参苓白术散联合美沙拉嗪肠溶片治疗脾虚湿盛证轻中度克罗恩病的临床研究

目的：观察参苓白术散联合美沙拉嗪肠溶片治疗脾虚湿盛证轻中度克罗恩病的临床疗效。方法：将60例符合纳入标准的克罗恩病患者随机分为对照组和观察,各30例。对照组予以美沙拉嗪肠溶片口服,观察组在对照组基础上加用参苓白术散口服。治疗疗程为12周。比较2组患者治疗前后CDAI评分、血清中炎症因子水平、免疫功能情况、中医证候评分的改变。结果：观察组和对照组治疗后的CDAI评分,中医证候评分,血清中IL-17A、TNF-α、CRP、ESR、CD4⁺T淋巴细胞水平均较治疗前降低,CD8⁺T淋巴细胞水平较前升高,但观察组的改变更加显著,差异具有统计学意义(P<0.05)。观察组与对照组的临床缓解率分别为83.33%和53.33%,随访6个月,复发率分别为10%和33.33%,差异均具有统计学意义(P<0.05)。结论：参苓白术散联合美沙拉嗪肠溶片治疗脾虚湿盛证轻中度克罗恩病症性肠病患者疗效显著,能减轻机体炎症反应,增强免疫功能,可有效减少复发率,延缓疾病的进展。     

参苓白术散加减配合中药保留灌肠治疗脾胃虚弱型溃疡型结肠炎疗效观察

目的:观察和分析参苓白术散加减配合中药保留灌肠治疗脾胃虚弱型溃疡性结肠炎的临床疗效。方法:74例患者随机分成治疗组和对照组。治疗组37例用以参苓白术散加减配和中药保留灌肠治疗;对照组37例用以美沙拉嗪联合中药保留灌肠治疗,疗程为6周,观察疗效。结果:治疗6周后,治疗组治愈率91.9%,总有效率97.3%;对照组治愈率81.8%,总有效率89.2%。两组治愈率及总有效率均具有统计学意义(P0.05)。结论:参苓白术散方加减配合中药保留灌肠治疗脾胃虚弱型溃疡性结肠炎疗效优于美沙拉嗪联合中药保留灌肠。     

参苓白术散对脾胃气虚型溃疡性结肠炎患者的疗效评价

目的评价脾胃气虚型溃疡性结肠炎患者予以参苓白术散治疗的临床效果。方法评价对象选择我院2016年2月至2017年2月所收治的脾胃气虚型溃疡性结肠炎患者60例,以计算机表法进行分组,对照组与观察组(30例/组)。对照组给予美沙拉嗪进行治疗,观察组给予参苓白术散进行治疗,对比2组的疗效。结果每组分别实施不同的治疗方案,观察组的治疗总有效率相比对照组更高。予以统计学检验数据差异明显(P0.05),统计学有分析意义。结论应用参苓白术散对脾胃气虚型溃疡性结肠炎患者进行治疗。     

溃结方联合隔药灸治疗大肠湿热型溃疡性结肠炎疗效观察

目的:观察溃结方灌肠联合隔药灸对大肠湿热型溃疡性结肠炎(UC)的治疗作用。方法:纳入符合标准的80例轻中度大肠湿热型UC患者,按照随机数字表法分为治疗组与对照组各40例,对照组给予美沙拉嗪肠溶片,每次1 g,日4次;治疗组以溃结方灌肠联合隔参苓白术散艾灸神阙穴治疗,连续治疗4周。评价治疗后两组患者血清白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)及中医症状积分、中医证候疗效、Baron内镜积分。同时选择40例健康体检者为正常组,检测IL-10、TNF-α水平作为基线。结果:两组治疗后血清IL-10、TNF-α及中医症状积分、中医证候疗效、Baron内镜积分均较治疗前改善,两组治疗后血清IL-10、TNF-α水平比较差异无统计学意义(P 0.05),但与正常组比较差异均有统计学意义(P0.05)。两组治疗后Baron内镜积分比较差异无统计学意义(P 0.05)。治疗组在改善患者腹痛、腹泻、里急后重方面优于对照组(P0.05),在改善患者黏液脓血便方面与对照组比较差异无统计学意义(P 0.05)。结论:溃结方联合隔药灸治疗大肠湿热型溃疡性结肠炎在改善患者临床症状、减轻肠道炎症方面优于美沙拉嗪口服治疗。     

