萱草花对抑郁模型大鼠行为学及学习记忆的影响

Objective To observe the effects of the extract from daylily on the learning and memory in depression model rats, and to explore its possible mechanism. Methods Rats were randomly divided into control group, model group ( CUMS), the positive group (CUMS + fluoxetine) , high, medium and low dose group (stress + daylily extract in different doses), 12 rats in each group. The depression model was established by combining separation and chronic unpredictable stress. Body mass, open-field-test and sugar consumption experiment were used to evaluate the changes of behaviors in rats. And morris water Maze test was used to evaluate the ability of learning and memory. Results There was no statistically distinction between the rats of each group on weight and the behavioral indicator before modeling. Compared with the control group, the vertical movement,horizontal movement of open box test in the model group were reduced (P＜0.05 ) ,and sugar consumption and preference degree decreased (P<0.05 ).The target quadrant time, platform resident time, effective area residence time and crossing platform times in the water maze test of the model group was less than those of the control group. The daylily effect was evaluated at 0, 7, 14, 21, 28, 35, 42 days respectively post treatment. There were significant differences in depression behaviors between model group and daylily group(P＜0.05). And each indicator in the water maze test of the daylily group (high, medium dose) was more than that of model group (P ＜ 0. 05). Control group, model group, positive group, high, medium and low dose group, vertical movement scores were (41.83 ± 17.63; 8.14 ±4.23; 12.73 ±7.21; 23.17 ± 18.75; 8.38 ±3.46; 13.50 ±5.44); horizontal movement scores were (69.92 ±34.04; 28.33 ±20.36; 62.25 ± 15.72; 69.42 ±35.17 ; 49.08 ±32.85; 48.08 ±21.19). Conclusion Daylily may be partially work on the depression of rats, with some antidepressant effect, meantime,daylily can improve the ability of learning and memorizing of the depressed rats.     

中国胆道结石双频双脉冲激光碎石专家建议

胆道结石是消化系统常见疾病,目前主要治疗手段有外科手术、内镜下介入治疗等,但部分困难结石临床上仍面临挑战。双频双脉冲激光碎石术因其安全、高效等特点,是解决困难结石的有效方法。双频双脉冲掺钕钇铝石榴石激光是目前被国家药品监督管理局批准的可用于胆道结石碎石的激光技术,但其适应证、导入方式和操作规范等问题尚未形成共识。为此,国家消化系统疾病临床医学研究中心(上海)、中国医师协会内镜医师分会和中华医学会消化内镜学分会特邀国内消化、内镜与外科等相关领域专家,在参考国内外文献的基础上,经过充分讨论形成本专家建议,以期为国内规范开展胆道结石激光碎石提供指导和参考。     

祝味菊名医类案回忆录

<正> 祝味菊为上海名医,原籍浙江绍兴,随父迁居重庆。幼年学习岐黄,少年涉猎西医,衷中参西,学有专长,壮年至沪悬壶问世,善治疑难杂症,遐尔闻名。先生对中医学有独特之见解,宗于《内经》:“阳气者若天与日,失其所则折寿而不彰。”,“邪之所凑,其气必虚。”之说,以保持阳气为要务,是以在处方中尝用附子。     

不同pH值纳米羟基磷灰石复合根充糊剂的体外抑菌性

背景：目前临床应用的根管充填糊剂抗菌作用有限,存在组织刺激性强、成形困难、根管封闭性较差及易降解等缺点。 目的：比较不同pH值纳米羟基磷灰石复合根充糊剂对感染根管常见菌的体外抑菌作用。 方法：建立体外根管粪肠球菌、白色念球菌感染模型,评价pH 8纳米羟基磷灰石糊剂、pH 9纳米羟基磷灰石糊剂、pH 10纳米羟基磷灰石糊剂在离体牙根管内的抗菌作用,并以氧化锌丁香油做对照。 结果与结论：所有根充糊剂均具有抑菌作用。各pH值纳米羟基磷灰石糊剂对粪肠球菌抑制作用实验组优于氧化锌丁香油组(P < 0.05),不同pH值纳米羟基磷灰石组组间比较差异无显著性意义(P > 0.05)。而对白色念珠菌抑制作用各pH值纳米羟基磷灰石组不及氧化锌丁香油组(P < 0.05),各pH值纳米羟基磷灰石组组间比较,pH10纳米羟基磷灰石组>pH 9纳米羟基磷灰石组>pH 8纳米羟基磷灰石组(P < 0.05)。结果表明,感染根管模型中,纳米羟基磷灰石根充糊剂对粪肠球菌的抑制作用好于氧化锌丁香油(P < 0.05),而对白色念珠菌的抑制作用不及氧化锌丁香油(P < 0.05)。pH=10纳米羟基磷灰石复合根充糊剂的抑菌作用最佳。     

