中医学基础主干课程网络测评系统的构建

基于计算机网络技术,利用遗传算法制定编码方法和初始种群、设计适应度函数和停机条件实现组卷,构建具有中医药学科特色的中医学基础主干课程网络测评系统,并对测评结果进行分析.该系统较好地解决了中医药学科关键的需求——跨知识点组卷,将中医学基础主干课程知识点融合一起测评,生成的试卷科学、合理,符合中医药学科特色.     

A meta-analysis of the secondary fractures for osteoporotic vertebral compression fractures after percutaneous vertebroplasty

To identify the risk factors of the secondary fractures for osteoporotic vertebral compression fractures (OVCFs) after percutaneous vertebroplasty (PVP).We conducted a search of relevant articles using Cochrane Library, PubMed, Medline, Science Direct, Embase, the Web of Science and other databases. The time range we retrieved from establishment of the electronic database to November 2017. Gray studies were found in the references of included literature reports. STATA version 11.0 (Stata Corporation, College Station, Texas) was used to analyze the pooled data.Fourteen studies involving 1910 patients, 395 of whom had fracture secondary to the surgery were included in this meta-analysis. The result of meta-analyses showed the risk factors of the secondary fractures for OVCFs after PVP was related to bone mineral density (BMD) [95%CI (−0.650, −0.164), SMD=−0.407, P=.001], cement leakage ((RR=0.596, 95%CI (0.444,0.798), P = .001)), and kyphosis after primary operation ((SMD=0.741, 95%CI (0.449,1.032), P = .000)), but not to gender, age, body mass index, cement volume, thoracolumbar spine, and cement injection approaches.Bone mineral density, cement leakage, and kyphosis after primary operation are the risk factors closely correlative to the secondary fracture after PVP. There have not been enough evidences to support the association between the secondary fracture and gender, age, body mass index, cement volume, thoracolumbar spine, and cement injection approaches.     

荧光引导下脑胶质瘤边界的组织病理学研究

目的 5-氨基乙酰丙酸(ALA)引导的荧光手术已应用于临床恶性脑胶质瘤的治疗,本实验的目的是探讨ALA荧光引导切除脑胶质瘤的荧光边界与侵袭性的关系.方法 对11例胶质母细胞瘤患者麻醉诱导前3h给予口服ALA,术中使用荧光显微镜检测肿瘤荧光,根据有无荧光留取组织标本.利用免疫组化方法检测荧光组与非荧光组组织中侵袭性指标细胞粘附分子CD44(CD44-HCM)、基质蛋白酶-9(MMP-9)和肌腱蛋白(TN)的表达.结果 CD44-HCM、MMP-9和TN在荧光组织与无荧光组织中的阳性表达率有显著差异(P＜0.01),与无荧光的组织相比,荧光组中CD44-HCM、MMP-9和TN表达的阳性率明显增加.结论 ALA诱导的肿瘤荧光边界与脑胶质瘤组织病理学边界相符,进一步表明,荧光引导手术能够有效的切除脑胶质瘤,并且为手术提供客观边界.     

清胃散加味治疗复发性口腔溃疡53例

目的:观察清胃散加味治疗复发性口腔溃疡的临床疗效.方法:选取复发性口腔溃疡患者53例,均给予清胃散加味治疗.结果:53例患者中,治愈49例,好转3例,未愈1例,有效率为98.11％.结论:清胃散加味治疗复发性口腔溃疡疗效显著.     

双头加压螺钉与带血管蒂骨瓣植骨治疗成人股骨颈骨折

目的 探讨成人新鲜股骨颈骨折的治疗方法.方法 采用双头加压螺丝钉内固定及带血管蒂骨瓣植骨术进行治疗.结果 治疗效果优24.1%,良53.4%,可17.2%,差5.3%,优良率达77.5%.结论 该方法治疗效果满意.     

