黄连温胆汤加减治疗失眠的Meta分析

目的：评价黄连温胆汤加减治疗失眠的临床疗效及安全性。方法采用文献系统评价定性研究与定量Meta分析相结合的方法与技术,检索国内有关黄连温胆汤加减治疗失眠的临床随机对照试验,包括中国知网数据库、维普期刊全文数据库、万方数据库、中国生物医学文献数据库,依据所定纳入标准及排除标准对所检索的文献进行筛选,提取有效数据,运用RenMan 5.3软件对文献进行Meta分析。结果最终纳入16篇随机对照试验,合计1511例患者。Meta分析显示,黄连温胆汤加减治疗失眠的临床总有效率高于西药治疗组（OR=3.61,95%CI[2.68,4.85],P<0.00001）。结论本次系统评价显示黄连温胆汤加减治疗失眠总有效率高于西药治疗组,安全性较高。但是所纳入的研究质量普遍偏低,需要高质量的随机对照试验进行验证。     

枳实消痞汤治疗功能性消化不良Meta分析

目的 :评价枳实消痞汤治疗功能性消化不良(FD)的临床疗效。方法 :计算机检索维普数据库(VIP)、万方数据库、中国期刊全文数据库(CNKI),纳入有关枳实消痞汤治疗功能性消化不良的临床随机对照研究,按照RCT质量评价的修改后Jadad量表评价标准对纳入文献进行质量评价,使用Review Manger 5.3软件进行Meta分析统计学处理。结果 :共纳入16个RCT研究,包括1348例患者。Meta分析结果显示:与对照组相比,枳实消痞汤治疗FD在临床总有效率、治愈率、上腹痛、腹胀及早饱等主要临床症状改善情况均显示出较好的疗效。结论 :研究表明,枳实消痞汤治疗功能性消化不良有较好疗效,但还需大样本、高质量的随机对照试验进一步验证支持。     

中西医结合治疗小儿难治性肺炎支原体肺炎的Meta分析

目的:用Meta分析系统评价中西医结合治疗小儿难治性肺炎支原体肺炎的临床疗效.方法:计算机检索中国知网、万方、维普、中国期刊全文数据库,纳入小儿难治性肺炎支原体肺炎的随机对照试验,对纳入文献进行方法学质量评价,并采用Review Manager 5.3进行Meta分析.结果:检索得到2011~2016年的8篇随机对照试验文献,研究患者576例,中西医结合治疗组290例,西医治疗组286例.以中西医结合治疗小儿难治性肺炎支原体肺炎的临床疗效做Meta分析,结果显示:OR=0.21,95%CI(0.15,0.26),Z=7.35,P<0.00001.结论: Meta分析提示中西医结合治疗小儿难治性肺炎支原体肺炎的疗效优于单一西药疗法,值得临床推广.但本次纳入研究的质量评分多不高,期待更多高质量的随机试验提供更有效的证据.     

中医药治疗颈性眩晕的Meta分析

目的分析中医药治疗颈性眩晕的临床疗效。方法通过在维普资讯中文科技期刊数据库及CNKI中国期刊全文数据库中检索,纳入以颈性眩晕患者为研究对象,比较中医药与西医治疗效果的随机对照试验,评价纳入研究的质量。采用Jadad量表记分法,并用RevMan4．2．7软件进行Meta分析。结果中医药治疗颈性眩晕患者总体疗效优于西药,其汇总[OR（95％CI）：5．25（3．61,7．65）,P〈0．00001]。结论中医药治疗颈性眩晕的总体疗效显示出比西药治疗支加有效的倾向。尚需更多高质量研究以增加证据的强度。     

中医药干预亚健康临床随机对照试验的系统评价

目的系统评价中医药干预亚健康临床随机对照试验的疗效和安全性。方法通过检索Cochrane临床试验注册库、MEDLINE、EMBASE、中国生物医学文献数据库（CBM）、万方数据库、中国知网数据库（CNKI）和维普全文期刊数据库（VIP）等中文数据库（截至2008年8月）,全面搜集有关中医药干预亚健康的随机对照试验。由2名评价员对文献进行筛选,纳入中医药干预亚健康的随机对照试验并提取资料和质量评价,质量评价参照CochraneRe—viewer’s Handbook5．0提供的标准,数据分析采用Revman5．0软件。结果纳入15篇（半）随机对照研究文献,经临床异质性检验,由于其异质性过高无法进行Meta分析,进而进行亚组分析,得出中药干预亚健康有明显的疗效且优于西药,推拿和中药干预亚健康疗效无明显差异。结论由于中医药干预亚健康的随机对照研究开展较少,纳入研究质量较低,故中医药干预亚健康的有效性和安全性尚缺乏足够的证据,有待进一步研究来验证。     

