湿热消汤联合银花泌炎灵片治疗ⅢA型前列腺炎临床研究

目的:探讨湿热消汤联合银花泌炎灵片治疗ⅢA型前列腺炎的临床疗效,及其对患者前列腺液细胞因子水平和疾病转归的影响。方法:分析140例ⅢA型前列腺炎患者临床资料,按照就诊顺序将患者1:1交替分配入两种治疗方案组,其中联合用药组70例采用湿热消汤联合银花泌炎灵片治疗,对照组70例采用银花泌炎灵片治疗,对比两种治疗方案在改善患者临床症状、调节前列腺液细胞因子水平以及影响疾病转归等方面的差异。结果:两组患者接受治疗后中医证候积分、慢性前列腺炎症状积分指数(the national institutes of health chronic prostatitis symptoms index,NIH-CPSI)评分均有改善,联合用药组的中医证候评分、前列腺炎症状NIH-CPS评分显著低于对照组(P0.01);两种治疗方案均能改善患者的前列腺液细胞因子水平,联合用药组对细胞因子的调节幅度优于对照组(P0.01);治疗结束时联合用药组患者的生活质量评分显著优于对照组(P0.01)。结论:湿热消汤联合银花泌炎灵片能有效改善ⅢA型前列腺炎患者的中医证候及前列腺炎症状,优化前列腺液细胞因子水平,并显著提高患者的生活质量。     

银花泌炎灵片治疗Ⅲ型前列腺炎临床观察

目的观察银花泌炎灵片与左氧氟沙星对治疗Ⅲ型前列腺炎的疗效观察。方法将120例Ⅲ型前列腺炎患者随机分为左氧氟沙星组(A组)、银花泌炎灵组(B组)和联合用药组(C组)各30例,分别给予盐酸左氧氟沙星片、银花泌炎灵片、银花泌炎灵与左氧氟沙星联合应用,观察三组疗效、NIH-CPSI评分差异。结果A组有效率43%,B组有效率63%,C组有效率70%,A组与B组,χ~2=4.945,P0.05,A组与C组,χ~2=14.062,P0.05,B组与C组,χ~2=2.222,P0.05。结论银花泌炎灵片治疗Ⅲ型前列腺炎疗效优于左氧氟沙星,联合用药在疗效上未显示出统计学意义。     

中西医结合治疗老年尿路感染60例疗效观

中西医结合(中药银花泌炎灵片+西药抗生素)治疗老年尿路感染60例,并与单纯西药治疗60例进行疗效比较.治疗组有效55例,无效5例;对照组有效47例,无效13例.两组疗效有显著性差异(P＜0.05),说明中西医结合治疗老年尿路感染有明显的优越性.     

真实世界银花泌炎灵片联合抗生素治疗泌尿系感染的用药特征分析

目的分析真实世界银花泌炎灵片联合抗生素治疗泌尿系感染的用药特征。方法对中国中医科学院中医临床基础医学研究所基于39家三级甲等医院HIS系统建立的数据库进行数据分析,其中使用银花泌炎灵片的医院共16家,收集16家医院HIS系统记录的使用银花泌炎灵片患者的一般信息、中西医诊断信息、医嘱信息等进行统计分析,采用Apriori算法建立模型,应用Clementine 12. 0进行关联分析,采用复杂网络分析联合用药并将结果可视化。结果全国16家医院382例患者纳入分析。银花泌炎灵片最常联合应用的单个抗生素为奥硝唑、司帕沙星、克林霉素、青霉素、头孢西丁钠、头孢替唑钠、左氧氟沙星、头孢甲肟、替硝唑、氨曲南。最常联合应用的2种抗生素为克林霉素、奥硝唑,克林霉素、司帕沙星,司帕沙星、奥硝唑,头孢西丁钠、克林霉素,头孢西丁钠、奥硝唑。结论应用关联规则数据挖掘方法,深入分析真实世界银花泌炎灵片联合抗生素治疗泌尿系感染的人群特征和用药特征。人群特征符合泌尿系感染人群的一般规律。联合用药反映了银花泌炎灵与抗生素协同治疗泌尿系感染;泌尿系感染与妇科感染(盆腔炎、细菌性阴道炎、滴虫性阴道炎等)合并;泌尿系感染与妇科、骨科、恶性肿瘤等手术合并;以及上述术后并发泌尿系感染的情况。发现用药相关性、探索联合用药规律,指导合理、有效用药,是此研究的突出优势。     

慢性无菌性前列腺炎的综合治疗体会

目的 对慢性无菌性前列腺炎患者采取多种方法联合治疗，观察疗效。方法 对148例慢性无菌性前列腺炎患者根据具体病情，采取药物治疗、理疗、心理治疗等多种方法联合治疗。结果 148例慢性无菌性前列腺炎患者经多种方法联合治疗后有效者145例，91例治愈，1年后29例复发。结论 慢性无菌性前列腺炎采取药物治疗、理疗、心理治疗等多种方法联合治疗，明显优于药物、理疗两种方法治疗。1年复发率仍高，保持良好的生活习惯和有规律的性生活对预防复发有重要作用。     