美沙拉嗪栓联合美沙拉嗪缓释颗粒治疗溃疡性直肠炎的临床疗效分析

目的探讨美沙拉嗪栓联合美沙拉嗪缓释颗粒治疗溃疡性直肠炎的临床疗效。方法选择2014年6月~2016年5月在我院就诊的溃疡性直肠炎患者71例,随机分为对照组和观察组,对照组采用口服美沙拉嗪缓释颗粒治疗,观察组采用美沙拉嗪栓联合美沙拉嗪缓释颗粒治疗,连续治疗4~6周。比较两组患者临床症状缓解时间、治疗结束时的临床症状积分、临床疗效及治疗期间不良反应的发生情况。结果观察组腹泻恢复至正常时间及黏液脓血便消失时间显著短于对照组(P0.05)。观察组治疗后的症状积分显著低于对照组(P0.05)。观察组的临床疗效显著优于对照组(P0.05)。两组患者的肝功能异常、恶心、腹痛、腹胀及皮肤过敏等不良反应发生情况比较,差异无统计学意义(P0.05)。结论美沙拉嗪栓联合美沙拉嗪缓释颗粒治疗溃疡性直肠炎能增加肠道局部药物浓度,有利于缩短临床症状缓解时间,提高临床疗效,且安全性好。     

参苓白术散联合康复新液治疗溃疡性结肠炎30例

目的观察参苓白术散联合康复新液治疗溃疡性结肠炎（UC）的临床疗效。方法将60例UC患者按随机数字表法分为治疗组与对照组各30例。治疗组给予参苓白术散,1 d 1剂,分2次口服,同时给予康复新液50 mL加入生理盐水150 mL中灌肠,每晚1次;对照组单独口服美沙拉嗪1.0 g,4次/d。2组均连续治疗30 d,治疗结束后复查结肠镜进行临床疗效评价。结果治疗组症状改善及综合疗效显著优于对照组,差异均有统计学意义（P<0.05）。结论参苓白术散联合康复新液能有效改善溃疡性结肠炎患者临床症状,值得临床推广应用。     

思连康联合美沙拉嗪治疗轻中度溃疡性结肠炎的疗效分析

目的观察思连康联合美沙拉嗪治疗轻中度溃疡性结肠炎的临床疗效。方法将78例轻中度活动期溃疡性结肠炎(UC)患者随机分为治疗组和对照组,每组39例,治疗组在口服美沙拉嗪的基础上,同时口服思连康。对照组口服美沙拉嗪治疗。治疗6周后评价两组患者临床症状、疾病活动指数变化及结肠镜下分级积分。结果治疗后两组临床症状均有改善,治疗组粘液脓血便改善情况显著优于对照组,差异有统计学意义(P0.05)。治疗后治疗组Sutherland疾病活动指数、内镜下评分治疗效果较治疗前明显改善,差异有统计学意义(P0.05),且治疗组治疗前后变化较对照组更显著。结论思连康联合口服美沙拉嗪治疗轻中度UC近期疗效明显优于单独口服美沙拉嗪,且有较好的安全性。     

