参芪五味子联合归脾丸治疗心脾两虚型不寐的临床疗效

目的:本文采用参芪五味子联合归脾丸联合治疗心脾两虚型不寐。方法:将68例患者分为观察组和对照组,对照组使用归脾丸治疗,观察组在对照组的基础上加用参芪五味子。结果:实验组痊愈率和总有效率两方面均显著高于对照组,P<0.05。结论:在归脾丸治疗基础上加用参芪五味子治疗心脾两虚型不寐能够显著改善临床症状,疗效明显优于单用归脾丸治疗。     

心脾两虚型失眠的中医治疗

目的总结心脾两虚型失眠的中医治疗方法。方法阅读大量文献,评估中医治疗心脾两虚型失眠方法的疗效。结果心脾两虚型失眠的治疗归脾汤研究居多,也有效。结论归脾汤治疗心脾两虚型失眠有效,而其他方剂、针灸疗效也不差。有些甚至比归脾汤疗效还要好。     

温针灸治疗心脾两虚型不寐疗效观察

目的：观察温针灸治疗心脾两虚型不寐症的临床疗效。方法：将46例心脾两虚型失眠患者按就诊时间顺序随机分为治疗组和对照组,每组23例。治疗组取百会、神门、内关、安眠、足三里、三阴交、心俞、脾俞,针刺得气后对内关、足三里、三阴交行捻转补法,并施以温针灸治疗30min。每日1次,10次为1个疗程,每疗程间隔2天,总共治疗3个疗程;对照组采用口服归脾汤药物,疗程同治疗组。结果：对照组23例总有效率为82．6％,治疗组23例总有效率为91．3％。治疗组总有效率明显高于对照组,二者差异具有统计学意义（P＜0．05）。结论：温针灸治疗心脾两虚型不寐法疗效显优于口服归脾汤药物疗法,值得推广。     

平衡针刺配合归脾汤治疗心脾两虚型产后抑郁症156例临床观察

目的观察平衡针刺配合归脾汤治疗心脾两虚型产后抑郁症的临床疗效。方法将310例心脾两虚型产后抑郁症患者随机分为治疗组156例和对照组154例,对照组予归脾汤口服治疗,治疗组在对照组治疗方法的基础上配合平衡针刺治疗。2组均以7 d为1个疗程,治疗4个疗程后比较2组的临床疗效及汉密尔顿抑郁量表(HAMD)评分。结果治疗后2组HAMD评分均较同组治疗前显著降低,差异有统计学意义(P0.05),且治疗组降低幅度显著大于对照组,2组比较差异有统计学意义(P0.05);治疗组总有效率为91.02%,对照组为74.03%,2组比较差异有统计学意义(P0.05)。结论平衡针刺配合归脾汤治疗心脾两虚型产后抑郁症疗效显著,且无明显不良反应,值得临床推广应用。     

归脾汤加减治疗心脾两虚型失眠50例的疗效观察

目的:观察归脾汤加减治疗心脾两虚型失眠的疗效。方法:选取100例心脾两虚型失眠患者随机分为治疗组和对照组,每组各50例。对照组采用艾司唑仑进行治疗,治疗组采用归脾汤随证加减治疗。结果:治疗组临床总有效率为98.0%,对照组临床总有效率为82.0%,两组疗效差异显著,具有统计学意义(P<0.05)。结论:归脾汤加减治疗心脾两虚型失眠的临床疗效确切。     

归脾汤结合桂枝加龙骨牡蛎汤治疗心脾两虚型失眠的临床疗效观察

目的：探析归脾汤结合桂枝加龙骨牡蛎汤治疗心脾两虚型失眠的临床疗效。方法：选取2019年10月—2020年9月就诊的74例心脾两虚型失眠患者,随机分为观察组和对照组,各37例。对照组给予劳拉西泮片治疗,观察组在对照组基础上联合归脾汤结合桂枝加龙骨牡蛎汤治疗。比较两组临床疗效、治疗前后的睡眠质量指数、中医症候积分及神经递质含量情况。结果：观察组总有效率、中医症候积分改善情况均优于对照组（P<0.05）;观察组睡眠质量指数评分明显低于对照组（P<0.05）;观察组神经递质指标（5-HT、5-HIAA）均明显高于对照组（P<0.05）。结论：归脾汤结合桂枝加龙骨牡蛎汤治疗心脾两虚型失眠临床效果显著,可有效改善头蒙欲睡、睡而不实等相关症状,值得临床推广。     

归脾汤加减治疗心脾两虚型失眠症35例临床研究

目的 观察归脾汤加减治疗心脾两虚型失眠症的临床疗效。方法 将70例患者随机分为治疗组和对照组各35例,治疗组给予归脾汤加减水煎服,对照组予劳拉西泮片和谷维素作对照,15 d为一个疗程,两组均治疗两个疗程以观察疗效。结果 对照组总有效率68.57%,治疗组94.29%,治疗组疗效明显优于对照组,差异有统计学意义(P0.05)。结论 归脾汤加味治疗心脾两型虚失眠症有较好的疗效。     

归脾汤加减治疗少女月经先期34例

目的 观察归脾汤加减治疗少女月经先期的临床疗效.方法 选择本病34例,以归脾汤为主方加减进行辨证治疗.结果 34例中,治愈22例,好转10例,未愈2例,总有效率为94.1%.结论 以归脾汤为主方治疗少女月经先期证属心脾两虚、脾不统血型疗效显著.     

艾灸推拿结合归脾汤治疗心脾两虚型不寐的临床效果及睡眠质量评分分析

目的探究艾灸推拿结合归脾汤治疗心脾两虚型不寐的临床效果,并对患者睡眠质量进行匹兹堡评分。方法自2016年6月至2016年12月,来我院门诊部就诊的心脾两虚型不寐患者共96人,将其按照就诊时间顺序分为观察组和对照组,各48人。对照组患者给予归脾汤加减疗法,观察组患者在对照组基础上给予艾灸推拿治疗,采用艾灸对神门,心俞,脾俞,足三里,三阴交施灸,若有总做噩梦的情况,再加灸肾俞,灸后采用头腹背三部法对患者进行推拿。三个疗程后,观察两组患者的睡眠情况,记录两组患者治疗前后匹兹堡睡眠质量评分(PSQI),比较两组的总有效率。结果经治疗后,观察组总有效率为:95.83%,对照组总有效率为:83.33%,差异有统计学意义(P0.05)。两组PSQI评分分别为:观察组(9.65±4.21),对照组(6.73±3.42),差异有统计学意义(P0.05)。结论艾灸推拿结合归脾汤治疗心脾两虚型不寐效果较好,可以明显改善患者睡眠质量,具有很好的临床应用价值。     

柴芍龙牡汤治疗不寐症临床体会

目的：观察柴芍龙牡汤治疗不寐症的临床疗效。方法：根据不寐症阳不入阴的发病机制，以疏肝养血、潜阳安神为治法，自拟柴芍龙牡汤治疗不寐症，并按照肝郁化火、痰热内扰、阴虚火旺、心脾两虚4种证型分别加味，每日1剂，煎水分3次口服，1个月为1个疗程。结果：治疗91例，临床治愈30例，显效22例，有效29例，无效10例，总有效率为89．01％。结论：柴芍龙牡汤治疗不寐症临床疗效满意。     

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.     

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.     

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.