足部穴位艾灸对妇科全麻患者术后寒战和足温恢复的影响

[目的]探讨艾灸足部穴位促进妇科全麻患者术后寒战和足背皮肤温度恢复的效果。[方法]将86例妇科全麻术后低体温和足部皮肤低温的患者,随机分为对照组与观察组。对照组采用常规保暖,观察组在常规保暖的基础上,给予艾灸。观察记录足温及寒战变化情况。[结果]与对照组比较,观察组患者术后足温恢复及寒战缓解所需时间均明显缩短（P〈0.01）。[结论]艾灸足部穴位能有效地促进妇科全麻患者术后足温恢复及寒战缓解。     

腰椎Modic I、Ⅱ型面积改变率与TNF-α相关性研究

目的：探讨腰椎Modic I、Ⅱ型面积改变率与对应终板中TNF-α含量的相关性。方法52例因下腰痛手术患者（男29例,女23例）,平均年龄（51.0±11.89）岁。术前行MRI检查,其中无Modic改变型16例,Modic I型15例,ModicⅡ型21例。测量3组在MRI T2正中矢状位上Modic改变面积及对应椎体面积大小,计算Modic改变率。术中收集椎间盘髓核、椎体终板部分组织作TNF-α免疫组化染色,观察其在髓核和终板组织中的差异,统计与终板面积改变率的相关性。结果无Modic改变型：髓核和终板组织中TNF-α染色极少,Modic I型组：TNF-ɑ在终板的表达明显高于髓核,与面积变化率的相关系数r=0.431,P=0.021,两者具有正相关性。ModicⅡ型组：TNF-ɑ在终板的表达与髓核组织相似,与面积变化率的相关系数r=0.322,P=0.043,两者具有正相关性。结论下腰痛患者中Modic I、Ⅱ型面积改变率与所对应终板中TNF-ɑ炎性因子含量密切相关。     

2型糖尿病不同中医证型骨密度和骨代谢指标的研究

目的:探讨2型糖尿病不同中医证型的骨密度和骨代谢指标的关系。方法:选择74例男性2型糖尿病患者,按中医辨证分为3组,分别为痰湿型23例、气阴两虚型29例、肾虚型22例,另设正常男性对照组23例。测定骨密度、骨钙素、尿脱氧吡啶啉。结果:肾虚型组骨密度、骨钙素水平显著低于气阴两虚型组、痰湿型组和健康人组;而尿脱氧吡啶啉水平各组无明显差异。结论:2型糖尿病各中医证型均有不同程度的骨代谢异常,存在阶段性的特点,到后期的肾虚型,骨代谢异常较为严重。     

Study of dexamethasone,baicalin and octreotide on brain injury of rats with severe acute pancreatitis

Objective  

To investigate the protecting effects of dexamethasone (DXM), baicalin and octreotide on brain injury of rats with severe acute pancreatitis (SAP) and explore their underlying mechanism.     

Epstein–Barr-virus-associated hepatitis with aplastic anemia: A case report

ABSTRACT BACKGROUND Hepatitis-associated aplastic anemia (HAAA) is a rare condition. Patients with HAAA usually present with acute hepatitis, jaundice and significantly increased transaminase. After 1–2 mo, hepatitis gradually improves, but progressive hemocytopenia, bone marrow hematopoietic failure, and severe or extremely severe aplastic anemia are manifest. Most cases of HAAA are fulminant and usually lethal if left untreated. The literature on Epstein–Barr virus (EBV)-associated HAAA is sparse. CASE SUMMARY We report a 30-year-old man who was admitted to our hospital because of pale yellow urine and skin with a simultaneous decrease in peripheral blood ternary cells. We made a diagnosis of EBV-associated HAAA. The treatment strategy for this patient included eltrombopag, an immunosuppressive regimen of rabbit anti-human thymocyte immunoglobulin, cyclosporine, and supportive care. The patient was discharged in normal physical condition after five months. A hemogram performed on follow-up revealed that he had achieved a complete response. CONCLUSION Eltrombopag plus anti-thymocyte globubin and cyclosporine may be a therapeutic option for EBV-associated HAAA.Larger studies are warranted to confirm.     

The efficacy of surgical treatment on locomotive syndrome and physical function in patients with lumbar spinal canal stenosis

