中药敷脐联合健脾活血利水方治疗肝硬化腹水临床观察

目的:探讨中药敷脐联合健脾活血利水方治疗肝硬化腹水的临床疗效。方法:选取我院收治肝硬化腹水患者的80例,随机分为对照组和治疗组,各40例,对照组给予常规西医治疗,治疗组在对照组的基础上应用中药敷脐联合健脾活血利水方治疗,两组患者进行为期1个月的治疗。比较两组患者临床疗效、中医症状积分改变情况,治疗前后患者腹围、体质量、平均24 h尿量及肝功能改善情况。结果:治疗组患者中医症状积分降低较对照组更为明显(P0.05);两组患者治疗后腹围、体质量均明显降低,平均24 h尿量增多,且治疗组变化程度更为明显(P0.05);治疗组肝功能相关指标谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBIL)较对照组改善更为显著,差异具有统计学意义(P0.05);治疗组临床总有效率为92.50%高于对照组的75.00%,差异具有统计学意义(P0.05)。结论:中药敷脐联合健脾活血利水方具有活血行气、健脾利水之效,可以显著改善肝硬化腹水患者临床症状和体征,增加尿量,减少患者腹围和体质量,改善患者肝功能,对于肝硬化腹水有较好的的治疗效果,值得临床推广应用。     

中西医结合治疗肝硬化腹水临床研究

目的:观察利水疏肝化瘀方治疗肝硬化腹水疗效.方法:将56例肝硬化腹水病人随机分为两组,均予西药治疗,治疗组加用丹参注射液及利水疏肝化瘀方治疗.结果:治疗组有效率高于对照组.结论:利水疏肝化瘀方对腹水消退及改善肝功能有利.     

西药联合健脾利水方治疗肝硬化腹水40例疗效及安全性分析

目的 观察西药联合健脾利水方治疗肝硬化腹水的临床效果.方法 80例肝硬化腹水患者随机分为A组和B组,A组采用西药对症支持治疗,B组在A组的基础上加用中药健脾利水方治疗.比较2组治疗效果,治疗前后肝功能改善情况.结果 B组总有效率显著高于A组(P＜0.05),B组治疗后白蛋白(ALB)、天冬氨酸转氨酶(AST)、总胆红素(TBiL)、丙氨酸转氨酶(ALT)显著优于A组(P《0.05),2组不良反应差异无统计学意义(P＞0.05).结论 采用西药联合健脾利水方治疗肝硬化腹水,临床效果显著优于单用西药,可促进患者肝功能恢复,值得临床推广应用.     

健脾化瘀利水方治疗乙肝后肝硬化腹水60例临床观察

目的探讨健脾化瘀利水方治疗乙肝后肝硬化腹水的临床疗效。方法选我院2014～2017年收治的120例乙肝后肝硬化腹水患者为研究对象,120例患者随机分为对照组(n=60)和观察组(n=60)。对照组采用西药常规抗病毒保肝利尿对症治疗,观察组在对照组的基础上加用健脾化瘀利水方,4周为1个疗程。对两组疗效进行统计分析。结果对照组总有效率为75.0%,观察组为90.0%,较治疗前两组患者的肝生化都有得到有效的改善(P0.05);治疗后观察组肝生化改善程度及腹水减少幅度都优于对照组(P0.05)。结论在西药常规治疗基础上给予健脾化瘀利水方治疗肝硬化腹水可有效改善肝生化指标并促进腹水消退,值得推广。     

健脾活血利水方结合托拉塞米治疗乙肝后肝硬化腹水的临床观察

通过观察健脾活血利水方结合托拉塞米对乙肝后肝硬化腹水的治疗作用,结果表明健脾活血利水方联合托拉塞米能显著改善乙肝后肝硬化腹水患者的临床表现,改善肝纤维化程度及肝功能等.     

