运用“伏邪学说”论治亚急性甲状腺炎

亚急性甲状腺炎是临床常见的甲状腺疾病,其早期临床表现不典型,在亚急性甲状腺炎的发病中,外感伏邪,内伤伏邪,正气是三个主要的影响因素。治疗上扶正以"调肝、健脾、滋肾"为主,祛邪以祛除风热毒邪,气郁、湿浊、瘀血为先。运用"伏邪学说"诠释其发病机理及其对脏腑功能的影响,对指导临床治疗具有重要意义。     

“五心”护理结合Watson关怀理论在乳腺癌病人护理中的应用效果

[目的]探讨"五心"护理结合Watson人文关怀理论在乳腺癌病人护理中的应用效果。[方法]选择2014年3月—2016年4月入住我院乳腺甲状腺诊疗中心的乳腺癌病人320例,将2014年3月—2015年4月入院的160例乳腺癌病人作为对照组,实施人文关怀优质护理服务工作;2015年5月—2016年4月入院的160例乳腺癌病人作为观察组,实施基于Watson人文关怀理论的"五心"护理服务。比较实施前后两组病人的癌因性疲乏程度及生活质量,比较两组实施后护士人文关怀满意度。[结果]实施后两组病人的癌因性疲乏程度及生活质量得分比较差异有统计学意义(P0.05)。两组病人实施后护士人文关怀满意度各条目得分及总分比较差异有统计学意义(P0.05)。[结论]"五心"护理结合Watson人文关怀理论可以改善乳腺癌病人的癌因性疲乏,提高病人的生活质量及护士的人文关怀能力。     

依达拉奉对2型糖尿病合并脑梗死患者血清中sICAM-1和IL-6水平的影响

目的：观察依达拉奉对2型糖尿病合并脑梗死患者血清sICAM-1和IL-6水平的影响。方法将60例2型糖尿病合并脑梗死患者随机分为对照组和治疗组,每组30例。2组均给予常规治疗,治疗组在对照组的基础上加用依达拉奉。用ELISA法分别检测2组治疗前后血清sICAM-1、IL-6的水平变化。结果2组治疗后SICAM-1和IL-6水平均比治疗前有明显的下降（ P ＜0．05）,但治疗组下降更显著（ P ＜0．05）。结论依达拉奉可降低2型糖尿病合并脑梗死患者血清中sICAM-1、IL-6的水平,使患者获益。     

东城区东直门保健科 2011 至 2012 年智能发育迟缓儿童发病分析

目的在社区儿童保健工作中,通过智能发育监测,早期发现儿童智能发育问题、及早转诊、及早干预,降低儿童智力残疾的发生及减轻智力残疾程度,为今后的智能发育监测工作提供一些经验和借鉴。方法对象及监测时间：在本地段保健的所有0～3岁以下的儿童（包括在本地段居住的本市及外埠儿童）。监测时间：2011年9月1日至2012年8月31日。筛查方法：筛查方法采用经标准化的儿童发育筛查方法。北京市儿童保健现用儿童丹佛发育筛查法（DDST））。结果在智力筛查中发现,早期的智力筛查结果不正常,及早转诊康复治疗对儿童的智力恢复有很大作用。结论建立完善的高危儿转诊制度,使该科的高危儿管理工作做到：高危儿童管理无遗漏,做到了早发现、早诊断、早干预,使智能落后儿童的智力潜能得到充分地发挥。     

高压电烧伤对大鼠TNF-α及微循环的影响

目的检测高压电对大鼠血清肿瘤坏死因子-α（TNF-α）、皮肤微循环灌流量（SMH）的影响并探讨TNF-α在微循环障碍中的作用及乌司他丁（UTI）的干预效果。方法将144只SD大鼠按完全随机设计方法分为对照组、电伤组和治疗组,每组48只,每组再分为6个时相组,每时相组8只。电伤组和治疗组大鼠用调压器和实验变压器制成高压电烧伤模型,对照组大鼠接相同装置但不通电,致假伤。用ELISA法检测三组伤前15 m in及伤后5 m in、1 h、2 h、4 h、8 h大鼠血清TNF-α变化,用激光多普勒微循环图像仪检测以上各时相胸部SMH。结果①TNF-α变化：组内比较,电伤组和治疗组TNF-α在伤后5 m in上升,持续至伤后8 h,均呈逐渐升高趋势,伤后8 h达最高值,分别为（54.71±4.82）、（24.26±3.17）pg/m l;组间比较,治疗组TNF-α在伤后5 m in较电伤组无明显变化,从伤后18 h,治疗组TNF-α均低于电伤组,高于对照组。②SMH变化：组内比较,电伤组和治疗组SMH在伤后5 m in开始下降,持续到伤后8 h,均呈逐渐下降趋势,均以伤后5 m in最低值,分别是（1.01±0.05）V、（1.12±0.11）V;组间比较,治疗组SMH在伤后5 m in8 h,SMH均高于电伤组,低于对照组。结论高压电可引起大鼠血清TNF-α升高及SMH下降,而UTI能抑制伤后血清TNF-α升高和SMH下降。TNF-α在高压电烧伤后微循环障碍中起一定作用     

