煨脓长肉法治疗肛瘘术后创面64例疗效观察

[目的]观察煨脓长肉法治疗肛瘘术后创面的临床疗效.[方法]将128例肛瘘术后患者随机分成两组,治疗组(64例)术后待腐肉脱落后,采用煨脓长肉法(生肌玉红膏纱条)换药;对照组(64例)术后采用凡士林纱条换药,观察两组创面愈合情况.[结果]治疗组创面愈合时间和创面愈合率均优于对照组.[结论]煨脓长肉法对肛瘘术后创面愈合具有...     

中药贴敷疗法治疗臁疮的临床观察

目的探讨中药臁疮膏纱条贴敷治疗臁疮(下肢静脉性溃疡)的临床疗效。方法将60例臁疮患者,按随机数字表法分为两组,治疗组30例外用臁疮膏纱条;对照组30例应用无菌换药,两组均应用全身对症支持治疗,8周后观察总疗效。结果治疗组总有效率、症状体征评分、腐肉脱落时间、创面愈合时间、新生上皮出现时间明显优于对照组(P0.05)。结论中药臁疮膏纱条贴敷治疗臁疮疗效显著、经济安全、使用方便。     

下肢溃疡汤治疗臁疮的体会

本文通过对我科运用内服中药下肢溃疡汤为主分型论治。外用象皮生肌膏治疗10例臁疮病人进行小结。并分析了臁疮的病因病机,初步认识到本病以肝肾不适,气血两亏为本,感受湿热或淤血阻络为标。只有标本兼顾,采用补肝肾,益气养血,清热利湿,通络化淤之法方能取效。故拟以“下肢溃疡汤”,以益气养血之药为君,佐以清热利湿,通络化淤之品。根据患老偏淤血,偏湿热,偏气血两虚的不同,予以加减治疗,同时局部外用象皮生肌膏外敷,疗效满意,通过对病人的观察,初步认识到象皮生肌膏有调动机体的抵抗力,促进肉芽组织增生的作用,证明中医的“煨脓长肉”的理论是有一定科学根并的,附有典型病例一例。     

康复新液联合凡士林纱布煨脓生肌法治疗Ⅲ期压疮的疗效观察

目的:分析联合康复新液及凡士林纱布煨脓生肌法对Ⅲ期压疮的疗效。方法:采用分层抽样法抽选50例Ⅲ期压疮患者纳入本次试验,并采用均等双盲划分法将其中25例纳入对照组(涂抹百多邦药膏后用凡士林纱布对创面进行覆盖),剩余25例纳入观察组(予以康复新液联合凡士纱布煨脓生肌法),统计并比较两组治疗总有效率、治疗前后疼痛视觉模拟评分(VAS)、治疗后压疮疮面情况、换药次数、换药时间、换药费用以及愈合时间。结果:两组治疗有效率比较,差异无统计学意义(P0.05)。治疗前,两组VAS评分比较,差异无统计学意义(P0.05);治疗4周后,观察组VAS评分比对照组更低(P0.05)。观察组治疗4周后的压疮疮面情况比对照组更优,换药次数及换药费用比对照组更少,换药时间及愈合时间比对照组更短(P0.05)。结论:康复新液联合凡士林纱布煨脓生肌法对Ⅲ期压疮疗效显著,能减轻疼痛程度,促进疮面愈合,降低经济负担,减轻医护人员的工作量,是一种实用经济的疗法,值得采用。     

加味生肌膏联合红外线治疗Ⅲ期压疮的临床应用

目的观察加味生肌膏联合红外线治疗Ⅲ期压疮的临床疗效。方法将83例Ⅲ期压疮患者随机分为观察组（42例）和对照组（41例）,观察组采用常规护理后加自制加味生肌膏联合红外线治疗,对照组常规护理后加用红外线治疗。结果观察组和对照组的总有效率分别为92.85%和78.0%,差异有统计学意义（P〈0.05）。结论自制生肌膏联合红外线治疗Ⅲ期压疮疗效显著,值得临床推广应用。     

