射频靶点热凝联合臭氧消融治疗腰椎间盘突出症173例疗效观察

目的:观察射频靶点热凝联合臭氧消融术治疗腰椎间盘突出症的临床疗效。方法:173例腰椎间盘突出症患者,在CT引导下,行突出髓核射频热凝治疗,然后向椎间盘内注射臭氧。采用视觉模拟评分法(VAS)和改良Macnab评价法评价疗效。结果:术后1天、1周、1个月、3个月VAS评分值均明显低于术前,差异有统计学意义(P<0.001);术后3个月疗效评定,优良率93.06%,总有效率98.27%,无1例出现严重并发症。结论:射频靶点热凝联合臭氧消融治疗腰椎间盘突出症疗效确切,安全性好,值得临床推广。     

射频靶点热凝术联合臭氧消融治疗腰椎间盘突出症680例临床观察

目的:研究分析射频靶点热凝手术联合臭氧消融方法治疗腰椎间盘突出症的疗效。方法:选择腰椎间盘突出症患者680例随机分为两组,对照组给予常规手术,实验组给予射频靶点热凝手术联合臭氧消融,对比疗效。结果:实验组疼痛感降低到(0.89±0.37),疗效优于对照组,P0.05。结论:射频靶点热凝术联合臭氧消融治疗腰椎间盘突出症效果好。     

两种靶点入路射频热凝联合臭氧治疗腰椎间盘突出症

目的观察两种靶点入路行射频热凝术联合臭氧消融术治疗不同类型腰椎间盘突出症的临床效果。方法 112例腰椎间盘突出症患者,均分为联合组和对照组,联合组根据突出类型行靶点射频消融联合臭氧盘内、外注射,对照组行单纯靶点射频消融术。分别评价术后VAS评分及远期疗效。结果术后两组的VAS评分均较治疗前有明显降低（P〈0.05）,远期疗效联合组高于对照组,两组相比有统计学意义（P〈0.05）。结论射频热凝联合臭氧消融对不同的腰椎间盘突出类型采用相应的靶点入路,能更精确地到达靶点,达到满意效果,远期疗效优于单纯射频消融术。     

臭氧联合射频治疗腰椎间盘突出症的疗效分析

目的分析臭氧联合射频治疗腰椎间盘突出症的临床疗效。方法选取2008年4月至2012年4月于河南大学第一附属医院就诊的80例腰椎间盘突出症但是拒绝接受外科手术治疗的患者,采用随机数字表法分为射频热凝组和臭氧联合射频组,各40例。射频热凝组行射频热凝术治疗,臭氧联合射频组在射频热凝术治疗的基础上,加用臭氧髓核氧化术。治疗后,采用视觉模拟评分(VAS)法、改良Mac Nab方法和远红外热成像检查患者双下肢红外热图温差3种方法观察术后疗效。结果射频热凝组和臭氧联合射频组治疗前VAS评分、双下肢红外热图温差差异均无统计学意义(均P>0.05)。治疗后射频热凝组的VAS评分显著高于臭氧联合射频组[(4.2±1.1)比(2.9±1.3)](P<0.01);双下肢红外热图温差显著高于臭氧联合射频组[(0.42±0.05)℃比(0.32±0.02)℃](P<0.01)。射频热凝组总有效率为72.5%,臭氧联合射频组总有效率为92.5%,臭氧联合射频组治疗后的总有效率高于射频热凝组,差异有统计学意义(P<0.05)。结论臭氧联合射频治疗腰椎间盘突出症比单纯采用射频治疗的疗效更佳,可显著减轻患者疼痛症状,改善下肢血供。     

射频热凝联合三氧消融术治疗颈腰椎间盘突出症287例疗效观察

目的:观察射频热凝联合三氧消融术治疗颈腰椎间盘突出症的临床疗效。方法:287例颈腰椎间盘突出症患者在C臂引导下,行突出髓核的射频热凝术联合三氧消融术。采用视觉模拟评分法(VAS)及改良的Macnab评价法评价疗效。结果:术后1天、1周、1月、3个月VAS评分值较术前明显降低,差异有统计学意义(P0.05);术后3个月疗效评定,优良率93.37%,总有效率96.86%,无1例出现严重并发症。结论:射频热凝联合三氧消融术治疗颈腰椎间盘突出症操作简便,疗效确切,安全性高。     

