八段锦对糖尿病前期患者影响的系统评价与Meta分析

[目的]系统评价八段锦功法运动对糖尿病前期患者（PDM）的影响。[方法]计算机检索PubMed、Embase、Cochrane Library、CBM、中国知网、万方和VIP数据库,收集八段锦运动对PDM患者影响的随机对照试验（RCTs）,检索时限均为建库至2022年9月。由2名研究者独立筛选文献,提取资料并评价纳入研究的偏倚风险后,采用Revman5.4.1软件进行Meta分析。[结果]共纳入11项RCT研究,包括665例患者。Meta分析结果显示：1）糖代谢方面,与对照组相比,八段锦功法运动可降低空腹血糖[MD=-0.46,95%CI(-0.60,-0.31),P<0.01]、糖化血红蛋白[MD=-0.46,95%CI(-0.82,-0.10),P=0.01]、空腹胰岛素[MD=-1.32,95%CI(-2.06,-0.57),P=0.000 5]和胰岛素抵抗指数[MD=-0.60,95%CI(-0.87,-0.33),P<0.01]。2）形体改善方面,与对照组相比,八段锦功法运动可降低身体质量指数[MD=-1.04,95%CI(-1.28,-0.80),P<0....     

中药联合西医常规治疗帕金森病伴轻度认知功能障碍的临床有效性及安全性的Meta分析

【目的】系统评价中药联合西医常规治疗帕金森病伴轻度认知功能障碍（PD-MCI）的临床有效性及安全性。【方法】通过计算机检索国内外相关数据库中关于中药联合西医常规（治疗组）对比西医常规（对照组）治疗PD-MCI的临床随机对照试验（RCTs）,根据纳入及排除标准进行文献筛选。采用Cochrane系统评价手册的偏倚风险评价工具对所纳入的文献进行质量评价,采用Review Manager 5.3软件对所提取的数据进行Meta分析。【结果】共纳入10项RCTs。Meta分析结果显示：与西医常规治疗比较,中药联合西医常规治疗帕金森病伴轻度认知功能障碍能显著提高患者的临床有效率（RR=1.33,95%CI[1.10,1.60]）,降低帕金森病统一评分量表（UPDRS）总分（MD=-7.12,95%CI[-10.23,-4.00]）、UPDRS-Ⅱ量表评分（MD=-2.54,95%CI[-3.75,-1.33]）、UPDRS-Ⅲ量表评分（MD=-2.77,95%CI[-4.63,-0.91]）,提高蒙特利尔认知评估量表（MoCA）评分（MD=3.14,95%CI[2.25,4.02]）、简易智力精神状...     

参芪降糖颗粒联合二甲双胍治疗2型糖尿病有效性及安全性的Meta分析

目的系统评价参芪降糖颗粒联合二甲双胍治疗2型糖尿病的临床疗效和安全性。方法计算机检索CNKI、VIP、万方数据库、Pubmed、Cochrane Library等数据库,检索年限截止至2020年5月。按照纳入及排除标准提取数据,应用Revman 5.3软件对纳入文献进行质量评价与Meta分析。结果最终纳入10篇RCT,共计956例患者。Meta分析结果显示:参芪降糖颗粒联合二甲双胍治疗2型糖尿病的总体疗效优于单用二甲双胍[RR=1.29,95%CI(1.19,1.39),P 0.000 01],试验组空腹血糖(FPG)[MD=-1.61,95%CI(-2.18,-1.05),P 0.000 01]、餐后2 h血糖(2 h-PBG)[MD=-2.46,95%CI (-3.07,-1.85),P 0.000 01]、糖化血红蛋白(Hb A1c)[MD=-2.00,95%CI(-2.93,-1.08),P 0.000 01]、胰岛素抵抗指数(HOMA-IN)[MD=-1.04,95%CI(-1.27,-0.81),P 0.000 01],空腹胰岛素指数(FINS)[SMD=-0.75,95%CI(-0.96,-0.55),P 0.000 01]低于对照组。结论参芪降糖颗粒联合二甲双胍片治疗2型糖尿病具有较好的疗效及安全性。但由于纳入文献的质量不高,其疗效和安全性仍需通过高质量研究进一步验证。     

