加减化痰活血通络汤联合西药治疗缺血性中风疗效观察

目的:观察加减化痰活血通络汤联合西药治疗缺血性中风的疗效。方法:选取108例缺血性中风患者为研究对象,按照随机数字表法将其分为两组,各54例。对照组给予西药治疗,在此基础上观察组给予加减化痰活血通络汤治疗。观察两组疗效、神经功能缺损程度、日常生活能力及中医证候积分。结果:对照组治疗总有效率77.78%(42/54),低于观察组的92.59%(50/54),差异有统计学意义(P<0.05);治疗后,NIHSS评分低于治疗前,Barthel指数高于治疗前,且观察组改善更加显著,差异均有统计学意义(P<0.05);治疗后,两组中医证候积分均低于治疗前,观察组降低程度更加显著,差异有统计学意义(P<0.05)。结论:加减化痰活血通络汤联合西药治疗可有效改善缺血性中风患者临床症状,利于患者神经功能及日常生活能力的恢复,提高临床治疗效果。     

中医综合疗法治疗中风后抑郁疗效评估

目的通过临床观察评估中医综合疗法治疗中风后抑郁气郁化火型临床疗效,规范中风后抑郁中医综合治疗方案。方法选取于长春中医药大学附属医院二部脑病康复疗区治疗的中风后抑郁患者64例,随机分为治疗组及对照组。对照组单纯采取丹栀逍遥散加减治疗,治疗组采用丹栀逍遥散加减配合针刺疗法治疗。观察两组患者治疗后临床疗效及汉密顿抑郁量表(HAMD)、日常生活能力评定量表(ADL)、美国国立卫生研究院卒中量表(NIHSS)评分及中医证候积分情况。结果两组患者治疗后HAMD疗效比较,治疗组总有效率为84.38%,对照组为71.88%,差异有统计学意义(P0.05);中医证候疗效比较,治疗组总有效率为87.50%,对照组为75.00%,差异有统计学意义(P0.05)。两组患者治疗后HAMD、NIHSS、ADL评分及中医证候积分均显著优于本组治疗前(P0.05)。治疗组治疗后HAMD评分、中医证候积分与对照组比较,差异有统计学意义(P0.05);NIHSS、ADL评分与对照组治疗后比较,差异无统计学意义(P0.05)。结论中医综合疗法治疗能够有效改善中风后抑郁气郁化火型患者临床症状,临床效果良好,值得进一步运用及深入研究。     

中风复元口服液治疗气虚痰浊内阻型中风60例临床疗效观察

目的:观察中风复元口服液治疗气虚痰浊内阻型的临床疗效。方法:90例符合纳入标准的病人,随机分为两组,其中治疗组60例,对照组30例,治疗组在一般常规治疗基础上加用中风复元口服液进行治疗,对照组仅进行一般常规治疗;观察两组临床疗效、中医证候疗效、治疗前后积分值及血液流变学指标变化的情况。结果:两组临床疗效比较,治疗组总疗效优于对照组(P<0.05),两组病例中医证候疗效进行比较,两组总有效率差异有统计学意义(P<0.05),对两组治疗前后的临床神经功能缺损程度、中医证候积分值进行比较,两组均能有效地改善神经功能(P<0.01),两组间比较差异有统计学意义(P<0.05),治疗组中医证候积分减少明显优于对照组,差异有统计学意义(P<0.05);两组治疗前后血液流变学指标变化比较,组间及组内治疗前后比较均有统计学意义(P<0.05)。结论:中风复元口服液是治疗气虚痰瘀内阻型中风患者的有效方药,且安全无毒性,值得推广。     

中风祖方对急性缺血性卒中血瘀证患者NIHSS评分及证候积分的影响

目的:观察中风祖方治疗血瘀证急性缺血性卒中的临床疗效。方法 :选取急性缺血性卒中血瘀证患者166例,按随机数字表法分成治疗组82例,对照组84例,对照组予标准治疗(阿司匹林100 mg,口服,日1次;立普妥20 mg,口服,每晚1次)并配合中药治疗,治疗组予标准治疗+中风祖方,治疗14 d后观察美国国立卫生研究院卒中量表(NIHSS)评分及血瘀证证候积分变化。结果:与治疗前比较,治疗后两组NIHSS评分及血瘀证证候积分均有下降(P0.05);治疗后治疗组NIHSS评分差值及血瘀证证候积分与对照组比较差异有统计学意义(P0.05);治疗组中医证候总有效率52.43%,对照组35.71%,两组比较差异有统计学意义(P0.05)。结论:中风祖方能明显改善急性缺血性卒中患者神经功能及中医证候。     

自拟中风疼痛汤治疗中风后半身疼痛的临床疗效及NHSS、ADL评分变化观察

目的探讨自拟中风疼痛汤在中风后半身疼痛患者中的临床治疗效果及对神经功能缺损(NHSS)、日常生活能力评分(ADL)的变化。方法将2013年3月至2014年5月收治的82例中风后半身疼痛的患者,采用随机分组平行观察的方法,将患者分为治疗组(42例)与对照组(40例)。对照组患者采用西药卡马西平片口服治疗,治疗组采用自拟中风疼痛汤口服治疗,10 d为一个疗程,治疗结束后观察两组患者的临床治疗效果,统计分析治疗前后NHSS、ADL评分的变化。结果(1)治疗组临床总有效率为95.24%(40/42),对照组临床总有效率为75.00%(30/40),两组比较差异有统计学意义(P0.05);(2)治疗前两组NHSS、ADL评分比较,差异无统计学意义(P0.05),治疗后治疗组NHSS评分低于对照组患者NHSS的评分,ADL评分高于对照组ADL评分,两组比较差异均有统计学意义(P0.05)。结论自拟中风疼痛汤治疗中风后半身疼痛患者,与单纯西药治疗比较其临床疗效更加确切,可以明显改善神经功能缺失状况,提高患者治疗后的日常生活能力,是临床上值得应用的中医治疗手段。     

