柴胡龙骨牡蛎汤加减治疗冠心病并发抑郁焦虑患者的临床观察

目的研究柴胡龙骨牡蛎汤加减治疗冠心病并发抑郁焦虑患者的临床效果。方法选取我院于2016年11月至2017年5月收治的90例冠心病并发抑郁焦虑患者,采用随机数字法分为2组,各45例;对照组给予冠心病常规治疗,观察组则在冠心病常规治疗基础上附加柴胡龙骨牡蛎汤加减进行治疗;治疗干预后,观察对比2组患者抑郁焦虑情况、生活质量以及临床治疗总有效率。结果 2组患者对比结果显示,治疗后观察组患者HAMD和HAMA评分分别为(20.03±4.34)分、(13.20±3.24)分;对照组为(23.54±4.42)分、(17.64±2.74)分,观察组患者抑郁焦虑状态评分明显低于对照组,P0.05;生活质量评分以及治疗总有效率明显高于对照组,P0.05。结论在冠心病并发抑郁焦虑患者的常规治疗中附加柴胡龙骨牡蛎汤加减具有良好临床疗效,可有效改善患者抑郁焦虑等不良心理反应,并改善其生活质量,促进其康复,值得用于临床。     

柴胡加龙骨牡蛎汤加减治疗脑震荡后综合征临床疗效评价

目的:观察柴胡加龙骨牡蛎汤加减治疗脑震荡后综合征(PCS)的临床疗效。方法:纳入64例PCS患者,采用随机数字表分为治疗组和对照组,每组32例。两组患者均给予常规对症治疗,在此基础上,治疗组患者予柴胡加龙骨牡蛎汤加减治疗,治疗周期为2个月。采用Rivermead脑震荡后综合征症状问卷评分量表进行患者的临床症状评分,比较两组患者治疗前后的症状总积分,评价临床疗效;采用匹兹堡睡眠质量指数(PSQI)评价患者的睡眠质量;采用焦虑自评量表(SAS)、抑郁自评量表(SDS)评价患者的焦虑、抑郁程度。结果:①治疗后,治疗组的临床总有效率为93.8%,对照组为78.1%,治疗组的疗效优于对照组(P0.05)。②治疗后,两组患者的症状总积分较治疗前均显著降低(P0.05),且治疗组患者的积分明显低于对照组(P0.05)。③治疗后,治疗组患者的PSQI评分较治疗前明显降低(P0.05),且治疗组患者的PSQI评分低于对照组(P0.05)。④治疗后,治疗组患者的焦虑、抑郁程度较治疗前明显改善(P0.05),且治疗组患者的焦虑、抑郁程度优于对照组(P0.05)。结论:柴胡加龙骨牡蛎汤加减治疗PCS,能够有效改善患者的症状、睡眠及焦虑、抑郁情绪,值得进一步研究。     

柴胡加龙骨牡蛎汤加减配合心理治疗对冠心病心绞痛抑郁状态的作用评价

目的:评价与总结对冠心病心绞痛抑郁状态实施柴胡加龙骨牡蛎汤加减配合心理治疗的临床效果。方法:选取本院在2014年7月至2015年7月间所收治的冠心病心绞痛患者70例作为临床对象,随机分成对照组、观察组。对照组予以常规临床治疗,观察组予以柴胡加龙骨牡蛎汤加减配合心理治疗,观察与比较临床疗效。结果:观察组在各方面评分及疗效皆优于其对照组,且经统计学分析,存在着P0.05的显著差异。结论:对于冠心病心绞痛临床患者,实施柴胡加龙骨牡蛎汤加减配合心理治疗的方案,疗效更加显著。     

柴胡加龙骨牡蛎汤加减方治疗乳腺癌并发抑郁患者的临床分析

目的探究柴胡加龙骨牡蛎汤加减方治疗乳腺癌并发抑郁患者的临床疗效。方法选取2017年1月至2019年4月诊治于我院的乳腺癌并发抑郁患者60例,采用随机数字表法分为两组,各30例。对照组在常规肿瘤治疗方案基础上口服氟西汀,观察组在此基础上行柴胡加龙骨牡蛎汤加减治疗。对比两组HAMD评分、临床疗效及不良反应发生率。结果与对照组相比,观察组总有效率较高,治疗后HAMD评分、不良反应发生率均较低,差异有统计学意义(P0.05)。结论柴胡加龙骨牡蛎汤加减方治疗乳腺癌并发抑郁患者可取得确切临床效果,利于减轻患者抑郁状态,具有较高安全性。     

