中医治疗椎动脉型颈椎病研究进展

中医治疗椎动脉型颈椎病(cervical spondylosis of vertebral artery type,CSA)的主要方法有针灸治疗、中药治疗、手法治疗、综合疗法治疗等,其中针灸治疗包括电针治疗、其他针具治疗、灸法治疗;中药治疗包括中药内服治疗与中药外用治疗;手法治疗是采用不同推拿手法改善颈部肌肉紧张状态;综合疗法为电针、推拿、艾灸、中药熏蒸等相结合,为目前临床应用较多的治疗方法。目前,中医治疗CSA仍存在一些问题,比如研究样本量较小、无高质量、多中心随机对照研究,对照组设计欠科学、观察指标简单、无远期疗效观察等;大部分研究手法及中药治疗缺乏安全性、规范性探讨。因此未来临床研究本病应扩大样本量,采取多中心、随机对照模式,细化研究指标,并将安全性、规范性纳入研究范围,制定手法量学标准,为CAS的实际推广治疗本病方法提供依据。     

Experimental manipulation of avoidable feelings of uncertainty: Effects on anger and anxiety

Though anger and anxiety are related, putative explanations for this association remain unclear. Beliefs about one’s state of uncertainty may be a pathway—the belief that one’s uncertain state is unavoidable might lead to anxiety, whereas the belief that one’s uncertain state is avoidable might lead to both anxiety and anger. To test this hypothesis, participants experienced an uncertainty induction and were then assigned to the avoidable uncertainty condition (experimental group) or the unavoidable uncertainty condition (control group). State anger and anxiety were assessed at baseline, following the uncertainty induction, and following the “avoidableness” manipulation. The uncertainty induction was successful; participants reported higher levels of anxiety at post-induction compared to baseline. As expected, the experimental group reported increases in anger from post-induction to post-manipulation whereas the control group reported decreases in anger. These findings suggest that when one’s state of uncertainty is avoidable, anger is experienced alongside anxiety.     

The ALERRT® instrument: a quantitative measure of the effort required to compromise prescription opioid abuse-deterrent tablets

Background: US FDA guidance recommends measuring the degree of effort needed to manipulate abuse-deterrent (AD) opioids. The ALERRT^® instrument (PinneyAssociates; Bethesda, MD) uses visual analog scales to assess the labor, effort, and resources necessary to physically compromise AD product candidates in standardized settings. Objective: Use the ALERRT^® instrument for testing morphine abuse-deterrent, extended-release, injection-molded tablets (ADER-IMT) 60 and 100 mg and the comparators immediate-release (IR) morphine sulfate 30 mg and extended-release (ER) morphine sulfate 60 mg. Methods: Four technicians tested the products using 10 household tools. The ALERRT instrument quantified effort (all tools) and time (3 preselected tools) required for manipulation. Results: Morphine-ADER-IMT 60 and 100 mg were difficult to manipulate, as demonstrated by high scores (mean range, 71.0?99.0 and 77.0?99.5, respectively). IR and ER morphine sulfate were easy to manipulate (low scores; mean range, 2.0?14.8 and 2.3?17.5, respectively). Statistically significant mean differences between morphine-ADER-IMT and comparators’ ALERRT scores were observed. Manipulations of morphine-ADER-IMT 60 and 100 mg for 300 seconds failed to produce substantial powdering. Manipulations of IR morphine sulfate (mean range, 65.5?175.8 seconds) and ER morphine sulfate (49.3?163.0 seconds) produced substantial to complete powdering in 92% of tablets. Conclusions: Morphine-ADER-IMT was extremely difficult to manipulate versus non-AD formulations of morphine. The ALERRT system differentiated the degree of effort for manipulation of morphine-ADER-IMT and non-AD morphine formulations, indicating sensitivity of this instrument as part of Category 1 testing. By measuring the degree of effort required for manipulation, the ALERRT instrument provides an empirical assessment into the relative difficulty of manipulating opioid analgesics for abuse.     

Numbers and Letters: Exploring an Autistic Savant’s Unpractised Ability

This paper describes an individual with autism and high-level calendar calculation ability who could perform a set of unpractised letter/number association tasks. The savant’s performance was compared with that of two control participants, one a departmental secretary and the other a professor of mathematics. The facility with which the savant could master the rules governing the relationships between the series of items suggests that he possessed a flexibility of mental processing transcending his ability of calendar calculation. Furthermore, he could recalibrate previous knowledge to solve new hitherto unpractised tasks. When presented with novel problems, the savant, unlike the mathematician, made no initial errors at all on any of the presented tasks, thereby indicating his fast and spontaneous recognition of new rules and of new relationships between items. It is concluded that a cognitive style of ‘weak central coherence’ as adopted by autistic savants may protect single representations from being retained in the form of stable enduring wholes, and that such a segmentation strategy may allow for the transformation, reorganization and reconstruction of the relationship between single items of information.     

