扶正化痰固本方对早期非小细胞肺癌术后患者免疫功能的影响

目的:观察扶正化痰固本方运用于早期非小细胞肺癌术后的临床疗效及其对患者免疫功能的影响。方法:将70例早期非小细胞肺癌患者按照随机数字表法分为对照组和观察组,每组各35例。两组患者均接受肺癌切除术治疗,对照组术后3周开始接受MVP方案化疗,观察组在对照组的基础上加用扶正化痰固本方治疗。比较两组患者的临床疗效及治疗前后中医证候积分、卡氏评分(karnofsky performance status,KPS)及生活质量评分变化情况。检测两组患者治疗前后免疫功能指标、血清肿瘤标志物[癌胚抗原(carcinoembryonic antigen,CEA)、糖类抗原153(carbohydrate antigen 153,CA153)]水平。结果:观察组有效率为91.43%,对照组有效率为71.43%,两组患者有效率比较,差异具有统计学意义(P<0.05)。两组患者治疗后中医证候积分低于本组治疗前,且观察组治疗后低于对照组治疗后,差异具有统计学意义(P<0.05)。两组患者治疗后免疫功能指标检测结果低于本组治疗前,且观察组治疗后低于对照组治疗后,差异具有统计学意义(P<0.05)。两组患者治疗后血清CEA、CA153水平低于治疗前,KPS评分、QLQ-C30评分均高于治疗前,且观察组治疗后血清CEA、CA153水平低于对照组,KPS评分、QLQ-C30评分均高于对照组,差异具有统计学意义(P<0.05)。观察组胃肠道反应及骨髓抑制发生率均低于对照组,差异具有统计学意义(P<0.05)。结论:扶正化痰固本方运用于早期肺癌术后,能够有效改善患者免疫功能,减轻毒副反应,提高患者生活质量。     

脉冲激光射线强化金属材料的几个问题

本文讨论了激光脉冲射线强化金属材料的几个问题:强化图形,材料性能,加工用量及表面涂层对被强化表面性能的影响。     

健脾化痰法在针刺治疗中风(风痰阻络型)中的作用及其机理研究

目的:观察健脾化痰法在针刺治疗中风风痰阻络型中的作用,并初步探讨其机理。方法:将中风风痰阻络型患者随机分为观察组和对照组各30例,观察组以健脾化痰合祛风通络法、对照组仅以祛风通络法针刺治疗,各30次后观察疗效及检测血脂情况。结果:治疗后观察组总有效率为86.67%,对照组为73.33%;痰证辨证积分观察组比对照组显著减低;血脂分析,观察组总胆固醇、载脂蛋白B水平比对照组显著减低,高密度脂蛋白比对照组显著升高。结论:健脾化痰法能有效提高针刺治疗中风风痰阻络型的临床疗效,其机理可能与调节脂代谢有关。     

滋阴补阳益气活血方治疗慢性乙型肝炎贫血评析

目的:观察滋阴补阳益气活血方治疗慢性乙型肝炎贫血的疗效.方法:用滋阴补阳益气活血中药组方,结合冲服紫河车、五谷虫等中药散剂治疗70例,设常规西药治疗组作对照35例,观察其肝功能及血象变化情况.结果:治疗组总有效率为91.43%,对照组总有效率为80%,两组治疗结果比较P＜0.01,明显优于对照组.结论:滋阴补阳益气活血方是治疗慢性乙型肝炎贫血的有效方法之一.     

壮阳药效动物实验评价方法的改进

目的 对壮阳药效评价方法进行优化,以探求更为有效的候选药物筛选方法.方法 模型组大鼠均灌胃给予西地那非10 mg/kg,对照组大鼠给予相同容量的生理盐水灌胃,每天1次,连续灌胃给药14 d.每次给药后连续记录2h内大鼠阴茎勃起、阴部理毛、爬背次数和参与动物数,并计算PEI值.采用改良的壮阳药效评价方法,整个过程采用摄像头观察并在不同时间段给予雌鼠诱导.结果 在雌鼠诱导组中,模型组大鼠给药后2 h PEI值较对照组明显升高(P＜0.05).在模型组中,与人为观察组相比,摄像头观察组大鼠给药后2 h PEI值明显升高(P＜0.05)；与非雌鼠诱导组相比,雌鼠诱导组大鼠给药后2 h PEI值明显升高(P＜0.05)；与持续诱导组相比,间断诱导组2h PEI值无明显差异,但60 ～ 120 min时间段PEI值明显升高(P＜0.05).结论优化后的壮阳药效评价方法能更为有效的评价候选药物的壮阳药效.     

非体外循环冠状动脉搭桥术合并糖尿病患者的强化护理干预

目的观察强化护理应用于非体外循环冠状动脉搭桥术合并糖尿病患者的效果。方法选择本院2013年1-12月收治的需行非体外循环冠状动脉搭桥术合并糖尿病的患者42例作为研究对象,随机分为两组,每组21例,对照组采取常规护理,观察组给予强化护理模式,比较两组患者疗效差异。结果观察组血糖、血肌酐、24h尿蛋白水平均低于对照组,差异有统计学意义,P<0.05;观察组住院期间焦虑程度重度1例(4.8%),中度7例(33.3%),轻度13例(61.9%),焦虑程度显著轻于对照组,P<0.05。观察组术后并发症发生率3例(14.3%),明显低于对照组9例(42.9%),P<0.05。结论强化护理应用于非体外循环冠状动脉搭桥术合并糖尿病患者效果较佳,血糖控制好,术后并发症发生率较低。     

