滋阴养血活血法辨治干燥综合征探析

干燥综合征是一种系统性自身免疫病,主要累及外分泌腺。中医学中并无干燥综合征之病名,脉证合参,其大致相当于文献记载中的“燥症（内燥）”范畴,也有称其为“燥痹”。现代中医对燥证的认识较传统中医有所创新,其中认为燥证发病原因以阴津亏虚为本者不在少数。津血同源是中医学对津与血生理关系的高度概括。燥证发病的病理基础是阴津亏虚,津液的亏虚每每导致血液生化乏源,故临床上燥证每多夹杂血虚的临床表现。     

干燥综合征中医研究概况

干燥综合征在中医学文献中无相似的病名记载,大多数医家将此病归为燥证范畴,本病目前尚无根治的方法;本论文从病因病机、辨证论治、专病专方、针灸治疗等方面对本病进行综述,指出中医药治疗干燥综合征取得了显著的疗效,具有一定优势,同时提出了目前研究中有待解决的问题。     

滋阴养血活血法辨治干燥综合征探析

干燥综合征是一种系统性自身免疫病,主要累及外分泌腺。中医学中并无干燥综合征之病名,脉证合参,其大致相当于文献记载中的"燥症(内燥)"范畴,也有称其为"燥痹"。现代中医对燥证的认识较传统中医有所创新,其中认为燥证发病原因以阴津亏虚为本者不在少数。津血同源是中医学对津与血生理关系的高度概括。燥证发病的病理基础是阴津亏虚,津液的亏虚每每导致血液生化乏源,故临床上燥证每多夹杂血虚的临床表现。     

中医对干燥综合征的辨治思路

干燥综合征(Sjgren syndrome)是一原因未明、以外分泌腺高度淋巴细胞浸润为特征的自身免疫疾病,主要临床表现为口眼干燥,可累及任何系统和任何器官.中医学治疗干燥综合征具有悠久的历史,其历代对本病病机的论述主要与燥邪、阴虚、血燥、湿困和瘀血有关.从病因病机的分析和整体调治入手,能有效控制病情,特别是在疾病的早期,可以将中医疗法作为治疗干燥综合征的首选方案.     

干燥综合征中医治疗概况

中医学根据干燥综合征 ( SS)燥象丛生的特点 ,将本病与中医学的燥证、干燥病、燥痹相对应。中医学认为 ,干燥病是因素体阴虚 ,或感染邪毒而致津液生化不足 ,清窍、关节失其濡养所致。是以口鼻干燥 ,眼干及涩痛、异物感为主要表现的虚弱性疾病[1] 。1　病因病机多数学者遵循燥盛则干的病机理论 ,认为本病的基本病机乃阴液亏损 ,致津液枯涸、脏腑不荣而燥象丛生。陈绎志等[2 ] 将本病病因大致归纳为 :慢性感染、内分泌功能紊乱、遗传因素以及自身免疫因素。马永桢[3 ] 认为本病内燥是关键 ,外燥是诱发因素或者使病情加重 ;其基本病机是阴血亏…     

干燥综合征的中医病因病机探析

干燥综合征(Sjogren's syndrome SS)是一种主要累及外分泌腺,以唾液腺、泪腺等腺体功能受损为主的慢性自身免疫病,又称自身免疫性外分泌腺体上皮细胞炎或自身免疫学外皮细胞病,属于中医"燥症""燥痹"范畴。目前干燥综合征中医病因病机尚不统一,古代医籍也甚少记载。掌握干燥综合征主要病因病机对中医认识和诊治该病具有重要意义。笔者通过查阅和分析近年来的文献,总结出干燥综合征主要的中医病因病机包括内邪致病、气血津液及脏腑功能失调、燥瘀毒合而致痹几个方面,以期为中医治疗干燥综合征提供思路和参考。     

干燥综合征从瘀论治的研究进展

干燥综合征是一种以口眼干燥为主症的慢性自身免疫性疾病,中医古籍中并无"干燥综合征"一词,根据其临床表现等可归于"燥证"、"痹证"、"燥痹"的范畴;瘀血在本病的发生发展及预后中起着重要作用,它既是干燥综合征发展过程中的病理产物,也是致病因素,瘀去则气血条达,津液输布如常,官窍得以濡养;活血祛瘀法是治疗干燥综合征的重要方法,应贯穿本病治疗的始末;从瘀论治干燥综合征丰富了中医对其的认识,在临床诊疗中具有一定的借鉴和指导意义。     

基于CiteSpace的国内外灵性研究的可视化分析

目的 利用可视化分析软件分析国内外灵性研究发展趋势及研究热点异同,为国内开展灵性研究提供参考。方法 以Web of Science中收录的4126篇及中国知网收录的177篇灵性研究文献为研究对象,检索主题词为“spirituality”“nursing”“灵性”“照护”;检索日期为2000年1月至2020年12月,采用文献计量学法对文献年度发文量、文献期刊分布及文献类型进行分析,运用CiteSpace V软件绘制知识图谱。结果 国内外灵性领域的文献数量呈增长趋势,英文文献期刊858种,研究领域主要涉及护理、卫生保健、肿瘤学和内科学等,中文文献期刊84种,研究领域主要集中于护理领域,英文文献发文类型以实验性研究为主,中文文献发文类型主要是非实验性研究;英文文献研究热点包括：生命质量、癌症、社会支持、干预、生命末期、乳腺癌、女性、儿童和艾滋病等;中文文献研究热点包括：灵性照护、灵性、灵性需求、护士、老年人和癌症患者等。结论 中国灵性研究处于快速发展阶段,但研究的广度和深度不足,中国应在借鉴国外灵性研究的基础上,构建出符合中国国情的灵性评估方法和干预模型,推动我国灵性研究的发展。     

干燥综合征从燥毒瘀辨证论治

干燥综合征(Sjgren syndrome)是一种主要累及外分泌腺的慢性炎症性自身免疫性疾病,最常见症状是口、眼干燥,同时可累及全身多个系统,引起内脏损害.一般可分为原发性干燥综合征和继发性干燥综合征两类,前者指单纯干燥综合征,不与任何其他弥漫性结缔组织病并存,后者指与某种肯定的弥漫性结缔组织病并存.目前中医界尚无与干燥综合征完全相对应的病名,多数学者将该病命名为"燥痹"[1],也有学者将其归为"燥证""燥病""燥毒证"等范畴.禀赋不足,阴津亏虚是根本,燥、毒、瘀三者相互作用则是该病的发病关键.因此对燥、毒、瘀相互关系在发病中作用的正确认识贯穿本病辨证论治的始终,治疗上也应当重视解毒清燥、活血化瘀法的运用.     

金明秀教授中医药治疗干燥综合征临证经验

干燥综合征（SS）是一种以口、眼干燥为特征,主要累及外分泌腺的慢性自身免疫性疾病。患者常以明显的口眼干燥、反复发生的腮腺肿大及关节疼痛等为主要临床表现。现代医学对本病病因及发病机理尚不明了,主要采用替代和对症处理（皮质类固醇激素和免疫调）,但副作用多且疗效不肯定。本病可归于中医学＂燥痹＂范畴,通过中医药治疗,对缓解患者症状、提高生活质量有着重要意义。作者跟随金明秀教授从事干燥综合征中医药治疗,临床以养阴润燥,配以益气生津、祛瘀通络等方法,辨证施治,取得了较好的疗效。     

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.