加味枳术汤治疗功能性便秘的临床研究

目的：观察加味枳术汤治疗功能性便秘的治疗效果及停药2周后复发情况。方法：根据罗马兀便秘诊断标准,排除肠道器质性病变,选取功能性便秘患者76例,随机分为加味枳术汤治疗组40例和服用果导片对照组36例。结果：服药2周后对照组和治疗组总有效率分别为63．99／6、90．0％,两组总有效率比较,差异有统计学意义（χ^2=7．4392,P〈0．05）;停药2周后,对照组和治疗组分别复发11,2例,两组复发率比较,差异有统计学意义（χ^2=14．5968,P〈0．05）。结论：加味枳术汤治疗便秘具有明显疗效和较低的复发率．     

温和灸配合润肠通幽汤治疗老年习惯性便秘疗效观察

目的：观察温和灸配合润肠通幽汤治疗老年习惯性便秘的临床疗效。方法对107例患者随机分为2组,治疗组根据辩证分型分为4个证型,采用温和灸配合润肠通幽汤为基础方随症加味治疗;对照组给予乳果糖口服液口服治疗。结果治疗组总有效率为93%,对照组78%,2组比较有显著性差异（ P﹤0.05）。结论温和灸配合润肠通幽汤对老年习惯性便秘疗效显著,且远期疗效巩固,不易复发。     

肛管松解术配合养阴汤治疗泻药性便秘的疗效观察

目的观察肛管松解术配合养阴汤治疗泻药性便秘的临床疗效。方法将98例泻药性便秘患者随机分为两组。治疗组56例,采用肛管松解术配合养阴汤治疗;对照组42例,采用聚乙二醇4000散口服治疗。观察两组临床疗效及主症积分的变化。结果两组临床疗效比较,治疗组总有效率为92.86%,对照组为76.19%,治疗组疗效优于对照组(P0.05)。两组总积分比较,治疗前差异无统计学意义(P0.05);治疗后1周,治疗组优于对照组(P0.05);治疗后2周和3周,治疗组均明显优于对照组(P0.01)。两组主症积分比较,治疗前差异无统计学意义(P0.05);在排便频率、排便困难程度方面,治疗后1周,治疗组优于对照组(P0.05),治疗后2周和3周,治疗组均显著优于对照组(P0.01);在粪便性状方面,治疗后1周,差异无统计学意义(P0.05),治疗后2周和3周,治疗组优于对照组(P0.05)。结论肛管松解术配合养阴汤治疗泻药性便秘具有良好治疗效果,值得临床推广应用。     

加味白术汤治疗虚秘型便秘58例疗效观察

[目的]观察加味白术汤治疗虚秘型便秘的临床疗效.[方法]采用随机分组对照试验方法,将86例虚秘型便秘患者随机分为治疗组(58例)和对照组(28例),分别以加味白术汤汤剂(由白术、熟地、菟丝子、当归、肉苁蓉、牛蒡子、桔梗、槟榔等中药组成)及酚酞片治疗,疗程4周,观察停药2周后的临床效果和排便间隔时间的变化.[结果](1)治疗组服药1 d后即出现不同程度排便的有30例(占51.72%),对照组有16例(占57.14%),两组比较差异无显著性意义(P＞0.05).(2)停药2周后,治疗组和对照组的总有效率分别为89.65%和46.43%,两组比较治疗组疗效优于对照组(P＜0.01).(3)治疗后2组患者的排便间隔时间均有显著缩短(与治疗前比较,P＜0.01);且治疗组在停药2周后的排便间隔时间较对照组显著缩短(P＜0.01).[结论]加味白术汤治疗虚秘型便秘的近期疗效与酚酞片相当,而远期疗效则优于酚酞片.     

加味四妙汤合金黄膏外敷治疗急性痛风性关节炎临床疗效观察

目的 观察加味四妙汤合金黄膏外敷治疗急性痛风性关节炎的临床疗效。方法 将82例急性痛风性关节炎患者随机分为对照组40例和治疗组42例。对照组采用洛索洛芬钠片治疗,治疗组采用加味四妙汤合金黄膏外敷治疗,2组疗程均为2周,观察2组总有效率、治疗前后主要症状体征积分、显效时间及红细胞沉降率(ESR)、C-反应蛋白(CRP)、血尿酸(UA)水平。结果 1治疗组总有效率为90.48%,对照组总有效率为77.50%,2组比较差异有统计学意义(P0.05);22组治疗后关节疼痛、红肿、活动受限等主要症状体征积分均较治疗前有改善(P0.05),治疗组积分优于对照组(P0.05);3治疗组显效时间与对照组比较,差异无统计学意义(P0.05);42组治疗后ESR、CRP、UA水平均较治疗前降低(P0.05),治疗组UA水平优于对照组(P0.05)。结论 加味四妙汤合金黄膏外敷治疗急性痛风性关节炎,不仅能改善临床症状,缩短显效时间,还能促进UA排泄,减轻炎症反应。     

