慢性前列腺炎伴抑郁症的中医证候特征研究

目的 探讨慢性前列腺炎伴抑郁症的中医证候分布特点. 方法 选取符合病例诊断标准的110例患者进行临床证候调查,根据其临床表现,结合中医证候诊断标准, 辨证分析确定其证型;将数据进行统计学处理,分析研究对象各中医证型、证候要素分布的特点.结果 110例患者共计12种证候,包含病位类证素6个,病性类证素11个.实性证候要素中以肝郁、气滞为基本要素,虚性证候要素中以肾虚、脾虚为主,各证候要素按出现频率高低依次为:肝郁>气滞>湿热>肾虚>痰湿>脾虚>血瘀>心虚>气虚>阴虚>阳虚. 结论 慢性前列腺炎伴抑郁症患者中医证候分布具有一定特征性,早期多以实证为主,后期为虚实夹杂证,肾虚肝郁、痰湿瘀阻是其基本病机,为指导临床辨证论治提供了一定的理论依据.     

基于聚类分析的140例中重度手足皮肤反应的中医证型及证型分布特征研究

[目的] 探讨中重度手足皮肤反应(hand-foot skin reaction，HFSR)的中医证型及证型分布特征。[方法] 采用临床流行病学研究中的回顾性时间横断面观察法，收集140例中重度HFSR患者的中医证候资料。通过聚类分析方法提取证候资料，得出中重度HFSR患者的中医证型，并进一步分析各证型的分布特征。[结果] 中重度HFSR中医证型分为3类:热毒蕴肤证、湿热瘀阻证、血虚风燥证；进一步从中分析出HFSR的病因病机为热毒、湿、瘀、血虚、风燥5个因素。中医证型频率分析显示，热毒蕴肤证占15.00%，湿热瘀阻证占56.43%，血虚风燥证占28.57%。所有患者平均疼痛数字评分(numerical rating scale，NRS)为(4.45±2.15)分，其中热毒蕴肤证平均NRS评分(4.14±1.35)分，湿热瘀阻证平均NRS评分(5.86±1.34)分，血虚风燥证平均NRS评分(1.83±0.87)分。轻度疼痛以血虚风燥证为主(71.15%)；中、重度疼痛均以湿热瘀阻证(75.44%、93.55%)为主，差异有统计学意义(P<0.01)。[结论] 中重度HFSR临床最常见证型为湿热瘀阻证，血虚风燥证次之，热毒蕴肤证最少见；其中湿热瘀阻证患者的疼痛程度相对较重，而血虚风燥证相对较轻。     

青年人气胸中医证型分析

目的研究青年人气胸中医证型及症状规律。方法根据中医四诊制定症状观察表,对2001年-2008年间在海南省中医院住院治疗的116例青年人气胸患者中医证型及症状规律进行研究。结果青年人气胸以胸闷为主要症状73例（62.93%）,胸痛为主要症状29例（25.00%）,咳嗽为主要症状13例（11.21%）,其中男性占94.0%,女性占6.0%,中医证型中主要有脾肺气虚、肝气郁结、气滞血瘀、湿热瘀阻等四种类型,其中最多的为湿热瘀阻及气滞血瘀两种类型,所占比例分别为39.7%、31.0%,肝气郁结及脾肺气虚所占比例较少,分别为19.8%、9.5%。结论在海口地区,青年人气胸中医证型主要为湿热瘀阻及气滞血瘀,且以胸闷为主要症状,治疗应有所侧重。     

肿瘤坏死因子-α基因启动子-308位多态性与慢性非细菌性前列腺炎／慢性骨盆疼痛综合征中医证型相关性研究

目的探讨肿瘤坏死因子—α（TNF-α）基因启动子-308位多态性与慢性非细菌性前列腺炎,慢性骨盆疼痛综合征中医证型的相关性。方法采用PCR-R FLP技术结合ELISA法。对115例CPPS患者和21例非CPPS健康人群前列腺液TNF-α水平及启动子-308位基因多态性进行检测。并对其与中医证型的相关性进行了分析。结果CPPS组TNF-α2等位基因型频率显著高于健康对照组,OR=6．286（95％CI1．471-26．850,P〈0．01）。中医证型中。湿热蕴阻证、湿热挟瘀证与TNF—α基因启动子308-2基因型相关。与气滞血瘀证及健康对照组比较差异显著（P〈0．05）。结论TNF-α2等位基因可能与CPPS的易感性相关,并可能是CPPS中医证型中湿热蕴阻证、湿热挟瘀证的易感基因。     

