中药内服联合熏蒸疗法治疗强直性脊柱炎临床研究

目的:探讨中药内服联合熏蒸疗法治疗强直性脊柱炎的临床疗效。方法:将103例强直性脊柱炎的患者随机分为对照组50例,治疗组53例,对照组患者用柳氮磺吡啶片治疗,治疗组患者给予中药汤剂内服联合熏蒸进行治疗,观察两组患者症状、体征改善程度及临床效果。结果:两组患者腰骶脊背疼痛、晨僵时间、关节疼痛、外周关节肿胀数、腰脊活动受限等症状体征均较治疗前有所改善,且治疗组优于对照组,两组比较,差异有统计学意义(P<0.05)。对照组有效率为72.0%,治疗组有效率为86.7%,两组比较,差异有统计学意义(P<0.05)。结论:中药内服联合熏蒸疗法治疗强直性脊柱炎临床疗效显著。     

中药熏蒸联合督脉灸对强直性脊柱炎患者临床症状及疼痛的护理分析

目的:分析中药熏蒸联合督脉灸对强直性脊柱炎患者临床症状及疼痛的护理。方法:选取我院2017年4月—2018年2月收治的强直性脊柱炎患者76例为观察对象,按照随机数表法将其分为两组,各38例。观察组给予中药熏蒸联合督脉灸治疗,对照组给予督脉灸治疗,两组治疗后均行护理干预。观察两组疗效、临床症状改善、疼痛改善情况。结果:观察组治疗总有效率比对照组高,差异有统计学意义(P<0.05);治疗后观察组晨僵时间、枕墙距、指地距均比对照组低,差异有统计学意义(P<0.05);治疗后两组VAS评分均比治疗前低,且观察组比对照组低,差异有统计学意义(P<0.05)。结论:中药熏蒸联合督脉灸治疗配合常规护理干预可有效改善强直性脊柱炎患者临床不适症状,缓解腰背部疼痛程度,提高康复效果。     

中药熏蒸治疗强直性脊柱炎93例疗效观察

目的 探讨中药熏蒸治疗强直性脊柱炎的疗效.方法 将183例强直性脊柱炎患者随机分为治疗组93例和对照组90例.两组均给予双氯芬酸钠双释放肠溶胶囊和柳氮磺吡啶片口服及常规护理;治疗组在此基础上另给予医院制剂追风酒的中药渣熏蒸治疗.10次为1个疗程,均治疗2疗程后评价疗效.结果 治疗组显效50例,有效31例,无效12例,总有效率87.1%;对照组显效21例,有效36例,无效33例,总有效率为63.3%;2组疗效比较,治疗组优于对照组,差异有显著性(P<0.05).结论 中药熏蒸治疗强直性脊柱炎疗效确切,良好的常规护理干预作用积极,不可或缺.     

中药熏蒸缓解强直性脊柱炎疼痛36例临床分析

目的观察评价中药熏蒸对强直性脊柱炎疼痛缓解的临床疗效。方法将36例确诊为强直性脊柱炎患者给予中药熏蒸治疗,每次熏蒸蒸汽温度控制60℃,时间设定为45 min,隔天一次,以20 d为1个疗程,3个疗程后采用vas疼痛评分法观察比较治疗前后疼痛改善及不良反应的发生情况。结果显效10例,有效23例,无效4例,总有效率91.67%。结论中药熏蒸治疗对强直性脊柱炎疼痛改善疗效满意,并且安全性高。     

盘龙灸治疗强直性脊柱炎的临床研究

目的观察盘龙灸治疗强直性脊柱炎的临床疗效。方法将60例强直性脊柱炎患者随机分为治疗组和对照组,每组30例。治疗组采用"盘龙灸"进行治疗,对照组服用药物治疗。两组均连续治疗40天,主要观察两组患者疼痛、僵直感的改善情况。结果治疗组临床症状改善的有效率为86.67%,对照组的有效率为66.67%,两组差异具有统计学意义(P0.05),治疗组疗效优于对照组。结论盘龙灸治疗强直性脊柱炎有效,值得推广。     

