西沙必利、藿香正气液联合治疗功能性消化不良疗效观察

目的 观察西沙必利联合藿香正气液口服对功能性消化不良患者的影响.方法 将功能性消化不良患者按分层单盲随机分组,治疗组112例口服西沙必利片和藿香正气液,对照组52例口服西沙必利片,并设健康志愿者30例作为空白对照组,观察治疗前后临床症状、体表胃电图及胃动素、胃泌素的变化.结果 西沙必利联合藿香正气液改善患者临床症状的总有效率为72.4%(与对照组比较,差异有统计学意义,P＜0.05),该组患者胃电节律紊乱显著改善,血浆胃动素含量明显升高(与治疗前比较,差异有统计学意义,P＜0.05).结论 西沙必利联合藿香正气液能改善功能性消化不良患者的临床症状,恢复正常的胃电节律,并对血浆胃动素含量有一定的影响.     

六味安消胶囊对功能性消化不良患者胃排空的影响

目的 观察六味安消胶囊对功能性消化不良患者的临床疗效及对胃排空、胃动素的影响.方法 72例功能件消化不良患者随机分为两组:治疗组和对照组.全部停止应用影响胃酸分泌及胃动力的药物一周后,给予症状评分,并进行胃排空、空腹血浆胃动素的检测;对照组给予多潘立酮口服2周,治疗组给予六味安消胶囊(邦消安)口服2周,然后再次进行症状评分并检测胃排空、空腹血浆胃动素的变化.结果 (1)FD患者口服六味安消胶囊2周后,上腹痛、腹胀、早饱、嗳气等临床症状明显改善,症状积分与治疗前比较有统计学意义(P＜0.01),与对照组比较无显著差异(P＞0.05 o(2)FD患者治疗后与治疗前胃排空率比较:2h、5h胃全排空例数及胃排空率均明显增加(P＜0.01)与对照组比较无统计学意义(P＞0.05).(4)FD患者治疗后与治疗前空腹血浆胃动素相比明显增加(P＜0.01),与对照组比较无统计学意义(P＞0.05).结论 六味安消胶囊可显著改善功能性消化不良患者的上腹痛、腹胀、早饱、嗳气等主要症状,改善胃动力,加速胃排空,提高空腹血浆胃动素.     

胃康宁胶囊治疗功能性消化不良临床观察

目的评价胃康宁胶囊治疗功能性消化不良的疗效及安全性.方法138例功能性消化不良患者随机分成两组,治疗组97例口服胃康宁胶囊,对照组41例口服吗叮啉片,并设健康志愿者30例作为空白对照组,观察治疗前、后临床症状积分值、体表胃电图、胃排空以及胃动素、胃泌素的变化.结果治疗组总有效率为67.0%,与对照组比较,差异有显著性(P＜0.05);症状改善总积分和总症状改善率与对照组相比差异无显著性;治疗前两组患者大多数存在胃电节律异常,且空腹胃电异常以节律紊乱为主,治疗后患者的胃电节律和临床症状可明显改善;胃排空较治疗前加快,治疗前、后比较差异有显著性,但与对照组相比,差异不显著;治疗前两组患者空腹血浆胃动素和血清胃泌素水平均较正常值明显下降(P＜0.01),治疗后,两组患者血浆胃动素水平均较治疗前明显升高(P＜0.05),治疗前、后血清胃泌素比较差异无显著性.结论胃康宁治疗FD安全、有效.     

奥美拉唑联合西沙比利治疗功能性消化不良老年患者的疗效观察

目的:观察奥美拉唑联合西沙比利治疗功能性消化不良老年患者的临床疗效.方法:将74例功能性消化不良老年患者随机分为联合治疗组38例和对照组36例.对照组单纯应用奥美拉唑治疗,联合治疗组为奥美拉唑和西沙比利联合治疗.治疗后观察症状改善情况,统计疗效变化.结果:联合治疗组治疗后患者上腹部不适及胃部烧灼感、餐后饱胀感、嗳气、反酸和胸骨后疼痛感等症状较治疗前和对照组治疗后有明显改善(P<0.01或P<0.05).联合治疗组总有效率84.2%,对照组总有效率61.1%,两组疗效比较差异有统计学意义(P<0.05).结论:奥美拉唑联合西沙比利治疗功能性消化不良老年患者有良好的疗效.     

