微波手术联合益气通脉法治疗下肢静脉曲张临床研究

目的:观察微波手术联合益气通脉法治疗下肢静脉曲张的临床疗效。方法:选取2017年1月-2019年3月周口市中医院普外科收治的102例住院患者,共116条下肢静脉曲张患肢。随机分为两组,对照组47例采用大隐静脉高位结扎联合微波手术治疗,观察组55例在对照组的基础上加用益气通脉法治疗。比较两组的治疗效果和临床症状恢复情况。结果:观察组的患肢静脉迂曲消失时间、色素沉着消失时间、肿胀消失时间及患肢溃疡愈合时间均短于对照组,差异有统计学意义(P<0.05)。观察组的总有效率为96.2%,显著高于对照组的84.1%,差异有统计学意义(P<0.05)。结论:微波手术联合益气通脉法治疗下肢静脉曲张临床疗效肯定,值得推广。     

先天性白内障手术中预防后发障的方法

目的　探讨小儿先天性白内障手术中预防后发障的方法。方法　对 46例 ( 4 6眼 )先天性白内障 ,以白内障超声乳化仪的注吸I/A系统吸净晶状体植入人工晶状体后 ,进行后囊连续环形撕囊及前段玻璃体切除联合手术 (A组 ) ,同期施行的3 2例 ( 3 2眼 )先天性白内障 ,以同样的方法行白内障摘出人工晶状体植入后 ,进行单纯后囊连续环形撕囊术 ,不做前段玻璃体切除 ,作为对照组 (B组 )。术后随访 2年以上。结果　后发障发生的情况 ,A组 2眼 ( 4 4% ) ,B组 7眼 ( 2 1 9% ) ,两组对比差异具有显著性意义 (P <0 0 5 )。两组均未发现眼底并发症。结论　先天性白内障术中行后囊连续环形撕囊联合前段玻璃体切除术 ,是预防后发性白内障的有效方法。     

长臂单轴椎弓根螺钉在单纯性胸腰椎压缩性骨折复位固定中的应用及对肌肉损伤的影响

目的分析长臂单轴椎弓根螺钉经 Wiltse入路在单纯性胸腰椎压缩性骨折中的应用效果及对肌肉损伤的影响。方法选取自 2018年 1月至 2020年 8月周口市中心医院收治的单纯性胸腰椎压缩性骨折病人 87例，根据复位固定术式不同，分为观察组 38例、对照组 49例，其中观察组采取长臂单轴椎弓根螺钉经 Wiltse入路，对照组采取 AF系统经传统后正中入路。记录两组病人围术期指标、手术前后血清肌肉损伤指标［肌酸激酶( CK)、肌红蛋白( Mb)］变化；采用疼痛视觉模拟评分( VAS)评价病人不同时间节点疼痛水平；经胸腰椎正侧位片检查获取伤椎原始高度( H0)、术前及术后 1周伤椎椎体前缘高度( H1H2)，计算术前、术后 1周伤椎相对高度( H1/H0、H2/H0)及伤椎复位率，并测量矢状位 Cobb角变化；随访 3个月，采用 Oswestry功能障、碍指数( ODI)评价功能障碍情况，并统计手术相关并发症。结果观察组手术时长、术中失血量、术后引流量及首次下床活动时间均明显短于或低于对照组( P<0.05)。术后 3d，两组血清 CK、Mb水平均较术前升高( P<0.05)，且观察组血清 CK、Mb水平     

Electrical response grading versus House-Brackmann scale for evaluation of facial nerve injury after Bell's palsy: a comparative study

OBJECTIVE: There are no convenient techniques to evaluate the degree of facial nerve injury during a course of acupuncture treatment for Bell's palsy. Our previous studies found that observing the electrical response of specific facial muscles provided reasonable correlation with the prognosis of electroacupuncture treatment. Hence, we used the new method to evaluate the degree of facial nerve injury in patients with Bell's palsy in comparison with the House-Brackmann scale. The relationship between therapeutic effects and prognosis was analyzed to explore an objective method for evaluating Bell's palsy. METHODS: The facial nerve function of 68 patients with Bell's palsy was assessed with both electrical response grading and the House-Brackmann scale before treatment. Then differences in evaluation results of the two methods were compared. All enrolled patients received electroacupuncture treatment with disperse-dense wave at 1/100 Hz for 4 weeks. After treatment, correlation analysis was conducted to fi nd the relationship between electrical response and therapeutic effects or prognosis.RESULTS: Checking consistency between electrical response grading and House-Brackmann scale: Kappa value 0.028(P = 0.578). Correlation analysis: the two methods were correlated with the prognosis, and electrical response grading(rER = 0.789) was better than the House-Brackmann scale(rHB = 0.423). CONCLUSION: Electrical response grading is superior to the House-Brackmann scale in efficacy and reliability, and can conveniently assess the degree of facial nerve injury. The House-Brackmann scale is suitable for the patients with mild facial nerve injury, but its evaluation quality for severe facial nerve injury is poor.     

