口三针滞针牵拉法治疗顽固性面瘫面神经功能指数评价

目的:探寻治疗顽固性面瘫口角歪斜的有效针刺手法。方法:将101例顽固性面瘫患者随机分为观察组(48例)、对照组(53例)。两组在针刺患侧攒竹、四白、颊车、牵正的基础上,同取患侧口三针(地仓、口禾髎、夹承浆),观察组采用滞针牵拉法,对照组采用常规刺法,每天1次,10天为一疗程,观察2个疗程后面神经功能指数(FNFI)的变化。结果:治疗后两组FNFI均显著升高(均P0.01),且观察组优于对照组(P0.01),观察组面神经功能基本恢复率为87.5%(42/48),优于对照组的67.9%(36/53)(P0.05)。结论:口三针滞针牵拉法是治疗顽固性面瘫口角歪斜的较佳方法。     

应用噬菌体展示技术筛选氯胺酮模拟表位的研究

目的应用噬菌体展示技术筛选氯胺酮模拟表位,为建立无毒ELISA检测体系提供基础。方法以抗氯胺酮单克隆抗体为配体,在噬菌体七肽库中淘选氯胺酮的模拟表位。经4轮淘选后,选择可与氯胺酮单克隆抗体有不同程度结合的噬菌体,并进一步以间接竞争ELISA确定与盐酸氯胺酮存在竞争抑制的阳性克隆。结果发现10个噬菌体均可与氯胺酮单克隆抗体不同程度的结合;以间接竞争ELISA确定其中5个阳性克隆与盐酸氯胺酮存在竞争抑制现象;5个阳性克隆测序结果表明,获得了4种不同的氨基酸序列。结论初步判断这4个噬菌体展示了氯胺酮模拟抗原表位。     

中药贴敷涌泉穴治疗肺间质纤维化机理的探讨

根据中医学理论,分别从经络循行,肺、脾、肾三脏之间的关系以及中医"治未病"思想,阐述运用中药贴敷涌泉穴达到补肾益脾固肺、未病先防,治疗肺间质纤维化的机理。     

针刺夹脊穴治疗痉挛型脑瘫的临床观察

目的观察针刺夹脊穴治疗痉挛型脑瘫(spastic cerebral palsy,SCP)的临床疗效。方法将62例SCP患儿随机分成2组,治疗组采用针刺夹脊穴,对照组采用假针刺,每天针刺1次,10次为1个疗程,共治疗6个疗程,两组均配合常规康复治疗。同时以修订的Ashworth量表(MAS)、粗大运动功能量表(GMFM)、儿童功能独立检查(WeeFIM)作观察指标,观察评定两组的治疗结果。结果在治疗结束、随访0.5、1年时治疗组MAS评分均较治疗前明显降低(P0.01),对照组治疗结束时MAS评分明显降低(P0.01),但随访0.5、1年时MAS评分与治疗前比较,差异无统计学意义(P0.05),而治疗组MAS评分在治疗结束、随访0.5、1年时明显低于对照组(P0.05,P0.01);两组患者GMFM评分、WeeFIM评分在治疗结束、随访0.5、1年时均较治疗前显著提高(P0.01),且治疗组GMFM评分、WeeFIM评分明显高于同期对照组(P0.01,P0.05)。结论针刺夹脊穴治疗痉挛型脑瘫患儿的临床疗效良好。     

神阙、关元穴温和灸防治脑瘫儿反复呼吸道感染的临床观察

目的观察神阙、关元穴温和灸防治脑瘫儿反复呼吸道感染的临床疗效。方法将64例患儿随机分为温和灸组和对照组,每组32例,在感染急性期均给予常规对症治疗,其中温和灸组采用温和灸神阙、关元穴,对照组静脉滴注西药丙种球蛋白,疗程3个月。观察反复呼吸道感染次数,复发的止咳时间和肺部罗音消失时间,血清免疫球蛋白(IgG、IgM、IgA值)进行疗效评价。结果治疗后,温和灸组和对照组感染复发次数分别减少至(2.38±0.64)次和(6.50±0.84)次;温和灸组平均止咳时间、平均肺部罗音消失时间分别为(3.92±1.32)天、(4.66±1.82)天,而对照组分别为(6.48±2.18)天、(7.64±1.44)天,温和灸组效果更佳(P0.01);两组治疗后血清免疫球蛋白IgG、IgM、IgA值均升高(P0.05),对照组短期效果好,温和灸组长期效果好。结论神阙、关元穴温和灸配合常规对症治疗防治脑瘫儿反复呼吸道感染有较好的长期临床效果。     

Recovery of Continence Function following Simulated Birth Trauma Involves Repair of Muscle and Nerves in the Urethra in the Female Mouse

Background

The natural history and the mechanisms behind the alteration of vaginal distension (VD) in a mouse model are not clear.

Objective

We examined the temporal sequelae of VD and pudendal nerve transection (PNT) on leak-point pressure (LPP) and the muscular and nerve components of the urethra in mice.

