Hypercholesterolemia treated with medicinal pad-separated moxibustion: A randomized clinical trial隔药饼灸治疗高胆固醇血症-随机临床试验

ObjectiveTo assess the effect of medicinal pad-separated moxibustion for reducing low-density lipoprotein cholesterol (LDL-C) in the patients with hypercholesterolemia.DesignClinical randomized controlled trial with blinding for outcome assessors and statisticians.SettingDepartment of Acupuncture-Moxibustion and Tuina, Department of Physical examination of the First Affiliated Hospital of Hunan University of Chinese Medicine and three community health centers adjacent to the Hospital and University, from July 2015 to December 2017.Patients60 patients with hypercholesterolemia (elevated LDL-C).InterventionsThe therapeutic lifestyle change (TLC) was provided in both groups.In the experiment group, medicinal pad-separated moxibustion was applied using two groups of acupoints (Group No.1: Jùquē [巨阙CV14], Tiānshū [天枢ST25] and Fēnglóng [丰隆ST40]). Group No.2: Xīnshū [心俞BL15], Gānshū [肝俞BL18] and Píshū [脾俞BL20]) alternatively for 3–5 times a week. In the control group, Simvastatin tablets were administered orally by the patients in accordance with instructions in the medication guides (10 mg/d).Main outcome measuresChange of LDL-C after 12 weeks of treatment compared with the baseline.ResultsAfter 12 weeks of treatment, LDL-C was reduced in both the medicinal pad-separated moxibustion group and the simvastatin group compared with that at baseline (both P < 0.05). The difference on change of LDL-C was not significant between groups (P > 0.05). At week 4 of follow-up, LDL-C was reduced compared with that at baseline in the medicinal pad-moxibustion group (P < 0.05), and the difference on change of LDL-C was significant between groups (P < 0.05). At week 12 of follow-up, the difference on change of LDL-C was not significant when compared with the baseline in each group (both P > 0.05) and between groups (P > 0.05). In comparison with values before treatment, the values of triglyceride (TC) and triacylglycerol(TG) were reduced in both groups (all P < 0.05), while value of high-density lipoprotein cholesterol (HDL-C) was increased in the medicinal pad-separated moxibustion group after 12 weeks of treatment (P < 0.05). The change of TG and HDL-C values were significantly different between groups (both P < 0.05). At week 4 of follow-up, values of TC and TG were lower (both P < 0.05) and HDL-C was higher (P < 0.05) when compared with that at baseline in the medicinal pad-separated moxibustion group; and value of TC was lower and HDL-C higher in the medicinal pad-separated moxibustion group compared with that in the simvastatin group (both P < 0.05). At week 12 of follow-up, compared with that at baseline, all blood lipid outcomes were not significantly different either within (P > 0.05) or between groups (P > 0.05).ConclusionMedicinal pad-separated moxibustion could reduce LDL-C and increase HDL-C in patients with hypercholesterolemia. However, these results need to be further verified by study with large sample size.Trial registrationClinicaltrials.gov NCT02269046.     

电针促进周围神经损伤再生机制的研究进展

〔摘 要〕 作为再生能力最差的组织之一，神经损伤后的修复是目前临床上治疗的重大难题。大量的试验和临床研究表明， 电针对于周围神经损坏后运动和感觉功能的恢复有比较满意的疗效。本研究通过查阅大量文献，回顾近几年国内外关于电 针治疗周围神经损伤（PNI）的机制研究，发现电针主要是通过促进施旺细胞再生分化、促进血管重建、抑制失神经的肌肉 萎缩以及减轻炎症反应等方面来达到促进神经再生的目的。     

高效液相色谱法测定清咽片中葛根素的含量

目的：采用反相高效液相色谱法测定清咽片中葛根素的含量。方法：以甲醇-水（20∶80）为流动相,Kromasil C18（4.6mm&#215;250mm,5μm）为固定相,流速为1.0ml/min,检测波长为250nm。结果：葛根素在80.40～402.00ng间有良好的线性关系,回收率为98.435%,RSD为1.58%（n=6）。结论：方法简单、灵敏度高,可用于清咽片中葛根素的含量测定。     

急性肾盂肾炎血清C-反应蛋白检测的临床价值

在感染、创伤、组织坏死、自身免疫性疾病等因素刺激下,C反应蛋白(C-reactive prote in,CRP)均可作为可靠的全身或局部炎症反应指标。又因其测定方法简单、快速、可靠,使CRP成为临床中最为常用的急性期蛋白检测项目。本实验旨在观察分析,急性肾盂肾炎患者血清CRP动态变化规律及     