The role of Ntcp,Oatp2, Bsep and Mrp2 in liver injury induced by Dioscorea bulbifera L. and Diosbulbin B in mice

Dioscorea bulbifera L. (DB) is a traditional Chinese herb used in thyroid disease and cancer. However, the clinical use of DB remains a challenge due to its hepatotoxicity, which is caused, in part, by the presence of Diosbulbin B (DIOB), a toxin commonly found in DB extracts. As abnormal expression of hepatobiliary transporters plays an important role in drug-induced liver injury, we assessed the hepatotoxicity induced by DB and DIOB, and explored their impacts on hepatobiliary transporter expression levels. Following liquid chromatography-tandem mass analysis of the DIOB content of DB extract, male ICR mice were randomly orally administered DB or DIOB for 14 days. Liver injury was assessed by histopathological and biochemical analysis of liver fuction. The levels of transporter protein and mRNA were determined by western blotting and real-time PCR. Liver function and histopathological analysis indicated that both DB and DIOB could induce liver injury in mice, and that DIOB might be the primary toxic compound in DB. Moreover, down-regulation of Mrp2 blocked the excretion of bilirubin, glutathione disulfide, and bile acids, leading to the accumulation of toxic substrates in the liver and a redox imbalance. We identified down-regulated expression of Mrp2 as potential factors linked to increased serum bilirubin levels and decreased levels of glutathione in the liver and increased liver injury severity. In summary, our study indicates that down-regulation of Mrp2 represents the primary mechanism of DB- and DIOB-induced hepatotoxicity, and provides insight into novel therapies that could be used to prevent DB- and DIOB-mediated liver injury.     

手术切除肺腺癌患者免疫细胞浸润分析及预后关系

目的探究肺腺癌手术患者免疫细胞浸润模式及预后关系。方法基于GSE68465数据集,利用CIBERSORT软件包,对442例样本中22种免疫细胞进行定量分析,利用Survival包,Kaplan-Meier法分析22种免疫细胞含量与总生存率关系,利用Cox多变量回归分析构建肺腺癌手术患者免疫细胞预后风险模型,根据风险评分中位数,分为高风险组和低风险组,绘制Kaplan-Meier生存曲线和ROC曲线,评估模型的预测效果。结果肺腺癌组织浸润的免疫细胞主要有浆细胞、M2巨噬细胞和M0巨噬细胞,肺腺癌组织与正常组织免疫浸润存在显著差异。静息NK细胞与预后关系显著(P<0.05)。基于5种免疫细胞构建预后风险模型(Risk Score=8.156×静息NK细胞+9.059×活化CD4+记忆T细胞+3.899×活化肥大细胞+2.452×M0巨噬细胞+5.575×活化树突状细胞),高风险组较低风险组预后显著较差(P<0.0001),ROC曲线提示该风险模型具有较好的预后预测效果。结论免疫细胞浸润风险评分模型可以有效预测肺腺癌手术患者预后。     

《中药学》与《中国药典》中药名称差异探究

目的:规范中药材(饮片)名称,使处方名称大众化、科学化、合理化,减少因因人、因地而异发生的中药材(饮片)名称差异。方法:参考《中国药品通用名称命名原则》,以《中药学》教材记录的中药材(饮片)品种为基数,与《中国药典》中药材(饮片)进行统计、对比、分析,整理《中药学》教材与《中国药典》收录中药材(饮片)描述不一致的现象。结果:通过对比,本文总结出9方面存在不一致现象。结论:统一中药材(饮片)名称,可使中药更好的服务于临床,减少处方应付差错率,提高中医药疗效,有利于推进我国中药处方的合理化、规范化、统一化,为走向世界奠定基础。     

