胸背部平衡松解术治疗产后缺乳的效果

目的 观察胸背部平衡松解术对产后缺乳的临床疗效.方法 将96例产后缺乳患者随机分为观察组和对照组各48例,观察组采用胸背部平衡松解术治疗,对照组依照常法操作,通过泌乳量、乳房疼痛VAS评分、血清泌乳素及整体疗效4个指标来观察产后缺乳病征改善情况.结果 1个疗程治疗后,观察组泌乳量显著多于对照组且观察组泌乳量随治疗次数增加而明显增加,乳房疼痛VAS评分显著低于对照组,血清泌乳素(PRL)浓度也显著高于对照组,差异均有统计学意义(P<0.05);对照组治愈12例、好转23例、未愈13例,总有效率72.92%,观察组治愈30例、好转12例、未愈6例,总有效率87.50%,观察组总体疗效明显优于对照组(P<0.05).结论 胸背部平衡松解术对产后缺乳具有良好的疗效,从神经内分泌反射、体态以及中医整体观和辨证论治的角度治疗,为产后缺乳治疗提供了新思路.     

针药结合中医情志护理对气血亏虚型产妇产后母乳喂养及泌乳素水平的影响

目的 探讨针药结合中医情志护理对气血亏虚型产妇产后母乳喂养、泌乳素水平的影响.方法 选取2016年2月-2019年2月在首都医科大学附属北京妇产医院收治的98例气血亏虚型产妇,按照随机数字表法分为观察组与对照组,各49例.对照组在产后给予催产素治疗,观察组在对照组的基础上加用针药治疗,2组均采用中医情志护理,均干预4周.比较2组干预前后焦虑、抑郁情绪,乳房胀痛评分变化,比较2组干预前及干预2、4周后血清泌乳素水平变化,并观察2组干预后纯母乳喂养率、泌乳量及乳房充盈程度.结果 干预4周后,观察组纯母乳喂养率、泌乳量充足率及乳房Ⅰ度充盈率均显著高于对照组(P<0.05);干预4周后,2组SAS、SDS评分以及乳房胀痛评分均降低,且观察组显著低于对照组(P<0.05);干预2～4周后,2组血清泌乳素水平均升高,且干预后2、4周观察组显著高于对照组(P<0.05).结论 针药结合中医情志护理可提高气血亏虚型产妇血清泌乳素水平、泌乳量及纯母乳喂养率,消除不良情绪,缓解疼痛症状.     

米非司酮联合利凡诺对中晚期引产孕妇激素及泌乳素、前列腺素的影响观察

目的 探讨米非司酮联合利凡诺对中晚期引产孕妇激素及泌乳素、前列腺素的影响.方法 将2010年5月~2012年9月本院的74例中晚期引产孕妇随机分为对照组和观察组每组各37例,对照组采用利凡诺进行引产,而观察组则采用米非司酮联合利凡诺进行引产,然后将两组患者用药前后不同时间的血清雌二醇、雌三醇、孕酮、泌乳素水平及血清、羊水中的PGE、PGF-2α进行检测及比较.结果 观察组的用药后12h及引产后24h的血清雌二醇、雌三醇均高于对照组,而孕酮及泌乳素水平则低于对照组,另外血清及羊水中的PGE、PGF-2α高于对照组,P均＜0.05.结论 米非司酮联合利凡诺对中晚期引产孕妇激素及泌乳素、前列腺素的影响较大,引产效果优于单用利凡诺.     

巨泌乳素筛查在高泌乳素血症中的诊断价值

目的探讨巨泌乳素(M-PRL)筛查在高泌乳素血症诊断中的价值。方法测定216例高泌乳素血症患者和120例正常体检者的血清泌乳素(PRL),血清经聚乙二醇(PEG)沉淀后,取上清液再次检测PRL,并进行比较。结果在高泌乳素血症患者血清中,M-PRL的检出率为23.61%,正常体检者仅为2.50%,两者差异有统计学意义(<0.05);单体泌乳素组的标本经PEG处理前后PRL含量差异无统计学意义(>0.05),而含M-PRL的标本在PEG处理前后PRL含量差异有统计学意义(<0.05)。结论 M-PRL是造成高泌乳素血症的常见原因,应用PEG沉淀法筛查M-PRL对高泌乳素血症的诊断具有重要价值。     

