养阴活血汤联合厄贝沙坦治疗糖尿病伴高血压临床疗效分析

目的探讨养阴活血汤联合厄贝沙坦治疗糖尿病伴高血压临床疗效。方法选取我院2016年4月至2017年2月收治的糖尿病伴高血压患者148例作为研究对象,随机分为观察组和对照组,各组74例。对照组给予厄贝沙坦治疗,观察组给予养阴活血汤联合厄贝沙坦治疗。比较两组血压、餐后2h血糖、空腹血糖、糖化血红蛋白、中医证候积分。结果观察组患者血压、餐后2h血糖、空腹血糖、糖化血红蛋白均比对照组低(P0.05);观察组患者中医证候积分比对照组低(P0.05)。结论养阴活血汤联合厄贝沙坦治疗糖尿病伴高血压临床疗效明显。     

养阴逐瘀汤联合依帕司他治疗消渴病痹病阴虚血瘀证

目的探究养阴逐瘀汤联合依帕司他治疗消渴病痹病阴虚血瘀证的临床疗效和安全性。方法将2016年11月-2018年6月期间无锡市中西医结合医院收治的消渴病痹病阴虚血瘀证患者病例107例作为研究对象,按照随机数字法分成观察组和对照组。观察组54例,采用养阴逐瘀汤联合依帕司他治疗;对照组53例,采用依帕司他治疗。比较2组治疗前后的中医证候积分变化、临床疗效、血糖水平以及不良反应等。结果治疗后,观察组的四肢疼痛、感觉减退、肢体麻木以及肌肉萎缩等中医证候积分明显低于对照组,差异具有统计学意义(P 0.05);观察组与对照组治疗后的临床总有效率分别为85.19%及66.67%,观察组明显高于对照组,差异具有统计学意义(P 0.05);治疗后,观察组的FBG、2h PG及Hb A1c等水平明显低于对照组,差异具有统计学意义(P 0.05)。结论养阴逐瘀汤联合依帕司他治疗消渴病痹病阴虚血瘀证临床疗效明显,可以促进临床症状缓解,降低血糖水平,安全性高。     

滋阴活血方治疗2型糖尿病阴虚血瘀的临床研究分析

目的研讨阴虚血瘀证2型糖尿病患者采取滋阴活血方治疗的临床价值。方法选择160例阴虚血瘀证2型糖尿病患者作为实验对象,并按随机数表法分配患者至两组,Ⅰ组(n=80)接受常规西医基础治疗,Ⅱ组(n=80)在Ⅰ组治疗下接受滋阴活血方温服,对比评估两组的临床药效,以及不同治疗时段的中医证候积分与血糖水平。结果与Ⅰ组药效比较,Ⅱ组患者在临床药效的提高方面更显著,数据处理有统计学意义(P0.05),治疗后Ⅱ组相比Ⅰ组在证候积分、各项血糖指标(FBG、2 hBG等)水平的改善方面均更显著,有统计学意义(P0.05)。结论对阴虚血瘀证2型糖尿病患者使用滋阴活血方治疗有显著药效,并且能够促进相关证候缓解,加强对患者血糖水平的调控,值得推荐。     

益气养阴法治疗早期糖尿病肾病的临床疗效观察

目的：观察益气养阴法治疗早期糖尿病肾病的临床疗效。方法：选取我院早期糖尿病肾病患者60例,随机分为治疗组与对照组,对照组血糖控制,低盐、优质低蛋白饮食、控制血压和运动指导等,治疗组在此基础上加用益气养阴类方剂参芪地黄汤治疗2个月,治疗前后测定 mALB、NAG、SCr、FBG、HbA1c、中医证候积分。结果：治疗前 mALB、NAG、SCr、FBG、HbA1c、中医证候积分两组比较无统计学意义（P ＞0．05）,治疗前后2组组内比较差异有统计学意义（P ＜0．05）,治疗后比较2组比较差异有统计学意义（P ＜0．05）。结论：益气养阴法在早期糖尿病肾病中疗效肯定,值得推广。     

养阴清热汤治疗2型糖尿病临床观察

目的 观察养阴清热汤治疗2型糖尿病的临床疗效.方法 将64例病人随机分为治疗组和对照组,对照组采用西医常规治疗,治疗组在常规西药治疗上加服养阴清热汤,观察治疗6周. 结果治疗组总有效率、中医证候积分、血糖、血脂及血液流变学等变化,均优于对照组(P＜0.05),有显著性差异.结论 养阴清热汤是治疗2型糖尿病的有效方药.     

