中西医结合治疗缺血性进展性卒中临床研究

目的:观察中西医结合治疗缺血性进展性卒中的临床疗效。方法:将220例进展性卒中患者分为中西医结合治疗组(观察组)与西医治疗组(对照组),每组110例。观察组在西医治疗的基础上根据中医辨证给予中药治疗,对照组给予西医治疗。结果:观察组愈显率92.7%,对照组愈显率81.8%。观察组疗效优于对照组(P0.05)。观察组治疗后第7天、第14天、第21天NIHSS评分较治疗前均降低,观察组降低程度优于对照组(P0.05)。结论:缺血性进展性卒中在西医规范化治疗的基础上进行中医辨证治疗可明显提高临床疗效。     

补阳还五汤对气虚血瘀型脑梗死患者脑血管储备功能的影响

目的:采用经颅多普勒(TCD)结合屏气试验评价补阳还五汤对气虚血瘀型脑梗死患者脑血管储备功能的影响,并观察两组临床疗效和神经功能缺损评分。方法:将150例气虚血瘀型脑梗死患者随机分为2组,治疗组78例;对照组72例。两组均给予西医规范治疗,口服阿司匹林肠溶片,100 mg/次,1次/d,或口服硫酸氢氯吡格雷片,75 mg/次,1次/d;根据病情给予脱水降颅压,脑细胞保护药物,他汀类降脂治疗,调控血压、血糖及康复治疗。对照组在西医规范治疗基础上加三七通舒胶囊,0.2 g/次,3次/d。治疗组在西医规范治疗的基础上加用补阳还五汤,180 m L/次,2次/d。通过TCD结合屏气试验测定治疗前后脑血管储备功能(CVR),屏气指数(BMI)和平均血流速度(V_m)上升率。并观察两组临床疗效和神经功能缺损(NIHSS)评分。结果:治疗组总有效率达到91%,对照组总有效率76.4%,治疗组优于对照组(P0.05)。与治疗前比较,治疗后7,14 d治疗组NIHSS评分明显降低(P0.05),治疗组低于对照组(P0.05)。与治疗前比较,治疗后14 d治疗组CVR,BMI,Vm上升率均明显提高(P0.05);治疗后14 d,治疗组CVR高于对照组(P0.05)。结论:在西医常规治疗的基础上,补阳还五汤能改善气虚血瘀型脑梗死患者的脑血管储备功能,改善神经功能缺损,提高临床疗效。     

中国老年人跌倒发生率meta分析

目的对中国老年人跌倒发生率进行meta分析。方法参考Cochrane协作网工作手册检索2001-2014年相关数据库及其他网络资源的相关资料,应用加强观察性流行病学研究报告质量（strengthening the reporting of ob-servational studies in epidemiology, STROBE）为参考标准评价文献质量,对23个研究应用Stata/SE11.0软件进行meta分析,选用随机效应模型合并效应量。结果资料存在异质性（I2=93.4%）,通过随机效应模型得出,老年人的跌倒发生率的合并值是18.3%（95%CL是15.7%~20.8%）。结论跌倒在老年人中的发生率较高,老年人需要警惕。     

Breast milk macronutrient composition and the associated factors in urban Chinese mothers

Background Infancy is a critical period of growth and physiological development,in which breast milk is the best source of nutrients.Compared to western countries,research on breast milk of Chinese population are limited.Thus,it is necessary to measure breast milk energy and macronutrient concentrations of healthy urban Chinese mothers at different lactation stages,to expand the database of milk composition of Chinese population,and to examine whether dietary or other maternal factors can affect the levels of macronutrients in breast milk.Methods Breast milk of full expression of one side breast from 436 urban Chinese lactating mothers at 5-11 days,12-30 days,31-60 days,61-120 days,and 121-240 days postpartum was obtained at 9：00 a.m.to 11：00 a.m.Total energy,lactose,protein,and fat contents were measured.24-hour dietary recall was surveyed,and maternal nutrient intakes were analyzed.Results Milk composition changed over the course of lactation and large individual variations were documented.The concentrations were 61.3 kcal/dl for total energy,7.1 g/dl for lactose,0.9 g/dl for protein,and 3.4 g/dl for fat in mature milk.Stage of lactation was a strong factor affecting milk composition.Minimal evidence was found for associations between maternal current dietary intake and milk macronutrient concentration,consistently with prior research.Maternal body mass index （BMI） was positively associated with milk fat content,to a greater extent than did dietary intake.All other maternal characteristics were not significant for milk composition.Conclusion These findings suggest that milk composition is generally weakly associated with maternal factors except for stage of lactation,and is likely to be more susceptible to long-term maternal nutritional status than short-term dietary fluctuation.     

