老年便秘应用生物反馈联合乳果糖治疗的观察

目的探讨老年便秘应用生物反馈联合乳果糖治疗的观察。方法将我所2017年1月至2019年1月老年便秘患者60例,随机分组,乳果糖治疗组就诊患者采取乳果糖等治疗,生物反馈辅助组采取生物反馈辅助乳果糖治疗。比较两组老年便秘疗效;腹部疼痛消失时间、排便费劲消失时间;治疗前后患者每周排便的次数、便秘评分量表(CCS)评估分值、生活质量SF-36量表总评分。结果生物反馈辅助组疗效高于乳果糖治疗组,P0.05。生物反馈辅助组每周排便的次数高于乳果糖治疗组,P0.05。生物反馈辅助组便秘评分量表(CCS)评估分值低于乳果糖治疗组,P0.05。生物反馈辅助组生活质量SF-36量表总评分高于乳果糖治疗组,P0.05。生物反馈辅助组腹部疼痛消失时间、排便费劲消失时间短于乳果糖治疗组相应的指标,P0.05。结论生物反馈辅助乳果糖治疗老年便秘效果良好,可有效缓解便秘症状,改善患者的生活质量。     

高分辨肛门直肠测压与生物反馈训练在功能性大便失禁中的应用

目的  探讨高分辨肛门直肠测压和生物反馈训练对功能性大便失禁（FFIC）患者肛门直肠测压、临床症状、心理状况和生活质量的影响。方法  对29例符合FFIC罗马Ⅲ标准的患者进行高分辨肛门直肠测压及生物反馈训练,比较治疗后测压结果,并应用疗效评估、Zung焦虑自评量表（SAS）、抑郁自评量表（SDS）、汉化版简明健康调查量表（SF-36）评定患者治疗前后临床症状、心理状况和生活质量的改善情况。结果  治疗1个月后患者直肠静息压、最大缩窄压和直肠排便最大耐受量明显增加,直肠排便初始感觉域值、初始排便冲动容量下降,临床症状不同程度改善。汉化版简明健康调查量表（SF-36）的8个维度（总体健康、生理功能、生理职能、躯体疼痛、活力、社会功能、情感职能和精神健康）的评分显著提高;患者治疗后与治疗前比较,SAS量表评分和SDS量表评分亦显著降低（焦虑、抑郁状况改善）。结论  生物反馈训练不仅能有效改善大便失禁患者的肛门直肠条件及临床症状,还可提高患者的生活质量和心理健康水平。

     

综合干预对功能性便秘患者生活质量的影响

目的 观察综合干预对功能性便秘患者临床症状及生活质量的影响.方法 选取我院收治的功能性便秘患者.100例,随机分为治疗组及对照组,2组均给予等渗盐水或0.2％肥皂液800～1 000 mL不保留灌肠,1次/d;治疗组患者配合1个疗程的综合干预治疗,对照组患者不进行综合干预治疗,对比2组干预前后临床症状改善情况,并采用汉化版简明健康调查量表(SF-36)对生活质量进行评定,采用Zung的焦虑自评量表(SAS)和抑郁自评量表(SDS)评估患者的心理状况.结果 2组干预1疗程后生理职能、生理功能、社会功能、躯体疼痛、总体健康5个纬度评分均显著高于对照组(P＜0.05);治疗组干预后焦虑、抑郁状态改善显著优于对照组(P＜0.05);治疗组干预后临床总有效率显著高于对照组(P＜0.05).结论 综合干预可有效改善功能性便秘患者不良情绪,缓解排便困难症状,提高患者生活质量.     

生物反馈结合精神心理治疗功能性便秘的疗效研究

目的 研究生物反馈结合精神心理治疗功能性便秘的疗效.方法 筛选功能性便秘(Functional constipation,FC)患者70例,随机分为两组,各35例.实验组35例予生物反馈结合精神心理治疗,对照组35例予生物反馈治疗,统计两组治疗后SAS(焦虑自评量表)评分、SDS(抑郁自评量表)评分、症状积分、肛门直肠测压各指标、72小时结肠排出率(粒)的变化.结果 治疗后实验组SAS评分低于对照组(P<0.05).实验组症状改善优于对照组(P<0.05).实验组排便紧迫感阈值差异高于对照组(P<0.05).实验组72 h结肠排出率(粒)高于对照组(P<0.05).结论 两组患者的精神心理、便秘症状、结肠动力、肛门直肠排便功能明显改善,并且生物反馈结合精神心理治疗便秘症状、结肠传输能力改善效果优于单纯性生物反馈治疗.     

护理干预对冠心病患者焦虑抑郁状态及生活质量的影响分析

目的:观察并分析护理干预对冠心病患者焦虑、抑郁状态及生活质量的影响,为今后的临床护理工作提供参考。方法:选取收治的冠心病患者85例,在开展护理干预前后,应用焦虑自评量表(SAS)、抑郁自评量表(SDS)、生活质量评定量表(SF-36)分别评价患者焦虑、抑郁状态和生活质量。对比两次评价结果的差异。结果:经过系统的护理干预后,患者SAS、SDS评分明显下降;SF-36评分明显上升,差异有统计学意义(P<0.05)。结论:对伴有焦虑抑郁症状的冠心病患者在治疗的同时给予系统的护理干预措施,有助于消除或缓解患者的不良情绪,使之积极地配合治疗,有利于疾病的恢复和生活质量的提高。     