替格瑞洛、氯吡格雷对急性冠脉综合征患者PCI术后血小板聚集率、血流动力学及免疫功能的影响

目的:探讨替格瑞洛、氯吡格雷对急性冠脉综合征（ACS）患者经皮冠状动脉介入治疗（PCI）术后血小板聚集率、血流动力学及免疫功能的影响。方法:选取本院心血管内科收治的124例ACS患者作为研究对象,随机分为观察组（n=62）和对照组（n =62）,观察组给予替格瑞洛治疗,对照组给予氯吡格雷治疗,观察比较两组患者治疗前后小板聚集率、血流动力学指标、免疫功能指标变化情况和出血情况。结果:治疗后,两组患者血小板聚集率（PAV）均低于治疗前（P＜0.05）,且观察组明显低于对照组（P＜0.05）;治疗后,两组患者全血黏度（BV）、血浆粘度（PV）均低于治疗前（P＜0.05）,观察组明显低于对照组（P＜0.05）,而收缩期血流速度峰值（SPV）,舒张期血流速度峰值（DPV）,冠脉血流储备（CFVR）均高于治疗前（P＜0.05）,且观察组明显高于对照组（P＜0.05）;治疗后,两组患者CD3+、CD4+水平均高于治疗前（P＜0.05）,观察组明显高于对照组（P＜0.05）,而CD8+水平低于治疗前（P＜0.05）,观察组低于对照组（P＜0.05）;两组患者总出血事件发生率比较差异无统计学意义（P＞0.05）。结论:替格瑞洛能有效抑制ACS患者PCI术后血小板凝集,改善血流动力学和免疫功能,安全性高。     

不同树脂嵌体材料边缘微渗漏的对比研究

目的：通过对比4种树脂嵌体材料的微渗漏大小,为临床树脂嵌体材料的选择提供参考.方法：40颗离体牙按嵌体备洞原则制备近中邻（牙合）Ⅱ类洞,随机分为4组,每组10颗.分别用Z350、P60、Ceramage、Solitaire 2制作嵌体后使用Adper Single Bond 2和Adper Rely X ARC进行粘结.经冷热循环500次品红染色后,金刚砂片平行于牙体长轴沿近远中方向将修复体纵向剖开2次,在体式显微镜下测量染料渗入轴壁、龈壁的深度.结果：4组树脂嵌体材料轴壁和龈壁均出现微渗漏.经单因素方差分析,不同树脂嵌体材料之间的轴壁（F=0.131）及龈壁（F=0.385）微渗漏差异无统计学意义（P＞0.05）;同材料组的龈方渗漏程度均显著高于轴壁,配对t检验显示差异有统计学意义（P＜0.01）.结论：从微渗漏深度大小来进行评价,4种树脂嵌体材料均是临床上制作树脂嵌体理想的材料;树脂嵌体与牙釉质粘结效果比牙本质好.     

游离旋髂浅动脉皮瓣修复足部皮肤缺损的临床应用

目的探讨游离旋髂浅动脉皮瓣修复足部皮肤缺损的临床效果。方法 2015年5月—2017年4月周口淮海医院采用游离旋髂浅动脉皮瓣修复足部皮肤缺损13例,其中男性10例,女性3例;年龄13～65岁,平均37. 5岁。致伤原因:道路交通伤4例,机械绞伤3例,压砸伤6例。皮肤软组织缺损范围4. 0cm×6. 5cm～9. 0cm×12. 5 cm,创面均不同程度存在泥沙、碎屑等异物残留,并伴有足部的肌腱、骨骼等深部组织损伤外露。皮瓣切取范围为5. 0cm×7. 0cm～10. 0cm×14cm,其中急诊修复4例,经清创术后应用VSD技术处理7～10d,择期修复创面9例。结果 11例皮瓣完全成活,2例皮瓣边缘局部皮肤坏死,经拆线、换药等对症治疗后创缘愈合。供区切口均Ⅰ期愈合。13例经术后6个月～2年随访,皮瓣外形满意及足部功能恢复满意,无皮肤破溃及磨损现象,患足负重、行走功能恢复良好。结论应用游离旋髂浅动脉皮瓣修复足部皮肤缺损,临床效果良好。