《中国中医古籍总目》著录国家图书馆所藏医籍补正

《中国中医古籍总目》(以下简称《总目》)是我国目前较为全面准确记载中医古籍收藏分布情况的大型中医古籍联合目录,其中著录国家图书馆藏中医古籍1 898种。但经分析发现,《总目》对国家图书馆藏中医古籍信息的著录存在作者信息不全或错误、成书年代不详以及版本记录错讹等问题,尤其体现在版本记录方面,《总目》记载的有,但国家图书馆并无存书或者其官网联机目录暂时检索缺失的医籍版本计351种。国家图书馆能检索到的版本,而《总目》中未载录此版本的医籍计639种。通过对《总目》著录信息与国家图书馆实际藏书信息进行对比,并对相关古籍进行实地勘察及进一步的考证,补充、修正了《总目》著录部分书目的作者信息、成书时间和版本信息。     

民国时期中国针灸医籍数量考

以《中国中医古籍总目》为基础,参考相关书目工具书及研究论文,对民国时期针灸医籍数量进行详细考证,发现《中国中医古籍总目》收录医籍与其收录原则不完全相符.统计民国时期中国针灸医籍的数量时应当注意：时间范围为1912-1949年;应将丛书作为子目各书的一个版本,而不应将二者分别作为2种不同书籍计算;译作及外国人的著作不应计算在内.根据以上原则统计的结果是：民国时期中国针灸医籍数量为201种.     

中医妇科古籍书目计量分析及思考

目的 基于《中国中医古籍总目》对中医妇科书目进行统计和分析,揭示中医妇科古籍文献现状,提出保护建议。方法 对《中国中医古籍总目》著录的女科书目信息,从医籍的成书年代、版本年代和类型、存世古籍版本数量、被收录于丛书情况及现代影印和出版情况几方面进行统计和分析。结果 《中国中医古籍总目》共收录729种中医妇科书目信息,其中女科通论类古籍387种,产科类古籍280种,广嗣类古籍62种。成书于1911年及以前的古籍共计477种,成书于1912-1949年的古籍共计252种;版本年为1911年及以前的古籍有404种,1912-1949年间的古籍有261种,版本年代不详的有64种;版本类型丰富多样,以抄本和刻本为多;版本数量最多的医籍为《达生篇》,版本数量达到174种,版本为孤本的医籍有430种,占医籍总数的58.98%;收录于丛书中的妇科医籍121种;54种中医妇科古籍被整理点校或影印。结论 在中医妇科古籍的保护和利用方面,可以提高妇科古籍的再生性保护、加强民国时期妇科文献保护力度、建立共建共享的妇科古籍数据库、加强对出土文献的研究等,从而更好地发挥中医妇科古籍的作用。     

中医古籍分类体系及其演变

中医古籍主要收录在历代综合性书目及中医专科书目中,介绍了中医古籍在七分法、四分法、十二分法中的归类,以及中医专科书目《医藏目录》和《中国中医古籍总目》的医籍分类,分析了中医古籍的分类体系及其演变过程,有助于从分类角度在浩如烟海的古文献中查找医籍文献。     

朝鲜《医方类聚》引用中国伤寒、金匮类文献考

成书于公元1445年的《医方类聚》是朝鲜王朝政府组织编纂的大型医书,援引152种中国医药典籍和1种高丽医方著作。本文以《中国中医古籍总目》《中国医籍大辞典》等目录书中所划分的伤寒、金匮类内容为依据,探讨《医方类聚》对中国伤寒、金匮类文献的引用情况,首先确定伤寒类文献的作者、成书年代等基本情况,再结合其他资料全面分析;并对金匮引文版本进行核查,与现存张仲景《金匮要略方》底本元邓珍本《新编金匮方论》核对,分析16种伤寒类著作及1种金匮类著作的引用情况,考证此类引文的价值。     

元代医家尚从善及《伤寒纪玄妙用集》

《伤寒纪玄妙用集》10卷,元代医家尚从善著。此书书名,《医藏书目》作《伤寒纪元》,《中国医籍考》作《尚氏伤寒纪选》。书首有名士张翥于至元二年（1336）六月一日以小篆书于广陵寓斋的序文。序后有尚氏手书的《张仲景传》,时为至元戊寅年（1338）。     

浅谈国家图书馆馆藏中医古籍概况与利用对策

在《中国中医古籍总目》著录的16家北京地区的图书馆中有6 383种中医古籍,占其著录医籍总数的48%,其中国家图书馆有1 898种。经对比,国家图书馆诸医籍的数百种版本与《中国中医古籍总目》著录存在区别,究其原因或为《中国中医古籍总目》编纂时统计、记录不准确导致收录不全或错讹;或为国家图书馆信息逐步公开及更新导致。经考察,《中国中医古籍总目》著录与国家图书馆实际存书,存在作者信息不全、成书年代阙如、卷数记载错讹等问题;整体上国家图书馆的中医古籍利用率较低。国家图书馆应对中医古籍进行专门的普查和著录,更正补充现在登载内容的错讹和缺失,并寻求有效方式提高中医古籍的利用率。     

《医学六经》考

《医学六经》一书收录了《重广补注黄帝内经素问》《灵枢》《针灸甲乙经》等6部医籍,颇受学界重视。《中国中医古籍总目》《中国医籍大辞典》等著录该丛书为明代顾从德所编纂,由吴勉学刊刻。通过查考原书、梳理相关资料,结果表明此书与吴勉学所刻《古今医统正脉全书》前6部医书内容及版式相同,疑为后人将此6部医书从《古今医统正脉全书》析出,另名《医学六经》。顾从德与吴勉学并非《医学六经》的编纂者与刊刻者,学界考察医籍版本时所说的“六经本”实际上就是“医统正脉本”。     

中国古医籍的数量与特点

据《中国古籍总目》《中国中医古籍总目》等推断,现存古医籍不少于8 000种,占现存古籍的1/25以上。与其他类古籍相比,古医籍具有抄本多、精校本少、隐喻性语言、具有实用价值等特点。医籍种类众多,其中方书占据绝对优势。统观古医籍的发展史,呈现出不同朝代各异的特征。     

《枕藏外科》版本源流考

对《枕藏外科》版本的研究,有助于对该书学术源流及学术价值的研究和利用。据《中国中医古籍总目》,《枕藏外科》有10种版本。但在实际版本调查中,发现有12种版本。经比对,发现《中国中医古籍总目》著述与实际版本有不符之处。通过对各版本特点及相互关系的研究,发现该书的版本流传系统分为2个,其一,以胡刻本为代表;其二,以元盛堂本为代表。     

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.