胃病胃镜像与中医辨证的相关性探讨

目的:研究胃病中医辨证与胃镜像的相关性。方法:采用门诊或住院病人作为研究对象,按临床中医诊断辨证分型,然后按照我们拟定的胃镜下中医望诊分型标准另行分型,根据中医辨证分型和胃镜像特征分类比较。结果:胃病中医分型与胃镜下中医望诊分型标准一致度高。结论:我们拟定的胃镜下中医望诊分型方法能指导胃病中医分型。      

慢性乙型肝炎患者内皮素变化与中医各证型关系的探讨

对慢性乙型肝炎（以下简称“慢肝”）的治疗，目前中、西医未取得突破性进展，中医辨证施治疗效与辨证的准确性关系甚大，由于中医辨证客观指标少，更缺乏量化指标．故慢肝辨证分型客观量化指标的研究一直为中医临床和科研工作者所重视，有鉴于此，本研究采用国内权威性慢肝诊断，中医辨证分型标准，通过大样本临床观察，就内皮素（ET）的变化与中医各证型关系进行探讨，为了辅助慢肝中医证型诊断的量化，寻找新的途径．现将研究资料报道如下：     

慢性乙型病毒性肝炎中医证型与肝功能指标的相关性研究

为进一步加深对慢性乙型病毒性肝炎(以下简称慢乙肝)中医证型实质的认识,以探讨慢乙肝中医辨证分型的客观依据,我们对200例慢乙肝患者进行了辨证分型和肝功能多项生化指标的检测,并对慢乙肝中医证型与肝功能生化指标之间的关系进行了分析,现报告如下.     

鼻咽癌中医辨证分型与病理组织学关系初探

为了探讨鼻咽癌中医辨证分型的实质，寻求鼻咽癌中医辨证分型的客观依据，本研究首次对１７６例鼻咽癌初诊患者进行了中医辨证分型与病理组织学及癌间质反应关系的前瞻性研究。初步发现鼻咽癌的辨证分型与癌间质反应具有密切的关系；痰浊结聚型以癌间质中淋巴细胞，浆细胞，肥大细胞的浸润程度较高，气血凝结型以癌间质中血管的增生程度较高，火毒困结型以癌间质中中性白细胞的浸润程度较高。故认为癌间质反应的不同可能是鼻咽癌微观     

非酒精性脂肪肝肝纤维化指标与中医辨证分型相关性探讨

目的探讨非酒精性脂肪肝患者肝纤维化指标与中医辨证分型的关系.方法将46例非酒精性脂肪肝患者予以中医辨证分型,并作肝纤维化指标检测,以不嗜酒的健康人作为对照.结果脂肪肝组肝纤维化指标明显高于对照组(P＜0.05,P＜0.01);治疗组内各证型间比较,痰浊夹瘀型的Ⅲ型前胶原(PCⅢ)、层粘连蛋白(LN)明显高于其他三型.结论非酒精性脂肪肝患者存在不同程度的肝纤维化倾向,并与中医辨证分型具有一定的关系.     

白血病的中医辨证分型及其与微观指标关系的研究进展

白血病是正常造血组织发育过程中某一阶段细胞恶性扩增的克隆性异质性疾病.近年来,白血病中医辨证分型各家说法不一,中医辨证与白血病微观指标关系的研究也有了长足进展.本文综述白血病的中医辨证分型及其与微观指标关系的研究进展.     

女性盆腔炎性疾病红外热像与中医证候关系

目的:分析女性盆腔炎性疾病(pelvic inflammatory disease,PID)红外热像与中医证候关系。方法:对229名PID患者进行盆腔红外热像检测,并根据盆腔炎诊疗方案进行中医辨证。结果:PID患者盆腔红外热像可呈高温像(86%)、低温像(4.8%)和高低温共存像(9.2%);红外热像表现与年龄密切相关;研究中未发现寒湿凝结证患者,低温像组中未发现湿热瘀结证病例,湿热瘀结证病例有10.1%表现为高低温共存像,脾虚湿瘀互结证和气滞血瘀证病例在三个像组中均占一定比例。结论:盆腔红外热像检测客观反映了PID病理变化的复杂多样性,热是PID的主要致病因素及病理改变;PID红外热像表现与年龄密切相关,说明PID的病理状态与年龄密切相关;红外热像检测为PID的中医辨治提供了新的思路。     

慢性肝炎辨证分型的实验研究综述

慢性肝炎(包括慢性迁延性肝炎和慢性活动性肝炎),中医之发病机理复杂,症状繁多,且证型与证型间互为间挟或出现转换,故临床各家辨证分型不一。有的学者从现代生理、生化及免疫学等方面进行了探讨,目前集中在免疫学和血液流变学与辨证分型关系的实验研究方面,对慢性肝炎辨证分型的客观化和标准化研究进行了有益的探索。本文对慢性肝炎辨证分型的有关实验研究综述如下。1 慢性肝炎辨证分型与免疫学指标的关系慢性肝炎的发病机制目前仍不十分清楚,但已知机体对肝炎病毒的免疫过程的失调,是导致慢性化的关键。故慢性肝炎辨证分型与免疫学指标的关系也是十分密切的。概括起来主要表现为以下四个方面。     

血液流变学与血栓性浅静脉炎辨证分型相关性

目的:探讨血栓性浅静脉炎的血液流变学指标与中医辨证分型之间的关系.方法:将本组95例患者根据中医辨证分型分为湿热蕴结型(A组),瘀血阻络型(B组),肝气郁结型(C组)和健康对照组(D组),观察各组患者的血液流变学变化.结果:患者组的全血粘度、红细胞沉降率、红细胞变形指数、电泳指数、血浆纤维蛋白原等多项指标与正常组比较,差异有显著意义,各患者组之间的各项指标也存在一定的差异性.结论:血栓性浅静脉炎血液流变学与中医辨证分型之间存在一定关系,临床血液流变学指标的监测对血栓性浅静脉炎的诊断及治疗均有一定的指导意义.     

慢性乙型肝炎证型与生化指标关系的研究

分析142例慢性乙型肝炎的中医辨证分型的4种临床类型与HBV复制程度、蛋白代谢功能、肝功能及免疫功能的异常关系，为中医证型提供客观的实验室检查指标，与现代医学关于慢性乙型肝炎进展基本一致。     

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.