New Exploration of Needling Manipulations at Point Tianzong

In present clinical practice, point Tianzong (SI 11) is often used to treat pain and numbness in the scapular region and the upper limbs. The authors have tried various needling manipulations at this point and obtained extraordinarily good therapeutic result, as is reported in the following.     

新生儿肝血管瘤13例报道

目的 总结新生儿肝血管瘤的诊治经验.方法 回顾性分析我院近10年来收治的13例新生儿肝血管瘤病例,分析其首发症状、合并症、诊治方法以及临床疗效.结果 13例首发症状包括腹部包块、肝脏肿大、黄疸、肺炎.合并症包括全身多发皮肤血管瘤、心功能不全.2例为产前B超发现.全部病例B超和CT检查均有典型的血管瘤表现,单个病灶的直径在53～91 mm.接受手术切除4例,活检2例,7例仅接受激素治疗.病理报告为海绵状血管瘤2例,毛细血管瘤11例.有心功能不全和肺炎者接受内科强心、利尿及抗炎治疗.结果 1例因顽固性心衰伴肺炎和多脏器感染于术后死亡,1例肝脏多发病例于活检后放弃治疗,其余病例均获5个月～1.5年的随访.3例手术切除患儿无复发.所有保守治疗病例均见血管瘤在1年内自行消退,无死亡病例.结论 肝血管瘤可通过临床症状、超声和CT检查明确诊断.激素治疗是有效的治疗方法.积极治疗充血性心力衰竭对肝血管瘤的治疗有帮助.手术有增加并发症的危险,不宜作为新生儿肝血管瘤的治疗选项.     

Increased VEGFR2 and MMP9 protein levels are associated with epithelial dysplasia grading

The present study aimed to compare levels of VEGFR2 and MMP-9 among control, epithelial dysplasia (ED) and oral squamous cell carcinoma (OSCC) groups. We analyzed 48 patients with oral leukoplakia (OL), 20 patients with OSCC and 21 patients without OL and OSCC. Immunohistochemistry of VEGFR2 and MMP9 were performed and compared among groups. Analysis of tissue immunolocalization of VEGFR2 and MMP-9 assumed non-parametrical distribution and comparison between groups was performed using the Mann–Whitney and Kruskal–Wallis statistical tests. VEGFR2 and MMP9 immunoexpression appeared to correlate with the degree of dysplasia and was observed to increase in lesions with more severe dysplasia as compared to those with lower degrees of dysplasia. Immunoreactivity of MMP-9 was lower in the OL samples compared to the OSCC samples (p = 0.004). We observed no difference in VEGFR2 protein levels between OL and OSCC samples. A positive correlation was found between VEGFR2 and MMP-9 in OL samples (r = +0.452, p = 0.001), however, no correlation was found in OSCC samples (r = −0.042, p = 0.861). In conclusion, the results of the current study suggest that expression of MMP9 and VEGFR2 is associated with ED grading and MMP9 levels are increased in OSCC.     

电针睛明穴对家兔眼压的影响

目的：观察电针睛明穴对兔眼眼压的调节作用。方法：对治疗组与对照组高眼压家兔模型用电针睛明穴的方法观察比较。结果：治疗组的眼压最高值６．５３６±０．９１２ｋＰａ和最低值２．９８±０．３４５ｋＰａ均低于对照组的眼压最高值和最低值（７．０５６±１．０５２ｋＰａ和３．６３６±０．４２５ｋＰａ）。两组间眼压比较。除１０分钟时段外，，其他各时段组间差异均有显著性意义。结论：电针睛明穴对高眼压兔眼有明显降低眼压的作用     

夏龙方对人胃癌SGC-7901细胞黏附和侵袭的影响

目的:观察夏龙方对胃癌细胞SGC-7901黏附、侵袭、移动等转移生物学行为的影响。方法:体外培养SGC-7901细胞,分为夏龙方50,100,200 mg·L-1(低、中、高剂量)组和对照组,采用Cytoselect 48-Well Cell Adhesion Assay检测胃癌细胞与基质黏附能力;利用Transwell侵袭转移模型评价夏龙方对胃癌细胞侵袭能力的影响、划痕实验观察夏龙方对SGC-7901细胞移动能力的影响。结果:终浓度100,200 mg·L-1夏龙方能显著降低SGC-7901细胞黏附能力,50～200 mg·L-1可抑制SGC-7901细胞侵袭,终浓度50 mg·L-1夏龙方可显著抑制SGC-7901细胞迁移。结论:夏龙方可降低SGC-7901细胞的黏附能力,侵袭能力,抑制细胞迁移。     

