Combination Treatment with Gua Sha and Blood-letting Causes Attenuation of Systemic Inflammation, Activated Coagulation, Tissue Ischemia and Injury during Heatstroke in Rats

Objective:Gua Sha and Blood-letting at the acupoints were Chinese traditional therapies for heatstroke.The purpose of present study was to assess the therapeutic effect of Gua Sha on the DU Meddian and Bladder Meridian combined with Blood-letting acupoints at Shixuan(EX-UE 11)and Weizhong(BL 40)on heatstroke.Methods:Anesthetized rats,immediately after the onset of heatstroke,were divided into four major groups:Gua Sha group,Blood-letting group,Gua Sha combined with Blood-letting group and model group.They were exposed to ambient temperature of 43℃to induce heatstroke.Another group of rats were exposed to room temperature(26℃)and used as normal control group.Their survival times were measured.In addition,their physiological and biochemical parameters were continuously monitored.Results:When rats underwent heatstroke,their survival time values were found to be 21-25 min.Treatment of Gua Sha combined with Bloodletting greatly improved the survival time(230±22 min)during heatstroke.All heatstoke animals displayed and activated coagulation evidenced by increased prothrombin time(PT),activated partial thromboplastin time(aPTT),D-dimer,and decreased platelet count,protein C.Furthermore,the animals displayed systemic inflammation evidenced by increased the serum levels of cytokines intedeukin-1β(IL-1β),tumor necrosis factorα(TNF-α)and malondialdehyde(MDA).Biochemical markers evidenced by cellular ischemia and injury/dysfunction included increased plasma levels of blood urea nitrogen(BUN),creatinine,serum glutamic oxaloacetic transaminase(SGOT),serum glutamic pyruvic transaminase(SGPT),and alkaline phosphatase(ALP)were all elevated during heatstroke.Core temperatures(Tco)were also increased during heatstroke.In contrast,the values of mean artedal pressure were significantly lower dudng heatstroke.These heatstroke reactions were all significantly suppressed by treatment of Gua Sha and Blood-letting,especially the combination therapy.Conclusion:Gua Sha combined with Blood-letting after heatstroke may improve survival by ameliorating systemic inflammation,hypercoagulable state,and tissue ischemia and injury in multiple organs.     

32例急性肢体动脉栓塞行Fogarth导管取栓术的护理体会

目的总结急性肢体动脉栓塞行Fogarth导管取栓术的护理体会。方法对急性肢体动脉栓塞患者行Fogarth导管取栓术的患者资料进行回顾性分析。结果除2例因栓塞时间过长行截肢外,其余患者术后恢复良好,患肢血运均有不同程度的改善,无因护理不当而产生的并发症。结论 Fogarth导管取栓术是治疗急性肢体动脉栓塞的首选方法。Fogarth导管取栓术后的专科护理是保证手术成功、减少术后并发症的重要措施。     

幽门螺杆菌唾液非侵入性检测法与14碳-尿素呼气试验的比较研究

现已明确幽门螺杆菌(Hp)是慢性胃炎与消化性溃疡的重要致病因子,并且是胃癌的早期危险因素,有学者研究认为,口—口传播或粪—口传播为其可能传播途径,并提出口腔内有Hp寄居,并可能是胃病复发的重要原因。本研究应用酶联免疫吸附试验(ELISA)对唾液中Hp抗原进行非侵入性检测,研究唾液中Hp的存在情况,并与14C-尿素呼气试验(14C-UBT)结果进行比较,探讨其临床应用价值。     

幽门螺杆菌感染患者血清可溶性黏附分子1(sICAM-1)检测研究

目的研究慢性胃病患者幽门螺杆菌(Helicobacter pylori,Hp)感染与血清可溶性黏附分子1(Soluble Intercellular Adhesion molecule-1,sICAM-1)水平关系。方法对205例慢性胃病患者进行了血清sICAM-1水平检测,并同时进行RUT、组织MB染色、Hp抗体和~(14)C-UBT四项方法检测Hp感染。结果胃粘膜Hp阳性组患者血清sICAM-1为889.43±22.52ng/m1,明显高于Hp阴性组患者747.07±30.45ng/ml(P<0.05);胃粘膜Hp感染菌量+、++、+++三组患者sICM-1水平分别为841.68±72.36ng/ml、905.43±37.59ng/ml和1012.54±49.34ng/ml,三组间差异显著(P<0.05);慢性胃炎、消化性溃疡患者血清sICAM-1水平明显高于正常对照组(P<0.05).结论胃粘膜Hp感染患者血清sICAM-1水平明显升高,血清sICAM-1水平可作为判断Hp感染新的感染免疫活动指标。     