柴胡加龙骨牡蛎汤加减配合心理治疗对改善肿瘤患者抑郁状态的作用评价

目的:分析柴胡加龙骨牡蛎汤加减配合心理治疗对改善肿瘤患者抑郁状态的作用评价。方法:选取2015年3月至2016年2月在我院接受手术治疗并且同意参与本次研究的肿瘤患者60例作为研究对象,将其按照随机数字法分为实验组和常规组。常规组实施心理护理;实验组在常规组基础上采用柴胡加龙骨牡蛎汤加减配合心理治疗。记录并对比实验组与常规组患者的抑郁、焦虑评分。结果:在干预之前,两组患者的抑郁评分、焦虑评分无明显差别,不具备统计学意义(P0.05);干预后,两组患者的抑郁、焦虑评分存在明显差别,并且实验组患者抑郁、焦虑评分显著低于常规组,数据差异均显著,具备统计学意义(P0.05)。结论:柴胡加龙骨牡蛎汤加减配合心理治疗对改善肿瘤患者抑郁状态的作用显著,不仅可以优化患者的心理情绪,还可以促使患者更加积极接受治疗,提高临床疗效,值得临床推广。     

柴胡龙骨牡蛎汤对泌尿系统肿瘤抑郁患者的效果观察

目的:探讨在泌尿系统肿瘤合并抑郁症患者的治疗中使用柴胡加龙骨牡蛎汤的疗效。方法:选取2015年3月~2016年7月我院泌尿科收治的68例患者为研究对象,随机分成治疗组与对照组各34例,两组患者均进行肿瘤治疗,而对照组使用常规药物治疗抑郁,治疗组使用柴胡加龙骨牡蛎汤治疗抑郁,治疗一个疗程后,使用汉密顿抑郁量表(HAMD)对疗效进行判断并比较两组治疗前后评分变化。结果:治疗组总有效率高于对照组,差异有统计学意义(P0.05);治疗前两组患者HAMD评分无差异,而治疗后两组患者评分均低于治疗前,且治疗组评分下降要优于对照组,差异有统计学意义(P0.05)。结论:在泌尿系统肿瘤抑郁患者的治疗中使用柴胡加龙骨牡蛎汤的方法能够降低患者的抑郁评分,效果显著,且无不良反应情况发生。     

调气活血法治疗中风后情绪障碍的临床观察

目的 观察运用调气活血法治疗中风后情绪障碍的临床效果及安全性.方法 采用临床随机对照试验方案,选择2011年1月～2013年1月的121例患者随机分为治疗组61例和对照组60例,在内科常规治疗基础上,治疗组按中医辨证给予丹栀逍遥散、柴胡加龙骨牡蛎汤、血府逐瘀汤、归脾汤加减方治疗,对照组口服盐酸氟西汀治疗.观察两组患者治疗前及治疗2、4、6周后汉密尔顿抑郁量表评分(HAMD)、汉密尔顿焦虑量表评分(HAMA)进行临床疗效评价,使用美国国立卫生院神经功能缺损评分(NIHSS)评价神经功能,使用脑卒中专用生活质量量表评分(SS-QOL)评价生活质量,采用治疗药物副反应量表(TESS)评价不良反应情况.结果 治疗组总有效率(80.33％)与对照组总有效率(83.33％)比较,差异无统计学意义(P＞0.05).治疗后两组患者HAMD、HAMA、NIHSS、SS-QOL评分均明显改善,治疗前后比较差异有统计学意义(P＜0.05).治疗组不良反应发生率低于对照组,差异有统计学意义(P＜0.05).结论 运用调气活血法治疗中风后情绪障碍临床效果明显,与对照药氟西汀具有类似疗效,而副作用少,值得临床推广应用.     

