中药口服配合穴位贴敷治疗药物性便秘60例疗效观察

目的 观察中药口服配合穴位贴敷治疗阿片类药物所致便秘的临床疗效.方法 将120例符合纳入标准的患者随机分为治疗组和对照组各60例,治疗组予中药口服配合穴位贴敷治疗,对照组予口服麻仁软胶囊治疗,2组均以2周为1个疗程.结果 治疗组总有效率90%,对照组总有效率66.7%,差异具有统计学意义(P<0.05).结论 中药口服配合穴位贴敷治疗药物性便秘有较好的疗效.     

穴位埋线联合穴位贴敷治疗咳嗽变异性哮喘的随机对照研究

目的:探讨穴位埋线联合穴位贴敷治疗咳嗽变异性哮喘患者的临床效果和安全性分析。方法:采用前瞻性分析法,选取咳嗽变异性哮喘患者120例。采用简单数字的随机方法随机分为治疗组和对照组,每组60例。治疗组给予常规治疗加穴位埋线联合穴位贴敷;对照组给予常规治疗加孟鲁司特咀嚼片口服。观察两组患者治疗前后细胞因子水平、症状积分变化及临床疗效,比较治疗后2组患者不良反应的发生率。结果:治疗后治疗组在细胞因子子(Hs-CRP、IL-8、TNF-α)水平、症候积分(咳嗽、咯痰、胸膈满闷)方面比较有显著性差异(P0.05);治疗组临床疗效总有效率为93.33%,对照组临床疗效总有效率为83.33%,2者比较差异有统计学意义(P0.05)。治疗组不良反应的发生率低于对照组(P0.05)。结论:穴位埋线联合穴位贴敷能够有效地缓解咳嗽变异性哮喘患者患者临床症状,安全性高,值得进一步推广及应用。     

天枢穴按压联合便秘膏神阙穴贴敷对老年慢性心力衰竭患者功能性便秘的疗效研究

目的观察排便时按压天枢穴联合便秘膏神阙穴贴敷对老年慢性心力衰竭患者功能性便秘的疗效。方法选择2019年5月至2019年12月在我院接受治疗的老年慢性心力衰竭合并功能性便秘患64例,按照随机数字表法分为观察组和对照组各32例。对照组予以便秘膏神阙穴贴敷,观察组在对照组基础上加用排便时按压天枢穴。观察两组治疗后临床疗效,治疗前后症状积分、便秘积分、焦虑评分。结果治疗2周后,观察组临床总有效率93.75%,高于对照组的75.00%(P0.05)。干预前,两组症状积分、便秘积分、焦虑评分等比较,差异均无统计学意义(P0.05)。干预后,两组症状积分、便秘积分、焦虑评分均降低,观察组均低于对照组(P0.05)。结论排便时按压天枢穴联合便秘膏神阙穴贴敷可改善老年慢性心力衰竭合并功能性便秘患者排便状况.改善不良情绪,值得推广。     

中药穴位贴敷疗法治疗慢性功能性便秘的应用价值

目的探讨对慢性功能性便秘患者实施中药穴位贴敷疗法的应用价值。方法选择于我院消化科诊治的慢性功能性便秘患者42例,按照治疗方法将其分为治疗组和对照组。其中治疗组21例,实施中药穴位贴敷疗法,对照组21例,实施常规药物治疗,分析两组临床疗效及症状积分。结果治疗组治疗有效率显著高于对照组,且主要症状积分与次要症状积分更低,数据差异具有显著性(P0.05)。结论对慢性功能性便秘患者实施中药穴位贴敷疗法可以有效改善其便秘症状,毒副作用小,在临床上是具有借鉴与推广价值的治疗方法。     

排便贴联合艾灸对慢传输型便秘的效果观察

目的研究运用排便贴联合艾灸对慢传输型便秘的临床观察。方法随机选取在本院2017年4月至2017年12月,本院接治的67例符合慢传输型便秘患者为对象,进行随机分为临床试验组34例及对照组33例,对照组采用单一排便贴贴敷神阙穴,观察组在原有排便贴增加艾灸的护理。临床观察疗效。结果治疗组在增加排便频率、改善粪便性状、减少腹胀和使用泄剂、降低每次排便时间上优于对照组,自身总积分比较有统计学差异(P0.05);观察组总有效率92%,对照组70%,两组总积分比较有统计学差异(P0.05)。结论提示排便贴联合艾灸治疗对慢传输型便秘治疗效果满意。     

中药穴位贴敷治疗美施康定所致便秘的临床观察及护理体会

目的:探讨中药穴位贴敷对服用阿片类药物(美施康定)所致便秘的疗效.方法:60例美施康定所致便秘患者,随机分入治疗组(中药穴位贴敷)30例、对照组(麻仁润肠丸)30例,观察两组疗效、便秘评分、副反应.结果:中药穴位贴敷治疗美施康定所致便秘总有效率为75%,优于麻仁润肠丸(总有效率53.3%),P<0.05.结论:中药穴位贴敷对服美施康定致便秘患者具有明显的缓泻通便作用,不良反应轻微,简便易行.     

