中西医结合治疗慢性失眠及戒除镇静剂成瘾后患者睡眠质量、多导睡眠图的变化

目的探讨中西医结合治疗慢性失眠及戒除镇静剂成瘾后患者睡眠症状、多导睡眠图的变化。方法将2014年6月至2015年6月河南省直属机关第一医院收治的慢性失眠和戒除镇静剂成瘾患者198例,按随机数字法分为联合组和对照组,各99例。对照组给予抗抑郁、焦虑药物联合认知行为治疗,联合组在对照组基础上采用药磁渗透、经络导平治疗,2个疗程后,观察两组患者治疗前后睡眠情况及匹茨堡睡眠质量指数量表(PSQI),快速眼球运动睡眠潜伏期(RL)、快速眼球运动睡眠活动期(RA)、快速眼球运动强度(RI)、快速眼球运动密度(RD)、第1次快速眼球运动睡眠时间(FRT)、快速眼球运动睡眠次数(RSN)、睡眠纺槌指数(SS);治疗后随访3个月,记录两组患者镇静剂停用情况。结果治疗后联合组总睡眠时间、睡眠效率、睡眠满意度显著高于对照组[(391.8±12.4)min比(345.3±11.6)min,(74.3±6.7)%比(63.7±5.6)%,(83.1±5.4)%比(71.4±4.8)%],PSQI显著低于对照组[(8.3±0.5)分比(11.8±0.8)分,P<0.01]。联合组RL显著高于对照组[(83.5±8.1)min比(71.5±7.3)min],RA、RI、RD、FRT、RSN、SS显著低于对照组[(58.4±5.3)U比(79.4±6.7)U,(23.1±3.5)%比(34.3±4.1)%,(80.7±5.6)%比(104.5±7.5)%,(13.2±2.1)min比(15.3±2.7)min,(3.1±0.2)次比(4.3±0.3)次,(4.2±0.3)%比(5.7±0.5)%](P<0.01)。联合组镇静剂停用率显著高于对照组[59.6%(59/99)比39.4%(39/99),P<0.05]。结论慢性失眠患者采用中西医结合治疗能够显著改善患者的睡眠质量,且对镇静剂成瘾的戒除效果确切。     

针刺结合生物反馈疗法治疗老年慢性失眠的临床研究

目的 探讨针刺疗法结合生物反馈疗法治疗老年慢性失眠的临床效果.方法 150名老年慢性失眠症自愿受试患者,按就诊顺序分成3组,A组单纯接受针刺加耳穴贴磁珠治疗,B组单纯接受生物反馈放松疗法,C组接受上述两种疗法联合治疗.单盲法评估、记录3组患者在治疗前、治疗后4周末、8周末的匹兹堡睡眠质量指数(PSQI)、睡眠效率、入睡时间、总睡眠时间及汉密顿焦虑量表(HAMA)总分、汉密顿抑郁量表(HAMD-17)总分及副反应观察.结果 治疗8周末时,联合治疗组的PSQI总分、睡眠效率、入睡时间、总睡眠时间以及HAMA总分、HAMD总分等指标[分别为(7.92±2.59)分,(82.52±8.93)%,(24.06±8.23)min,(413.75±42.41)min,(9.63±3.75)分,(10.10±3.27)分]均好于其他两组[分别为针刺组(9.51±2.92)分,(79.06±10.70)%,(33.16±11.31)min,(373.47±40.65)min,(15.08±4.20)分,(14.33±3.56)分;生物反馈组(11.46±3.75)分,(68.85±12.34)%,(33.65±11.38)min,(281.88±38.02)min,(11.63±4.15)分,(12.08±4.08)分],差异有显著性(P＜0.01).结论 针刺结合生物反馈疗法能显著改善老年人慢性失眠的睡眠质量,并且能改善与失眠相关的焦虑和抑郁不良心理状态.     

