中医综合疗法治疗腰椎间盘突出症的临床观察

目的：观察中医综合治疗方式对腰椎闻盘突出症的临床治疗效果。方法：对近两年我院329例住院腰椎闻盘突出症患者进行针欠、推拿、牵引、中药等综合治疗。结果：治疗329例，显效108例，好转184例，无效37例，总有效率88．75％。结论：采用中医综合疗法治疗腰椎间盘突出症绝大部分病例明显有效，需要手术治疗的只占很小部分，保守疗法应该是腰椎间盘突出症首选的治疗方法。     

前列地尔Lipo-PGE1干预肝脏血流灌注的实验研究

目的： 探讨前列地尔脂微球(liposome prostaglandin E₁,Lipo-PGE₁) 不同用药时间和途径对肝脏血流灌注的作用机制。方法: 选取健康成年犬12只，经左小隐静脉注射Lipo-PGE₁₁ μg/kg，速度均为0.05 μg·kg^-1·min^-1。分别于0 min、5 min、15 min、30 min后行肝脏CT灌注成像（computed tomography perfusion imaging，CTPI）扫描，计算肝动脉灌注量(hepatic arterial perfusion,HAP)、门静脉灌注量 (portal vein perfusion,PVP)、总肝灌注量（total liver perfusion,TLP），对照分析不同时间Lipo-PGE1对肝脏血流灌注的影响。选取健康成年犬24只，随机平均分成4组：对照组、外周静脉用药组、肝动脉组、肠系膜上动脉组。Lipo-PGE₁的用药量均为1 μg/kg、用药速度均为0.05 μg·kg^-1·min^-1，0.9%生理盐水用量为20 mL。各组用药5 min后行肝脏CTPI，比较分析不同途径给予Lipo-PGE₁对肝脏血流灌注的影响。结果: 经外周静脉注射Lipo-PGE10 min、5 min、15 min、30 min后CTPI测量的HAP(mL·min^-1·mL^-1)分别为：0.22 ±0.65、0.24±0.65、0.22±0.69、0.22±0.06；PVP (mL·min^-1·mL^-1)：1.22±0.40、1.88±0.59、1.55±0.55、1.29 ±0.57；TLP (mL·min^-1·mL^-1)分别为：1.44±0.42、2.12±0.61、1.77±0.56、1.51±0.58。方差分析显示HAP组间比较无显著差异（F=0.249，P>0.05），而PVP、TLP组间比较有显著差异（F=3.812，P<0.05）、（F=3.805，P<0.05）。5 min组PVP、TLP增加最为显著，15 min、30 min时两者仍处于高值水平。对照组和外周静脉组、肝动脉组、肠系膜上动脉组的HAP (mL·min^-1·mL^-1)分别为：0.22±0.06、0.24±0.06、0.31±0.07、0.26±0.05；PVP (mL·min^-1·mL^-1)分别为1.28±0.38、2.33±0.41、2.37±0.55、2.83±0.94；TLP (mL·min^-1·mL^-1)分别为：1.50±0.40、2.57±0.42、2.67±0.58、3.09±0.94。方差分析显示HAP组间比较无显著差异（F=2.248，P>0.05），而PVP、TLP组间比较有显著差异（F=6.892，P<0.01）、（F=7.802，P<0.01）。经肠系膜上动脉给药较其它途径给药PVP、TLP增加趋势更为显著。结论: Lipo-PGE₁能显著增强肝脏血流灌注，且主要影响门静脉灌注分量，介入技术可为快速改善肝血流灌注提供有效途径。     

基于数据挖掘的刺络放血疗法治疗 外感发热的选穴规律研究

〔摘 要〕 目的：探究基于数据挖掘的刺络放血疗法治疗外感发热的选穴规律。 方法：2019 年 7 月至 2019 年 12 月采 用 Excel 2019 建立刺络放血数据仓库模型,随后下载、筛选已建数据库中刺络放血疗法治疗外感发热的文献资料,以及所 需信息的录入,借助建立的刺络放血数据库平台,对其进行数据挖掘。 结果：纳入刺络放血疗法治疗外感发热的文献共计 63 篇,其中刺络放血针具三棱针使用频次最高,刺络放血刺法使用频次最高的为点刺;刺络放血治疗未配合拔罐的研究 占比 80 %;采用刺络放血配合疗法的有 46 项,占比 73 %,其中以拔罐使用频次最高。 结论：刺络放血疗法治疗外感发热 以三棱针点刺治疗为主,且部分研究常配合其他疗法以明显提升治疗效果,但配合拔罐治疗临床应用较少。     

