精索静脉曲张性不育与中医体质的相关性研究

目的 探讨精索静脉曲张性不育患者中医体质辨识的分布规律并分析其精液参数与中医体质之间的相关性。 方法 选取2016年9月1日-2017年11月30日期间在宁波市中医院男科门诊就诊并符合纳入标准的患者146例，年龄20～45岁。通过回收患者所填写的《精索静脉曲张性不育临床症状调查表》、《中医体质观察表》，记录患者一般信息、精液常规以及中医体质情况等结果，再经过相关统计学处理，分析患者基本信息、中医体质及精液常规相关结果之间的统计学关系。 结果 ①146例精索静脉曲张性不育患者中，各体质类型所占比例分别为气郁质17.59%、气虚质16.67%、血瘀质11.58%、阴虚质11.34%、阳虚质10.88%、痰湿质9.72%、湿热质9.49%、平和质7.87%、特禀质4.86%。②在相关精液参数与主要中医体质类型的关系中，采用非参数秩和检验或者独立样本t检验分析后可知，气郁质与非气郁质、阴虚质与非阴虚质患者的精子浓度差异均有统计学意义(均P<0.05)，气虚质与非气虚质患者的精子总活力差异有统计学意义(P<0.05)。而前向运动精子及正常形态精子比例与主要中医体质类型之间不相关(均P>0.05)。 结论 精索静脉曲张性不育与中医体质类型相关；其精子浓度分别与气郁质、阴虚质有相关性，精子总活力与气虚质有相关性。      

高血压病患者中医体质特点与心血管危险因素分析

目的研究高血压病患者的中医体质特点,分析其与血管危险因素的相关性。方法选择2016年5月～2019年2月于陕西中医药大学附属医院体检中心体检并患有高血压病的480例患者为研究对象,采用身心康经络传感仪对患者进行中医体质辨识,并采集研究对象一般资料、既往病史、心血管危险因素、传导系数及中医四诊信息,建立三维结构化关联数据库,分析高血压病患者中医体质特点与心血管危险因素的相关性。结果 480例高血压病患者体质分布情况为:平和质22例(4.6%)、阴虚质64例(13.3%)、痰湿质127例(26.5%)、湿热质115例(24.0%)、血瘀质61例、(12.7%)、气郁质48例(10.0%),由高至低顺序排为:痰湿质湿热质阴虚质血瘀质气郁质气虚质平和质阳虚质;高血压病痰湿质者心血管危险因素比例最高,是涉及心血管危险因素最多的体质,其中,同时存在糖尿病、血脂异常、吸烟史、饮酒史等方面占比均最高,比例分别为79%、60.9%、71.9%和50%;在糖尿病患病情况方面,痰湿质与平和质、阴虚质、气虚质、气郁质、血瘀质、阳虚质、湿热质比较差异均具有统计学意义(P0.05);在吸烟情况方面,痰湿质与平和质、气郁质、血瘀质、阳虚质、湿热质差异有统计学意义(P0.05);在饮酒情况方面,湿热质与阴虚质、气虚质、气郁质、血瘀质、阳虚质比较均有统计学意义(P0.05);在血脂异常方面,湿热质与平和质、阴虚质、气虚质比较差异具有统计学意义(P0.05)。结论痰湿质、湿热质、阴虚质是高血压病患者最常见的3种体质类型,且同时合并存在更多的心血管危险因素,是影响心血管疾病发生、发展最常见的体质类型。     

中医体质类型与非急性发作期支气管哮喘的相关性研究

[目的]研究中医体质类型与非急性发作期支气管哮喘的相关性。[方法]运用北京中医药大学王琦教授的"中医体质分类判定标准",对108例支气管哮喘非急性发作期患者进行中医体质学分析。[结果]⑴体质频数由高到低的顺序依次是:气虚质(41.67%)、特禀质(33.33%)、阳虚质(28.70%)、阴虚质(14.81%)、痰湿质(13.89%)、血瘀质(12.04%)、湿热质(8.31%)、气郁质(7.41%)、平和质(7.41%);⑵与普通人群相比较,体质构成比有明显差异(P<0.001),气虚质、阳虚质、特禀质与非急性发作期支气管哮喘患者有相关性。[结论]气虚质、特禀质、阳虚质与非急性发作期支气管哮喘患者有相关性。     

