玫瑰解郁汤联合穴位埋线及耳穴贴压治疗血液透析患者抑郁症临床研究

目的:观察玫瑰解郁汤联合穴位埋线及耳穴贴压疗法治疗血液透析患者抑郁症的临床疗效。方法:选取患有抑郁症的血液透析患者66例,随机分为观察组和对照组,每组各33例。观察组采用玫瑰解郁汤联合穴位埋线、耳穴贴压治疗,对照组单纯采用玫瑰解郁汤治疗。观察治疗后两组患者汉密尔顿抑郁量表(Hamilton depression scale,HAMD)评分及抑郁自评量表(self-rating depression scale,SDS)评分,评价临床疗效。结果:治疗后两组患者HAMD评分及SDS评分均较治疗前降低,观察组优于对照组,两组比较,差异有统计学意义(P0.05);观察组有效率84.9%,对照组有效率57.6%,两组比较,差异有统计学意义(P0.05);两组治疗期间均未出现明显不良反应。结论:玫瑰解郁汤联合穴位埋线、耳穴贴压疗法治疗血液透析患者抑郁症效果明显,无明显不良反应。     

耳穴贴压合肝豆灵对肝豆状核变性患者抑郁状态的影响

目的 观察耳穴贴压联合肝豆灵治疗肝豆状核变性（hepatolenticular degeneration,HLD）患者抑郁状态的疗效。方法 将82例HLD伴抑郁状态患者随机分成对照组、肝豆灵组、肝豆灵合耳穴贴压组。对照组患者接受常规治疗和常规护理,肝豆灵组患者在对照组疗法基础上接受肝豆灵治疗,肝豆灵合耳穴贴压组患者在肝豆灵组疗法基础上接受耳穴贴压治疗。治疗前和治疗6周后分别采用汉密尔顿抑郁量表(Hamilton depression scale, HAMD)评价患者的抑郁状态。结果 3组患者治疗6周后HAMD总分均较治疗前显著下降（P<0.05）,其中肝豆灵合耳穴贴压组HAMD总分及绝望因子、睡眠障碍因子评分降低程度显著大于肝豆灵组和对照组（P<0.05）。结论 耳穴贴压联合肝豆灵在改善HLD患者抑郁状态方面具有一定疗效。     

自拟开窍解郁汤联合针刺治疗卒中后抑郁患者的效果

目的：观察自拟开窍解郁汤联合针刺治疗卒中后抑郁（post stroke depression,PSD）患者的效果。方法：回顾性分析2019年2月至2021年2月该院收治的90例PSD患者的临床资料,根据治疗方案不同将其分为对照组（n=45）和观察组（n=45）。两组均给予盐酸舍曲林片治疗,对照组在此基础上采用针刺治疗,观察组在对照组基础上给予自拟开窍解郁汤治疗。比较两组治疗前后蒙哥马利-艾斯伯格抑郁量表（MADRS）评分、血清神经功能指标[脑源性神经营养因子（BDNF）、5-羟色胺（5-HT）、去甲肾上腺素（NE）]水平、中国卒中量表（CSS）评分、改良Barthel指数（MBI）评分及不良反应发生率。结果：治疗后,观察组MADRS评分、CSS评分明显低于对照组,MBI评分及血清BDNF、5-HT、NE水平高于对照组,差异均有统计学意义（P<0.05）;两组均未发生明显不良反应。结论：自拟开窍解郁汤联合针刺治疗PSD患者效果明显,可减轻患者的抑郁症状,提高其生活自理能力和血清BDNF、5-HT、NE水平,改善神经功能。     