激光腔内闭合术联合高位结扎术治疗大隐静脉曲张疗效观察

目的探讨激光腔内闭合术联合高位结扎术治疗大隐静脉曲张的疗效。方法将我院2014年1月~2017年1月收治的700例大隐静脉曲张患者随机分为对照组和观察组,对照组予高位结扎剥脱术,观察组予激光腔内闭合术联合高位结扎术。采用回顾性分析方法比较两组的临床疗效。结果观察组患者在手术时间、术中出血量、切口总长度方面均显著优于对照组(P0.05);观察组患者临床治疗满意度显著优于对照组(P0.05);术后3个月对患者的溃疡愈合情况进行随访,两组患者的溃疡愈合率比较,差异无统计学意义(P0.05)、术后半年的色素沉着减退情况进行随访,两组均无显著差异(P0.05)、2年的静脉曲张复发率随访,两组均无显著差异(P0.05);观察组(2.93%)大隐神经损伤率显著优于对照组(5.25%)(P0.05)。结论在大隐静脉曲张治疗过程中,激光腔内闭合术联合高位结扎术治疗治疗显著优于传统大隐静脉治疗术,同时激光腔内闭合术联合高位结扎术治疗还具有创伤小、并发症低等特点,具有良好的临床推广价值。     

芩矾汤洗剂外敷治疗臁疮临床观察

目的 观察芩矾汤洗剂外敷治疗臁疮的临床疗效.方法 将50例臁疮患者按3:2的比例随机分为治疗组30例,对照组20例.治疗组予芩矾汤洗剂外敷;对照组予常规手术和换药治疗,观察臁疮的控制及创面愈合情况.结果 治疗组总有效率为86.67%,对照组为65.00%,两组比较有显著差异(P＜0.05).结论 芩矾汤洗剂外敷治疗臁疮有较好的临床疗效.     

氦氖激光联合云南白药外敷在治疗压疮中的应用

目的：探讨氦氖激光联合云南白药外敷治疗压疮的疗效。方法：将43例Ⅲ期即浅度溃疡期压疮患者随机分为对照组21例和治疗组22例。分别给予0．5％碘伏消毒加红外线灯照射,以及氦氖激光联合云南白药外敷治疗,观察15d并记录2组患者压疮治疗情况及愈合时间。结果：治疗组治愈率及总有效率明显高于对照组,两组比较,差异有统计学意义（P〈0．05）。治疗组痊愈时间明显缩短,与对照组比较,差异有统计学意义（P〈0．01）。结论：氦氖激光联合云南白药外敷治疗压疮效果显著,值得在临床中推广应用。     

自制祛腐生肌膏联合吹氧法治疗压疮效果观察

目的探讨重度（Ⅲ～Ⅳ期）压疮的治疗方法。方法选择60例Ⅲ～Ⅳ期压疮患者随机分为观察组和对照组各30例,对照组采用常规方法及雷佛奴尔液湿敷创面;观察组采用常规方法加上自制祛腐生肌膏联合吹氧法治疗创面。结果观察组的疗效及愈合时间均显著优于对照组（P〈0.05）。结论在常规护理基础上采用自制祛腐生肌膏联合吹氧法治疗创面可以显著提高Ⅲ～Ⅳ期压疮疗效。     

百多邦联合湿润烧伤膏阶梯式治疗压疮的疗效观察

目的:探讨百多邦联合湿润烧伤膏治疗溃疡期压疮的疗效。方法:将溃疡期压疮43例分为对照组与观察组。对照组21例,压疮30处,观察组22例,压疮31处。观察组采用百多邦联合湿润烧伤膏阶梯式治疗溃疡期压疮,对照组用0·5%碘伏湿敷。结果:观察组与对照组总有效率分别为100%和80%。两组治疗效果比较差异有统计学意义(P(0·05)。结论:百多邦联合湿润烧伤膏阶梯式治疗溃疡期压疮,疗效显著,值得临床推广。     

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.