研究益生菌结合美沙拉嗪治疗溃疡性结肠炎的临床疗效

目的总结分析益生菌结合美沙拉嗪治疗溃疡性结肠炎的临床疗效。方法选择2017年6月至2018年6月我院收治的68例溃疡性结肠炎患者为研究对象,其中接受美沙拉嗪治疗的30例为对照组,接受益生菌、美沙拉嗪联合治疗的38例为观察组,比较两组治疗疗效。结果①观察组治疗总有效率86.84%明显高于对照组治疗总有效率66.67%,组间差异显著(P0.05);②观察组治疗后临床症状积分(2.2±0.6)分明显低于对照组,组间差异显著(t=10.5332,P0.05);③观察组不良反应率7.89%明显低于对照组不良反应率16.67%,组间差异显著(χ2=1.2427,P0.05)。结论益生菌结合美沙拉嗪治疗溃疡性结肠炎的临床疗效显著,且不良反应低,值得推广应用。     

参苓白术散辅助治疗初治肺结核患者的效果观察

目的探讨参苓白术散辅助治疗初治肺结核的临床效果。方法选择2018年1～12月肺结核患者100例为研究对象,随机分为观察组与对照组,各50例。两组均给予2SHRZ/4HR治疗,观察组在此基础上给予参苓白术散辅助治疗。比较两组治疗后中医证候积分,中医证候疗效、病灶变化,痰菌转阴率,红细胞沉降率及不良反应。结果 (1)治疗后,两组ESR较治疗前均显著下降,差异有统计学意义(P0.05);治疗后,观察组ESR显著低于对照组,差异有统计学意义(P0.05)。(2)治疗后,两组中医证候积分较治疗前均显著改善,差异有统计学意义(P0.05);治疗后,观察组中医证候积分显著低于对照组,差异有统计学意义(P0.05)。(3)秩和检验显示,观察组中医证候疗效显著优于对照组,差异有统计学意义(P0.05)。(4)秩和检验显示观察组治疗后病灶显著吸收率显著高于对照组,差异有统计学意义(P0.05)。(5)观察组治疗后45例痰菌转阴,转阴率为90.0%;对照组36例痰菌转阴,转阴率为72.0%。两组比较差异有统计学意义(P0.05)。(6)观察组不良反应严重程度显著低于对照组,差异有统计学意义(P0.05)。结论参苓白术散辅助治疗初治肺结核,可显著改善症状,提高痰菌转阴率,能有效缓解患者不良反应情况。     

美沙拉嗪联合小檗碱对远端溃疡性结肠炎的疗效及对TNF-α、IL-17和IL-23水平影响

目的 探讨美沙拉嗪联合小檗碱对远端溃疡性结肠炎的临床疗效及对TNF-α、IL-17和IL-23水平影响。方法选取我院消化内科自2016年12月至2019年12月收治的116例远端溃疡性结肠炎患者,将其随机分为对照组与观察组,每组各58例,在常规治疗的基础上对照组加用美沙拉嗪,观察组加用美沙拉嗪联用盐酸小檗碱保留灌肠,两组均连续治疗21 d,考察两组的临床疗效、症状缓解时间、炎症因子水平变化及不良反应等。结果 观察组临床总有效率(94.8%)与对照组(75.9%)比较,差异有统计学意义(P0.05);观察组腹痛、腹泻和黏液脓血便缓解时间分别为(3.2±0.6)d、(3.5±0.8)d、(4.7±1.1)d,与对照组腹痛、腹泻和黏液脓血便缓解时间[(5.6±1.3)d、(6.1±1.7)d、(6.4±1.8)d]比较,差异有统计学意义(P0.05);观察组炎症因子TNF-α、IL-17和IL-23水平分别为(15.68±3.26)ng/mL、(226.29±58.46)pg/mL、(324.85±39.24)pg/mL,对照组分别为(24.17±4.61)ng/mL、(325.69±65.27)pg/mL、(431.42±43.77)pg/mL,两组比较,差异均有统计学意义(P0.05);观察组不良反应发生率为17.3%,与对照组的19.0%比较,差异无统计学意义(P0.05)。结论 美沙拉嗪联合小檗碱对远端溃疡性结肠炎,可显著改善临床症状,提高临床疗效,有较好的临床借鉴意义。     

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.