磁珠耳穴贴压联合重复经颅磁刺激对脑卒中后抑郁的疗效

目的 探讨磁珠耳穴贴压联合重复经颅磁刺激(rTMS)治疗脑卒中后抑郁患者的效果以及对血清中的瞬时受体电位通道1蛋白(TRPC1)、5-羟色胺(5-HT)、S100β蛋白水平的影响。方法 选取脑卒中后抑郁的患者120例,采用随机数字表分为对照组(抗抑郁药物治疗)、rTMS组(抗抑郁药物+rTMS治疗)、耳穴组(抗抑郁药物+磁珠耳穴贴压治疗)、rTMS+耳穴组(抗抑郁药物+rTMS+磁珠耳穴贴压治疗)各30例,治疗疗程为4周;对比4组治疗前后的汉密尔顿抑郁量表(HAMD)评分、临床疗效和血清TRPC1、5-HT、S100β水平变化及不良反应。结果 治疗前,对照组、rTMS组、耳穴组及rTMS+耳穴组的HAMD评分,差异无统计学意义(P>0.05);治疗后,rTMS+耳穴组的HAMD评分低于对照组、rTMS组及耳穴组(P<0.05); rTMS组、耳穴组的HAMD评分低于对照组(P<0.05);治疗前,对照组、rTMS组、耳穴组及rTMS+耳穴组的血清TRPC1、5-HT、S100β水平差异无统计学意义(P>0.05);治疗后,rTMS+耳穴组患者的血清S100β水平...     

耳穴贴压疗法中风后抑郁的影响

目的：探讨耳穴贴压疗法对中风后抑郁治疗对汉密尔顿抑郁量表（HAMD）和Barthel ( BI）指数的影响。方法：选取2010年1月~2013年12月我院收治的中风后抑郁患者80例,随机分成2组,观察组40例,对照组40例;对照组接受常规治疗,观察组在常规治疗的基础上运用耳穴贴压疗法对患者干预治疗14~28天,观察比较2组患者在入院、出院后6个月的HAMD和BI指数。结果：2组患者在入院时HAMD和BI指数比较,差异没有统计学意义（P>0.05）;2组患者在出院6个月观察比较,观察组明显优于对照组,2组比较,差异有统计学意义（P<0.05）。结论：耳穴贴压疗法对中风后抑郁HAMD和BI有明显影响,治疗效果显著。     

柴胡加龙骨牡蛎汤合黛力新治疗脑卒中后抑郁的临床疗效分析

目的：探讨柴胡加龙骨牡蛎汤联合黛力新对于脑卒中后抑郁（PSD）的疗效。方法将78例PSD患者纳入研究并随机分组,对照组40例采用黛力新治疗,观察组38例采用黛力新联合柴胡加龙骨牡蛎汤治疗。观察2组治疗前及治疗2、4、8周后HAMD评分、8周后神经功能缺损（NIHSS评分）、生活能力评分（FIM量表,由美国物理医学会制订）情况;比较2组临床疗效及不良反应情况。结果患者各项评分均改善,但观察组更显著（P<0.05）;观察组总有效率97.37%,高于对照组的82.50%,差异有统计学意义（P<0.05）;未发现不良反应。结论应用柴胡加龙骨牡蛎汤联合黛力新治疗PSD疗效显著,安全可靠,优于单用黛力新治疗,值得推广。     

解郁1号方联合八段锦干预脑卒中后抑郁的临床观察

目的观察解郁1号方联合八段锦干预脑卒中后抑郁(PSD)的临床疗效及作用机制。方法研究对象为2019年1—12月在温州市中医院神经内科住院的80例PSD患者,随机分成试验组和对照组,每组40例。对照组予盐酸舍曲林治疗,试验组予解郁1号方联合八段锦治疗,治疗后观察两组临床疗效并进行比较。分别采用汉密尔顿抑郁量表(HAMD)、症状自评量表(SCL-90)对PSD患者抑郁情况及相关心理状况进行评价,两组患者治疗前、治疗4周后分别评价1次;治疗前、治疗4周后检测患者血清中5-羟色胺(5-HT)、脑源性神经营养因子(BDNF)水平。结果治疗4周后,试验组患者的HAMD、SCL-90躯体化、抑郁、其他(饮食睡眠)因子均低于对照组,差异均有统计学意义(P0.05);两组患者5-HT和BDNF水平均比治疗前明显提高,差异均有统计学意义(P0.05),且试验组治疗后5-HT和BDNF数值均高于对照组(P0.05);两组不良反应和脱落发生率比较,差异无统计学意义(P0.05)。结论解郁1号方联合八段锦治疗PSD的临床疗效显著,可能与提高患者5-HT、BDNF的表达有关。     

