复方丹参片对颈动脉粥样硬化兔PPAR-γ/LXR-α/ABCA1信号通路的影响

目的：通过动物实验阐明复方丹参片对颈动脉粥样硬化兔PPAR-γ/LXR-α/ABCA1信号通路的影响。方法：高脂饲料加空气干燥法建立兔颈动脉粥样硬化模型,并用100mg/kg和100mg/kg剂量的复方丹参片进行治疗后,经耳缘静脉抽血后空气栓塞处死兔,迅速剥离颈动脉,并检测各组动物血脂含量、颈动脉病理学变化及兔颈动脉中PPAR-γ、LXR-α及ABCA1的表达。结果：复方丹参片能显著降低兔血清总胆固醇、三酰甘油、低密度脂蛋白(P<0.01);并能抑制内膜增生,减少脂质沉积,增加PPAR-γ、LXR-α及ABCA1 mRNA及蛋白质的表达(P<0.01)。结论：复方丹参片可能通过激活PPAR-γ/LXR-α/ABCA1信号通路而发挥抗动脉粥样硬化作用。     

灸法治疗肩周炎的临床应用概况

通过对近10年来灸法治疗肩周炎的文献加以回顾性综述,旨在总结灸法治疗肩周炎的临床概况,从而更好的指导临床,同时也为今后灸法治疗肩周炎的临床研究指明方向。     

基于分子对接的车前草抗炎机制研究

目的:优选车前草具抗炎作用的化学成分。方法:以计算机辅助药物设计(CADD)中的分子对接技术为研究方法,以多个具有明确晶体结构的环氧化酶复合物为靶点,对车前草所含34种化合物进行联合筛选研究。结果:车前草中多个化合物与靶点有互补作用,其中桃叶珊瑚苷、京尼平甙酸、梓醇等互补性较强的化合物与文献报道的实验活性值相一致,提示很可能是车前草最主要的抗炎物质。结论:将分子对接结合多靶点研究技术应用于车前草具抗炎作用化合物寻找中是可行的,同时也给中药复方的多作用靶点研究提供新的参考。     

艾灸背俞穴为主治疗慢性失眠的随机对照研究

目的:观察艾灸背俞穴为主治疗慢性失眠症的临床疗效。方法:将120名慢性失眠患者随机分为两组,分别采用针灸疗法、西药进行治疗,评价治疗前后和随访期间两组患者匹兹堡睡眠量表积分及每周失眠天数变化。结果:针灸组和西药组患者治疗前后PSQI各成分积分及PSQI总分比较均有显著性差异(P<0.05);针灸组与西药组在改善患者睡眠质量上无明显差异,但在入睡时间与日间功能紊乱评分在治疗后与随访期均有显著性差异(P<0.05)。结论:针灸治疗和舒乐安定口服均可明显改善患者的失眠情况;艾灸背俞穴为主的针灸疗法优势主要体现在改善患者的入睡时间及改善患者日间功能紊乱方面,且安全性更高,不良反应更少,适于临床推广使用。     

Thread embedding acupuncture for herniated intervertebral disc of the lumbar spine: A multicenter,randomized, patient-assessor-blinded,controlled, parallel,clinical trial

Backgroundand purpose: Although several studies have reported that thread embedding acupuncture (TEA) is effective for lumbar herniated intervertebral disc (LHIVD), the evidence remains limited because previous studies had a high risk of bias. This study aimed to investigate the efficacy and safety of TEA for LHIVD through a rigorously designed trial.Materials and methodsThis was a randomized, patient-assessor-blinded, sham-controlled trial. Participants were screened according to eligibility criteria, and 70 patients with LHIVD were randomly allocated to the TEA and sham TEA (STEA) groups in a 1:1 ratio. Both groups received TEA or STEA treatment at 23 acupoints once per week for eight weeks. Changes in low back pain, radiating pain, Oswestry disability index, Roland–Morris disability questionnaire, EuroQol 5–Dimensions 5–Levels, and global perceived effect were measured at baseline and at 4, 8, 12, and 16 weeks after screening and compared between the two groups.ResultsTEA showed no significant difference in all outcomes compared to STEA immediately after eight weeks of treatment. After an additional eight weeks of follow-up, TEA showed a more significant effect on the low back pain than STEA (p < 0.05) and showed a better tendency in maintaining or enhancing the improvement of radiating pain, function, and quality of life even after the end of treatment. No serious adverse events were observed.ConclusionTEA is effective in improving low back pain in patients with LHIVD and may help improve function and quality of life, especially in the long term.     