Effect of exercises according to the circadian rhythm in type 2 diabetes: Parallel-group,single-blind,crossover study

Background and aimTo evaluate the effectiveness of structured exercise appropriate the circadian rhythm in terms of blood sample test (BST), functionality and quality of life (QoL) in individuals with type 2 diabetes.Methods and resultsThis was a parallel-group, single-blind, crossover study. Thirty individuals with type 2 diabetes aged 35–65 years were enrolled in the study and allocated into 2 groups as the Morning Chronotype (MC) Group (n = 15) and the Evening Chronotype (EC) Group (n = 15) using Morningness-Eveningness Questionnaire which was used to determine the chronotypes. Participants were evaluated in terms of BST, functionality and QoL at the beginning of the study (T0), at 6 (T1), 12 (T2), and 18 (T3) weeks after the study started. A structured exercise program for 3 days a week over 6 weeks was applied in accordance with the chronotypes (T1-T2) and cross-controlled for the chronotypes (T2-T3). Significant differences were found in favor of the exercise given at the appropriate time for the chronotype in all parameters in both groups within groups (T0-T1-T2-T3) (p < 0.05). In the time1group interactions, exercise in accordance with the appropriate chronotype in both groups provided the highest statistical improvement in all parameters (p < 0.05).ConclusionIt was concluded that structured exercise performed at the appropriate time for chronotype improves HbA_1c, fasting blood glucose, HDL-LDL cholesterol, triglyceride, total cholesterol, functionality and quality of life in type 2 diabetes. This variation in blood values was observed to reflect the quantitative effects of exercise administered according to the circadian rhythm in individuals with type 2 diabetes.Trial registrationClinicalTrials.gov (NCT04427488). The protocol of the study was registered at ClinicalTrials.gov (NCT04427488).     

沈力教授治疗乳腺癌十一法

摘 要 乳腺癌是我国女性发病率最高的恶性肿瘤，并以每年高于发达国家1~2个百分点的速度快速增长，该病起病隐匿，发现时往往已是晚期，西医综合治疗效果不佳。浙江省名中医沈力教授在多年临证实践中系统总结了乳腺癌防治以及围手术期、放化疗期的综合治疗，取得了较好的临床疗效，本文详细介绍了沈力教授治疗乳腺癌的经验，将其整理归纳，总结为两期十一法，并附以医案，以资各位同道参考借鉴。     

The closing survival gap after liver transplantation for hepatocellular carcinoma in the United States

BackgroundSocio-economic inequalities among different racial/ethnic groups have increased in many high-income countries. It is unclear, however, whether increasing socio-economic inequalities are associated with increasing differences in survival in liver transplant (LT) recipients.MethodsAdults undergoing first time LT for hepatocellular carcinoma (HCC) between 2002 and 2017 recorded in the Scientific Registry of Transplant Recipients (SRTR) were included and grouped into three cohorts. Patient survival and graft survival stratified by race/ethnicity were compared among the cohorts using unadjusted and adjusted analyses.ResultsWhite/Caucasians comprised the largest group (n=9,006, 64.9%), followed by Hispanic/Latinos (n=2,018, 14.5%), Black/African Americans (n=1,379, 9.9%), Asians (n=1,265, 9.1%) and other ethnic/racial groups (n=188, 1.3%). Compared to Cohort I (2002-2007), the 5-year survival of Cohort III (2012-2017) increased by 18% for Black/African Americans, by 13% for Whites/Caucasians, by 10% for Hispanic/Latinos, by 9% for patients of other racial/ethnic groups and by 8% for Asians (All P values<0.05). Despite Black/African Americans experienced the highest survival improvement, their overall outcomes remained significantly lower than other ethnic∕racial groups (adjusted HR for death=1.20; 95%CI 1.05-1.36; P=0.005; adjusted HR for graft loss=1.21; 95%CI 1.08-1.37; P=0.002).ConclusionThe survival gap between Black/African Americans and other ethnic/racial groups undergoing LT for HCC has significantly decreased over time. However, Black/African Americans continue to have the lowest survival among all racial/ethnic groups.     

健脾和胃降逆止呕中药内服加穴位贴敷治疗妊娠恶阻脾胃虚弱证的临床研究

【目的】观察健脾和胃降逆止呕中药穴位贴敷治疗妊娠恶阻的临床疗效。【方法】将122例妊娠恶阻脾胃虚弱证患者随机分为观察组63例和对照组59例,对照组2例中途退出,最终纳入57例。对照组采用健脾和胃降逆止呕中药内服、静脉输液、饮食起居护理与情志调护,观察组在对照组治疗的基础上加用健脾和胃降逆止呕中药穴位贴敷。每日1次,4d为1个疗程,连续治疗2个疗程。观察2组妊娠恶阻临床症状的改善情况,比较2组临床疗效,并评价其安全性。【结果】（1）观察组总有效率为96.8%,显著优于对照组的71.9%（P＜0.01）;（2）观察组呕吐症状消失所需时间显著少于对照组（P＜0.01）;（3）治疗过程中,2组均无明显不良反应情况发生。【结论】健脾和胃降逆止呕中药穴位贴敷可显著提高妊娠恶阻的临床疗效,联合中药内服、静脉输液、饮食起居护理与情志调护可达最佳治疗效果。