养血清脑颗粒对脑梗死抑郁患者治疗效果的影响

目的探讨养血清脑颗粒对脑梗死后抑郁症患者治疗效果的影响。方法将2016年6月-2019年6月本院纳入的100例脑梗死后抑郁症患者随机分为两组,对照组用帕罗西汀治疗;观察组在对照组基础上加养血清脑颗粒治疗,比较两组汉密斯顿抑郁量表(Hamilton depression scale,HAMD)、汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)、脑卒中神经功能缺损评分量表(national institute of health stroke scale,NIHSS)评分和皮质醇、去甲肾上腺素(noradrenaline,NE)、多巴胺(dopamine,DA)及5-羟色胺(5-hydroxytryptamine,5-HT)水平及不良反应。结果治疗后,两组NIHSS、HAMD、HAMA评分、皮质醇水平均较治疗前降低,观察组显著低于对照组(均P<0.05),两组5-HT、DA及NE均显著上升,观察组显著高于对照组(均P<0.05);两组不良反应率差异无统计学意义(P>0.05)。结论养血清脑颗粒联合帕罗西汀治疗脑梗死后抑郁患者效果显著,且不增加不良反应。     

“十一五”环保科普事业发展情况分析

以国家科普统计环保行业数据为基础,从科普人员、场地、经费、资源与传媒和活动5个方面,分析了“十一五”期间我国环保科普事业的发展情况,认为《全民科学素质行动计划纲要（2006-2010-2020）》等政策文件的出台,有力地促进我国环保科普事业的发展和进步.同时也指出环保科普事业发展的薄弱环节是科普场地设施的建设和发展以及精品科普资源的开发和创作,这是“十二五”末期环保科普工作和“十三五”环保科普工作规划中应该重点考虑的方向.     

肝脓肿临床特点及抗菌药物的治疗策略(附58例分析)

目的探讨肝脓肿抗生素种类的选择及疗程确定,以提高肝脓肿治疗水平。方法回顾性分析北京协和医院2002年5月—2012年9月收治的58例肝脓肿住院病例临床资料。结果 58例以发热、腹痛症状多见,有糖尿病史者占86.21%,均经影像学检查确诊,并进行血、脓肿穿刺细菌培养,细菌来源最常见为隐源性,其次为胆源性,前三位病原菌为肺炎克雷伯杆菌、大肠埃希菌及混合菌。抗生素选择以头孢类联合硝咪唑类为多,其次为喹诺酮类和碳青霉烯类,抗生素应用时间最短9 d,最长87 d。本组16例单纯使用抗菌药物治疗,33例行CT引导下肝穿刺引流治疗,5例行B超引导下肝穿刺引流治疗,4例行手术治疗。本组治愈8例,好转49例,死亡1例,病死率1.72%。结论对肝脓肿的经验性抗菌药物治疗中,首选针对肺炎克雷伯杆菌、大肠杆菌的抗生素,进一步待细菌培养后根据药物敏感性实验结果选择敏感药物,CT/超声引导下肝穿刺引流治疗有助于缩短病程。     

Echinacea purpurea is ineffective for upper respiratory tract infections in children

QuestionHow safe and effective is Echinacea purpurea at reducing the duration and severity of upper respiratory tract infections in children?Study designMulticentre randomised controlled trial.Main resultsThere was no significant difference in duration or severity of symptoms with Echinacea purpurea compared with placebo in children with upper respiratory tract infection (median duration of symptoms (95% CI): 9 days (8 to 10 days) with Echinacea vs. 9 days (8 to 10 days) with placebo; P=0.89; median severity of symptoms (95% CI): 33 (29 to 40) with Echinacea vs. 33 (30 to 38) with placebo; P=0.69). Rash occurred in significantly more children receiving Echinacea compared with placebo (reports of rash: 24 with Echinacea v 10 with placebo; P=0.008).Authors’ conclusionsEchinacea purpurea is ineffective for treating upper respiratory tract infections in children aged 2 to 11 years.     

