针刺奇穴结合辨证选穴治疗脑卒中后便秘

目的观察针刺奇穴结合辨证选穴治疗脑卒中后便秘患者的临床疗效。方法将脑卒中后便秘患者74例随机分为观察组和对照组各37例。观察组采用针刺治疗,每日1次,连续治疗10 d;对照组采用乳果糖口服溶液治疗,每日25 mL,早餐时一次口服,连续服用10 d。比较2组患者首次排便时间(首次治疗结束后至首次排便所需要的时间)、便秘评分(治疗后、随访时)及不良反应发生率。结果观察组的总有效率为 89.19%,优于对照组的75.68%(P<0.05);观察组的首次排便时间为(28.56±14.13)h,优于对照组的(45.07±23.28)h(P<0.05);观察组治疗后与随访时的便秘评分为(3.68±2.35)分和(5.13±1.65)分,优于对照组的(5.08±1.62)分和(7.22±1.97)分(均P<0.05);2组患者均未出现明显的不良反应。结论针刺奇穴结合辨证选穴能较好改善脑卒中后便秘患者的临床症状,与口服乳果糖口服溶液比较,具有见效快、疗效优、效果持续时间长的优势。     

两种浅静脉留置针穿刺法在老年患者运用中的比较分析

目的提高老年患者浅静脉留置针穿刺的成功率。方法将100例老年患者随机分为2组，实验组采用2人配合法穿刺，对照组采用传统手法。结果实验组穿刺成功率明显高于对照组。结论对于老年患者或皮肤松弛，弹性差的患者宜采用2人配合法进行浅静脉留置针穿刺，以提高穿刺成功率。     

Ultrasonographic fine-needle aspiration of pathological masses in the head and neck region.

Two hundred and eight ultrasonographic fine-needle aspiration biopsies were performed in patients with head and neck masses and examined cytologically. The average minimum diameter of the masses was 1.5 cm. The smallest punctured lymph node located in the perivascular sheath had a diameter of 0.4 cm. In none of the patients were complications observed. Ninety-seven percent of the diagnoses based on cytological examination were confirmed in the histological examination of surgical biopsies or in the further clinical course.     

针刺小鼠安全刺激量探析

小鼠实验是研究针刺作用机制的主要方式,文章从针刺小鼠安全刺激量入手,探讨针刺过程中如何保障小鼠的生命安全。总结分析了针具、选穴、针刺量学参数、得气等与安全刺激量之间的关系。探讨量学研究的主流观点及对实验的指导意义,强调开展针刺小鼠安全刺激量研究的必要性,减少实验动物无谓的牺牲,科学、合理、人道地使用实验动物。     

激痛点特种针法治疗颈肩肌筋膜疼痛综合征的临床研究进展

随着现代颈肩疾病的频繁发生,颈肩肌筋膜疼痛综合征(Myofascial Pain Symdrome, MPS)已逐渐成为困扰人们生活和工作的因素。针刺治疗软组织损伤引起的疼痛,因疗效确切、安全、无不良反应等优势在临床上被广泛应用。在国家知识基础设施数据库、中文科技期刊数据库、中国学术期刊数据库、PubMed数据库中,对2009—2019年间有关针刺治疗肌筋膜疼痛综合征、针刺治疗肌筋膜炎、激痛点的相关资料进行查阅和筛选,从激痛点特种针刺手法运用,特种针具使用以及复合其他温热电等针刺疗法临床运用3个方面来对激痛点针刺治疗颈肩MPS临床文献进行总结,结果发现颈肩MPS在激痛点行特种针刺疗法有显著的疗效。     

背俞指针疗法对GERD大鼠食管下端组织的ICC内质网AMPK/mTOR自噬通路的影响

目的研究背俞指针疗法对胃食管反流病(gastroesophageal reflux disease,GERD)大鼠食管下端组织的ICC内质网中腺苷酸活化蛋白激酶(AMPK)和哺乳动物雷帕霉素靶蛋白(mTOR)mRNA及蛋白表达的影响,探讨背俞指针疗法的效应机制。方法将76只大鼠随机分为空白组、空白指针组、模型组、指针组。采用贲门钢圈固定法制作GERD动物模型,指针组予背俞指针疗法干预,疗程均为2周。干预结束后,切取大鼠食道下段组织制作标本。采用Western Blot检测食管下端组织ICC内质网中的AMPK和mTOR蛋白表达情况;采用逆转录聚合酶链反应(RT-PCR)检测食管下端组织ICC内质网的AMPK mRNA、mTOR mRNA水平。结果Western Blot检测结果表明:模型组AMPK蛋白表达低于空白组,指针组AMPK蛋白表达显著高于模型组,差异具有统计学意义(P<0.05);空白指针组AMPK蛋白表达与模型组比较,差异无统计学意义(P>0.05);mTOR蛋白表达情况组间比较差异均无统计学意义(P>0.05)。RT-PCR检测结果表明,mTOR mRNA及AMPK mRNA水平组间比较均无统计学差异(P>0.05)。结论GERD的发病机制可能与食管下段组织ICC AMPK蛋白水平下调有关,与AMPK/mTOR自噬信号通路可能不相关。背俞指针疗法治疗GERD的起效机制可能通过提高ICC细胞AMPK蛋白表达而实现。     

FDG PET-CT combined with TBNA for the diagnosis of atypical relapsing polychondritis: report of 2 cases and a literature review

Objective

To explore the value of ¹⁸F-fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET-CT) combined with transbronchial needle aspiration (TBNA) in diagnosing atypical relapsing polychondritis (RP).

Methods

Data from two patients with atypical RP, which had been diagnosed in our hospital using FDG PET-CT combined with TBNA, were retrospectively analyzed. A review of the relevant literature was also performed.

Results

Consistent with the previously reported 20 cases of RP that had been diagnosed using FDG PET-CT, the two patients in the present study showed the involvement of multiple organs, including the nose, throat, trachea, bronchi, costicartilage and joint cartilages, and increased FDG uptake was found in these areas. The mean value of SUVmax was 5.14. PET-CT revealed that 86.4% of the patients with RP had airway involvement. TBNA technique was used for biopsy of the hypermetabolic lesions, and pathologic examinations confirmed the diagnosis of RP. The time to diagnosis in these two patients and the 20 cases reported previously was about 6.9 months, significantly shorter than the average diagnosis time (20 months).

Conclusions

FDG PET-CT has several advantages for diagnosing RP, especially atypical RP. TBNA is a minimally invasive and safe technique for obtaining airway cartilage. Combining PET-CT with TBNA may play an important role in shortening the time to diagnosis in patients with RP involvement of airway.