加味补阳还五汤联合双补通络丸治疗气虚血瘀型中风后遗症效果分析

目的研究加味补阳还五汤联合双补通络丸对气虚血瘀型中风后遗症患者神经功能缺损(NIHSS)评分及日常生活能力(BI)指数的影响。方法选取济源市精神卫生服务中心2015年1月至2017年3月收治的126例气虚血瘀型中风后遗症患者,按治疗方案分为两组,各63例。对照组接受加味补阳还五汤治疗,观察组接受加味补阳还五汤+双补通络丸治疗。比较两组治疗效果,治疗前后NIHSS评分BI指数。结果观察组总有效率为95.23%,高于对照组的82.54%,差异有统计学意义(P<0.05);治疗前,两组NIHSS评分、BI指数比较,差异无统计学意义(P>0.05);治疗3个月后,两组NIHSS评分与BI指数较治疗前均升高,且观察组高于对照组,差异有统计学意义(P均<0.05)。结论加味补阳还五汤联合双补通络丸治疗气虚血瘀型中风后遗症效果显著,可改善患者神经功能,提高其日常生活能力。     

益脑通络方联合刺络放血治疗缺血性中风患者的疗效观察

目的 探讨益脑通络方联合刺络放血治疗缺血性中风患者的临床疗效。方法 选取2019年10月—2021年6月期间安阳市中医院脑病一科收治的缺血性中风患者100例,按照入院先后顺序分为对照组和观察组,每组各50例。对照组采用益脑通络方治疗,观察组采用益脑通络方联合刺络放血治疗。治疗2周后,观察比较两组患者临床疗效,治疗前后中医证候积分、神经功能缺损评分[美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale, NIHSS)评分]、脑血管血流动力学指标(大脑中动脉血流速度、基底动脉血流速度)、神经生化标志物指标[神经元特异性烯醇化酶(Neuron-specific Enolase, NSE)、中枢神经特异蛋白(Soluble Protein-100β,S100β)]。结果 治疗后两组患者中医证候积分及神经功能缺损评分均较治疗前降低,差异有统计学意义(P<0.05);且观察组中医证候积分及神经功能缺损评分明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者脑血管血流动力学指标较治疗前升高,差异有统计学意义(P<...     

补阳还五汤治疗缺血性卒中患者的效果

目的:观察补阳还五汤治疗缺血性卒中患者的效果。方法:选取90例缺血性卒中患者为研究对象,依据随机数字表法分为观察组和对照组各45例。两组均行常规治疗,在此基础上,对照组行阿司匹林治疗,观察组在对照组基础上行补阳还五汤治疗,比较两组治疗总有效率,治疗前后中医证候积分、神经功能缺损[美国国立卫生研究院卒中量表(NIHSS)]评分、基质金属蛋白酶-9(MMP-9)水平、C反应蛋白(CRP)水平和不良反应发生率。结果:观察治疗总有效率为97.78%(44/45),高于对照组的80.00%(36/45),差异有统计学意义(P<0.05);治疗后,两组中医证候积分均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组NIHSS评分均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);治疗后,两组MMP-9、CRP水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:在阿司匹林治疗基础上采用补阳还五汤治疗缺血性卒中患者可提高治疗总有效率,降低中医证候积分、NIHSS评分、MMP-9水平和CRP水平,效果优于单纯阿司匹林治疗。     

安宫牛黄丸联合通腑化痰汤对中风(阳闭证)患者神经功能的影响

目的探究安宫牛黄丸联合通腑化痰汤对中风(阳闭证)患者神经功能的影响。方法选取2016年1—12月平舆县中医院收治的中风(阳闭证)患者90例,随机分为对照组和观察组,各45例。对照组接受常规西医治疗,观察组在对照组的基础上加用安宫牛黄丸和通腑化痰汤,比较两组治疗前后的神经功能(NIHSS评分)。结果治疗前,两组患者NIHSS评分比较,差异无统计学意义(P>0.05);治疗后,两组患者NIHSS评分均降低,且观察组低于对照组,差异有统计学意义(P<0.05)。结论采用安宫牛黄丸联合通腑化痰汤治疗中风(阳闭证)患者效果显著,可改善其神经功能缺损情况,促进疾病康复,值得推广应用。     

补益肝肾法联合西药治疗脑梗死恢复期神经功能损伤30例临床报道

目的：探讨补益肝肾法治疗脑梗死恢复期神经功能损伤的临床疗效.方法：将60例脑梗死恢复期伴发神经功能损伤患者,按照随机数字表随机分为两组,每组30例,标记为治疗组、对照组.对照组采用常规西药治疗,治疗组采用常规西药联合补益肝肾法治疗,比较两组临床疗效.结果：治疗组治疗前后中医证候积分及NIHSS评分明显缓解,差异有统计学意义（P＜0.05）;对照组治疗前后中医证候积分及NIHSS评分明显缓解,差异有统计学意义（P＜0.05）;两组治疗后中医证候积分及NIHSS评分均明显缓解,但差异有统计学意义（P＜0.05）.治疗组中医证候治疗总有效率为83.33％,神经功能损伤治疗总有效率为96.67％,对照组中医证候治疗总有效率为53.33％,神经功能损伤治疗总有效率为50.00％,两组间差异具有统计学意义（P＜0.05）.结论：补益肝肾法联合西药治疗脑梗死恢复期神经功能损伤患者疗效确切,有利于神经损伤修复,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.     

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.