杏仁治疗与配伍用量的探讨

目的探讨杏仁在治疗咳痰喘、便秘和配伍作用下的用量关系。方法以中医药在线（http：／／www．cintcm．eom）中的现代方剂数据库为来源，选取所有含杏仁的方剂，按其在方中的宣肺、润肠作用和配伍分成三组，统计杏仁用量。运用SPSSl5．0描述资料，并比较在三种作用下杏仁用量的均数，推断其所代表的总体是否相同。结果共收集方剂78首，其中治疗咳痰喘组54首，便秘组5首，配伍组19首。经Shapiro—Wilk和Kolmogorov—Smimov检验三组均不服从正态分布（P〈0．01）；遂采用KruskalWallisTest计算统剂量H=4．348；经校正后值为4．852（P〉0．05）。结论还不能认为杏仁在上述三个作用下用量完全不同。     

米索前列醇不同用药途径中期妊娠引产的效果观察

目的探讨米非司酮配伍米索前列醇不同用药途径终止10～18周妊娠的效果。方法300例中期妊娠孕妇，随机分为三组：A组100例，米非司酮配伍米索前列醇口服用药；B组100例，米非司酮口服，米索前列醇阴道给药；C组100例，米非司酮口服，米索前列醇直肠给药。结果三组引产后2h内出血量无统计学意义（P〉0．05），但B、C组引产成功率较A组高，引产时间较A组缩短，差异具有显著性（P〈0．05）；B、C组问无差异性（P〉0．05）。结论米非司酮口服配伍米索前列醇局部用药终止中期妊娠优于米非司酮联合米索前列醇口服用药，其中米索前列醇直肠给药更方便、快捷。     

肺结核病人对抗结核FDC制剂治疗可接受性的研究

目的 评价肺结核病人对抗结核FDC制剂治疗可接受性的情况。方法对373例新发涂阳肺结核病例，随机分为FDC制剂组和广泛使用的组合药组。在治疗期间对病人的耐受性、副反应和实验室检查结果进行监测。结果与组合药组病人相比，更多的FDC组病人认为服药方式可以接受，药片大小合适，药片数适中（P〈0．05）；但药片吞咽情况、药片苦不苦、药片是否粘喉等问题上两组病人回答结果接近（P〉0．05）；FDC组病人强化治疗期流感综合症的出现率略高于组合药组（P〈0．05），其余副反应（包括消化道症状、皮肤反应、神经系统症状以及视听神经症状）的出现情况两种药物之间差异无显著性意义（P〉0．05）；实验室检查，FDC组AST异常率高于组合药组，但TBIL异常率低于组合药（P〈0．05），两组肝功能异常者ALT、AST、TBIL的分布一致（P〉0．05）。结论相对于传统组合药，病人对FDC制剂的接受性改善，但FDC组流感综合症和AST异常率高于组合药组。     

丙泊酚、芬太尼复合用于无痛人流的临床观察

目的：比较不同的丙泊酚、芬太尼配伍用于无痛人流的临床效果。方法：择期行无痛人流术的早期妊娠病人150例，随机分成三组。A组（n=50）丙泊酚200mg＋芬太尼0．1mg的混合液；B组（n=50）丙泊酚200mg＋芬太尼0．05mg的混合液；C组（n=50）单纯丙泊酚；静脉给药。观察三组病人术前、术后的血压（MAP）、心率（HR）、氧饱和度（SpO2）及所用丙泊酚的量和清醒时间。结果：A组病人MAP无显著变化（P〉0．05），HR、SpO2术后比术前有显著降低（P〈0．05）；B组病人MAP、HR、SpO2无显著变化（P〉0．05），C组病人MAP、HR有显著降低（P〈0．05），SpO2无显著变化（P〉0．05）；术后组间比较：C组病人MAP比A、B两组有显著降低（P〈0．05），A、B两组间则无显著差别（P〉0．05）；A、C两组两组病人HR比B组有显著降低（P〈0．05），A、C两组间则无显著差别（P〉0．05）；A组病人SpO2比B、C两组有显著降低（P〈0．05），B、C两组间则无显著差别（P〉0．05）。所用丙泊酚的量A、B两组元差别（P〉0．05），且均比C组明显少（P〈0．05），B组清醒时间比A、C两组明显快（P〈0．05），A、C两组则无显著差别（P〉0．05）。结论：丙泊酚与芬太尼复合用于无痛人流有明显优点，且以丙泊酚200mg＋芬太尼0．05mg配伍最佳。     