小脑生物电治疗卒中后抑郁50例

目的观察小脑生物电治疗卒中后抑郁（post-stroke depression,PSD）的疗效。方法将100例PSD患者采用随机双盲对照法分为治疗组和对照组,每组50例。2组患者均采用常规卒中治疗,均不使用抗抑郁药物。在此基础上,治疗组加用脑循环功能治疗仪进行小脑生物电治疗,共9周。2组患者治疗后分别于第1、3、5、7,9周进行汉密顿抑郁量表（HAMD）测评和HAMD减分率疗效评定,并记录不良反应。结果治疗组治疗后第9周HAMD评分、HAMD减分率与对照组比较差异均有统计学意义（P均〈0.01）。治疗组1例因感冒、发热而中途退出治疗。结论小脑生物电治疗PSD患者疗效肯定,无严重不良反应发生,患者情绪好转,自信心强,并积极配合医生治疗脑卒中。     

头针结合耳穴贴压疗法治疗脑卒中后抑郁症患者的临床研究

目的观察头针结合耳穴贴压疗法对脑卒中后抑郁症患者血清5-羟色胺(5-HT)含量的影响及临床疗效。方法选择符合入选标准的60例脑卒中后抑郁症患者,随机分成耳压组、头针+耳压组和对照组3组,3组患者除了脑卒中常规治疗外,耳压组接受耳穴贴压治疗,头针+耳压组接受头针结合耳穴按贴压治疗,对照组口服帕罗西汀治疗。3组患者于治疗前和治疗后2周、4周、8周进行观察,测量各组血清5-HT含量的变化,并采用汉密尔顿(HAMD)抑郁量表进行评定。结果 3组患者治疗后血清5-HT含量及HAMD评分组内比较均有明显差异,组间比较头针+耳压组治疗组明显优于其他2组。结论头针结合耳穴贴压是临床治疗脑卒中后抑郁症的一种有效方法,值得推广。     

颐脑解郁方治疗肾虚肝郁型帕金森病抑郁的临床观察研究

目的：观察颐脑解郁方治疗肾虚肝郁型帕金森病抑郁的临床疗效及其对血清5-羟色胺（5-HT）、去甲肾上腺素（NE）的影响。方法：将60例肾虚肝郁型帕金森病抑郁患者随机分为研究组和对照组,每组30例。在常规抗帕金森药物的基础上,对照组采用帕罗西汀片治疗,研究组再联用颐脑解郁方,干预8周后,评定两组治疗前后汉密顿抑郁量表（HAMD）总分、HAMD筛选因子评分、统一帕金森病评定量表（UPDRS）评分的变化,观察治疗前后血清5-HT、NE水平的变化。 结果：研究组的疗效高于对照组（P<0.05）。治疗后,两组的HAMD评分、UPDRS评分均显著下降（P<0.05）,且研究组的评分低于对照组（P<0.05）;两组HAMD筛选因子评分较前均明显下降（P<0.05）,且研究组的抑郁情绪、早醒、工作和兴趣、胃肠道症状等筛选因子评分明显低于对照组（P<0.05）。相较于治疗前,两组患者血清中5-HT、NE水平均显著上升（P<0.05）,且研究组5-HT、NE的上升更为明显（P<0.05）。结论：颐脑解郁方可改善肾虚肝郁型帕金森抑郁患者的抑郁症状,其机制可能与升高5-HT、NE水平有关。     

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.