浮针结合隔药饼灸治疗顽固性肱骨外上髁炎临床研究

目的:观察浮针结合隔药饼灸治疗顽固性肱骨外上髁炎的临床疗效。方法:将80例顽固性肱骨外上髁炎患者随机分为两组,每组40例。浮针组采用浮针结合隔药饼灸治疗,电针组采用电针结合隔药饼灸治疗,两组在治疗3个疗程后进行疗效评定。结果:浮针组治愈率为90.0%,总有效率为100%;电针组治愈率为52.5%,总有效率为87.5%,两组疗效差异有统计学意义(P0.05)。结论:浮针结合隔药饼灸治疗顽固性肱骨外上髁炎疗效明显优于电针。     

隔三七饼灸配合推拿治疗血瘀型膝原发性骨关节炎临床疗效观察

[目的]观察隔三七饼灸配合推拿治疗血瘀型膝原发性骨关节炎（knee ostevarthritis,KOA）临床疗效,期望丰富临床治疗方法提高临床治疗水平.[方法]选取2011年1月至2013年10月间温岭市中医院针灸推拿科门诊和住院收治的原发性KOA患者60例,分成2组,每组各30例,对照组采用常规西医治疗,治疗组予以隔三七饼灸配合推拿治疗.观察两组治疗后临床效果情况.[结果]治疗组总有效率90％,明显优于对照组76.2％.治疗组在改善KOA症状、体征分级量化评分积分方面均有非常明显的疗效,且优于对照组.治疗后在缓解关节疼痛、关节肿胀、关节功能及膝围方面,治疗组均优于对照组,而在改善KOA的X线方面无明显差异.[结论]隔三七饼灸配合推拿疗法治疗KOA能明显改善血瘀型KOA的关节疼痛、肿胀及功能活动,且操作简单,值得临床推广.     

隔药饼灸治疗气滞血瘀型慢性盆腔炎经验介绍

[目的]探讨气滞血瘀型慢性盆腔炎的治疗方法。[方法]回顾近年来运用隔药饼灸治疗气滞血瘀型慢性盆腔炎患者的方法,从中总结经验。[结果]隔药饼灸法简单、方便,温度稳定,易控制,无污染,灸法有效率高于针法。[结论]隔药饼灸能有效治疗气滞血瘀型慢性盆腔炎,值得推广。     

围刺加灸后穴注丹参治疗网球肘50例

目的 采用围刺加灸后穴注丹参与封闭疗法治疗顽固性网球时的疗效对比。方法 将98例网球肘患者随机分为治疗组50例采用围刺加灸后穴注丹参治疗，对照组采用封闭疗法。结果 治疗组的治愈率明显高于对照组。结论 围刺加灸后穴注丹参治疗网球肘疗效好，有床研究应用价值。     

隔药灸配合梅花针叩刺治疗神经根型颈椎病疗效观察

[目的] 观察隔药灸配合梅花针叩刺治疗神经根型颈椎病的临床疗效。[方法] 将150例椎神经根型颈椎病患者随机分为治疗组90例和对照组60例。治疗组采用隔药灸配合梅花针叩刺治疗,对照组采用药物配合牵引治疗,两组在治疗3个疗程后由专人进行疗效评定。[结果] 治疗组临床治愈率为51.1%,总有效率为 97.8%,对照组临床治愈率为18.3%,总有效率为78.3%,治疗组总有效率及临床治愈率均优于对照组;两组痊愈患者中疗程与疗效比较显示,治疗组1个疗程和2个疗程内痊愈率均高于对照组,说明隔药灸配合梅花针叩刺能明显的缩短治疗神经根型颈椎病的疗程。治疗组疗效明显优于对照组,两组比较差异有统计学意义(P<0.05)。[结论] 隔药灸配合梅花针叩刺治疗神经根型颈椎病疗效显著, 值得临床推广应用。     