BackgroundLocomotive syndrome is a condition of reduced mobility due to problems with locomotive organs. Although lumbar spinal canal stenosis is one of the major diseases constituting locomotive syndrome, only few studies have focused on the association between the two pathologies. We aimed to investigate the effect of surgery on lumbar spinal canal stenosis with respect to locomotive syndrome using various physical function tests, including locomotive syndrome risk tests, before and after surgery.MethodsClinical data of 101 consecutive patients (male = 46; female = 55; mean age, 69.3 years) who underwent surgery for lumbar spinal canal stenosis at our institute were prospectively collected. Results of physical function tests, including stand-up test, two-step test, and 25-Question Geriatric Locomotive Function Scale, and the sagittal vertical axis were evaluated before and 1 year after surgery. The association between several parameters and improvement of risk level in locomotive syndrome was evaluated.ResultsIn the total assessment, 93.1% of cases were in stage 2 and 6.9% in stage 1 preoperatively, while 72.4% were in stage 2, 22.4% in stage 1, and 5.2% in stage 0 at 1 year postoperatively. Postoperative improvement in the total assessment was observed in 28.7% of cases. Several physical function tests and sagittal vertical axis showed significant improvement after surgery. On multiple logistic regression analysis, age >75 years (odds ratio = 10.9, confidence interval = 1.09–109) and postoperative sagittal vertical axis >40 mm (odds ratio = 17.8, confidence interval = 1.78–177) were significant risk factors associated with non-improvement in risk level of locomotive syndrome.ConclusionsSurgical treatment for lumbar spinal canal stenosis improved physical function, including locomotive syndrome. Risk factors associated with non-improvement of locomotive syndrome were later-stage elderly and postoperative sagittal balance impairment.     

An age-adjusted instruction video enhances the correct use of nasal corticosteroid sprays in children

Introduction and objectivesAllergic rhinitis is a common disorder. Intranasal corticosteroid sprays are used to control symptoms. However, incorrect use of these sprays can decrease efficacy and lead to side effects such as nose bleeding. We studied if watching an age-adjusted instruction video is effective to improve administration technique.Materials and methodsWe invited children who used intranasal corticosteroid sprays. We examined their administration technique before, directly after, and one month after showing them an age-adjusted instruction video. We compared their administration technique with the instructions in the patient information leaflet. We assessed whether the children performed the seventeen maneuvers mentioned in the patient information leaflet and the eight we considered essential.ResultsOf the 99 eligible children, 23 (15 boys, median age nine years) participated. Before watching the instruction video none of them administered according to all maneuvers in the patient information leaflet or showed all essential maneuvers. One month after seeing the instruction video, three children demonstrated correct inhalation as per the patient information leaflet. Three performed the essential maneuvers. When a 75% threshold level for carrying out all 17 maneuvers was used, still none showed 75% of all or of the essential maneuvers before watching the video. Yet, after one month 12 children showed sufficient administration technique (52%, 95% confidence interval (CI) 31%–73%, p = 0.004). Nine showed all essential manoeuvres (47%, 95%CI 24%–71%, p = 0.004).ConclusionsAn age-adjusted instruction video is a useful and easy method to teach children to administer nasal intranasal corticosteroid sprays correctly.     

恶性肿瘤高凝状态的中西医发病机制

恶性肿瘤患者普遍存在高凝状态,尤其是晚期患者。而高凝状态与恶性肿瘤的增殖、血管生成和转移密切相关,从而形成恶性循环,最终可导致血栓的形成。因此,了解恶性肿瘤高凝状态的发病机制,对改善恶性肿瘤患者的生存和预后有着重要意义。本文主要就恶性肿瘤高凝状态的中西医发病机制作一简要综述。     

程序性死亡1/程序性死亡配体1和细胞毒性T淋巴细胞相关蛋白4信号通路在膀胱尿路上皮癌中的研究进展

膀胱尿路上皮癌是泌尿系统中最常见的恶性肿瘤,长期以来以铂为基础的化疗一直是不可切除或转移性膀胱尿路上皮癌的标准治疗方法,但预后不良。针对程序性死亡1(PD-1)/程序性死亡配体1(PD-L1)和细胞毒性T淋巴细胞相关蛋白4(CTLA-4)通路的免疫检查点抑制剂在临床试验中显示出了显著的抗肿瘤活性、可耐受的安全性和长期持久的反应性,开创了晚期膀胱尿路上皮癌治疗的新时代。本文回顾PD-1/PD-L1及CTLA-4信号通路与膀胱尿路上皮癌的关系,综述膀胱尿路上皮癌中已经完成和正在进行的抗PD-1/PD-L1及CTLA-4治疗的临床试验,重点介绍免疫检查点抑制剂在膀胱尿路上皮癌不同阶段中的使用和最佳组合策略的临床研究,以期改进免疫抑制剂在膀胱尿路上皮癌中的使用,提高临床疗效。     

全髋关节置换术联合生物制剂治疗髋骨关节炎的效果及对S100A12、基质金属蛋白酶-13 水平的影响

Objective To observe the therapeutic effect of biological agents in the treatment of hip osteoarthritis patients undergoing total hip arthroplasty (THA). Methods A total of 128 patients with HOA who were admitted into our hospital from June 2016 to December 2017 were randomly divided into observation group and control group. All patients were given THA combined with routine treatment. The observation group was given additional biologics. The pain score, Harris score, serum CRP, IL-18, S100A12 and MMP-13 levels were observed before and after treatment. The imaging K-L classification and adverse reactions were evaluated before and after treatment. Results There was no significant difference in blood volume, operation time or postoperative drainage volume between the two groups (P?>?0.05). Pain score decreased while the Harris score increased significantly after 12 weeks of treatment when compared with those prior to any treatments (P?相似文献