痛泻要方加味联合蒙脱石散治疗结直肠癌术后腹泻30例总结

目的：观察痛泻要方加味联合蒙脱石散治疗结直肠癌术后肝郁脾虚型腹泻的临床疗效。方法：将60例结直肠癌术后肝郁脾虚型腹泻患者随机分为2组各30例,对照组口服蒙脱石散治疗,治疗组在对照组治疗的基础上加用痛泻要方加味治疗。结果：痊愈率治疗组为46.7%,对照组为20.0%,组间比较,差异有统计学意义（P＜0.05）;2组中医证候积分治疗前后组内比较及治疗后组间比较,差异均有统计学意义（P＜0.05）;2组肛门排便功能优良率比较,差异有统计学意义（P＜0.05）。结论：痛泻要方加味联合蒙脱石散治疗结直肠癌术后肝郁脾虚型腹泻有较好的临床疗效。     

白头翁汤灌肠联合美沙拉嗪治疗溃疡性结肠炎44例临床观察

目的：观察白头翁汤灌肠联合美沙拉嗪治疗溃疡性结肠炎（UC）大肠湿热证的临床疗效。方法：将94例UC大肠湿热证患者随机分为治疗组和对照组,每组各47例（但2组分别只有44、45例完成观察）。对照组给予美沙拉嗪缓释颗粒治疗,治疗组在对照组基础上加用白头翁汤灌肠治疗,疗程均为4周。比较2组治疗前后中医证候积分、疾病积重程度积分（Mayo积分）、内镜下肠黏膜病变程度评分（Baron评分）、黏膜损伤程度（Geboes指数）及肠道菌群的变化。结果：2组治疗后中医证候积分、Mayo积分、内镜Baron评分及Geboes指数均较治疗前明显降低,且治疗组降低幅度大于对照组（P＜0.05）;2组治疗后肠球菌、肠杆菌数量明显减少,双歧杆菌、乳酸杆菌数量显著增多,且治疗组减少、增多幅度均大于对照组（P＜0.05）。结论：白头翁汤灌肠联合美沙拉嗪能够显著改善UC大肠湿热证患者的临床症状,提高临床疗效,促进肠黏膜恢复,其作用机制可能与改善肠道菌群紊乱有关。     

加味旋代颗粒联合丁艾贴丸治疗胃食管反流病肝郁脾虚证40例

目的：观察加味旋代颗粒联合丁艾贴丸治疗胃食管反流病（GERD)肝郁脾虚证的临床疗效。方法：将80 例GERD肝郁脾虚证患者随机分为治疗组和对照组,每组各40 例。治疗组予加味旋代颗粒联合丁艾贴丸治疗,对照组予奥美拉唑肠溶片合枸橼酸莫沙必利片治疗,疗程均为8周。观察2组治疗前后中医证候（反流、烧心、嗳气、胸骨后疼痛等）积分的变化,评定中医证候疗效及胃镜疗效。结果：中医证候疗效总有效率治疗组为87.5%（35/40）,对照组为57.5%（23/40）,组间比较,差异有统计学意义（P＜0.05）;胃镜疗效总有效率治疗组为82.5%（33/40）,对照组为67.5%（27/40）,组间比较,差异无统计学意义（P＞0.05)。2组中医证候积分治疗前后组内比较及治疗后组间比较,差异均有统计学意义（P＜0.05)。结论：加味旋代颗粒联合丁艾贴丸治疗GERD肝郁脾虚证疗效确切,值得临床推广应用。     

五音疗法联合痛泻要方加味治疗肝郁脾虚腹泻型肠易激综合征28 例临床观察

目的：观察五音疗法联合痛泻要方加味对肝郁脾虚腹泻型肠易激综合征（IBS-D）患者的临床疗效。方法：将84 例肝郁脾虚型IBS-D患者随机分为3组,每组各28 例。西药组给予匹维溴铵片口服治疗,中药组给予痛泻要方加味汤剂口服治疗,五音疗法联合中药组在中药组基础上配合五音疗法治疗,3组疗程均为4周,评价患者临床疗效、治疗前后中医证候积分、治疗后生活质量评分及治疗前后的焦虑、抑郁评分。结果：总有效率五音疗法联合中药组为92.86%（26/28）,明显高于西药组的78.57%（22/28）和中药组的75.00%（21/28）,差异有统计学意义（P＜0.05）。3组治疗后中医证候积分较治疗前均有下降,五音疗法联合中药组改善情况显著优于中、西药组（P<0.01）;五音疗法联合中药组IBS生活质量量表（IBS-QOL）各维度评分和总分均高于中、西药组（P<0.05）,且在Zung氏焦虑自评量表（SAS）和抑郁自评量表（SDS）评分方面均显著低于中、西药组（P<0.05）。结论：五音疗法联合痛泻要方加味治疗肝郁脾虚型IBS-D具有良好的临床疗效,能减轻临床症状、提高生活质量、改善患者焦虑和抑郁情绪,值得临床推广。     

