“冬病夏治”单一疗法和综合疗法治疗慢性呼吸系统疾病疗效对比观察

[目的]对比＂冬病夏治＂单一疗法和综合疗法治疗慢性呼吸系统疾病的疗效。[方法]478例支气管哮喘、慢性支气管炎、慢性咽喉炎、过敏性鼻炎、慢支伴肺气肿的患者,在＂三伏天＂以中药内服、外用穴位敷贴及耳穴按压相结合的综合疗法和单一使用穴位敷贴的单一疗法疗效做对比,并作随访观察,最后对随访结果进行分析。[结果]慢性呼吸系统疾病患者采用＂冬病夏治＂综合疗法治疗,较单一治疗明显改善,两组疗效比较有统计学差异（P〈0.05）,特别是针对支气管哮喘、慢性支气管炎、慢性咽喉炎、过敏性鼻炎的治疗,综合疗法组较单一疗法组明显改善,两组间比较有统计学意义（P〈0.05）。[结论]＂冬病夏治＂综合疗法控制和治疗慢性呼吸系统疾病效果明显。     

冬病夏治治疗慢性支气管炎及支气管哮喘121例临床观察

慢性支气管炎及支气管哮喘是临床的常见慢性呼吸系统疾病,好发于春秋及冬季.我们自2003年以来,在夏季三伏采用穴位药物敷贴法治疗本病121例,疗效明显,现总结报告如下.     

硫酸镁加酚妥拉明治疗哮喘急性发作116例疗效分析

目的探讨硫酸镁注射液与酚妥拉明对慢性支气管炎、支气管哮喘、慢性肺心病所致哮喘急性发作的疗效。方法将167例患者随机分为硫酸镁注射液加酚妥拉明治疗的观察组与常规治疗的对照组。观察组116例,对照组51例。两组均予氨苄青霉素或舒他西林抗感染,治疗组予硫酸镁注射液3～5g加酚妥拉明10mg于5%葡萄糖溶液100mL中缓慢静滴;对照组予氨茶碱、地塞米松常规治疗。两组皆每日1次,7～14d为一疗程。结果两组总有效率分别为93.97%和80.39%。治疗组的综合疗效明显优于对照组（P〈0.01）。结论硫酸镁注射液加酚妥拉明对于慢性支气管炎、支气管哮喘、慢性肺心病所致的哮喘急性发作具有较好疗效。亦适用于慢性肺心病,因其具有抗心律失常、改善心功能、纠正心衰等作用。     

穴位贴敷联合大青龙汤治疗小儿哮喘外寒内热证的临床研究

【目的】观察穴位敷贴联合大青龙汤治疗小儿支气管哮喘外寒内热证的临床疗效。【方法】选择外寒内热证轻—中度慢性持续期哮喘患儿105例,随机分为敷贴联合大青龙汤组、大青龙汤组、孟鲁司特钠组各35例,分别给予穴位敷贴联合大青龙汤、大青龙汤、孟鲁司特钠治疗,疗程均为4周,随访12周。观察3组治疗前后中医症候积分变化及随访12周末哮喘控制水平、哮喘急性发作次数、病程长短等。【结果】(1)治疗后4周末及16周末,3组的症候积分均显著减少,与治疗前比较差异均有统计学意义(P0.05);治疗后4周末,敷贴联合大青龙汤组的症候积分减少优于大青龙汤组(P0.05),与孟鲁司特钠组比较差异无统计学意义(P0.05);治疗后16周末(即随访12周末),敷贴联合大青龙汤组的症候积分减少优于大青龙汤组及孟鲁司特钠组,差异均有统计学意义(P0.05)。(2)敷贴联合大青龙汤组的临床控制水平优于大青龙汤组及孟鲁司特钠组,差异均有统计学意义(P0.01)。(3)与大青龙汤组、孟鲁司特钠组比较,敷贴联合大青龙汤组的哮喘急性发作次数最少、病程最短,差异有统计学意义(P0.01)。【结论】穴位贴敷联合内服大青龙汤能够减轻小儿支气管哮喘外寒内热证的临床症状,提高哮喘控制水平,减少急性发作次数,缩短病程。     