隔花椒饼灸对类风湿关节炎大鼠抗炎镇痛作用观察

目的:观察隔花椒饼灸对类风湿性关节炎(RA)大鼠的抗炎镇痛作用。方法:将SD大鼠随机分为空白组、模型组、实验组(隔花椒饼灸组)、对照组(隔附子饼灸组),除空白组外,其余3组大鼠采用弗氏完全佐剂法复制实验性RA模型,于造模后10 d,实验组与对照组分别用隔花椒饼灸、隔附子饼灸施灸,空白组与模型组不予任何治疗。在造模前、造模后第10天及治疗第7、14、21天分别测量各组大鼠痛阈,治疗结束后处死大鼠取大鼠脾脏、双侧肾上腺测量脾指数及肾上腺指数,取病变关节周围软组织制备病理切片,比较各组大鼠痛阈、脾指数、肾上腺指数及病理切片变化。结果:隔花椒饼灸、隔附子饼灸均能明显提高RA大鼠痛阈、降低脾指数、提高肾上腺指数(P0.05),其中隔花椒饼灸痛阈在治疗后7 d时即有明显差异(P0.05),并在治疗后14 d时达高峰(P0.01);隔花椒饼灸、隔附子饼灸均能减轻RA大鼠炎性反应,隔花椒饼灸炎性浸润最轻。结论:隔花椒饼灸与隔附子饼灸治疗实验性RA均有明显的抗炎镇痛作用,对脾脏、肾上腺等免疫及内分泌器官有保护作用。隔花椒饼灸镇痛效应起效时间早于隔附子饼灸,而抗炎作用则优于隔附子饼灸。     

隔药饼灸配合针刺治疗腰椎间盘突出症

目的 探讨隔药饼灸配合针刺治疗腰椎间盘突出症(LDH)的临床疗效.方法 将80例患者按随机数字表法分为2组,每组40例.观察组予针刺配合隔药饼灸夹脊、环跳、委中、昆仑等穴,对照组予针刺配合隔面饼灸相同的穴位.均1次/d,共治疗10 d.观察治疗前后的视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)评分,并评价临床疗效,进行对比分析.结果 观察组和对照组的总有效率分别为97.5%、90.0%,观察组高于对照组(P<0.05);治疗后2组VAS评分、ODI评分较治疗前下降,差异有统计学意义(P<0.05,P<0.01);治疗后观察组VAS评分为(1.32±0.83),ODI评分为(13.18±7.73),均低于对照组(P<0.05).结论 隔药饼灸配合针刺治疗腰椎间盘突出症,能明显减轻疼痛,改善腰椎功能.     

隔药饼灸治疗脾胃虚寒型胃脘痛60例

目的观察隔药饼灸治疗脾胃虚寒型胃脘痛的临床疗效。方法选取2017年9月～2018年9月符合脾胃虚寒型胃脘痛诊断标准的住院患者120例,使用数字表法随机分为对照组和治疗组各60例。对照组患者予常规治疗,治疗组在常规治疗基础上,加用隔药饼灸神阙、天枢、中脘穴进行干预,比较两组的疗效情况。结果两组患者治疗后中医症候评分都较治疗前提高,治疗组提高分值明显大于对照组患者,差异具有统计学意义(P0.05);治疗组患者治疗2周后无重度疼痛患者,无痛患者明显多于对照组患者,轻度疼痛、中度疼痛患者明显少于对照组患者,差异具有统计学意义(P0.05);治疗组临床有效率为90%,对照组临床有效率仅为70%,治疗组明显高于对照组,差异具有统计学意义(P0.05)。结论隔药饼灸治疗脾胃虚寒型胃脘痛疗效显著。     

隔附子饼灸神阙穴对中风后尿潴留的临床观察

目的:观察隔附子饼灸神阙穴治疗中风后尿潴留的临床疗效。方法:40例尿潴留患者随机数字表法分为治疗组20例和对照组20例。对照组以针刺关元、中极、气海穴为主穴,治疗组在对照组基础上隔附子饼灸神阙穴两个疗程,观察两组膀胱功能指标及疗效评价。结果:治疗后,两组治疗均有效,两组愈显率、平均起效时间、平均膀胱容量、残余尿量、日均单次排尿比较,差异均有统计学意义(P0.05)。结论:针刺配合隔附子饼灸神阙穴治疗中风后尿潴留疗效优于常规针灸疗法。     

隔发酵附子饼灸治疗肾阳虚型良性前列腺增生症疗效观察

目的:观察隔发酵附子饼灸与传统隔附子饼灸治疗肾阳虚型良性前列腺增生症的疗效差异。方法:203例患者随机分为治疗组、对照组,治疗组102例采用关元穴隔发酵附子饼灸,对照组101例在关元穴隔传统附子饼灸,观察两组治疗前后中医症状积分、国际前列腺症状评分(I-PSS)、生活质量评估(QOL)、膀胱残余尿量(PVR)的变化。结果:总有效率治疗组84.3%,对照组70.3%,两组比较有显著性差异(P0.05)。两组均能改善中医症状积分、I-PSS评分及PVR,治疗后两组比较有显著性差异(P0.01);两组均能改善QOL评分(P0.01),两组治疗后比较无显著性差异(P0.05)。结论:隔发酵附子饼灸治疗肾阳虚型良性前列腺增生症优于传统隔附子饼灸。     

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.