应用生物反馈技术治疗肠易激综合征的临床观察

目的探讨生物反馈治疗对肠易激综合征（IBS）的疗效。方法 28例IBS患者进行了生物反馈治疗,治疗前后分别对患者作抑郁自评量表（SDS）、焦虑自评量表（SAS）和胃肠道症状评定量表（GSRS）评分,.并作比较。结果 28例患者中有23例伴有抑郁、焦虑等心理障碍,治疗后SDS、SAS和GSRS评分均有明显下降（P<0.05）;另5例无明显心理障碍,治疗后GSRS评分也有下降,但差异无显著性（P>0.05）。结论 IBS患者多伴有心理障碍,生物反馈治疗有明显效果。     

肌电生物反馈技术治疗肠易激综合征的临床观察

目的:评价肌电生物反馈技术治疗肠易激综合征(IBS)的疗效。方法:将60例IBS患者随机分为试验组和对照组,两组均给予胃肠促动力药、肠道菌群调节药及植物神经调节药等常规药物治疗,试验组在此基础上给予为期4周的肌电生物反馈治疗。治疗前后分别对两组患者做抑郁自评量表(SDS)、焦虑自评量表(SAS)、胃肠道症状评定量表(GSRS)评分及内脏痛觉阈值测定。结果:治疗4周后,与对照组相比,试验组SDS、SAS和GSRS评分显著下降(P<0.05),内脏痛觉阈值明显升高(P<0.05)。结论:肌电生物反馈技术治疗IBS可明显改善患者心理障碍,降低患者内脏高敏感性,减轻患者胃肠道症状。     

心理治疗对慢性前列腺炎患者焦虑及抑郁情绪的影响

目的探讨心理治疗对慢性前列腺炎患者焦虑、抑郁情绪的影响。方法将90例确诊为慢性前列腺炎伴有不同程度心理障碍患者随机分为对照组和观察组各45例,对照组用常规药物治疗,观察组在此基础上给予一系列心理治疗措施,分别采用焦虑自评量表（SAS）和抑郁自评量表（SDS）进行测评。结果治疗6周后观察组SAS、SDS评分明显优于治疗前,治疗后观察组SAS、SDS评分均明显优于对照组,差异均有统计学意义（P〈0．05）。结论心理治疗能有效改善慢性前列腺炎患者的焦虑及抑郁情绪,对慢性前列腺炎的治疗有积极作用。     

肠易激综合征患者的心理健康状况分析

目的：探讨肠易激综合征（IBS）与心理健康状况之间的关系．方法：采用心理卫生自评量表（SCL-90）、抑郁自评量表（SDS）、焦虑自评量表（SAS）对40例IBS患者进行了调查．结果：IBS组在躯体化、强迫症状、抑郁、焦虑、恐怖、偏执因子分及总分方面均高于对照组和急性胃炎组（P〈0．05）;IBS组SDS,SAS分值均高于对照组（P〈0．05）．结论：IBS患者存在一定程度的心理异常,心理因素可能在IBS发病过程中起重要作用．     

肠易激综合征患才的心理情绪因素探讨

目的：探讨肠易激综合征（IBS）发病机制和心理情绪间的关系。方法：采用焦虑自评量表（SAS）和抑郁自评量表（SDS）对27例诊断明确的IBS患者进行心理和情绪状态评定。以SAS标准分大于50分,SDS标准分大于53分作为心理和情绪障碍的诊断标准,将IBS患者的SAS、SDS评分与我国常模对照,进行比较研究。结果：IBS患者SAS、SDS标准评分明显高于我国常模,其SAS或SDS标准评分有一项或一项以上达到超过心理情绪障碍的诊断标准。结论：IBS患者普遍地存在着焦虑,抑郁等心理情绪障碍,治疗时应采用相应的措施,以达到预期的效果。     