成人三种膜性肾病的临床与病理分析

目的阐明成人病理类型表现为膜性肾病的乙肝相关性肾炎、狼疮性肾炎、特发性膜性肾病的临床与病理特点。方法回顾性分析经肾活检确诊的三种膜性肾病患者86例,对其临床资料、病理特征进行统计分析。结果①三种膜性肾病占有率为乙肝相关性肾炎11.6%、狼疮性肾炎24.4%、特发性膜性肾病64.0%。②三种膜性肾病患者临床表现均以肾病综合征为主,而血尿、高血压及肾功能不全的发病情况在三者间无统计学意义。血清补体C3、C4的降低在狼疮性肾炎患者中明显。③病理改变均以Ⅰ期、Ⅱ期为主,在病理表现中,系膜中重度增生、电子致密物多部位沉积在乙肝相关性肾炎、狼疮性肾炎和特发性膜性肾病间比较有显著差异(P<0.05)。结论成人以特发性膜性肾病为主,三种膜性肾病的临床表现相似,但有各自临床与病理特点,确诊需综合进行分析。     

双人观察对肠镜息肉检出率影响的前瞻性研究

目的了解医护双人观察在结肠镜检查退镜过程是否可以提高息肉检出率。方法连续性收集内镜室诊断性结肠镜检查患者,前瞻性地随机分医护双人观察组和医生单人观察组,记录比较两组的息肉检出率。结果在4个月研究期间共完成985例诊断性结肠镜检查,其中271例检出息肉,总704枚。498例医护双人观察组和487例医生单人观察组的息肉检出率分别为30.5%和24.4%,差异有统计学意义(P=0.032)。在医生单人观察组中,护士证实医生在21例患者中共漏检息肉27枚。结论医护双人观察在结肠镜检查退镜过程中协助医生共同观察可以提高息肉检出率。     

比索洛尔对充血性心力衰竭患者血浆脑钠肽水平的影响

目的探讨比索洛尔对充血性心力衰竭患者血浆脑钠肽（BNP）水平的影响。方法对84例慢性充血性心力衰竭患者在常规抗心衰治疗的基础上应用比索洛尔,2．5mg／a,治疗2周后根据患者心功能恢复情况调整5—10mg／d,维持治疗3个月,观察患者治疗前后心率、血压、射血分数的变化,并应用ELISA检测检测者血BNP水平变化。结果84例患者中,心功能：Ⅰ级14例,Ⅱ级24例,Ⅲ级28例,Ⅳ级18例,BNP水平分别为：（112．56±14．79）ng／L、（242．69±37．35）ng／L、（452．57±49．66）ng／L、（882．75±163．27）ng／L,随着心功能变差BNP水平逐渐增高,两两比较,差异均有统计学意义（t=4．241、4．573、4．074、7．328,均P〈0．01）。经治疗后,显效28例（33．3％）,有效41例（48．8％）,无效15例（17．9％）,有效率82．1％;治疗后患者心率减慢、血压降低、左室射血分数较治疗前明显升高（t=3．585、3．245、3．347,均P〈0．05）,治疗后BNP水平明显降低（（t=4．876,P〈0．01）。结论BNP水平可以反映充血性心力衰竭患者心功能水平,应用比索洛尔治疗充血性心力衰竭可以改善患者心功能,降低患者BNP水平。     

胰腺炎的漏误诊分析

目的:总结急性胰腺炎的漏诊和误诊的情况以及其原因,以提高对急性胰腺炎的诊治水平.方法:收集我院急诊科2004年1月-2010年12月急性胰腺炎135例患者的资料,对其漏诊和误诊情况进行回顾性统计分析.结果:135例急性胰腺炎中漏诊5例,漏诊率为3.7%,误诊22例,误诊率为16.3%,总漏误诊率为20.0%.结论:对急性胰腺炎缺乏典型症状和体征的病例,应利用辅助检查,密切动态观察病情变化,尽早明确诊断,及时治疗,尽量避免漏诊和误诊.     

健脾止嗽颗粒质量标准研究

目的建立健脾止嗽颗粒的质量标准。方法采用薄层色谱法定性鉴别健脾止嗽颗粒中的苍术、木香,采用高效液相色谱法测定橙皮苷含量。色谱柱为Elipse XDB-C18柱(150 mm×4.6 mm,5μm),流动相为甲醇-水(60∶40),检测波长283 nm,流速1.0 mL/min,柱温25℃。结果薄层色谱斑点清晰,阴性无干扰;橙皮苷质量浓度在31.04～155.20μg/mL范围内与峰面积线性关系良好,r=0.999 6(n=5),平均加样回收率为98.35%,RSD=1.64%(n=6)。结论定性定量方法简便、准确、可靠,可作为健脾止嗽颗粒的质量控制方法。     

幽门螺杆菌与口腔疾病研究新进展

幽门螺杆菌（Helicobacter Pylori,Hp）与全身多种疾病密切相关,口腔是幽门螺杆菌的第二储存库,与多种口腔疾病的发生有密切关联,近年来口腔幽门螺杆菌成为研究的热点,本文对口腔幽门螺杆菌的研究新进展作一综述。