自拟鼓胀方治疗乙型肝炎肝硬化腹水

目的:观察和分析自拟鼓胀方治疗乙型肝炎肝硬化腹水的临床疗效。方法:选取我院乙型肝炎肝硬化腹水患者共40例,并随机分为对照组和观察组,每组各20例,对照组采用常规的西药治疗,观察组采用中医自拟鼓胀方治疗,对比两组的治疗效果。结果:观察组的总显效率明显优于对照组的总显效率,对比数据间有明显差异具有统计学意义(P0.05)。结论:在治疗乙型肝炎肝硬化腹水上采用自拟鼓胀方治疗,能有效改善肝功能、有效消退肝腹水,并且能预防肝纤维化,该种治疗方式值得在临床中推广和应用。     

健脾活血利水冲剂治疗肝硬化腹水60例临床观察

目的观察健脾活血利水；中剂治疗肝硬化腹水的临床疗效。方法将120例肝硬化腹水患者随机分为两组，实验组60例，对照组60例。两组患者都应用西药治疗，实验组同时加用健脾活血利水冲剂，10d为1疗程，连续治疗3个疗程。结果实验组总有效率为91．67％，对照组总有效率为76．67％，两组比较差异非常显著（P〈0．01）。结论健脾活血利水冲剂治疗肝硬化腹水有显著疗效。     

自拟中药煮散剂治疗肝硬化腹水的临床观察

目的自拟中药煮散剂治疗乙型病毒性肝炎后肝硬化且以腹水为首发症状的患者,观察其临床疗效。方法将遂川县中医院40例乙型病毒性肝炎后肝硬化以腹水为首发症状的患者随机分为治疗组、对照组各20例,对照组使用拉米夫定片(贺普丁片,0.1 g/d),口服抗病毒治疗,及常规西药治疗,治疗组在对照组基础上加用中药自拟方加减,以煮散形式口服,观察两组患者治疗3个月前后的肝功能、肝纤维化、肝脾B超及腹水消退时间各项指标。结果治疗3个月后,治疗组肝功能TBIL、ALB;肝纤维化PCⅢ、LN指标;门静脉脾静脉恢复情况及腹水消退时间明显优于对照组。自拟中药煮散剂联合拉米夫定片治疗乙型病毒性肝炎后肝硬化腹水的临床疗效显著。结论自拟中药煮散剂适用于临床治疗乙型病毒性肝炎后肝硬化腹水,值得推广。     

健肝消胀丸联合西药治疗乙肝肝硬化腹水的临床观察

目的：观察研究健肝消胀丸联合西药治疗乙肝肝硬化腹水患者的临床疗效。方法收集本院2013年6月～2014年10月期间治疗的符合纳入标准的78例乙肝肝硬化腹水患者的临床资料,将患者按随机分组的方法分为健肝消胀丸组和对照组,健肝消胀丸组给予健肝消胀丸联合西药治疗,对照组给予单纯西药治疗,治疗3个月后观察疗效。结果健肝消胀丸组与对照组比较,在肝功能改善方面效果更好,差异有统计学意义（P＜0.05）;在凝血功能改善方面差异无统计学意义（P＞0.05）;在改善主要临床症状方面优于对照组,差异有统计学意义（P＜0.05）。结论健肝消胀丸联合西药治疗乙肝肝硬化腹水在肝功能改善及主要临床症状改善较单独西药治疗的疗效更显著,安全性可靠,值得在临床中推广使用。     

消胀利水合剂治疗肝硬化腹水328例临床观察

目的 观察消胀利水合剂治疗肝硬化腹水的临床效果。方法 应用消胀利水合剂治疗肝硬化腹水328例,并与西药利尿剂治疗肝硬化腹水110例进行比较。结果 中药治疗组腹胀、纳差、乏力、胁痛、腹水等临床症状明显改善,与对照组比较,差异有显著性(P<0.05)。中药治疗组对肝功能复常及肝纤维化指标明显下降,治疗前后比较,P<0.05,治疗组与西药对照组比较,P<0.05。结论 消胀利水合剂为治疗肝硬化腹水的有效药物。     

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.