鼻内镜下切割吸引刀与腺样体刮勺盲刮治疗腺样体肥大的疗效比较

目的 探究鼻内镜下切割吸引刀与腺样体刮勺盲刮治疗腺样体肥大的疗效。方法 选取江苏省如皋市人民医院2017年3月至2018年3月收治的腺样体肥大患者90例,按随机数字表法分为观察组和对照组,每组各45例。对照组采用腺样体刮勺盲刮治疗,观察组采用鼻内镜下切割吸引刀治疗。对比两组患者的临床疗效、并发症发生率、手术前后血清相关指标及鼻通气功能变化。结果 观察组治疗总有效率高于对照组,差异有统计学意义（P<0.05）;观察组并发症发生率低于对照组,差异有统计学意义（P<0.05）;观察组手术前后白细胞介素4（IL-4）、IL-6嗜酸性细胞阳离子蛋白（ECP）、肿瘤坏死因子-α（TNF-α）、重组人细胞间黏附因子-1（ICAM-1）水平差值均低于对照组,差异均有统计学意义（P<0.05）;观察组手术前后双侧呼气总阻力（TER）、吸气总阻力（TIR）、鼻呼气量差异比（NPRe）、鼻吸气量差异比（NPRi）、鼻腔呼气量（EC）、鼻腔吸气量（IC）差值均高于对照组,差异有统计学意义（P<0.05）。结论 鼻内镜下切割吸引刀治疗腺样体肥大较刮勺盲刮治疗疗效更好,患者术后炎症反应低,并发症少,值得临床推广。     

Vaccine hesitancy and Web 2.0: Exploring how attitudes and beliefs about influenza vaccination are exchanged in online threaded user comments

The growth of Web 2.0 has been particularly impactful in shaping information assessment in decision-making with regards to vaccination. The aim of the present study was to explore how attitudes and beliefs about influenza vaccination are exchanged in Web 2.0 through an analysis of user comment threads in response to related news reports on the Canadian Broadcasting Corporation national news website (average of 5.8 million unique visitors per month). User comments (n?=?2042) were extracted using a Google Chrome data mining extension, from 33 articles reporting on the seasonal influenza vaccine between September 2015 and October 2016. User comments were analyzed using thematic discourse analysis to identify themes within the data, and also identify how information is exchanged, including identifying the rhetorical devices and tactics used. Mostly unrelated to article content, user comments were extremely polarized with only those with strong positions at either end of the vaccination spectrum (for or against) engaging actively in online debates. Observed exchanges, and the use of rhetorical devices and tactics employed by users are identified as furthering or reinforcing polarization. In addition to exchanging information, forums served as ‘echo chambers’ where individuals connect with likeminded users and collect additional information to reinforce pre-existing beliefs, rather than encouraging the enrichment of user knowledge. Our data lead us to question existing calls for public health engagement in such online forums, as doing so may actually reduce the intention to vaccinate among individuals against vaccination. Rather, we identify a greater need to observe online platforms to better understand the social mechanisms that may contribute to, or reinforce, attitudes and beliefs related to influenza vaccine refusal. Further research may also explore the effect that such dialogue has on the attitudes and beliefs of passively observing individuals who have yet to decide whether to receive the flu vaccine.     

The cytology of the normal cyclic endometrium

Endometrial cytologic samples obtained with Cohen's endocyte from 501 normally menstruating women were studied and correlated with histologic sections from cell blocks. In this article, the cytologic diagnostic criteria for normal cyclic endometrium are pointed out. The diagnostic accuracy of normal cyclic endometrium has been 92%. A possibility of a cytologic dating is discussed. The diagnostic accuracy was 71.8% for early proliferative endometria, 82% for late proliferative, 93% for early secretory, 81% for midsecretory, and 60% for late secretory endometria.     