胃肠安对人胃癌SGC-7901细胞TGF-β1诱导上皮间质转化作用

目的:观察胃肠安对人胃癌SGC-7901细胞上皮间质转化的影响。方法:接种SGC-7901细胞贴壁后,按5μg.L-1加入转化生长因子β1(transforming growth factor-β1,TGF-β1)建立人胃癌SGC-7901细胞上皮间质转化模型。同时,胃肠安组按1 000 mg.L-1加入胃肠安药液,继培5 d后,显微镜观察细胞形态,Western blot检测上皮、间质标记基因E-cad,N-cad,vimentin蛋白与相关激酶蛋白激酶B(Protein kinase B,PKB或AKT)、转录因子Twist,Snail蛋白表达情况。结果:较空白组,加入TGF-β1后,SGC-7901细胞发生上皮间质转化,细胞形态拉长变窄且细胞间连接更疏松,上皮标记基因E-cad蛋白相对表达量降低0.241;间质标记基因N-cad,vimentin蛋白相对表达量分别升高0.225,0.371。较模型组,胃肠安作用后,SGC-7901细胞大部仍成卵石状不典型上皮细胞形态,仅少数细胞出现间质细胞形态,上皮标记基因E-cad蛋白相对表达量升高0.210;间质标记基因N-cad,vimentin蛋白相对表达量分别降低0.119,0.124;相关通路AKT表达及磷酸化,转录因子Twist,Snail蛋白相对表达量分别降低0.248,0.085,0.402,0.382。结论:胃肠安可抑制人胃癌SGC-7901细胞上皮间质转化,可能与抑制AKT表达及磷酸化,下调转录因子Twist,Snail蛋白相关。     

CD1a和S100阳性血管树突状细胞在动脉粥样硬化主动脉的分布

目的：研究CD1a和S100阳性血管树突状细胞在动脉粥样硬化主动脉管壁内的分布情况,探讨血管树突状细胞和动脉粥样硬化之间的关系。方法：收集尸检的主动脉标本18例,常规石蜡切片,HE染色;5例内膜形态结构未见明显改变的设为对照组,13例主动脉病变较明显（均处于纤维粥样斑块期）的设为病变组,免疫组化染色观察CD1a和S100阳性反应血管树突状细胞的分布。结果：对照组动脉管壁未检出CD1a和S100表达;病变组CD1a和S100阳性反应树突状细胞主要分布在内膜斑块处和外膜小血管周围,数量较多,中膜内未见明显阳性细胞分布。结论：CD1a和S100阳性反应树突状细胞在动脉硬化过程中聚集,主要分布于病变内膜和外膜,提示血管树突状细胞可能参与了动脉粥样硬化的形成过程。     

离心泵辅助股静脉引流应用于微创心脏瓣膜手术的体外循环管理经验

目的总结离心泵辅助股静脉引流应用于微创心脏瓣膜手术的体外循环(ECC)管理经验。方法我院自2009年7月至2009年12月共开展经右肋间小切口心脏瓣膜手术共64例(男23例,女41例),其中二尖瓣置换(MVR)24例,二尖瓣成形(MVP)23例,主动脉瓣置换(AVR)16例,双瓣置换(DVR)1例。全组患者使用双腔气管插管全麻,常规全身肝素化后,使用Edwards 18~20 Fr的股动脉和24~28 Fr的股静脉插管建立ECC,股静脉由下腔静脉经右房达上腔静脉口,侧孔位于右房,将离心泵串连于静脉回路。根据引流情况调节离心泵负压动力增加静脉引流,满足灌注流量及手术视野的要求。记录不用离心泵辅助时的最大静脉引流量(D1),以及在离心泵辅助下能达到的最大静脉引流量(D2)。结果①全组患者ECC时间51~181(84.8±23.9)min,主动脉阻断时间20~118(47.7±17.5)min,术中转流平稳,血流动力学稳定,监测SvO2、血气及尿量等指标均在正常范围,手术视野暴露良好,无延长切口或转正中切口病例,无手术死亡病例;②全组患者D11.2~2.5(1.74±0.32)L/min,D21.9~3.6(2.69±0.43)L/min,离心泵转速335~1330(881±215)r/min,D2比D1平均增加57.7%,两者比较有显著性差异;③比较24Fr与28Fr的股静脉插管引流量无显著性差异。结论离心泵辅助股静脉引流能增加股静脉的引流量,满足全身所需的灌注流量及手术视野要求。     