C臂引导下射频靶点热凝联合臭氧消融治疗腰椎间盘突出症的临床效果观察

目的评价C臂引导下射频靶点热凝联合臭氧消融治疗腰椎间盘突出症的临床效果。方法选取2016年4月至2017年4月我院收治的腰椎间盘突出症患者90例,采用C臂引导下射频靶点热凝联合臭氧消融治疗法,对比治疗前后的抑郁评分与治疗效果。结果经过调查得知治疗前抑郁评分高于治疗后,组间对比呈现为P0.05的差异性。治疗一周的效果低于治疗三个月的效果,组间对比呈现为P0.05的差异性。结论在腰椎间盘突出症治疗过程中,采用C臂引导下射频靶点热凝联合臭氧消融治疗方式,能够加快患者的康复速度,且安全性较高,值得进行推广。     

CT引导下臭氧消融联合射频热凝治疗腰椎间盘突出症

目的探讨CT引导下臭氧消融联合射频热凝治疗腰椎间盘突出症的临床应用价值。方法 65例经临床、影像检查确诊的腰椎间盘突出症患者在CT引导下先行椎间盘内、外注射臭氧,后行射频热凝治疗。结果 65例患者治疗后随访3~6个月,按改良Macnab疗效评定标准分级。优22例、良33例、可6例、差4例,总有效率93.8%,优良率为84.6%,均未出现并发症。结论 CT引导提高了穿刺的准确性,在严格掌握适应证的情况下,臭氧消融联合射频热凝是治疗腰椎间盘突出症的一种微创、安全、有效的方法。     

臭氧消融联合射频热凝术治疗腰椎间盘突出症与非手术治疗的比较

目的观察臭氧消融联合射频热凝治疗腰椎间盘突出症的临床效果,并与非手术治疗相比较。方法选择2009年11月~2011年4月我院收治的腰椎间盘突出症患者160例,随机分为臭氧消融联合射频热凝术治疗组（联合组）和非手术治疗组（保守组）,每组80例,比较两组治疗3个月后VAS评分和近期疗效。结果联合组和保守组治疗前VAS评分分别为（6.8±2.0）分和（6.3±1.8）分,两组间比较差异无统计学意义（P〉0.05）,治疗后分别降低到（1.2±0.5）分和（2.3±1.1）分,联合组疼痛缓解明显（t=2.107,P=0.048）,且有效率高于保守组（χ2=10.009,P=0.007）。结论臭氧消融联合射频热凝术治疗腰椎间盘突出症在疼痛缓解和有效率方面优于非手术治疗。     

靶点射频联合臭氧消融治疗腰椎间盘突出症的临床应用

目的观察靶点射频联合臭氧消融对腰椎间盘突出症的临床疗效。方法选择腰椎间盘突出症患者128例,在CT引导下将穿刺针穿刺到椎间隙靶点后,由60℃逐渐升温至90℃,每周期40s,90℃再持续加温4min,然后调整针尖,用5 ml注射器抽取浓度为60μg/ml的臭氧5ml缓慢注射至椎间盘内,观察术后1周、3个月的有效率、优良率及与治疗前的VAS评分。结果术后1周的有效率、优良率分别为85.9%、69.5%,术后3个月的有效率、优良率分别为88.3%、79.7%,且随时间延长优良率明显提高;治疗后VAS较治疗前明显降低（P〈0.01）。结论靶点射频联合臭氧消融对腰椎间盘突出症的临床治疗效果良好、可控性较好、风险小,有重要临床应用价值。     

微创联合配合中药熏蒸治疗腰椎间盘突出症的临床研究

目的:探讨射频热凝、臭氧盘内外注射联合针刀松解治疗腰椎间盘突出症的临床疗效。方法:将208例腰椎间盘突出症患者随机分成2组。对照组104例采用射频热凝联合臭氧注射治疗。实验组采用射频热凝、臭氧注射联合针刀松解治疗。临床疗效采用VAS评分和MacNab评分标准分析。结果:术后1天、7天的有效率组间比较差异无显著性(P>0.05),术后1个月,3个月的有效率组间比较差异有显著性(P<0.05)。结论:射频热凝、臭氧注射联合针刀松解是治疗腰椎间盘突出症的有效方法,集中了三者的优势,远期效果明显。     

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.     

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.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.