健脾生肌汤联合熏洗散在混合痔术后的应用效果

目的观察健脾生肌汤联合熏洗散对混合痔术后创面水肿、疼痛、愈合程度的影响。方法选取2016年3月至2017年6月在鄢陵县中医院手术的混合痔患者,共90例,按随机数表法分为熏洗散组和联合组,各45例。两组均在腰麻下进行混合痔外剥内扎手术,术后给予抗菌药物、止血药物等常规治疗,熏洗散组从术后第1天开始采用金玄痔科熏洗散,每天换药1次,患者仰卧,常规消毒后熏洗,便后亦消毒后熏洗。联合组在熏洗散组治疗的基础上于术后第3天开始服用自拟健脾生肌汤治疗,1剂/d。观察两组患者治疗前后术后创口疼痛、肛缘水肿发生率、创面面积、上皮开始覆盖创口时间、愈合时间等。结果两组治疗前创口疼痛积分、水肿积分、创面面积比较,差异无统计学意义(均P>0.05);治疗后两组创口疼痛积分、水肿积分、创面面积均较治疗前明显降低,且联合组低于熏洗散组,差异有统计学意义(均P<0.05)。联合组上皮开始覆盖时间、愈合时间短于熏洗散组,差异有统计学意义(均P<0.05)。结论健脾生肌汤联合熏洗散可以改善混合痔术后创面水肿、疼痛,加快创面愈合。     

中药熏洗坐浴用于混合痔术后水肿的疗效观察

目的:探讨采用中药熏洗坐浴对混合痔术后肛门水肿的治疗效果。方法:84例混合痔患者随机分为治疗组和对照组,治疗组采用中药熏洗坐浴,对照组采用高锰酸钾溶液坐浴熏洗,对比两组混合痔术后患者肛门水肿消退情况及创面愈合时间。结果:治疗7d后治疗组肛门水肿情况评分(0.42±0.31)较对照组(1.74±0.48)低,治疗组创面愈合时间(18.15±2.8)较对照组(22.56±2.6)短,治疗组总有效率92.86%高于对照组85.71%,差异性具有统计学意义(P0.05)。结论:中药熏洗坐浴可以有效减轻对混合痔术后肛门水肿,缩短创面愈合时间,治疗效果显著。     

中药熏洗坐浴、穴位贴敷、普济痔疮栓三联治疗混合痔术后患者的效果

目的:观察中药熏洗坐浴、穴位贴敷、普济痔疮栓三联治疗混合痔术后患者的效果。方法:选取80例混合痔术后患者为研究对象,按照随机数字表法分为观察组与对照组各40例。对照组给予普济痔疮栓治疗,观察组在对照组基础上给予中药熏洗坐浴联合穴位贴敷治疗,比较两组肛门功能指标(肛管静息压、肛管高压带长度、肛管最大收缩压和肛管舒张压)水平、疼痛程度[视觉模拟评分法(VAS)]评分、肛缘水肿发生情况、肛缘水肿消失时间和创面愈合时间。结果:术后第14天,观察组肛管最大收缩压、肛管舒张压、肛管静息压均高于对照组,肛管高压带长度短于对照组,差异有统计学意义(P<0.05);术后第14天,两组VAS评分均低于术后第1天,且观察组低于对照组,差异有统计学意义(P<0.05);术后,观察组肛缘水肿分度优于对照组,差异有统计学意义(P<0.05);观察组术后肛缘水肿消失时间和创面愈合时间明显短于对照组,差异有统计学意义(P<0.05)。结论:中药熏洗坐浴、穴位贴敷、普济痔疮栓三联治疗混合痔术后患者可改善其肛门功能和术后肛缘水肿程度,降低其术后VAS评分,缩短其术后肛缘水肿消失时间和创面愈合时间,效果优于单纯普济痔疮栓治疗。     

乳没洗剂治疗混合痔术后50例临床观察

目的:观察乳没洗剂熏洗治疗混合痔术后患者的临床疗效。方法:将100例混合痔外剥内扎术后患者随机分为治疗组和对照组,每组50例。治疗组给予乳没洗剂熏洗治疗,对照组给予痔疾洗液熏洗治疗。分别于术后第3、7、10天评价并记录两组患者的创面疼痛、出血、创面水肿、肛门坠胀情况,比较两组患者的创面愈合天数。结果:在缓解术后疼痛、创面水肿和肛门坠胀方面,治疗组的疗效优于对照组(P0.05);而在减少术后便血及促进创面愈合方面,两组比较差异无统计学意义(P0.05)。结论:乳没洗剂在改善混合痔术后创面疼痛、水肿及肛门坠胀方面具有一定的优势。     

中药熏洗坐浴用于混合痔术后水肿的疗效观察

目的：探讨采用中药熏洗坐浴对混合痔术后肛门水肿的治疗效果。方法：84例混合痔患者随机分为治疗组和对照组,治疗组采用中药熏洗坐浴,对照组采用高锰酸钾溶液坐浴熏洗,对比两组混合痔术后患者肛门水肿消退情况及创面愈合时间。结果：治疗7d后治疗组肛门水肿情况评分（0．42±0．31）较对照组（1．74±0．48）低,治疗组创面愈合时间（18．15±2．8）较对照组（22．56±2．6）短,治疗组总有效率92．86％高于对照组85．71％,差异性具有统计学意义（P＜0．05）。结论：中药熏洗坐浴可以有效减轻对混合痔术后肛门水肿,缩短创面愈合时间,治疗效果显著。     

