丽参注射液对老年男性冠心病肾虚患者性激素的影响

本研究观察了３２例经丽参注射液治疗前后老年男性冠心病肾虚患者雌二醇（Ｅ２）、睾酮（Ｔ）及Ｅ２／Ｔ的变化。结果表明：肾阳虚和肾阴虚两组Ｔ均降低（Ｐ＜０．０５～０．０１）；肾阴虚组Ｅ２、Ｅ２／Ｔ升高，而肾阳虚组Ｅ２则降低（Ｐ＜０．０１）。治疗后随着肾虚症状改善两组Ｔ均回升，肾阴虚组Ｅ２、Ｅ２／Ｔ回落，肾阳虚组Ｅ２回升（Ｐ＜０．０１），均接近对照组水平。提示老年男性冠心病肾虚患者阴阳失调与性激素紊乱有关，主要表现在血清Ｔ浓度的降低和Ｅ２水平的升高或降低；人参既可调整阴阳改善肾虚症状又可逆转性激素变化，在提高Ｔ水平的同时，对Ｅ２有很好的双向调节作用，有助于人体内环境雌雄性激素的平衡     

肾虚证与血浆中分子及巯基关系初探

本文检测了90例肾虚证(肾阴虚46例,肾阳虚44例)患者的血浆中分子物质(MMS)与巯基(—SH),并与20例正常人对照。结果发现:1.肾虚证患者—SH低于正常人,P<0.01,为肾虚的内在依据之一;2.—SH低下的程度是肾阴虚<肾阳虚,P<0.01.在肾病患者中尤为突出;3.MMS的量变关系反映了肾虚状态下继发“邪实”的程度,依量变关系为肾阴虚<正常人<肾阳虚,肾阳虚组的MMS高于肾阴虚组,P<0.01。作者认为:MMS的升高可作为“邪毒”,—SH作为正气虚损的指标,有助于认识正虚与邪实,肾阴虚与肾阳虚的质量互变关系,值得进一步探讨。     

慢性特发性血小板减少性紫癜肾虚证免疫紊乱的临床研究

目的 探讨慢性特发性血小板减少性紫癜（ＩＴＰ）发病机理中肾虚与免疫紊乱的关键及才者如何参与该病发病机制。方法 根据中医辨证将３８例女性ＩＴＰ患者分为肾虚组和非虚组。肾虚组发为肾阳虚组和肾阴虚组,测定３组的血小板表面相关抗体（ＰＡＩｇＧ）的Ｔ淋巴细胞亚群。结果 肾虚组ＰＡＩｇＧ明显高于非肾虚组,而Ｔ辅助淋巴细胞与Ｔ抑制淋巴细胞（ＴＨ／Ｔｓ）比值明显低于非肾虚组。肾阴虚组ＴＨ／Ｔｓ明显低于肾阳虚组,而     

多囊卵巢综合征的中医证候与内分泌的相关性

目的探讨多囊卵巢综合征（PCOS）患者的中医证型与内分泌指标变化的相关性。方法采用前瞻性研究方法,收集广州市中医医院及广东省中医院2年的住院及门诊的多囊卵巢综合征的中医四诊信息及相关因素。建立数据库,采用数据库软件EPIdata3．2及SPSS13．0软件包对数据进行管理、处理。结果PCOS中医证候类型主要表现为肾阳虚证、肝郁证、痰浊证、肾虚血瘀证和肾阴虚证。不同中医证型的体质量指数（BMI）、腰臀比（WHR）、空腹血糖、空腹胰岛素水平不同,有统计学意义。痰浊证的WHR值较肾阳虚证、肾阴虚证、肝郁证者高,肾虚血瘀证者较肝郁证者高;痰浊证的BMI、空腹胰岛素值较肾阳虚证、肾阴虚证、肝郁证、肾虚血瘀证者高;痰浊证的空腹血糖较肾阴虚证者高,均有统计学意义。PCOS中医辨证为痰浊证和肾虚血瘀证者多表现为中心性肥胖。结论PCOS中医证型与内分泌指标呈现一定的相关性。     

强直性脊柱炎证型与HLA-B27及免疫炎症指标相关性研究

目的探讨强直性脊柱炎（AS）证型与HLA～B27及免疫炎症指标间的相关性。方法随机选取2010年3月～2012年3月于本院及协作医院中医科、骨科、内科和康复科进行治疗的的AS患者60例,其中肾虚湿热痹阻型、肾阴虚型、肾阳虚型各20例。比较三种证型患者在HLA—B27表达、血沉（ESR）、C反应蛋白（CRP）、血小板计数（PLT）、免疫球蛋白水平等的差异。结果肾虚湿热痹阻型、肾阴虚型、肾阳虚型的强直性脊柱炎的HLA—B27的阳性率分别为95％、55％、35％,肾虚湿热痹阻型强直性脊柱炎患者的ESR、CRP、PLT水平与肾阴虚型和。肾阳虚型比较,均明显高于后二者的水平（P〈0．05）,但三种证型间免疫球蛋白水平差异无统计学意义（P〉0．05）。结论强直性脊柱炎证型与HLA—B27、ESR、CRP、PLT间具有一定的相关性。     

