理气健脾法治疗气秘经验

<正>便秘是指排便周期延长；或周期不长，但粪质干结，排便困难；或粪质不硬，虽有便意，但便出不畅的病证^[1]。功能性便秘属于功能性肠病的一种，主要表现为排便困难、排便次数减少或排便不尽感，且不符合便秘型肠易激综合征(IBS-C)的诊断标准^[2]。西医学中的功能性便秘可参照中医学的便秘一病辨证论治^[1]。气秘是便秘的一种常见证型，是指因气机郁滞或元气不足所致便秘。     

老年人急性肠梗阻193例分析

老年人急性肠梗阻虽也有“痛、吐、胀、秘”等临床表现，但因老年人对疼痛反应差，腹肌薄弱或皮下脂肪积聚，又易与老年人消化不良，便秘相混淆等因素，常不仅就诊较迟；而且影响早期诊断和处理。详细询间病史，认真查体可减少误诊率。腹部X射线检查有肯定价值，应常规使用。老年人急性肠梗阻就诊时病变多已进入中晚期，在治疗上多较困难，已并存病多，是影响疗效及死亡率的重要因素。     

便秘外科治疗的研究进展

慢性便秘是最常见的胃肠道疾病症候群,发病率高,对人类身体健康和生活质量产生严重的影响。目前,临床上分为结肠慢传输型便秘(STC)、出口梗阻型便秘(OOC)和混合型便秘。罗马Ⅲ便秘诊治标准将出口梗阻型便秘命名为排粪困难型便秘。据美国的一项调查结果显示,普通人群中便秘发生     

止秘胶囊治疗便秘的实验研究

目的：通过研究止秘胶囊对便秘小鼠小肠运动的影响,探讨止秘胶囊治疗便秘的作用机制。方法：观察止秘胶囊不同剂量组对正常小鼠、复方地芬诺酯便秘模型小鼠小肠运动的影响;观测止秘胶囊对便秘小鼠小肠碳墨推进运动、首粒排便时间、粪便粒数及粪便重量的影响。结果：止秘胶囊可使便秘模型小鼠小肠碳墨推进率明显加快、碳墨排出时间均明显缩短。结论：止秘胶囊对便秘小鼠有明显的促排便作用。     

便秘的中医辩证治疗

便秘系因气阴不足,阳虚寒凝,或燥热内结,痰湿阻滞,使大肠传导功能失常所致的,以排便间隔时间延长,大便干结难解,或虽有便意而排出困难为主要临床表现的病证.便秘,又名脾约、大便秘、阳结、阴结、不更衣、不大便、大便难、肠结、后不利、便闷、虚秘、热秘、冷秘、气秘、湿秘、秘结、燥结、大便闭结等名.常见于"老人、虚人、阴脏人及产后、病后、多汗后,或小水过多"(<景岳全书·秘结>).     

便秘的中西医治疗

1便秘的概念及病因1.1中医便秘的含义及病因病机便秘是大肠秘结不通、排便时间延长或欲大便而艰涩不畅的一种病证,可发生于急慢性疾病中。在伤寒论中,有“阳结”、“阴结”及“脾约”之称,后人又有“风秘”、“气秘”、“热秘”、“寒秘”、“湿秘”及“热燥”、“风燥”、“胃     

急性心肌梗死患者便秘原因分析及护理

急性心肌梗死（AMI）是目前危害人类健康的主要疾病之一。然而在AMI患者的护理中，对便秘的早期预防及护理是降低本病摔死率的重要环节。下面就其可能发生便秘的？司及护理作一简述，以提高AMI患者的抢救护理效果。1便秘原因分析1．l精神神经因素：AMI患者，由于剧烈疼痛，过度紧张，但值物神经功能紊乱，抑制规律性的排便活动，而产生便秘。1．2排匣习惯方式的改变：多数患者开始不习惯于床上排便；或要依赖他人，思想上顾虑重重；或因环境改变，缺少隐蔽性，以致强迫或党制不排便，久而久之，大便于结形成便秘。1二〕长时间的卧床：…     

王微教授辛润通络法治疗便秘

王微教授认为,便秘病程较长,大便留于肠道,影响肠道脉络的通畅和血液的运行,提出"久秘入络""久秘必瘀的"的理论。并从络病理论出发,总结出"辛润通络法"治疗便秘,认为便秘主要病因为血瘀于肠道、肠道津液不足,运用辛润(木香、香附、藿香、火麻仁、郁李仁、当归、桃仁等)的药物治疗便秘,能起到行气布津、入血入络、润肠通便的作用。     

产后便秘的护理

便秘是产妇产后的常见症状，主要表现为：大便秘结，排便次数减少，排便时间延长，虽有便意却排便困难，常伴有头痛、腹胀、食欲不振等，常给产妇带来很大的痛苦。若产后大便秘结，难以排出，可影响子宫收缩，导致阴道流血量增多；过度用腹压可引起子宫脱垂；压迫膀胱，可伴发尿潴溜，从而影响产后康复，因此对产后便秘的护理十分重要。     

中医药治疗治疗长期卧床病人功能性便秘的疗效观察

功能性便秘是指缺乏器质性病因，没有结构异常或代谢障碍，又除外肠易激综合征的慢性便秘。功能性便秘患者可以有粪便坚硬、排便困难、便不尽感和便次减少等表现[1]。长期卧床病人由于胃肠道功能下降如肠管分泌消化液减少、肠管张力蠕动减弱以及参与排便肌肉张力低下等原因造成习惯性便秘，如不及时处理，可导致各脏器储备能力下降，免疫力降低，容易发生并发症和后遗症。我科自2011年1月到2012年10月，对长期卧床病人的便秘采用中医治疗方法，取得满意疗效。     

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.