长沙市男性不育症患者睾丸体积与中医体质类型分析

目的：通过对长沙市344例男性不育症患者进行中医体质的问卷调查,探讨男性不育症患者体质分布的特点及其精液质量、睾丸大小与中医体质的关系,分析常见病因对中医体质的影响。方法根据中华中医药学会《中医体质分类与判定》(ZYYXH／T157-2009)对344例不育男性进行体质辨识,结合临床资料进行统计分析,讨论中西医结合治疗的方法和思路。结果344例男性不育患者中平和体质占17.4％,单一偏颇体质(为一种偏颇体质者)占25.6％,混合偏颇体质占57.0％。总体体质类型前10位依次为平和质（17.4％）、湿热痰湿质（14.2％）、阳虚气虚质（9.59％）、湿热质（8.43％）、阳虚痰湿质（6.69％）、痰湿质（5.81％）、气虚湿热质（5.81％）、气虚质（4.94%）、阳虚质（4.36％）、气郁气虚质（3.49％）。结论从单一体质类型看除平和质外,湿热质和气虚质是不育患者的主要体质类型;复合类型中,虽然各复合型相对分散,但仍然表现以湿热复合类为主要特征,而阳虚、气虚、痰湿复合类次之的分布特征;而总体阴虚质、特禀质、血瘀质及其复合类都很少见;不育症患者不同睾丸体积的中医体质分布差异具有统计学意义。     

长沙地区男性不育患者精索静脉宽度与中医体质类型相关性探讨

目的通过对长沙地区男性不育患者进行中医体质的问卷调查,得出男性不育患者体质分布的特点及精索静脉宽度与中医体质的关系,分析常见病因对中医体质的影响,探讨中医药防治男性不育的新思路。方法根据《中医体质分类与判定》(ZYYXH/T157-2009)对长沙地区344例不育男性进行中医体质判定,并分析精索静脉宽度与中医体质的相关性。结果男性不育患者中平和体质占17.4%,单一偏颇体质占25.6%,混合偏颇体质占57.0%。总体体质类型前10位依次为平和质(17.4%),湿热痰湿质(14.2%),阳虚气虚质(9.59%),湿热质(8.43%),阳虚痰湿质(6.69%),痰湿质(5.81%)、气虚湿热质(5.81%),气虚质(4.94%),阳虚质(4.36%),气郁气虚质(3.49%)。男性不育患者双侧精索静脉宽度与中医体质分布差异有统计学意义(P0.01)。湿热质、痰湿质在精索静脉曲张所致男性不育患者中分布比例较高。结论男性不育患者中,平和质、湿热质和气虚质是主要单一体质类型;复合类型中各型相对分散,但仍然表现以湿热复合类为主要特征,而阳虚、气虚、痰湿复合类次之的分布特征。湿热质、痰湿质与精索静脉曲张所致男性不育存在一定联系。     

应用中医体质量表对大学生兼夹体质情况的研究

目的 通过对甘肃中医学院2012级学生进行中医体质调查,探讨该人群中医体质类型的分布及兼夹体质情况.方法 采用标准化的9种中医体质量表调查法实施中医体质辨识.结果 偏颇体质中,1人带有1种体质的占26.95％,1人带有2种或2种以上体质的占73.05％;1人3种体质的居于前4位的分别是气虚质-气郁质-阴虚质、气虚质-痰湿质-阴虚质、气虚质-阳虚质-阴虚质、气郁质-痰湿质-阴虚质,男生中居于前3位的分别是气虚质-气郁质-阴虚质、气虚质-痰湿质-阴虚质、气虚质-湿热质-阴虚质,女生中居于前3位的分别是气虚质-气郁质-阴虚质、气虚质-痰湿质-阴虚质、气虚质-阳虚质-阴虚质.结论 高校大学生健康状况不容乐观,偏颇体质比例较高,兼夹体质现象普遍存在.     

