颈椎牵引配合穴位敷贴治疗颈椎病的护理

目的观察颈椎牵引配合穴位敷贴治疗颈椎病的疗效,并总结其护理方法。方法将我院2008年5月至2011年5月使用颈椎牵引配合穴位敷贴治疗的颈椎病患者156例随机分两组,对照组78例采用牵引治疗配合穴位敷贴治疗。观察组78例采用对照组治疗基础上增加护理治疗,统计两组有效率,总结其治疗效果和护理经验。结果观察组治愈率明显高于对照组,差异具有统计学意义,两组均未见严重不良反应。结论颈椎牵引配合穴位敷贴治疗颈椎病效果较好,但是对其的护理尤为重要,护理人员应加强这方面的意识。     

经皮穴位电刺激对神经根型颈椎病LTPNPA术后疼痛的影响

目的观察经皮穴位电刺激（TEAS）对神经根型颈椎病低温等离子髓核消融术（LTPNPA）术后疼痛、颈椎活动度的影响。方法将64例神经根型颈椎病LTPNPA术后疼痛的患者通过随机数字表法分为对照组和观察组各32例。对照组给予术后常规护理措施,观察组在对照组护理基础上予TEAS双侧肩井、颈百劳穴,每次20 min,每日1次,共治疗2周。观察两组治疗前后VAS评分和颈椎活动度,并比较其疗效。结果与护理前比较,两组护理后VAS评分和颈椎前屈、后伸、左侧屈、右侧屈活动角度均明显改善（P<0.05）,其中以观察组改善程度最为明显（P<0.05）;观察组疗效优于对照组（P<0.05）。结论 TEAS作为中医护理操作技术,可缓解神经根型颈椎病LTPNPA后疼痛,改善颈椎活动度,减轻僵硬,具有一定疗效,值得临床推广。     

枕颌牵引结合颈椎康复操治疗神经根型颈椎病疗效观察

目的:观察枕颌牵引结合颈椎康复操治疗神经根型颈椎病的疗效.方法:100例神经根型颈椎病患者随机分为观察组和对照组,每组50例,对照组患者给予常规药物治疗,观察组患者在对照组的基础上给予枕颌牵引结合颈椎康复操治疗.比较两组患者的治疗有效率、颈椎活动度评分和VAS疼痛评分.结果:观察组的治疗有效率为96％(48/50),显著高于对照组的治疗有效率(P＜0.05).观察组患者治疗后颈椎活动度评分和VAS疼痛评分的改善情况明显优于对照组治疗后(P＜0.05).结论:枕颌牵引结合颈椎康复操治疗神经根型颈椎病疗效可靠,可显著提高颈椎活动度和减轻患者疼痛.     

颈椎旁注射脉络宁复合液配合仰卧位手法牵引治疗神经根型颈椎病临床观察

目的观察颈椎旁注射脉络宁复合液配合仰卧位手法牵引治疗神经根型颈椎病的临床疗效。方法将120例神经根型颈椎病患者按照随机方法分为中药组60例和激素组60例。两组患者分别采用脉络宁复合液和复方倍他米松注射液颈椎旁注射配合仰卧位手法牵引治疗,每周治疗1次,4次为1个疗程。观察两组患者治疗后临床疗效及疼痛情况,疼痛程度采用视觉模拟评分(VAS评分)评定。结果两组患者治疗后VAS评分与治疗前比较均有明显降低(P0.05),且中药组患者治疗后VAS评分与激素组治疗后比较,降低更加明显(P0.05)。中药组治愈率和总有效率与激素组比较,差异有统计学意义(P0.05)。结论颈椎旁注射脉络宁复合液配合仰卧位手法牵引治疗神经根型颈椎病,充分发挥了中西医结合方法的优势,同时避免了使用激素的副作用,具有操作简单,见效快,效果好,副作用少等优点,为治疗神经根型颈椎病的有效方法之一。     

牵引联合Mulligan手法治疗青年颈型颈椎病效果观察

目的:总结牵引联合Mulligan手法治疗青年颈型颈椎病的临床效果。方法:选择青年颈型颈椎病76例治疗10天,其中对照组37例仅用颈椎牵引治疗,观察组39例以颈椎牵引联合Mulligan手法治疗。采用视觉疼痛模拟评分法(VAS评分)对治疗前、后疼痛进行评分,采用皮尺测量法、Borden氏测量法对治疗前、后颈椎活动度及颈椎曲度值进行测量。结果:观察组治疗前VAS评分7.29±1.26分,治疗后VAS评分0.85±1.54分;对照组治疗前VAS评分7.32±1.29分,治疗后VAS评分4.26±1.37分。观察组治疗前颈椎曲度3.19±1.41mm,治疗后颈椎曲度6.85±3.28mm,治疗前后差值3.66±2.37mm;对照组治疗前颈椎曲度3.23±1.45mm,治疗后颈椎曲度4.79±2.74mm,治疗前后差值1.56±2.02mm。两组VAS评分治疗前后相比差异均有统计学意义(P<0.05);治疗后VAS评分观察组优于对照组(P<0.05)。两组治疗前后颈椎活动度、颈椎曲度值差异均有统计学意义(P<0.05);治疗后颈椎活动度、颈椎曲度值观察组优于对照组(P<0.05)。结论:牵引联合Mulligan手法治疗青年颈型颈椎病疗效好、见效快。     

