基于中医传承计算平台挖掘符文彬教授治疗郁病的针刺选穴规律

[目的]通过中医传承计算平台（V3.0）分析符文彬教授治疗郁病的针刺选穴规律，并挖掘新方。[方法]收集2015年1月至2021年12月符教授门诊诊治郁病的首诊处方，建立医案数据库，录入中医传承计算平台（V3.0），运用频次统计分析、相关规则分析、聚类分析等数据挖掘方法，总结符教授选穴规律，挖掘有效组穴处方，为针灸治疗郁证的临床实践提供依据。[结果]收集符合纳入标准的病例共504例，其中针刺处方所涉及穴位共90个，总使用频次5 176次；最常使用的前5位穴位有百会、印堂、中脘、廉泉、关元；其中以任脉穴位出现的频率最高，其次是足太阴脾经、足少阴肾经等，常用的穴位组合共37个。聚类分析结合临床经验得到常用穴位组合5组，分别为“百会、印堂、中脘、太冲、合谷、廉泉”“百会、印堂、照海、廉泉、列缺、中脘”“百会、印堂、中脘、关元、足临泣、外关”“百会、印堂、中脘、气海、关元、下脘”“百会、印堂、阳陵泉、中脘、关元、内关”。[结论]符教授运用针刺治疗郁病着重调神，任督并用，提炼出“疏肝调神，心胆论治”的诊疗思路，不仅调畅气机，亦固本培元，同时根据辨证使用八脉交会穴。     

基于数据挖掘技术探析针灸治疗单纯性甲状腺肿的选穴规律

[目的]采用数据挖掘技术探析针灸治疗单纯性甲状腺肿的选穴规律。[方法]通过检索1959年1月至2018年12月中国期刊全文数据库、万方数据知识服务平台、中国生物医学文献数据库、Pubmed数据库和Cochrane Library数据库中针灸治疗单纯性甲状腺肿的临床研究文献,采用数据挖掘技术,建立数据库,从腧穴、经络、特定穴、选穴部位及刺灸方法等方面对针灸治疗单纯性甲状腺肿的选穴特点进行分析和归纳。[结果]总共纳入35篇相关文献,涉及74个穴位,频次为216次,包括十四经穴、经外奇穴、经验穴等,以合谷、阿是穴、天突等最为常用,方法以针刺为主,大肠经和胃经是最常选用的经脉。[结论]针灸治疗单纯性甲状腺肿注重经络辨证结合脏腑辨证,重视特定穴的使用,并且重视局部取穴。     

基于数据挖掘的针灸治疗产后抑郁症的选穴规律研究

目的:通过数据挖掘针灸治疗产后抑郁的RCT文献,得到其穴位使用规律和配伍方法,从而为临床提供有效穴位的参考意见。方法:通过中国知网数据库、万方数据库、重庆维普数据库一共检索到557篇关于针灸治疗产后抑郁症的临床研究文献,通过纳入、排除标准筛选最后得到44篇文献。借助SPSS20.0以及SPSS Modeler18.1进行统计学分析。结果:针灸医治产后抑郁症最常使用的穴位分别是百会、太冲、三阴交、足三里、内关;督脉、足厥阴肝经、足太阳膀胱经这三条经脉与治疗产后抑郁症密切相关,大部分医生临床针灸治疗部位为头部、四肢、背部,由SPSS Modeler软件得到的关联分析结果为太冲-内关-足三里、太冲-内关、内关-太冲-足三里,最后对高频穴位进行聚类分类获得4个聚类群,分别是太冲、内关、三阴交、足三里;合谷、四神聪;百会、神门;脾俞、关元。结论:通过数据挖掘针灸治疗产后抑郁症的穴位使用规律,可以为今后临床治疗产后抑郁症提供一些穴位使用方法的参考。     

基于数据挖掘技术探讨针灸治疗梅尼埃病的选穴配伍规律

目的 运用数据挖掘技术探索针灸治疗梅尼埃病(MD)的选穴配伍规律。方法 检索中国期刊全文数据库、万方数据库、维普数据库自建库至2021年10月针灸治疗MD的临床研究文献,并建立针灸穴位处方数据库。运用SPSS Statistics 26.0及Rversion 3.6.1对数据进行描述性分析、聚类分析及关联规则分析。结果 对纳入的142条针灸处方进行分析,穴位频数分析得百会、风池、内关、太冲、足三里使用频率较高;最常选用的经脉为督脉和胆经;特定穴以交会穴为主。聚类分析结果显示,使用频次≥15的穴位可聚为四类。关联规则分析结果显示,百会和风池的支持度最高,内关、足三里和丰隆的提升度最高。结论 通过数据挖掘技术,分析发现针灸治疗MD临床选穴具有重视局部选穴、阳经选穴、交会穴,配合远端选穴等特点,可为临床针灸选穴用经提供一定参考。     

基于数据挖掘技术分析历代针灸治疗偏头痛的用穴特点

目的：讨论并分析历代采用针灸治疗偏头痛的相关规律和用穴特点。方法：以文献中关于先秦至清末的针灸内容为研究对象,采用数据挖掘技术进行分析,对常用的经脉和穴位进行总结,并以此为依据找出潜在的规律。结果：历代采用针灸治疗偏头痛中,胆经出现的频率最高;就腧穴出现频率来看,以少阳经脉的丝竹空、风池和率谷出现的次数最多。结论：通过数据挖掘技术对历代针灸治疗头痛的用穴特点进行分析发现,穴位的选择是以经络理论为基础,特殊穴位则是处方构成的关键。     

