神经阻滞配合推拿治疗重症肩周炎的临床观察

目的探讨重症肩周炎的有效治疗方法。方法通过二种神经阻滞方法配合中医推拿治疗重症肩周炎100例．对比观察治疗效果．探讨更有效的中西医结合疗法。结果二种阻滞方法优良率经x^2检验．差异无统计学意义。二组病例达优良率的累积治疗平均次数，经检验差异有统计学意义。对疼痛症状治疗的均数二组差异无统计学意义，功能障碍推拿松解均数差异有统计学意义。结论臂丛神经阻滞下推拿松解可作为重症肩周炎的首选方法。‘     

神经阻滞下粘连松解术与关节松动术治疗粘连性肩周炎的疗效评价

目的比较臂丛阻滞和星状神经节阻滞下分别配合粘连松解术和关节松动术治疗粘连性肩周炎的疗效。方法60例粘连性肩周炎患者随机分为4组,每组15例：Ⅰ组：臂丛阻滞下粘连松解术;Ⅱ组：臂丛阻滞下关节松动术;Ⅲ组：星状神经节阻滞下粘连有限松解术;Ⅳ组：星状神经节阻滞下关节松动术;记录治疗方法及次数、治疗前后疼痛程度以及肩关节运动功能状态。结果近期疗效优良率Ⅳ组显著优于其他3组（P〈0.05）;神经阻滞＋手法治疗次数及痛点注射治疗次数Ⅰ组与Ⅱ、Ⅲ、Ⅳ组相比差异有显著的统计学意义（P〈0．01）。结论星状神经节阻滞下关节松动术疗效最好,对关节功能的改善更为显著,且患者无手臂麻木无力引起的不适感,治疗依从性较好。     

臂丛神经阻滞下针刺配合推拿治疗肩周炎

[目的]探讨治疗肩周炎的快速有效疗法。[方法]肩周炎102例,随机分为臂丛神经阻滞下针刺配合推拿治疗组52例,单纯针刺组50例,对患者治疗前后自觉疼痛、肩关节活动情况进行评定。[结果]臂丛神经阻滞下针刺配合推拿治疗组与单纯针刺对照组痊愈率比较,差异有非常显著性意义（P〈0．05）。[结论]臂丛神经阻滞下针刺配合推拿疗法可快速提高肩周炎疗效。     

臂丛神经阻滞加阿是穴注药治疗肩周炎的体会

目的 探讨肩周炎的中西医结合治疗。方法 选择60例肩周炎患者，随机分成2组，每组30例，采用不同方法进行观察。A组肌间沟臂丛阻滞加功能锻炼；B组肌间沟臂丛阻滞加阿是穴注液加推拿按摩手法松解黏连加功能锻炼。结果 两组治愈率A组40％，B组90％，B组明显优于A组（P〈0．05）。结论 中西医结合治疗肩周炎是较理想的治疗方法。     

神经阻滞加痛点注射治疗冻结肩的临床观察

目的：评价神经阻滞及痛点注射治疗冻结肩的疗效。方法：将所诊治的肩周炎患者中的冻结肩患者76例，所有病例首次就诊时都先在臂丛阻滞下完成手法松解，次日开始治疗。随机分为观察组神经阻滞（肩胛上神经阻滞、星状神经节阻滞）及痛点注射；对照组TDP照射及痛点注射组。治疗效果分Ⅳ级：优、良、好转、无效。结果：神经阻滞加痛点注射组优81．6％，良15．8％，优良率97．4％。TDP照射及痛点注射组优28．9％，良47．4％，优良率76.3％。两组间疗效的差异有统计学意义。结论：神经阻滞加痛点注射用于冻结肩疗效明显优于TDP照射加痛点注射。     

神经阻滞配合推拿治疗肩周炎100例

临床上治疗肩周炎的方法颇多,如中药西药、针灸、理疗、推拿等,均有一定疗效,但疗程长患者常感不便,甚至间断治疗,使病情久治不愈。近10余年疼痛门诊以神经阻滞为主配合手法治疗,使肩周炎疗效明显提高。我们选择两种神经阻滞方法配合中医推拿治疗肩周炎100例,对比观察治疗效果及治疗次数,探讨更有效、便捷、治疗次数少的中西医结合疗法。全部病例由熟练神经阻滞操作者及西学中     

神经阻滞加痛点注射治疗冻结肩的临床观察

目的:评价神经阻滞及痛点注射治疗冻结肩的疗效。方法:将所诊治的肩周炎患者中的冻结肩患者76例,所有病例首次就诊时都先在臂丛阻滞下完成手法松解,次日开始治疗。随机分为观察组神经阻滞(肩胛上神经阻滞、星状神经节阻滞)及痛点注射;对照组TDP照射及痛点注射组。治疗效果分IV级:优、良、好转、无效。结果:神经阻滞加痛点注射组优81.6%,良15.8%,优良率97.4%。TDP照射及痛点注射组优28.9%,良47.4%,优良率76.3%。两组间疗效的差异有统计学意义。结论:神经阻滞加痛点注射用于冻结肩疗效明显优于TDP照射加痛点注射。     

痛点注射曲安奈德并配合推拿治疗肩周炎的疗效观察

目的 观察肩关节周围痛点注射曲安奈德治疗后再配合中医推拿对治疗肩关节周围炎(简称肩周炎)疗效的影响。方法 把216例早、中、后期肩周炎患者分成A、B两组，A组肩关节周围痛点注射曲安奈德后自行功能锻炼；B组肩关节周围痛点注射曲安奈德后配合正规中医推拿手法。结果 早期患者A、B两组疗效无明显差异，中、后期患者A、B两组疗效有明显差异，B组优于A组。结论 早期肩周炎患者单独应用肩关节周围痛点注射曲安奈德的治疗方法即可取得良好疗效，且经济、简便。中、后期患者特别是后期患者需采用痛点注射与推拿相结合的方法，方能提高疗效。     

痛点阻滞与臂丛神经阻滞联合应用治疗肩周炎的体会

目的观察痛点阻滞联合臂丛神经阻滞、配合手法运动治疗伴有不同程度肩关节活动受限的肩周炎的疗效。方法收集各种类型的肩周炎患者82例，采用曲安奈德20～30mg＋0．5％布比卡因等组成10mL混合液，作痛点阻滞，7d注射一次，最多注射3次；臂丛神经阻滞术：痛点阻滞结束、患者无明显不适后行患侧臂丛神经阻滞术，用2％利多卡因5～10mL＋当归2mL＋NS至15mL注射，1次，d，连续5次；手法治疗：按肩关节受限的程度给予适当的松解运动术。结果患者肩关节活动范围和疼痛程度均明显改善。结论该法对各种类型肩周炎治疗具有见效快、疗效确切、疗程相对较短等优点，可临床推广应用。     

痛点阻滞、小针刀配合手法松解治疗粘连性肩周炎

目的:观察痛点阻滞、小针刀配合手法松解治疗粘连性肩周炎的疗效。方法:粘连性肩周炎患者随机分成治疗组和对照组,每组40例。对照组采用痛点阻滞疗法;治疗组采用痛点阻滞、小针刀治疗配合手法松解,观察两组疗效并比较。结果:治疗组治愈率57.5%,优良率90.0%,明显高于对照组的32.5%及55.0%,差异有统计学意义(P<0.01)。结论:痛点阻滞后再用小针刀配合手法治疗粘连性肩周炎疗效较单用痛点阻滞疗法好。     

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.