补骨方治疗膝骨性关节炎的疗效观察

目的　探讨应用补骨方治疗膝骨关节炎的疗效。方法　临床应用补骨方和芬必得治疗老年性膝骨性关节炎 6 0例 4周 ,并比较随访疗效。结果　治疗后两组患者症状平均分值、日常活动功能障碍平均分值和总评分平均分值较治疗后显著升高 ,膝关节临床症状明显减轻 ,关节功能显著改善 ,比较具有显著性差别 (P <0 0 1)。经统计学处理 ,两组膝关节日常生活活动评分治疗前后。两组临床资料没有显著差异 (P >0 0 5 ) ,具可比性。结论　补骨方能明显改善膝骨关节炎患者的临床症状和关节功能。     

Enhanced energy efficiency for the complete mineralization of diclofenac by self-sequential ultrasound enhanced ozonation

Diclofenac (DCF), an anti-biodegradable drug, needs to be post-treated after conventional biochemical treatment. In this paper, ultrasound enhanced ozonation (UEO) under different conditions was employed to degrade DCF. The results showed that DCF was completely degraded by UEO in 8 min and complete total organic carbon (TOC) removal occurred in 120 min. The generation of ˙OH via UEO could be achieved through ozone decomposition, H₂O sonolysis, and ozone sonolysis, which contributed to the complete mineralization of DCF. The total amount of ˙OH produced by 200 kHz UEO was 3.8 times higher than that of single ozonation plus single sonolysis in 120 min. Typical persistent intermediates of DCF, such as oxalic acid and oxamic acid, could be efficiently degraded by UEO. It was found that 60 min ozonation followed by 60 min UEO had the best mineralization energy efficiency (MEE) (113 mg (kW h)⁻¹) at the base of complete mineralization and there was one-third reduction in the total energy consumption compared to that for single UEO. Based on the analysis of the evolution index (EI), pH was selected as the best judgment index of self-sequential UEO for indicating the time point of ultrasound irradiation, which saves irradiation times for practical use.

Self-sequential ultrasound enhanced ozonation is a feasible energy-saving solution for the diclofenac mineralization, which is due to the combination of oxidative decomposition ability of ozone and continuous mineralization ability of ˙OH.     

开窗髓核摘除术治疗腰椎间盘突出症的不同病理分型的疗效观察

目的 探讨开窗髓核摘除术治疗腰椎间盘突出症的不同病理分型的疗效.方法 回顾性分析经后路椎板开窗髓核摘除术治疗98例腰椎间盘突出症患者,根据术中所见椎间盘突出的髓核形态及纤维环破损大小将其分为四型,并对各型进行术后3个月疗效观察,并进行统计学分析比较.结果 术前术后JOA评分显示下腰背痛、腿痛和/或麻刺痛、步态、日常活动受限度及总分的改善各分型都有显著的统计学差异（P＜0.01）;下腰背痛和直腿抬高试验,除Ⅰ型外,其它各型术前术后比较均有统计学差异（P＜0.01）;感觉、运动及膀胱功能方面,除Ⅳ型外,其它各型术前术后比较均无统计学差异（P＞0.05）.手术后,各型VAS评分显著低于术前（P＜0.01）.根据SC标准,疗效优劣依次为Ⅳ型、Ⅱ型、Ⅲ型、Ⅰ型.结论 腰椎间盘突出症患者在采用开窗髓核摘除术后患者的下腰背痛、步态、腿痛和/或麻刺痛及总分改善各分型等方面均较明显改善,有较好临床疗效.开窗髓核摘除术治疗腰椎间盘突出症的预后跟术前椎间盘的纤维环的完整性密切相关.     

地佐辛复合不同剂量布托啡诺用于下肢术后静脉镇痛的研究

目的比较地佐辛复合不同剂量布托啡诺用于下肢术后静脉镇痛的临床效果。方法择期骨科手术患者90例,美国麻醉医师协会（ASA）Ⅰ或Ⅱ级,年龄20～55岁,按随机数字表法分为A、B、C三组,每组30例,术毕按三种方案施行患者自控静脉镇痛（PCIA）。每组用地佐辛0．2mg／kg分别复合布托啡诺0．14,0．16,0．18mg／kg加0．9％氯化钠稀释至100ml。在术后2,4,8,12,24h观察并记录视觉模拟量表（VAS）评分、Ramsay评分、PCIA给药次数、不良反应,计算出综合满意度。结果B组和C组PCIA方案能达到满意的镇痛效果,B、C组在术后4,8,12hVAS和Ramsay评分均优于A组（P〈0．05）,A组在术后4,8h按压PCIA次数多于B、C组（P〈0．01）,C组嗜睡人数多于A组和B组。B、C组满意度高于A组（P〈0．01）。结论地佐辛0．2mg／kg复合布托啡诺0．16mg／kg可以较好地用于下肢术后静脉镇痛。     

