国医大师夏桂成运用“阳化气、阴成形”理论防治子宫内膜息肉经验

子宫内膜息肉是临床常见病和多发病,国医大师夏桂成教授基于《黄帝内经》“阳化气、阴成形”理论,认为子宫内膜息肉属本虚标实证,病机为心肾阳虚,气化失常,瘀滞胞宫,治以温阳化气法,结合补肾调周法,并创立温阳化气方,于经前期阳长之时,采用温肾助阳,化气消癥之法,以期“六阳”到位,实现重阳转阴,恢复子宫功能,促进行经期子宫内膜瘀浊及水液排净,减少子宫内膜息肉的复发。      

月经周期与调周法（续1）

本文分析了行经期病理变化，冲任子宫功能失调重阳必阴的转化失常、圆运动生物钟节律失常对月经的影响。论述行经期的治疗方法，一般调经方剂及药物；治疗中要注意重阳及脂膜湿浊，同时还必须认为到初中末三个时期的不同；介绍了几种特殊的调经方法药物，如逐瘀破膜法，温经止痛法，清肝调经法、清降通瘀法、补气调经法、化痰利湿法等。在运用调经方法的同时，务必注意到掌握服药的关键时期，及主次药物的剂量，以及行经期的保护措施     

月经周期与调周法（续2）

本文分析了经后期血、阴、精的物质概念及其相关性与区别；论述了阴长在经后初中末３个阶段中的形式、与“７、５、３”奇数律的关系和重要意义、阴长“７、５、３”规律的类型。指出经后期的病理特点首先是血、阴、精的不足和相互关系失调，其次是阴长运动形式与“３、５、７”奇数律的失常，以及阳消的病变     

韩百灵运用百灵育阴汤治疗妇科疾病经验

百灵育阴汤主要用于治疗肝肾不足、肾精亏虚所致诸症,如肝肾阴虚兼内热导致月经过多、经期延长、崩漏、胎动不安者,可酌加黄芩、地榆炭、茜草炭等清热凉血;兼肝郁者可加郁金、柴胡等疏肝理气;兼见心肾不交者可加交泰丸;兼血瘀者加丹参、赤芍等活血化瘀。运用该方治疗月经病时需根据月经周期的变化调整用药。月经周期的阴阳变化规律为:行经期乃重阳转阴,经后期则阴长阳消,经前期阳长阴消。故治疗月经病前半周期以育阴汤为主,后半周期要加入补阳之品,如肉桂、鹿角霜。同时需重视阴阳转化及阴阳互根互用,"善补阴者,必于阳中求阴,则阴得阳生而泉源不竭。"故于育阴汤中稍加温阳之品,可合阳中求阴之意。     

王隆卉运用蔡氏内异育肾法治疗卵巢子宫内膜异位囊肿经验

目的〓介绍王隆卉教授运用蔡氏内异育肾法治疗卵巢子宫内膜异位囊肿的临床经验。认为宿瘀内结是基本病机，肾虚为重要环节，湿、浊、毒为病理产物。治疗采用活血祛瘀、化痰消癥为主，消除"离经之血"。同时结合育肾调周法，审时论治，行经期治以化瘀止痛，缓解痛经；经后期育肾消坚，化瘀散结，缩小囊肿；经间期、经前期育肾助阳，促进余血浊液的消散。临证注重顾护脾胃，宁心疏肝，中西互参，提高疗效。     

肺源性心脏病的病因病机及治则探讨

据中医理论认为,内外合邪为肺源性心脏病发病之因,气阴两虚为其发病之基础,痰瘀阻络是其主要病理改变,致瘀原因有三：脏气不足,正虚致瘀;痰浊久蕴,导致血瘀,饮食失节,起居失常致瘀。阳虚水泛必使肺心病病情危重。肺心病病位主要在肺,与心脾,肾诸脏关系密切。本文还对清热解毒,化痰降浊,活血化瘀,祛瘀化痰,调理气血,温阳化瘀,清热化瘀,补虚扶正等中医治则进行了分析。     

基于阳热圆运动解析国医大师夏桂成教授“月周律与调周法”

国医大师夏桂成教授所倡导的“月周律与月经周期调治法”(简称“月周律与调周法”)是中医固有的阐述圆运动生物钟规律的理论,有助于分析月经周期和生殖节律的变化。圆运动是宇宙生命运动的普遍规律,古人通过二十四节气描述大自然中与生物生命相关的阳热降沉升浮的圆运动。月周律是女性自身阳热降沉升浮圆运动的结果,同时受大自然阳热圆运动的影响。月周律与大自然阳热圆运动存在着对应关系：阳热升极而降与经期重阳转阴相应;阳热金秋肃降与经后期阳消阴长相应;阳热降极而升与经间期重阴转阳相应;阳热春木温升与经前期阴消阳长相应。调周法的本质是基于月周律,恢复机体阴阳消长及动静升降的正常节律。     

论中医夏季养生调摄观

夏季是一年中自然界阳气最旺的时期,天地气交,阳长阴消达到顶点,人们应该合理的利用自然界阳热之势调补身体。该文从起居有常、饮食有节、精神舒畅、劳作有度、房事和合等方面,结合夏季的特点,根据天人相应理论,探讨中医夏季养生的原则。     

刘华一教授从"痰瘀浊毒"理论论治慢性萎缩性胃炎的经验撷菁

基于慢性萎缩性胃炎炎癌转化的机制,探讨并总结刘华一教授从"痰瘀浊毒"理论论治慢性萎缩性胃炎的经验.刘华一教授认为慢性萎缩性胃炎的炎癌转化阶段,既有脾胃气阴的亏虚,又有瘀血、痰饮、浊毒等内蕴.刘华一教授在治疗本病时,提出慢性萎缩性胃炎防癌治疗三大法则:一当扶正补虚,二当消瘀化痰,三当解毒消癥,予扶正消瘀化浊毒方随证加减,...     

营卫失常与动脉粥样硬化相关性探讨

阐述营卫失调与动脉粥样硬化及其斑块形成的相关性。首先提出将动脉粥样硬化斑块的中医病名定为"脉积"。营卫功能与血脉紧密相关,营卫又与体质量、体脂、血糖、血压相关,营卫失常是肥胖、糖尿病、高血压、高脂血症的基本病机,因此,营卫失常与脉积密切相关。其中,营气失常,痰浊瘀血内结,成为脉积的基本成分;营阴亏虚,阴不制阳,火热内生,扰动气血,炙灼动脉,有形之邪稽留,发生脉积。卫气失常是脉积发病之关键。卫气有余,火热灼脉;卫气失常,腠理疏松,痰浊瘀血遁脉,久成脉积。总之,营卫失常,动脉损伤,发生脉积。因此,通调营卫是防治脉积的基本原则。     

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.     

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.     

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.