消癖散结汤配合中医情志疗法治疗乳腺增生临床研究

目的:观察消癖散结汤配合中医情志治疗乳腺增生的临床疗效。方法:将104例乳腺增生患者采用随机数字法分为对照组和观察组各52例。对照组给予消癖散结汤内服,1剂·d-1。观察组在对照组的基础上给予中医情志护理。疗程均为3个月。治疗后比较主要症状、体征评分;采用高频彩色多谱勒检测治疗前后肿块大小;检测治疗前后雌二醇(estradiol,E2)、泌乳素(prolaction,PRL)、孕酮(progesterone,P)、睾酮(testosterone,T)水平;记录治疗期间的不良反应。结果:观察组临床疗效有效率为96.15%,高于对照组的82.69%(χ~2=4.981,P0.05);观察组超声疗效有效率为92.31%,优于对照组的76.92%(χ~2=4.727,P0.05);治疗后观察组乳房疼痛、乳房触痛、肿块硬度、肿块分布范围及肿块大小评分均较治疗前显著下降,并低于对照组(P0.01);治疗后观察组E2和PRL水平低于对照组(P0.01);两组治疗期间均无明显不良反应发生。结论:消癖散结汤内服配合情志护理干预乳腺增生能减轻患者疼痛,软化缩小肿块,并能调节内分泌,临床疗效显著。     

柴胡疏肝汤合二仙汤治疗乳腺增生病65例

目的:观察柴胡疏肝汤合二仙汤治疗乳腺增生病的临床疗效.方法:将105例乳腺增生病患者随机分为治疗组和对照组,治疗组采用疏肝汤合二仙汤治疗.对照组用乳癖消治疗,疗程为三个月,比较两组疗效.结果:治疗组与对照组比较有显著性差异(P＜0.05).结论:柴胡疏肝汤合二仙汤治疗乳腺增生病疗效显著.     

乳癖散结胶囊治疗乳腺增生病102例疗效观察

目的观察乳癖散结胶囊与乳癖消片对比治疗乳腺增生病的临床疗效。方法治疗组102例口服乳癖散结胶囊，对照组60例口服乳癖消片。结果治疗组总有效率96.08％，对照组8500％，两组比较差异有统计学意义（P〈0.05）。结论乳癖散结胶囊治疗乳腺增生病的临床疗效确切。     

理活丸治疗乳腺增生病的临床研究

目的 观察理活丸治疗乳腺增生病的临床疗效及其安全性,初步探讨其对乳腺增生病患者黄体期血清性激素的影响.方法 选择300例乳腺增生病患者,随机分为治疗组200例和对照组100例,治疗组给予理活丸口服,对照组给予乳癖消口服,疗程3个月,痊愈患者随访3个月;每组随机抽取50例患者检测治疗前后黄体期血清雌二醇(E2)、孕酮(P)、卵泡刺激素(FSH)、黄体生成素(LH)、泌乳素(PRL)及睾丸酮(T)激素水平.结果 治疗组总有效率91%,明显高于对照组,且远期疗效稳定;治疗组治疗后血清E2、PRL降低,P回升,FSH、LH、T变化无显著性差异,对照组治疗后血清E2、PRL降低,P、T回升,两组比较有显著性差异.结论 理活丸治疗乳腺增生病疗效确切,无明显不良反应,对乳腺增生病患者的性激素水平失调有一定改善作用.     

自拟消癖汤治疗雄性大鼠乳腺增生实验研究

目的 观察自拟消癖汤对雄性大鼠乳腺增生的治疗效果,以指导男性乳房肥大症的治疗作用研究.方法 腹腔注射给予苯甲酸雌二醇(1.0 mg/kg),1次/d,连续20 d,以复制雄性大鼠乳腺增生模型.60只SPF级Wistar雄性大鼠随机均分为正常对照(等溶生理盐水)组、模型(等溶生理盐水)组、三苯氧胺(1.8 mg/kg)组、自拟消癖汤低、中、高(2.5、5、7.5 mL/kg)剂量组,各组大鼠均于复制模型结束后腹腔注射给药,2次/d,连续30 d.采用酶联免疫吸附(ELISA)法测定大鼠血清雌二醇(E2)、睾酮(T)的水平,观察大鼠乳腺组织结构变化,对比评价疗效.结果 与正常对照组比较,模型组乳腺增生明显,血清E2增加,血清T含量减少;差异均有统计学意义(P＜0.05).与模型组比较,三苯氧胺组与自拟消癖汤低、中、高剂量组大鼠乳腺增生均有不同程度减轻,血清E2水平降低,血清T水平升高,差异均有统计学意义(P＜0.05);与三苯氧胺组比较,自拟消癖汤高剂量组大鼠血清E2水平降低,血清T水平升高,乳腺组织增生程度明显减轻,差异均有统计学意义(P＜0.05).结论 自拟消癖汤对雄性大鼠乳腺增生有明显的抑制作用,疗效显著.     