升阳益胃汤加减治疗消化心身疾病脾虚湿困证56例

目的：探讨升阳益胃汤加减治疗消化心身疾病脾虚湿困证的临床疗效。方法：根据不同病种将110 例消化心身疾病脾虚湿困证患者随机分为治疗组和对照组,治疗组（56 例）采用升阳益胃汤加减治疗,对照组（54 例）采用氟哌噻吨美利曲辛片治疗,2组患者若伴有器质性疾病或症状较重者则予以对症治疗。比较2组中医证候疗效、中医证候评分及躯体症状群积分。结果：中医证候疗效总有效率治疗组为87.50%（49/56）,对照组为68.52%（37/54）,差异有统计学意义（P<0.01）。2组中医主症（反酸烧心、胃胀）评分、中医次症评分、躯体症状群积分治疗前后组内比较及治疗后组间比较,差异均有统计学意义（P<0.05）;治疗组腹痛、口疮评分及对照组腹痛评分治疗前后比较,差异均有统计学意义（P<0.05）。结论：升阳益胃汤加减治疗消化心身疾病脾虚湿困证疗效较好,能有效改善患者的临床症状,缓解患者焦虑、抑郁情绪。     

俞募配穴针刺法联合五音疗法治疗肝郁脾虚型失眠40例

目的：观察俞募配穴针刺法联合五音疗法治疗肝郁脾虚型失眠的临床疗效。方法：将80 例肝郁脾虚型失眠患者随机分为2组,每组各40 例。治疗组采用俞募配穴针刺法联合五音疗法治疗,对照组予以口服阿普唑仑治疗,2组均治疗2周,比较2组治疗前后中医证候评分、匹兹堡睡眠质量指数量表（PSQI）评分以及多导睡眠图（PSG）,并评定综合疗效。结果：总有效率治疗组为95.00%（38/40）,对照组为80.00%（32/40）,2组比较,差异有统计学意义（P＜0.01）;2组治疗后中医证候评分、PSQI各项指标评分及总积分、PSG结果均较治疗前改善,且除PSQI量表中睡眠时间、睡眠效率、催眠药物评分外,其余指标治疗组改善均优于对照组（P＜0.05或P＜0.01）。结论：俞募配穴针刺法联合五音疗法治疗肝郁脾虚型失眠有较好的疗效,可显著改善肝郁脾虚型失眠患者的临床症状及睡眠质量。     

疏肝解毒剂治疗肝郁脾虚型HCV感染32例疗效观察

目的:探讨自拟疏肝解毒剂联合索磷布韦维帕他韦治疗肝郁脾虚型丙型肝炎病毒（HCV）感染患者的临床疗效。方法:选取肝郁脾虚型HCV感染患者60 例,随机分为治疗组（32 例）与对照组（28 例）,对照组予以常规西药治疗,治疗组在对照组基础上加疏肝解毒剂治疗,疗程均为12周;观察比较2组治疗前后中医证候积分、HCV-RNA定量、肝功能,评定中医证候疗效、病毒免疫学水平疗效,并记录不良反应。结果：中医证候疗效总有效率治疗组为96.88%（31/32）,对照组为67.86%（19/28）,2组比较,差异有统计学意义（P<0.05）;2组病毒免疫学水平疗效总有效率均为100%（32/32,28/28）,2组比较,差异无统计学意义（P＞0.05）。2组中医证候积分中,治疗组治疗后各项主症、次症积分较本组治疗前均降低,差异有统计学意义（P<0.05）;对照组治疗后胁肋胀痛、纳差、恶心呕吐评分较治疗前降低,差异有统计学意义（P<0.05）;治疗后组间比较,治疗组在改善胁肋胀痛、腹胀便溏、烦躁抑郁、倦怠乏力、多思多虑、善太息、舌淡有齿痕方面均优于对照组,差异有统计学意义（P<0.05）。肝功能指标中,2组总胆红素（TBiL）、丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）治疗前后组内比较及治疗后组间比较,差异均有统计学意义（P<0.05）。2组不良反应发生情况比较,差异无统计学意义（P＞0.05）。结论：自拟疏肝解毒剂联合索磷布韦维帕他韦能有效改善肝郁脾虚型HCV感染患者中医证候,促进患者肝细胞炎症的修复,减轻索磷布韦维帕他韦相关不良反应。     

