补肾活血祛痰方治疗肥胖型多囊卵巢综合征疗效分析

目的 评价补肾活血祛痰方治疗肥胖型多囊卵巢综合征疗效。方法 抽取2018 年1 月～2019 年5 月我院收治的70 例肥胖型多囊卵巢综合征患者为研究对象,随机将其分为对照组与治疗组。对照组（35 例）采用常规治疗,治疗组（35 例）采用中药补肾活血祛痰方治疗。比较两组患者症状评分、血清性激素水平、血脂水平、体质量和胰岛素抵抗改善情况。结果 治疗组患者症状评分明显低于对照组,差异有统计学意义（P＜0.05）;治疗组血清性激素水平、血脂水平优于对照组,差异有统计学意义（P＜0.05）;治疗组体质量及胰岛素抵抗改善情况优于对照组,差异有统计学意义（P＜0.05）。结论 补肾活血祛痰方治疗肥胖型多囊卵巢综合征能明显改善血清性激素水平、血脂水平,降低体质量,改善胰岛素抵抗,值得推广。     

补肾祛痰化瘀方联合二甲双胍治疗多囊卵巢综合征40例疗效观察

目的观察补肾祛痰化瘀方联合二甲双胍治疗多囊卵巢综合征(PCOS)的临床疗效。方法将2011年6月至2013年6月在我院门诊就诊的40例PCOS患者以补肾祛痰化瘀方联合二甲双胍治疗3个月经周期,观察患者治疗前后月经来潮情况、性激素水平、体质量指数(BMI)、胰岛素抵抗指数(IR)。结果治疗后月经来潮情况明显改善,总有效率75%;睾酮(T)、促黄体生成素(LH)/卵泡刺激素(FSH)、BMI、IR均下降,差异有统计意义(P<0.05)。结论补肾祛痰化瘀方联合二甲双胍治疗多囊卵巢综合征效果显著,值得临床推广应用。     

自拟补肾祛痰方联合克罗米芬治疗多囊卵巢综合征所致不孕30例疗效观察

目的：探讨自拟补肾祛痰方联合克罗米芬治疗多囊卵巢综合征所致不孕的临床疗效。方法选取我院2014年1月—2015年9月接收的60例多囊卵巢综合征所致不孕患者,随机均分为对照组和观察组,对照组患者采用克罗米芬治疗,观察组患者采用自拟补肾祛痰方联合克罗米芬治疗,观察并对比2组治疗效果。结果观察组治疗总有效率（90%）高于对照组（66.6%）,差异具有统计学意义（P<0.05）。结论采用自拟补肾祛痰方联合克罗米芬治疗多囊卵巢综合征所致不孕,能有效改善患者临床症状,使患者月经周期和月经量基本恢复正常,恢复排卵,整体提高了治疗有效率。     

多囊卵巢综合征患者的临床护理措施分析与研究

目的：分析多囊卵巢综合征患者的临床护理措施。方法：多囊卵巢综合征患者100例,随机分为观察组和对照组。对照组采用多囊卵巢综合征常规护理,观察组在对照组基础上采用优质综合护理干预。结果：观察组治疗期间妊娠率显著高于对照组（P ＜0.05）,干预后观察组睾酮、黄体生成素、空腹血糖显著优于对照组（P ＜0.05）。结论：采用优质综合护理干预多囊卵巢综合征效果良好,能够提高妊娠率,促进病情好转。     

益气补肾痰瘀活化方治疗不稳定型心绞痛32例临床观察

目的 观察益气补肾痰瘀活化方治疗UA患者的临床疗效及预后.方法 将纳入的64例UA患者按标准对照1∶1比例,按治疗方法不同分为治疗组、对照组各32例.两组均以阿司匹林、单硝酸异山梨酯、美托洛尔为治疗药,治疗组加服益气补肾痰瘀活化方汤药,按疗程服用.结果 临床主症与兼症积分治疗组明显优于对照组(P＜ 0.01),心电图改善对照组65.62％,治疗组87.50％,治疗组明显优于对照组(P＜0.05);治疗组血清CRP值下降水平优于对照组(P＜0.01);治疗组心脏事件发生率下降水平优于对照组(P＜ 0.01).结论 益气补肾痰瘀活化方治疗UA患者临床疗效显著,预后良好.     