硫酸镁加酚妥拉明治疗哮喘急性发作116例疗效分析

目的探讨硫酸镁注射液与酚妥拉明对慢性支气管炎、支气管哮喘、慢性肺心病所致哮喘急性发作的疗效。方法将167例患者随机分为硫酸镁注射液加酚妥拉明治疗的观察组与常规治疗的对照组。观察组116例,对照组51例。两组均予氨苄青霉素或舒他西林抗感染,治疗组予硫酸镁注射液3～5g加酚妥拉明10mg于5%葡萄糖溶液100mL中缓慢静滴;对照组予氨茶碱、地塞米松常规治疗。两组皆每日1次,7～14d为一疗程。结果两组总有效率分别为93.97%和80.39%。治疗组的综合疗效明显优于对照组(P<0.01)。结论硫酸镁注射液加酚妥拉明对于慢性支气管炎、支气管哮喘、慢性肺心病所致的哮喘急性发作具有较好疗效。亦适用于慢性肺心病,因其具有抗心律失常、改善心功能、纠正心衰等作用。     

穴位敷贴治疗过敏性哮喘的临床研究

目的:研究穴位药物敷贴治疗过敏性哮喘的临床治疗效果.方法:采用穴位药物敷贴疗法,并与西药氨茶碱治疗作比较,分析疗效.结果:穴位敷贴疗法对发作期哮喘患者的远期疗效明显优于口服氨茶碱,并发现穴位敷贴法对哮喘各中医辨证分型有明显不同的治疗效果,其近期疗效与病程及病情轻重无明显关系.结论:穴位药物敷贴疗法治疗过敏性哮喘效果优良.     

热敏腧穴穴位敷贴治疗支气管哮喘（慢性持续期）20例

目的：比较热敏腧穴穴位敷贴与传统腧穴穴位敷贴治疗支气管哮喘（慢性持续期）患者的疗效差异。方法：40例支气管哮喘（慢性持续期）患者随机分为热敏腧穴穴位敷贴试验组（以下简称试验组）和传统腧穴敷贴对照组（以下简称对照组）各20例,于夏季三伏天进行敷贴治疗,敷药时间为4h,1次/10d,3次为一疗程,共治疗一疗程。于治疗前与治疗后3个月进行疗效比较。结果：试验组有效率为85%,对照组有效率为55%,与对照组相比,试验组疗效差异有统计学意义（P〈0.05）。结论：治疗支气管哮喘（慢性持续期）患者热敏腧穴穴位敷贴疗法优于常规腧穴穴位敷贴疗法。     

中医外治疗法治疗支气管哮喘的临床观察与护理干预

目的探讨中医外治疗法治疗支气管哮喘的临床疗效与护理措施。方法将82例患者随机分为治疗组和对照组各41例,对照组41例采用肌注胸腺五肽注射液及口服茶碱缓释片,治疗组41例用自体血穴位注射及穴位敷贴外治疗法配合良好的护理措施,观察治疗前后哮喘发作次数及发作程度的变化。结果治疗组有效率为80%,对照组为51%,两组差异有统计学意义(P<0.05)。结论采用自体血穴位注射联合穴位敷贴的中医外治疗法配合良好的护理措施治疗支气管哮喘疗效满意。     

冬病夏治“喘敷贴”穴位贴敷临床研究

目的探讨＂喘敷贴＂穴位敷贴预防支气管哮喘的临床疗效及安全性。方法选择143例支气管哮喘患者,随机分为试验组和对照组。试验组采取穴位贴敷方法,对照组贴敷安慰剂。两组均间隔4d贴敷1次,共贴敷8次。通过观察两组患者治疗前后的中医临床症状来评价＂喘敷贴＂预防哮喘的临床疗效。结果中医证候疗效评价显示,试验组总有效率为94.67%,对照组总有效率为47.06%。单项症状喘息疗效评价显示,试验组总有效率为95.24%,对照组为51.02%;胸膈满闷疗效评价显示,试验组总有效率为90.62%,对照组为55.10%;哮鸣音疗效评价显示,试验组总有效率为95.16%,对照组为40.82%。结论中药＂喘敷贴＂三伏天穴位贴敷可显著减轻哮喘缓解期患者的症状,有利于控制哮喘病冬季发作。     

中药穴位敷贴治疗、护理支气管哮喘的临床研究

目的观察中药穴位敷贴治疗、护理支气管哮喘的临床疗效。方法选取128例支气管哮喘患者,将这些患者随机分为对照组和治疗组,对照组给予内科常规治疗、护理,治疗组除给予内科常规治疗、护理外,于缓解期在三伏天加中药穴位敷贴3个疗程,将两组疗效进行比较。结果两组总有效率比较,无显著性差异（P〉0.05）;治疗组治愈率显著高于对照组（P〈0.05）;治疗组复发率显著低于对照组（P〈0.05）。结论三伏天中药穴位敷贴治疗、护理支气管哮喘临床疗效显著,是提高支气管哮喘治愈率和降低复发率的有效方法,值得临床推广应用。     

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.