养血柔肝埋线法治疗腹泻型肠易激综合征肝郁脾虚证37例

目的：观察养血柔肝埋线法治疗腹泻型肠易激综合征（IBS-D）肝郁脾虚证的临床疗效。方法：将80 例IBS-D肝郁脾虚证患者随机分为治疗组与对照组,每组各40例。治疗组脱落3例,对照组脱落2例。最终治疗组37 例,对照组38 例。治疗组采用养血柔肝埋线法治疗,对照组采用常规针刺法治疗。比较2组综合疗效、中医证候（腹痛不适、大便次数、大便性状、排便急迫感、腹胀、黏液便等）评分、汉密尔顿焦虑量表（HAMA）评分、汉密尔顿抑郁量表（HAMD）评分。结果：总有效率治疗组为89.19%（33/37）,对照组为71.05%（27/38）,2组比较,差异有统计学意义（P<0.05）。2组治疗后各项中医证候评分（除外大便次数）、HAMA评分、HAMD评分均较治疗前改善,且治疗组优于对照组,组内、组间比较,差异均有统计学意义（P<0.01）。结论：养血柔肝埋线法治疗IBS-D肝郁脾虚证疗效显著,优于常规针刺治疗,值得临床推广应用。     

通阳化气方治疗脾虚气滞型功能性消化不良50例

目的：观察通阳化气方治疗脾虚气滞型功能性消化不良（FD）的临床疗效。方法：将脾虚气滞型FD患者100例随机分为治疗组与对照组,每组各50例。治疗组给予通阳化气方治疗,对照组给予莫沙必利联合雷贝拉唑治疗。2组均以4周为1个疗程,2个疗程后比较2组综合疗效、中医证候积分及不良反应。结果：总有效率治疗组为90.0%（45/50）,对照组为74.0%（37/50）,2组比较,差异有统计意义（P＜0.05）。2组中医证候积分治疗前后组内比较及治疗后组间比较,差异均有统计学意义（P＜0.05）;2组治疗过程中均未出现明显不良反应。结论：通阳化气方治疗脾虚气滞型FD疗效显著,值得临床推广应用。     

健脾消癌方治疗晚期结直肠癌Ⅳ期脾虚瘀毒证30 例

目的：观察健脾消癌方治疗结直肠癌Ⅳ期脾虚瘀毒证的临床疗效。方法：将60 例结直肠癌Ⅳ期脾虚瘀毒证患者随机分为治疗组与对照组,每组各30 例。对照组采用mFOLFOX6方案行全身化疗,治疗组在对照组基础上联合中药汤剂健脾消癌方口服治疗。比较2组治疗前后Karnofsky功能状态（KPS）评分、肿瘤标志物［血清癌胚抗原（CEA）、糖类抗原199（CA199）］水平、免疫功能指标水平及中医证候积分,评定中医证候疗效。结果：中医证候疗效总有效率治疗组为83.33%（25/30）,对照组为60.00%（18/30）,2组差异有统计学意义(P<0.05);与治疗前比较,治疗后2组KPS评分均提高,CEA和CAl99水平、中医证候积分均降低,免疫功能相关指标水平均升高,且治疗组均优于对照组,差异均有统计学意义（P<0.05）。结论：基于扶正消积法拟定的健脾消癌方可有效提高结直肠癌Ⅳ期脾虚瘀毒证患者的生活质量及免疫功能,并改善患者中医临床症状,降低肿瘤标志物水平,具有较好的推广价值。     

Microbial Biomass and Organic Nutrients in the Deep-Sea Sediments of the Central Indian Ocean Basin