闭合复位经皮穿针内固定治疗Bennett骨折

目的:探讨闭合复位经皮穿针内固定治疗Bennett骨折的临床疗效和安全性。方法:采用闭合复位经皮穿针内固定治疗Bennett骨折患者56例,男46例,女10例;年龄17~63岁,中位数30岁;左侧20例,右侧36例;均为新鲜闭合性骨折。术后随访观察骨折愈合、患肢功能恢复及并发症发生情况。结果:本组56例患者均获随访,随访时间6~12个月,中位数9个月;骨折均愈合,愈合时间5~7周,中位数6周。拇指功能恢复,第一腕掌关节活动改善。参照Kriegs-Au等疗效评定标准评定疗效,本组优48例、良5例、可3例。均无克氏针松动、断针、针孔感染等并发症发生。结论:闭合复位经皮穿针内固定治疗Bennett骨折,固定可靠、有利于骨折愈合和手部功能的恢复,且操作简单、并发症少。     

0.1％他克莫司软膏治疗成人激素依赖性皮炎的Meta分析

目的 评价外用0.1％他克莫司软膏治疗激素依赖性皮炎(CDD)的疗效和安全性.方法 计算机检索重庆维普数据库(1976-2011年)、中国知网(1999-2010年)、万方数据库(1999-2011年)关于他克莫司软膏治疗CDD的病例对照研究.采用Cochrane协作网提供的RevMan 5.1进行Meta分析.结果 共纳入7篇随机对照试验,690例CDD患者,其中实验组351例,对照组339例.分析显示0.1％他克莫司软膏治疗CDD的疗效优于对照组(P＜0.05),疗程2周、4周和2个月的OR值(95％CI)分别为4.83(2.70,8.64)、3.44(1.25,9.52)和5.25(2.33,11.85)(P＞ 0.05).患者不良反应轻微,主要为可耐受的灼热和瘙痒.结论 0.1％他克莫司软膏治疗CDD安全有效,疗程短,不良反应小.     

萱草花对抑郁模型大鼠行为学及学习记忆的影响

目的 观察萱草花提取物对抑郁模型大鼠行为学及学习记忆能力的影响,评价萱草花的抗抑郁作用及其对学习记忆的干预作用.方法 将大鼠按抽签法随机分为对照组、模型组(应激)、阳性组(应激+盐酸氟西汀),高、中、低剂量组(应激+不同剂量萱草花提取物),每组均12只;应用孤养结合慢性不可预见性应激(CUMS)复制抑郁症模型;采用体质量测定、敞箱实验、糖水消耗实验对照研究各组大鼠行为学的改变;应用Morris水迷宫对照研究大鼠的学习记忆能力.结果 与正常组比较,造模组大鼠体质量、敞箱实验的垂直运动、水平运动均减少(P＜0.01或P＜0.05),糖水消耗量及糖水偏好度降低(P＜0.01),各造模组之间比较无统计学差异(P＞0.05);经治疗后高、中、低剂量组,阳性组大鼠的抑郁样行为较模型组均有不同程度的改善(P＜0.01或P＜0.05),但体质量无明显改善(P＞0.05),垂直运动得分分别为[(41.83±17.63)分;(8.14±4.23)分;(12.73±7.21)分;(23.17±18.75)分;(8.38±3.46)分;(13.50±5.44)分];水平运动得分分别为[(69.92±34.04)分;(28.33±20.36)分;(62.25±15.72)分;(69.42±35.17)分;(49.08±32.85)分;(48.08±21.19)分];水迷宫实验中模型组大鼠目标象限时间,平台停留时间,有效区域停留时间,经过平台次数均少于正常组(P＜0.05或P＜0.01),阳性组及高中剂量组目标象限时间,平台停留时间,有效区域停留时间,经过平台次数均多于模型组(或P＜0.01).结论 萱草花可以部分改善抑郁大鼠的抑郁样行为,具有一定抗抑郁作用,同时萱草花能提高抑郁大鼠的空间学习记忆能力,且与给药剂量有一定关系.