门诊森田疗法与认知行为疗法辅助治疗慢性失眠的对照研究

  目的   对比门诊森田疗法与失眠的认知行为疗法(CBT-I)对慢性失眠的疗效,了解2种疗法的差异,促进门诊森田疗法在临床中的推广与应用。   方法   选择2019年6月—2020年11月于芜湖市第四人民医院复诊的慢性失眠患者60例,通过随机数字表法分为研究组与对照组,各30例,分别采用门诊森田疗法和CBT-I, 比较2组患者干预前后主观睡眠质量、被束缚症状及焦虑症状。   结果   干预后研究组匹兹堡睡眠质量指数量表(PSQI)评分除催眠药物外,其余各项得分与治疗前比较差异均有统计学意义,对照组除入睡时间和催眠药物外得分均低于治疗前,且研究组干预后的睡眠质量(1.47±0.63)分、入睡时间(1.73±0.91)分、日间功能障碍(1.37±0.93)分及PSQI总分(12.23±4.18)分显著低于对照组[(1.80±0.48)分、(2.67±0.66)分、(2.03±0.77)分、(14.23±3.07)分];研究组中文版神经症被束缚自评量表(SSTN)各维度与总分均较干预前显著减少,对照组仅症状受容性维度与治疗前差异有统计学意义;干预后,研究组汉密尔顿焦虑量表(HAMA)评分为(3.50±2.86)分,对照组为(4.73±2.46)分,均显著低于干预前,2组间得分比较差异无统计学意义(P=0.079)。   结论   2种疗法均对慢性失眠有疗效,门诊森田疗法在睡眠质量、入睡时间、日间功能障碍及总体的睡眠评价上的疗效优于CBT-I,且门诊森田疗法能缓解患者的被束缚症状,可以在临床推广门诊森田疗法。      

失眠认知行为疗法对酒依赖患者睡眠质量及情绪的影响

目的 探讨失眠的认知行为疗法对于酒依赖患者睡眠质量和抑郁、焦虑情绪等方面的影响,为临床提供参考。 方法 招募了于2017年5月—2018年12月期间杭州市第七人民医院收治的符合入组标准的酒依赖患者共66例,将其随机分为观察组和对照组各33例。对照组接受常规治疗和护理干预,观察组在此基础上进一步接受失眠的认知行为疗法干预,总干预时间持续4周。并分别在治疗前、治疗后评估2组患者的入睡时间、睡眠时间、睡眠效率、抑郁和焦虑情绪。 结果 2组患者的人口学资料及基线PSQI评分、SDS评分、SAS评分差异均无统计学意义(P>0.05)。干预后,观察组入睡时间评分[(1.77±0.52)分vs.(2.21±0.67)分,P=0.004]、睡眠时间评分[(1.26±0.83)分vs.(1.72±0.95)分,P=0.040]、睡眠效率评分[(0.76±0.84)分vs.(1.26±0.75)分,P=0.013]及PSQI总分[(9.38±6.29)分vs.(13.54±6.85)分,P=0.013]、SDS评分[(36.81±7.76)分vs.(45.47±8.25)分,P<0.001]、SAS评分[(33.18±6.73)分vs.(42.26±11.48)分,P<0.001]均低于对照组,2组评分差异均有统计学意义(均P<0.05)。 结论 失眠的认知行为疗法可有效改善酒依赖患者的睡眠质量、抑郁和焦虑情绪,减少其入睡时间,增加总睡眠时间,提高睡眠效率,改善睡眠质量,有助于患者病情恢复。      

网络认知行为疗法对慢性失眠症患者睡眠质量及心理状态的影响研究

目的:探讨网络认知行为疗法对慢性失眠症患者睡眠质量及心理状态的影响。方法:选取60例慢性失眠症患者为研究对象,按照干预治疗方式不同分为干预组(n=31)和对照组(n=29)。对照组给予单一催眠药物治疗;干预组在对照组基础上给予网络认知行为疗法,疗程均为6周。比较两组患者干预前、干预结束及12周随访时匹兹堡睡眠质量量表(PSQI)评分、汉密尔顿焦虑量表(HAMA)和抑郁量表(HAMD)评分及催眠药减药率。结果:12周随访时,干预组PSQI各维度得分、PSQI总分、HAMA及HAMD评分低于对照组(P<0.05);患者PSQI总分有时间变化趋势(P<0.01);不同干预方式对患者PSQI总分影响的差异有统计学意义(P<0.01);干预措施与干预时间存在交互效应(P<0.05)。干预结束时,干预组患者催眠药物减药率高于对照组(P<0.05)。结论:网络认知行为疗法联合催眠药物治疗慢性失眠症可以减少催眠药物的使用,且对失眠症患者睡眠质量、心理状态改善效果要好于单一使用催眠药物治疗。     