Design, setting, and participants

Seventy-two virgin female C57BL/6 mice were equally distributed into three groups. The VD group underwent VD for 1 h. The PNT group received bilateral PNT. A control group underwent sham VD.

Intervention

Each group was divided into four subgroups of six mice for measurement of LPP at 0, 4, 10, and 20 d after VD or PNT.

Measurements

LPP was measured. Morphology and neurofilament-immunoreactive nerve of the urethra were assessed.

Results and limitations

LPP was decreased at 0, 4, and 10 d but not at 20 d after VD. Decreased LPP persisted to 20 d in the PNT group. The external urethral striated muscle appeared disrupted and/or wavy in two mice at 0 d, in three mice at 4 d, in one mouse at 10 d, and in one mouse in 20 d after VD. The density of neurofilament-immunoreactive nerve in the urethra was reduced at 4 and 10 d after VD, but not at 20 d, and at 4, 10, and 20 d after PNT compared with the corresponding values of the sham VD group. The limitation of this animal model is that the pelvic floor structure of the mouse is different from that of female humans. Therefore, results of this study should be carefully applied to human subjects.

Conclusions

VD causes reversible stress urinary incontinence in female mice. Recovery of continence function following VD is associated with repair of the external urethral sphincter and reinnervation of the urethra. This mouse model will be useful for mechanistic investigation and targeting of therapeutic intervention by taking advantage of genetic manipulation.     

Optimum view distance for laparoscopic surgery

Background Proper visualization of the surgical field without fatigue is essential in laparoscopic surgery and reduces the risk of iatrogenic injuries. One of the important factors influencing visualization is the viewing distance between the surgeon and the monitor. This was the subject of the current investigation. Methods For this study, 14 surgeons participated in experiments designed to determine two working distances from a standard 34-cm (14 in. diagonal) cathode ray tube (CRT) monitor: (a) the maximum view distance permitting small prints of a near vision chart to be identified clearly by sight, (b) and the minimum view distance (of a standard resolution chart) just short of flicker, image degradation, or both. The range of the monitor optimal working distance for laparoscopic surgery was extrapolated from these data sets. Results The maximum view distance allowing identification of detail averaged 221 cm (range, 166–302 cm). The mean minimal view distance short of flicker/image degradation was 136 cm (range, 102–168 cm). The coefficient of variation for the two view distances was almost identical (18% vs 17%, respectively), and a frequency histogram confirmed the normality of the two data sets. Thus, for most surgeons, the extrapolated monitor view distances for laparoscopic surgery using a 14-in. diagonal (34-cm) monitor range from 139 to 303 cm (57–121 in.) for maximal distance viewing and from 90 to 182 cm (36–73 in.) for close-up viewing (i.e., a monitor optimal working distance ranging from 90 to 303 cm (36–121 in.). Conclusions For most surgeons operating from a 14-in. diagonal CRT monitor, both the maximal and minimal (close-up) view distances are individually variable, but the surgeon should never be farther than 3 m (10 ft) or less than 0.9 m (3 ft) from the monitor. However, within limits, the maximal view distance increases with increasing monitor size. The limit for close-up distance is 0.9 m, irrespective of monitor size.     

缪刺考

At present, most physicians hold that Miu Ci is "left and right cross collateral prick-ing",but it does not conform to the original meaning of "Suwen·Miucilunpian"(Plain Questions ·Trea-tise on Miu Ci). Miucilanpian holds that Miu Ci is the extension and perfection of Ju Ci (contralateral me-ridian needling), which mainly pricks the collateral but is not limited to the collateral, as it also pricks the acupuncture point. As for the "left and right cross" point selection, it is one step in the procedure of the treatment in the process of contralateral collateral needling instead of being a principle.     

茶碱微乳经皮吸收及药代动力学研究

目的：研究茶碱微乳在家兔不同皮肤部位给药后的经皮吸收及药代动力学。方法：采用HPLC测定血浆中茶碱的浓度,应用基于Guass-Newton-Zhu原理设计的NLFTZ计算机程序对实验数据进行解析。结果：茶碱微乳经背部肺腧穴给药后的血药浓度高于非穴位给药,有极显著性差异（P〈0．01）;茶碱经皮吸收符合两个独立的具不同时滞的零级吸收、一级消除的一室模型迭加形成的复合模型,血药浓度平稳,可以维持24h以上。结论：茶碱微乳经皮吸收均具有双通道、双过程复合的特征;穴位经皮给药的两种通道中存在特殊的加速通道,而药物经穴位周围皮肤的穿透表现为慢吸收过程。     

Correct anatomical location of entry point for antegrade femoral nailing

Closed intramedullary nailing is a well-accepted method of treatment for femoral shaft fractures. The issue of the correct entry point for antegrade nailing remains a matter of controversy, and the literature is confusing. We reviewed the opinions of 100 orthopaedic surgeons by means of questionnaires. Only four surgeons were able to identify and label their respective entry points for femoral nailing correctly, possibly because of incorrect illustration in publications or errors in terminology. Although the piriformis fossa appears to be the ideal entry point, the importance of exact localisation in the sagittal plane, centered over the axis of medullary canal, cannot be overlooked.