芪桂活血汤联合针刺治疗气虚血瘀型糖尿病周围神经病变的临床研究

目的 探讨芪桂活血汤联合针刺治疗气虚血瘀型糖尿病周围神经病变（DPN）的效果。方法 选取2019年1月至2021年10月安徽省六安市中医院收治的99例DPN患者,根据随机数字表法将其分为三组,每组33例。对照组1接受针刺治疗,对照组2接受芪桂活血汤治疗,观察组接受芪桂活血汤联合针刺治疗,均连续治疗4周。比较三组临床疗效和中医证候积分、多伦多临床评分系统（TCSS）、腓总神经传导速度、视觉模拟评分（VAS）,记录不良反应发生情况。结果 观察组临床疗效优于对照组1、对照组2(P <0.05)。治疗后三组中医证候积分、TCSS评分、VAS评分均较治疗前降低,腓总神经的感觉神经传导速度（SNCV）和运动神经传导速度（MNCV）较治疗前升高（P <0.05）,且治疗后观察组中医证候积分、TCSS评分、VAS评分低于对照组1、对照组2,SNCV和MNCV高于对照组1、对照组2(P <0.05)。三组在治疗过程中均未出现明显不良反应。结论 芪桂活血汤联合针刺治疗气虚血瘀型DPN效果显著,能改善神经传导速度,缓解疼痛。     

褐藻多糖硫酸酯与贝那普利联合应用治疗早期糖尿病肾病

目的 观察褐藻多糖硫酸酯联合贝那普利对早期糖尿病肾病(DN)的临床疗效.方法 将40例早期DN患者随机分为对照组(20例)和治疗组(20例),对照组采用常规西药和贝那普利治疗,治疗组在对照组治疗基础上加用褐藻多糖硫酸酯.比较两组血压、空腹血糖(FBG)、血肌酐(Scr)、尿素氮(BUN)、血浆白蛋白、尿白蛋白排泄率(UAER)、尿β2微球蛋白(β2-MG)的改变.结果 经2月治疗后,两组血压、UAER、尿β2-MG较治疗前均有明显下降(P＜0.05或P＜0.01),且治疗组较对照组下降更明显;FBG、Scr、BUN治疗组较对照组稍低,但差异无统计学意义(P＞0.05).结论 褐藻多糖硫酸酯联合贝那普利及常规西药治疗早期DN临床疗效比常规西药联合贝那普利疗效显著.     

益气化瘀汤治疗早期糖尿病肾病26例临床观察

目的：观察益气化瘀汤治疗早期糖尿病肾病（DN）的临床疗效。方法：将52例DN患者随机分为治疗组和对照组，各26例。2组均采用基础降糖治疗，治疗组加服益气化瘀汤，每日两次。疗程为3个月，观察2组治疗前后的血糖水平、尿蛋白排泄率（UAER）、全血黏度的变化。结果：治疗组临床有效率88.5％，对照组61.5％，治疗组治疗后空腹血糖（FBG）、餐后2小时血糖（P2hBG）、糖化血红蛋白（HbA1c）、尿蛋白排泄率（UAER）等指标的改善优于对照组。2组全血黏度低切、高切比较，差异有显著性意义（P〈0.05，P〈0.01）。结论：益气化瘀汤治疗早期糖尿病肾病疗效满意。     

胰岛素联合格列美脲治疗2型糖尿病临床观察

目的观察胰岛素联合格列美脲治疗2型糖尿病的临床疗效。方法选择确诊为2型糖尿病患者120例,随机分为观察组和对照组各60例,观察组采用胰岛素联合格列美脲治疗,治疗组单用格列美脲治疗,治疗12周后观察两组空腹血糖（FBG）、餐后2h血糖（2hBG）、糖化血红蛋（HbAlc）、体重指数（BMI）等指标。结果治疗12周后,观察组空腹血糖（FBG）、餐后2h血糖（2hBG）、糖化血红蛋白（HbAlc）均明显低于对照组（P〈0．05）。结论甘精胰岛素联合格列美脲治疗2型糖尿病临床疗效良好,值得推广。     

解郁方治疗2型糖尿病抑郁症的临床观察

目的 观察中药解郁方治疗2型糖尿病抑郁症的疗效及安全性,探讨中医药治疗该病的可行性.方法 肝郁阴虚、痰瘀夹杂证的2型糖尿病抑郁症患者50例,随机分为解郁方组与帕罗西汀（对照）组,疗程2个月.治疗前后分别测抑郁症评分（HAMD评分）、证候积分、空腹血糖（FBG）、餐后2 h血糖（2 h BG）、糖化血红蛋白（HbA1C）、胰岛素敏感指数（IAI）、心、肝、肾功能等.结果 2组治疗后病情均有明显改善,治疗前后HAMD评分、证候积分、FBG、2 h BG、HbA1C、IAI差别有统计学意义（P＜0.01或P＜0.05）,但2组治疗后组间差别无统计学意义（P＞0.05）.治疗后2组之间证候积分差别明显（P＜0.05）,并以2组合并为标准组,治疗组的R=0.5824,对照组-R=0.4176,U=2.02,治疗组的疗效优于对照组（P＜0.05）.在治疗过程中治疗组无不良反应,对照组部分病人出现不良反应.结论 解郁方能安全有效地改善2型糖尿病抑郁症患者的抑郁症状.     

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.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

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.