男性原发性骨质疏松肾虚三证与血液流变学变化关系的临床研究

目的 探讨男性原发性骨质疏松（primary osteoporosis:POP)肾虚三证与血液流变学变化的关系为临床辨证施治提供客观诊断依据。方法 选择96例有肾虚见证的老年男性为研究对象,其中肾气虚36例,肾阴虚32例,肾阳虚28例,另选正常对对照组30例,同步检测全血粘度ηb、（高切）、血浆粘度ηp、血沉SR、红细胞压积HCT,并进行统计学分析。结果 与对照组相比,肾虚三型全血粘度,血浆粘度显著增高（P＜0．01）,肾阳虚证的血沉值、红细胞压积显著上升（P＜0．05）,其余两型升高无显著性,肾气虚、肾阳虚、肾阴虚三个证型的ηb,ηp,SR,HCT水平组间差异不显著（P＞0．05）。结论 （1）男性POP肾虚三证患者ηb,ηp的含量较对照组显著升高。（2）男性POP患者血液粘、凝状态变化与肾虚三证关系密切,其变化依肾阴虚、肾气虚、肾阳虚逐渐明显。（3）本研究揭示血液流变学水平变化可作为判断男性POP肾虚三型的客观指标,活血化瘀应作为治疗POP的基本方法。     

肾虚型月经失调患者宫颈粘液变化40例临床分析

目的：为探讨肾虚型月经失调患者宫颈粘液在月经周期中性质及量的变化。方法：观察并记录40例肾虚型月经失调患者的宫颈粘液量，拉丝度及结晶情况变化，结果：发现肾阴虚，肾阳虚在宫颈粘液的变化上有不同表现：肾阴虚组排卵期粘液量明显少于肾阳虚组和正常组；肾阳虚组在排卵前粘液的拉丝度显著高于肾阴虚和正常组，而肾阴虚组在排卵期及其前后拉丝度均较低；肾阳虚组在估计排卵前粘液结晶不如肾阴虚组和正常组典型，而在估计排卵后则较两组明显典型，结论：认为该病病机实质及辨证分型有一定关系。     

氢化可的松致肾虚证小鼠模型的建立及相关指标的评价

目的 建立氢化可的松致肾阳虚、肾阴虚小鼠模型,并探讨其相关评价指标。方法 采用氢化可的松灌胃建立肾阳虚及肾阴虚小鼠模型;观察肾阳虚、肾阴虚模型小鼠生存状态,测定各组模型小鼠体重变化;采用放射免疫法检测HPA轴中促肾上腺皮质激素（ACTH）、皮质醇（Cor.）、HPT轴中甲状腺激素（TSH）、三碘甲腺原氨酸（T3）、甲状腺素（T4）、HPG轴中促卵泡素（FSH）、雌二醇（E2）、睾酮（T）含量。结果 肾阳虚、肾阴虚模型小鼠体重均下降,肾阳虚模型小鼠血清ACTH、Cor.、TSH、T3、T4水平降低,血清FSH、E2、T水平升高,且差异均有显著性（P<0.01）;而肾阴虚模型则反之。结论 肾虚小鼠内分泌系统中ACTH、Cor.、TSH、T3、T4、FSH、E2、T各激素水平均发生了改变,其中Cor.可作为评价糖皮质激素法建立肾虚模型的重要指标。     

噪声对高频听力损伤的影响

目的：探讨稳态、脉冲噪声及接噪工龄对作业工人高频（１０～２０ｋＨｚ）听力的影响。方法：应用频率范围（０．５～２０ｋＨｚ）的纯音听力计对３７４ 名１８～２５ 岁噪声作业工人的高频听力进行检测,以同年龄５０ 名健康人作为对照组。结果：脉冲组的高频阈值明显高于稳态组（Ｐ＜ ０．００１）,两组高频听阈的出现率较正常组明显下降。接噪工龄５ 年之内,各工龄组间的高频阈值没有明显的变化,与正常组比较差异显著（Ｐ＜ ０．００１）。结论：噪声性质对高频听力有影响,脉冲噪声比稳态噪声对内耳高频听力危害更大,噪声工龄对高频听力的影响主要发生在接触噪声第一年。同时对噪声引起高频听力下降的机理进行初步探讨。     

六味地黄丸汤对肾阴虚型癌症患者某些检验指标的影响(附46例病例分析)

本文通过对肾阴虚、肾阳虚及非肾虚三组常见临床指标的观察,提示肾阴虚的肿瘤患者肾脏功能优于肾阳虚组,而肝功不及肾阳虚组。一些化验指标显示六味地黄丸对肾阴虚组的作用大于肾阳虚组及非肾虚组。     

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.