夏季伏天中药穴位贴敷治疗过敏性鼻炎随机平行对照研究

[目的]观察夏季伏天中药穴位贴敷治疗过敏性鼻炎疗效。[方法]使用随机平行对照方法,将118例门诊患者按就诊顺序编号分为两组,对照组60例针刺治疗(风池、迎香、印堂、肺腧、大椎、风门),0.25mm×40mm毫针针刺,平补平泻法,得气后留针30min,每10min行针1次。在初伏起1次/d,连续治疗7次休息3d为1个治疗周期,连续治疗3周期为1疗程。治疗组58例中药穴位贴敷(甘遂、细辛、白芷各50g,延胡索、白芥子各100g,共研细末,过100目筛,加姜汁调成药膏状)。初伏取百劳、肺腧、膏肓腧;中伏取大椎、风门、脾腧;末伏取大杼、肺腧、肾腧。暴露腧穴,常规消毒后用梅花针重叩至红晕或微出血。取药膏3g,贴敷于所选穴位,以无菌纱布覆盖,胶布固定。每次贴药5h左右,局部有红肿、起泡或烧灼感者可在4h后去掉,轻者不予处理,水泡大并有糜烂者可用百多邦膏外涂。贴药时间:初、中、末伏后3天贴敷1次/d,3伏贴敷完成为1个疗程。观测临床症状、治疗前后记分。随访1年。[结果]随访30d临床疗效对照组优于治疗组(P<0.05),随访1年临床疗效治疗组优于对照组(P<0.05)。[结论]伏天中药贴敷治疗过敏性鼻炎近期疗效逊于针刺,远期疗效优于针刺。     

浅谈“春夏养阳，秋冬养阴”在中医养生方面的应用

"春夏养阳,秋冬养阴"首出于《素问·四气调神大论》,为顺应四时阴阳之气变动而采取的养生方法。基于现代社会普遍存在的"春夏不知养阳,秋冬不知养阴"的情况,结合对中医经典古籍的初步领悟和传统养生方法的切身体会,阐述"春夏养阳,秋冬养阴"的机理及其在中医临床方面的应用。     

“冬病夏治”治疗慢性肺系疾病临床观察

目的探讨＂冬病夏治＂治疗慢性肺系疾病的临床疗效。方法将66例慢性肺系疾病（慢性支气管炎、慢性阻塞性肺疾病及支气管哮喘）患者随机分为治疗组（34例）与对照组（32例）;治疗组每年于6～9月予中药穴位敷贴结合穴位注射,对照组仅在发作时予对症处理。观察临床疗效及St.George’s呼吸疾病问卷评分情况。结果治疗组第1年、第2年临床总有效率分别为70.6%、91.2%,对照组分别为46.9%、43.8%;治疗组第2年临床疗效优于对照组（P〈0.01）。与本组治疗前比较,治疗组第1年、第2年St.George’s呼吸疾病问卷评分差异有统计学意义（P〈0.01）,对照组差异无统计学意义（P〉0.05）;组间同期比较,差异均有统计学意义（P〈0.01）。结论 ＂伏天＂运用穴位敷贴和穴位注射可有效减少慢性肺系疾病患者的急性发作次数,减轻发作程度,改善临床症状,提高患者生活质量。     

Three-dimensional reconstruction studies and morphometric analysis of rudimental tooth primordia in the upper incisor region of the sheep (Ovis aries,Ruminantia)

The functional dentition of the domestic sheep lacks all upper incisors and the upper canines. Nevertheless, occurrence of a dental lamina and rudimental tooth primordia had been described in the upper incisor region of the sheep. The aim of this study was to describe temporo-spatial pattern of origin and regression of these rudimental tooth primordia by light microscopy, computer-aided three-dimensional reconstruction and morphometry of the dental epithelium. Transient existence of a dental lamina in the upper incisor region of the sheep and three epithelial thickenings on its deep mesenchymal margin has been observed at day of ontogeny (DO) 48-53. They could not been identified as full-value tooth primordia, because they did not induce differentiation of tooth mesenchyme, but they could represent last remnants of functional upper incisors in early ancestors of ruminants. Additionally, a large rudimental upper canine primordium near the sutura maxilloincisiva occurred at DO43, reached early cap stage at DO52 and started to regress at DO53. Thus, our findings showed a discrepancy between the embryonic and adult dental pattern in the sheep. Similar molecular mechanisms as described for diastemal tooth rudiments in rodents could be involved during regression of rudimental tooth primordia in the upper incisor region of the sheep.     