生物反馈疗法对乙肝肝硬化患者焦虑抑郁状态的治疗效果分析

目的探讨生物反馈疗法对乙肝肝硬化焦虑抑郁的疗效。方法将82例乙肝肝硬化合并焦虑抑郁患者随机分为对照组44例和治疗组38例,两组均给予常规保肝抗乙肝病毒及心理护理干预,治疗组同时予生物反馈治疗4周,采用焦虑自评量表（SAS）、抑郁自评量表（SDS）、生活满意度评定量表（LSR）、90项症状自评量表（SCL-90）进行心理状况调查并评定两组临床疗效。结果治疗结束时,两组SAS、SDS评分较入组时均显著降低;与对照组比较,治疗组SAS、SDS评分显著降低,LSR评分显著升高（P〈0.05）,SCL-90项目中躯体化、强迫、抑郁、焦虑、恐怖、精神病性等因子分及总分下降更明显（P〈0.05）,治疗组有效率高于对照组（P〈0.05）。结论生物反馈治疗乙肝肝硬化焦虑抑郁的疗效优于常规治疗。     

肠易激综合征患者精神心理分析

目的比较肠易激综合征患者（IBS）与正常健康人之间焦虑、抑郁症状的差异,探讨IBS发病与精神心理因素的关系。方法收集蚌埠医学院第一附属医院消化内科确诊的IBS患者100例及正常对照100例,采用焦虑自评量表（SAS）及抑郁自评量表（SDS）分别对2组进行焦虑、抑郁症状评分,并进行统计分析。结果 IBS患者的焦虑、抑郁患病率分别为28%（28/100）、35%（35/100）;IBS患者SAS及SDS评分分别为47.27±10.53、48.16±9.41,正常对照组分别为40.62±8.23、42.25±9.25,IBS组SAS及SDS评分均显著高于正常对照组（P均〈0.01）;其中,女性IBS患者分别占IBS组焦虑、抑郁患病率的64.3%（18/28）、60.0%（21/35）,其SAS及SDS评分分别为49.12±9.21、52.25±9.34,男性IBS患者SAS及SDS评分分别为46.56±8.72、47.81±8.93,女性IBS患者SAS及SDS评分均显著高于男性IBS患者（P均〈0.05）。结论 IBS发病与精神心理因素密切相关,女性IBS患者精神心理症状比男性更为多见。     

支持性心理治疗对系统性红斑狼疮患者的情绪障碍疗效分析

将84例系统性红斑狼疮（SLE）患者随机分为两组，对照组用常规治疗护理；治疗组在此基础上加支持性心理治疗。用抑郁自评量表（SDS）及焦虑自评量表（SAS）对患者入院时和住院治疗2周后的焦虑抑郁状态分别进行评定。探讨SLE患者抑郁焦虑发生的特点及支持性心理治疗对SLE住院期间消除抑郁焦虑的效果。结果：治疗前两组患者约84％有抑郁，约53％有焦虑。治疗后两组SDS、SAS评分均有改善。治疗后对照组抑郁焦虑评分下降无显著性（P〉0．05），而治疗组焦虑抑郁改善非常显著（P〈0．01）。提示支持性心理治疗有助于SLE患者焦虑抑郁状态的改善。     

西酞普兰治疗肠易激综合征的临床观察

目的：探讨抗抑郁药治疗肠易激综合症（IBS）的疗效。方法：将36例患者随机分成两组,抗抑郁组予以抗抑郁药西酞普兰20 mg/日;抗消化不良组根据患者具体症状应用相应消化系统药物治疗;两组均配合一般性支持治疗。治疗期8周,分别予以焦虑自评量表（SAS）和抑郁自评量表（SDS）测评及IBS症状评分。结果：IBS患者的SAS和SDS评分与常规组之间存在显著性差异（P〈0.01）;治疗8周后抗抑郁组SAS和SDS评分及IBS症状评分均明显低于抗消化不良组。结论：IBS患者多存在情绪问题,抗抑郁药不仅能改善患者的情绪状态,而且能明显改善消化系统症状,治疗IBS疗效显著。     

糖尿病患者的心理障碍分析及心理干预

目的：探讨糖尿病患者的心理状态,评估综合心理干预对其的影响。方法：采用抑郁自评量表（SDS）和焦虑自评量表（SAS）评定128例2型糖尿病患者的心理状态。在常规治疗基础上,采用健康教育与心理干预3个月后重新评估SDS及SAS评分,并与国内常模比较。结果：糖尿病患者SDS及SAS评分明显高于国内常模（均P〈0.05）。经过健康教育与综合性心理干预后,糖尿病患者的SDS及SAS评分显著降低（均P〈0.05）。结论：糖尿病患者存在明显的抑郁、焦虑等心理障碍;健康教育与综合性心理干预能缓解和改善糖尿病患者的抑郁、焦虑等症状。     

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.