腰椎后路椎间盘镜术后5年疗效分析

目的：探讨腰椎后路椎间盘镜手术治疗腰椎间盘突出症的中期疗效。方法：腰椎间盘突出症患者117例,男63例,女54例;年龄24～72岁,平均50.6岁。单纯腰椎间盘突出症60例,单纯侧隐窝狭窄症10例,腰椎间盘突出症伴有侧隐窝狭窄32例,伴有髓核钙化15例。L3,42例,L4,556例,L5S148例,L4,5合并L5S111例。中央型22例,旁侧型95例。隆起型32例,破裂型73例,游离型12例。单侧98例,双侧19例。采用腰椎后路椎间盘镜椎间盘切除术（MED）对腰椎间盘突出症患者行髓核摘除和神经根管扩大。结果：117例经随访48～84个月,平均5.5年,根据中华骨科学会脊柱学组腰背痛手术评定标准：优93例,良16例,差8例。结论：严格掌握适应证、熟练的操作技术是减少MED手术并发症、提高疗效的关键。     

Immunomodulatory of selenium nano-particles decorated by sulfated Ganoderma lucidum polysaccharides

In this study, we employed a one-step method to prepare selenium nanoparticles (SeNPs) decorated by the water-soluble derivative of Ganoderma lucidum polysaccharides (SPS). The SeNPs–SPS complexes were stable, and the diameter of the SeNPs was homogeneous at around 25 nm. We investigated the anti-inflammatory activity of SeNPs–SPS against murine Raw 264.7 macrophage cells induced by LPS. SeNPs–SPS were found to significantly inhibit LPS-stimulated nitric oxide (NO) production against Raw 264.7 macrophages. RT-PCR results reveal the down-regulation of mRNA gene expressions for pro-inflammatory cytokines, including inducible NO synthase (iNOS), interleukin (IL)-1 and TNF-α in a dose-dependent manner. However, the anti-inflammation cytokine IL-10 was markedly increased. In the NF-κB signal pathway, SeNPs–SPS significantly inhibited the phosphorylation of Iκ-Bα. Similar results were observed for inhibition of the phosphorylation of JNK1/2 and p38 mitogen-activated protein kinase(MAPKs), whereas ERK1/2 MAPK was not apparently affected by SeNPs–SPS. All of these results suggest that SeNPs–SPS complexes have anti-inflammatory potential modulating pro-/anti-inflammation cytokine secretion profiles, and that the mechanism is partially due to inhibition of activations of NF-κB, JNK1/2 and p38 MAPKs.     

低甲状腺素血症早产儿喂养不耐受的早期干预治疗

目的探讨甲状腺素片早期干预治疗早产儿暂时性低甲状腺素血症合并喂养不耐受的临床意义。方法将66例低甲状腺素血症合并喂养不耐受的早产儿随机分为治疗组和对照组,对照组予常规治疗;治疗组在常规治疗的基础上给予鼻饲或口服左旋甲状腺素每日5mg.kg-1,1天1次,连续7d;均采静脉血作甲状腺5项动态测定,比较两组早产儿喂养不耐受改善情况及甲状腺功能恢复情况。结果治疗组在奶量增加、残余奶量、恢复出生体重时间、达全肠内喂养时间、留置胃管时间、住院时间较对照组差异有统计学意义（P〈0.01或P〈0.05）。治疗后14d复查甲状腺素水平治疗组已基本正常,对照组5项水平仍较低;除TSH外,两组差异有统计学意义（P〈0.01或P〈0.05）。结论早期小剂量短疗程甲状腺素片治疗低甲状腺素血症早产儿喂养不耐受疗效显著,同时使甲状腺功能恢复正常,改善低甲状腺素血症早产儿的预后。     

载阿霉素介孔二氧化硅纳米粒的细胞毒性及细胞摄取

目的制备载阿霉素的介孔二氧化硅纳米粒(mesoporous silica nanoparticles,MSN),对其理化性质及细胞摄取行为进行初步研究。方法通过聚合法制备MSN,透射电镜表征纳米粒的形态,动态光散射粒径测定仪测定粒子的平均粒径及分布。紫外分光光度计测定阿霉素的负载行为,MTT比色分析法研究粒子的细胞毒性,激光共聚焦显微镜观察其人乳腺癌MCF-7细胞对载药粒子的摄取。结果纳米粒分布均一,平均粒径约70 nm(PDI<0.1),载药量质量分数达到20%。MCF-7细胞对载药粒子的摄取较快,空白纳米粒具有较低的细胞毒性。结论介孔二氧化硅纳米粒具有较高的药物载药量和良好的生物相容性,能较快地被对人乳腺癌MCF-7细胞摄取,有望成为一种新型的药物化疗载体。     

Combined therapy of intensive statin plus intravenous rt-PA in acute ischemic stroke: the INSPIRE randomized clinical trial

Journal of Neurology - To investigate the safety and efficacy of intensive statin in the acute phase of ischemic stroke after intravenous thrombolysis therapy. A total of 310 stroke patients...     

“胆气春升论”的病机探讨与临床运用

胆气春升论是李杲受《黄帝内经》的启发及《伤寒论》少阳证基础上创立的理论,他认为"胆者,少阳春生之气,春气升则万化安,故胆气春升,则余脏从之,胆气不升,则飱泄、肠癖不一而起矣",强调了少阳胆气在脏腑运化过程中的重要地位。文章就该理论展开详细的病机探讨并归纳其在临床的运用,望能为各位同道在相关疾病的诊治上开拓思路,提高疗效。