非那司提联合坦洛新治疗慢性非细菌性前列腺炎的临床疗效及尿动力学改变研究

目的通过临床疗效评定及尿动力学改变观察非那司提联合坦洛新治疗慢性非细菌性前列腺炎的有效性。方法选择门诊患慢性非细菌性前列腺炎患者60例,随机分为治疗组和对照组,治疗组应用非那司提联合坦洛新治疗,对照组应用坦洛新治疗,进行观察分析。结果治疗组有效率优于对照组（P〈0.05）,在降低NIH-CPSI评分、尿动力学改变方面均优于对照组（P〈0.05）。结论非那司提联合坦洛新治疗慢性非细菌性前列腺炎疗效良好。     

银花泌炎灵片联合左氧氟沙星对急性尿路感染临床疗效

目的 观察银花泌炎灵片与左氧氟沙星结合使用对于急性尿路感染患者的疗效观测.方法 将我院2010年10月～2011年10月收治的70例患者,随机分为治疗组和对照组,均35人.予治疗组用银花泌炎灵片（4片/次、3次/日）、左氧氟沙星胶囊（1片/次、2次/日）;予对照组服用左氧氟沙星胶囊（1片/次、2次/日）.并于两周以后观察两组临床疗效,并对其进行对比.结果 治疗组、对照组总有效率分别为89.4％、68.6％.结论 银花泌炎灵片与左氧氟沙星胶囊合用治疗急性尿路感染疗效确切、治愈率高,临床上值得推广应用.     

非那司提联合坦洛新治疗慢性非细菌性前列腺炎的效果分析

目的探讨非那司提联合坦洛新治疗慢性非细菌性前列腺炎的临床效果。方法选取郑州颐和医院2013年10月至2015年10月期间收治的78例慢性非细菌性前列腺炎患者,并随机分为两组,对照组38例单纯采用坦洛新治疗,观察组40例在对照组基础上加用非那司提治疗,比较两组患者的临床疗效。结果观察组治疗有效率为97.5%,对照组为78.9%,观察组治疗有效率明显高于对照组(P<0.05);治疗后,两组NIH-CPSI评分较治疗前均明显下降,且观察组下降程度明显优于对照组(P<0.05)。结论采用非那司提联合坦洛新治疗慢性非细菌性前列腺炎具有较好的临床效果,值得推广应用。     

心理疗法后复诊的慢性前列腺炎患者加服盐酸坦洛新疗效观察

目的：观察心理疗法后复诊的慢性前列腺炎患者加用盐酸坦洛新缓释胶囊的治疗效果。方法选取60例单纯心理疗法后复诊的慢性前列腺炎患者,年龄20岁~50岁,平均年龄38.2岁,均要求再治疗,纳入研究。随机分为2组,其中一组继续心理疗法的同时加服盐酸坦洛新缓释胶囊（试验组,n=30）,另一组继续心理疗法（对照组,n=30）,比较2组患者的治愈情况。结果心理疗法后复诊的慢性前列腺炎患者加服盐酸坦洛新缓释胶囊后治愈率为70%,高于未服用的对照组,两者比较差异具有统计学意义（P<0.05）。结论心理疗法后的慢性前列腺炎患者加服盐酸坦洛新缓释胶囊,依从性好且能够明显提高治愈率,值得推荐。     

盐酸坦洛新联合前列安通片对慢性前列腺炎的临床研究

目的观察盐酸坦洛新联合前列安通片对慢性前列腺炎的临床疗效。方法随机选取我院2009年3月-2012年3月门诊及住院慢性前列腺炎患者40例,给予口服盐酸坦洛新和前列安通片治疗,观察治疗前后患者的疗效、慢性前列腺炎症积分指数(NIH-COSI评分)、前列腺液中白细胞(EPS-WBC)、卵磷脂小体的变化,以及自由尿流率、最大尿流率(MFR)、达到最大尿流率的时间(MT)、残余尿量的变化。结果盐酸坦洛新联合前列安通片对慢性前列腺炎的总有效率为92.5%。与治疗前比较,NIH-CPSI评分、前列腺液中白细胞、卵磷脂小体的变化均有明显的改变,差异有统计学意义(P <0.05);自由尿流率、最大尿流率(MFR)、达到最大尿流率的时间(MT)以及残余尿量也有明显改善,差异有统计学意义(P <0.05)。二者联合治疗期间患者无明显的药物不良反应。结论盐酸坦洛新联合前列安通片对慢性前列腺炎有较好的临床效果,药物不良反应少,值得推广应用。     

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.