加味痛泻要方治疗肠易激综合征疗效观察

目的：观察加味痛泻要方治疗腹泻型肠易激综合征（IBS）的临床疗效。方法：对80例符合罗马Ⅲ诊断标准的IBS患者随机分为治疗组和对照组。治疗组采用加味痛泻要方治疗，对照组用得舒特治疗，同时口服培菲康调节肠道茵群。结果：总有效率治疗组90％，对照组70％，两组比较，P〈0．05；治疗组患者腹痛、泄泻改善明显优于对照组，且不良反应的发生率低于对照组。结论：加味痛泻要方治疗IBS疗效优于单纯西医治疗。     

痛泻要方加味治疗腹泻型肠易激综合征临床观察

目的:观察中药痛泻要方加味治疗肠易激综合征(IBS)腹泻型的疗效.方法:选择腹泻型肠易激综合征患者110例,随机分为两组,治疗组予痛泻要方加味治疗,对照组予西药得舒特治疗,两组均治疗6周,停药2周观察疗效.结果:治疗组总有效率为89.1%,对照组总有效率为70.9%,两组总有效率比较有显著差异(P<0.05).结论:中药痛泻要方加味治疗腹泻型肠易激综合征疗效优于西药得舒特.     

四君子汤合痛泻要方加味治疗腹泻型肠易激综合征（脾虚肝郁证）42例

目的观察四君子汤合痛泻要方加味治疗腹泻型肠易激综合征的疗效。方法将84例腹泻型肠易激综合征患者随机分为治疗组和对照组各42例,治疗组口服四君子汤合痛泻要方加味,对照组口服匹维溴胺片。结果治疗4周后,治疗组在常见症状改善方面均优于对照组,差异有统计学意义（P<0.05）;治疗组总有效率明显优于对照组,差异有统计学意义（P<0.05）。结论四君子汤合痛泻要方加味治疗腹泻型肠易激综合征有较好的疗效,能明显缓解临床症状,缩短疗程,且无不良反应,值得临床推广。     

痛泻要方加味联合洛赛克治疗溃疡性结肠炎

目的探讨痛泻要方加味联合洛赛克治疗溃疡性结肠炎的临床效果。方法将96例慢性溃疡性结肠炎患者随机分成2组:治疗组48例,用痛泻要方加味,水煎服,1剂/d,洛赛克20mg,2次/d。对照组48例,用补脾益肠丸治疗,每次6g,3次/d,口服。两组均以30d为一疗程,连用2疗程,所有患者随访1年。结果治疗组与对照组的治愈率及有效率分别为79.2%、95.8%与66.7%、79.2%。两组总有效率比较差异具有显著性(χ2=6.095,P<0.05)。结论痛泻要方加味联合洛赛克胶囊能明显改善溃疡性结肠炎病人的症状,疗效肯定,无毒副作用。     

匹维溴铵和丙咪嗪治疗IBS的对比研究

目的　探讨匹维溴铵与丙咪嗪治疗腹痛型、腹泻型肠易激综合症 (P IBS,D IBS)的躯体症状和精神心理状态的作用 ,评价这两种药物的疗效并探讨其临床意义。方法　本研究为随机对照开发临床试验。选择P IBS及D IBS病人 40例 ,随机分为 2组 ,匹维溴铵组 2 0例 (50mgtid) ,丙咪嗪组 2 0例 (2 5mgbid) ,4周后比较两组在IBS症状严重程度评分、心理卫生状况评价 (采用汉密尔顿焦虑量表HAMA ,汉密尔顿抑郁量表HAMD)、总体情况评分方面的变化。结果　治疗前两组症状及症状总积分无统计学差异 ,P >0 .0 5 ;治疗前后组内各个症状积分比较有差异 ,P <0 .0 5 ;两组间各症状治疗前后的差值比较 :腹痛、腹泻、不成形便、腹胀、肠鸣、排气、排便紧迫感等症状积分前后差值无显著差异 ,P >0 .0 5。两组治疗前HAMA、HAMD评分达到轻 中度焦虑、抑郁水平 ,HAMA、HAMD评分比较无差异 ,P >0 .0 5 ,治疗后HAMA、HAMD评分都有显著降低 ,治疗前后组内HAMA、HAMD比较有显著差异 ,P <0 .0 1 ,组间HAMA、HAMD差值组间比较无统计学意义 ,P >0 .0 5。治疗前两组患者IBS严重程度总体评分比较无差异 ,P >0 .0 5,治疗后两组IBS严重程度总体评分的改善比较无差异 ,P >0 .0 5。结论　匹维溴铵和丙咪嗪均能有效改善P IBS和D IBS患者的肠道症状、     

