超短波及电刺激联合神经生长因子治疗大鼠坐骨神经损伤的疗效观察

目的 观察超短波及电刺激联合神经生长因子(NGF)治疗大鼠坐骨神经损伤的疗效.方法 共选取成年雌性Wistar大鼠60只,将其随机分为正常对照组、模型组、NGF组、物理因子组及联合治疗组.将模型组、NGF组、物理因子组及联合治疗组大鼠制成坐骨神经损伤模型.于术后次日开始,NGF组局部给予NGF注射治疗,物理因子组给予超短波及电刺激治疗,联合治疗组则在NGF注射基础上给予超短波及电刺激治疗.于术后次日及术后7,14,30 d时观察各组大鼠坐骨神经恢复情况,同时检测各组大鼠坐骨神经功能指数(SFI)及神经传导速度(NCV).结果 术后发现NGF组、物理因子组及联合治疗组坐骨神经SFI、NCV及神经再生情况均明显优于模型组,并且以联合治疗组的改善幅度尤为显著;在术后30 d时,该组大鼠SFI、NCV及受损神经轴突、髓鞘分布情况均与正常对照组一致,组间差异无统计学意义(P＞0.05);而NGF组、物理因子组上述指标改善均不及联合治疗组及正常对照组(P＜0.05).结论 在NGF注射基础上辅以超短波及电刺激治疗,能进一步促进大鼠坐骨神经损伤后的再生及功能恢复.

Abstract：

Objective To investigate the effects of ultrashortwave (USW) diathermy and electrical stimulation (ES) used in combination with nerve growth factor (NGF) in the treatment of experimental sciatic nerve injury.Methods Sixty adult Wistar rats were randomly divided into a normal control group, a model group, an NGF group,a physiotherapy group and a combined treatment group. A model of sciatic nerve injury was established in the latter four groups. Beginning on the 2nd day after the operation, no treatment was given in the model group, NGF was injected in the NGF group, diathermy and ES were administrated to rats in the physiotherapy group, and the combined treatment group was treated with USW diathermy, EW and NGF. Function, electrophysiology and morphology were evaluated at the 2nd, 7th, 14th and 30th days after the operation Results The average sciatic nerve function index (SFI), nerve conduction velocity (NCV) and nerve regeneration in the NGF, physiotherapy and combined treatment groups were significantly better than in the model group, with those in the combined treatment group improved to the greatest extent. At the 30th day there was no significant difference between the combined treatment group and the normal control group in terms of SFI, NCV, axon regeneration or myelin sheath thickness. The number of myelinated nerve fibers and the average axon diameter in the combined treatment group and normal control group were significantly higher than those in the model, NGF or physiotherapy group. Conclusions With NGF injection, additional application of USW diathermy and ES may significantly enhance the regeneration of the sciatic nerve and aid functional recovery after injury.     

医院感染管理专职人员工作定位探讨

[目的]探讨医院感染管理专职人员的工作定位。[方法]对医院感染专职人员应具备的素质、能力和工作方法进行分析。[结果]明确了医院感染管理专职人员在医院感染预防和控制中的作用和地位。[结论]医院感染管理专职人员的素质和工作方法是搞好医院感染管理工作的前提。     

CpG-ODN联合HBsAg对慢性乙型肝炎患者外周血树突状细胞表型和功能的影响

目的　研究含非甲基化CpG基序的免疫刺激寡核苷酸 (CpG- ODN)与重组HBsAg对慢性乙型肝炎患者 (CHB)外周血树突状细胞 (dendriticcell ,DC)表型和功能的影响。方法　以重组人GM CSF、IL 4自CHB患者和健康者外周血单个核细胞诱导扩增DC ;以CpG ODN和HBsAg单独或联合刺激DC ,并与TNF α比较 ,评价其对DC表达表面分子HLA DR、CD86、CD1a ,分泌IL 12p70以及刺激同种T细胞增殖能力的影响 ;同时检测血浆TGF- β、IFN- γ含量。 结果　与PBS组比 ,CpG- ODN单用或联合HBsAg均能明显提高CHB患者DC表面分子HLA DR的表达 ,使IL- 12分泌增加 ,刺激同种T细胞增殖的能力亦增强 ,CpG ODN联合HBsAg尚能明显提高CD1a的表达 ;CpG- ODN的上述刺激作用类似于TNF α ;CHB患者血浆TGF- β、IFN -γ含量明显高于正常对照。 结论　CpG -ODN与TNF α一样能够促进CHB患者外周血DC分化和成熟 ;CpG- ODN与HBsAg联合刺激能协同增强DC的特异性抗原递呈作用 ;CHB患者的细胞因子环境可能是DC功能沉默的重要原因。     