噻托溴铵吸入辅助布地奈德/福莫特罗治疗重度支气管哮喘患者的疗效观察

目的 探讨噻托溴铵吸入辅助布地奈德/福莫特罗治疗重度支气管哮喘患者的疗效以及对肺部通气功能的影响.方法 选取我院2015年1月至2016年1月收治的重度支气管哮喘患者80例为研究对象,按随机数字表法分为对照组(40例)和观察组(40例),分别给予布地奈德/福莫特罗单用和在此基础上加用噻托溴铵吸入辅助治疗,两组疗程均为6个月.比较两组患者近期疗效,急性发作频率,治疗前后哮喘控制测试量表(ACT)评分、肺部通气功能指标及不良反应发生率.结果 观察组患者和近期治疗总有效率为95.00%,明显高于对照组的75.00%,差异有统计学意义(P<0.05);观察组患者治疗后1、3、6个月的急性发作频率分别为(8.09±0.67)次/月、(6.24±0.38)次/月、(2.94±0.31)次/月,呈逐渐下降趋势,且分别低于对照组的(11.78±1.10)次/月、(9.66±0.85)次/月、(6.56±0.72)次/月,差异均有统计学意义(P<0.05);观察组患者治疗后ACT评分为(21.77±5.24)分,明显高于治疗前的(7.27±2.26)分和对照组的(14.36±3.18)分、差异均有统计学意义(P<0.05);观察组患者治疗后1 s用力呼气量占预计值的百分率(FEV1%)、1 s用力呼气容积(FEV1)、呼气峰流速值(PEF)及呼气流量峰值昼夜波动率(PEFR)分别为(90.38±9.50)、(3.20±0.84)L、(6.54±0.54)L/s、(7.60±2.13)%,均明显优于治疗前的(61.70±5.80)、(2.01±0.48)L、(4.23±0.30)L/s、(34.75±7.99)%和对照组的(79.87±8.35)、(2.42±0.69)L、(5.70±0.44)L/s、(12.63±3.51)%,差异均有统计学意义(P<0.05);观察组患者的不良反应发生率为22.50%,与对照组的15.00%比较,差异无统计学意义(P>0.05).结论 噻托溴铵吸入辅助布地奈德/福莫特罗治疗重度支气管哮喘可有效降低急性发作频率,利于控制病情,提高肺部通气功能,且未增加不良反应.     

羟基磷灰石诱导脂肪间充质干细胞成骨分化的实验研究

目的 探究羟基磷灰石（HA）对脂肪来源的间充质干细胞（ADSCs）向成骨分化的影响。方法 分离、纯化 并鉴定C57BL/6小鼠的ADSCs，将HA与ADSCs共培养，CCK-8法检测不同浓度（0、5、10、20、50、100、500 mg/L）的HA 对ADSCs增殖的影响；碱性磷酸酶（ALP）染色检测不同浓度HA对ADSCs成骨分化的影响；实时荧光定量逆转录-聚 合酶链反应（qRT-PCR）检测ADSCs成骨相关基因骨钙素（BGLAP）、碱性磷酸酶（ALP）、Ⅰ型胶原（COL1A1）、骨桥蛋 白（OPN）、Runt相关转录因子2（Runx2）的mRNA表达情况。结果 低浓度HA（≤20 mg/L）对ADSCs增殖的影响较 小，随着HA浓度增加，细胞的增殖活性下降。HA与ADSCs共培养可显著增加其ALP活性，并促进成骨相关基因的 表达（P＜0.01），且HA为20 mg/L时诱导效果较好。结论 HA具有诱导ADSCs向成骨细胞分化的能力，为两者混合 制作成新的骨支架修复材料提供了理论基础。     

Ursolic acid induces neural regeneration after sciatic nerve injury

In this study,we aimed to explore the role of ursolic acid in the neural regeneration of the injured sciatic nerve.BALB/c mice were used to establish models of sciatic nerve injury through unilateral sciatic nerve complete transection and microscopic anastomosis at 0.5 cm below the ischial tuberosity.The successfully generated model mice were treated with 10,5,or 2.5 mg/kg ursolic acid via intraperitoneal injection.Enzyme-linked immunosorbent assay results showed that serum S100 protein expression level gradually increased at 1-4 weeks after sciatic nerve injury,and significantly decreased at 8 weeks.As such,ursolic acid has the capacity to significantly increase S100 protein expression levels.Real-time quantitative PCR showed that S100 mRNA expression in the L4-6 segments on the injury side was increased after ursolic acid treatment.In addition,the muscular mass index in the soleus muscle was also increased in mice treated with ursolic acid.Toluidine blue staining revealed that the quantity and average diameter of myelinated nerve fibers in the injured sciatic nerve were significantly increased after treatment with ursolic acid.10 and 5 mg/kg of ursolic acid produced stronger effects than 2.5 mg/kg of ursolic acid.Our findings indicate that ursolic acid can dose-dependently increase S100 expression and promote neural regeneration in BALB/c mice following sciatic nerve injury.