Effects of dry needling plus exercise therapy on post-stroke spasticity and motor function: A case report

Background and purposeThe use of dry needling (DN) with other treatments may be more beneficial in managing post-stroke spasticity. We report the effects of DN plus exercise therapy (ET) on wrist flexor spasticity.Patient presentationThe patient was a 45-year-old man with an 8-year history of stroke. The outcome measures included the Modified Modified Ashworth Scale (MMAS), H_max/M_max ratio, H-reflex latency, Action Research Arm Test (ARAT), Fugl-Meyer Assessment (FMA), and range of motion (ROM) which were assessed before (T1), after (T2), and after 3-week follow-up (T3).ConclusionThe MMAS was improved at T2 from “3” to “2”. The H_max/M_max decreased from 0.77 to 0.53 at T3. The H-reflex latency increased from 15.4 ms to 18.5 ms at T3. The wrist active and passive ROM increased ∼30° and ∼20° at T2, respectively.A 4-session DN plus ET may improve spasticity and ROM. No meaningful improvement was observed in function.     

Dynesys系统结合PLIF在多节段腰椎退行性疾病的应用

目的:探讨Dynesys动态稳定系统联合腰椎后路椎间融合(PLIF)在腰椎多节段退变性疾病治疗中的临床疗效。方法:对2010年9月至2013年5月采用Dynesys动态稳定系统结合PLIF治疗的46例多节段腰椎退变性疾病患者进行回顾性分析,男17例,女29例;年龄38～68岁,平均(56.38±11.63)岁。手术节段:L₂-L₅ 16例(6例融合L_4,5,10例融合L_3,4、L_4,5);L₃-S₁ 30例(11例融合L₅S₁,19例融合L_4,5、L₅S₁).术后分别指术后3个月、术后1年和末次随访。分析内容包括:Oswestry功能障碍指数(ODI)、腰痛和腿痛的视觉模拟评分(VAS),并通过腰椎动力位X线观察节段活动度(ROM)、椎间隙高度(DHI)的变化情况。结果:术后随访时间16～48个月,平均(23.23±7.34)个月,术后3次随访腰痛、腿痛VAS 及ODI均较术前有明显降低 (p<0.01);融合节段椎间隙高度较术前明显增大(p<0.05),邻近非融合节段椎间隙高度与术前比较无明显变化(p>0.05);融合手术节段术后活动度均较术前显着减小(p<0.01),非融合的手术节段活动度均较术前减少(p<0.05).上邻近非融合手术节段活动度术前与术后3个月及术后1年比较差异无统计学意义(p>0.05),但与末次随访时比较时活动度增加(p<0.05).结论:Dynesys动态稳定系统结合PILF治疗腰椎多节段退行性疾病的近期疗效满意,可在融合、非融合中个体化选择。能够部分保留椎间活动度,预防邻近节段早期退变的发生,但长期临床疗效还需长时间临床观察。     

王绪鳌治疗消化系统恶性肿瘤举要

王绪鳌多年来从事中医肿瘤临床,尤对消化系统恶性肿瘤有独到阐发,临床积累了丰富的经验。介绍其对消化系统恶性肿瘤的临床治疗经验,并举验案一则,以体现其临证用药特色。     

针刺通过调节脑可塑性相关信号缓解脑卒中肢体痉挛状态研究进展（英文）

脑卒中发生后上运动神经元受损而产生痉挛。大脑的可塑性是神经系统受损时大脑可以被环境和经验所修饰的能力。针刺可通过提高脑可塑性而缓解脑卒中的相关病理状态,针刺可通过抑制神经递质γ-氨基丁酸、脑源性神经营养因子、突触可塑性相关蛋白,最终促成兴奋性神经递质与抑制性神经递质在体内的平衡。本文分析并总结了针刺在脑卒中肢体痉挛状态时,通过神经可塑性使神经细胞再生恢复上运动神经元对运动的相关调控进而缓解肢体痉挛状态,以及针刺调控脑可塑性相关信号的研究应用,期待为今后针刺治疗脑卒中痉挛状态的研究提供体系性研究思路。     

