功能性消化不良胃电图与胃排空检测的同步研究

目的: 通过胃电图与胃排空检测,研究功能性消化不良(functional dyspepsia, FD)的发病机制. 方法: 以FD患者为观察对象,依据罗马Ⅱ标准,将符合纳入标准的患者分为3个临床亚型,每型患者随机取10人为一组,并以10名健康志愿者作为对照组,分别做胃电图及胃排空检测. 胃排空检测后,再将30例FD患者分为2组,胃排空正常组和胃排空延迟组. 利用胃电图仪记录胃电变化,通过99Tcm标记的固体餐检测胃排空. 结果: ①30例FD患者中,胃排空延缓18例,占60.0%,其中,溃疡样型4例,动力障碍样型7例,非特异性型7例. 与健康对照组比较,胃电图餐后平均振幅降低(P<0.05),就餐前后平均振幅差减小(P<0.05),就餐前后平均频率、餐前平均振幅无显著性差异(P>0.05);②胃排空正常组胃电图41.7%异常,各项指标与健康对照组、胃排空延迟组比较均无显著性差异(P>0.05);③FD胃排空延迟组胃电图83.3%异常,就餐前后平均振幅差减小(P<0.05),餐后平均振幅降低(P<0.05),就餐前后平均频率、餐前平均振幅与健康对照组比较无显著性差异(P>0.05). 结论: 胃运动障碍是FD发病的重要病理生理机制,胃电图与胃排空检测有较好的一致性.     

功能怀消化不良患者的症状,体表胃电与幽门螺杆菌感染？…

目的 从功能性消化不良 (FD)患者的症状和体表胃电活动两方面探讨幽门螺杆菌 (Hp)感染与 FD的关系。 方法 Hp阳性和 Hp阴性的 FD患者各 30例,胃镜下无活动性胃炎,胃镜下活检病理学检查证实胃粘膜炎症轻微。两组患者分别进行症状评分和体表胃电图检查 。结果 FD患者总的症状评分与有无 Hp感染无关 (Hp阳性和 Hp阴性组分别为 26.57± 9.16和 24.37± 6.86, P=0.298),而 Hp阳性组烧心症状评分 (2.30± 2.04)较 Hp阴性组 (1.13± 1.78)高 (P=0.021)。两组 FD患者餐前、餐后胃电参数无差异,但 Hp阳性组随症状加重,餐后正常胃电节律百分比下降 (r=0.41,P     

慢性胃炎患者固体餐胃排空功能的临床研究

目的探讨慢性胃炎(CG)患者幽门螺杆菌(Hp)感染、胃炎程度及是否活动性、临床症状等与胃固体排空功能的相关性.方法30例诊断为CG的患者,根据Hp检测或组织病理学结果分为Hp阳性组(n=8)及Hp阴性组(n=22);活动性炎症组(n=16)和无活动性炎症组(n=14);炎症轻度(n=15)、中度(n=9)、重度(n=6).所有患者服标准试餐加不透X线的小钡条,5 h后摄腹部平片1张,观察胃内残留钡条数目,计算胃排空率. 结果30例CG患者平均固体餐胃排空率为(67.8±40.1)%.Hp阳性者胃排空率为(75.0±39.2)%,Hp阴性者为(65.2±41.0)%,差异无显著性意义(P>0.05).伴活动性炎症者为(58.8±42.1)%,无活动性炎症者为(78.2±36.5)%,无显著性差异(P>0.05).慢性胃炎轻、中、重度患者胃排空率分别为(68.3±42.8)%,(76.1±33.5)%,(54.2±45.3)%,均无显著性差异. 结论Hp感染、炎症及是否活动性与CG的固体餐胃排空功能无显著相关性.     

功能性消化不良患者症状与病理生理改变的相关性

目的：分析不同亚型功能性消化不良(functional dyspepsia,FD)患者症状与幽门螺杆菌感染(Helicobacter pylori,Hp)和病理生理改变的相关性。方法符合罗马Ⅲ诊断标准的功能性消化不良患者分为上腹痛综合征(epigastric pain syndrome, EPS)组、餐后不适综合征(postprandial distress syndrome,PDS)组及症状重叠(overlapped,OL)组。问卷调查患者的主要症状及严重程度,经胃镜、黏膜病理、5 h不透X线标记物胃排空试验及饮水试验检查。分析不同亚型患者之间Hp感染、胃排空功能和感觉阈值的差异,以及单一症状与上述病理生理改变之间的相关性。结果共纳入108例患者。EPS组的Hp感染率(10/28,35.71%)明显高于PDS组(8/50,16.00%)(P=0.038)和OL组(3/30,10.00%)(P=0.021)。腹胀症状患者的Hp感染率低。PDS患者的胃排空延迟率明显高于EPS组。早饱症状患者的胃排空率明显高于无早饱症状者。腹胀、餐后饱胀患者及嗳气症状者的最大耐受阈值降低。结论不同亚型FD患者Hp感染率不同,但症状及胃排空功能和感觉功能异常与Hp无明显相关性。FD患者的胃排空及感觉功能改变与某些特定症状关系更为密切,治疗中应重视患者的主导症状。     

儿童功能性消化不良多导胃电图改变的临床研究

目的探讨儿童功能性消化不良(FD)多导胃电图的改变规律.方法采用对比的方法,检测80例功能性消化不良患儿(观察组)和40例正常儿童(对照组)的多导胃电图,分析胃电描记数据.结果观察组较对照组餐前及餐后各导联主频率、主功率降低,主频不稳定系数(DFIC)增高,慢波耦联百分比明显降低.结论多导胃电图检测功能性消化不良患儿的胃动力障碍,主要体现在胃慢波频率和功率的降低和规律性的不稳定,以及慢波从近端向远端传导的减弱.     