仰卧角度牵引联合中药熏洗治疗颈型颈椎病的疗效观察

目的观察仰卧角度牵引联合中药熏洗治疗颈型颈椎病的临床疗效。方法选取本院颈肩腰腿痛四科确诊为颈型颈椎病的住院患者50例,随机分为治疗组和对照组各25例。治疗组采用仰卧角度牵引联合中药熏洗治疗,对照组采用坐位牵引联合中药熏洗治疗。观察比较两组治疗前后视觉模拟评分(VAS)、颈椎曲度、颈椎活动度及临床疗效。结果治疗后治疗组VAS评分明显低于对照组(P<0.05),弓弦值及颈椎活动度的改善均优于对照组(P<0.05);治疗组的总有效率92.00%高于对照组的76.00%(P<0.05)。结论仰卧角度牵引联合中药熏洗治疗可有效缓解颈型颈椎病患者的临床症状,明显恢复患者的颈椎曲度,改善患者颈椎活动度。     

正骨手法治疗神经根型颈椎病60例临床观察

目的:观察间歇拔伸推拿手法配合牵引下正骨手法治疗神经根型颈椎病的临床疗效.方法:选择2007年1月～2010年1月在福建省第二人民医院推拿科就诊的120例神经根型颈椎病患者,随机分为治疗组(间歇拔伸推拿配合牵引下正骨手法)和对照组(常规推拿手法).使用国际公认的简化McGill疼痛询问量表进行疼痛积分评价,观察治疗前后颈椎生理曲度、椎间隙、颈椎稳定性变化情况.结果:治疗组与对照组总有效率比较,差异具有统计学意义(P＜0.05),治疗组优于对照组;治疗组治疗前后疼痛积分比较、颈椎生理曲度、椎间隙、颈椎稳定性变化情况差异有意义(P＜0.05),治疗组优于对照组.结论:间歇拔伸推拿手法配合牵引下正骨手法的疗效优于常规推拿治疗组.     

颈百劳滞针加灸配合后溪、手三里电针治疗神经根型颈椎病的临床研究

目的观察颈百劳滞针加灸配合后溪、手三里电针治疗神经根型颈椎病的临床疗效。方法将120例神经根型颈椎病患者均分成两组,试验组采用颈百劳滞针加灸配合后溪、手三里电针治疗,对照组采用持续枕颌带牵引法。比较两组患者治疗前后的VAS疼痛评分、NDI颈椎功能障碍指数和临床结局。结果治疗后两组患者的VAS疼痛评分、NDI颈椎功能障碍指数和临床结局均比治疗前明显改善(P0.05),其中NDI指数和治愈率治疗组改善比对照组更明显(P0.05)。结论颈百劳滞针加灸配合后溪、手三里电针治疗神经根型颈椎病临床疗效满意,具有一定的推广前景。     

水针刀联合葛根汤加减治疗神经根型颈椎病患者临床效果观察

目的:探讨分析水针刀联合葛根汤加减治疗神经根型颈椎病患者临床效果.方法:选取2018年2月至2020年10月收治的98例神经根型颈椎病患者分为观察组和对照组,对照组给予水针刀治疗,观察组联合葛根汤治疗,比较两组临床疗效、临床症状缓解时间、治疗前后NDI、VAS评分及中医症状评分.结果:观察组临床疗效总有效率93.88％,高于对照组的75.51％(P<0.05);观察组症状消失时间、颈椎恢复正常活动时间与对照组相比缩短(P<0.05);治疗前两组颈椎功能障碍指数(neck disabilitv index,NDI)及视觉模拟评分法(visual ana-logue scale,VAS)评分差异无统计学意义(P>0.05),治疗后观察组NDI及VAS评分下降更显著(P<0.05);治疗前两组中医症状评分差异无统计学意义(P>0.05),治疗后观察组疼痛、麻木、项强、恶寒怕风症状评分下降更显著(P<0.05).结论:水针刀联合葛根汤加减治疗神经根型颈椎病可提高临床疗效,改善临床症状及颈椎功能,缓解疼痛,值得应用.     

芪桂葛根汤配合牵引治疗神经根型颈椎病30例

目的芪桂葛根汤配合牵引治疗颈椎病临床疗效。方法将60例神经根型颈椎病患者随机分为2组各30例,治疗组用芪桂葛根汤口服配合颈椎牵引治疗,对照组用甲钴胺片口服配合颈椎牵引治疗,7 d为1个疗程,2个疗程后比较疗效。观察2组治疗前后颈肩部疼痛、上肢放射痛以及感觉异常等的改善程度。结果治疗组疗效优于对照组（P<0.05）。结论芪桂葛根汤配合牵引治疗神经根型颈椎病效果更好。     

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.