RIA测定泌乳血症患者血清中人垂体泌乳素结果分析

目的探讨泌乳血症的患者血清中人垂体泌乳素指标改变在垂体疾病，特别是垂体瘤和泌乳综合症等诊断中的意义。方法用GC-911Y放射免疫计数器测定8例高泌乳血症的患者血清中PRL及性激素（FSH、LH、E、T）的含量。结果泌乳血症的患者血清中人垂体泌乳素含量，随治疗时间的延长而下降，治疗前后和治疗后不同时间差异具有显著性（P〈0．05）。结论放射免疫法测定人垂体泌乳素具有灵敏度高、特异性强、准确性、精确性好的优点，对垂体疾病的诊断有一定价值。     

α-细辛脑和苯妥因钠对癫痫患者血清泌乳素和睾丸酮影响的研究

用放射免疫法测定30例正常对照组和54例癫痫患者使用α-细辛脑和苯妥因钠前后血清泌乳素和睾丸酮水平。结果发现:①α-细辛脑和苯妥因钠均可导致血清泌乳素和睾丸酮水平升高,②未使用抗癫痫药物前血清泌乳素和睾丸酮与正常对照组比较无统计学意义。     

原发性甲状腺功能减退患者治疗前后血清泌乳素水平变化探讨

目的观察原发性甲状腺功能减退（原发性甲减）患者血清泌乳素（PRL）水平,在予替代治疗后其血清PRL水平变化。方法选择原发性甲减女性患者30例,观察在左旋甲状腺素（L-T4）片替代治疗前后,血清PRL、促甲状腺激素（TSH）、游离三碘甲状腺原氨酸（FT3）及游离甲状腺素（FT4）水平变化。结果治疗前,18例患者血清PRL升高,占原发性甲减患者的60%,经替代治疗后,血清PRL明显下降,差异有显著统计学意义（〈0.01）。结论原发性甲减患者经替代治疗后泌乳素水平可以明显下降,对于原发性甲状腺功能减退患者监测血清泌乳素有一定临床价值。     

利培酮对男性精神分裂症患者血清泌乳素的影响探讨

目的探讨利培酮对男性精神分裂症患者血清泌乳素的影响。方法选取本院2015年7月至2016年7月收治的74例男性精神分裂患者作为此次研究对象,依照就诊时间的不同将74例患者随机分为两组,对照组37例患者使用奥氮平治疗,观察组37例患者使用利培酮治疗。治疗7周比较两组患者血清泌乳素水平。结果观察组患者治疗结束后测定血清泌乳素水平明显高于对照组,组间数据比较差异有统计学意义(P0.05)。结论男性精神分裂症患者使用利培酮治疗后血清泌乳素水平明显升高,因此在临床治疗时,应选择对血清泌乳素相对影响更小的药物进行治疗。     

原发性甲状腺功能减退患者治疗前后血清泌乳素变化

目的观察原发性甲状腺功能减退（甲减）患者血清泌乳素（PRL）水平及治疗后血清泌乳素变化.方法采用放射免疫方法测定60例正常对照组、32例原发性甲减组治疗前及治疗后血清泌乳素的水平.结果甲减组比对照组血清泌乳素水平显著性升高（P＜0.01）,原发性甲减组治疗后血清泌乳素的水平比治疗前显著性下降（P＜0.01）.     

剖宫产术后镇痛对产妇血清泌乳素及产后泌乳影响

目的研究剖宫产术后硬膜外自控镇痛(PCEA)对产妇血清泌乳素水平(PRL)及产后泌乳量的影响。方法选择足月妊娠拟行剖宫产孕妇200例,随机分为观察组和对照组,其中观察组取75例,对照组取74例。采用视觉模拟评分法(VAS)测评产妇疼痛程度,用放射免疫分析法测定术前、术后24 h、术后72 h血清PRL浓度:泌乳始动时间及泌乳量。结果观察组VAS评分显著低于对照组(均P<0.01);两组产妇血清泌乳素水平、泌乳始动时间及泌乳量比较,差异无显著性(均P>0.05)。结论剖宫产术后实施PCEA可减轻产妇产时疼痛,不影响产后泌乳。     

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.