马齿苋合剂熏洗治疗嵌顿性混合痔术后临床观察

目的探讨马齿苋合剂熏洗治疗嵌顿性混合痔术后的效果,寻求嵌顿性混合痔的最佳治疗方法。方法采用随机分组的方法,将100例患者分为治疗组和对照组各50例。治疗组患者自术后2 d排便后开始使用马齿苋合剂熏洗;对照组患者自术后2 d排便后开始使用复方高锰酸钾速溶片液熏洗。分别记录用药后第2、4、6 d两组病例疼痛、水肿、出血的积分情况并进行统计;观察术后创面愈合时间及疗效等情况,并进行统计学比较。结果通过统计学分析比较,马齿苋合剂熏洗治疗嵌顿性混合痔术后,在缓解术后肛门疼痛程度、减轻肛缘水肿,减少创面出血量、缩短创面愈合时间等方面均优于对照组。结论马齿苋合剂熏洗治疗嵌顿性混合痔术后,能较快解除病人痛苦,有效地改善局部血液、淋巴循环,促进创面的愈合,值得应用。     

中药熏洗治疗混合痔术后肿痛50例

目的探讨运用中药熏洗治疗混合痔术后切口肿痛的临床疗效。方法将采用"混合痔内扎外剥术"术后肿痛混合痔患者100例按数字表法随机分为治疗组和对照组各50例,治疗组采用中药熏洗,对照组采用高锰酸钾溶液熏洗。结果 2组总有效率比较无显著性差异(P>0.05),治疗组在切口肛缘水肿消退、肛门疼痛缓解及创面愈合时间方面均明显快于对照组,2组比较有显著性差异(P<0.05)。结论中药熏洗可减轻混合痔术后切口肛缘水肿、疼痛症状,缩短疗程,疗效确切。     

苦硝熏洗剂联合特定电磁波治疗混合痔术后肛缘水肿临床观察

目的 :观察苦硝熏洗剂熏洗坐浴联合特定电磁波照射治疗混合痔术后肛缘水肿的临床疗效。方法 :选择80例经混合痔外剥内扎术术后第2天出现肛缘水肿的患者,按随机数字表法分为观察组、对照组各40例。观察组给予苦硝熏洗剂熏洗坐浴联合特定电磁波照射治疗,对照组给予硫酸镁溶液湿敷联合特定电磁波照射,比较两组患者肛缘水肿量化积分及疼痛评分变化情况。结果:治疗后观察组肛缘水肿量化积分、疼痛程度两方面明显优于对照组(P0.05)。结论:苦硝熏洗剂熏洗坐浴联合特定电磁波照射治疗混合痔术后肛缘水肿疗效确切。     

紫草膏配合中药熏洗治疗肛瘘术后创面恢复疗效观察

目的 研究紫草膏配合中药熏洗治疗肛瘘术后创面的恢复情况.方法 将120例患者随机分成对照组和试验组,每组60例,对照组采用中药熏洗治疗肛瘘术后创面,试验组采用紫草膏配合中药熏洗治疗肛瘘术后创面,比较两组患者治疗后的总有效率及创面的愈合时间、创面的疼痛减轻及肛缘水肿消退情况.结果 试验组患者治疗的总有效率为95.00%,对照组为75.00%,试验组高于对照组,两组比较差异有统计学意义(P<0.05);试验组患者的术后愈合时间、术后疼痛例数均少于对照组,肛缘水肿消退例数多于对照组,两组比较差异有统计学意义(P<0.05).结论 紫草膏配合中药熏洗能有效地促进肛瘘术后创面的愈合,能有效减少患者疼痛及肛缘水肿,紫草膏联合中药熏洗对肛瘘术后创面有较好的疗效,且价格低廉,使用方便.     

清热活血消肿方治疗混合痔术后并发症临床研究

目的：观察清热活血消肿方熏洗治疗混合痔术后并发症的临床疗效。方法：将60例Ⅱ～Ⅳ期混合痔外剥内扎术后患者随机分为治疗组和对照组,每组各30例,术后第1天开始,治疗组采用清热活血消肿方熏洗,对照组采用痔疾洗液熏洗;两组均治疗7d,观察两组患者用药前、用药第1、3、5、7天创面疼痛、出血、水肿情况,记录患者有效率和创面实际愈合时间,同时观察与用药相关的局部皮肤过敏反应、全身不良反应情况。结果：两组创面实际愈合天数比较,差异有统计学意义（P〈0．05）。两组治疗前后疼痛、出血、水肿积分比较,差异有统计学意义（P〈0．05）,两组治疗后组间疼痛、出血、水肿积分比较,差异有统计学意义（P〈0．05）。结论清热活血消肿方在减轻混合痔术后创面疼痛、出血、水肿及促进创面愈合方面安全有效。     

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.