Application of Acoustic Bessel Beams for Handling of Hollow Porous Spheres

Acoustic manipulation of porous spherical shells, widely used as drug delivery carriers and magnetic resonance imaging contrast agents, is investigated analytically. The technique used for this purpose is based on the application of high-order Bessel beams as a single-beam acoustic manipulation device, by which particles lying on the axis of the beam can be pulled toward the beam source. The exerted acoustic radiation force is calculated using the standard partial-wave series method, and the wave propagation within the porous media is modeled using Biot's theory of poro-elasticity. Numerical simulations are performed for porous aluminum and silica shells of different thickness and porosity. Results indicate that manipulation of low-porosity shells is possible using Bessel beams with large conical angles, over a number of broadband frequency ranges, whereas manipulation of highly porous shells can occur over both narrowband and broadband frequency domains.     

屈髋屈膝按压法作用于骨盆的三维有限元分析

目的 应用有限元法研究仰卧位屈膝屈髋按压法对骨盆应力及骶髂关节应变分布特点的影响,讨论该手法扳动整个骶髂关节的可能性。方法 利用CT图像建立正常骨盆三维有限元模型。根据手法原理,将屈膝屈髋按压法分解为两个方向的力,将这两个力加载于三维有限元模型并进行计算分析,得到该加载下骨盆应力和骶髂关节应变的分布情况。结果 加载模拟手法后,骨盆的主要应力位于骶髂关节前下1/3处、坐骨大切迹及臀下线和臀前线的中1/3;骶髂关节的最大应变主要位于骶髂关节的后上缘、后下缘及上缘中部1/2。结论 屈膝屈髋按压法只能扳动骶髂关节的下1/3处,而不能扳动整个骶髂关节。     

Mast cell degranulation during abdominal surgery initiates postoperative ileus in mice

BACKGROUND & AIMS: Inflammation of the intestinal muscularis following manipulation during surgery plays a crucial role in the pathogenesis of postoperative ileus. Here, we evaluate the role of mast cell activation in the recruitment of infiltrates in a murine model. METHODS: Twenty-four hours after control laparotomy or intestinal manipulation, gastric emptying was determined. Mast cell degranulation was determined by measurement of mast cell protease-I in peritoneal fluid. Intestinal inflammation was assessed by determination of tissue myeloperoxidase activity and histochemical staining. RESULTS: Intestinal manipulation elicited a significant increase in mast cell protease-I levels in peritoneal fluid and resulted in recruitment of inflammatory infiltrates to the intestinal muscularis. This infiltrate was associated with a delay in gastric emptying 24 hours after surgery. Pretreatment with mast cell stabilizers ketotifen (1 mg/kg, p.o.) or doxantrazole (5 mg/kg, i.p.) prevented both manipulation-induced inflammation and gastroparesis. Reciprocally, in vivo exposure of an ileal loop to the mast cell secretagogue compound 48/80 (0.2 mg/mL for 1 minute) induced muscular inflammation and delayed gastric emptying. The manipulation-induced inflammation was dependent on the presence of mast cells because intestinal manipulation in mast cell-deficient Kit/Kitv mice did not elicit significant leukocyte recruitment. Reconstitution of Kit/Kitv mice with cultured bone marrow-derived mast cells from congenic wild types restored the manipulation-induced inflammation. CONCLUSIONS: Our results show that degranulation of connective tissue mast cells is a key event for the establishment of the intestinal infiltrate that mediates postoperative ileus following abdominal surgery.     

Ploidy manipulation and induction of alternate cleavage patterns through inhibition of centrosome duplication in the early zebrafish embryo

Results : A heat pulse at a later time point during the first cell cycle (22 mpf, HS2) results in a high (>80%) frequency of embryos exhibiting a precise one‐cell division stall during the second cell cycle, inducing whole genome duplication. Coupled with haploid production, HS2 generates viable gynogenetic diploids with yields up to 4 times higher than those achieved through standard Heat Shock. The cell cycle delay also causes blastomere cleavage pattern variations, supporting a role for cytokinesis in spindle orientation during the following cell cycle. 相似文献   

中医手法复位及小夹板外固定治疗儿童尺桡骨闭合骨折的病例报告

儿童尺桡骨双骨折是创伤骨科里常见病之一,临床对于骨折全错位治疗的方法常常是手术内固定治疗。但我院自2012年9月至2014年8月两年的时间,采用中医手法复位,小夹板外固定治疗48例,效果满意,现报告如下。