从瘀论治顽固性失眠

血瘀既是长期失眠的结果,又是造成失眠顽固不愈的重要原因。瘀血阻滞心、脑、肝之脉络,气血运行失畅,卫气出入异常,阴阳失调,故失眠反复不愈。从瘀论治失眠的经典配方为血府逐瘀汤。久坐、少动是目前普遍的生活方式,常造成气滞血瘀等病理因素的形成,失眠的证型中兼有血瘀证的患者越来越多。因此,临床用药上,加用活血化瘀药治疗失眠可取得较好的疗效。     

失眠从瘀论治

失眠属于慢性疾病,久病及瘀,所以失眠患者都存在瘀血的病理特征;反过来瘀血又是致病因素,相互影响造成失眠的迁延不愈,形成恶性循环.当箭西医研究认为失眠同脑循环障碍、脑神经元异常兴奋有重要的关系.     

失眠从瘀论治

失眠属于慢性疾病,久病及瘀,所以失眠患者都存在瘀血的病理特征;反过来瘀血又是致病因素,相互影响造成失眠的迁延不愈,形成恶性循环。当前西医研究认为失眠同脑循环障碍、脑神经元异常兴奋有重要的关系。既往中医治疗失眠主要从心、肝、脾、肾入手,采用养血、滋阴、化湿、安神等治疗方法。自从王清任创立血府逐瘀汤治疗失眠以来,瘀血作为失眠中的致病因素受到临床广泛的重视,本文就临床上从瘀血方面治疗失眠作以综述。     

失眠伴记忆障碍患者的中医辨证要素特征分析

目的探讨综合医院神经内科门诊失眠伴记忆障碍患者的中医辨证要素特征及其记忆障碍特征。方法将患者分为失眠伴记忆障碍组50例、失眠不伴记忆障碍组50例,比较2组中医辨证要素差异。结果2组在临床记忆测查中的指向记忆、联想学习、图像自由回忆、无意义图形再认、人像特点回忆上差异极显著（P〈0.01）;失眠伴记忆障碍组血瘀证的出现率高于失眠不伴记忆障碍组（P〈0.05）。结论失眠患者的记忆损害涉及指向、联想、图像、再认等各个方面;失眠患者伴记忆障碍与血瘀相关。     

失眠与瘀血的关系

目的探讨失眠与血瘀证的关系,找出中医辨证论治失眠的规律,为临床治疗提供一定的依据。方法回故性分析161例门诊失眠患者,治疗血瘀证在失眠各证型中的分布,和活血化瘀法对治疗本病的影响,并对其进行统计分析。结果有血瘀兼证者在失眠患者中占了很高的比例,失眠治疗中加用活血化瘀法后有较好的疗效。结论失眠患者多兼有血瘀证,治疗失眠时加入活血化瘀药对治疗是有益的。     

论血瘀与失眠

血瘀是导致顽固性失眠的重要原因,血瘀脉中,阻滞营卫阴阳交通之道,则夜寐不安。形成瘀血的常见原因包括：气虚无力推动血液运行而血瘀;阳虚寒凝,血脉失于温煦而血瘀;水行不利,水血互化,水液内停而血瘀。治疗此类失眠,当以益气活血、温阳活血、利水活血等法为根本,使瘀去脉通,营卫畅行,心神收纳,则寤寐得安。     

慢性盆腔炎血瘀证的血液流变学研究

慢性盆腔炎是妇科常见病、多发病,其发病机制为“寒 湿热瘀蓄积胞中,气血运行不畅所致”。慢性炎症由于久治 不愈,反复发作,给病人造成很大痛苦。血液流变学检测近 年来广泛应用于血瘀证的诊断和研究,目前认为血液流变 性、血液黏度的异常是形成血瘀证的病理基础之一。本课题 应用血液流变学理论,通过血液流变学检测,来研究慢性盆 腔炎血瘀证在血液流变学方面的改变,为慢性盆腔炎发病机 制的认识及治疗提供依据。     

血府逐瘀汤加减治疗乳腺增生症25例

血府逐瘀汤为清·王清任<医林改错>中著名的活血化瘀方.该方配伍精当,力专效著,独具一格.其适应证亦极为广泛,向来深受历代临床医家喜用.此方用于治疗胸中血瘀内阻,血行不畅所致的胸痛,头痛日久不愈,痛如针刺而有定处或失眠多梦,心烦心慌,呃逆干呕以及傍晚发热等症.余据其方意,十余年来用本方加减先后治疗乳腺增生症数十例,疗效颇为满意.     

加味温胆汤治愈顽固性失眠

失眠是内科一种常见病,顽固性失眠由于休息不好不但 影响工作,而且影响身体健康,还给患者的心理造成沉重的 压力,笔者在十几年的临床中,应用加味温胆汤治疗顽固性 失眠病人多例,收到明显效果,现整理如下。 典型病例:女,50岁,农民。患者失眠数年,于1年前 下地收青突感心慌心跳,心电图诊为心动过速,此后每遇到 劳累而复发,时发时愈精神负担较重,近3个月来,彻夜不     

顽固性失眠从瘀论治

失眠是临床常见病症,中医称之谓"不寐"、"不得卧"及"目不瞑".失眠多由精神因素引起.大多数失眠患者经过中西方法治疗后能够治愈或缓解,但临床也经常会遇到经久不愈的顽固性失眠.这些失眠患者临床上具有血脉瘀阻表现,我们运用清代王清任<医林改错>中的血府逐瘀汤从瘀论治,每多奏效.现报告如下.     

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.