复方大黄粉穴位贴敷改善湿热内阻型肝硬化患者便秘临床观察

目的观察复方大黄粉穴位贴敷对湿热内阻型肝硬化患者便秘的临床疗效。方法选取180例湿热内阻型肝硬化便秘患者,随机分成实验组90例和对照组90例。实验组给予复方大黄粉神阙穴穴位贴敷;对照组给予安慰剂神阙穴穴位贴敷。5 d为1个疗程,疗程结束后分别观察两组患者的粪便性状、便秘症状积分及口服乳果糖的剂量。结果实验组总有效率,粪便性状评分、便秘症状积分均优于对照组,两组差异具有统计学意义(P0.05)。结论复方大黄粉穴位贴敷对湿热内阻型肝硬化患者便秘临床效果确切、显著,且安全可靠,推荐临床推广。     

穴位贴敷联合加味葛根芩连汤治疗腹泻型肠易激综合征脾胃湿热证临床疗效观察

目的 观察穴位贴敷联合加味葛根芩连汤治疗腹泻型肠易激综合征（diarrhea type irritable bowel syndrome,IBS-D）脾胃湿热证的临床疗效。方法 将60例IBS-D脾胃湿热证患者随机分为对照组和治疗组,每组30例。对照组予以加味葛根芩连汤治疗,治疗组采用穴位贴敷联合加味葛根芩连汤治疗,疗程均为2周。观察两组临床疗效及生活质量改善情况。结果 治疗组临床疗效优于对照组（P＜0.05）;与治疗前比较,两组治疗后腹泻、腹痛、口渴、小便短黄、肛门灼热积分和总积分均显著降低（P＜0.05）,治疗组腹泻积分和总积分降低程度显著大于对照组（P＜0.05）。两组生活质量评分（SF-12）总分均明显提高（P＜0.05）,但治疗组较对照组提高更为显著（P＜0.05）。结论 加味葛根芩连汤能改善IBS-D脾胃湿热证患者的临床症状,提高其生活质量,联合穴位贴敷治疗疗效更佳。     

耳穴压豆联合穴位贴敷治疗中风患者便秘的临床研究

目的探讨耳穴压豆联合穴位贴敷治疗中风患者便秘的疗效。方法取住院中风患者80例,随机分成研究组40例和对照组40例。研究组采取耳穴压豆配合穴位贴敷治疗及常规护理方法,对照组采取常规护理治疗,比较两种方法治疗护理两组患者便秘的疗效。结果显示研究组便秘发生率明显少于对照组,疗效显著,差异有统计学意义(P0.05)。结论耳穴压豆配合穴位贴敷能够显著降低中风患者便秘发生率,同时降低此病的复发率,疗效显著。     

天麻钩藤饮联合穴位贴敷治疗1级高血压及对生活质量影响

目的 :探讨天麻钩藤饮联合穴位贴敷治疗1级高血压及其对生活质量的影响。方法 :选取2016年11月—2018年4月我院收治的1级高血压患者240例,采用随机数字表法分为对照组和治疗组,各120例。其中对照组予以宣传教育、限盐饮食及运动处方进行治疗;治疗组在对照组的基础上予以天麻钩藤饮联合穴位贴敷的治疗方案,两组患者均治疗2周。比较两组患者临床疗效、治疗前后不同时段血压改善情况、中医证候积分及生活质量。结果 :治疗组患者临床总有效率为96.67%,对照组患者临床总有效率为68.33%,差异具有统计学意义(P0.05);与对照组相比,治疗组患者治疗后1周、2周的收缩压及舒张压改善更显著(P0.05);经治疗,与对照组相比,治疗组患者中医证候积分改善更显著(P0.05);治疗后,治疗组患者生活质量较对照组患者改善明显,差异具有统计学意义(P0.05)。结论 :天麻钩藤饮联合穴位贴敷治疗1级高血压取得较好的临床疗效,起到平肝熄风、清热活血、补益肝肾之功效,同时还可提高患者生活质量,促进恢复速度,值得临床推广应用。     

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.