针刺和聚焦冲击波疗法对肩袖肌腱病的止痛作用:一项回顾性临床研究

ObjectiveThe purpose of the study is to evaluate whether the clinical effects of focused extracorporeal shockwave therapy (f-ESWT) and acupuncture anticipate the clinical response in patients with rotator cuff tendinopathy in the short term.DesignAn observational retrospective clinical study.Setting/LocationPhysical Medicine and Rehabilitation Unit, Sant'Andrea University Hospital in Rome, Italy.Subjects/InterventionsWe analyzed retrospectively thirty patients (22 females and 8 males) with rotator cuff tendinopathy.Fifteen patients underwent f-ESWT and acupuncture combined therapy (Group A) and fifteen patients underwent only f-ESWT therapy (Group B).Outcome measuresThe outcome measures were the Visual Analogic Scale (VAS), Assessment Shoulder and Elbow Scale (ASES) and Roles and Maudsley Score (RMS). The follow-ups were T0 (pre-treatment), T1 (3 weeks after the start of the treatment), and T2 (at 8 weeks). In order to compare groups, the ANOVA and Friedman tests were adopted.Group A patients had a more rapid and statistically significant improvement trend in VAS (P <0.001), ASES scale (P <0.001), and a higher level of satisfaction to treatment assessed by RMS (P<0.001) than group B in the short term.ConclusionsThe study showed that combined treatment decreases the recovery time of the shoulder involved in terms of pain and motor function in the short term. However, these results shall be confirmed by controlled randomized studies.     

股密葆方治疗早中期非创伤性股骨头坏死肾虚血瘀证的临床研究

目的:观察股密葆方治疗早中期非创伤性股骨头坏死肾虚血瘀证的临床疗效.方法:2010年1月至2018年12月收治57例(61髋)非创伤性股骨头坏死肾虚血瘀证患者,男33例、女24例;年龄28～63岁,中位数41岁;国际骨微循环研究学会(association research circulation osseous,AR...     

火针点刺承泣穴治疗周围性面瘫后遗溢泪症的临床观察

ObjectiveTo compare the clinical therapeutic effect on epiphora as sequela of peripheral facial paralysis treated with pricking technqiue of fire needling therapy at Chéngqì (承泣 ST1) and acupuncture treatment at conventional acupoints.MethodsFrom September 2018 through to October 2018, 64 cases of epiphora as sequela of peripheral facial paralysis were collected from the Department of Acupuncture-Moxibustion in Suzhou TCM Hospital. According to random number table, they were divided into an observation group and a control group, 32 cases in each one. In the observation group, pricking technique of fire needling therapy was used at ST1, once every two days. In the control group, acupuncture with filiform needle was applied to Jīngmíng (睛明BL1), Tàiyáng (太阳EX-HN5), Tóngzĭliáo (瞳子髎GB1), Sìbái (四白ST2) and Quánliáo (颧髎SI18) on the affected side as well as Hégŭ (合谷LI4) on the contralateral side, once per day. The 10-day treatment was as one 1 course and the consecutive 3 courses of treatment were required in either of the groups. Before and after treatment, Munk grade, clinical effective rate and the number of treatments were observed in the evaluation of therapeutic effect.ResultsAfter treatment, Munk grade was improved in the patients of the two groups (both P < 0.05). The improvement range in the observation group was larger than that of the control group (P < 0.05). The treatment in either group achieved the obviously therapeutic effect on epiphora as sequela of peripheral facial paralysis. The effective rate in the observation group was 90.32%, higher than 61.29% in the control group (P < 0.05). The mean number of treatments of the curative case were 5.11 in the observation group and were 13.73 in the control group, indicating the statistical significance in difference (P < 0.05).ConclusionPricking technique of fire needling therapy at ST1 achieves the better effect on epiphora as sequela of peripheral facial paralysis as compared with acupuncture at conventional acupoints.     

苦味中药激活肠道苦味受体分泌胰高血糖素样肽-1的研究现状

胰高血糖素样肽-1(GLP-1)可以刺激胰岛素释放以及抑制胰高血糖素释放,与2型糖尿病有关。苦味中药可以激活肠道上的苦味受体(TAS2Rs),通过磷脂酶C通路和磷酸二酯酶通路刺激肠道内分泌L细胞未分泌GLP-1,广泛用于2型糖尿病的防治。本文综述了苦味中药对肠道TAS2Rs介导的GLP-1分泌的调控作用,为苦味中药防治2型糖尿病提供新视角。     

中药防风抗肝癌作用及机制的网络药理学和细胞实验研究

目的: 应用网络药理学和细胞实验,探究中药防风提取液的抗肝癌效应及可能机制,为防风在抗肝癌的临床应用提供依据。方法: 应用网络药理学方法筛选防风抗肝癌的有效成分及相应靶点,并建立"药物-成分-靶点"可视化网络;采用富集分析筛选信号通路;利用Autodock Vina软件验证效应成分与肝癌相关靶点结合力,MTT法测定细胞增殖率,流式细胞术检测细胞凋亡率,Western blot检测相关蛋白表达。结果: 通过多种数据库共筛选得到防风抗肝癌的15种有效成分和AKT1、CASP3、TP53、JUN、IL-6前5个核心靶点基因。富集分析显示细胞凋亡通路尤为集中。前5位的有效成分与核心靶点对接,结果显示其结合能均小于-20.92 kJ·mol^-1。与空白对照组比较,24和48 h时防风提取液对HepG-2细胞的抑制率随浓度升高而增大;细胞凋亡率亦升高;同时促使Caspase-3蛋白磷酸化,提高Bax/Bcl-2比值。结论: 防风提取液可抑制人肝癌细胞 HepG-2 的增殖,诱导人肝癌细胞 HepG-2凋亡,且呈剂量、时间依赖性,其作用机制可能是通过上调HepG-2细胞内Bax蛋白表达、下调Bcl-2蛋白并促进Caspase-3蛋白磷酸化发挥作用。     