病毒学因素对ALT持续正常的e抗原阴性慢性乙型肝炎病毒感染者肝脏组织学改变的影响

Objective To investigate the correlation between viral factors and liver histological changes of HBeAg-negative chronic hepatitis B patients with persistently normal serum ALT levels (PNAL). Methods HBV DNA level, HBV genotype, basal core promoter (BCP) and precore mutation were exam- ined in 52 HBeAg-negative chronic hepatitis B patients with PNAL (defined as normal ALT measured on at least 3 occasions in the intervals of about two months over a period of 12 months or more prior to the biopsy). Viral factors influencing histological changes of HBeAg-negative chronic hepatitis B patients with per-Results Subjects with both BCP and precore mutations had significantly higher HBV DNA levels than those without mutations [(4.9±1.4) vs (4.1±1.1) log10copies/ml, t = 2.308, P < 0.05]. A higher proportion of patients with histological activity index (HA1)≥ 4 was found in patients with both mutations (32.1% vs 16.7%) than in patients without mutation, however, the proportion of patients with histological activity index (HAl)≥ 3 in patients with mutations was not significantly different from that in patients without mutations (14.3% vs. 12.5%, χ2 = 0.000, P > 0.05). In patients without precore or BCP mutations, there was a strong positive correlation between viral load and liver inflammation as well as fibrosis (precore: r = 0.626, 0.592, P < 0.01; BCP: r = 0.730, 0.641, P < 0.01). In patients without both mutations, HBV DNA has shown a high accuracy for predecting fibrosis (F≥3) (AUC = 0.905, 95% CI: 0.771±1.039, P < 0.05) with the cutoff value of 4.5 log10copies/ml (sensitivity = 1.000, specificity = 0.778, PPV = 42.9%, NPV = 100.0%). Results of both genotypes and mutations were successfully obtained in 40 samples with HBV DNA≥ 104 copies/ml. The higher viral load was observed in the patients with genotype B than genotype C (5.1 vs 4.3 Iog,0copies/ml, t = 2.059, P < 0.05), but no difference was seen of liver pathologic changes between these two genotypes. Conclusions Virus harboring both BCP and precore mutants has the higher replication level than wild type virus. 32.1% and 14.3% of the patients with both mutations have moderate or severe inflammation and fibrosis. There was a strong positive correlation between viral load and liver histological changes in patients without precore or BCP mutations, and viral load shows a high accuracy for predecting sig-nificant fibrosis (F ≥ 3).     

马齿苋对化学性肝损伤的保护作用

马齿苋（Portulaca OleraceaL）为马齿苋科（Portulacaceae）一年生肉质草本植物,是我国古老的食药兼用植物,在我国大部分地区均有分布,主要以野生为主,资源极为丰富,具有很高的食用价值和医药保健价值,在我国民间享有“长命苋”、“长寿菜”之美誉,近年来马齿苋用于软化血管、降低血脂血压、调治糖尿病、治疗老年性冠心病及动脉硬化等,收到很好效果。     

先天性甲状腺功能减低症患儿的智能发育探讨

目的:了解佛山市先天性甲状腺功能低下患儿经治疗后的智能发育状况。方法:对2000年6月～2006年6月88例经新生儿筛查确诊的先天性甲低患儿和同期专科门诊诊治的5例甲低患儿进行智能发育测试。结果:经早期正规治疗,仍有21.6%患儿智能发育偏低,4.5%患儿出现智能发育低下。治疗月龄在1月和2月内患儿智能发育无差异,治疗月龄在3月后智能发育与前两者具有显著性差异,总发育商各能区中大运动较其它能区发育好。结论:为甲低患儿提供早期综合治疗和干预对促进甲低患儿脑功能恢复,降低智力低下的发生,减轻社会和家庭的经济负担及精神负担,提高本地区人口素质具有重要意义。     

一起导致脏器损害的食品中毒毒蕈动物急性毒性研究

脏器损害型毒蘑菇属剧毒毒蕈,是导致严重人体健康危害的植物性食物中毒的主要因素之一,人体食用毒蕈后主要引起肝损伤,重者肝坏死、肝衰竭,转氨酶等提示肝脏损伤的特征性生化指标呈现的增高改变,病情凶险,死亡率高。     

线粒体基因组np16181～16193区基因变异与2型糖尿病的关联研究

目的 探讨线粒体基因组np16181～16193区基因变异与2型糖尿病(type 2 diabetes mellitus,T2DM)之间的关联.方法 随机收集199例浙江地区2型糖尿病患者和205名正常对照,采用聚合酶链反应、基因直接测序检测该区域基因,同时分析变异与2型糖尿病及主要临床指标间的关联.结果 发现np16181～16193区域为高度变异区,存在多种变异形式,考虑为基因多态性位点;在该区域发现有4种变异碱基排列形式仅存在于T2DM中;在np16181～16193区域中变异组餐后1 h血糖明显高于未变异组(P<0.05),而其余各生化指标差异无统计学意义(P>0.05).结论 线粒体基因组np16181～16193区域引起的变异尚不能视为2型糖尿病的易感因素.     

牵引结合微波治疗神经根型颈椎病

目的:观察牵引结合微波治疗神经根型颈椎病的临床疗效。方法:188例神经根型颈椎病患者分为3组,牵引组60例采用单纯颈椎牵引治疗;微波组60例采用单纯微波颈部辐射治疗;综合组68例2种方法联合治疗。采用数字疼痛评分(NRS)、颈部残障指数(NDI)、中医病症诊断疗效标准评定治疗前后效果。结果:治疗20d后,NRS及NDI评分3组均较治疗前明显下降,且综合组低于其它2组(均P0.05);牵引组NDI评分低于微波组。3组临床疗效比较,治愈率及总有效率综合组牵引组微波组(均P0.05)。结论:牵引结合微波治疗能明显提高神经根型颈椎病患者的临床疗效,且安全无不良反应。     

小麦纤维素颗粒治疗妊娠期便秘的临床疗效观察

<正>妊娠期便秘是妊娠期常见症状之一,在妊娠期发生率为11%～13%[1],不仅影响患者的生活质量,诱发或加重痔疮,严重时诱发宫缩、甚至导致早产。小麦纤维素颗粒(非比麸)为纯天然小麦制剂,可用于治疗妊娠期便秘。为观察小麦纤