温经止痛汤治疗痛经30例临床疗效观察

目的：观察温经止痛汤（自拟）治疗痛经寒湿凝滞型患者的临床疗效。方法：以自拟温经止痛汤治疗痛经寒湿凝滞型患者60例。治疗组：温经止痛汤口服治疗组30例;对照组：消炎痛口服治疗组30例。结朵：治疗组总有效率为90．00％,对照组总有效率为86．67％,两组比较差异无统计学意义（P〉0．05）;远期疗效比较,治疗组总有效率为86．67％,对照组总有效率为63．33％,两组比较差异有统计学意义（P〈0．05）。结论：运用温经止痛汤治疗痛经寒湿凝滞型患者远期疗效较好。     

隔物灸治疗原发性痛经寒湿凝滞型的临床观察

目的 观察隔物灸治疗原发性痛经寒湿凝滞型的疗效,探讨其作用机制.方法 将209例原发性痛经寒湿凝滞型患者随机分为2组,治疗组105例,采用隔物灸神阙、关元穴治疗,并设口服月月舒冲剂104例为对照组.治疗后进行疗效评价,同时随机对部分患者治疗前后及正常人经期血清前列腺素F_(2α)(PGF_(2α))、血浆血管加压素(AVP)含量进行检测.结果 治疗组疗效明显优于对照组(P＜0.01).2组治疗前血清PGF_(2α)、血浆AVP含量均较正常组明显升高(P＜0.01);2组治疗后血清PGF_(2α)、血浆AVP含量均较治疗前明显降低(P＜0.01,P＜0.05).治疗后2组间血清PGF_(2α)含量比较,差异有统计学意义(P＜0.05);对照组血清PGF_(2α)含量仍较正常组高(P＜0.05).结论 隔物灸对原发性痛经寒湿凝滞型患者有明显的治疗作用,其作用机制可能与降低血清PGF_(2α)及血浆AVP水平有关.     

隔药灸治疗寒凝血瘀型原发性痛经临床观察

目的:观察隔药灸治疗寒凝血瘀型原发性痛经患者的临床疗效。方法:将40例寒凝血瘀型原发性痛经患者随机分成两组,治疗组采用隔药灸进行治疗,对照组采用艾条温和灸法(以下称单纯艾灸法)进行干预,每个月经周期施灸7次,连续3个月经周期。观察治疗3个月经周期后腹部疼痛VAS评分及中医证候积分的变化,并比较两组之间的差异。结果:隔药灸组与单纯艾灸组治疗前后腹部疼痛VAS评分比较差异均有统计学意义(P0.05),且隔药灸组疗效优于单纯艾灸组(P0.05)。在中医证候疗效方面,隔药灸组和单纯艾灸组有效率分别为95%、80%,两组比较差异有统计学意义(P0.05)。结论:隔药灸是治疗寒凝血瘀型原发性痛经的有效方法。     

艾灸联合腰痛散药烫治疗寒湿型腰椎间盘突出症的临床护理

目的 探讨艾灸联合腰痛散药烫治疗寒湿型腰椎间盘突出症的临床护理效果。方法 选取2012年3月～2013年3月在广东省韶关市中医院住院的寒湿型腰痛患者120例,随机分为治疗组和对照组各60例。对照组予艾灸疗法及常规护理,治疗组予艾灸联合腰痛散药烫及综合护理干预。比较两组的临床疗效及疼痛视觉模拟评分法（VAS）、数字评分法（NRS）、腰椎功能评定情况。结果 治疗组有效率为91．67％,对照组为81．67％,两组比较,差异有统计学意义（P〈0．05）。两组VAS评分治疗后与治疗前比较,差异有统计学意义（P〈0．05）;治疗后,治疗组的VAS评分为（2．34±0．57）分,对照组为（3．07±0．83）分,治疗组显著低于对照组,两组比较,差异有统计学意义（P〈0．05）。两组NRS评分治疗后与治疗前比较,差异有统计学意义（P〈0．05）;治疗后,治疗组的NRS评分为（3．21±0．87）分,对照组为（4．23±0．89）分,治疗组显著低于对照组,两组比较,差异有统计学意义（P〈0．05）。治疗后治疗组患者的疼痛程度较冶疗前均得到改善,屈曲伸直比明显减小,中位频率斜率明显增大;腰椎功能评定指标比较,治疗组均明显优于对照组,差异有统计学意义（P〈0．05）。两组均未见明显不良反应。结论 艾灸联合腰痛散药烫治疗寒湿型腰椎间盘突出症临床护理效果显著,值得在临床推广应用。     

隔药灸不同时长对寒湿凝滞型痛经患者生殖内分泌表达水平影响

目的 :观察不同隔药灸时长对寒湿凝滞型痛经患者治疗后生殖内分泌表达水平的影响。方法 :将40例寒湿凝滞型痛经患者根据完全随机法分成4组,各组10例。每组采用时长分别为15 min、30 min、45 min、60 min进行隔药灸,于每次月经周期前7 d开始治疗,直至月经来潮后停止治疗,连续治疗3个月经周期。治疗完成后利用VAS评分评价各组治疗前后痛经改善情况,检测治疗前后每组血清雌二醇(E2)、孕酮(P)、前列腺素(PGF2α)表达水平。结果:各组治疗后与治疗前比较,痛经疼痛程度均有所缓解,检查生殖内分泌结果提示E2、PGF2α表达下降,P表达升高(P0.05)。各组治疗后比较,45 min与60 min时长与其他两组比较E_2、PGF2α下降水平明显,P升高水平明显(P0.05)。45 min与60 min两组组间比较差异不显著(P0.05)。结论 :隔药灸能够改善寒湿凝滞型痛经患者的生殖内分泌表达水平,且通过下调E2、PGF2α表达水平,上调P表达水平起到缓解痛经症状的作用,而选择45～60 min隔药灸时长效果更佳。     