微生态制剂和乳果糖联合治疗儿童功能性便秘疗效分析

目的分析微生态制剂和乳果糖联合治疗儿童功能性便秘的临床疗效和不良反应。方法 75例功能性便秘患儿随机分成两组：治疗组45例,对照组30例。对照组采用基础疗法,包括调整饮食、训练排便习惯及每日进行适量活动等;治疗组在此基础上加服微生态制剂和乳果糖溶液。治疗4周,停药后随访8周。采用症状评分方法评价疗效。结果治疗组总有效率为88.89%,对照组总有效率为46.67%,治疗组疗效优于对照组（P〈0.01）,且远期复发率较对照组低（7.5%vs78.6%）（P〈0.01）;两组在治疗前后均进行大便pH值测定,治疗组差异有高度统计学意义（P〈0.01）,而对照组差异无统计学意义（P〉0.05）;治疗组有1例出现轻度腹泻,两组未发现其他不良反应。结论微生态制剂和乳果糖联合治疗儿童功能性便秘疗效显著。     

枸橼酸莫沙必利联合胆宁片治疗老年性功能性便秘的临床研究

目的 观察枸橼酸莫沙必利联合胆宁片治疗老年性功能性便秘的临床疗效.方法 将114例老年性功能性便秘患者随机分为3组,对照组A、B组,各38例,A组给予枸橼酸莫沙必利,B组给予胆宁片,治疗组C组38例,给予枸橼酸莫沙必利联合胆宁片.3组患者共治疗4周,评估疗效、记录不良反应,并比较复发率.结果 治疗4周后,3组患者总有效率分别为60.5％,81.6％,97.4％,C组疗效显著高于A、B组(P<0.05),A、B组比较差异有统计学意义(P<0.05);C组排便次数、大便性状、排便困难缓解程度与A、B组比较差异有统计学意义(P<0.05);停药4周后随访,各组复发率比较差异无统计学意义;各组患者不良反应均较低.结论 枸橼酸莫沙必利联合胆宁片可有效治疗老年性功能性便秘,不良反应小,值得临床推广应用.     

加味六磨汤治疗结直肠癌术后早期炎症性肠梗阻临床研究

目的:观察加味六磨汤治疗腹腔镜结直肠癌切除术后早期炎症性肠梗阻的临床疗效。方法:将74例腹腔镜结直肠癌切除术后早期炎症性肠梗阻患者,按随机数表法分成对照组和试验组。对照组37例,采用开塞露灌肠治疗;试验组37例,采用加味六磨汤灌肠治疗。比较两组患者治疗前后中医证候积分、便秘积分、生存质量评分的变化情况及不良反应发生率,评价临床疗效。结果:和治疗前相比,治疗后、治疗后10 d两组患者中医证候积分、便秘积分均明显下降,生存质量评分均明显上升,差异有统计学意义(P0.05);和治疗后相比,治疗后10 d两组患者中医证候积分、便秘积分均明显下降,生存质量评分均明显上升,差异有统计学意义(P0.05);治疗后、治疗后10 d试验组中医证候积分、便秘积分均显著低于对照组,生存质量评分均明显高于对照组,差异有统计学意义(P0.05);对照组不良反应发生率明显高于试验组,差异有统计学意义(P0.05);对照组临床有效率明显低于试验组,差异有统计学意义(P0.05)。结论:加味六磨汤治疗腹腔镜结直肠癌切除术后早期炎症性肠梗阻疗效确切,可显著改善患者便秘情况,提高临床疗效,降低不良反应的发生,提高生存质量。     

乳果糖口服液治疗婴幼儿功能性便秘疗效观察

目的观察乳果糖口服液治疗婴幼儿功能性便秘(FC)的疗效。方法 60例FC患儿分为2组,每组30例。对照组采用调整饮食、适量活动、使用开塞露等对症治疗,观察组在对照组的基础上加用乳果糖口服液,疗程3周,观察便秘改善情况。结果观察组治疗前后患儿临床症状积分分别为13.24±1.73和7.85±1.46,对照组分别为13.46±1.67和11.64±1.56;2组治疗前患儿临床症状积分比较差异无统计学意义(P>0.05);观察组治疗后患儿临床症状积分显著低于治疗前(P<0.01);对照组治疗前后患儿临床症状积分比较差异无统计学意义(P>0.05);治疗后观察组患儿临床症状积分显著低于对照组(P<0.05)。结论乳果糖口服液治疗婴幼儿FC有良好疗效,且不良反应少。     

气滞胃痛颗粒联合乳果糖治疗便秘型肠易激综合征临床研究

目的:观察气滞胃痛颗粒联合乳果糖治疗便秘型肠易激综合征(irritable bowel syndrome,IBS)临床疗效。方法:将便秘型IBS患者90例分为两组,A组45例口服气滞胃痛颗粒+乳果糖,B组45例口服乳果糖,治疗8周。对比两组临床疗效。结果:A组有效率为93.33%,B组有效率为84.44%,两组有效率比较差异具有统计学意义(P0.05)。两组患者疗程结束3个月随访期间疗效比较,A组有效率为88.89%,B组有效率为64.44%,两组有效率比较差异具有统计学意义(P0.05)。治疗2周后统计两组患者排便次数和正常粪便性状比较,A组优于B组,差异均有统计学意义(P0.05)。结论:气滞胃痛颗粒联合乳果糖治疗便秘型肠易激综合征疗效确切。     

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.