探“春夏养阳,秋冬养阴”

"春夏养阳,秋冬养阴"的目的是"阴平阳秘,精神乃至",故应该因时、因地、因人正确理解"春夏养阳,秋冬养阴"的内涵,不应该过分偏执。在正常生理情况下,"春夏养阳,秋冬养阴"是中医"治未病"思想的主要体现,强调的是人体与自然有着十分密切的联系,应根据自身体质以及时令特点、地域差别在起居、运动、饮食以及情志上进行调整以顺应自然阴阳的变化。如对于盛夏炎热之地,可适量食用甘寒之物以生津,防止热盛津伤,对于严冬苦寒之地,可适量进食温补之物以助阳气,防止阴寒内盛。而在病理情况下应首先辨别机体阴阳气血之盛衰,再结合时令、地域、体质,用药物来纠正人体气血阴阳之偏盛偏衰。即"不足之病,顺时补之;有余之病,逆时泻之"。     

Compositae dermatitis in a Danish dermatology department in 1 year

During our first year of routine testing with Compositae allergens and extracts, contact allergy to Compositae was frequently found in eczema patients (4.5%), especially in middle-aged or elderly persons. Based on clinical patterns, patch test reactions and the long-term course of the disease, 4 groups of patients were recognized: (a) a small group with localized eczema: (b) another with classic Compositae dermatitis of exposed skin; (c) a 3rd group, the largest, with localized eczema that suddenly one summer turned into a widespread dermatitis: (d) a 4th group with a vesicular hand eczema and more-or-less widespread dermatitis with seasonal variation from the beginning, 65% of the patients had vesicular hand eczema at some time, partly reflecting the frequency of atopy (25%) and metal allergy (44%). 75% of the patients had contact allergy to 5 ≥1 compounds besides Compositae Thus, Compositae allergy may be primary, e.g., in young patients with occupational plant contact, or secondary to other contact allergies, perhaps as a result of increased individual susceptibility. The clinical patterns in the latter patients were most often a widespread dermatitis with summer exacerbation. The variability in the clinical picture makes routine patch testing with Compositae allergens recommendable.     

A Review of Effects of Spinal Cord Stimulation on Spectral Features in Resting-State Electroencephalography

BackgroundSpinal cord stimulation (SCS) is an effective therapy for patients with refractory chronic pain syndromes. Although studies have shown that SCS has both spinal and supraspinal effects, the current understanding of cortical effects is still limited. Neuroimaging techniques, such as magnetoencephalography (MEG) and electroencephalography (EEG), combined here as M/EEG, can reveal modulations in ongoing resting-state cortical activity. We aim to provide an overview of available literature on resting-state M/EEG in patients with chronic pain who have been treated with SCS.Materials and MethodsWe searched multiple online data bases for studies on SCS, chronic pain, and resting-state M/EEG. Primary outcome measures were changes in spectral features, combined with brain regions in which these changes occurred.ResultsWe included eight studies reporting various SCS paradigms (tonic, burst, high-dose, and high-frequency stimulation) and revealing heterogeneity in outcome parameters. We summarized changes in cortical activity in various frequency bands: theta (4–7 Hz), alpha (7–12 Hz), beta (13–30 Hz), and gamma (30–44 Hz). In multiple studies, the somatosensory cortex showed modulation of cortical activity under tonic, burst, and high-frequency stimulation. Changes in connectivity were found in the dorsal anterior cingulate cortex, dorsolateral prefrontal cortex, and parahippocampus.ConclusionsThe large heterogeneity observed in outcome measures is probably caused by the large variety in study designs, stimulation paradigms, and spectral features studied. Paresthesia-free paradigms have been compared with tonic stimulation in multiple studies. These studies suggest modulation of medial, lateral, and descending pathways for paresthesia-free stimulation, whereas tonic stimulation predominantly modulates lateral and descending pathways. Moreover, multiple studies have reported an increased alpha peak frequency, increased alpha power, and/or decreased theta power when SCS was compared with baseline, indicating modulation of thalamocortical pathways. Further studies with well-defined groups of responders and nonresponders to SCS are recommended to independently study the cortical effects of pain relief and SCS.     

