局部放置云南白药预防下颌阻生智齿拔除术后并发症

目的:评价云南白药预防下颌阻生智齿拔除术后并发症的临床效果.方法:门诊随机选择需要拔除下颌阻生智齿患者190例,单盲法随机将患者分为实验组和对照组,各95例,实验组阻生牙拔除术后牙槽窝内置适量云南白药粉剂再缝合拔牙创口,对照组阻生牙拔除术后牙槽窝内不置云南白药粉剂,直接缝合拔牙创口.均于术后第3天复诊,比较两组的术后并发症情况.结果:实验组术后局部肿胀、出血,张口受限和干槽症的发生率分别是37.89%、1.05%、4.21%、2.11%,明显少于对照组的61.05%、8.42%、11.58%、10.53%,差异有统计学意义(p＜0.05).结论:云南白药预防下颌阻生智齿拔除术后并发症效果良好.     

地塞米松加云南白药对下颌阻生智齿术后反应的疗效观察

目的:观察局部肌注地塞米松加云南白药填塞创面对下颌阳生智齿拔除术后不良反应的临床效果.方法:行下颌阻生智齿拔除术患者156例,随机分为治疗组和对照组,各组78例,其性别、年龄、阻生智齿类型及阻生程度之间比较差异无显著性(P＞0.05).治疗组局部注射地塞米松加云南白药填塞创面,对照组局部不应用地塞米松和云南白药.术后30mim、1d、3d和5d复诊,观察术后肿胀、疼痛、张口受限程度以及创面愈合程度.结果:与对照组比较,治疗组术后局部肿胀、疼痛以及张口受限程度明显减轻(P＜0.05);创面愈合程度中甲级愈合率差异显著性(P＜0.01).结论:局部肌注地塞米松加云南白药填塞创面能够明显减轻阻生智齿拔除术后不良反应,且简使易行.     

阻生智齿拔除后局部注射地塞米松的疗效观察

目的 分析局部注射地塞米松减轻阻生智齿拔除术后反应的临床效果,为阻生智齿拔除术后不良反应提供一种新的治疗方法.方法 回顾分析诊断明确需行下颌阻生智齿拔除患者120例,分为局部注射地塞米松的治疗组70例和局部不注射地塞米松的对照组50例,术后24~48 h随访观察,术后肿胀、疼痛、开口困难程度.结果 两组术后不适症状发生率比较,差异有统计学意义(P<0.01).结论 局部注射地塞米松能够明显减轻下颌阻生智齿拔除术后反应.     

口服云南白药对下颌阻生智齿拔除术后面部肿胀影响的评价

目的评价口服云南白药对埋伏下颌阻生智齿拔除术后面部反应性肿胀的缓解情况。方法 48例下颌埋伏阻生智齿患者按随机数字表法分为实验组和对照组,每组24例,于术前3 d开始,连续8 d口服云南白药胶囊或安慰剂胶囊。分别在术前以及术后第1天、第3天和第5天进行面部三维扫描,重建面部三维模型,利用逆向工程技术软件测定术后不同时间点面部肿胀的体积和厚度,分析两组患者术后面部肿胀度、疼痛强度和张口度。结果口服云南白药组和口服安慰剂组在不同时间点所测定的疼痛强度和张口度差别均无统计学意义,而2组间面部肿胀厚度和肿胀度差异有统计学意义。结论下颌埋伏阻生智齿拔除术中采用围术期口服云南白药胶囊对预防和治疗术后面部反应性肿胀有一定的疗效。     

云南白药预防阻生第三磨牙拔除术后疼痛的效果观察

目的 观察云南白药对复杂阻第第三磨牙拔除术后疼痛的预防作用。方法 将云南白药放入100颗阻生第三磨牙的拔牙窝内。结果 云南白药组术后疼痛为0级者占60%，Ⅰ级者占36%，有效率96%，对照组有效率12%，两组比较差异有显著性。结论 云南白药可有效预防阻生第三磨牙拔除术后的疼痛。     