靳三针治疗中风后痉挛性偏瘫的系统评价与Meta分析

【目的】系统评价靳三针治疗中风后痉挛性偏瘫的临床疗效，为临床治疗中风后痉挛性偏瘫提供循证医学依据。【方法】计算机检索中国知网期刊全文数据库（CNKI）、万方学术期刊全文数据库（Wanfang）、维普中文科技期刊数据库（VIP）、中国生物医学文献数据库（CBM）、美国生物医学信息检索系统（PubMed）、荷兰医学文摘（Embase）、国际循证医学图书馆（Cochrane Library）等各大数据库中所有关于靳三针治疗中风后痉挛性偏瘫的随机对照临床试验（RCTs）文献。检索语言为中文和英文；检索时间为各数据库自建库以来至2022年5月。由2名研究员独立筛选文献、提取资料并采用Cochrane偏倚风险评估工具评价纳入研究的偏倚风险后，采用RevMan 5.4.1进行Meta分析。【结果】最终共纳入12篇文献，共1 200例患者。Meta分析结果显示，与康复组相比，靳三针组改善临床神经功能缺损程度（NDS）评分[MD=-1.55,95%CI(-2.09,-1.00),P<0.000 01]、四肢简化Fugl-Meyer评分（FMA）[MD=4.02,95%CI(2.71,5.32),P...     

单独针灸疗法治疗卵巢早衰的系统评价与Meta分析

【目的】系统评价单独针灸疗法治疗卵巢早衰的临床疗效。【方法】计算机检索中国知网期刊全文数据库(CNKI)、维普数据库(VIP)、万方数据库、中国生物医学数据库(CBM)及PubMed、Cochrane Library、Embase数据库,筛选针灸治疗卵巢早衰的随机对照试验(RCTs)文献。采用Cochrane偏倚风险评估工具对纳入研究进行质量评价,采用RevMan 5.3统计软件进行Meta分析。【结果】共纳入16篇符合标准的文献,涉及1 102例患者。Meta分析结果显示,针灸治疗卵巢早衰的有效率显著高于西药组[OR=4.70,95%CI(3.34,6.61),P 0.000 01],并且针灸治疗在降低促卵泡生成素(FSH)[MD=-3.30,95%CI(-5.88,-0.72),P=0.01]、降低促黄体生成素(LH)[MD=-5.81,95%CI(-7.42,-4.20),P0.000 01]及升高雌二醇(E2)方面[MD=24.15,95%CI(12.82,35.48),P 0.000 1]均优于西药对照组。【结论】单独针灸治疗卵巢早衰在提高有效率及改善激素水平方面疗效显著,不良反应少,但鉴于纳入的研究样本量少,研究质量不高,有待更多高质量、大样本的随机对照试验进一步验证。     

针灸疗法对2型糖尿病患者胰岛功能影响的Meta分析

目的 系统评价针灸疗法对糖尿病患者胰岛功能的影响。方法 检索针灸对糖尿病患者胰岛功能影响的随机对照研究,以胰岛素抵抗指数（HOMA-IR）、胰岛素敏感指数（ISI）等为胰岛功能评价指标,并进行Meta分析。结果 8项研究符合纳入标准,Meta分析结果显示在改善患者空腹血糖[WMD=-0.81,95%CI(-0.98,-0.64),P<0.01]、空腹胰岛素[WMD=-2.67, 95%CI=(-3.35,-1.98),P<0.01]、胰岛素抵抗指数[WMD=-1.51,95%CI(-1.96,-1.06),P<0.01],胰岛素敏感指数[WMD=0.80,95%CI(0.36,1.24),P<0.01]等方面,针灸组优于对照组,差异有统计学意义。结论 针灸疗法对糖尿病患者胰岛功能有明显的改善作用,适合推广应用。      

培元通脑胶囊联合西药治疗脑梗死临床疗效及安全性的Meta分析

【目的】系统评价培元通脑胶囊联合西药治疗脑梗死的临床疗效及安全性。【方法】计算机检索国内外主要数据库中采用培元通脑胶囊联合常规西药对比常规西药治疗脑梗死的随机对照试验（RCTs）,按照纳入与排除标准筛选文献后提取相关资料;根据Cochrane偏倚风险评估标准对纳入文献进行方法学质量评价后,运用RevMan 5.3统计软件进行Meta分析。【结果】最终纳入12项研究,涉及1 420例患者。Meta分析结果显示：培元通脑胶囊联合常规西药治疗脑梗死的临床总有效率显著高于常规西药治疗[RR=1.18,95%CI(1.11,1.25);P<0.000 01];在改善美国国立卫生研究院卒中量表（NIHSS）评分[MD=-3.46,95%CI(-5.09,-1.83);P<0.00 01]、改良Rankin量表（mRS）评分[MD=-0.91,95%CI(-1.15,-0.66);P<0.000 01]及Barthel指数（BI）评分（[MD=9.18,95%CI(7.06,11.29);P<0.000 01]方面也均优于常规西药治疗。两组之间不良反应率差异无统计学意义[RR...     