GC-MS法测定麻黄汤不同配伍对桂皮醛含量的影响

目的　建立气相色谱 -质谱法 (GC- MS)测定麻黄汤中桂皮醛含量的方法 ,研究配伍对桂皮醛含量的影响。方法　 GC- MS法测定桂皮醛的含量 ,并用 MS鉴定其他色谱峰。采用 L8(2 7)正交设计安排试验 ,统计软件(SPSS10 .0 )分析麻黄、杏仁、甘草及两两交互作用对桂皮醛含量的影响。p H计测定各组合的 p H值。结果　麻黄、杏仁对方中桂皮醛的含量影响差异具有显著性 (P<0 .0 5 ) ,甘草及两两交互作用对其影响不显著 (P>0 .0 5 )。各组合 p H值变化不明显。结论　麻黄、杏仁显著降低桂皮醛的含量 ,甘草及交互作用则对其含量的降低无统计学意义     

丁螺环酮治疗焦虑症前后脑内神经递质的变化及意义

目的：用脑电超慢涨落分析（ET）仪检测焦虑症患者治疗前后脑内神经递质的变化。方法：对符合入组标准的43例患者治疗前后用脑电超慢涨落分析（ET）仪对神经递质含量进行检测。结果：焦虑症组GABA、DA分值低于正常对照组（P〈0．01）；5-HT及NE分值高于正常对照组，（P〈0．01），Ach分值与对照组相比基本一致，差别无显著性（P〉0．05）。焦虑症组治疗后GABA较治疗前升高，差别具有显著性（P〈0．05）；5-HT较治疗前降低，差别具有显著性（P〈0．05）；DA、NE、Ach差别无显著性（P〉0．05）。结论：ET检测脑内神经递质在焦虑症中随疾病恢复的动态变化．可作为判断疗效、治疗安仝性的依据。     

医学论文中统计学处理结果的解释和表达

统计结果的解释和表达：当P〈0．05（或P〈0．01）时，应说对比组之间的差异具有统计学意义，而不应说对比组之间具有显著性的差别；     

奥扎格雷钠联合葛根素注射液治疗急性脑梗死疗效观察

目的 探讨奥扎格雷钠（洲邦注射液）联合葛根素注射液对急性脑梗死患者的治疗效果。方法 将73例急性脑梗死患者随机分为治疗组38例和对照组35例，治疗组采用奥扎格雷钠加葛根素治疗，对照组采用葛根素治疗，疗程均为15d。结果 两组患者疗效间差别有显著性意义（P〈0．05）；两组患者治疗前及治疗后7d神经功能缺损评分间差别均无显著性意义（P〉0．05），治疗后15d及30d时神经功能缺损评分间差别均有显著性意义（P〈0．01）。结论 联合应用奥扎格雷钠与葛根素治疗急性脑梗死效果确切、安全，优于单用葛根素治疗。     

疏风散寒活血化瘀法治疗冷性荨麻疹的临床观察

【目的】观察疏风散寒、活血化瘀法治疗冷性荨麻疹的临床疗效，并探讨其可能的作用机理。【方法】将66例患者按简单随机法随机分为两组，治疗组36例给予疏风散寒、活血化瘀中药（由麻黄、桂枝、荆芥、防风、北杏仁、生姜、大枣、丹参、当归、鸡血藤、赤芍等组成）治疗，对照组30例予以西药盐酸西替利嗪片治疗，两组均连续治疗2个疗程（20d），疗程结束1周后统计疗效；观察两组治疗前后血液流变学各项指标的变化情况，并与38例正常对照组作比较。【结果】治疗组总有效率为80．6％，对照组为63．3％，两组比较差异具有显著性意义（P〈0．05）；两组治疗后血液流变学各项指标均有改善（与治疗前比较，P〈0．01），且治疗组的改善优于对照组（P〈0．05），基本达到正常对照组水平（P〉0．05）。【结论】疏风散寒、活血化瘀法是治疗冷性荨麻疹的重要法则，所选方药是临床治疗冷性荨麻疹的有效药物；其作用机理可能与其改善患者的血液流变学指标有关。     

卒中后抑郁患者认知功能和多导睡眠图对照研究

目的探讨卒中后抑郁（PSD）患者认知功能和睡眠特征。方法应用威斯康星卡片分类测验（WCST）和多导睡眠图检查对68例PSD和65例卒中后非抑郁患者进行测评，并与60例抑郁症和60例正常人比较。结果（1）WCST测试结果显示，PSD组、非抑郁组和抑郁症组与对照组比较各项指标差异均有显著性（P〈0．01）；PSD组与非抑郁组比较，除Nrpe外，其余指标差异均有显著性（P〈0．01）；PSD与抑郁症组比较，Re和Rpe两项差异有显著性（P〈0．05—0．01）。②多导睡眠图结果显示，PSD组、非抑郁组和抑郁症组与对照组比较各项指标差异均有显著性（P〈0．05—0．01）；PSD组与非抑郁组比较睡眠潜伏期、深睡眠、觉醒次数、REM潜伏期、REM时间和密度差异均有显著性（P〈0．05—0．01）；PSD组与抑郁症组比较，除REM睡眠潜伏期无差异外，其余各项指标比较差异均有显著性（P〈0．01）。结论PSD患者存在明显的认知功能障碍和睡眠障碍。     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

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.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

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.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.