苏黄止咳胶囊治疗感冒后咳嗽的系统评价

目的评价苏黄止咳胶囊治疗感冒后咳嗽临床疗效与安全性。方法检索主要数据库从建库至2016年10月15日苏黄止咳胶囊治疗感冒后咳嗽随机对照试验研究。Cochrane评价员手册进行偏倚风险评价,Jadad评分法进行质量评价。应用RevMan5.3软件进行Meta分析。结果符合纳入标准的文献共3篇。Meta分析结果显示,苏黄止咳胶囊治疗感冒后咳嗽治疗组与对照组相比,临床疗效总有效率比值比(odds ratio,OR)为3.31,95%可信区间(confidence interval,CI)[2.01,5.47],差异有统计学意义(P0.00001);临床疗效愈显率OR为3.53,95%CI[2.40,5.20],差异有统计学意义(P0.00001);纳入研究未有重大不良反应报道。结论苏黄止咳胶囊治疗感冒后咳嗽临床疗效显著,临床安全性较好。但由于本系统评价纳人研究的总体质量较低,研究的数量和样本量均较小,尚需要更多高质量、多中心、大样本、严格设计的随机对试验来进一步验证其疗效与安全性。     

苏黄止咳胶囊治疗咳嗽变异性哮喘的Meta分析

目的：评价苏黄止咳胶囊治疗咳嗽变异性哮喘的疗效与安全性。方法：检索2008年至2014年中国期刊全文数据库、万方医学网数据库、维普资讯中文科技期刊数据库、中国生物医学文献数据库（ CBM）、PubMed数据库、The Cochrane Library。对符合纳入标准的6篇文献应用Rev Man 5.1软件进行Meta分析。结果：共纳入6个研究583名患者,结果显示治疗组：①咳嗽总疗效优于对照组,差异有统计学意义（ OR合并=4.59,95%CI：[2.85,7.39],P<0.00001）;②不良反应发生率较对照组小,差异有统计学意义（ OR合并=0.13,95%CI为[0.03,0.52],P=0.004）。结论：现有的临床证据表明,苏黄止咳胶囊治疗咳嗽变异性哮喘安全、有效。但尚需更多大规模、高质量的随机对照试验进一步证实。     

乌梅丸加减治疗泄泻的Meta分析

目的:系统评价乌梅丸加减治疗泄泻的临床疗效.方法:采用计算机及纸质书籍两种方式,综合检索中国知网(CNKI)、维普(VIP)、万方、中国生物医学文献数据库(CBM)及PubMed等数据库中以乌梅丸加减治疗泄泻的随机对照试验(RCT).提取基本信息及研究数据后进行质量评价,纳入研究的结局指标由Revman5.3软件进行Meta分析.结果:共纳入28篇文献,总计2337名患者.Meta分析结果显示:与西医对照组比较,乌梅丸加减试验组的疗效更优[总有效率OR=4.55,95％CI为(3.52,5.89),Z=11.54,P<0.00001;中医症候积分改善SMD=-1.51,95％CI为(-2.61,-0.87),Z=4.59,P<0.00001;安全性评价OR=0.43,95％CI为(0.23,0.79),Z=2.70,P=0.007;降低复发率RR=0.34,95％CI为(0.13,0.86),Z=2.27,P=0.02].结论:乌梅丸加减治疗泄泻疗效显著,但因纳入文献质量偏低且存在发表偏倚,需要高质量的随机对照试验的支持.     

酮替芬治疗感冒后咳嗽的系统评价

目的评价酮替芬治疗感冒后咳嗽临床疗效与安全性。方法检索主要中英文数据库从建库至2015年12月20日酮替芬治疗感冒后咳嗽随机对照试验研究,筛选合格研究。Cochrane评价员手册、Jadad评分法分别进行偏倚风险评价及质量评价。应用Rev Man5.3软件进行Meta分析。结果符合纳入标准的文献共3篇。Meta分析结果显示,酮替芬治疗感冒后咳嗽治疗组与对照组相比,临床疗效总有效率比值比(odds ratio,OR)为9.44,95%可信区间(confidence interval,CI)(2.81,31.70),差异有统计学意义(P=0.0003);不良反应OR为1.94,95%CI(0.40,9.54),差异无统计学意义(P=0.41)。结论酮替芬治疗感冒后咳嗽有显著临床疗效,但仍需更多高质量、大样本的临床研究来进一步验证。     

苏黄止咳胶囊治疗咳嗽变异性哮喘的系统评价

目的:评价苏黄止咳胶囊治疗咳嗽变异性哮喘临床疗效。方法:检索11个数据库从建库至2014年6月30日苏黄止咳胶囊治疗咳嗽变异性哮喘随机对照试验研究,筛选合格文献。应用Cochrane评价员手册进行偏倚风险评价,Jadad评分法进行质量评价,应用Rev Man 5.3软件进行Meta分析。结果:符合纳入标准的文献共5篇。Meta分析结果显示,苏黄止咳胶囊治疗咳嗽变异性哮喘治疗组与对照组相比,临床疗效有效率比值比(odds ratio,OR)为4.82,95%可信区间(confidence interval,CI)[2.92,7.96],差异有统计学意义(P0.000 01)。结论:苏黄止咳胶囊治疗咳嗽变异性哮喘临床疗效显著。     

中医药治疗冠心病PCI术后合并焦虑和（或）抑郁疗效及安全性的Meta分析

目的：系统评价中医药治疗冠心病PCI术后合并焦虑和（或）抑郁的临床疗效与安全性。方法：计算机检索中国知网、万方、维普、中国生物医学文献数据库（CMB）、PubMed、Web of Science、Cochrane Library数据库,纳入自建库至2020年11月前公开发表的中医药治疗冠心病PCI术后合并焦虑和（或）抑郁的中英文随机对照研究（randomized controlled trials,RCTs）,运用Cochrane偏倚风险工具和改良后的Jadad量表对纳入文献进行质量评价,采用RevMan 5.3、Stata16.0软件进行Meta分析。结果：共计纳入23篇随机对照试验,包括1 837例研究对象,其中中医药治疗组917例,对照组920例,组间基线情况一致,具有可比性。Meta分析结果显示,中医药治疗在提高临床总有效率[OR=2.34,95%CI(1.61,3.40),P<0.000 01],中医证候疗效[OR=5.19,95%CI(2.74,9.86),P<0.000 01],降低汉密尔顿焦虑量表HAMA评分[SMD=-0.96,95%CI(-1.78,-0...     