高血压患者人巨细胞病毒感染率及其血浆中和抗体水平分析

目的 对高血压患者人巨细胞病毒（HCMV）感染率及其血浆中和抗体水平展开研究分析,研究高血压与人巨细胞病毒感染的相关性.方法 随机选取2011年12月-2013年12月期间接收治疗的50例高血压患者血标本作为观察组,同时选取50例健康体检人员的血标本作为对照组.对两组标本人巨细胞病毒特异性中和抗体、人巨细胞病毒特异性IgG和IgM、人巨细胞病毒特异性UL93 DNA进行检测.结果 观察组HCMV UL93 DNA的阳性率为72.0％,HCMV IgG阳性率为70.0％,HCMV IgM阳性率为4.0％;对照组HCMV UL93 DNA阳性率为54.0％,HCMV IgG阳性率为52.0％,HCMV IgM阳性率为2.0％;观察组HCMV UL93 DNA阳性率、HCMV IgG阳性率显著高于对照组,数据差异具有统计学意义（P＜0.05）;两组HCMV IgM阳性率数据对比差异无统计学意义（P＞0.05）.结论 高血压患者人巨细胞病毒感染率显著高于健康对照组,但特异性中和抗体水平较健康对照组显著下降,即高血压患者的人巨细胞病毒感染体液免疫状态不足,高血压与人巨细胞病毒感染显著相关.     

The association of red meat,poultry, and egg consumption with risk of hip fractures in elderly Chinese: A case–control study

Background/purposeThe epidemiological evidence that the consumption of red meat, poultry or eggs may be associated with the risk of hip fractures is inconsistent and no studies have differentiated between types of red meat or poultry. We evaluated the association between the consumption of red meat, poultry or eggs and the risk of hip fracture.MethodsA 1:1 age- (± 3 years) and gender-matched case–control study of 646 pairs (female/male: 484/162) of elderly Chinese was conducted between June 2009 and January 2013 in Guangdong, China. Information on meat and egg consumption was collected using a 79-item food frequency questionnaire administered in face-to-face interviews. Conditional logistic regression was used to test the relationship between intake of red meat, poultry, and eggs and the risk of hip fracture. Multivariate ORs and their 95% CIs were estimated.ResultsAfter adjusting for potential confounders, risk of hip fracture was found to be positively associated with total red meat consumption (P for trend < 0.001), but not with total poultry or egg consumption. The adjusted ORs (95% CIs) for hip fractures, comparing extreme quartiles, were 2.94 (1.82, 4.76) for total red meat, 1.11 (0.74, 1.66) for total poultry, and 0.99 (0.63, 1.56) for eggs. Subtype analyses indicated that the unfavorable effect of total red meat was primarily associated with the consumption of fatty pork and organ meat, whereas fatty and lean poultry had opposite effects. Men with higher fatty pork intake tended to have greater risk than women (P interaction = 0.019).ConclusionsOur findings suggest that greater consumption of fatty, but not lean, red meat and poultry may increase the risk of hip fracture. These results provide preliminary evidence for the feasibility of a dietary program for the prevention of hip fractures, which should be confirmed by further studies.     

改良斜轴位磁共振成像扫描在距腓前韧带损伤中的应用价值

目的  评估改良斜轴位磁共振成像（MRI）检查对慢性踝关节不稳患者距腓前韧带损伤诊断的可靠性及有效性。方法  选取2013年1月-2015年11月从该院预行踝关节镜检查的住院患者中招募研究对象。所有研究对象行踝关节常规轴位及改良斜轴位MRI检查，利用MRI图像评估距腓前韧带损伤，对比上述检查对韧带全长的显示效果，利用ICC指数评估观察者间一致性，以踝关节镜检查结果作为金标准，评估上述检查的敏感性、特异性、阴性预测值，阳性预测值、准确性。结果  招募91例研究对象。其中，男性49例，女性42例,平均（34.6±13.2）岁。常规轴位MRI显示，效果与改良斜轴位MRI的差异有统计学意义（观察者A：Z =-4.987，P =0.000；观察者B：Z =-4.084，P =0.000），斜轴位MRI检查观察者间ICC指数为0.943，95%CI：0.902，0.987。共有60例患者经关节镜检查确诊为距腓前韧带损伤。改良斜轴位MRI检查的敏感性、特异性、阴性预测值、阳性预测值及准确度：观察者A分别为92%、97%、86%、98%和95%；观察者B分别为95%、94%、91%、97%和95%。结论  对于诊断距腓前韧带损伤，改良斜轴位MRI检查具有很好的观察者间一致性以及突出的诊断价值，可以较好地显示韧带全长，值得在临床推广应用。