经筋刺法结合运动治疗周围性面神经炎的临床疗效观察

目的：观察经筋针刺方法结合运动疗法对周围性面神经炎的临床疗效。方法：将2014年1月至2015年1月收治的面神经炎患者60例随机分成两组,每组30人,观察组采用经筋针刺方法结合运动疗法,对照组单独采用经筋刺法治疗,比较两组患者的临床疗效和症状改善程度。结果：观察组患者治疗总有效率明显高于对照组患者(p<0.05)；按照面瘫类型分组,观察组所分3组患者治疗总有效率显著高于对照组3组患者(p<0.05)；两组患者在治前期,面神经功能评分接近(p>0.05)；在治疗中期,观察组患者评分明显低于对照组患者(p<0.05)；在治疗结束后,观察组患者评分显著低于对照组患者(p<0.01)；观察组痊愈患者治疗完成所需天数为(27.33±2.71)天,明显少于对照组组的(35±1.62)天(p＜0.01)；治疗后两组患者面部表情,眼裂闭合,鼻唇沟变浅,口角歪斜,额纹消失症状体征改善明显,而观察组改善程度明显高于对照组(p<0.05)。结论：经筋针刺法结合运动疗法对治疗周围性面神经炎具有一定临床应用价值,值得推广使用。     

小细胞肺癌患者外周血辅助性T细胞的表达情况及临床意义

目的研究小细胞肺癌(SCLC)患者外周血中辅助性T细胞1(Th1)、Th2、Th17及调节性T淋巴细胞(Treg)的表达情况,探讨其在SCLC进展中的作用。方法选择2016年1月至2018年4月本院收治的44例住院的SCLC患者(SCLC组)及24名健康者(对照组)作为研究对象。采用流式细胞法检测两组研究对象外周血中Th1、Th2、Th17及Treg细胞的表达情况,应用微量样本多指标流式蛋白定量技术(CBA)检测血清中的细胞因子IFN-γ、IL-17及IL-10的表达情况。结果SCLC组患者的外周血中Th1细胞、Th1/Th2、IFN-γ表达水平显著低于对照组,差异具有统计学意义(P<0.01)。SCLC组患者的外周血中Th2、Treg、Th17、Treg/Th17、IL-17、IL-10表达水平显著高于对照组,差异具有统计学意义(P<0.01)。结论SCLC患者外周血中Th1/Th2的降低、Treg/Th17的升高可能与SCLC的致病机理及预后密切相关,该结论将为SCLC的治疗提供新的思路。     

孕妇外周血中无细胞胎儿DNA的研究进展及应用

孕妇外周血中无细胞胎儿DNA(cffDNA)是无创性产前诊断中重要的胎儿物质的检测来源.由于孕妇血中大部分是母体DNA,而游离胎儿DNA的量非常少,仅占3％～6％.因此从孕妇血中成功分离cffDNA,对后续的无创性产前诊断有着十分重要的意义.本文分别从孕妇外周血中cffDNA的发现来源,cffDNA的结构与稳定性,分离孕妇外周血中的cffDNA的实验方法,及在无创性产前诊断中的应用等方面进行介绍,并着重对该技术近年来的研究进展作一综述.旨在探寻较高效率分离孕妇外周血中cffDNA的实验方法,为无创性产前诊断提供较高浓度的检测物质,提高其准确率及成功率.     

Dorsal Root Ganglion Stimulation for the Management of Intractable Painful Polyneuropathy: A Prospective Pilot Study

Objectives: Dorsal root ganglion stimulation (DRGS) is a promising neurostimulation modality in the treatment of painful polyneuropathy. The aim of this prospective pilot study was to investigate the effect of DRGS on pain intensity in patients with intractable painful polyneuropathy.Materials and Methods: Nine patients with chronic, intractable painful polyneuropathy in the lower limbs were recruited. In each subject, between two and four DRGS leads were placed at the level of the L5 and S1 dorsal root ganglion. If trial stimulation was successful, a definitive implantable pulse generator (IPG) was implanted. Pain intensity was scored using an 11-point numeric rating scale (NRS) and reported as median and interquartile range (IQR), and compared to baseline values using the Wilcoxon signed-rank test. Additionally, patients’ global impression of change (PGIC), pain extent, presence of neuropathic pain, physical functioning, quality of life, and mood were assessed.Results: Eight out of nine patients had a successful trial phase, of which seven received an IPG. Daytime pain decreased from a median (IQR) NRS score of 7.0 (5.9–8.3) to 2.0 (1.0–3.5) and 3.0 (1.6–4.9) in the first week and at six months after implantation, respectively. Similar effects were observed for night time and peak pain scores.Conclusions: The results of this study suggest that DRGS significantly reduces both pain intensity and PGIC in patients with intractable painful polyneuropathy in the lower extremities. Large-scale clinical trials are needed to prove the efficacy of DRGS in intractable painful polyneuropathy.