Study of electroacupuncture with different frequencies for the treatment of headache and anxiety-depression symptoms in patients with migraine: A randomized clinical trial: 不同频率电针改善偏头痛患者头痛及焦虑抑郁症状的差异性研究-随机临床试验

ObjectiveTo observe the effects of electroacupuncture (EA) with varied frequencies on headache and anxiety-depression symptoms in patients with migraine and to screen optimal frequency of EA for patients with such conditions.DesignSingle-center, randomized, controlled clinical trial was designed, and the outcome assessors and statisticians were blinded. The patients with migraine were randomized into 2 Hz EA group, 100 Hz EA group and sham-stimulation group. In each group, the changes in migraine attacks, days with headache, the scores of visual analogy scale (VAS), self-rating anxiety scale (SAS), self-rating depression scale (SDS) and migraine-specific quality-of-life questionnaire (MSQ), as well as the dosage of analgesics were observed at the baseline, during treatment, in 1, 2 and 3 months of follow-up separately.SettingPatients were enrolled in the Third Affiliated Hospital of Zhejiang Chinese Medical University, between 1^st August 2018 and 31^st July 2021.ParticipantsSixty-five migraine patients with or without aura.InterventionsIn the EA groups, the acupoints were bilateral Fengchi (GB20), Gongxue (Extra), Sizhukong (TE23), Taiyang (EX-HN5), Shuaigu (GB8), Waiguan (TE5) and Yanglingquan (GB34). Electric stimulation was exerted at GB20 and Gongxue (Extra), with 2 Hz and 100 Hz separately. In the sham-stimulation group, the shallow acupuncture was operated at the sites 1 cm lateral to GB20 and Gongxue (Extra), and on the radial side of TE5 and GB34. The output wires were cut off after attached to the acupoints. The patients in each group received the treatment 3 times weekly, once every two days, for consecutive 4 weeks. The complete intervention was composed of 12 treatments.Main outcome measuresChanges in numbers of migraine attacks at treatment phase (week 1 to week 4) from the baseline(week -4 to week 0) in patients of each groupResults(1) Changes in migraine attacks and days with headache: In the 2 Hz EA and 100 Hz EA groups, the changes for migraine attacks and days of headache were higher significantly when compared with that in the sham-stimulation group at the same time stage (P < 0.05). There was no statistical difference between two EA groups. (2) Changes of VAS score: In the 2 Hz EA and 100 Hz EA groups, the changes of VAS score were significantly higher when compared with that in the sham-stimulation group at the same time stage (P < 0.05). There was no statistical difference between two EA groups. (3) Assessment of anxiety and depression: The differences in the changes of SAS and SDS scores had no statistical significance in patients of each group at each assessment stage (P > 0.05). (4) Assessment on the quality of life: Compared with the sham-stimulation group at the same time stage, the improvement in MSQ score was increased significantly during treatment in patients of the 2 Hz EA and 100 Hz groups (P < 0.05). There was no statistical difference between two EA groups. (5) Assessment on safety and compliance: The patients of each group had sound compliance. There was no adverse events during trial, suggesting promising safety of treatment.ConclusionEA may effectively reduce the migraine attacks, and the days and intensity of headache, presenting promising safety. However, there was no significant improvement on anxiety-depression symptoms, and no significant difference between high and low frequencies of EA treatment in relieving headache and anxiety/depression symptoms in the patients with migraine.Trial registrationChiCTR1800017259     

基环氧合酶-2和诱导型一氧化氮合酶在舌不典型增生和鳞癌组织中的表达

背景与目的:近期研究表明,环氧合酶(cyclooxygenase-2,COX-2)和诱导型一氧化氮合酶(induciblenitricoxidesynthase,iNOS)共同参与肿瘤的发生发展过程,但有关它们异常表达与舌鳞癌生物学行为的关系尚不清楚。本研究拟探讨COX-2和iNOS在舌鳞癌的表达和两者间的相互关系。方法:应用免疫组化SP法,检测59例舌鳞癌及其45例增生性病变(轻、中、重度不典型增生分别为22例、20例、3例)和36例癌旁正常鳞状上皮中COX-2蛋白、iNOS蛋白的表达情况,并对这些指标进行相关分析。结果:在癌旁正常鳞状上皮、轻、中、重度不典型增生上皮和舌鳞癌组织中,COX-2蛋白异常表达检出率分别为8.3%(3/36)、4.5%(1/22)、5.0%(1/20)、0(0/3)和45.8%(27/59);iNOS蛋白异常表达检出率分别为44.4%(16/36)、72.8%(16/22)、80.0%(16/20)、100.0%(3/3)和98.3%(58/59)。COX-2蛋白在癌旁正常鳞状上皮的表达,与舌鳞癌组织的表达差异有显著性(P<0.001),与不典型增生总体的表达差异无显著性(P>0.05);iNOS蛋白在癌旁正常鳞状上皮的表达,与不典型增生总体和癌组织的表达差异均有显著性(P<0.001)。等级相关分析结果显示,COX-2、iNOS表达异常与组织学分级均显著正相关(相关系数r分别为0.418和0.607,P值均<0.001),而且COX-2蛋白与iNOS蛋白之间也具有显著相关性(r=0.245,P<0.001)。结论:COX-2和iNOS蛋白异常表达与舌鳞癌癌变过程显著相关。     