经椎弓根伤椎植骨与伤椎置钉及单纯短节段固定治疗胸腰段骨折回顾性对比研究

目的 探讨经椎弓根伤椎植骨与伤椎置钉及单纯短节段固定治疗胸腰段骨折临床效果差异。方法 180例胸腰段骨折患者以随机抽样方法分为A、B和C三组,每组60例,分别采用单纯短节段固定,伤椎置钉及椎弓根伤椎植骨治疗;比较三组患者手术时间,术中出血量,手术前后伤椎前缘高度比、Cobb矢状面角度及日本整形外科学腰椎疾患治疗成绩（JOA）评分等。结果 B、C组患者手术时间和术中出血量均显著优于A组,差异有统计学意义（P〈0.05）;但B、C两组患者手术时间和术中出血量比较,差异无统计学意义（P〉0.05）;B、C两组患者术后伤椎前缘高度比、Cobb矢状面角度及JOA评分均显著优于A组,差异有统计学意义（P〈0.05）;但B、C两组患者术后伤椎前缘高度比、Cobb矢状面角度及JOA评分比较,差异无统计学意义（P〉0.05）。结论 相较于单纯短节段和经椎弓根伤椎植骨短节段固定治疗,伤椎置钉短节段固定治疗胸腰段骨折手术具有操作简便,微创等优点,有助于改善固定稳定程度,避免术后矫正角度过度丢失,并提高腰椎活动功能。     

唐长金从肺论治肝病经验探讨

唐长金主任医师是安徽省第二批名老中医、国家第五批名老中医、硕士研究生导师、教授。在四十多年的临床实践中,唐老师摸索出“从肺论治”治疗肝病的诸多宝贵经验。笔者有幸跟随学习,获益匪浅,现在从唐老师治疗肝病从肺论治的经验进行探讨,现介绍如下。     

老年患者肢体动脉栓塞15例治疗体会

急性肢体动脉栓塞是血管外科常见的急症之一,若没有得到及时诊治可导致截肢或危及生命[1].随着我国社会老龄化程度的不断加深,老年患者肢体动脉栓塞病例逐年增加.本文回顾性分析我科近来收治的老年肢体动脉栓塞病例.     

血管紧张素Ⅱ对胰岛β细胞的影响

2型糖尿病(type 2 diabetes mellitus,T2DM)的发病率日益增高,其各种并发症严重危害着人们的生活质量和生命安全,因此成为医学界关注的重要问题之一。目前虽T2DM的发病机制尚未完全澄清,但研究表明T2DM是以胰岛素抵抗和胰岛细胞功能衰竭为主要特征,且细胞凋亡增加是其功能     

鼻内镜术后应用湿润烧伤膏的疗效观察

目的观察湿润烧伤膏促进鼻腔黏膜上皮化及减少术后鼻腔血痂形成,防止鼻腔粘连的临床效果。方法选择鼻窦炎伴或不伴鼻息肉患者共150例,按左右侧鼻腔分为实验组与对照组。实验组术腔用20 mL注射器均匀涂美宝湿润烧伤膏,然后正常填塞膨胀海绵;对照组术腔常规填塞膨胀海绵。观察2组患者的填塞反应、血痂脱落时间及鼻腔黏膜上皮化的进程。结果实验组术后鼻部渗血及血痂明显减少,术后黏膜上皮化时间缩短。结论鼻内镜鼻部手术后应用湿润烧伤膏可以缩短病程。     

电针对慢性坐骨神经压迫性损伤大鼠神经病理学及背根神经节P2X_3受体表达的影响

目的：观察EA对CCI大鼠坐骨神经组织病理学及DRG P2X3受体表达的影响,探讨电针对神经组织学的影响及P2X3受体在电针镇痛效应中的作用。方法：将32只成年雄性SD大鼠,分为假模组、模型对照组、健侧EA组、患侧EA组,每组8只,模型对照组及EA组结扎坐骨神经造成CCI疼痛模型。各组于术前（0天）及术后3、57、1、01、2、14天分别测量大鼠患侧足MWT和TWL,EA组于术后第8天电针＂足三里＂-＂阳陵泉＂连续7天,每天1次。术后14天对坐骨神经标本行组织学观察,采用Estebe评分方法行组织学评分,免疫荧光组织化学检测患侧L5背根神经节中P2X3受体的表达情况。结果：与术前比较,CCI各组大鼠痛阈明显降低,出现痛觉过敏（P〈0.01）,而电针干预后EA组较CCI模型组痛阈明显增加（P〈0.05）但仍低于假模组。各组大鼠坐骨神经组织学观察无明显差异,各组评分差异无统计学意义（P〉0.05）。术后14天EA组较模型对照组患侧DRG L5中P2X3受体表达显著减少（P〈0.05）,并且患侧EA组较健侧EA组减少明显。结论：电针对坐骨神经压迫性损伤的镇痛效果可能是通过抑制大鼠DRG中P2X3受体的表达产生作用;患侧电针较健侧电针镇痛效果明显;电针后坐骨神经未见明显的病理组织学改变。