从唇看健康

嘴唇不仅是性感的方向标,更是健康的晴雨表。健康的嘴唇应该是水润、细软、粉嫩的。当嘴唇颜色发现变化或出现裂痕等情况,有可能是身体发生了病变。唇色唇色发白：常见于贫血和失血症。上唇苍白泛青：会有大肠虚寒、泄泻、胀气、腹绞痛、畏寒、冷热交加等症状出现。下唇苍白：为胃虚寒,会出现上吐下泻、胃部发冷、胃阵痛等现象。

论见血无寒

世人患吐衄者多，而洁古则日：见血无寒。东垣亦云：诸见血皆责于热。丹溪亦日：血无火不升。三家之论出，而世之治吐衄者，皆以滋阴降火为法矣。岂知《内经》论血溢、血泄，六淫皆有，故《纲目》序失血症，独载运气六淫之邪。王海藏云：六气能使人失血，不独一火。此语大发千古聋聩。夫六气使人失血，此为外感之邪言也。

论见血无寒

世人患吐衄者多，而洁古则曰：见血无寒。东垣亦云：诸见血皆责于热。丹溪亦曰：血无火不升。三家之论出，而世之治吐衄者，皆以滋阴降火为法矣。岂知《内经》论血溢、血泄，六淫皆有，故《纲目》序失血症，独载运气六淫之邪。王海藏云：六气能使人失血，不独一火。此语大发千古聋聩。夫六气使人失血，此为外感之邪言也。

Hepatic encephalopathy complicated with hyponatremia and acid-base disturbance and its prognosis

Objective:To improve the diagnosis and therapeutic effect of occurrence and development of hyponatremia and disorder of acid-base balance among patients with hepatic encephalopathy(HE) by elucidating the regularity and mechanism,as well as its influence on prognosis.Methods:327 HE patients admitted to our hospital from January 1990 to June 2010 were enrolled.Meanwhile 316 patients hospitalized in the medical department of the same hospital were chosen as the control group.Patients in both groups were given the same methods to measure arterial blood gas parameters(pH value,PaCO2,[HCO3-],TCO2,BE and SaO2),blood biochemistry([Na+],[K+],[Cl-]),liver function,kidney function and blood glucose,serum sodium,and thereupon tocalculate the anion gap(AG) and the potential [HCO3-],and acid-base balance disorder.Results:Among the 327 HE patients,hyponatremia was found in 188 cases(57.4%),of whom 132 patients died(70.2%).While among the 316 patients in control group,68 presented with hyponatremia(21.5%),and 19 died(27.9%).The incidence and mortality were significantly different between the two groups(P<0.001).All the 327 patients presented with different degrees of acid-base balance disorder and 178 died(54.4%),in whom 164(50.2%) belonged to simple acid-base balance disorder and 74(45.1%) died,136(41.6%) were dual acid-base balance disorder and 80(58.8%) died,27(8.2%) were triple acid-base disturbance and 24(88.9%) died.Whereas in the control group only 83 patients(26.2%) were recognized as simple and dual acid-base balance disorder,and 18(21.7%) died.There was higher incidence of acid-base balance disorder and mortality rate in HE group than control one(P<0.001).Conclusion:Hyponatremia is valuable to judge HE patients' prognosis.The key parameters in the judgment and evaluation on acid-base balance disorder among HE patients are the change of pH values and serum electrolyte values.When pH value ≤ 7.30 or > 7.55,it generally suggests a poor prognosis.

Anemia as a Predictor of Mortality in Patients with Decompensated Heart Failure

Objective： To correlate file presence of anemia with mortality in hospitalized patients with decompensated HF （heart failure）. Methods： A total of 148 patients hospitalized for HF compensation were analyzed from April 1 to December 31, 2017 in a tertiary referral hospital for cardiovascular diseases. The diagnosis of anemia was established according to the Brazilian Ministry of Health criteria, considering a serum hemoglobin value of 〈 13 g/alL for men and 〈 12 g/dL for women. Data were collected through medical and physical attendance records. Statistical analysis was performed using the Epi Info program, version 7.0 for Windows, with Student＇ s t test for unpaired variables, Chi-square test and Fischer test. The significance ofp 〈 0.05 was considered. Results： Of the 148 selected patients, 63.5% were male, 60.1% were over 65 years old, 50.74% were enrolled in the first grade, and 93.2% were self-declared white. The prevalence of anemia observed in the study population was 72 （56.25%）, of which 49 （68%） were male and 23 （32%） were female. The mortality rate of the anemic patients was 19.4%, a total of 14 patients, whereas the non-anemic patients rate was 7.9%. It was observed that patients with worse outcome had hemoglobin 〈 12rag/alL （p = 0.045） and Functional Class （FC IV） by the New York Heart Association （NYHA） （p = 0.0001） at hospital admission. Conclusions： It is noticed that anemia is a frequent finding in patients with HF and that it interferes in the clinical manifestations, with worsening of the prognosis. Anemia treatment is not yet standarized in the HF approach, but patients without anemia appear to evolve with more favorable outcomes than anemia.

