二黄去脂汤治疗痰瘀内阻证非酒精性脂肪肝临床研究

目的:探讨二黄去脂汤治疗痰瘀内阻证非酒精性脂肪肝的临床疗效.方法:将80例痰瘀内阻证非酒精性脂肪肝患者随机分为对照组和治疗组各40例.对照组给予东宝肝泰片,每天3次,每次4片;治疗组给予二黄去脂汤(方药组成:姜黄15 g,酒大黄12 g,茯苓15 g,泽泻15 g,枳壳12 g,郁金15 g,丹参30 g,三七粉10 g,生山楂30 g,何首乌20 g,决明子20 g)治疗,每天1剂,水煎服.两组治疗期间均低盐低脂饮食,戒烟限酒,适当体育锻炼.3个月为1个疗程.结果:治疗组有效率为95.00％,对照组有效率为80.00％,两组比较x2 =4.114,P=0.043＜0.05,有显著性差异,治疗组优于对照组.结论:二黄去脂汤治疗痰瘀内阻证非酒精性脂肪肝疗效显著.     

肝脂消胶囊治疗非酒精性脂肪肝临床研究

目的 观察肝脂消胶囊治疗非酒精性脂肪肝的临床疗效和安全性,并探讨其治疗机制.方法 选择120例非酒精性脂肪肝,中医辨证属脾虚湿盛、痰热血瘀、阻滞脉络之证患者,随机分为治疗组60例,对照组60例.治疗组口服肝脂消胶囊,对照组口服东宝肝泰片,两组均治疗90 d.观察中医证候积分、肝功能、血脂及肝脏B超治疗前后变化.结果 治疗组临床证候总有效率为95.0%,两组比较P＜0.05.两组对降低患者的血脂、血清转氨酶及脂肪肝的影像学改变方面有明显的作用;治疗组在改善脂肪肝患者的症状及影像学改变等方面的作用优于对照组,P＜0.01.结论 肝脂消胶囊用于非酒精性脂肪肝的治疗,其主要机理为健脾化湿、清热化痰、活血通络,有较好的临床疗效,无明显毒副作用.     

针药结合治疗风痰阻络证中风后吞咽障碍患者75例临床观察

目的 观察化痰通咽汤结合针灸治疗中风后风痰瘀阻证吞咽障碍的临床疗效.方法 选取在武汉市第一医院康复医学科住院的证属风痰瘀阻证中风后吞咽障碍患者150例,随机分为对照组和治疗组各75例.治疗组采用针刺结合化痰通咽汤进行治疗,对照组采用针刺治疗,两组均给予神经内科基本治疗和康复治疗,疗程4周,对比临床疗效.结果 治疗后两组洼田饮水试验评分,吞咽功能障碍中医评价量表评分,电视X线透视吞咽功能检查,吞咽困难生活质量测量比较差异均有统计学意义,治疗组优于对照组(P＜0.05).结论 在神经内科基本治疗和康复治疗基础上综合运用化痰通咽汤结合针灸治疗中风后风痰瘀阻证吞咽障碍患者,能提高疗效,值得推广应用.     

扶正消脂汤治疗非酒精性脂肪肝60例临床观察

目的：观察自拟扶正消脂汤治疗非酒精性脂肪肝的疗效。方法：治疗组用自拟扶正消脂汤治疗非酒精性脂肪肝60例,同时与对照组60例应用口服水飞蓟宾胶囊,比较两组疗效。蛄果：治疗组总有效率为90．00％,对照组总有效率为68．33％,两组比较。差异有显著性（P＜0．05）。结论：自拟扶正消脂汤治疗非酒精性脂肪肝有较好的疗效。     

痰瘀通胶囊治疗非酒精性脂肪肝合并高脂血症的临床研究

目的观察痰瘀通胶囊治疗非酒精性脂肪肝(NAFLD)合并高脂血症(痰瘀互结证)的临床疗效。方法 93例NAFLD合并高脂血症患者随机分为治疗组62例,对照组58例,分别给予痰瘀通胶囊和易善复胶囊治疗3个月。观察两组的临床疗效,肝脏B超、肝功能、血脂及血液流变学变化。结果两组患者治疗后症状积分下降(P0.01),且治疗组优于对照组(P0.01);治疗组总有效率优于对照组(P0.05)。治疗组超声声像、血脂异常明显改善且优于对照组(P0.05或P0.01)。两组肝功能明显改善(P0.01),但组间比较差异无统计学意义(P0.05)。治疗组血流变显著改善且优于对照组(P0.05或P0.01)。结论痰瘀通胶囊治疗非酒精性脂肪肝合并高脂血症(痰瘀互结证)有较好疗效,具有护肝、降脂、改善血流变等作用。     

保肝消脂方治疗肝郁脾虚型非酒精性脂肪肝临床疗效观察

目的探讨“保肝消脂方”治疗非酒精性脂肪肝的临床疗效.方法将62例非酒精性脂肪肝患者随机分为2组,治疗组给予“保肝消脂方”联合血脂康治疗,对照组给予血脂康治疗,疗程均为8周,观察2组患者临床症状、肝功能、B超的变化.结果治疗组治疗8周后治愈8例,显效13例,有效5例,无效4例,总有效率86.67%.对照组治愈3例,显效9例,有效12例,无效8例,总有效率75.00%.两组疗效比较差异有统计学意义(P<0.05).结论“保肝消脂方”联合血脂康治疗非酒精性脂肪肝疗效优于单用血脂康.     