柴胡加龙骨牡蛎汤干预甲基苯丙胺依赖者戒断抑郁情绪42例临床观察

目的:观察柴胡加龙骨牡蛎汤干预甲基苯丙胺(冰毒)依赖者戒断抑郁情绪的临床疗效。方法:将63例符合诊断标准的患者按照2∶1的比例随机分为治疗组(给予柴胡加龙骨牡蛎汤治疗)和对照组(不予任何治疗)两组,采用抑郁自评量表(SDS)、汉密尔顿抑郁量表(HAMD)评分,观察冰毒依赖者戒断后抑郁情绪变化情况。结果:总有效率治疗组76.19%,对照组19.05%,两组疗效比较差异有统计学意义(P0.01);治疗组SDS、HAMD评分均低于对照组,差异有统计学意义(P0.05,P0.01)。结论:柴胡加龙骨牡蛎汤改善冰毒依赖者戒断后抑郁情绪效果显著。     

止颤汤合柴胡加龙骨牡蛎汤治疗帕金森病抑郁的临床观察

目的:观察止颤汤合柴胡加龙骨牡蛎汤对帕金森病(PD)抑郁患者的临床疗效。方法:选择肝肾阴虚兼肝气郁结型PD伴抑郁患者76例,随机分为治疗组38例和对照组38例。两组患者均接受抗帕金森病西医常规治疗,对照组患者加服止颤汤,治疗组患者加服止颤汤合柴胡加龙骨牡蛎汤,两组治疗周期均为12周。比较两组患者的中医证候疗效及治疗前后的中医证候积分;于治疗前及治疗4周、8周、12周后,采用蒙哥马利抑郁量表(MADRS)、汉密尔顿抑郁量表(HAMD)评价患者的抑郁程度,采用统一帕金森病综合量表(UPDRS)评价两组患者的临床疗效。结果:治疗后,治疗组的中医证候疗效总有效率为88.89%,对照组为75.76%,治疗组的疗效优于对照组(P0.05);两组患者的中医证候积分均显著降低(P0.01),且治疗组患者的积分低于对照组(P0.01)。治疗4周、8周、12周后,两组患者的MADRS、HAMD评分均显著降低(P0.05,P0.01),且治疗组患者的评分均明显低于对照组(P0.05,P0.01)。治疗前后,两组患者的UPDRS评分比较,差异均无统计学意义(P0.05)。结论:止颤汤合柴胡加龙骨牡蛎汤治疗肝肾阴虚兼肝气郁结型PD伴抑郁患者具有较好的疗效,可明显改善患者的抑郁状态。     

柴胡加龙骨牡蛎汤对气郁质失眠患者疗效及焦虑抑郁状态影响

目的探讨柴胡加龙骨牡蛎汤对气郁质失眠患者疗效及焦虑抑郁状态的影响。方法选取2018年7月—2019年2月医院收治的气郁质失眠患者148例,采用随机数字表法分为对照组和治疗组,各74例。其中对照组予以常规西药治疗;治疗组在对照组的基础上联合柴胡加龙骨牡蛎汤口服,两组均连续治疗6周。比较两组患者临床疗效、汉密尔顿抑郁量表评分(HAMD)、焦虑自评量表(SAS)评分、匹兹堡睡眠质量指数量表评分(PSQI)、中医体质分类与判定自测表CCMQ评分、血清P物质(SP)、多巴胺(DA)及5-羟色胺(5-HT)含量变化。结果治疗后,治疗组患者HAMD、SAS、PSQI及CCMQ评分降低幅度均较对照组显著(P0.05);治疗组患者DA及5-HT含量升高较对照组明显,SP含量降低较对照组明显,差异均具有统计学意义(P0.05);治疗组患者临床总有效率为93.24%,显著优于对照组患者的78.38%,差异具有统计学意义(P0.05)。结论柴胡加龙骨牡蛎汤治疗气郁质失眠疗效显著,具有条达肝气、解郁安神之效,有效调节神经功能,改善焦虑、抑郁状态,控制失眠症状。同时还可调节血清指标含量,降低焦虑、抑郁等相关评分,值得临床推广应用。     

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.     

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.     

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.