痛泻要方对肠易激综合征大鼠内脏高敏感性及肥大细胞活化的影响

[目的]研究痛泻要方对肠易激综合征（IBS）大鼠内脏高敏感性和肥大细胞（MC）的影响,探讨痛泻要方治疗IBS的可能作用机制。[方法]将60只SD大鼠随机分为6组,分别为空白对照组,模型对照组,匹维溴铵组,痛泻要方低、中、高剂量组,每组10只。采用束缚应激法制作内脏高敏感性IBS大鼠模型。评价各组大鼠腹部回缩反射（AWR）,观察近端结肠黏膜MC数量、组胺浓度以及C-Fos阳性率。[结果]痛泻要方各组大鼠的AWR、近端结肠组织中的MC数量均明显改善（P〈0.05）,与匹维溴铵组比较无明显差异（P〉0.05）;痛泻要方中、高剂量组大鼠近端结肠组织中的组胺浓度均明显减少（P〈0.05）,低剂量组无明显下降（P〉0.05）。痛泻要方各组大鼠近端结肠组织中的C-Fos阳性率均明显减少（P〈0.05）。[结论]痛泻要方能降低内脏高敏感性IBS大鼠的AWR评分、结肠组织的MC数量及抑制其活化;抑制C-Fos表达及降低组胺浓度;痛泻要方的作用机制可能是通过减少MC数量,抑制MC活化,减少组胺的释放,从而降低内脏高敏性。     

痛泻要方加味和参苓白术散治疗腹泻型肠易激综合征39例

观察痛泻要方加味和参苓白术散治疗中医辨证为肝脾虚的腹泻型肠易激综合征（D—IBS）临床疗效。方法：痛泻药方加味参苓白术散治疗。疗程30天-6个月。结果：治愈15例．好转21例,无效3例,有效率为92．01％。结论：痛泻要方加味和参苓白术散对中医辨证为肝郁脾虚型D—IBS有较好的近期疗效。     

痛泻要方加味治疗腹泻型肠易激综合征45例

目的观察痛泻要方加味治疗肠易激综合征（腹泻型）患者的临床疗效。方法将90例肠易激综合征（腹泻型）患者随机分为治疗组45例,对照组45例,其中治疗组口服痛泻要方加味并随症加减。对照组给予口服思密达,观察两组患者的临床常见症状改善情况。结果两组患者治疗前常见症状积分比较差异无统计学意义（P〉0.05）。治疗4周后治疗组在腹痛、泄泻、郁怒或紧张、胸胁胀闷、嗳气、纳差、肠鸣矢气等常见症状改善方面,均优于对照组,差异有统计学意义（P〈0.05）;治疗组在治疗4周后总有效率明显优于对照组,两组比较,差异有统计学意义（P〈0.05）。结论痛泻要方对腹泻型肠易激综合征有较好的疗效,能明显缓解临床症状,缩短治疗时间,且无不良反应,值得临床推广。     

痛泻要方加味治疗腹泻型肠易激综合征临床观察

目的　观察中药痛泻要方加味治疗腹泻型肠易激综合征的疗效。方法　 6 2例患者随机分组 ,治疗组 32例 ,予中药痛泻要方加味治疗 ;对照组 30例 ,予西药思密达治疗。结果　治疗组总有效率 90 .6 % ,对照组总有效率 6 3.3% ,两组差异有显著性意义 (P <0 .0 5 )。结论　痛泻要方加味治疗腹泻型肠易激综合征有显著疗效     

加味痛泻要方治疗脾虚肝郁型经行泄泻的临床研究

目的 观察加味痛泻要方治疗脾虚肝郁型经行泄泻的临床疗效.方法 将200例经行泄泻的患者随机分为试验组和对照组,试验组100例,服用加味痛泻要方治疗;对照组100例,给予逍遥散治疗.2组在治疗4个月经周期后比较疗效.结果 试验组治疗有效率为95.0%,对照组患者为74.0%,2组比较差异具有统计学意义(P<0.05).结论 加味痛泻要方治疗脾虚肝郁型经行泄泻疗效可靠、安全性高,值得临床应用.     

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.