综合护理干预对脑卒中后患者失眠伴焦虑的影响研究

目的 探讨综合护理干预对脑卒中后患者失眠伴焦虑的影响。 方法 选取2013年12月-2016年7月台州医院神经内科收治的脑卒中后失眠伴焦虑患者168例,按随机数字表法分组,对照组84例予以常规护理,研究组84例在对照组基础上予以综合护理干预,包括心理护理、康复训练、饮食护理、睡前护理以及药物护理。干预后观察并记录2组间心理状态、睡眠质量、认知功能、神经功能及运动功能,同时对比临床疗效。 结果 与对照组比较,研究组干预后汉密尔顿焦虑量表(HAMA)、抑郁量表(HAMD)、Zung氏焦虑自评量表(SAS)和抑郁自评量表(SDS)评分较低,干预后醒觉次数、入睡潜伏期时间及匹兹堡睡眠质量指数(PSQI)评分较低,睡眠总时间、睡眠效率较高,干预后简明精神状态量表(MMSE)、简式Fugl-Meyer运动功能评分法(FMA)评分较高,脑卒中神经功能缺损评分表(CNS)评分较低,差异具有统计学意义(P<0.05);研究组治疗有效率为80.95%(68/84),高于对照组治疗有效率95.24%(80/84),差异具有统计学意义(Z=2.595,P=0.010)。 结论 综合护理干预能够有效缓解脑卒中后失眠伴焦虑患者的焦虑情绪,提高睡眠质量,改善认知功能、神经功能及运动功能,提高患者生活质量,护理效果确切。      

子午流注灸法对脾胃气虚型慢性胃炎伴失眠患者的治疗效果

目的:探讨子午流注择时灸法对脾胃气虚型慢性胃炎伴有失眠患者的治疗效果.方法:选取86例脾胃气虚型慢性胃炎伴失眠患者,随机分为观察组和对照组,各43例.2组均予以西医常规治疗,同时对照组于14:00～17:30进行艾灸,观察组采用子午流注灸法于辰时7:00～9:00进行艾灸.比较2组干预前后患者脾胃气虚症状积分、焦虑、抑郁评分及匹兹堡睡眠质量指数(PSQI)评分.结果:干预4周后观察组中医证候积分[(11.15±1.55)分]低于对照组[(13.69±2.74)分];焦虑得分[(42.20±7.72)分]低于对照组[(46.23±7.28)分];观察组抑郁得分[(38.85±7.05)分]低于对照组[(43.64±7.90)分],观察组PSQI总分[(10.15±2.06)分]低于对照组[(11.51±2.20)分],观察组失眠治疗总有效率90.00％高于对照组82.05％,差异均有统计学意义(P＜0.05).结论:子午流注择时灸法可改善脾胃气虚型慢性胃炎伴失眠患者的睡眠质量、焦虑、抑郁情况.     

互联网+中医养生调摄对失眠伴焦虑、抑郁情绪的临床疗效观察

[目的]观察使用互联网技术进行中医养生调摄对失眠伴焦虑、抑郁情绪患者的临床疗效。[方法]将轻、中度失眠伴焦虑、抑郁症状的120例患者随机分为干预组和对照组各60例,分别通过互联网进行中医综合养生干预和认知行为疗法(cognitive behavior therapy-insomnia,CBT-I)。治疗8周后比较两组患者睡眠和焦虑抑郁的改善情况及临床疗效。[结果]与治疗前比较,干预组和对照组的匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)、健康问卷抑郁量表(patient health questionnaire-9,PHQ-9)、广泛性焦虑障碍量表(generalized anxiety disorder-7,GAD-7)评分均显著降低(P＜0.05)。与对照组比较,治疗后干预组的PSQI、PHQ-9、GAD-7评分显著低于对照组(P＜0.05),中西医临床有效率显著高于对照组(P＜0.05)。[结论]通过互联网+技术运用中医综合养生方法可以有效改善慢性失眠患者的睡眠质量和焦虑、抑郁症状,临床疗效优于CBT-I,值得应用与推广。     