外伤性脾破裂合并失血性休克在胸腹联合伤患者中的临床治疗

目的研究外伤性脾破裂合并失血症休克、胸腹损伤患者的临床治疗效果。方法选择2013年7月—2015年7月进行外伤性脾破裂合并失血症休克、胸腹损伤治疗的58例患者为观察组,选择同期治疗的58例外伤性脾破裂患者为对照组,排除失血性休克、胸腹损伤以及其他复合伤,比较两组治疗效果、手术情况及术后并发症,所得数据采用SPSS20.0进行统计学分析。结果观察组总有效率(93.10%)低于对照组(100.00%);观察组出血量、手术时间、住院时间、动脉收缩压波动、低血压持续时间以及格拉斯评分均显著高于对照组;并且观察组并发症发生率为24.14%(14/58),显著高于对照组的3.45%(2/58),上述指标比较差异均有统计学意义(均P<0.05)。结论外伤性脾破裂合并失血症休克伴有胸腹损伤的概率非常大,临床上需要根据实际情况实施及时、有效的手术,降低术后并发症的发生率以及保证患者术后的生活水平。

鸡冠花的传说与药用

前段时间痔疮犯了，还出现了便血。在中医学院学习的堂弟知道后，推荐我用鸡冠花蛋汤试试。取鸡冠花30克，加水750毫升，煎至300毫升左右，去渣取汁，打入1枚鸡蛋，煮熟后加适量白糖调味服食，每日1次，连服1周。堂弟介绍，鸡冠花性凉味甘，功能凉血、止血。《玉楸药解》说它能“清风退热，治吐血、血崩、血淋诸失血症”，《本草纲目》记载其主治“痔漏下血，赤白上痢，崩中，赤白带下”。

Clinical observation on row needling at the Governor Vessel on the head for poststroke insomnia

Objective:To observe the clinical efficacy of row needling at the Governor Vessel on the head for poststroke insomnia,analyze the changes of sleep structure,serum amino acid neurotransmitters,vascular endothelial cell function and cognitive function,in order to explore the mechanism of this therapy.Methods:A total of 41 patients with poststroke insomnia were included in an observation group and treated with row needing at the Governor Vessel on the head;33 patients with poststroke insomnia were included in a control group and given routine acupuncture treatment.The patients in both groups were treated consecutively for one month.The efficacy was observed and the changes of related indicators were compared.Results:After treatment,the efficacy of the observation group was better than that of the control group(P<0.05).The sleep latency in the observation group was shorter than that in the control group(P<0.05);the total sleep duration,deep sleep duration,light sleep duration and rapid eye movement sleep duration in the observation group were significantly longer than those in the control group(P<0.05);the total waking duration and the waking times over 5 min were significantly less than those in the control group(P<0.05).The serum glutamic acid,γ-aminobutyric acid,calcitonin gene-related peptide,brain-derived neurotrophic factor,nerve growth factor and nitric oxide levels were significantly higher than those in the control group(P<0.01).The tumor necrosis factor-α,interleukin-6,bradykinin,and endothelin-1 levels were lower than those in the control group(P<0.01).The Pittsburgh sleep quality index score in the observation group was lower than that in the control group(P<0.01),and the mini-mental state examination score was higher than that in the control group(P<0.05).Conclusion:Row needling at the Governor Vessel on the head can effectively improve the sleep structure,cognitive function,and sleep quality of patients with poststroke insomnia.The possible mechanisms are regulating serum amino acid neurotransmitters and improving the function of vascular endothelial cells.