自拟乳腺1号方治疗乳腺增生病的临床研究

目的观察自拟乳腺1号方治疗乳腺增生病的临床疗效,并探讨自拟乳腺1号方治疗乳腺增生病的作用机制。方法将2012年6月~2013年6月本院160例门诊乳腺增生病患者随机分为乳腺1号方组(80例)及乳癖消颗粒组(80例)。疗程均为3个月经周期。根据治疗前后评分计算改善率判断临床疗效,同时测定治疗前后黄体期雌二醇(E_2)、孕酮(P)、泌乳素(PRL)的水平。结果乳腺1号方组临床有效率高于乳癖消组,差异有统计学意义(P0.05)。乳腺1号方组治疗后E_2、PRL水平下降,P水平升高,差异有统计学意义(P0.05)。乳癖消颗粒治疗后E_2、P、PRL均呈下降趋势,但差异无统计学意义(P0.05)。结论自拟乳腺1号方比乳癖消颗粒具有更好的临床疗效,其作用机制是调节激素水平,改善乳腺增生病患者的内分泌环境。     

消癖汤对乳腺增生病患者的临床疗效观察及血清性激素的影响

目的观察消癣汤时乳腺增生病患者的临床疗效观察并通过对血清性激素的检测来阐述其治疗乳腺增生病的机理。方法将30例患者随机分为两组,治疗纽15例服用消癖汤,水煎服每日1剂,3个月为1个疗程,观察疗效。在治疗前后于患者黄体期用放射免疫测定法（RAI）检测血清性激素水平的变化,包括雌二醇（E2）、孕激素（P）、对照组15例服用逍遥散。结果治疗组治愈率为46．67％,总有效率为93．33％;治疗后患者E2较治疗前有非常显著性的降低（P〈0．01）;P较治疗前明显升高（P〈0．05）,治疗前后相比有显著性差异。对照组治愈率为42．00％,总有效率为81.00％,经统计学处理二者差异显著（P〈0．05）。结论1）消癣汤治疗乳腺增生病有较好的疗效,可明显缓解症状、减轻病情。2）降低E2,升高P是消癣汤治疗乳腺增生病的重要机理。     

消乳散结胶囊治疗乳腺增生症200例临床分析

目的观察消乳散结胶囊治疗乳腺增生症的疗效及安全性。方法采用随机,双盲,前瞻性平行对照试验,将350例乳腺增生患者随机分为两组,治疗组：200例,采用消乳散结胶囊治疗;对照组：150例,采用乳癖消薄膜衣片治疗,两组疗程均为1个月。结果消乳散结胶囊治疗组的临床显效率为92.0％,对照组显效率为80．0％。治疗组疗效优于对照组,差异有统计学意义（P〈0.05）。治疗组治疗后主要症状积分与对照组比较差异有统计学意义（P〈0．05）,说明治疗组症状改善优于对照组。结论消乳散结胶囊对乳腺增生症有明显的临床疗效,且安全,值得临床推广应用。     

乳癖散结胶囊联合他莫昔芬治疗乳腺增生症153例疗效分析

目的:观察乳癖散结胶囊联合他莫昔芬与乳癖消片对比治疗乳腺增生症的临床疗效.方法:245例经确诊乳腺增生患者,随机分为治疗组153例口服乳癖散结胶囊;对照组92例口服乳癖消片.疗程45天;治疗期间及治疗后分别观察两组药物副作用和疗效.结果:治疗组总有效率96.08％,对照组84.78％,两组比较差异有统计学意义(P＜0....     

乳癖散结胶囊治疗乳腺增生病的疗效观察及机制探讨

目的 观察乳癖散结胶囊治疗乳腺增生病的疗效及其对性激素水平的影响.方法 180例患者按服药时间(1、2、3疗程)随机均分成A、B、C 组.观察各组患者的总有效率、复发率及治疗前后卵泡期血清性激素雌二醇(E2)、孕酮(P)、催乳素(PRL) 水平变化.结果 3组总有效率分别为70%、90%和93.3%;B组、C组患者总有效率明显高于A组( P<0.05),复发率明显低于A组(P<0.05);C组总有效率及复发率与B组比较差异无统计学意义.A组患者治疗后血清E2、P、PRL水平与治疗前比较差异均无统计学意义.B 组、C组患者治疗后血清E2、PRL水平较治疗前明显降低( P<0.05),P水平较治疗前明显升高(P<0.05);且B组、C组患者治疗后血清 E2、PRL水平较A组患者治疗后明显降低(P<0.05),P水平较A组患者治疗后明显升高( P<0.05).结论 乳癖散结胶囊治疗乳腺增生病的疗效确切,延长疗程能提高疗效、降低复发率,其机理可能与血清E2、PRL水平下降、P水平上升有关.     

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.