老年失眠伴焦虑症状实施中西医结合心理护理的效果分析

目的探讨中西医结合心理护理模式在老年失眠伴焦虑症状患者中的应用效果。方法选择2016年7月~2017年1月在我院诊断治疗的老年失眠伴焦虑患者100例为研究对象,随机分为观察组与对照组,各50例。对照组采用常规护理,观察组采用中西医结合心理护理。比较两组干预前后睡眠质量(PSQI)、生活质量(SF-36)、焦虑评分(HAMA)。结果干预后,两组PSQI评分总分均较干预前显著下降(P0.05);干预后观察组PSQI总分、睡眠质量、入睡时间、睡眠时间、日间功力障碍评分均显著低于对照组,差异有统计学意义(P0.05)。干预后,观察组躯体疼痛、一般健康状况、活力、社会功能、情感职能、精神健康维度评分均显著高于对照组,差异有统计学意义(P0.05)。两组干预后HAMA评分均显著低于干预前,差异有统计学意义(P0.05);干预后,观察组HAMA评分显著低于对照组,差异有统计学意义(P0.05)。结论中西医结合心理护理用于老年失眠伴焦虑症状患者能够显著改善睡眠质量、生活质量及缓解焦虑症状。     

急性小脑出血患者失眠与出血部位、神经损伤程度和IL-1β浓度的关系

目的 监测急性小脑出血患者的睡眠状态,并分析其与出血部位、神经损伤程度、血浆中IL-1β浓度的关系.方法 选择2014年4月至2016年11月在武汉大学人民医院神经内科治疗的小脑出血患者127例,根据PSQI量表得分将其分为小脑出血伴失眠组72例及小脑出血非失眠组55例,并设立健康组(18例),分析组间临床一般资料、睡眠状况、多导睡眠仪相关数据及IL-1β浓度间的差异.结果 小脑出血伴失眠组患者的睡眠质量评分(PSQI)为(16.34±5.32)分、Epworth评分为(10.54±4.77)分,均明显高于小脑出血无失眠组的(6.28±3.55)分、(4.67±4.21)分以及健康组的(4.79±2.79)分、(3.26±3.73)分,差异均具有统计学意义(P<0.05);小脑出血伴失眠组患者的出血量为(10.26±4.85)mL、神经损伤程度评分(NIHSS)为(10.68±1.07)分,均显著高于小脑出血无失眠组的(7.56±3.80)mL、(6.28±3.55)分及健康组的0 mL、(4.79±2.79)分,差异均有统计学意义(P<0.05).小脑出血伴失眠组患者总睡眠时间为(345.98±49.75)min,明显短于小脑出血非失眠组的(405.15±52.83)min及健康组的(423±50.21)min,并且小脑出血伴失眠组睡眠潜伏期[(47.61±19.23)min]、S1期睡眠比例[(19.25±4.26)％]明显高于小脑出血非失眠组[(47.61±19.23)min、(12.29±3.21)％]以及健康组[(21.36±13.24)min、(9.02±3.99)％],而REM睡眠比例显著减少[(13.78±4.23)％vs(21.56±3.89)％、(22.77±3.75)％],差异均具有统计学意义(P<0.05).此外,小脑出血伴失眠组[(14.75±4.88)ng/L]与小脑出血非失眠组[(9.65±3.11)ng/L]血浆中IL-1β浓度均显著高于健康组[(2.65±1.02)ng/L],差异有统计学意义(P<0.05).结论 急性小脑出血患者的出血量、神经损伤程度、出血部位及血浆中IL-1β浓度可以影响患者的睡眠状态.     

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.