明清时期针灸治疗中风后失语选穴规律的数据挖掘分析

[目的]运用数据挖掘技术,分析明清时期针灸文献治疗中风后失语的处方选穴规律及配伍意义。[方法]收集明清时期针灸文献,利用Excel建立中风后失语针灸治疗处方数据库,用IBM SPSS modeler18.0、SPSS24.0软件对数据进行描述性分析、关联规则分析。[结果]共收集中风后失语针灸处方108条,涉及经络14条,穴位111个,总频次494次,频次最高的穴位为合谷、百会、哑门,使用最多的经络为督脉、手阳明大肠经、足阳明胃经、足少阳胆经,部位集中在头面颈、上肢、下肢,特定穴频次最高的为五输穴、交会穴,配伍关联结果显示,排在前五的为然谷→阴谷、阴谷→然谷、复溜→灵道、阴谷→灵道、然谷→鱼际。[结论]针灸治疗中风后失语的处方选穴规律遵循:局部选穴、远端取穴、辨证取穴,远近配穴、同名经配穴、上下配穴法,注重特定穴的运用。     

基于数据挖掘技术针灸治疗阿尔茨海默病的选穴规律分析

目的应用数据挖掘技术探索针灸治疗阿尔茨海默病体针疗法的腧穴优选、经络优选及配伍规律。方法收集中国知网、万方数据库、Pubmed数据库中1985年1月-2017年6月针灸或针灸结合其他疗法治疗阿尔茨海默病的文献,对文献中体针疗法使用的腧穴进行频次、归经统计,并进行关联规则分析。结果共纳入79篇文献,涉及60个腧穴;其中应用百会52次,频率最高;涉及12条经脉,使用督脉的频次和选穴个数均最高;关联规则分析显示,腧穴之间相关性最高的是百会-四神聪;处方简化结果表明百会-四神聪-内关之间存在着强关联。结论临床医家在体针疗法治疗阿尔茨海默病时以督脉上的腧穴为主,尤其首选百会;百会常配伍四神聪、大椎、风池、内关、三阴交等腧穴;百会-四神聪-内关可作为优选处方供临床参考。     

基于中医传承辅助平台对针灸治疗原发性痛经选穴组方规律分析

[目的]通过运用中医传承辅助平台,基于临床文献数据挖掘、分析针灸治疗原发性痛经的穴位配伍规律,总结针灸治疗原发性痛经的核心处方。[方法]检索1991~2017年中国知网期刊数据库收录的针灸治疗原发性痛经相关的临床研究文献,采用中医传承辅助平台分析、统计所有穴位中最常见穴位和穴位组合的频次以及核心穴位组合特点。[结果]共纳入204篇文献、287首穴位处方,得出针灸治疗原发性痛经多采用三阴交、关元、次髎、气海、地机、中极、足三里、肾俞、太冲、子宫等穴位及"中极、三阴交""气海、关元""气海、三阴交""关元、三阴交""关元,足三里"等常用穴位组合14个,并可得出针灸治疗原发性痛经"补益肝脾肾及冲任为主,兼以活血祛瘀行气祛湿"的用穴特点。[结论]运用中医传承辅助平台对研究数据结果进行整理分析,所得到的穴位配伍规律和核心处方可为临床治疗原发性痛经提供统计学依据及参考方案。     

基于数据挖掘探讨国内外针灸治疗阿尔茨海默病的选穴规律*

目的 运用数据挖掘技术分析国内外针灸治疗阿尔茨海默病的选穴规律。方法 检索建库至2020年12月31日中国期刊全文数据库（CNKI）、维普中文期刊服务平台（VIP）、万方数据知识服务平台（Wanfang）、Web of Science、Pubmed、Embase、Cochrane Library数据库收录的针灸治疗阿尔茨海默病的相关文献,采用Microsoft Excel 2019建立针灸处方数据库,对腧穴、经脉进行频数统计,并运用IBM SPSS Modeler 18.0软件对腧穴、经脉进行关联规则分析。结果 共纳入182篇文献,包括308个针灸处方、96个腧穴,腧穴使用总频次为1 928次。其中,主要选取的经脉为督脉及足三阳经;腧穴主要分布于头面、下肢和上肢;累计应用频次最高的腧穴为百会、四神聪、足三里;特定穴多使用交会穴;腧穴配伍以大椎→百会最为常见。结论 国内外针灸治疗阿尔茨海默病重视督脉及足三阳经的使用;取穴以近部取穴及远近配穴为主;重视特定穴使用,尤其是交会穴。     

古代针灸治疗中风穴位处方配伍规律研究

目的：检索从先秦至清代的古代中风针灸处方文献,研究针灸处方的主要配伍规律。方法：选取半身不遂和不省人事2个具代表性的中风症状,用数据挖掘方法分析其治疗中腧穴、经络和特定穴运用规律,总结、提炼针灸处方配伍方式。结果：①半身不遂：使用腧穴频次最多的为曲池、肩髃等手阳明经穴;肩髃、曲池、足三里、百会、风池配伍是最常用处方;多选用足少阳经和手足阳明经穴位。②不省人事：使用腧穴频次最多的为督脉百会穴、心包经中冲穴;风池、百会、曲池配伍或大椎、百会、风池配伍是最常用处方;经脉多选用督脉和足少阳、手阳明等阳经穴位。结论：古代治疗半身不遂和不省人事针灸处方所选腧穴的配穴组方及特定穴运用与现代临床常用处方基本一致。在经络选取上,治疗不省人事针灸处方选用经络与现代临床常用处方基本相同,而治疗半身不遂选用足少阳胆经最多,与现代临床常用足阳明胃经不同,需要进一步思索与研究。     

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.