生物反馈治疗便秘型肠易激综合征的临床疗效研究

目的探讨生物反馈治疗便秘型肠易激综合征（IBS-C）患者的临床效果。方法对30例IBS-C患者给予生物反馈治疗,每疗程5次,应用症状评分、焦虑自评量表（SAS）、抑郁自评量表（SDS）及简明健康调查量表（sF-36）分别评估患者生物反馈治疗前后的临床症状、精神状态及生活质量的变化。结果生物反馈治疗后,患者肠道总体症状,腹痛／腹部不适、腹胀、排便形状异常、排便过程异常的症状积分均较治疗前有显著降低[（12．31±2．01）分vs（19．16±2．17）分、（2．95_＋0．57）分vs（5．04±1．04）分、（2．64±0．92）分vs（4．25±1．09）分、（3．66±1．09）分VS（5．10±0．57）分、（3．06±1．08）分vs（4．77±0．95）分,均P〈0．01],差异有统计学意义,其中以腹痛／腹部不适症状的改善最为明显。IBS—C患者的SAS积分、SDS积分也分别较治疗前明显下降[（39．53±6．39）分VS（44．43±7．89）分,P〈0．05;（40．70＋8．38）分VS（46．46±8．74）分,均P〈0．05]。sF-36得分在生理职能、社会功能、精力、情感职能及精神健康5个维度积分较治疗前明显增加[（74．16±21．25）分VS（57．0±39．40）分、（86．21±13．54）分VS（75．54±20．96）分、（75．16±13．42）分VS（64．66±20．54）分、（78．87±28．36）分V8（57．76±46．26）分、（81．60±16．08）分VS（71．20±22．04）分,均P〈0．05]。结论生物反馈治疗能够改善IBS-C患者临床症状,缓解焦虑和抑郁的情绪,提高生活质量。     

肾病综合征患者的抑郁、焦虑情绪及生活质量的初步研究

目的初步探究肾病综合征（NS）患者的抑郁、焦虑情绪及生活质量情况,为患者的康复治疗提供有效依据。方法应用焦虑自评量表（SAS）、抑郁自评量表（SDS）以及简明健康状况量表（SF-36）对152例患者进行调查,并对焦虑、抑郁总分和SF-36的各维度分值进行单因素分析。结果 NS患者的SAS总分与SF-36中的躯体疼痛、精神健康、情感职能、总体健康以及社会功能之间是负相关关系,其中与躯体疼痛相关最为显著;NS患者的SDS总分与SF-36中的活力、情感职能、精神健康、总体健康以及社会功能之间存在一定联系,其中与精神健康相关最为显著。结论 NS患者普遍存在焦虑、抑郁情绪,临床上需要加强针对性的心理干预,提高患者的心理健康;NS患者的焦虑、抑郁情绪与生活质量存在一些相关,提示两者存在相互影响。     

颈椎病患者的生活质量及相关因素分析

目的探索颈椎病患者的生活质量及相关因素。方法对60例颈椎病患者进行一般情况调查,汉密顿焦虑量表(HAMA)、汉密顿抑郁量表(HAMD)、健康情况调查问卷(SF-36)评定。结果除生理机能外,颈椎病患者SF-36各维度评分均显著低于常规(P<0.01)。病程影响患者的生活质量,病程大于4年的患者的生活质量除生理机能评分外均低于病程小于4年的患者(P<0.01),伴有抑郁或焦虑症状的颈椎病患者,其SF-36的躯体疼痛、一般健康状况、精力、社会功能、情感职能、精神健康6个维度评分显著低于不伴抑郁或焦虑症状的患者(P<0.05或P<0.01)。结论颈椎病患者的生活质量低于一般正常人群,病程长,伴有抑郁或焦虑症状的生活质量受损更加严重。     

终末期肾衰患者的精神症状与生活质量的相关分析

目的:探讨终末期肾衰患者焦虑、抑郁症状与生活质量的关系。方法:采用健康相关生活质量量表(SF-36)调查57例终末期肾衰患者生活质量,SF-36包括8个纬度,体能(PCS)和精神(MCS)两方面总分;分别用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)评估患者抑郁、焦虑症状,并将其分为抑郁组与非抑郁组、焦虑组与非焦虑组,比较生活质量组间差异。结果:抑郁症状的发生率为38.6%,焦虑症状的发生率为54.4%。抑郁、焦虑评分与生活质量8个纬度中7项呈负相关,与PCS和MCS呈负相关(P<0.05)。抑郁组、焦虑组以及二者共存组的生活质量明显低于无相应精神症状组患者(P<0.05)。结论:终末期肾衰患者焦虑症状和抑郁症状发生率较高,与患者生活质量相关。有效改善患者精神症状可能是提高患者生活质量途径之一。     

补气活血法联合生物反馈治疗排便推力不足型功能性排便障碍的疗效评价

【目的】评价补气活血法联合生物反馈治疗排便推力不足型功能性排便障碍(FDD-IDP)的疗效。【方法】将41例FDDIDP患者随机分为治疗组20例和对照组21例,对照组给予生物反馈治疗,治疗组给予补气活血法联合生物反馈治疗,疗程均为20 d。比较2组患者治疗前后症状评分、便秘结局量表(PRO)评分、焦虑自评量表(SAS)和抑郁自评量表(SDS)评分、便秘生活质量量表(PAC-QOL)评分、肛门直肠测压和盆底肌电测量结果,并评价2组疗效。【结果】(1)治疗20 d后,治疗组的总有效率为85.00%,对照组为52.38%,治疗组的疗效明显优于对照组(P0.05)。(2)与治疗前相比较,对照组和治疗组在治疗后患者的症状评分、PRO评分、SAS和SDS评分、PAC-QOL评分、肛门直肠测压和盆底肌电测量结果等均得到改善(P0.05或P0.01),且治疗组治疗后对上述指标的改善作用均明显优于对照组,差异均有统计学意义(P0.05或P0.01)。【结论】生物反馈治疗对FDD-IDP具有较好疗效,补气活血法联合生物反馈治疗的疗效优于单纯生物反馈治疗。     

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.