急性脑血管病病人血浆甲状腺激素浓度变化及其临床意义

目的探讨急性脑梗死与脑出血病人血浆甲状腺激素(TH)的变化及其临床意义.方法应用放射免疫分析法测定68例急性脑梗死与脑出血病人和56例健康人(对照组)的血浆TH含量.结果急性脑梗死和脑出血病人血浆T3/FT3含量测定(1.18±0.41)/nmol/L/(2.90±1.12)pmol/L、(1.04±0.39)nmol/L/(2.83±1.36)pmol/L明显低于对照组(1.98±0.51)nmo/L,P＜0.01/(6.37±1.31),P＜0.001;死亡组T3/FT3水平与非死亡组T3/FT3水平相比较有显著差异(P＜0.05/P＜0.01).结论TH参与了急性脑梗死和脑出血病人的病理生理过程,监测急性脑梗死和脑出血病人的血浆TH水平可作为反映病情程度和评估预后的一项参考指标.     

氯波比利治疗功能性消化不良的临床分析

目的:探讨氯波比利治疗功能性消化不良(FD)的疗效.方法:将196例FD患者随机分为氯波比利组(治疗组)98例,胃复安组(对照组)98例,进行对照研究,观察两组病人用药的疗效和不良反应及复发率.结果:氯波比利组治疗前后病人功能性消化不良症状明显减轻,差异有显著性(P＜0.05).氯波比利组与胃复安组比较,疗效差异有显著性(P＜0.05),停药4周后,氯波比利组复发率低,与胃复安组差异有显著性(P＜0.05).结论:FD患者应用氯波比利治疗疗效确切,复发率低,不良反应少,值得临床推广应用.     

功能性消化不良与十二指肠球部溃疡血浆胃动素水平测定

通过对 37例功能性消化不良与 36例十二指肠球部溃疡血浆胃动素水平测定 ,探讨胃肠道激素及其与胃肠道运动和神经调节的关系 ,结果显示 :两组疾病血浆胃动素水平差异无显著性 (P >0 .0 5 ) ,且功能性消化不良症状评分与血浆胃动素水平无相关性。表明此组疾病虽然发病机制中迷走神经张力高低不一 ,而两组疾病血浆胃动素水平无差异 ,提示胃动素可能没有参与功能性消化不良的动力紊乱     

莫沙必利分散片联合热敏灸治疗功能性消化不良的临床效果研究

目的:分析莫沙必利分散片联合热敏灸治疗功能性消化不良的临床效果,以及对患者各项症候评分的改善情况。方法:将80例功能性消化不良的患者随机分为2组。两组均给予莫沙必利分散片进行治疗,在此基础上,观察组40例联合采用热敏灸治疗。治疗后观察两组临床效果、症候评分、血浆胃动素(MTL)水平和胃泌素(GAS)水平。结果:观察组治疗有效率为90.00%,对照组为70.00%。观察组治疗有效率明显高于对照组(P0.05)。治疗后2组患者各项症候评分、MTL水平以及GAS水平均有改善,与治疗前相比,差异有统计学意义(P0.01);治疗后2组比较,差异也有统计学意义(P0.01)。结论:莫沙必利分散片联合热敏灸治疗功能性消化不良的临床效果显著,症状改善明显。     

西沙比利治疗老年人功能性消化不良的效果

目的 探讨西沙比利治疗老年人功能性消化不良的疗效。方法 随机将１５２例６０岁以上功能性消化不良患者分成西沙比利、胃复安、安慰剂３组进行４周治疗、对照。结果 西沙比利组治疗前后症状明显改善,与安慰剂组比较,差异有显著性（ｐ〈０．０５）;停药４周后,西沙比利组比胃复安组复发率低（ｐ〈０．０５）。结论 西沙比利治疗老年人功能性消化不良疗效佳,复发率低,副作用少。     

金龙汤治疗功能性消化不良53例疗效观察

目的 探讨金龙汤治疗功能性消化不良的临床效果。方法 采用症状积分法,观察比较金龙汤组与吗叮啉组的临床疗效,同时检测服用金龙汤前、后血清胃泌素和血浆胃动素的变化。结果 金龙汤症状改善和临床总有效率均优于吗丁啉组（Ｐ〈０．０１）。金龙汤组服药后血浆胃动素水平较服药前显著升高（Ｐ〈０．０１）。而血清胃泌素水平变化不明显（Ｐ〉０．０５）。结论 金龙汤是治疗功能性消化不良的有效方剂,疗效优于临床常用西药吗丁     

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.