合肥高校过度自慰在校男性大学生的中医证候与其体质的构成分析

目的探讨合肥高校在校男性大学生在过度自慰后的中医证候与其体质的关系。方法根据中华中医药学会2009年4月实施的《中医体质分类与判定》(ZYYXH/T157-2009)对1000名男性大学生进行体质辨识,分析男性大学生体质类型的分布规律;根据其近五年内自慰频率判断为过度自慰,同时记录每位过度自慰者的中医证候学表现,分析合肥地区男性大学生的过度自慰情况及症状表现与其体质类型间的关系。结果问卷有效回收数量为845份,其中过度自慰的男性大学生为423人。423位过度自慰男性大学生群体中平和质占26.1%;单一偏颇体质占19.6%,混合偏颇体质占45.1%。单一偏颇体质中,湿热质最多见,其次为气虚质,阳虚质,阴虚质,痰湿质,特禀质,气郁质,血瘀质。在193例混合偏颇体质中,以湿热兼阴虚质最多,其他依次为湿热兼痰湿质,湿热兼气郁质,湿热兼血瘀质,阳虚质兼气虚质,阴虚兼气郁质,阳虚兼痰湿质,阳虚兼血瘀质,痰湿兼血瘀质,阴虚兼阳虚质,气郁兼气虚质,痰湿兼气郁质,气虚兼阴虚质。不同证型中医体质分布不相同。阴阳两虚证中以气虚质分布较多,湿热下注证中以痰湿质和湿热质分布较多,脾肾阳虚证中以阳虚质和气虚质分布较多,肝郁气滞证以气郁质分布较多,肝肾阴虚证中以阴虚质分布较多。结论 845例合肥高校男性大学生过度自慰者占50.0%,其体质多为混合偏颇体质,平和质及单一偏颇体质较少;体质分布以湿热质、气虚质、阴虚质、痰湿质、气郁质为主,不同的体质分布和其证候各不相同,因此对于男性大学生过度自慰的诊治要"辨证候",同时要"辨体质"。     

中风病人的中医体质类型分布情况调查

目的：：探讨中风与中医体质类型的相关性。方法：通过问卷调查的方法,按照叶中医体质分类与判定》标准,2012年4月至2012年10月期间对85例中风患者进行体质分析,总结中风与中医体质类型的相关性。结果：本组中风病例中位居前3位的体质为痰湿质、平和质、气虚质,比例为31.24%(27/85)、15.17%(13/85)、13.65%(12/85);中风人群性别与中医体质分析,其中阳虚质、阴虚质、痰湿质、湿热质这四种类型体质性别比较差异具有统计学意义(P<0.05),平和质、气虚质、血瘀质、气郁质、特禀质性别比较差异无统计学意义(P跃0.05)。结论：中风患者体质分布具有趋向性,最常见体质类型为痰湿质、平和质、气虚质;阳虚质、阴虚质、痰湿质、湿热质这4种类型体质具有性别差异性。     

原发性血脂异常体质类型及其与血脂指标相关性研究

目的 分析原发性血脂异常患者的体质分布特点,以及中医体质类型与血脂指标间的关系.方法收集122例原发性血脂异常患者的一般资料、血脂指标;采用王琦的体质分类方法,将患者分为9种体质类型,使用SPSS 18.0进行统计运算.结果122例原发性血脂异常患者的主要体质类型是气虚质,占61.48%,其次是痰湿质、阴虚质、气郁质及阳虚质,其中,男性的主要体质为气虚质、痰湿质、阴虚质和湿热质;而女性则以气虚质、痰湿质、阴虚质和气郁质最多.低密度脂蛋白(LDL-C)与气虚质、阳虚质呈正相关性,血清载脂蛋白A1(ApoA1)与气郁质呈负相关性.结论气虚质是原发性血脂异常最常见的体质类型;体质类型与血脂指标有一定的相关性.     

体质辨识在支气管扩张症中的应用

[目的]探讨支气管扩张症患者中医体质特点以及体质与证型关联性,为支气管扩张症的临床防治提供依据。[方法]选取2011年5月至2012年3月浙江中医药大学附属第一医学院呼吸内科住院及门诊符合纳入条件的支气管扩张症患者80例,采用标准化的体质量表进行体质辨识和辩证分型,归纳分析体质与证型的关系。[结果]①支气管扩张症患者中医体质以平和质、气虚质和阴虚质为多见,其次为痰湿质、湿热质、阳虚质和气郁质,特禀质和血瘀质少见。②中医证候类型以痰热郁肺证最多,占48.75%,肝火犯肺证和阴虚火旺证分别占21.25%和18.75%,气阴两虚证仅占11.25%。③从不同体质支扩患者中医证候类型分布可以发现：平和质、气虚质、阳虚质、痰湿质、湿热质患者以痰热郁肺证较多;气虚质患者以气阴两虚证较多;阴虚质患者以阴虚火旺证较多;气郁质患者以肝火犯肺证较多。[结论]支气管扩张症患者中痰热郁肺证是最主要的中医证型,符合支气管扩张症本虚标实的病理特征;不同体质的患者发病后决定其不同的证候类型。     

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.