中成药联合枸橼酸氯米芬治疗排卵障碍性不孕症的网状Meta分析

目的：运用网状Meta分析评价不同中成药联合枸橼酸氯米芬（CC）治疗排卵障碍性不孕症的疗效。方法：计算机检索PubMed、荷兰医学文献数据库（EMbase）、Cochrane图书馆（Cochrane Library）、中国生物医学文献数据库（CBM）、中国期刊全文数据库（CNKI）、万方（Wanfang）数据库及维普（VIP）数据库,搜集不同中成药联合CC治疗排卵障碍性不孕症的随机对照试验文献,检索时限均为从建库至2023年2月,运用Stata 16.0进行网状Meta分析。结果：共纳入30篇文献,共2 647例病例,涉及12种中成药。Meta分析结果显示：在改善子宫内膜厚度、提高排卵率、提高妊娠率方面,分别是定坤丹、归脾丸、调经促孕丸联合CC的效果最优。结论：纳入的中成药联合CC治疗排卵障碍性不孕症的疗效均优于单纯使用CC的疗效。由于本研究具有一定局限性,尚需高质量、大样本的随机对照研究加以验证。     

中医药治疗糖尿病肾病疗效的系统评价

目的：运用循证医学的方法，评价中西医结合与纯西医治疗糖尿病肾病的疗效。方法：在维普咨询中文科技期刊数据库（1989-2007）、中国生物医学文献数据库（CBM）（1990-2007）、中国期刊全文数据库（CNKI）（1989-2007），万方数据（1998-2007），手工检索广州中医药大学图书馆，纳入以糖尿病肾病患者为研究对象、比较中西医结合疗法与纯西医疗法疗效的随机对照试验，评价纳入研究的质量，并用RevMan4．2．8软件进行Meta分析。结果：共纳入20个随机对照试验，1392例患者，5个检验指标。Meta分析结果显示，五个指标：空腹血糖、24h尿蛋白定量变化，总胆固醇，甘油三酯，尿素氮分析结果均显示中西医结合疗效好于纯西医治疗。且中西医结合治疗糖尿病肾病不良反应极少发生，表现轻微，使用相对安全。结论：现有的有限证据表明，中西医结合治疗糖尿病肾病较纯西医治疗效果好，受纳入研究的数量和质量限制，中西医结合治疗糖尿病肾病的疗效和安全性需要更多高质量的随机双盲安慰剂对照试验加以证实。     

桂枝芍药知母汤治疗类风湿关节炎的系统评价及Meta分析

目的将桂枝芍药知母汤治疗类风湿关节炎的随机对照试验文献进行搜集、筛选及评价,通过系统评价与Meta分析,探讨桂枝芍药知母汤治疗类风湿关节炎(RA)的临床疗效,为临床使用桂枝芍药知母汤治疗RA提供循证医学依据。方法检索PubMed、中国期刊全文数据库、万方数据库、维普期刊数据库和中国知网,检索桂枝芍药知母汤治疗RA的随机对照研究(RCT),将检索结果依据本次纳入标准、排除标准等筛选后得到最终纳入文献。由两名互不知情的研究者独立读取资料并进行方法学质量评估,数据分析采用RevMan 5.3软件进行统计分析。结果共选取13项试验研究,Meta分析结果显示,桂枝芍药知母汤治疗RA总有效率优于对照组;在改善晨僵时间、关节疼痛及肿胀个数、血沉、C反应蛋白、不良反应方面,与对照组比较差异均有统计学意义(P0.05)。结论桂枝芍药知母汤治疗RA的总有效率、临床症状、生化指标、不良反应率均优于对照组,临床值得推广。     

中药保留灌肠治疗粘连性肠梗阻疗效的Meta分析

目的：系统评价中药保留灌肠治疗粘连性肠梗阻的疗效。方法：计算机检索中国期刊全文数据库（CNKI）,维普中文科技期刊数据库（VIP）,中国生物医学文献数据库（CBM）以及互联网资料。全面收集有关中药RevMan4.2.8统计软件对数据进行Meta分析。结果：共纳入17个随机对照试验,共1641例患者。与西医治疗组对照,中药保留灌肠组治疗粘连性肠梗阻的总有效率较高。结论：目前证据表明,中药保留灌肠治疗粘连性肠梗阻的方法较西医常规治疗好,而且不良反应少,复发率小。但由于纳入的文献其研究方法学质量不高,需要高质量的研究对其疗效进一步予以证实。     

肝豆汤治疗肝豆状核变性疗效的Meta分析

目的 通过Meta分析评价肝豆汤治疗肝豆状核变性的疗效.方法 检索中国期刊全文数据库(CNKI),维普中文科技期刊全文数据库(VIP),中国学术期刊数据库(万方),中国生物医学文献数据库(CBM),Pubmed并结合手工检索,检索肝豆汤治疗肝豆状核变性的随机对照试验研究.按照纳排标准选择最终纳入研究文献,进行资料提取和...     

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.