穴位贴敷防治支气管哮喘不同皮肤反应对免疫球蛋白及嗜酸粒细胞的影响

目的:研究穴位贴敷防治支气管哮喘所出现的不同程度皮肤反应对血清免疫球蛋白(Ig E、Ig A、Ig M、Ig G)和嗜酸粒细胞(EOS)的影响。方法:对支气管哮喘患者于三伏天穴位贴敷,每伏贴敷一次,共3次。根据穴位贴敷后皮肤反应评分情况分为A、B、C、D 4组,A组43例,B组42例,C组39例,D组40例。检测治疗前、后各组患者血清Ig E、Ig A、Ig M、Ig G水平和血EOS计数。结果:除A组外,B、C、D 3组治疗前后各种血清免疫球蛋白及血EOS均有显著性差异(P<0.05或P<0.01)。治疗后与A组比较,B组各种血清免疫球蛋白及血EOS均无显著差异(P>0.05),C组除血EOS有显著差异外(P<0.05),各种免疫球蛋白均无显著差异(P>0.05),D组血清除Ig M及血EOS有显著差异外(P<0.05),Ig E、Ig A、Ig G均无显著差异(P>0.05)。结论:冬病夏治穴位贴敷有皮肤反应比无皮肤反应更能有效调节支气管哮喘患者的免疫功能。而出现皮肤反应后,随皮肤反应增强其对免疫功能的调节仅有轻度影响。因此适度皮肤反应即可有效调节免疫功能。     

Epilepsia partialis continua in tick‐borne Russian spring‐summer encephalitis

Objectives – Epilepsia partialis continua (EPC) is characterized by localized continuous jerks, from time to time with spreading Jacksonian seizures and, more rarely, secondarily generalized tonic‐clonic seizures. EPC has numerous possible etiologies. In this paper we describe EPC in the tick‐borne Russian spring‐summer encephalitis (TBRSSE) and compare it with Rasmussen syndrome. Methods – We included patients with EPC in TBRSSE (between 2003 and 2010). The diagnosis was verified by immunology (antibodies against TBRSSE virus). The patients were followed 1–7 (mean 3.4) years. Results – We studied 10 patients (eight males, age 10–21 years) with MRI and video‐EEG. Nine developed EPC after acute TBRSSE (meningoencephalitic form), and one had a tick bite without clinical symptoms of encephalitis, but with subsequent EPC. All patients came from Ural and Siberia. The onset was at age 4–14 (mean 8.6 years). The interval from onset of TBRSSE or the tick bite to seizure onset was 1 day–4 years. We identified three phases of clinical course EPC in TBRSSE: (i) acute (meningoencephalitic/encephalitic); (ii) development of EPC; and (iii) chronic EPC. The effect of antiepileptic drugs differed according to seizure types. Conclusion – EPC caused by TBRSSE is relatively frequent in the Eastern parts of the Russian Federation but not west of the Ural. Unlike Rasmussen encephalitis, EPC with TBRSSE does not progress even in the long term. It appears as disabling but not fatal condition with a time course where three phases can be distinguished.     

Coronavirus Disease Spread during Summer Vacation,Israel, 2020

The relative increase in coronavirus disease incidence during summer 2020 in Israel was most prominent in young children. This finding contrasts with the lower increase in incidence observed in children than in adults during the school attendance period. School closure without lockdown conditions might not be independently effective at reducing spread.