补肾化瘀方对PCOS大鼠卵巢颗粒细胞FSHR、LHR蛋白表达的影响

目的 通过观察补肾化瘀方对大鼠卵巢颗粒细胞上卵泡刺激素受体(FSHR)、黄体生成素受体(LHR)蛋白的表达,探讨中药对多囊卵巢综合征(PCOS)卵巢局部的影响及作用机制.方法 应用补肾化瘀方作用于以丙酸睾酮联合HCG诱导PCOS大鼠模型,采用免疫组化法,检测PCOS大鼠颗粒细胞FSHR、LHR蛋白表达.结果 与正常组相比,模型组大鼠卵巢体质量增加,呈多囊性改变,卵泡颗粒细胞减少而膜细胞层增加,补肾化瘀方组卵巢形态接近正常组.补肾化瘀方能明显提高PCOS大鼠颗粒细胞FSHR、LHR蛋白表达,补肾化瘀方各剂量组与模型组和妈富隆阳性对照组比较差异均有统计学意义(P＜0.05或0.01),而中剂量组与正常对照组比较,差异均无统计学意义.结论 补肾化瘀方能提高PCOS大鼠卵巢颗粒细胞FSHR、LHR蛋白表达,可能与补肾化瘀方具有促进卵泡发育和排出的作用机制有关.     

妈富隆联合二甲双胍治疗多囊卵巢综合征临床观察

目的 探讨妈富隆联合二甲双胍治疗多囊卵巢综合征的临床疗效.方法 48例多囊卵巢综合征不孕患者按照随机分组的方法分为两组.其中观察组24例患者应用妈富隆+二甲双胍治疗;对照组24例患者应用妈富隆治疗.观察两组的临床表现、性激素水平、胰岛素水平及卵巢体积大小等各项指标变化.结果 两组月经稀发、面部痤疮、多毛症状发生率均明显低于治疗前;两组LH、T均较治疗前明显下降(P＜0.05);观察组(A组)FG、INS、IBM较治疗前明显下降,其中INS、IBM与对照组(B组)比较差异有统计学意义(P＜0.05);两组患者经过治疗3个疗程后发现,与治疗前相比,两组患者的卵泡数及卵巢体积均有所下降(P＜0.05).结论 在妈富隆的治疗基础上,联合二甲双胍更能明显改善患者的内分泌状况,在降低胰岛素、促黄体生成素及睾酮水平方面效果更优,进而提高多囊卵巢综合征的治愈率.     

补肾化瘀法治疗多囊卵巢综合征探讨

目的关于补肾化瘀法对多囊卵巢综合症治疗的效果探讨。方法选择2017年7月至2018年8月我院收治的多囊卵巢综合征患者80例以随机方法分为常规治疗组和中医治疗组,每组患者平均为40例,常规治疗组选择常规西药治疗方案治疗,中医治疗组则在常规治疗组基础之上采用中医补肾化瘀法进行治疗,评价治疗效果并作比较。结果常规治疗组的治疗总有效率为77.50%(31/40),中医治疗组为92.50%(37/40),P0.05,差异存在统计学意义;比较两组患者治疗结束后的血清促卵泡生成激素(FSH)、促黄体生成激素(LH)、雌二醇(E2)、睾酮(T)等相关情况,中医治疗组优于常规治疗组,P0.05,差异存在统计学意义。结论选择采用补肾化瘀方法进行多囊卵巢综合征的治疗能提升治疗效果,改善患者的相关指标,值得推广。     

优思明联合二甲双胍治疗青春期多囊卵巢综合征疗效观察

目的 探讨优思明联合二甲双胍治疗青春期多囊卵巢综合征的临床疗效.方法 选取60例青春期多囊卵巢综合症患者随机分为两组.其中研究组30例应用优思明联合二甲双胍治疗;对照组30例应用优思明治疗.治疗3个周期后,观察两组的临床表现、性激素水平、胰岛素水平及卵巢体积大小等各项指标变化.结果 两组月经稀发、闭经、面部痤疮、多毛症状发生率明显低于治疗前;两组黄体生成素(LH)、睾酮(T)均较治疗前明显下降(P＜0.05);研究组血糖(FPG)、胰岛素(FINS)体质量指数(BMI)较治疗前明显下降,与对照组比较差异有统计学意义(P＜0.05);两组患者与治疗前相比,卵泡数和卵巢体积均有下降(P＜0.05).结论 优思明联合二甲双胍能明显改善患者的内分泌情况及胰岛素抵抗,是目前治疗青春期多囊卵巢综合征较为有效的理想方法.     

多囊卵巢综合征所致不孕症25例采用补肾活血中药加克罗米芬治疗的临床效果

目的探索多囊卵巢综合征所致不孕症25例采用补肾活血中药加克罗米芬治疗的临床疗效。方法选取我院在2012年12月至2015年12月期间收治的50例多囊卵巢综合征所致不孕症患者,进行动态随机化分为两组(观察组和对照组),每组各有25例患者,对照组采用克罗米芬治疗,观察组采用补肾活血中药联合克罗米芬治疗。结果观察组患者的雌二醇、黄体生成素、卵泡刺激素、睾酮指标以及妊娠率显著优于对照组(P0.05)。结论补肾活血中药联合克罗米芬治疗多囊卵巢综合征所致不孕症患者效果显著。     

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.