古今治疗痛经的四物汤类方关联规则研究

用关联规则的数据挖掘方法探讨了古今医家用四物汤类方治疗痛经的用药规则,通过比较其置信度,确定古今医家在用药规律上无显著差别.并通过假设检验找出在治疗痛经时与四物汤关系最密切的药物及药对,即在用四物汤类方治疗痛经时,香附、延胡索是与四物汤同时出现频率最高的药物.香附和延胡索这组药对最常与四物汤配合运用.     

香附四物汤全方与组方药材挥发油经皮外用“药辅合一”作用研究

  目的  比较香附四物汤全方挥发油与组方药材挥发油经皮外用“药辅合一”作用。  方法  以水蒸气蒸馏法提取得到香附四物汤全方挥发油和当归油、川芎油、木香油、香附油等4种组方药材挥发油。采用GC-MS分析挥发油成分, 通过皮肤电阻法比较全方挥发油和各组方药材挥发油的透皮促渗效果, 以人角质形成细胞HaCaT评价挥发油的皮肤细胞毒性, 并采用大鼠离体子宫收缩模型评价全方挥发油和组方药材挥发油的生物效应。  结果  香附四物汤全方挥发油以藁本内酯为其最主要成分, 含量为43.54%;与各组方药材挥发油相比, 全方挥发油含有16种新成分。全方挥发油及4种组方药材挥发油均具有显著的透皮促渗效果(P < 0.05), 其中全方挥发油的促渗作用较强, 是氮酮的2.5倍。5种挥发油对人角质形成细胞的毒性均显著低于氮酮(P < 0.05), IC₅₀值为氮酮的1.98~6.25倍。5种挥发油均不同程度地抑制缩宫素诱导的离体子宫收缩, 其中全方挥发油对平滑肌收缩幅度、收缩频率和肌张力的抑制作用均最强, 分别为66.69%, 47.56%和66.98%。  结论  香附四物汤全方挥发油作为透皮促渗剂应用于中药外用制剂具有低毒、高促渗和生物活性强的特点, 更易发挥“药辅合一”作用。      

理气类中药对大鼠离体胃平滑肌条的作用

目的：观察理气类中药对大鼠离体胃平滑肌条运动的影响。方法：将肌条放置在灌流肌槽中，用生理记录仪记录肌条的收缩活动。结果：陈皮、枳实对胃各部位平滑肌条均为抑制效应，香附、薤白、木香、柿蒂、乌药对胃底肌条为兴奋效应，但对其他部位肌条则表现为兴奋或抑制不同的效应，沉香仅降低胃窦环行肌收缩波平均振幅，对其他肌条无影响。结论：理气类中药对大鼠离体胃平滑肌条既有兴奋作用，也有抑制作用。     

桃红四物汤治疗妇科疾病的药理作用与临床应用进展

桃红四物汤可活血祛瘀、养血调经,是治疗妇科血瘀证的代表方。该方具有调经止痛、促进血管生成和产后子宫修复、调节内分泌、促进卵巢发育、降低血液黏度、抑制血小板聚集等作用,临床上用于治疗痛经、子宫腺肌病、子宫内膜异位症、月经失调、月经失调伴黄褐斑、慢性盆腔炎、产后组织残留、子宫肌瘤等妇科疾病,具有较好的疗效。     

固环止血胶囊对大鼠离体子宫收缩的影响

目的：探讨固环止血胶囊的止血、止痛效应与子宫收缩的相互关系。方法：应用BL-420生物信号系统记录离体大鼠子宫平滑肌的收缩情况,观察不同剂量固环止血胶囊对大鼠离体子宫的收缩的幅度及频率的影响。结果：固环止血胶囊对大鼠离体子宫收缩幅度无明显影响;大中剂量固环止血胶囊可减慢其收缩频率（P〈0.01,P〈0.05）,降低离体子宫的活动力（P〈0.05）。结论：固环止血胶囊的止血、止痛效应与其减慢收缩频率有关,与子宫收缩幅度无关。     

四物汤对小鼠离体子宫收缩模型的生物效应及物质基础评价研究

目的 分析评价四物汤及各分离部位(SW-1～SW-15)对小鼠离体子宫收缩的拮抗效应,并探讨各部位物质基础与效应之间的关系.方法 采用大孔吸附树脂法分离制备各部位样品(SW-1～SW-15);采用小鼠离体子宫收缩模型评价该方及各部位的生物效应;采用HPLC-DAD-ESI-MS法对活性显著部位SW-4中的主要色谱峰进行分析鉴定.结果 四物汤拮抗子宫平滑肌收缩的活性部位主要贡献者是SW-4、SW-7、SW-11 3个部位,部位SW-8、SW-10、SW-13、SW-14也有一定的活性;通过标准化合物对照及质谱特征对活性显著部位SW-4色谱峰进行了归属和指认,鉴定了其中9个化合物分别为没食子酸、原儿茶酸、香草酸、咖啡酸、芍药内酯苷、芍药苷、阿魏酸、洋川芎内酯I、洋川芎内酯H.结论 四物汤拮抗离体子宫收缩效应源于挥发油部位及除去生物大分子的水溶性部位;水溶性小分子部位经大孔树脂吸附醇梯度洗脱得到了30%～40%(SW-7～8)、60%～80%(SW-10～12)两段活性部位.     

