针灸推拿配合中医五行对自闭症患儿康复的干预研究

目的探讨针灸推拿配合中医五行方法对自闭症患儿的临床干预治疗效果。方法选择我院2013年7月-2015年8月接收治疗的98例自闭症患儿,按照随机数字表法,奇数号作为对照组,偶数号作为治疗组,每组49例。对照组患儿采用单纯康复训练,治疗组患儿采用针灸推拿配合中医五行音乐治疗。以患儿儿童孤独症评定量表(Childhood Autism Rating Scale,CARS)、孤独症儿童行为量表(Autism Behavior Checklist,ABC)、Gesell发育量表(社会适应DQ、语言DQ、个人社交DQ)为观察指标,统计分析治疗前后两组的临床疗效及量表指标的变化。结果 1治疗组临床总有效率为87.76%,对照组为53.06%,两组比较,差异有统计学意义(χ~2=25.94,P0.05);2治疗组治疗前后CARS量表、ABC量表数值变化比较,差异有统计学意义(P0.05),对照组患儿治疗前后数值无明显变化,差异无统计学意义(P0.05),治疗组与对照组比较,CARS、ABC量表数值均明显降低,差异有统计学意义(P0.05);3治疗后治疗组患儿社会适应DQ、语言DQ、个人社交DQ值与对照组比较均明显升高,差异有统计学意义(P0.05)。结论针灸推拿配合中医五行用于自闭症患儿的治疗中,与常规康复手段比较,可以明显改善患儿的自闭症状,提高患儿的社交能力,改善患儿的语言能力,是有效的治疗手段。     

针灸推拿配合中医五行音调理对自闭症儿童行为心理康复的干预

研究表明,针灸推拿配合中医五行音调理干预对自闭症儿童行为具有一定的临床意义。将70例自闭症患儿分为观察组(30例)和对照组(40例)。观察组采用中医五行音乐配合针灸推拿疗法的治疗模式治疗,对照组采用结构化教育治疗模式治疗。采用克氏孤独症行为量表、儿童孤独症评定量表(CARS量表)、孤独症儿童行为量表(ABC量表)、Gesell发育量表(社会适应DQ、个人社交DQ、语言DQ)于治疗前后评定,所得结果通过SPSS 13.0软件进行分析。1)在相同的治疗时间内,观察组在改善自闭症儿童交流能力及智力方面的效果明显优于对照组。2)观察组中大龄组及小龄组相比较,在克氏评分、ABC评分、社会适应评分3个方面均无显著性差异,说明无论年龄大小,经中医五行音乐疗法配合针灸推拿疗法的治疗模式治疗均能改善其行为及智力水平。3)观察组治疗前后语言评分比较有显著性差异,说明观察组治疗方法能较好地改善患儿语言功能,且优于对照组治疗方法。中医五行音乐配合针灸推拿疗法的治疗模式能显著提高治疗效果,能较好地改善患儿的自闭症状及提高智商、语言能力。     

针刺治疗儿童自闭症40例疗效观察

【目的】观察针刺治疗儿童自闭症的临床疗效。【方法】依据患者家属自愿的原则,将80例自闭症患儿分为针刺组与干预组各40例。针刺组采用“靳三针疗法”治疗,主穴以“自闭十项”为主,每天1次,每周6次,星期天休息,120次为1个疗程;干预组采用综合性措施进行干预治疗,主要包括物理治疗、认知训练、行为分析及矫正和语言训练,每天1次,每次4 h,每周6次,星期天休息,120次为1个疗程。两组疗效采用儿童孤独症及相关发育障碍心理教育评定量表—中文修订版(C-PEP)中的功能发展量表进行评价。【结果】经1个疗程治疗后,针刺组与干预组均能增加功能发展量表评分(P<0.05);针刺组与干预组比较,针刺组的总体疗效及在改善感知觉、精细动作、粗动作、口语四个方面更加显著(P<0.05)。【结论】针刺治疗儿童自闭症具有一定的疗效。     

听觉统合训练系统在自闭症谱系障碍儿童中的应用研究

目的探讨听觉统合训练系统在自闭症谱系障碍儿童中的应用。方法选取2018年1～7月期间我院与商丘市睢阳区脑瘫智障康复训练中心自闭症谱系障碍儿童,将其随机分为对照组和实验组,每组各20例。对照组进行常规教育训练和感觉统合训练,实验组儿童进行常规教育训练、感觉统合训练和听觉统合训练系统训练。两组儿童在听觉统合训练的检测模块后、治疗中期和全部治疗结束后进行自闭症行为测试量表(ABC量表)评估疗效。结果治疗前两组儿童年龄、ABC总分、语言能力和交往能力评分比较差异均无统计学意义(P0.05)。治疗结束后,实验组儿童ABC总分[(37.05±5.69)分]、语言能力[(4.85±2.11)分]、交往能力[(5.50±2.23)分]评分明显低于对照组[(69.85±12.73)分、(14.60±4.65)分、(15.55±5.14)分],差异均有统计学意义(P均0.01)。结论听觉统合训练系统在自闭症谱系儿童的语言能力和交往能力症状方面明显改善,自我照顾能力方面需要进一步观察。     