中药联合硫酸羟氯喹治疗干燥综合征疗效和安全性的Meta分析

目的：系统评价中药联合硫酸羟氯喹（HCQ）治疗干燥综合征（Sj?gren’s syndrome,SS）的疗效与安全性。方法：2名研究者通过计算机检索知网、万方、维普、中国生物医学文献数据库、PubMed、Web of Science和The Cochrane Library数据库（检索年限为建库至2020年10月份）并独立筛选文献,提取资料进行偏倚风险评估后,使用RevMan 5.3软件进行Meta分析。结果：共纳入19篇文献,涉及1 185例患者,其中治疗组617例,对照组568例。合并数据分析显示：中药联合硫酸羟氯喹治疗干燥综合征的总有效率较单用硫酸羟氯喹更高[RR=1.34,95%CI(1.24,1.44),P<0.000 01],在改善唾液腺[SMD=0.66,95%CI(0.47,0.85),P<0.000 01]、泪液分泌功能[MD=2.56,95%CI(1.29,3.83),P<0.000 1]以及降低C反应蛋白（CRP）[MD=-3.53,95%CI（-3.93,-3.14）,P<0.000 01]、红细胞沉降率（ESR）[MD=-5.80,95...     

电针联合膀胱功能锻炼治疗脊髓损伤后神经源性膀胱的系统评价及Meta分析

目的：通过Meta分析评价电针联合膀胱功能锻炼治疗脊髓损伤后神经源性膀胱的临床疗效。方法：系统检索The Cochrane Library、Clinical Trials、PubMed、中国知网（CNKI）、万方数据库（Wanfang Data）和维普数据库（VIP Data）,按照拟定的纳入标准与排除标准进行筛选,将文献按照Cochrane协作网提供的偏倚风险项目评估手册进行质量评估,并运用Rev Man 5.3软件进行Meta分析。结果：初步检索文献535篇,按照标准最终纳入文献20篇（中文文献19篇,英文文献1篇）。结果显示,治疗有效率[OR=0.26,95%CI(0.15,0.44),P<0.00001],排尿次数[MD=-2.89,95%CI(-3.26,-2.51),P<0.00001],平均尿量[MD=65.20,95%CI(51.99,78.42),P<0.00001],最大膀胱容量[MD=44.25,95%CI(29.96,58.54),P<0.00001],最大尿流率[MD=2.08,95%CI(1.21,2.95),P<0.00001...     

苏黄止咳胶囊治疗成人咳嗽变异性哮喘随机对照试验的Meta分析

目的:系统评价苏黄止咳胶囊治疗成人咳嗽变异性哮喘(CVA)的有效性和安全性。方法:系统检索中国学术期刊全文数据库(CNKI)、PubMed等7个中英文数据库,检索时间限定为自建库至2020年6月,筛选及纳入苏黄止咳胶囊联合吸入性激素及长效支气管扩张剂(ICS-LABA)治疗成人CVA的随机对照试验研究(RCTs)。由两名研究员独立进行资料提取并应用质量风险评估量表(ROB)对纳入文献进行质量评价,应用Review Manager 5.3软件进行统计分析。结果:共纳入18项RCTs(1619例患者),所有文献偏倚风险评估均为高风险。Meta分析结果发现,与单用ICS-LABA相比,ICS-LABA联合苏黄止咳胶囊可明显缓解咳嗽症状[3 RCTs,n=1127,RR=1.20,95%CI(1.15,1.26),P0.000 01]、降低咳嗽症状积分[白天:n=460,MD=-0.13,95%CI(-0.19,-0.07),P0.000 01;夜间:n=460,MD=-0.28,95%CI(-0.35,-0.22),P0.000 01]、增加第1秒用力呼气量(FEV1)[5 RCTs,n=456,MD=0.36,95%CI(0.27,0.44),P0.000 01]、改善呼气峰值流速(PEF)[2 RCTs,n=158,MD=2.20,95%CI(1.91,2.50),P0.000 01]、降低诱导痰嗜酸性粒细胞百分比[5 RCTs,n=326,MD=-1.79,95%CI(-2.36,-1.22),P0.000 01]、降低IgE含量[4 RCTs,n=344,MD=-21.14,95%CI(-28.24,-14.03),P0.000 01],且安全性良好,无严重不良反应。结论:在ICS-LABA基础上联合应用苏黄止咳胶囊治疗CVA可提高临床疗效、改善肺功能、减轻炎症反应且安全性良好。     

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.