骨质疏松症用药规律研究

目的:分析探讨骨质疏松症中药处方的用药规律。方法:通过中国知网、维普、万方数据库收集2013年-2015年中药治疗骨质疏松症的处方,采用关联规则apriori算法等无监督数据挖掘方法,分析处方中各种药物的使用频次、性味归经和药物之间的关联规则。结果:中药治疗骨质疏松症常用的药物以归肝、脾、肾经的补阳药、补血药及活血化瘀药等为主,性多温、平,味辛、苦、甘。熟地黄、当归、淫羊藿、骨碎补、牛膝、杜仲、山药、补骨脂、黄芪、茯苓、白芍等是临床治疗骨质疏松症常用的核心药物。结论:通过中医传承辅助平台软件,运用数据挖掘技术对现代文献进行用药规律研究,可获得传统文献整理和统计不能发现的隐性知识和信息,为临床治疗骨质疏松症提供参考。     

防治骨质疏松症中药保健品及中成药组方分析

目的 归纳分析防治骨质疏松症（OP）的中药保健品和中成药应用现状及组方规律。方法 检索药智网,获得增加骨密度的中药保健品及防治OP中成药,利用中医传承辅助平台V2.5和Excel2016分析其组方规律。结果 共获得增加骨密度的保健品信息694条,其中名称重复48种,未注明成分45种,主要成分含有中药319种,使用频次≥20的中药有8味,共使用390次,分别为淫羊藿、骨碎补、大豆、杜仲、珍珠、葛根、补骨脂、枸杞子。检索到防治OP的中成药信息22条,名称重复1种,使用频次≥5的中药有6味,共使用42次,分别为淫羊藿、熟地黄、骨碎补、续断、牡蛎、补骨脂。结论 防治OP的中药保健品及中成药主要通过补益肝肾、强筋健骨、健脾益气、活血止痛发挥作用。本研究为研发具有增加骨密度的中药保健品及中成药提供新思路。     

周少虎治疗男性不育少弱精子症用药规律的数据挖掘分析

采用频数分析、关联规则分析、聚类分析等方法对周少虎教授治疗男性不育少弱精子症的中药处方进行数据挖掘,分析其组方用药特点。共纳入195首处方,涉及中药60味;其中使用频次≥93次的药物有13味,分别是枸杞子、盐菟丝子、五味子、炙甘草、淫羊藿、黄芪、当归、盐杜仲、土茯苓、酒黄精、覆盆子、丹参、车前子;性味主要以甘平温为主,归经主要归肾、肝、脾经。关联规则分析结果显示,药物组合使用频次最高的是枸杞子-盐菟丝子、枸杞子-盐菟丝子-五味子、枸杞子-盐菟丝子-五味子-炙甘草、枸杞子-盐菟丝子-五味子-炙甘草-淫羊藿。聚类分析结果显示,其高频用药可聚为5类。分析结果提示,周少虎教授基于“辨精论治”的思路治疗少弱精子症,对患者首辨阴阳、再辨气血进行分类施治;以益肾活血、疏肝解郁、清热利湿为治法,多采用补血、活血、疏肝、益肾、填精、清热等药物。     

中医治疗原发性骨质疏松症组方配伍规律探析

目的探讨中医治疗原发性骨质疏松症的核心用药,分析药物间的配伍规律。方法收录近十年骨质疏松症的中药复方文献,运用SPSS13.0统计软件探讨用药规律,分析核心药物及方剂的应用规律。结果检索出103个验方,涉及125种药物,使用频次依序为熟地、淫羊藿、杜仲、当归、黄芪、牛膝、骨碎补、补骨脂、山茱萸、山药、茯苓、鹿茸、丹参、甘草、白术等。常用药物主要为补虚药和活血化瘀药两大类。所有验方基本方来源多为六味地黄丸、左归丸、右归丸等,在其方上加减化裁为各自的经验方。结论中医治疗原发性骨质疏松症的临床用药的确是以补益肝肾为主,健脾益气,活血化瘀为辅。     