中药结合内热针治疗强直性脊柱炎临床观察

目的观察中药内服结合内热针治疗强直性脊柱炎的临床疗效。方法将72例强直性脊柱炎患者分为治疗组和对照组,每组各36例。治疗组采用中药内服结合内热针治疗,对照组采用口服柳氮磺胺吡啶片和双氯芬酸钠肠溶片治疗。治疗1个月后评定临床疗效,同时测定脊柱疼痛评分与夜间疼痛评分、脊柱活动功能的变化。结果治疗组总有效率为91.7%,对照组总有效率为83.3%,差异有统计学意义(P0.05);两组患者脊柱疼痛评分与夜间疼痛评分治疗后均有下降趋势,但治疗组下降更为明显,差异有统计学意义(P0.05);两组患者Schober实验与胸廓活动度均有一定程度改善,但是治疗组改善较为显著(P0.05)。结论中药结合内热针治疗能显著改善患者脊柱运动功能与疼痛,且临床疗效明显优于口服西药治疗。     

西药联合中药熏蒸治疗强直性脊柱炎的临床疗效及护理观察

目的对应用西药联合中药熏蒸治疗强直性脊柱炎的临床疗效及护理效果进行观察;方法以我院2015年4月至2017年3月诊治的68例强直性脊柱炎患者为研究对象,根据治疗方式将患者分为中药熏蒸组与非中药熏蒸组,各34例;两组患者均进行中药治疗,观察西药联合中药熏蒸的临床疗效与护理效果;结果中药熏蒸组患者临床有效率为88.6%,非中药熏蒸组患者临床有效率为62.4%,中药熏蒸组治疗效果优于非中药熏蒸组(P0.05);中药熏蒸组患者治疗前后手指地间距、髋关节前屈、枕墙距及髋关节后伸比较,数据差异具有统计意义(P0.05);中药熏蒸组患者的ESR、CRP下降幅度优于非中药熏蒸组(P0.05);结论对AS患者采用西药联合中药熏蒸方式治疗,具有积极的临床疗效,安全性高。     

云克联合治疗强直性脊柱炎疗效评价

目的评价云克联合治疗强直性脊柱炎的疗效。方法选取活动期强直性脊柱炎初诊患者56例,随机分为两组:治疗组(云克 甲氨喋呤和/或柳氮磺吡啶)28例、对照组(非甾类抗炎药 甲氨喋呤和/或柳氮磺吡啶)28例,对比观察两组治疗前后临床症状、实验室指标变化及不良反应。结果治疗后两组各项指标均较治疗前明显改善(P<0.001),治疗组总有效率为95%,对照组总有效率93%,两组比较,无统计学意义(P>0.05),治疗组在疼痛程度、疾病活动度评价及Dougados指数等指标的改善值高于对照组(P<0.05),且不良反应的发生率少于对照组,两者差异有统计学意义(P<0.05)。结论云克联合治疗强直性脊柱炎疗效可靠,副作用少。     

热敏灸配合蜂针治疗强直性脊柱炎的疗效观察

目的：探讨热敏灸配合蜂针治疗强直性脊柱炎的疗效观察。方法：将我院108例强直性脊柱炎患者随机分为两组,治疗组54例,对照组54例。治疗组采用热敏灸配合蜂针治疗,对照组采用传统针灸治疗。结果：治疗组54例患者坚持持续治疗疼痛均改善,畸形没有明显继续加重,总有效率为74.07%,对照组总有效率为42.31%,两组比较,差异有统计学意义（P〈0.05）。结论：热敏灸配合蜂针治疗强直性脊柱炎疗效确切、经济方便,而且该治疗方法简单、副作用小,值得临床推广。     

中西医结合治疗强直性脊柱炎患者疼痛的效果观察

目的探讨和观察中西医结合疗法用于改善强直性脊柱炎患者疼痛的效果。方法选取2017年5月～2018年5月我院收治的强直性脊柱炎患者60例,分为两组,每组30例,两组均予以常规治疗,观察组同时联合中药治疗,连用3个月,治疗后对比两组的临床疗效及VAS评分的变化情况。结果研究组患者治疗后的总有效率达93.3%,显著高于对照组的总有效率70.0%,差异具有显著性(P0.05),治疗后研究组和对照组患者的VAS评分分别显著低于治疗前(P0.05),且研究组患者的VAS评分显著低于对照组,差异具有显著性(P0.05)。结论中西医结合疗法用于改善强直性脊柱炎可以显著提高临床疗效,减轻患者的疼痛,值得广泛推广和应用。     

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.