Curcumin protects against staurosporine toxicity in rat neurons

Objective Curcumin is extracted from the turmeric plant (Curcuma longa Linn.) and is widely used as a food additive and traditional medicine. The present study investigated the activity of curcumin against staurosporine (STS) toxicity in cell culture. Methods Rat hippocampal neurons in primary culture were exposed to STS (20 μmol/L) and treated with curcumin (20 μmol/L). Cell viability was tested by MTT assay and reactive oxygen species (ROS) were measured using the MitoSOX red mitochondrial superoxide indicator. Western blot was used to assess changes in the levels of caspase-3 (Csp3), heat shock protein 70 (Hsp70) and Akt. Results The results showed that curcumin protects against STS-induced cytotoxicity in rat hippocampal neurons. Csp3, Hsp70, Akt and ROS activation may be involved in this protection. Conclusion Curcumin could be a potential drug for combination with STS in cancer treatment to reduce the unwanted cytotoxicity of STS.     

绿斑本质的分析研究

目的：绿斑的本质难以揭示,普遍认为钎料是绿斑形成的根源,但相悖于其成因之理,它不溶于水。条件：试制生物小试样的条件因陋就简,采用空气炉中冶炼的合金雾化的金属小球和最简单的钎焊模式。分析：抓住绿斑的特性,即绿色小斑点有腐蚀性,根据金属小球中有黑色细小颗粒炉渣,在钎焊温度下,对熔化的Ni基粉末钎料其表面上微小区域中发生偏析的纯Ni产生化学反应的结果,生成NiCl2。植入术后形成NiCl2？6H2O,是绿斑形成的机制。只要工艺措施予以改变,绿斑就会永远消失。结论：使用粉末Ni基钎料＋金属小球中夹杂氯化物小而黑的炉渣会产生绿斑,其他任何的条件下不会产生绿斑。     

结核性多发浆膜炎45例临床分析

目的　探讨结核性多发浆膜炎的临床特点,提高结核性多发浆膜炎的诊断治疗水平。方法对45例结核性多发浆膜炎的临床资料进行回顾性分析。结果 (1)40岁以下的中青年多见。(2)发热、腹胀为常见临床症状。(3)均并发胸膜炎,且单侧胸腔积液并发腹腔积液最为常见。(4)近半数三腔同时出现积液患者肺内发现血行播散型肺结核。(5)含RFP治疗组的临床效果较为满意。高龄、并发心包炎、并发低蛋白血症是影响疗效的相关因素。结论 对于发热伴有胸闷、腹胀的中青年患者,应进行胸片及B超检查以除外结核性多发浆膜炎,对已发现浆膜腔积液的患者亦应注意其它浆膜腔的相关检查,血播型结核应进行各浆膜腔的相关检查。早期诊断并采用含RFP方案治疗,效果较好。     

33例球形肺炎的临床和影像学特征分析

目的　探讨球形肺炎的影像学特点。方法 对33例经临床或病理确诊的球形肺炎进行回顾性分析。结果 球形肺炎X线主要表现:(1)圆形或椭圆图形;(2)病灶中央密度高,边缘密度较低,呈晕圈样改变;(3)病灶纹理明显增粗,即“胡须征”;(4)早期应用有效抗生素常可完全消失。CT主要表现:(1)球形肺炎CT层面多呈楔形或方形;(2)病灶边缘毛糙,边缘不规则,但较模糊;(3)病变周围血管纹理增粗,增多,但无僵直;(4)好发于背段或外侧野;(5)累及胸膜时接触面广且厚;(6)密度均匀,可有空洞,无钙化。结论 球形肺炎有一定的影像学特点,但有时其征象与肺结核,周围形肺癌鉴别困难,需依赖临床及病理。     

两种不同方法肺活检的比较

目的　探讨二种不同肺活检方法的临床价值,以提高诊断准确率。方法 回顾我院1988～2000年经影像学、痰细胞学、细菌学及纤维支气管镜 (以下简称纤支镜 )检查不能确诊的患者293例,对两种不同方法的肺活检结果进行比较分析。结果 经皮肺穿刺活检148例,分别采用X线、CT、B超引导方法,其活检阳性率为87.8%;经纤支镜肺穿刺活检145例,活检阳性率为79.3%。并发症发生率分别为23.6%和21.4%。结论 采用肺活检的方法不同,其结果和临床意义不同,经皮肺活检以CT引导下的方式,诊断准确率最高。