用温针灸法联合关节松动术治疗神经根型颈椎病的疗效观察

目的：探讨用温针灸法联合关节松动术治疗神经根型颈椎病的临床效果。方法：对近年来我院收治85例神经根型颈椎病患者的临床资料进行回顾性研究。我们将这85例患者随机分为治疗组和对照组,其中治疗组有43例患者,对照组有42例患者。我们对对照组患者进行温针灸治疗,对治疗组患者在进行温针灸治疗（方法与对照组患者相同）的基础上,给其使用关节松动术进行治疗。结果：在治疗前,两组患者PRI（疼痛分级指数）的评分、VAS（疼痛目测类比指数）的评分和PPI（现有疼痛强度）的评分相比无显著性差异。在治疗后,两组患者PRI的评分、VAS的评分和PPI的评分均较治疗前有明显的下降,其中治疗组患者PRI评分、VAS评分和PPI评分的下降幅度明显大于对照组患者,二者相比差异具有显著性( P<0.05)。治疗结束后,两组患者治疗的总有效率大体相同,但治疗组患者治疗的显愈率（显效率+痊愈率）明显高于对照组患者,二者相比差异具有显著性( P<0.05)。结论：用温针灸法联合关节松动术治疗神经根型颈椎病疗效确切,可有效地提高患者治疗的痊愈率和显效率,改善其临床症状。此疗法值得在临床上推广使用。     

超微针刀治疗神经根型颈椎病的疗效观察

目的观察超微针刀治疗神经根型颈椎病患者的治疗效果。方法将符合标准的60例患者分成实验组、对照组各30例,治疗组采用超微针刀治疗,对照组采用温针加火罐治疗。记录治疗前后患者麦吉尔疼痛量表各项评分,通过SPSS17.0软件进行分析比较显著性。结果 (1)治疗组愈显率为80%,与对照组56.6%比较(P0.05)。(2)两组治疗前后差值进行比较,PRI和PPI积分,治疗组较对照组明显降低,且有极显著性差异(P0.01),而VAS治疗组较对照组降低,有显著性差异(P0.05)。结论超微针刀治疗神经根型颈椎病疗效可靠。     

调脊通督针法治疗神经根型颈椎病临床研究

目的:观察调脊通督针法治疗神经根型颈椎病的临床疗效。方法:将216例患者随机分成两组,观察组采用调脊通督针法治疗,对照组采用常规针刺法治疗,观察两组临床疗效,并采用简化Mc Gill疼痛评分(short-form Mc Gill pain questionnaire,SF-MPQ)量表系统评定两组患者治疗前后疼痛分级指数(pain rating index,PRI)、视觉模拟评分法(visual analogue scale,VAS)评分、现有疼痛强度(present pain intensity,PPI)。结果:观察组临床疗效显著优于对照组(P0.05)。两组患者VAS及PRI评分与治疗前比较,有显著性差异(P0.05),且观察组改善更显著(P0.05)。观察组患者PPI评分较对照组有显著性差异(P0.05)。结论:调脊通督针法取穴简便,能更好地改善神经根型颈椎病患者疼痛症状,疗效确切。     

温针灸辅助牵引治疗神经根型颈椎病的疗效观察

目的 探讨温针灸辅助牵引治疗神经根型颈椎病的临床疗效。方法 选取2018年1月至2020年1月本院收治的神经根型颈椎病患者140例,随机分为对照组和观察组,各70例。对照组采用单纯牵引治疗,观察组在对照组基础上辅以温针灸治疗,比较两组临床疗效、治疗前后MPQ评分及颈椎活动度。结果 观察组治疗总有效率为92.86%,高于对照组的72.86%,差异有统计学意义（P<0.05）。治疗后,两组疼痛分级指数（PRI）、视觉模拟量表（VAS）评分、疼痛强度（PPI）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,两组颈椎前屈、后伸、左旋及右旋角度均高于治疗前,且观察组高于对照组,差异均有统计学意义（P<0.05）。结论 温针灸辅助牵引治疗神经根型颈椎病可有效缓解疼痛症状,改善颈椎活动度。     

穴位贴敷治疗原发性痛经104例临床观察

目的 观察关元穴穴位贴敷治疗原发性痛经的疗效.方法 采用穴位贴敷关元穴治疗原发性痛经104例,并与对照组针灸治疗96例比较.结果 治疗组有效率95.20%,对照组78.13%,穴位贴敷疗法疗效优于针灸治疗(P＜0.05).结论 穴位贴敷疗法治疗原发性痛经疗效确切,且疗效优于针灸治疗.尤其适于气血瘀滞及寒湿凝滞之原发性痛经.     