丙泊酚、依托咪酯对小鼠离体子宫平滑肌收缩功能的影响

目的观察丙泊酚、依托咪酯对小鼠离体子宫平滑肌收缩功能的影响。方法制备孕9d雌性ICR小鼠子宫平滑肌肌条,采用Med—Lab—U／4cs生物信号采集处理系统记录不同浓度的丙泊酚（2．7、5．4、10．8ug／mL）和依托咪酯（0．2、0．4、0．8ug／mL）对子宫平滑肌收缩张力、强度、频率的影响。结果与基础值比较,2．7ug／mL的丙泊酚使子宫平滑肌的张力、强度降低（P〈0．05）,对其频率、活动力无影响（P〉0．05）;5．4ug／mL、10．8ug／mL丙泊酚使子宫平滑肌的张力、强度、活动力显著降低（P〈0．01）,对频率无影响;而三种浓度依托咪酯对子宫平滑肌的张力、强度、频率、活动力均无影响（P〉0．05）。结论浓度为2．7、5.4、10．8ug／mL的丙泊酚对子宫平滑肌收缩功能有浓度依存性抑制作用。     

少腹逐瘀汤对小鼠离体子宫收缩模型的生物效应及物质基础评价

目的:分析评价少腹逐瘀汤及各分离部位对小鼠离体子宫收缩的拮抗效应,并探讨各部位物质基础与效应之间的关系。方法:采用大孔吸附树脂分离制备各部位样品(SF-1~SF-14);采用小鼠离体子宫收缩模型评价该方及各部位的生物效应;采用TLC法对活性部位进行定性分析,并初步分析各部位所包含化学成分的结构类型与效应间的相关性;采用HPLC-DAD-ESI-MS法对活性显著部位SF-3中的主要色谱峰进行分析鉴定。结果:少腹逐瘀汤拮抗子宫平滑肌收缩的活性部位主要为SF-3、SF-7、SF-10,其化合物类型包含黄酮苷类、内酯类、有机酸类等;部位SF-6、SF-9、SF-11也有一定的活性;通过与标准化合物对照及质谱特征对活性显著部位SF-3色谱峰进行了归属和指认,鉴定了其中11个化合物分别为芍药苷、芍药内酯苷、原儿茶酸、咖啡酸、香草酸、盐酸川芎嗪、阿魏酸、异鼠李素-3-O-芸香糖苷、异鼠李素-3-O-新橙皮糖苷、洋川芎内酯H、洋川芎内酯I。结论:少腹逐瘀汤拮抗离体子宫收缩效应源于挥发油部位及除去生物大分子的水溶性部位的贡献;水溶性小分子部位经大孔树脂吸附,醇梯度洗脱得到了以30%~40%(SF-6、SF-7)、60%~80%(SF-9~SF-11)两段活性部位,前者主含黄酮苷类、内酯类、有机酸类,后者主含生物碱类等;实验中发现生物大分子物质对小鼠离体子宫收缩模型呈现出兴奋作用。     

益母定痛颗粒对动物痛经模型的治疗作用

目的观察益母定痛颗粒对动物痛经模型的治疗作用。方法分别灌胃给予小鼠、大鼠，经十二指肠给予家兔。结果益母定痛颗粒对己烯雌酚和缩宫素联用引起的小鼠痛经模型以及己烯雌酚和前列腺素(PGF2d)联用引起的大鼠痛经模型有明显的治疗作用，显著降低动物扭体反应次数；对家免在体子宫正常收缩的幅度、频率和活动力均有明显抑制作用，对缩宫素引起的家兔在体子宫收缩的幅度有降低趋势，对其收缩的频率和活动力有明显降低。结论益母定痛颗粒对离体和在体痛经动物模型有较好的治疗作用。     

妇科再造丸对正常和妊娠大鼠在体及离体子宫平滑肌收缩的影响

目的：探讨妇科再造丸对正常及妊娠大鼠在体及离体子宫平滑肌收缩的影响,为其临床应用提供药理学实验依据.方法：采用常规方法制备大鼠在体及离体子宫标本,通过BL-420型生物机能实验系统,以子宫收缩的幅度、频率及收缩力作为评价指标,观察不同剂量的妇科再造丸对正常及妊娠大鼠子宫平滑肌收缩的影响.结果：妇科再造丸高剂量组能抑制大鼠子宫平滑肌的收缩幅度、频率及收缩力,与正常对照组比较差异有显著性（P＜0.01）.妇科再造丸中、低剂量组也能不同程度抑制大鼠子宫平滑肌的收缩（P＜0.01,P＜0.05）.结论：妇科再造丸能显著抑制大鼠子宫平滑肌的收缩,并随剂量加大抑制作用加强.     

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.