基于中医传承辅助系统挖掘陈如泉教授治疗甲状腺功能减退症用药规律

目的通过中医辅助传承平台系统(V2.5)对全国名中医陈如泉教授治疗甲状腺功能减退症进行数据挖掘,并分析其用药规律。方法收集2008年—2018年陈如泉教授在湖北省中医院甲状腺病专科门诊留存治疗甲状腺功能减退症的415首处方,并将方药信息录入中医辅助传承平台(V2.5)软件,采用关联规则Apriori算法、复杂算法熵聚类等数据挖掘方法,得到药物的使用频次、组方规律,并基于此数据推算出新方组合。结果陈如泉教授治疗甲状腺功能减退症常用补肾壮阳、益气健脾功效的中药,药物频次较高的10味中药为黄芪、淫羊藿、甘草、补骨脂、白术、当归、枸杞子、丹参、熟地黄、茯苓,药物频次较高的3个药对为:黄芪-淫羊藿,黄芪-补骨脂,黄芪-淫羊藿-补骨脂,并由此推算了10个新方。结论陈如泉教授治疗甲状腺功能减退症擅于补益脾肾,喜用补气温阳的药物。     

补肾中药改善骨质疏松症的实验研究进展

骨质疏松症是机体的一种全身性骨骼疾病。采用补肾中药如补骨脂、淫羊藿、杜仲、陈皮等治疗,对改善骨质疏松症有较明显的效果。     

FIA-UV法测定固骨缓释胶囊中总黄酮

固骨缓释胶囊是由淫羊藿和骨碎补经提取纯化有效部位制成的复方口服缓释制剂,主要用于骨质疏松症的治疗。总黄酮为主要活性部位。淫羊藿中总黄酮的测定方法有紫外分光光度法、高效液相色谱法等[1]。流动注射分析法(flow injection snalysis,FIA)是在连续流动分析技术(continuou     

治疗痛经方药的关联规则分析

目的应用关联规则方法探讨治疗痛经方药的用药规律。方法应用计算机检索中医方剂数据库(源于《中医方剂大辞典》)有关治疗痛经的217首方剂,以EXCEL 2000软件建立数据库,收录每首方剂中的单味药进行统计分析。应用关联规则方法中Apriori算法分析方剂中药对的应用规律。结果在治疗痛经的217首方剂中共使用427种药物2 450频次。其中,使用频次在10次以上的依次为当归、川芎、延胡索、赤芍、香附等56味中药,使用总频次为1 622次;关联规则方法分析出使用频次在10次以上的药对当归-川芎、当归-白芍、当归-香附等389对。结论运用用药频率统计与关联规则等数据挖掘方法,能较好地发现中医临床治疗痛经方药的用药规律,为临床遣方用药提供理论指导。     

中医药治疗围绝经期骨质疏松症用药规律的数据挖掘

【目的】探讨现代文献中有关中医药治疗围绝经期骨质疏松症（osteoporosis,OP）的组方规律及用药特点。【方法】收集中国知网（CNKI）、维普中文期刊数据库（VIP）、万方数据库（Wanfang Data）中关于中医药治疗围绝经期OP的相关文献,利用中医传承辅助平台对中医药治疗围绝经期OP的药物用药频次、四气五味及归经进行统计,分析其组方规律,挖掘核心组合及候选处方。【结果】收集得到中医药治疗围绝经期OP方剂126首,共涉及中药161味,药物频数排列在前10位的分别是熟地黄、淫羊藿、当归、山药、山茱萸、枸杞子、黄芪、茯苓、补骨脂、杜仲;药物主要归肝、肾经,其次归脾经与心经;药性以温、平为主,药味以甘、苦、辛为主;用药功效分类以补益肝肾、健脾养血为主。关联规则分析结果得到的核心药物分别是熟地黄、山茱萸、黄芪、山药、淫羊藿、补骨脂、枸杞子、川牛膝、当归、杜仲、茯苓;运用复杂系统熵聚类进行新方分析,得到14个核心组合,进一步衍化得到7首新方。【结论】中医药治疗围绝经期OP以健脾益气活血、补肾强筋壮骨为治疗原则,用药以左归丸与右归丸加减而成的药物为主,可实现阴阳双补。     

淫羊藿总黄酮提取及其含量测定

淫羊藿是使用最为悠久及药用来源种类最多的中药之一,最早记载于《神农本草经》;淫羊藿资源分布量大的有7个种,按分布区的面积依次分别是箭叶淫羊藿Epimediumsagittatum,淫羊藿E．brevicomu,粗毛淫羊藿E．acuminatum,朝鲜淫羊藿E．koreanum柔毛淫羊藿E．pubescens,黔岭淫羊藿E．leptorrhizum和巫山淫羊藿E．wushanense;目前研究证明,淫羊藿总黄酮为淫羊藿主要有效成分。     

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.