中医辨证施护在穴位贴敷联合电针治疗老年神经根型颈椎病患者的应用研究

目的：探讨中医辨证施护在穴位贴敷联合电针治疗老年神经根型颈椎患者的临床疗效及心理情绪的影响,为临床老年神经根型颈椎病的护理提供参考。方法：选择2014年6月至2016年8月 80例老年神经根型颈椎病患者作为研究对象,按照就诊顺序编号,采用数字随机表法分成对照组和观察组,每组各40例。对照组穴位贴敷联合电针治疗,观察组在对照组治疗基础上中医辨证施护,观察不同方法治疗后在中医证候、疗效、相关评分等情况变化。结果：中医证候积分上,两组治疗末在颈痛程度、颈痛与睡眠、手臂放射症状、每日持续时间、携带物件、阅读和看电视、工作和家务、社交活动、驾驶上较治疗前均显著下降（P<0.05）,观察组显著低于对照组(P<0.05);相关积分上,两组治疗末VAS、 PRI感觉分、PRI情绪分、PPI较治疗前显著下降（P<0.05）,观察组显著低于对照组(P<0.05);对照组痊愈率25%、总有效率77.5%,观察组痊愈率45%、总有效率92.5%,观察组显著高于对照组（P<0.05）。结论：中医辨证施护能改善穴位贴敷联合电针治疗老年神经根型颈椎病临床效果,减轻疼痛,增进疗效,对老年神经根型颈椎病具有较高的临床价值。     

超声引导下针刀松解疗法治疗颈型颈椎病临床观察

目的观察超声引导下针刀松解治疗颈型颈椎病的临床疗效。方法选取颈型颈椎病患者100例,采用随机数字表法分为观察组和对照组各50例,对照组根据骨度分寸法结合临床经验定点进行非直视下针刀松解疗法,观察组进行超声引导下针刀松解疗法,2组均每周治疗1次,2周为1个疗程,共治疗2个疗程。观察2组治疗前后的压痛点计数、疼痛评估指数(PRI)、视觉模拟评分量表(VAS)、现时疼痛强度(PPI)及颈椎活动度的变化。结果与治疗前比较,2组治疗后压痛点计数、PRI评分、VAS评分、PPI评分及颈椎活动度均能明显改善(P<0.05),且观察组改善程度最为显著(P<0.05);观察组疗效优于对照组(P<0.05)。结论超声引导下针刀软组织松解治疗颈型颈椎病能提高临床疗效,较安全可靠。     

针刀联合“王氏”整脊手法治疗神经根型颈椎病临床研究

目的观察针刀联合"王氏"整脊手法治疗神经根型颈椎病的临床疗效。方法选择我院88例神经根型颈椎病患者为研究对象,随机分成观察组与对照组各44例。观察组患者给予针刀联合"王氏"整脊手法治疗,对照组给予单独针刀治疗。观察两组患者的临床效果,比较治疗前后疼痛评分以及颈椎功能评分。结果治疗后,观察组临床有效率显著高于对照组(P0.05);两组患者疼痛分组指数(PRI)、视觉核拟评分法(VAS)、现有疼痛强度(PPI)评分较治疗前均明显下降,观察组低于对照组(P0.05);疗程结束后,两组患者颈椎功能评分均显著改善,观察组优于对照组(P0.05)。结论针刀联合"王氏"整脊手法治疗神经根型颈椎病疗效显著,能够有效缓解疼痛,促进颈椎功能恢复,具有较高的临床推广应用价值。     

三通平衡法针刺联合推拿治疗神经根型颈椎病的临床效果

目的 探究三通平衡法针刺联合推拿治疗神经根型颈椎病的临床效果。 方法 选择2021年11月至2022年8月安徽省马鞍山市中医院针灸推拿科门诊收治的80例神经根型颈椎病患者作为研究对象,按照随机数字表法将其分为常规针刺组和三通平衡法针刺组,各40例。常规针刺组在推拿治疗的基础上联合常规针刺疗法进行治疗,三通平衡法针刺组则在推拿治疗的基础上联合三通平衡法针刺进行治疗,治疗时间均为4周。比较两组治疗前后中医证候积分、视觉模拟评分法（VAS）、疼痛评级指数（PRI）、现时疼痛强度（PPI）、颈椎病临床评价量表（CASCS）评分,并比较两组临床疗效。 结果 治疗后,两组主证积分、次证积分及总积分均低于治疗前,且三通平衡法针刺组低于常规针刺组,差异有统计学意义（P＜0.05）。治疗后,两组VAS、PRI评分及PPI评分均低于治疗前,且三通平衡法针刺组低于常规针刺组,差异有统计学意义（P＜0.05）。治疗后,两组主观症状、临床症状及适应能力评分均高于治疗前,且三通平衡法针刺组高于常规针刺组,差异有统计学意义（P＜0.05）。三通平衡法针刺组临床疗效优于常规针刺组,差异有统计学意义（P＜0.05）。 结论 在治疗神经根型颈椎病上,三通平衡法针刺联合推拿的临床疗效明显优于常规针刺联合推拿治疗,患者的临床症状、颈椎疼痛和颈椎功能均得到显著改善,其改善幅度大于常规针刺联合推拿治疗,值得在临床上积极推广。     

穴位贴敷治疗慢性膝关节滑膜炎

目的 观察穴位贴敷疗法对慢性膝关节滑膜炎的临床疗效.方法 将符合条件的膝关节滑膜炎患者随机分为治疗组和对照组,各42例.治疗组采用穴位贴敷配合拔罐疗法治疗,对照组采用常规针灸治疗,观察2组临床症状及体征的改善情况.结果 治疗1、3月后,2组WOMAC评分明显低于治疗前(P＜0.05),治疗组较对照组下降明显(P＜0.05);治疗组总有效率为88.09％,对照组总有效率为75.60％,2组比较,P＜0.05.结论 穴位贴敷治疗慢性膝关节滑膜炎,体内药物浓度相对稳定,避免了直接内服药物产生的不良反应,提高了药物的生物利用率.     

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.