苦参中黄酮类成分薄层色谱鉴别研究△

目的：研究苦参的薄层色谱鉴别特征,建立苦参薄层色谱鉴别的专属性方法。方法：采用乙酸乙酯为提取溶剂,超声处理样品,硅胶G板分离鉴别苦参中黄酮类成分。结果：薄层色谱检出苦参酮、苦参醇Ⅰ、三叶豆紫檀苷、高丽槐素和槐属二氢黄酮G,色谱斑点清晰,能有效提供苦参的鉴别特征。结论：方法可行,重复性好,专属性强,为完善苦参薄层鉴别方法提供了实验资料和科学依据。     

基于“互联网+”探索药事服务模式的问卷调查研究

目的 研究患者对"互联网+"药事服务的接受程度及未来搭建网上药事服务平台的方向,探讨"互联网+"时代下药事服务类型及模式。方法 自制调查问卷,经过三轮专家审阅后形成问卷,在省内的3家"三甲"医院对600例门诊患者发放问卷。结果 488例患者中417例（85.5%）认为药师通过互联网提供药学服务是有必要的,其中网上预约药物配送、网上药师咨询、网上用药教育、药学知识的科普及网上售药的接受程度分别为73.5%,78.2%,64.3%,70.4%,47.4%。网上药师咨询中微信（68.8%）最受中青年患者的欢迎,中老年患者偏爱电话及短信等服务。当前"互联网+"药事服务在医保报销、运营监管、物流配送等方面存在问题。结论 "互联网+"药事服务是一种值得探讨的新型服务模式,其开展需完善相关的法律法规并加强监管,为患者的权益提供保障。     

广州市1998-2007年3449例骨质疏松髋部骨折患者住院医疗资源分析

目的 了解骨质疏松性髋部骨折的基本趋势及其所需要的医疗资源情况.方法 3449例患者的基本情况来源于医院病案信息管理系统.统计分析年龄50岁以上因髋部骨折住院患者的一般情况、住院时间、住院费用及其结构等.结果 髋部骨折的住院人数逐年呈曲线增长,女性患者人数显著多于男性,男女总人数比为1:1.95(男性33.86%,女性66.14%).患者平均年龄(76.32±9.52)岁,最大年龄116岁.平均住院时间(23.59±13.48)d,各年龄组住院时间的差异无统计学意义.70～79岁与80～89岁年龄组人数最多,分别占总人数的38.45%和33.08%.股骨颈骨折与粗隆问骨折的比例为1.33:1.患者住院总费用平均(2.35±1.70)万元(RMB),其中粗隆问骨折(2.14± 1.59)万元,股骨颈骨折(2.51±1.76)万元.住院总费用中包括治疗费(含内置物费用,52%)、药费(25%)、手术费(6%)、床位费(5%)、放射及其他检查费(5%)、化验费(4%).近10年米总住院费用逐年递增,平均年增加6.18%,总费用与住院时间密切相关.结论 随着社会老龄化,骨质疏松髋部骨折逐年增多,医疗费用逐年递增;有效控制治疗费及药费是减少髋部骨折占用医疗资源,减轻患者与社会经济负担的有效途径.     

健脾活络方治疗脾虚络瘀型的糖尿病远端对称性多发性神经病变的临床研究

目的探讨健脾活络方治疗脾虚络瘀型的糖尿病远端对称性多发性神经病变(DSPN)的临床疗效。方法将80例脾虚络瘀型的DSPN患者随机分为治疗组和对照组,各40例。两组均给予基础治疗配合甲钴胺片治疗(500μg,3次/d,口服),治疗组在对照组治疗基础上加用健脾活络方煎服治疗。治疗8周后,观察比较两组治疗前后多伦多临床评分(TCSS)、震动感觉阈值(VPT)检查结果、生活质量评分及疗效。结果治疗后,两组TCSS评分、VPT检查结果、生活质量评分均明显改善,差异有统计学意义(P<0.05),两组之间比较,差异有统计学意义(P<0.05)。临床疗效方面,治疗组总有效率85.00%、对照组60.00%,两组之间比较,差异有统计学意义(P<0.05)。结论健脾活络方明显改善脾虚络瘀型DSPN患者神经功能和生活质量,提高疗效。     

多药耐药相关蛋白基因、肺耐药蛋白基因在肝细胞癌中的表达及临床意义

目的　研究多药耐药相关蛋白基因 (MRP)和肺耐药蛋白基因 (LRP)在肝细胞癌 (HCC)中的表达及其与临床的关系。方法　采用SP免疫组化和PCR技术检测 5 4例HCC和 2 4例癌旁组织及 1 2 例肝炎后肝硬化组织中的两种基因表达。结果　MRP和LRP在 3种组织中均有表达,HCC组织中其基因表达显著高于其他组织 (P< 0. 0 5 )。HCC中两种基因表达呈正相关 (r= 0. 3 1 2, P <0. 0 5; r= 0. 3 2 8, P< 0. 0 5 );其表达与HCC的分化程度有关 (P< 0. 0 5 )。并且其表达阳性组患者化疗后AFP有效率和平均生存期分别高于和长于阴性组 (P< 0. 0 5 ),但LRP与平均生存期无关 (P> 0. 0 5 )。结论　HCC多药耐药 (MDR)与两种基因表达有关,起源于内源性耐药;检测其表达对预测化疗耐药具有指导意义;MRP可能与预后有关。