In order to assess the impact of deep-sea mining on the in situ benthic life, we measured the microbial standing stock and concentration of organic nutrients in the deep-sea sediments of the Central Indian Ocean Basin in the Indian pioneer area. Sediments were collected using box core and grab samples during September 1996. The total bacterial numbers ranged from 10 10 -10 11 cells per g -1 dry weight sediment. There was a marginal decrease in the number of bacteria from surface to 30 cm depth, though the subsurface section registered a higher number than did the surface. The highest numbers were encountered at depths of 4-8 cm. The retrievable number of bacteria were two orders less in comparison with the direct total counts of bacteria. An almost homogeneous distribution of bacteria, total organic carbon, living biomass, and lipids throughout the depth of cores indicates active microbial and benthic processes in the deep sea sediments. On the other hand, a uniform distribution of total counts of bacteria, carbohydrates, and total organic carbon in all the cores indicates their stable nature and suggests that they can serve as useful parameters for long-term monitoring of the area after the benthic disturbance. Further studies on temporal variability in this region would not only verify the observed norms of distribution of these variables but would also help to understand restabilization processes after the simulated benthic disturbance.     

Assessing the Validity of Seismo-Acoustic Predictor Equations for Obtaining Seabed and Sub-Surface Sediment Physical Properties

The interdependence between the seismo-acoustic properties of a marine sediment and its geotechnical/physical parameters has been known for many years, and it has been postulated that this should allow the extraction of geotechnical information from seismic data. Though in the literature many correlations have been published for the surficial layer, there is a lack of information for greater sediment depths. In this article, a desktop study on a synthetic seafloor model illustrates how the application of published near-surface prediction equations to subsurface sediments (up to several tens of meters burial depth) can lead to spurious predictions. To test this further, acoustic and geotechnical properties were measured on a number of sediment core samples, some of which were subjected to loading in acoustically-equipped consolidation cells (oedometers) to simulate greater burial depth conditions. For low effective pressures (representing small burial depths extending to around 10 meters subsurface), the general applicability of established relationships was confirmed: the prediction of porosity, bulk density, and mean grain size from acoustic velocity and impedance appears generally possible for the investigated sedimentary environments. As effective pressure increases through, the observed relationships deviate more and more from the established ones for the near-surface area. For the samples tested in this study, in some instances increasing pressure even resulted in decreasing velocities. There are several possible explanations for this abnormal behavior, including the presence of gas, overconsolidation, or bimodal grain size distribution. The results indicate that an appropriate depth correction must be introduced into the published prediction equations in order to obtain reliable estimates of physical sediment properties for greater subsurface depths.     

海上大直径钢管桩打桩过程中桩周土强度弱化研究

海上大直径钢管桩打桩过程中,桩周土体受到强烈扰动而发生强度弱化,掌握桩周土体强度弱化规律对于准确预测打桩过程、保证工程安全具有重要意义。为研究土体强度弱化规律,开展了环剪试验模拟打桩对桩周土体的扰动,测试土体强度随剪切速率的变化规律,建立了描述土体强度弱化规律的拟合公式,引入到打桩分析软件中。研究结果表明：土体的强度折减程度不仅与土体本身的性质有关还受到土体的埋深和剪切速率的影响,埋深越深土体强度折减程度越低,剪切速率越高土体强度折减越高,在打桩分析中可采用这里推荐的线性折减方法来模拟不同深度处土体强度的折减规律。     

Geoacoustic Inversion via Genetic Algorithm and Its Application to Manganese Sediment Identification

An acoustic inversion method using a wide-band signal and two near field receivers is proposed and applied to multiple layered seabed models including a manganese sediment. The inversion problem can be formulated into a probabilistic model comprised of signals, a forward model, and additive noise. The forward model simulates wide-band signals, such as chirp signals, and is chosen to be the source-waveletconvolution plane wave modeling method. The wavelet matching technique, using weighted least-squares fitting, estimates the sediment sound-speed and thickness on which determination of the possible numerical ranges for a priori uniform distribution is based. The genetic algorithm is applied to a global optimization problem to find a maximum a posteriori solution for determined a priori search space. Here the object function is defined by an L 2 norm of the difference between measured and modeled signals. Not only the marginal pdf but also its statistics are calculated by numerical evaluation of integrals using the samples selected during importance sampling process of the genetic algorithm.     