Effect of human neural progenitor cells on injured spinal cord

Human central nervous system ( CNS) has verylimited regenerative potentials. Patients withsevere injuries in the CNS such as spinal cordinjury (SCI) frequently endure lifelong disability. Avariety of methods have been tried to prevent spinalcord from further injury and foster regeneration afterSCI. Despite these efforts, an effective treatment forthis disease is still lacking. Since neural progenitorcells have already committed to become neural cells inthe CNS, they appear to be a good c…     

原发性高血压左室收缩功能无创生物力学分析

目的研究用最大心肌劲度(maxEav)评价高血压病左室重构的生物力学特性的临床意义。方法研究对象为96例高血压病患者和30例健康人。应用超声心动图测定左室收缩期及舒张末期内径、左室重量指数(LVMI)和相对室壁厚度(RWT),左室射血分数(EF)、左室短轴缩短率(FS)。联合袖带肱动脉血压值计算左室收缩末期压力。根据LVMI和RWT将高血压患者分为左室正常构型组、向心性重构组、向心性肥厚组、离心性肥厚组。应用上述各测值计算maxEav。结果(1)以EF、FS表示的心脏收缩功能在正常对照组与高血压各组间、高血压组内各组间无明显差异性(P>0.05)。(2)对照组maxEav与高血压各组有明显差异性(P<0.01);高血压各组间maxEav无明显差异性(P>0.05)。结论应用超声心动图无创测定心功能力学参数maxEav对高血压左室重构心肌生物力学特性的评价具有特殊的诊断价值。     

居家痴呆病人非雇佣女性照料者照料感受的质性研究

目的深入了解居家痴呆病人非雇佣关系女性照料者的正面和负面照料感受。方法运用质性研究中现象学研究方法,对9名居家痴呆病人非雇佣女性照料者进行深入访谈,并运用类属分析法进行资料的整理分析。结果提升出3个主题,主题1身心疲惫:沉重的心理负担和每况愈下的身体状况;主题2照顾的动力:对病人的深厚感情是照料动力的主要来源,感受到的正性情感为照料者增添动力;主题3主动疏解。结论非雇佣女性照料者的身心健康状况较差,应在身心两方面给予她们有效的支持,增加其照料过程中获得的正性情感,并建立痴呆病人专门的照料机构,减轻照料者负担。     

膝骨性关节炎经筋证型分布规律研究及其生物力学机理分析

目的：研究膝骨性关节炎经筋证型的分布规律,并探讨经筋证型的生物力学机理。方法：选取70例膝骨性关节炎（KOA）患者共102个患膝,采用手触诊法,统计经筋病灶点出现频次和经筋证型出现比率。结果：膝骨性关节炎患者存在足阳明经筋、足少阳经筋、足三阴经筋3种单一经筋证型和多种复合证型,其中足阳明经筋证型出现最多;随着疾病发展,出现了较多足太阳经筋复合证型。结论：KOA经筋证型的出现与膝关节解剖学结构和其生物力学特性密切相关,研究结果既为临床治疗打下基础,也为开展KOA经筋辨证的生物力学现代研究提供了理论依据。     

基于24个省市自治区诊疗方案的新型冠状病毒肺炎中医病因病机与证素特点探讨

2019年12月,湖北省武汉市爆发新型冠状病毒肺炎(简称新冠肺炎),并迅速波及全国乃至多个境外地区。国家卫生健康委员会、国家中医药管理局及各省市迅速出台了关于新冠肺炎的中医药诊疗方案,根据各地区患者发病特点,为新冠肺炎的快速诊治提供了参考。文章通过对24个省市自治区新冠肺炎的中医诊疗方案进行整理、分析,对新冠肺炎的病因病机及证素特点进行探讨。     

Determining the change in length of the anterolateral ligament during knee motion: A three-dimensional optoelectronic analysis

BackgroundThe variation of the anterolateral ligament (ALL) length during knee motion is still unclear, and the knee position in which a reconstruction graft should be tensioned remains controversial. The objective of this study was to determine the variation of the ALL length during knee motion using a three-dimensional optoelectronic system.MethodsKinematic analyses of 20 cadaveric knees were performed using a Motion Analysis® system. The variability of the measurements made during the five acquisition cycles was studied. Reliability was evaluated by two separate measurement sessions, with complete system reinstallation, using different cadavers and a new operator. The ALL length was analysed from extension to full flexion in three rotational conditions.FindingsWhen analysing the reliability of the five cycles, 82% of the measurements we found to have an Intra Class Correlation (ICC) >0.85. The reproducibility of inter-sessional measures by different operators and different cadavers was either good (ICC >0.75) or excellent (ICC >0.85). The ALL length was maximum in full internal rotation with the knee at 25° of flexion.InterpretationThis three-dimensional optoelectronic protocol allowed us to analyse the variation of the ALL length during intact knee motion with good reliability and the required accuracy to analyse this variable. The maximal length and highest tension of the ALL was reported at 25° of knee flexion in internal rotation, suggesting this as the optimal position for the knee joint when tensioning an ALL reconstruction.