Underlying mechnism of electroacupuncture for treating detrusor hyperreflexia after suprasacral spinal cord injury through the PACAP-cAMP signaling pathway: 基于PACAP-cAMP信号通路研究电针治疗骶上脊髓损伤后逼尿肌反射亢进型膀胱的效应机制

ObjectiveTo elucidate the underlying mechanism and effect of electroacupuncture (EA) on the neurogenic bladder following suprasacral spinal cord injury (SSCI). A rat model of detrusor hyperreflexia after SSCI was established to examine the urodynamics, detrusor muscle tissue morphology, the protein and mRNA expression levels of pituitary adenylate cyclase activating peptide (PACAP) and its receptor PAC1R, and cyclic adenosine monophosphate (cAMP) content in the detrusor muscle with a focus on the PACAP-cAMP signaling pathway.MethodA total of 72 female SD rats were randomized into control group and sham operation group (n=12 per group) by using a random number table. The remaining 48 rats were established into the model of detrusor hyperreflexia after SSCI. After successful modeling, these rats were randomly assigned to model, EA, and EA + PACAP6-38 groups (n=12 per group). The unsuccessful modeled rats were used for exploratory observation. For the rats in EA group, “Ciliao (BL32)” “Zhongji (CV3)”, and “Sanyinjiao (SP6)” were needled and stimulated by EA. The PACAP receptor antagonist PACAP6-38 was administered intraperitoneally in the EA + PACAP6-38 group before EA, and EA was applied for seven consecutive days. After treatment, the urodynamics of the rats were analyzed, and hematoxylin and eosin staining was used to examine rat bladder detrusor tissue morphology. The expressions of PACAP-38 and PAC1R were detected by immunohistochemistry and Western blot. The mRNA expression levels of PACAP-38 and PAC1R were examined by RT-qPCR, while cAMP content was detected by ELISA.Results(1) Compared with sham operation group, it was exhibited disarray in the transitional epithelium cells of the bladder in the modeled rats. The intercellular space was significantly widened, accompanied by inflammatory cell infiltration and noticeable tissue edema. Both the bladder initial pressure and leak point pressure of the rats were higher (P < 0.01), whereas the maximum cystometric capacity and bladder compliance were lower (P < 0.01). The protein and mRNA expression levels of PACAP-38 and PAC1R in the detrusor muscle, together with the cAMP content, were lower (P < 0.05). (2) Compared with the model rats, the EA group showed reduced inflammatory response in the detrusor muscle tissue, with decreased monocyte infiltration and less severe tissue edema. The bladder smooth muscle cells exhibited increased integrity, and there was decreased cellular tissue edema, inflammatory cell infiltration, and fibroplasia. The bladder initial pressure and leak point pressure were lower (P < 0.05), while the maximum cystometric capacity and bladder compliance were higher (P < 0.01). The protein and mRNA expression levels of PACAP-38 and PAC1R in the detrusor muscle, along with the cAMP content, were higher (P < 0.05). (3) Compared to the EA group, the EA + PACAP6-38 group showed a less organized arrangement of muscle fibers in the detrusor muscle tissue, larger intercellular space, monocyte infiltration, and considerable tissue edema. The changes in bladder initial pressure and leak point pressure were not significant (P > 0.05), while the maximum cystometric capacity and bladder compliance were lower (P < 0.05). The changes in the protein and mRNA expressions of PACAP-38 within the detrusor muscle were not significant (P > 0.05), whereas the protein and mRNA expressions of PAC1R were reduced (P < 0.05), and the cAMP content within the detrusor muscle was lower (P < 0.05).ConclusionEA can ameliorate the uninhibited contractile condition of the detrusor muscle in the bladder following SSCI. By mediating the PACAP-cAMP signaling pathway, it reduces the pathological damage to the detrusor muscle, thereby improving bladder function.