Abstract：

Objective To observe the effects of the extract from daylily on the learning and memory in depression model rats, and to explore its possible mechanism. Methods Rats were randomly divided into control group, model group ( CUMS), the positive group (CUMS + fluoxetine) , high, medium and low dose group (stress + daylily extract in different doses), 12 rats in each group. The depression model was established by combining separation and chronic unpredictable stress. Body mass, open-field-test and sugar consumption experiment were used to evaluate the changes of behaviors in rats. And morris water Maze test was used to evaluate the ability of learning and memory. Results There was no statistically distinction between the rats of each group on weight and the behavioral indicator before modeling. Compared with the control group, the vertical movement,horizontal movement of open box test in the model group were reduced (P＜0.05 ) ,and sugar consumption and preference degree decreased (P<0.05 ).The target quadrant time, platform resident time, effective area residence time and crossing platform times in the water maze test of the model group was less than those of the control group. The daylily effect was evaluated at 0, 7, 14, 21, 28, 35, 42 days respectively post treatment. There were significant differences in depression behaviors between model group and daylily group(P＜0.05). And each indicator in the water maze test of the daylily group (high, medium dose) was more than that of model group (P ＜ 0. 05). Control group, model group, positive group, high, medium and low dose group, vertical movement scores were (41.83 ± 17.63; 8.14 ±4.23; 12.73 ±7.21; 23.17 ± 18.75; 8.38 ±3.46; 13.50 ±5.44); horizontal movement scores were (69.92 ±34.04; 28.33 ±20.36; 62.25 ± 15.72; 69.42 ±35.17 ; 49.08 ±32.85; 48.08 ±21.19). Conclusion Daylily may be partially work on the depression of rats, with some antidepressant effect, meantime,daylily can improve the ability of learning and memorizing of the depressed rats.     

旋股外侧动脉降支多叶组织瓣修复手部多部位软组织缺损

目的 探讨旋股外侧动脉降支多叶瓣修复手部多部位软组织缺损的手术方法和临床效果。方法对手部多部位软组织缺损15例,采用旋股外侧动脉降支多叶瓣修复,根据手部缺损情况设计股前外侧皮瓣,沿皮瓣穿支血管向远端继续解剖旋股外侧动脉降支,考虑好手部各缺损处间距,按需切取分叶穿支皮瓣、阔筋膜瓣、股直肌肌瓣、股外侧肌肌瓣、股中间肌肌瓣或旋股外侧动脉降支远端肌间隔瓣。形成以旋股外侧动脉降支为主干的一蒂多叶瓣,在肌瓣及阔筋膜瓣上植皮,一次修复手部多部位软组织缺损。 结果 术后无血管危象发生。修复各创面在肌瓣、阔筋膜瓣或旋股外侧动脉降支远端血管肌间隔上植皮均成活良好,外形无臃肿,植皮处恢复保护性感觉,供区创面愈合好,股四头肌肌力及膝关节屈、伸活动均正常。全部病例获得随访,随访时间6 ～ 20个月,平均8.7个月。按中华医学会手外科学会上肢部分功能评定标准：优3例,良9例,可3例,优良率80％。 结论 旋股外侧动脉降支多叶瓣能一次修复手部多部位软组织缺损,缩短手术时间及疗程,手部功能恢复良好,外形满意,是修复手部多部位软组织缺损的理想方法。     

海军融合演训后方医院战救能力提升

运用PDCA循环对融合训练进行改进,并对2021年5月24日至2021年5月25日内科伤收治组训练情况督导考核成绩进行比较分析.改进后,组织指挥、工作流程、救治措施、队员职责、及时报告等5个方面考核成绩均有提升,特别是工作流程、救治措施项目成绩提高显著,但在队员职责项目上成绩提升不显著,同时将各组均存在的突出问题纳入下一个PDCA循环改进.PDCA循环在提高多家单位融合演训后方医院战伤救治能力方面值得借鉴.     

脑苷肌肽联合常规方案治疗血管性痴呆的疗效和安全性系统评价

目的系统评价脑苷肌肽治疗血管性痴呆的疗效和安全性。方法计算机检索PubMed、Embase、Cochrane Library、CNKI、VIP、CBM和万方数据库,搜集有关脑苷肌肽治疗血管性痴呆的随机对照试验(RCT),按照纳入与排除标准进行文献筛选、资料提取和评价纳入研究的偏倚风险后,采用RevMan5.3统计软件进行Meta分析。结果共纳入7项RCT,481例病人。Meta分析结果显示:5项RCT表明,与胞二磷胆碱相比,脑苷肌肽可提高简易智能精神状态量表(MMSE)评分[MD=3.46,95%CI(2.81,4.10),Z=10.48,P0.001],能显著提高总有效率[RR=2.07,95%CI(1.41,3.04),Z=3.71,P0.001],能显著降低ADL评分[MD=-4.77,95%CI(-6.48,-3.06),Z=5.46,P0.001];7项研究总MMSE得分,与胞二磷胆碱、尼莫地平、银杏叶注射液等药物相比,脑苷肌肽可提高MMSE评分[MD=3.19,95%CI(2.62,3.76),Z=10.95,P0.001]。结论基于现有临床证据,脑苷肌肽用于治疗血管性痴呆具有有效性和安全性。