隔药饼灸修复血管内皮功能调节血脂治疗高脂血症的临床机制研究

目的 探究隔药饼灸修复血管内皮功能调节血脂治疗高脂血症患者的临床作用机制。方法 选取湖南中医药大学第一附属医院及周边社区卫生服务机构招募符合纳入标准的60例高脂血症（低密度脂蛋白胆固醇增高）患者随机分为隔药饼灸组与辛伐他汀组,每组30例。隔药饼灸组给予隔药饼灸法,采用两组穴位（Ⅰ组：巨阙、天枢、丰隆;Ⅱ组：心俞、肝俞、脾俞）交替施灸;辛伐他汀组给予口服辛伐他汀。两组均治疗12周,随访4周、12周。采集治疗前后、随访期间两组患者的临床疗效、临床症状积分、临床症状积分疗效、血液流变学、同型半胱氨酸（homocysteine, Hcy）及胰岛素样生长因子1(insulin-like growth factor 1, IGF-1)各指标进行比较分析。结果 治疗后两组临床疗效比较,隔药饼灸组有效率86.67%,辛伐他汀组有效率93.33%,差异无统计学意义（P>0.05）。临床症状积分比较,隔药饼灸组治疗前后差值明显优于辛伐他汀组,差异有统计学意义（P<0.05）。临床症状积分疗效比较,隔药饼灸组有效率76.67%,辛伐他汀组有效率40.00%,差异有统计学意义（P<0.05）...     

隔花椒饼灸对足三里穴各时段热感度及痛感时间研究

目的：测定隔花椒饼灸对健康人右足三里穴各时段的热感温度及痛感时间,为隔花椒饼灸的临床应用提供实验支持。方法：采用抽签法将20名健康学生随机分为实验组（隔花椒饼灸组）和对照组（隔附子饼灸组）,每组10名,用温度记录仪分别记录在隔花椒饼灸、隔附子饼灸刺激下,右足三里穴位的初感温度、舒适温度、耐受温度、初感疼痛时间、耐受疼痛时间及最佳温度区域时间;并比较在同一穴位时2种不同隔物灸下各时段热感温度、痛感时间的差异。结果：不同隔物灸的初感温度、舒适温度、耐受温度依次增高（P〈0．05）;隔花椒饼灸的耐受温度高于隔附子饼灸（P〈0．05）;隔花椒饼灸的最佳温度区域时问明显长于隔附子饼灸（P〈0．05）。结论：隔花椒饼灸的热感温度耐受阈值高于隔附子饼灸,且最佳温度区域时间长于隔附子饼灸,为隔花椒饼灸的临床应用提供实验依据。     

隔中药饼灸联合按摩治疗原发性痛经研究

目的:探讨隔中药饼灸联合按摩治疗原发性痛经的临床疗效。方法:选取2015年3月至2016年4月我院收治的96例原发性痛经患者,将其随机分为两组,各48例。对照组服用元胡止痛片治疗,观察组给予隔中药饼灸联合按摩治疗。对两组治疗效果及中医证候积分展开对比。结果:观察组治疗效果较对照组明显改善(95.8%81.3%),差异有统计学意义(P0.05);观察组治疗后中医证候积分为(3.5±0.4)分、明显低于对照组的(5.3±0.9)分,差异有统计学意义(P0.05)。结论:隔中药饼灸联合按摩治疗原发性痛经疗效确切,具有三效合一优势,起到调经止痛、活血化瘀、温经暖宫之功效,值得应用。     

间苯三酚治疗原发性痛经的临床观察

目的：观察间苯三酚治疗痛经的疗效及安全性。方法：原发性痛经患者40侧，随机分为治疗组和对照组。分别于月经来潮时肌注间苯三酚40mg及硫酸阿托品0．5mg。观察用药后15min、30min、60min患者疼痛程度的VAS分及不良反应，并进行疗效判定。结果：①两组患者用药前及用药后15min、30min、60min时腹痛强度VAS分及腹痛缓解程度与治疗前比较差异有统计学意义（P〈0．05）。但两组之间比较，差异无统计学意义（P〉0．05）。②两组间的疼痛缓解例数、开始缓解时间及腹痛完全消失时间、显效率、总有效率比较均差异无统计学意义（P〉0．05）。③治疗组不良反应发生率较对照组低（P〈0．05）。结论：间苯三酚对原发性痛经的治疗是安全的，其疗效与阿托品相仿，但不良反应少。     

隔药灸治疗原发性痛经疗效及对PGF2α/PGE2的影响

目的：探讨隔药灸神阙穴治疗原发性痛经的疗效机制。方法：把90例原发性痛经患者按随机数字表分为3组各30例,分别是隔药灸组、隔盐灸组、西药组,并设正常空白对照组。结果：隔药灸组（总有效率96.7%）与隔盐灸组（总有效率90.0%）、隔盐灸组与西药组（76.7%）疗效比较,P〈0.05;隔盐灸组与西药组疗效比较,P〈0.01。隔药灸组与隔盐灸组、隔盐组与西药组治疗后PGF2α比较,P〈0.05;隔药灸组与西药组治疗后PGF2α比较,P〈0.01。隔盐组与西药组治疗后PGE2比较,P〈0.05;隔药灸组与隔盐灸组、隔药灸组与西药组治疗后PGE2比较,P〈0.01。隔药灸组、隔盐灸组、西药组治疗前的PGF2α、PGE2指标与正常空白组比较,P〈0.01。结论：灸法治疗痛经的疗效优于口服药物,且隔药灸疗效显著,其作用机制可能与降低经期外周血PGF2α含量,升高PGE2含量,降低PGF2α/PGE2有关。     

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.