中药活血祛瘀汤辅治药物流产的临床分析

目的研究中药活血祛瘀汤辅治药物流产的临床效果。方法选取我院在2018年5月至2019年5月收治的70例要求流产产妇为研究对象,将其随机分成对照组和实验组两个组别,每组35例。两组均采用米非司酮和米索前列醇进行药物流产,实验组在此基础上加以中药活血祛瘀汤进行辅助,观察两组产妇的流产效果、孕囊排出时间和完全流产产妇阴道出血时间。结果实验组流产有效率高于对照组流产有效率,数据差异显著,P0.05;同时实验组产妇的孕囊排出时间和完全流产产妇阴道出血时间都显著优于对照组,数据差异显著,P0.05。结论中药活血祛瘀汤辅治药物流产的临床效果显著,能够显著提高产妇的流产有效率以及显著改善流产产妇孕囊排出时间和阴道出血时间,值得临床推广。     

米索前列醇不同给药途径对药物流产结局的影响

目的 探讨米索前列醇口服、舌下含服与阴道给药对药物流产结局的影响,比较3种给药方式对早期妊娠的药物流产的效果.方法 分别采用口服(Ⅰ组241例),舌下含服(Ⅱ组238例)和阴道给药(Ⅲ组240例)的给药方法,比较药物流产者胎囊排出情况、流产结局以及不良反应.结果 Ⅰ组完全流产率(88.38％),与Ⅱ组(95.80％)、Ⅲ组(97.50％)比较,差异有显著性(P＜0.01).Ⅲ组中有234例排出胎囊,排出时间为( 147.36±99.08)分,与其他两组比较,差异有显著性(P＜0.01).三组的腹痛程度比较,差异无显著性(P＞0.05).Ⅲ组阴道出血量少,与Ⅰ、Ⅱ组比较,差异有显著性(P＜0.01).Ⅰ、Ⅱ组不良反应发生率较高,与Ⅲ组比较,差异有显著性(P＜0.01).结论 米索前列醇阴道给药以及舌下含服给药可代替传统的口服给药途径.     

五加生化胶囊用于药物流产160例临床观察

目的：观察五加生化胶囊用于药物流产的临床效果。方法：320例早孕妇女分为2组,观察组口服米非司酮及米索前列醇,同时加服五加生化胶囊,每次6粒,每日2次,共9 d;对照组口服米非司酮及米索前列醇。结果：观察组完全流产率为96.25%,对照组84.38%,两组差异有统计学意义（P〈0.05）;观察组孕囊排出时间和排出孕囊后阴道出血时间均明显短于对照组（P〈0.05）。结论：五加生化胶囊用于药物流产成功率高、孕囊排出时间短、阴道出血时间少,值得临床广泛推广。     

葆宫止血颗粒对药流后阴道出血的治疗效果

目的：观察葆宫止血颗粒对药物流产后阴道出血的治疗效果。方法120例早孕需行药物流产的患者,随机分为两组。观察组患者于孕囊排出后给予葆宫止血颗粒15 g口服,2次/d,共用6 d;对照组患者孕囊排出后未服任何药物。记录两组患者的阴道出血量和出血时间。结果观察组患者的阴道出血量明显比对照组的少,差异有统计学意义（P＜0.05）。观察组患者的出血时间明显短于对照组,差异有统计学意义（P＜0.05）。结论葆宫止血颗粒具有减少阴道出血量、缩短阴道出血时间的作用。     

药物流产后加服益母生化汤缩短阴道流血时间临床观察

目的:探讨加服益母生化汤对缩短药物流产后阴道出血时间的作用。方法:将107例早孕妇女分为两组,实验组于排出孕囊后加服益母生化汤,对照组排出孕囊后不加服益母生化汤,观察流产效果。结果:完全流产率:实验组98.1%,对照组89.1%,差异有极显著统计学意义(P<0.01)。阴道出血时间在14d内,实验组70.6%,对照组34.6%,差异有极显著统计学意义(P<0.01)。结论:益母生化汤有缩短药物流产阴道出血时间的作用。     

药物流产后加服米索前列醇对缩短阴道出血时间的临床观察

目的探讨药物流产后加服米索前列醇对缩短阴道出血时间的作用。方法将215例早孕妇女分成两组,实验组于排出孕囊后,加服米索前列醇600μg;对照组排出孕囊后,不加服米索前列醇,以观察流产效果。结果完全流产率实验组为98.11%,对照组为88.90%（P〈0.01）有极显著性差异。平均阴道出血时间,实验组为13.22±7.53d,对照组为21.44±14.13d,（P〈0.01）有极显著性差异。结论药物流产后加服米索前列醇有缩短阴道出血时间的作用。     

药流后加服米非司酮及生化汤减少宫腔残留的临床观察

目的：观察米非司酮联合生化汤减少药物流产后宫腔残留，缩短流产后阴道出血时间的效果。方法：选取2006年6月至2007年6月在我院行药物流产者80例，随机分成两组，每组各40例，观察组于排出胎囊后即加服米非司酮25mg，间隔12小时再加服25mg，同时口服中药生化汤每日1付，1日2次，连用3天。对照组胎囊排出后不加用米非司酮及生化汤。结果：观察组药物流产后完全流产率明显高于对照组，两者比较有极显著性差异（P〈0．01）。流产后阴道出血时间明显短于对照组。结论：药流后加服米非司酮及生化汤可以减少药物流产后宫腔残留，缩短阴道出血时间。     

药物流产后加服生化丸103例临床观察

目的 :探讨药物流产后加服生化丸对阴道出血时间的作用。方法 :选择 10 3例需终止妊娠的健康初孕妇女 ,随机分为二组 ,实验组于排出孕囊后加服中药生化丸 ,每日 3次 ,每次 1丸 ,共服 2日 ,对照组排出孕囊后不加服生化丸 ,以观察流产效果。结果 :完全流产率 ,实验组为 98% ,而对照组为 83 0 2 % ,(P <0 0 5 ) ,均有显著的差异。平均阴道出血时间 ,实验组为 (13 14± 8 5 1)天 ,对照组为 (2 1 2 2± 13 13)天 ,(P <0 0 5 ) ,有显著的差异。结论 :中药生化丸有缩短药物流产后阴道出血时间的作用     

中药配合西药终止早孕的临床观察

目的观察中药配合西药终止早孕的临床效果。方法将86例38—49d早孕孕妇随机分为观察组和对照组，每组43例。观察组口服米非司酮片25mg，bid，第3天口服米索前列醇600μg，服药前后2h禁食，凉开水送服，开始出血加服中药，计算孕囊排出时间，对照组单服西药。同时计算妊娠物排出时间、阴道出血时间、阴道出血量、副作用及月经复潮情况。结果观察组完全流产率、平均妊娠物排出时间及出血时间明显优于对照组，差异具有显著性（P〈0．05）。结论中药配合人流药终止早孕各种并发症少，更安全、有效、可行。     

复方米非司酮用于终止早孕的效果观察

目的：观察复方米非司酮用于终止早期妊娠的临床效果。方法：意外妊娠停经小于等于49天的早孕妇女90例,随机分为观察组和对照组。观察组使用复方米非司酮配伍米索前列醇,而对照组使用米非司酮配伍米索前列醇。观察并比较两组孕囊排出情况、出血时间及出血量、完全流产率及药物的不良反应。结果：观察组和对照组的完全流产率及药物的副作用发生率并无显著差异,观察组的孕囊排出时间及出血时间明显短于对照组。结论：复方米非司酮终止早期妊娠安全有效,与米非司酮相比可以加速孕囊排出及减少出血量。     

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.