针灸加刮痧治疗颈椎病33例临床观察

目的：探讨阿托伐他汀改善糖尿病患者血糖代谢的机制.方法：收集120例2型糖尿病患者,随机分为10mg/Qd和20mg/Qd阿托伐他汀治疗组,比较治疗前、治疗后第3和6个月时血糖、血脂、脂联素水平和血糖控制率.收集40例非糖尿病健康者作为对照.结果：糖尿病组血糖、血脂高于对照组,而脂联素低于对照组.阿托伐他汀治疗后两组血脂代谢得到改善,两组间无差别（P=0.158）,20mg/Qd组脂联素水平高于10mg/Qd组（Jp〈0.05）.Logistic回归分析提示脂联素和阿托伐他汀与血糖控制率呈正相关.结论：阿托伐他汀可提高糖尿病血糖控制率,可能是通过增加脂联素水平.     

刮痧刺络在眩晕高发时节对椎动脉血供的改善作用

目的观察颈部刮痧刺络放血对椎动脉型颈椎病（CSA）患者在寒热交替的眩晕症高发时节椎动脉血供的改善。方法上海地区在每年的三四月及八九月间,用经颅多普勒（TCD）观察对照组一星期前后椎动脉血流速度的变化和实验组刮痧刺络干预一星期后（3次）血流速度的变化。结果对照组在一星期内任意经受冷暖气候变化或高温季节长时间冷气环境生活,其椎动脉收缩期峰值流速（Vp）及部分舒张末期流速（Vd）下降（P〈0.05）;实验组在相同气候条件下,由于采用干预手段,其椎动脉Vp及Vd均明显上升（P〈0.01）。结论冷暖空气剧烈变化使人易受寒湿侵袭,从而导致CSA患者椎动脉血供不足;颈部刮痧刺络干预可有效抵御气候季节因素带来的不利影响,提高椎动脉血液供应能力,进而预防眩晕的发生。     

穴位注射联合刮痧治疗小儿遗尿临床效果观察

目的 观察穴位注射联合刮痧治疗小儿遗尿的近期及远期疗效.方法 将入选病例309例分为两组,治疗组153例,对照组156例.治疗组分为两组,治疗组一33例：给予黄芪注射液穴位注射联合刮痧疗法;治疗组二120例：在上述治疗的基础上配合中医护理.对照组分为四组,对照组一60例：口服甲氯芬酯;对照组二30例：口服金匮肾气丸;对照组三36例：单纯针灸疗法;对照组四30例：行为干预疗法.观察各组近期及远期疗效.结果 治疗组一33例患儿近期治愈率为72.73％,总有效率为90.91％;远期治愈率为60.61％,总有效率为78.79％.治疗组二120例患儿近期治愈率为76.67％,总有效率为91.67％;远期治愈率为55.00％,总有效率为78.33％.对照组一近期治愈率为60.00％,总有效率为70.67％;远期治愈率为43.33％,总有效率为61.67％.对照组二近期治愈率为63.33％,总有效率为83.33％;远期治愈率为56.67％,总有效率为73.33％.对照组三近期治愈率为58.33％,总有效率为69.44％;远期治愈率为47.22％,总有效率为66.67％.对照组四近期治愈率为33.33％,总有效率为43.33％;远期治愈率为20.00％,总有效率为33.33％.治疗组一与各对照组治愈率、总有效率比较,差异均有高度统计学意义（P＜0.01）.结论 黄芪注射液穴位注射联合刮痧疗法治疗复发性小儿遗尿及配合中医护理治疗小儿遗尿的近、远期疗效可靠,值得临床广泛推广.     