胃电起搏治疗儿童功能性消化不良

功能性消化不良（functionaldyspepsia，FD）发病率呈逐渐上升趋势，国内外的资料表明，FD与上消化道运动障碍有密切关系，FD患者存在胃肌电活动异常。儿童FD治疗较为困难，临床常用药物疗效欠佳。我院2005年采用胃电起搏治疗儿童功能性消化不良，观察其治疗效果以及对胃电图的影响，报道如下。     

功能性消化不良者胃排空功能和体表胃电变化的研究

以ＳＰＥＣＴ胃排空检测技术和ＷＣＤＦ－４Ｂ胃电分析仪检测了１２例ＦＤ患者液、固体食物胃排空和体表胃电图的变化。结果显示：ＦＤ患者的液体胃排空与对照组无明显差异，仅在摄食后比对照组更多地分布于远端胃内：固体食物的排模式发生变化，表现为初始排空较快，继后的排空延缓，７例半排空时间延长。     

慢性浅表性胃炎脾胃湿热证患者胃电图与胃排空的关系

目的 探讨慢性浅表性胃炎脾胃湿热证患者胃电图与胃排空的关系。方法 采用不透X线标记物一钡条法检测胃排空,休表胃电图法检测胃电,分别对慢性表性胃炎脾胃湿热证患者（37例）、脾虚证患者（20例）及对照组（13例,无慢性消化系统疾病史,一般检查无正常者）进行检测。结果 脾胃湿热证患者胃电图各指标与对照组无明显差异（P＞0．05）,但其胃排空率低于对照组（P＜0．05）;脾虚证患者胃电波幅及频谱累加值（SUM值）在餐前、餐后都明显低于对照组及脾胃湿热证患者（P＜0．05）,其胃排空率明显低于对照组（P＜0．005）及脾胃湿热证患者（P＜0．05）。结论 脾胃湿热证患者胃电图无特殊表现,正常的胃电不能预示正常的胃排空,胃排空率低下可能与胃电波幅及SUM值低下有关。     

功能性消化不良患者胃排空功能与幽门螺杆菌感染的相关性研究

目的观察功能性消化不良(FD)患者的胃排空功能,并进一步探讨FD患者幽门螺旋杆菌(HP)感染与胃排空功能的相关性。方法选择FD患者89例,症状均符合罗马Ⅲ标准。入选病例行胃镜检查,根据快速尿素酶检测法及病理活组织检查将患者分为HP阳性组49例和HP阴性组40例,同时选取无症状健康对照组30例。利用实时超声胃窦单切面法,分别测量空腹、500 m L饮水后即刻和饮水后20 min时胃窦近端单切面截面积,并计算20 min时胃排空率、拟胃排空时间、胃排空系数,评估两组FD患者的胃排空功能。结果 1与健康对照组相比,FD患者的20 min时胃排空率、拟胃排空时间、胃排空系数均有改变,差异显著(P<0.05);2FD患者的HP感染率为55.1%,HP阳性组和HP阴性组相比,20 min时胃排空率、拟胃排空时间、胃排空系数略有改变,但无显著性差异(P>0.05)。结论 FD患者的胃排空功能较无症状健康人群明显降低;FD患者是否合并HP感染,对胃排空功能无显著影响,推测FD的胃排空功能异常机制可能是多因素作用的结果。     

六味安消胶囊对功能性消化不良患者胃电图的影响

目的:初步探讨六味安消胶囊(邦消安)治疗功能性消化不良(FD)患者的作用机制。方法:采用自身对照的研究方法,随机选取46例FD患者,停止应用影响胃酸分泌及胃动力的药物1周后,给予症状评分,并进行餐前、餐后胃电图的检测;给予六味安消胶囊口服2周后,再次进行症状评分并检测餐前、餐后胃电图的变化。结果:FD患者口服六味安消胶囊2周后,上腹痛、腹胀、早饱、嗳气等临床症状明显改善,症状积分与治疗前比较差异有显著性(P<0.01)。FD患者治疗后与治疗前胃电参数指标进行比较:主频、主功率显著增加(P<0.05);正常胃电慢波百分比(N%)显著增多(P<0.01),胃动过缓百分比(B%)、胃动过速百分比(T%)显著减少(P<0.01)。结论:六味安消胶囊可显著改善FD患者的上腹痛、腹胀、早饱、嗳气等主要症状,增强胃肌电活动,增加胃电图的主频及主功率,使紊乱的胃电节律趋于正常。     

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.