马万千老中医化痰祛瘀方治疗痰瘀互结型非酒精性脂肪肝疗效评价研究

目的探讨马万千老中医化痰祛瘀方治疗痰瘀互结型非酒精性脂肪肝的疗效。方法选择2017年2月—2018年6月在我院接受治疗的痰瘀互结型非酒精性脂肪肝患者90例进行研究。采用随机数字表法将患者分为两组,观察组60例,对照组30例。对照组仅予生活方式干扰,观察组在此基础上采用马万千老中医"化痰祛瘀通络"治疗方案治疗。对比两组患者疗效、中医证候学指标、肝功能、血脂指标及安全性指标。结果对照组有效率为60.00%,明显低于观察组的81.67%(P0.05)。干预后两组患者中医症状积分均明显下降,但观察组下降幅度更大(P0.05)。干预后两组患者谷丙转氨酶、谷草转氨酶水平均明显下降,但观察组下降幅度更大(P0.05)。干预后两组患者血清总胆固醇、甘油三酯及低密度脂蛋白胆固醇均明显下降,但观察组下降更明显,高密度脂蛋白胆固醇均明显上升,但观察组升高幅度更大(P0.05)。两组患者治疗前后血常规、便常规、粪常规、肾功能均未出现异常,对照组未出现不良反应,观察组出现1例(1.67%)腹泻,两组对比差异均无统计学意义(P0.05)。结论化痰祛瘀方治疗痰瘀互结型非酒精性脂肪肝较常规生活方式干扰可明显提高疗效,改善中医症状、肝功能,降低血脂水平且具有较高的安全性。     

肾复汤治疗慢性肾炎痰瘀互结证的疗效及对血清脂联素的影响分析

目的:观察肾复汤治疗慢性肾炎痰瘀互结证的疗效及对血清脂联素的影响。方法:选取本院2017年5月—2018年10月收治的106例慢性肾炎患者,按照随机数字表法将其分为两组,各53例。对照组给予常规治疗,在此基础上,观察组给予肾复汤治疗。观察两组疗效、血清脂联素及中医证候积分。结果:对照组总有效率低于观察组,差异有统计学意义(P<0.05);治疗后,两组血清脂联素高于治疗前,中医证候积分低于治疗前,且观察组改善更加显著,差异有统计学意义(P<0.05)。结论:肾复汤可有效提高慢性肾炎痰瘀互结证患者血清脂联素水平,改善患者临床症状,提高治疗效果。     

垂葛酒肝丸治疗酒精性脂肪肝疗效观察

目的通过观察垂葛酒肝丸对酒精性脂肪肝(痰瘀互结型)临床症状的改善,肝功能的变化、肾功能的变化、肝脏影像学改变,评价垂葛酒肝丸治疗酒精性脂肪肝的有效性及安全性.方法选择酒精性脂肪肝符合痰瘀互结型患者80例,随机分为治疗组42例、对照组38例.两组均予基础治疗:禁酒,调整饮食结构,低脂、低糖饮食,控制体重,适当锻炼.治疗组:给予垂葛酒肝丸口服;对照组:多烯磷脂酰胆碱胶囊口服.30天为一疗程,共三个疗程后评判疗效,并观察肝肾功的变化.结果经治疗后治疗组总有效率97.62%,优于对照组84.21%;治疗组患者中医证候改善明显,ALT、AST、GGT有明显降低,且优于对照组(P<0.05或P<0.01);肾功BUN、SCr均正常.结论垂葛酒肝丸治疗脂肪肝的疗效显著,能明显改善患者症状和肝功能;无肝肾功能损坏,安全性高.     

消脂护肝胶囊治疗非酒精性脂肪肝82例

目的评价消脂护肝胶囊治疗非酒精性脂肪肝的临床疗效。方法对确诊为非酒精性脂肪肝的135例患者,随机分为治疗组82例和对照组53例。治疗组服用消脂护肝胶囊,对照组服用东宝肝泰片,疗程为12周。观察治疗前后临床症状、肝脏超声、肝功能及血脂的变化。结果治疗组总有效率为91．46％,对照组总有效率为79．24％,两组比较差异有统计学意义（P〈0．05）。结论消脂护肝胶囊治疗非酒精性脂肪肝的疗效强于东宝肝泰片,是治疗非酒精性脂肪肝的有效药物。     

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.