Observation on clinical effect of auricular acupoint sticking plus music therapy for post-stroke insomnia

Objective： To observe the clinical effect of auricular acupoint sticking plus music therapy for post-stroke insomnia. Methods： A total of 154 cases with post-stroke insomnia were randomly divided into a control group and an observation group by the random digital table, 77 cases in each group. The control group was treated by auricular acupoint sticking, while the observation group was treated by auricular acupoint sticking plus music therapy, to compare the clinical effects at the end of the treatment and three months after the treatment between the two groups. Results： At the end of treatment, the total effective rate was 98.7% in the observation group, remarkably higher than 89.6% in the control group, with a statistically significant difference between the two groups （P〈0.05）. Three months after the end of the treatment, the total effective rate was 90.9% in the observation group, remarkably higher than 80.5% in the control group, with a statistically significant difference between the two groups （P〈0.05）. Conclusion： Auricular acupoint sticking plus music therapy was affirmative in the clinical effects for post-stroke insomnia, providing a new idea to design a best nursing and rehabilitative plan for the patients with post-stroke insomnia.

Clinical Application of Yongquan (KI 1)Acupoint

Yongquan （KI 1） is the Jing-Well point of Kidney Meridian of Foot Shaoyin. It can be used to treat many kinds of diseases, such as parietal headache, vertigo and blurred vision, hypopharynx swelling and pain, dry tongue, voice loss, epistaxis, apoplexy and apoplectic sequela, dysufia, ungratifying defecation, epilepsy, syncope, planter fever, palpitations, lower limbs spasm, hypertension, vomiting, infantile convulsion. The author applied Yongquan （KI 1） in clinical practice and obtained satisfactory therapeutic effects. Now five cases were introduced as follows.

Acupuncture plus bloodletting therapy for insomnia in blood stasis constitution:a clinical study

Objective： To observe the clinical efficacy of acupuncture plus bloodletting therapy in treating insomnia in people with blood stasis constitution. Methods： Seventy-two patients were randomized into a treatment group and a control group by using the random number table, 36 cases each. The treatment group received acupuncture plus bloodletting therapy, while the control group was intervened by oral administration of estazolam. One-week treatment was taken as a course, for 3 successive courses in total. A follow-up study was conducted 3 months later. The Pittsburgh sleep quality index （PSQI） was evaluated before and after the intervention, as well as in the follow-up. The clinical efficacies were also compared. Results： The total effective rate was 88.9% in the treatment group versus 83.3% in the control group, and the between-group difference was statistically significant （P〈0.O5）. After the intervention, the PSO.I scores dropped significantly in both groups （both P〈0.05）; the between-group difference in PSQI score was statistically significant （P〈O.05）. The follow-up study showed that the between-group difference in the global score of PSO, I was statistically significant （P〈0.05）. Conclusion： Acupuncture plus bloodletting therapy can produce a more significant efficacy than oral administration of estazolam in treating insomnia in people with blood stasis constitution.

Effects of acupuncture plus language training on language function and cerebral blood flow in patients with motor aphasia after ischemic stroke

Objective:To observe the effects of acupuncture at the Governor Vessel acupoints plus language training on the language function and cerebral blood flow in patients with motor aphasia after ischemic stroke.Methods:Eighty-six patients were randomized into a control group and an observation group,with 43 cases in each group.Conventional symptomatic treatment was offered to both groups.Besides,the control group received language training,while the observation group received language training plus additional acupuncture at the Governor Vessel acupoints.Before and after treatment,the aphasia battery of Chinese(ABC)and Chinese functional communication profile(CFCP)were tested,and the mean velocity(Vm)and resistance index(Rl)of the left middle cerebral artery(MCA)were detected.Results:The total effective rate was higher in the observation group than in the control group(P<0.05).After treatment,the observation group gained higher scores in oral expression,comprehension,repeating,naming objects,reading,and writing,as well as the general score of ABC(all P<0.Q5)f higher than those in the control group(all P<0.05).The CFCP score increased in both groups after intervention,showing significant intra-group differences(both P<0.05),and the CFCP score was higher in the observation group than in the control group(P<0.05).After treatment,Vm of the left side MCA in creased in the con trol group(P<0.05),while no significant change was observed in Rl(P>0.05);in the observation group,Vm of the left side MCA increased and Rl decreased signfiicantly compared with the baseline(both P<0.05),and were markedly different from those in the control group(both P<0.05).Conclusion:Acupuncture at the Governor Vessel acupoints plus language training can produce valid efficacy in treating motor aphasia after ischemic stroke;it can notably improve the language function,everyday oral communication ability,and in crease cere bral perfusion of the patients.