Interannual Sea Level Variations and Annual Tides in the Northwestern Pacific

Specific properties of the interannual sea level variations and annual tides in the Northwestern Pacific were studied. Several tide stations were monitored. The monthly mean sea level for the year of 1995 was analyzed at each tide station. A seismic event in 1995, some tectonic activity around the subject area, and the Kuroshio (the oceanic western boundary current) may possibly contaminate results which would have occurred from the astronomical annual tide alone.     

Deep-Sea Sediment Compression Curves: Some Controlling Factors, Spurious Overconsolidation, Predictions, and Geophysical Reproduction

Oedometer tests have been carried out on 70 undisturbed surficial clays (at approximately 250 mm below the mudline), mostly collected by free-fall corers from sites widely scattered throughout the deep-sea North Atlantic. Acoustic measurements were also made, initially on contiguous samples and ultimately on the same sample using a geophysically instrumented oedometer which also collected electrical resistivity data. Apart from those quiescent areas below the carbonate compensation depth, such as north of the West Indies where very fine clays exist, most of the samples are silty clays whose geotechnical-geophysical properties are dependent on the type of clay minerals present (and their ability to take in moisture), the sand-size fraction, and the quantity of carbonate present. Thus the pure clays have high compressibilities which decrease on the addition of coarse particles, while the converse is true for the acoustic parameters, these increasing with the sand fraction. Using the notion of the intrinsic compression line for all samples, and comparison to it of the measured compression curves, it is clear that, contrary to some previously held ideas, most deep-sea clays are normally consolidated; the addition of carbonate has the effect of creating an open, stronger sediment skeleton. Interestingly, where information is available, the variation with depth of a sample's acoustic velocity follows the void ratio pressure relationship of the compression curve. This allows the construction of an in-situ sediment compression curve using the in-situ geophysical observations.     

Flow Cytometric Analysis of Coastal Lagoon Bacterioplankton and Picophytoplankton: Fixation and Storage Effects

The effect of different fixation and storage protocols on the flow cytometric (FCM) simultaneous analysis of bacterioplankton and phytoplankton in coastal seawater samples (Mediterranean coastal lagoons) was investigated. FCM measurements (cell number, fluorescence and scatter characteristics) were obtained through DAPI staining. Three fixatives [glutaraldehyde (GA), formaldehyde (FA) and paraformaldehyde (PFA)] and two storage (3 months duration) methods (5 °C and −196 °C) were tested. Two dominant populations were detected in studied samples: bacteria and eukaryotic picophytoplankton. Adding fixatives (2% final concentration) appears necessary to obtain FCM exhaustive counts of all the bacteria and phytoplanktonic cells. This was related to the permeation effect of fixatives which allowed a better DAPI staining of the cells. Maximum fluorescence, i.e. optimal staining of the cells was obtained with FA or PFA, and significant lower fluorescences with GA. Fixed samples stored at 5 °C induced rapid cell loss. Only storage in liquid nitrogen of samples fixed with FA or PFA, allows mid-term (≥4 months) preservation of bacteria or picophytoplankton cell numbers, and limited evolution of DAPI-induced fluorescence and scatter characteristics.     

Phylogenetic diversity and phenotypic characterization of cultivable bacterioplankton isolated from polar oceans

A set of 27 marine planktonic bacteria isolated from the polar regions was characterized by 16S rDNA sequencing and physiological and biochemical testing. More than half of these bacteria were positive for caseinase, gelatinase and 13-glucosidase, and could utilize glucose, maltose or malic acid as carbon source for cell growth. Twelve isolates expressed nitrate reduction activities. Except for one antarctic isolate BSwlO175 belonging to Actinobacteria phylum, these isolates were classified as γ-Proteobacteria, suggesting that γ-Proteobacteria dominated in cultivable marine bacterioplankton at both poles. Genus Pseudoalteromonas was the predominant group in the Chukchi Sea and the Bering Sea, and genus ShewaneUa dominated in cultivable bacterioplankton in the Prydz Bay. With sequence similarities above 97%, genus Psychrobacter was found at both poles. These 27 isolates were psychrotolerant, and significant 16S rDNA sequence similarities were found not only between arctic and antarctic marine bacteria （ 〉 99% ）, but also between polar marine bacteria and bacteria from other aquatic environments （ ≥ 98.8% ）, including temperate ocean, deep sea, pond and lake, suggesting that in the polar oceans less temperature-sensitive bacteria may be cosmopolitan and have a bipolar, even global, distribution at the species level.