基于高通量测序研究半夏泻心汤对3-脱氧葡萄糖醛酮致糖尿病前期大鼠肠道菌群的影响

目的 研究半夏泻心汤对3-脱氧葡萄糖醛酮(3 DG)致糖尿病前期大鼠肠道菌群的影响.方法 大鼠连续灌胃3DG(50 mg·kg-1·d-1)2周制得糖尿病前期大鼠模型.将雄性SD大鼠随机分为3组:正常组(7只)、模型组(7只)和实验组(3只).造模后,实验组灌胃半夏泻心汤水煎液(5 mL·kg-1),正常组和模型组灌胃...     

培补二天膏对老年自发性高血压大鼠血管形态及一氧化氮、血管紧张素Ⅱ的影响

【目的】观察培补二天膏对老年自发性高血压大鼠(SHR)血压及血管的影响。【方法】将50只SHR大鼠随机分为模型组,西药对照组,膏方低、中、高剂量组,每组10只;另将10只Wistar京都大鼠(WKY)作为正常对照组。膏方低、中、高剂量组给予培补二天膏混悬液(对应剂量分别为0.58、1.15、3.46 g·kg^-1·d^-1)灌胃;西药对照组给予厄贝沙坦混悬液(剂量为10.13 mg·kg^-1·d^-1)灌胃;模型组与正常对照组给予同体积蒸馏水灌胃。共4周,期间每周监测收缩压(SBP)。给药结束后,测血清一氧化氮(NO)、血管紧张素Ⅱ(AngⅡ)含量,苏木素-伊红染色(HE)观察胸主动脉组织病理改变。【结果】(1)实验过程中,模型组SBP始终高于正常对照组(P<0.01);膏方各剂量组及西药对照组干预1~4周后均能降低SBP;与模型组比较,膏方中剂量组治疗4周降压明显(P<0.01),膏方高剂量组与西药对照组治疗1周即出现明显的降压效果(P<0.05)。(2)与正常对照组比较,模型组血清NO含量明显下降,AngⅡ含量明显升高(均P<0.05);与模型组比较,膏方高剂量组NO含量明显升高,AngⅡ含量明显降低(均P<0.05),西药对照组AngⅡ含量降低明显(P<0.05)。(3)胸主动脉组织病理HE染色结果显示:SHR大鼠胸主动脉形态学明显改变;膏方各剂量组及西药对照组均可改善SHR大鼠胸主动脉形态学变化。【结论】培补二天膏可有效降压及保护血管,其作用可能是通过调节血液中AngⅡ和NO的水平来实现。     

Maisonneuve骨折的临床诊治特点及15例手术疗效分析

目的 :探讨Maisonneuve骨折(maisonneuve fractures of the fibula,MFF)的诊断和治疗特点,并评估其手术治疗的临床疗效。方法:自2017年3月至2018年6月,采用手术治疗15例MFF患者,其中男9例,女6例;年龄27～54(35.00±7.46)岁;受伤至手术时间5～8(6.33±1.04) d。所有骨折为新鲜闭合性损伤。观察患者术后骨性愈合时间及术后并发症情况,并于术后12个月采用美国足与踝关节协会(American Orthopaedic Foot and Ankle Society,AOFAS)评分评价患者术后踝关节功能恢复程度。结果:15例患者获得随访,时间12～28(17.00±3.79)个月。4例发生漏诊。所有骨折获得骨性愈合,时间4～6(4.80±0.94)个月。术后未出现切口感染、骨折延迟愈合或不愈合等并发症。术后12个月AOFAS评分为(90.23±7.27)分;其中优9例,良3例,可3例。结论:MFF是一类严重的不稳定的踝关节损伤类型,容易忽视腓骨高位骨折及下胫腓的分离而造成漏诊误诊,手术治疗可恢复下胫腓联合以及踝穴的解剖学关系,获得较满意的疗效。     

自噬与凋亡的相互关系在肿瘤方面的研究进展

肿瘤是一类涉及基因、代谢和信号传导异常等多方面因素引起的疾病,其发生的分子机制相当复杂,但本质上仍与细胞增殖与死亡的动态失衡有关。程序性细胞死亡（programmed cell death,PCD）是由基因控制的自杀程序引起的主动性死亡,对于多细胞生物个体发育的正常进行,维持内环境稳态以及抵御外界各种干扰因素方面有着关键性的意义。I型PCD（经典细胞凋亡）和II型PCD（自噬性细胞死亡）调控着肿瘤细胞的增殖与消耗,与肿瘤的发生、发展密切相关。本文结合近年来国内外研究进展,重点就自噬在肿瘤中的作用以及与凋亡的相互关系作一综述。