前列舒通胶囊治疗湿热瘀阻型慢性前列腺炎临床观察

目的观察前列舒通胶囊治疗湿热瘀阻型慢性前列腺炎的疗效。方法选取150例湿热瘀阻型慢性前列腺炎患者随机分为治疗组（前列舒通胶囊＋氟哌酸胶囊）和对照组（氟哌酸胶囊）。结果治疗组与对照组的总有效率分别为183.33%、68.33%（“P〈0.05”）,两组间中医证候积分及前列腺液白细胞计数均有显著性差异（“P〈0.05”）。结论前列舒通胶囊可有效治疗湿热瘀阻型慢性前列腺炎,并能提高抗生素的疗效。     

慢性前列腺炎辨证分型与尿流曲线变化相关性的研究

目的探讨慢性前列腺炎辨证分型与尿流曲线变化的相关性。方法选择符合慢性前列腺炎诊断标准的患者102例,按中医辨证分为湿热型、血瘀型、湿热瘀滞型、肾虚湿热型、肾虚血瘀型5组,并以正常人20例作为对照组,测试全部人员尿流曲线图,通过检测结果的分析研究,得出慢性前列腺炎不同证型尿流曲线特点、同一证型尿流曲线变化的规律性。结果①对照组尿流曲线呈"钟"型,或称高尖型、高丘型、丘状型;湿热证、肾虚湿热证尿流曲线呈低平型、低丘型或不规则起伏型;血瘀证、肾虚血瘀证和湿热瘀滞证尿流曲线呈重度低平型、长斜坡型、不规则起伏型、间断丘状型。②以上各证的最大尿流率、平均尿流率和2 s时的尿流率均小于正常对照组,达峰时间大于正常对照组,均有显著差异。③湿热证、肾虚湿热证与血瘀证、湿热瘀滞证、肾虚血瘀证相比,最大尿流率、平均尿流率均大于后三组,达峰时间小于后三组,具有显著性差异。湿热证、肾虚湿热证可见各指标无明显差异;血瘀证、湿热瘀滞证、肾虚血瘀证各组间亦无明显差异。结论慢性前列腺炎综合征患者存在后尿道梗阻现象,后尿道功能性梗阻导致前列腺内尿液返流是其重要发病机制之一。慢性前列腺炎综合征辨证分型中有瘀滞存在的其后尿道梗阻现象愈明显。     

自拟前列腺汤治疗慢性前列腺炎46例

慢性前列腺炎（CP）是临床常见病、多发病,好发于青壮年男性。笔者通过对46例慢性前列腺炎（湿热瘀阻兼肾虚型）患者使用自拟前列腺汤进行观察,取得满意效果。现报道如下。     

中西医结合治疗慢性细菌性前列腺炎140例

目的 观察中西医结合治疗慢性细菌性前列腺炎(湿热瘀阻型)的临床疗效.方法 将270例慢性细菌性前列腺炎(湿热瘀阻型)患者随机分为治疗组140例和对照组130例,两组均以4周为1疗程,比较治疗1个疗程后两组患者总有效率及中医症候学评分.结果 两组总有效率分别为88.10%和66.67%,差异有统计学意义(P<0.01);中医证候学评分显著下降,与对照组比较差异有统计学意义(P<0.01).结论 中西医结合治疗慢性前列腺炎比单纯西医常规治疗的疗效显著.     

300例帕金森病患者病机证素分布规律探讨

目的 根据300例帕金森病患者的中医病机证素的分布及兼夹规律,探讨帕金森病的病机本质。方法 采用流行病学横断面调查方法,对300例帕金森病患者中医病机证素进行分析,总结并归纳病机证素分布及兼夹特点。结果 8种病机证素一共出现1180频次,其中风、阴虚、痰、瘀4种病机证素所占比例最多,分别为22.88%,22.12%,14.89%,17.54%,且以上4种病机证素兼夹患者占总患者数32.33%。结论 肝肾阴虚是该病发生的病理基础,风痰瘀阻为中心病理环节;肝肾阴虚,风痰瘀阻证为该病的主要证型,因此滋补肝肾,化痰熄风通络法为本病主要治疗大法。      

急性冠状动脉综合征中医证候分布规律研究

[目的]通过流行病学调查了解急性冠脉综合征(ACS)患者的中医证候分布规律。[方法]对2006年2月至2009年4月间在我院住院的202例急性冠脉综合征患者中医证候分布规律进行调查研究。[结果]急性冠脉综合征患者证候分布:阳虚血瘀证32例(15.8%)、气虚血瘀证28例(13.9%)、气滞血瘀证28例(13.9%)、痰瘀交阻证24例(11.9%)。兼证中:血瘀证及其兼证(气虚血瘀证+阳虚血瘀证+气滞血瘀证)合计占88例(43.6%)、阳虚及其各兼证组(阳虚寒凝证+阳虚痰瘀证+阳虚血瘀证)合计占62例(30.8%)>气虚及其兼证组(气虚血瘀证+气虚痰瘀证)合计50例(24.8%)。[结论]血瘀阳虚证为急性冠脉综合征的主要证型。     

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.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

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.