局部弹拨、揉搓血管在自体动静脉内瘘急性血栓形成中的应用

目的探讨局部弹拨、揉搓血管在干预自体动静脉内瘘急性血栓形成时的疗效。方法对2007～2009年在我院血液透析,并且发生内瘘血管闭塞事件的23例病人进行弹拨、揉搓血管治疗。首先是弹拨、揉搓动静脉内瘘的吻合口和血管,其次是维持血压,最后是用低分子肝素皮下注射和尿激酶静脉推注进行抗凝治疗。结果经局部反复弹拨、揉搓自体动静脉内瘘血栓形成的吻合口、血管后,23例动静脉内瘘闭塞患者中,除1例3个月后再发内瘘闭塞外,其余22例患者均内瘘再通。结论采取弹拨、揉搓血管在自体动静脉内瘘急性血栓形成时使内瘘血管再通的方法简单易行,效果显著,相对安全,所以我们强调采取早期干预措施预防内瘘事件的发生。     

顶舌法联合刮舌法对舌系带过短患儿术后舌尖音训练效果的分析

目的：探讨顶舌法联合刮舌法对舌系带过短患儿术后舌尖音训练效果的影响。方法采用随机对照研究设计,将50例舌系带过短术后仅有舌尖音发音障碍的患儿（4～8岁）随机分为实验组25例,对照组25例。实验组在常规语音训练的基础上配合顶舌刮舌法训练,对照组采用常规语音训练,分别测试两组患儿在语音治疗前和治疗3个疗程后的语音清晰度,比较两组结果。结果实验组及对照组患儿治疗前的语音清晰度分别约为37．91％、37．69％,治疗后分别为87．69％、72．99％,两组患儿治疗前语音清晰度差异无统计学意义（t＝0．726,P ＞0．05）,治疗后两组患儿语音清晰度均较治疗前明显提高,差异有统计学意义（P ＜0．001）,且实验组患儿语音清晰度显著高于对照组。结论顶舌法联合刮舌法可以促进舌系带过短患儿术后仅有舌尖音发音障碍患儿语音清晰度的提高。     

Curing depth of (polyacid-modified) composite resins determined by scraping and a penetrometer

OBJECTIVES: The present study aimed to compare the curing depth of polyacid-modified composite resins (PAM-C) and some representative composite resins as a function of shade and post-cure using a scraping method and a penetrometer. METHODS: The curing depth of the PAM-C Hytac, F2000, Glasiosite, Dyract, Dyract AP, and Compoglass F and of the composite resins Durafill VS and Z100 were determined for shade A2 and A4 using a scraping method based on ISO 4049:2000 and a digital penetrometer. Samples were light-cured (800 mW/cm2 at 40 s) in bulk in split stainless steel molds. Immediately after light-curing or after a 24 h post-cure, the height of the cylinder of cured material was measured and taken as the curing depth. RESULTS: For both test methods, the curing depth was independent of post-cure (P > or = 0.05) but differed significantly among materials and shade (P<0.001). Moreover, there was a significant interaction between the latter (P<0.001). Regression analysis generally demonstrated that there was no significant systematic or proportional difference between the test methods. The curing depths of the PAM-C F2000 and Glasiosite were comparable to that of the hybrid composite Z100, but greater than the curing depth of the microfilled composite Durafill VS. The PAM-C Dyract AP, Dyract, Compoglass F and Hytac had a curing depth smaller than that of the microfilled composite. SIGNIFICANCE: The scraping method based on ISO 4049:2000 and a digital penetrometer give comparable curing depths for PAM-C. The curing depth greatly varies among the materials and can be considerably smaller than that of a microfilled composite resin. Shade A2 results in significantly greater values for the curing depth compared to shade A4, the effect depending quantitatively on the formulation of the material.     

痧点埋线治疗颈椎病疗效观察

目的观察痧点埋线治疗颈椎病的疗效。方法将64例患者随机分为治疗组和对照组,每组32例,治疗组于刮痧后采用痧点埋线法治疗,对照组则采用常规单纯针刺治疗。结果治疗组痊愈率为71.9%,对照组为37.5%,治疗组优于对照组(P<0.01);治疗组多在第1疗程痊愈(P<0.05),对照组多在第2、3疗程痊愈(P<0.05)。结论痧点埋线无论在痊愈率还是在疗程方面都优于单纯针刺。