局部注射地塞米松减轻阻生智齿拔除术后反应效果评价

目的：分析局部注射地塞米松减轻阻生智齿拔除术后反应的临床效果,为阻生智齿拔除术后不良反应提供一种新的治疗方法。方法：回顾性分析诊断明确需要行下颌阻生智齿拔除患者320例,阻生类型均为近中水平阻生,随机分为局部注射地塞米松的治疗组和局部不应用地塞米松的对照组各160例,两组患者性别、年龄构成差异无显著性（P>0.05）。术后2 d和7 d随访,观察术后肿胀、张口受限及疼痛程度。结果：与对照组比较,治疗组术后局部肿胀程度、张口受限程度和疼痛程度均明显减轻,组间比较差异有显著性（P<0.01）;两组患者创口甲级愈合率比较差异无显著性（P>0.05）。结论：局部注射地塞米松能够明显减轻阻生智齿拔除术后反应,且简便易行、无并发症,值得临床推广应用。     

阻生齿拔除后局部使用云南白药粉剂的疗效观察

目的:分析局部使用云南白药粉剂减轻阻生齿拔除术后反应的临床效果,为阻生齿拔除术后不良反应提供一种新的治疗方法.方法:回顾分析诊断明确需行下领阻生齿拔除患者120例,分为局部使用云南白药粉剂治疗组60例和常规处理对照组60例,观察术后肿胀、疼痛、张口受限程度.结果:两组术后不适症状发生率比较,差异有统计学意义.结论:局部使用云南白药粉可以明显减轻阻生齿拔除术后不良反应.     

云南白药胶囊治疗膝关节骨性关节炎行膝关节镜术后疼痛和肿胀的疗效观察

目的观察云南白药胶囊缓解膝关节骨性关节炎行膝关节镜术后疼痛和肢体肿胀的临床效果。方法 100例行膝关节镜手术的患者,按随机数字表法分为两组,每组50例。治疗组与对照组从入院至出院分别口服云南白药胶囊和塞来昔布胶囊,膝关节镜手术由同一组医生操作,术后不使用其他镇痛药,采用数字分级评估法(NRS)评估两组患者术后6h、12h、24h、48h、72h不同时间点疼痛情况,采用患侧与健侧肢体大腿周径的差值来评估患者入院时、术后24h、48h肢体肿胀情况以及患者出院时的临床疗效。结果治疗组临床总有效率优于对照组(P0.05);治疗组和对照组术后NRS评分及术后24h、48h肿胀值比较,治疗组优于对照组(P0.05)。结论云南白药胶囊能缓解膝关节镜手术患者术后疼痛和肢体肿胀,有利于患者尽早进行功能锻炼,促进康复。     

复方七叶皂苷钠凝胶在下颌阻生智齿拔除术中的应用

目的：评价复方七叶皂苷钠凝胶外敷面颊部对下颌阻生智齿拔除术后并发症的影响。方法：随机挑选双侧基本对称低位水平阻生智齿患者35例,一侧阻生智齿拔除术后面颊部外敷复方七叶皂苷钠凝胶（设为实验组）,对侧不予外敷（设为对照组）,自体双侧对照,比较2组术后并发症情况。采用SPSS17.0统计学软件对数据进行配对t检验。结果：实验组术后24、48 h疼痛、肿胀度、张口受限比对照组轻,2组比较差异有统计学意义（P＜0.05）。结论：复方七叶皂苷钠凝胶局部外敷能减轻下颌阻生智齿拔除术后短期肿痛及张口受限。     

下颌阻生智齿拔除术后干槽症临床分析

目的:探讨下颌阻生智齿拔除术后干槽症的发生情况及临床特点。方法:收集下颌阻生智齿患者242例,随机分为观察组与对照组,每组121例,观察组采用微创法拔齿,手术前后采用复方氯已定漱口;对照组采用锤凿法拔齿,术后给予甲硝唑口服,观察两组术后干槽症及其他并发症发生率。结果:对照组发生8例干槽症,观察组未发生1例,两组干槽症发生率比较差异有统计学意义(P<0.05);观察组发生1例张口受限、肿胀及疼痛,对照组发生10例,两组比较差异有统计学意义(P<0.05)。结论:下颌阻生智齿拔除术后干槽症临床常见,以微创拔除术及术前、术后复方氯已定漱口可有效降低干槽症发生率,值得临床推广。     

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.