痛患者血液流变学的探讨

我院自１９９３年１月以来采用自血光量子疗法，治疗冠心病心绞痛，临床疗效显著，并在治疗前后观察了血液流变学变化，发现全血比粘度显著下降（Ｐ＜０．０１）；全血比粘度的高切及血球压积也下降（Ｐ＜０．０５）。     

抗凝治疗对小儿肾病血液流变学的影响

对３４例原发性肾病综合征（ＩＮＳ）病儿抗凝治疗后的血液流变学改变及临床疗效进行了观察。结果显示，抗凝治疗后血液流变学指标中血浆比粘度、全血比粘度高切变、全血比粘度低切变、全血还原比粘度、纤维蛋白原、血沉均明显降低，与治疗前比较，差异有极显著性（Ｐ＜０．０１）；与治疗对照组（治疗后）比较，差异有显著性（Ｐ＜０．０１，Ｐ＜０．０５）。同时，临床症状明显改善，完全缓解率较对照组明显提高（Ｐ＜０．０５）。提示抗凝治疗对ＩＮＳ高凝状态有明显改善作用。     

脑溢安颗粒剂对脑出血病人的血液流变学与RCD的影响

对４０例脑出血患者采用脑溢安颗粒剂（中药组）和西药（西药组）治疗，观察血液流变学与红细胞变形能力（ＲＣＤ）的变化。结果表明：两组治疗前全血比粘度的高切、低切；全血还原粘度的高切；血浆比粘度以及ＲＣＤ均较正常人对照组高（均Ｐ＜０．０１）。治疗后，中药组上述指标均较治疗前明显降低（Ｐ＜０．０１）；而西药组较治前稍有降低，无统计学意义（Ｐ＞０．０５）；且中药组明显低于西药组（Ｐ＜０．０１）。提示中药脑溢安颗粒剂对降低血液粘度，提高ＲＣＤ，改善脑组织血液灌流，防止脑组织缺血缺氧继发性损伤，保护脑组织，提高疗效等方面均明显优于西药组     

氧透射载体疗法对冠心病血液流变性及甲襞微循环的影响

采用氧透射载体疗法（ＯＴＩＵ）治疗冠心病患者６１例，治疗前后均进行了血液流变性及甲襞微循环的检测。冠心病组治疗后与治疗前比，红细胞和血小板电泳时间有非常显著性缩短（Ｐ＜０．０１）。全血粘度、血浆比粘度、红细胞压积、全血还原粘度有显著性差异（Ｐ＜０．０５）。甲襞微循环加权积分值有显著性降低（Ｐ＜０．０５）。从而证实了ＯＴＩＵ对冠心病的治疗在降低血粘度、改善血液流变性等微循环方面有明显效果。是一种行之有效的方法，值得在临床上推广使用     

普恩复治疗脑梗塞50例疗效观察

应用普恩复治疗５０例脑梗塞患者，观察疗效及血液流变学指标，发现治疗组总有效率为９４％，对照组为４８％，治疗组全血粘度、血浆粘度、红细胞压积比、纤维蛋白原、血沉均较治疗前显著降低（Ｐ＜０．０１）；而对照组仅红细胞压积比及血沉明显降低（Ｐ＜０．０５）。提示：普恩复治疗脑梗塞有较好的临床疗效且有明显改善血液流变学作用     

超短波治疗脑动脉硬化症时对血脂,脑血流图,血流变的影响

分别采用头部超短波和６５４－２静滴治疗脑动脉硬化症（５６例和３０例）。两组对比，超短波组显效率特大（ｐ＜０．０５），脑血流图波幅明显增高（Ｐ＜０．０５），总胆固醇、甘油三脂均明显下降（Ｐ＜０．０５），高密度脂蛋白明显上升（Ｐ＜０．０５），全血比粘度、全血还原粘度均明显下降（Ｐ＜０．０１）。提示超短波通过扩张脑血管、增加脑血流，起到了改善临床症状、脑血流图、血脂和血流变的作用。     

新生窒息儿血液流变学研究

本文对１０３例新生窒息儿和２１例正常新生儿进行了血液流变学观察研究，结果新生窒息儿的全血粘度、全血还原粘度、血浆粘度均高于正常新生儿（Ｐ＜０．０１，Ｐ＜０．０１，Ｐ＜０．０５）；苍白窒息儿的全血粘度、全血还原粘度更高于青紫窒息儿（Ｐ＜０．０１）。提示窒息程度越重，缺氧、缺血程度也越重，血液粘度就越高。血液粘度和血浆粘度可作为新生窒息儿诊断与治疗的参考标准     

青紫型先天性心脏病患儿的凝血象改变和血栓弹力图观察

观察３７例青紫型先天性心脏病（ＣＣＨＤ）患儿的血栓弹力图（Ｔｈｒｏｍｂｅｌａｓｔｏｇｒａｍ，ＴＥＧ）、血小板聚集功能和血粘度等血液流变学参数的变化。结果显示：重度青紫组与对照组比较，ＴＥＧ的γ值、ｋ值和ｍ值显著延长，α角、ｍ_α值和ε值显著减小（Ｐ＜０．０１）：血小板聚集率显著降低（Ｐ＜０．０１），血小板计数和纤维蛋白原减少（Ｐ＜０．０５）；红细胞压积和全血粘度显著增高（Ｐ＜０．０１）；高、低切变率全血粘度与ＴＥＧ的ε值呈显著负相关，相关系数分别为－０．５７和－０．６４（Ｐ＜０．０５、＜０．０１）。结论：重度ＣＣＨＤ患儿具有显著的凝血机能障碍和血液流变学异常，血粘度越高凝血机能越低。     

初发Graves＇病血液流变学临床分析

对照观察３４例初发Ｇｒａｖｅｓ＇病患者、２８例甲亢性心脏病人及５０例除外对血液粘度影响较大疾病患者（对照组）的血液流变学变化。结果表明Ｇｒａｖｅｓ＇病组和甲亢性心脏病组全血比粘度高切值、低切值、红细胞压积、血小板聚集率均明显高于对照组（Ｐ＜０．０５或Ｐ＜０．０１），且甲亢心组血浆比粘度明显高于对照组（Ｐ＜０．０５）。甲亢心组与初发Ｇｒａｖｅｓ＇病组相比仅全血比粘度高切值、血浆比粘度及血小板聚集率三项显著增高（Ｐ＜０．０１），提示上述三项明显增高的甲亢患者需警惕甲亢心发生，并认为早期应用活血化瘀药可有利于甲亢心的预防。     

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.     

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.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…