Role of fibroscan and APRI in detection of liver fibrosis: A systematic review and meta-analysis

Background and study aimsFibroscan and APRI are promising noninvasive alternatives to liver biopsy for detecting hepatic fibrosis. However, their overall test performance in various settings remains questionable. The aim of our study was to perform a systematic review and meta-analysis of diagnostic accuracy studies comparing fibroscan and APRI with liver biopsy for hepatic fibrosis.Patients and methodsElectronic and manual bibliographic searches to identify potential studies were performed. Selection of studies was based on reported accuracy of fibroscan and APRI compared with liver biopsy. Data extraction was performed independently by two reviewers. Meta-analysis combined the sensitivities, specificities, and likelihood ratios of individual studies. Extent and reasons for heterogeneity were assessed.Results23 studies for fibroscan and 20 studies for APRI in full publication were identified. For patients with stage IV fibrosis (cirrhosis), the pooled estimates for sensitivity of fibroscan were 83.4% (95% confidence interval [CI], 71.7–95.0%) and specificity 92.4% (95% CI, 85.6–99.2%). For patients with stage IV fibrosis (cirrhosis), the pooled estimates for sensitivity of APRI at cutoff point of 1.5 were 66.5% (95% CI, 25.0–100%) and specificity 71.7% (95% CI, 35.0–100%). Diagnostic threshold bias was identified as an important cause of heterogeneity for pooled results in both patient groups.ConclusionsFibroscan and APRI appear to be clinically useful tests for detecting cirrhosis however not useful tools in early stages of fibrosis.     

罗格列酮对高血压大鼠的肾保护作用及其与血管紧张素Ⅱ受体表达的关系

目的 研究罗格列酮对高血压肾损伤的保护作用，及其与肾内血管紧张素Ⅱ(ATⅡ)受体表达的关系。 方法 两肾一夹高血压大鼠随机分为:(1)高血压未治疗组；(2)普通降压组(利血平50 µg·kg^-1·d^-1+二肼苯达嗪6.25 mg·kg^-1·d^-1+氢氯噻嗪6.25 mg·kg^-1·d^-1)； (3)常规剂量罗格列酮组(罗格列酮5 mg·kg^-1·d^-1)；(4)大剂量罗格列酮组(罗格列酮20 mg·kg^-1·d^-1)。假手术大鼠作为对照。 结果 常规剂量罗格列酮组收缩压为(176±18) mm Hg，与高血压未治疗组(191±25) mm Hg相比，无显著差异。大剂量罗格列酮组收缩压为(143±16) mm Hg， 普通降压组收缩压为(137±27)mm Hg，与高血压未治疗组相比，差异有统计学意义(P < 0.05)。 在血压、血糖、血脂水平相似的情况下，大剂量罗格列酮组尿蛋白排泄率为(16.78±3.50)mg/24 h，较普通降压组(27.94±12.79)mg/24 h显著降低(P < 0.05)。未钳夹侧肾脏病理改变轻，大剂量罗格列酮组肾小球损伤指数为18.04±7.76，与普通降压组27.92±6.39相比，差异有统计学意义(P < 0.05)；大剂量罗格列酮组微动脉壁/腔比为1.75±0.38，与普通降压组2.16±0.90相比，差异有统计学意义(P < 0.05)；大剂量罗格列酮组2型血管紧张素Ⅱ受体(AT2R)mRNA表达上调。 结论 罗格列酮对高血压肾损伤具有保护作用，可能与其上调肾内AT2R表达有关。