高压氧联合系统脱敏疗法治疗儿童孤独症的依从性及疗效

目的 探讨高压氧联合系统脱敏疗法治疗儿童孤独症的依从性及疗效。方法 选择我院收治的儿童孤独症患者70例，随机分为观察组和对照组，每组35例。对照组进行常规康复训练及宣教。观察组在对照组基础上行高压氧联合系统脱敏疗法。比较两组患儿治疗依从性及疗效。结果 观察组依从性优于对照组（P<0.05)；两组治疗前儿童孤独症行为评定量表（Autism Behavior Checklist,ABC）评分、儿童孤独症评定量表(CARS)评分比较，P均>0.05。同组治疗前后ABC、CARS评分变化比较：观察组治疗前后ABC、CARS评分比较，P均<0.05；对照组治疗前后ABC评分比较，P>0.05,CARS评分比较，P <0.05。两组治疗后ABC、CARS评分比较，P <0.05。观察组疗效优于对照组（P <0.05)。结论 高压氧联合系统脱敏疗法治疗儿童孤独症依从性高、疗效确切，值得临床推广应用。     

运用结构化教育对自闭症儿童康复训练的效果分析

目的:分析采用结构化教育对自闭症儿童进行康复训练的疗效。方法:对接受结构化教育康复训练的22名自闭症儿童,采用自闭症儿童发展及行为量表,由专业人员进行康复训练前后测评。结果:康复训练后自闭症儿童功能发展的七个范围均有显著提高(P<0.001)。结论:运用结构化教育法对患有自闭症的儿童进行康复训练是治疗自闭症的有效方法之一,在提高他们各项功能的同时,病态行为将得以减轻或消除,为他们今后融入社会奠定较好的基础。     

音乐治疗干预自闭症儿童临床效果的实证研究

目的 探讨音乐治疗在综合性干预自闭症儿童中的作用.方法 将30例自闭症患儿随机分为实验组(n=15)和对照组(n=15),两组均接受医教结合的整合疗法,并对实验组患儿采用音乐治疗.实验干预前、后用自闭症儿童行为量表(ABC)和发展及行为量表(PEP)评估.结果 实验组在情绪、行为得分上与对照组比较差异有统计学意义.但在感觉反应、交往方面比较差异无统计学意义.结论 在综合性干预自闭症儿童中,音乐治疗对自闭症儿童的情绪、行为的改善临床效果显著.     

奥尔夫音乐疗法配合重复经颅磁刺激治疗自闭症谱系障碍儿童的效果

目的 观察奥尔夫音乐疗法配合重复经颅磁刺激治疗自闭症谱系障碍（ASD）儿童的效果。方法 选择2021年5月至8月湖南省儿童医院收治的80例ASD儿童为研究对象,按照随机数字表法将其分成对照组（40例）与治疗组（40例）。对照组接受重复经颅磁刺激治疗,治疗组在对照组的基础上接受奥尔夫音乐疗法治疗。比较两组治疗前后自闭症治疗评估表（ATEC）、儿童自闭症行为评定量表（ABC）及前庭功能评分,观察两组治疗过程中不良反应发生情况。结果 治疗后,两组ATEC、ABC评分较治疗前降低,前庭功能评分较治疗前升高;且治疗组ATEC、ABC评分低于对照组,前庭功能评分高于对照组（P<0.05）。两组不良反应总发生率比较,差异无统计学意义（P>0.05）。结论 奥尔夫音乐疗法配合重复经颅磁刺激治疗ASD儿童效果确切,可改善患儿的临床症状,改善感觉综合失调状态,且安全可靠。     

感统训练配合海豚屋训练对自闭症谱系障碍儿童核心症状的影响研究

目的：探讨感统训练联合海豚屋训练治疗自闭症谱系障碍(ASD)患儿的临床疗效。方法：选取2020年3月—2022年6月我院收治的ASD患儿84例，按照随机数字表法分成两组，对照组(42例)行感统训练，试验组(42例)在对照组基础上开展海豚屋训练，连续治疗3个月。分别采用儿童自闭症评定量表(CARS)、儿童自闭症行为量表(ABC)、Conners父母症状问卷(PSQ)及自闭症治疗评价量表(ATEC)评估患儿核心症状的改善及治疗有效率，对比两组患儿不良反应发生情况。结果：试验组患儿总有效率为85.71%,显著高于对照组的64.29%(P=0.023);治疗后两组CARS评分均低于治疗前，且试验组显著低于对照组(P<0.05);相较治疗前，治疗后两组患儿ABC量表各因子及总评分均下降，且试验组均显著低于对照组(P<0.05);相较于治疗前，治疗后对照组冲动—多动、焦虑及多动指数3个因子评分均显著下降(P<0.05),试验组学习问题、冲动—多动、焦虑及多动指数4个因子评分均显著下降(P<0.05)。组间比较，试验组学习问题、焦虑等因子评分明显低于对照组(P<0.05...     

中药辨证治疗自闭症的临床疗效观察

目的观察中药辨证治疗自闭症的临床疗效。方法将50名自闭症儿童根据患儿家属意见进行分组,最终30例入组教育+中药治疗组,20例入组纯教育组。教育治疗均在深圳市星愿树儿童展能中心展开。中药处方根据患儿症状、体征辨证分析,由深圳市中医院叶兵医师拟定,口服中药每日1剂,日2次,每周复诊进行中药调整,治疗周期为2个月。治疗前后进行儿童自闭症评估量表(CARS)测评,根据分数降低及有效率进行疗效评价。结果治疗结束后,2组CARS评分均有所下降(P0.05),但2组末次评分及末次-初次评分比较无意义(P0.05)。而从有效率看对照组的总有效率为10.00%,实验组为43.33%,两组疗效比较差异有统计学意义(P0.05)。结论中药辨证治疗对自闭症有一定疗效,且近期治疗效果优于纯教育组。在临床实践中,中药辨证治疗不失为治疗自闭症的有效选择之一。     

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.