黄芪颗粒治疗小儿病毒性心肌炎效果的系统评价

目的评价黄芪颗粒治疗小儿病毒性心肌炎的临床效果与安全性。方法检索EMBASE、PUBMED、MEDLINE、AMED、CINAHL、Cochrane图书馆、中国知网数据库、万方数据库、重庆维普中文科技期刊数据库、中国生物医学文献数据库和中国中医药期刊文献数据库从建库至2014年8月15日黄芪颗粒治疗小儿病毒性心肌炎随机对照试验研究,筛选合格研究。应用Cochrane评价员手册进行偏倚风险评价,Jadad评分法进行质量评价。应用Rev Man 5.3软件进行Meta分析。结果符合纳入标准的文献共5篇。Meta分析结果显示,黄芪颗粒治疗小儿病毒性心肌炎治疗组与对照组比较,总有效率比值比(OR)为3.85,95%可信区间(CI)(2.24,6.63),差异有统计学意义(P<0.000 01)。治愈率OR为2.35,95%CI(1.09,5.10),差异有统计学意义(P=0.03)。治疗后心肌酶谱指标(肌酸激酶同工酶、乳酸脱氢酶、谷草转氨酶)治疗组低于对照组,差异有统计学意义。纳入研究未报道有不良反应发生。结论黄芪颗粒治疗小儿病毒性心肌炎临床效果显著,临床安全性较好。但由于本系统评价纳入研究的总体质量较低,研究的数量和样本量均较小,尚需要更多高质量、多中心、大样本、严格设计的随机对试验来进一步验证其疗效与安全性。     

国内卷曲霉素联合左氧氟沙星治疗耐药肺结核疗效和安全性的meta分析

目的 系统评价国内卷曲霉素联合左氧氟沙星治疗耐多药肺结核的疗效和安全性.方法 计算机检索中国生物医学文献数据库(CBM,1978年至2011年10月)、中国期刊全文数据库(CNKI,1994年至2011年10月)、中文科技期刊全文数据库(VIP,1989年至2011年10月)、万方数据库等,并利用Google、Baidu等搜索引擎获取相关临床试验.按照Cochrane系统评价的方法评价纳入研究的质量,并使用Cochrane协作网RevMan4.2.8软件进行统计分析.结果 本研究最终纳入6个随机对照试验,总共857例(治疗组441例,对照组416例).固定效应模型分析结果显示,在痰菌阴转率[OR合并=4.21,95％ CI(3.08,5.75),P＜0.05],病灶吸收率[OR合并=1.78,95％CI(1.24,2.54),P＜0.05],空洞闭合率[OR合并=2.50,95％ CI(1.32,4.71),P＜0.01]方面,卷曲霉素联合左氧氟沙星的治疗组均明显高于对照组.2组不良反应发生率差异无统计学意义[OR合并=0.82,95％CI为(0.56,1.18),P＞0.05].结论 在疗效方面,卷曲霉素联合左氧氟沙星的治疗组的痰菌阴转率、病灶吸收率、空洞闭合率均高于对照组；但是在安全性方面,2组不良反应发生率相同.由于本系统评价纳入的文献质量较低、数量较少,因此尚需开展更多设计合理、执行严格的多中心大样本的随机对照试验来验证本研究的结论.     

苏黄止咳胶囊治疗小儿咳嗽变异性哮喘的系统评价

目的评价苏黄止咳胶囊治疗小儿咳嗽变异性哮喘的临床疗效与安全性。方法检索主要中英文数据库从建库至2015年8月20日苏黄止咳胶囊治疗小儿咳嗽变异性哮喘随机对照试验研究,筛选合格研究。应用Cochrane评价员手册进行偏倚风险评价,Jadad评分法进行质量评价。应用Rev Man5.3软件进行Meta分析。结果对符合纳入标准的5篇文献进行Meta分析显示,对比治疗组及对照组,两组临床疗效总有效率比值比(odds ratio,OR)为5.70,95%可信区间(confidence interval,CI)[2.95,11.01],差异有统计学意义(P0.001);临床疗效愈显率OR为3.38,95%CI[2.04,5.60],差异有统计学意义(P0.001)。结论苏黄止咳胶囊治疗小儿咳嗽变异性哮喘有显著临床疗效,但仍需更多高质量、大样本的临床研究来进一步验证。     

环孢素治疗特发性膜性肾病的Meta分析

目的 用Meta分析方法评价环孢素治疗特发性膜性肾病(IMN)的疗效.方法 检索PubMed Database、Cochrane Database、中国期刊全文数据库、中国生物医学文献数据库等数据库,检索环孢素治疗IMN的随机对照临床试验(RCT),对符合纳入标准的RCT进行质量评价和Meta分析.结果 入选国内外3个RCT,纳入127例患者.Meta分析结果显示环孢素治疗组与对照组相比,治疗IMN的完全缓解率(RR=0.35,95%,CI 0.20-0.62)有显著的统计学意义.结论 环孢素治疗IMN与传统的治疗方案相比具有更高的完全缓解率.     

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.