不同剖宫产术式对再次剖宫产的影响研究

目的探讨两种剖宫产术式对再次剖宫产术的影响。方法回顾性分析再次剖宫产术产妇120例的临床资料,按照前次手术方式分为观察组(新式剖宫产组)及对照组(传统子宫下段剖宫产组),并对两组开腹时间、手术时间、术中出血量,盆、腹腔粘连情况和术后恢复情况进行比较。结果观察组开腹时间9.6±3.7 min高于对照组5.3±2.4 min,差异有统计学意义(P<0.05)。两组在手术时间和术中总出血量方面差异无统计学意义(P>0.05);观察组盆、腹腔粘连情况明显较对照组重,差异有统计学意义(P<0.05);观察组在术后住院时间较对照组短,观察组术后发热例数较对照组少,差异均有显著性(P<0.05)。结论新式剖宫产与传统子宫下段剖宫产相比,新式剖宫产引起粘连情况较传统子宫下段剖宫产重,增加了再次手术的难度,但术后恢复快、并发症少。     

高压电烧伤家兔球结膜微循环变化和己酮可可碱干预作用

Objective To study the changes in bulbar conjunctiva microcirculation (BCM) and the therapeutic effect of Pentoxifylline on BCM disturbance after high-voltage electrical burn (HEB) in rabbits. Methods Forty-five rabbits were divided into control group (C) , electrical burn group (EB) , and Pentoxifylline treatment group (PT) according to random number table, with 15 rabbits in each group. Model of HEB was reproduced in rabbits from EB and PT groups with voltage regulator and experimental transformer. Rabbits in C group were sham injured with the same devices without electrification. Changes in BCM were observed with microcirculation microscope at 15 minutes before HEB and 5 minutes, 1, 2, 4, 8 hour (s) post HEB (PHM or PHH) , including: (1) morphology of microvessels, such as the descemibleness, diameters of arterioles, venules, and capillaries, the unevenness in caliber, and ischemic area; (2) dynamic changes in microvascular blood flow, such as blood flow speed in arterioles, venules, and capillaries, erythrocyte aggregation, and microthrombi formation; (3) condition of tissues surrounding microvessel, such as bleeding and exudation. Measurement data were processed with t test; enumeration data were processed with Fisher's exact test. Results (1) Morphology of microvessel: descernibleness of microvessels in EB and PT groups was decreased, but that of PT group was better than that of EB group. At PHM 5 , diameter of ar-terioles, venules and capillaries was respectively (7. 3 ± 2. 5) , (12. 3 ± 2. 4) , (3. 5 ± 0. 7) μm in EB group, all narrower than those of the control group [(14.6 ±3. 1) , (27.2±3.5), (9.0±1.4) μm, with t value respectively 5. 23 , 13. 66, 14. 04, P values all below 0. 05]. Diameters of the microvessels in PT group [(10. 2 ±3.8) , (21.5±3.1), (7. 1 ±1.2) μm] were larger than those in EB group (with t value respectively 2. 21 , 8. 99, 10. 18, P values all below 0. 05). Diameters of arterioles, venules and capillaries in EB and PT groups recovered to the before HEB size at PHH 1. From PHH 2 to 8, arterioles and capillaries decreased gradually in caliber, venules dilated gradually in EB and PT groups, but the changes in PT group were not obvious. Thickness of microvessel was observed uneven in EB group at PHM 5, which lasted until PHH 8. Ischemia of the tissue was observed in EB group at PHM 5, which improved at PHH 2. Situation in PT group was better. (2) Dynamic changes in microvascular blood flow; at PHM 5, blood flow speed in arterioles, venules and capillaries was respectively (202 ±53), (198 ± 44) , (46 ±12) μm/s in EB group, all slower than those of the control group [(544 ± 37) , (359 ± 32) , (220 ± 19) μm/s, with t value respectively 20.47, 11. 51, 30. 02, P values all below 0.05] , and those of PT group [(335 ± 42) , (260 ± 35), (119 ± 23) μm/s] were faster than those of EB group (with t value respectively 7. 55 , 4. 26, 14. 85, P values all below 0.05). Blood flow speed in EB and PT groups recovered to the before HEB level at PHH 1. From PHH 2 to 8, blood flow speed decreased gradually in EB and PT groups, but that of PT group was faster than that of EB group. Erythrocyte aggregation in venules and capillaries was observed in EB group at PHM 5, which eased up at PHH 1 , but aggregated at PHH 2, lasting until PHH 8. Obvious microthrombi were observed in EB group at PHH 2, which increased gradually. These changes were less obvious in PT group. (3) Condition of surrounding tissues of microvessel: in EB group, exudation was observed around microvessels at PHH 1, bleeding at PHH 2, with a worsening tendency. Changes in those in PT group were less obvious. Conclusions HEB causes disturbance in BCM, but it can be ameliorated by Pentoxifylline.     

抗氧化治疗老年糖尿病性骨质疏松的疗效

目的探讨抗氧化治疗对老年人糖尿病性骨折疏松的临床疗效。方法将该院2012年4月至2013年1月收治的100例老年糖尿病性骨质疏松患者采用随机对照的方法分为观察组和对照组,每组50例,对照组采用常规降血糖和补钙治疗,观察组在对照组的基础上采用抗氧化治疗,比较两组的临床疗效。结果观察组中显效20例,有效25例,总有效率(90.0%)显著高于对照组(76.0%)(P0.05)。两组患者治疗前的血糖、疼痛评分、骨钙素(BGP)、骨密度(BMD)、血钙无统计学差异(P0.05)。观察组治疗后的疼痛评分、血糖水平显著低于对照组(P0.05)。观察组治疗后的BGP和BMD显著高于对照组,血钙显著低于对照组(P0.05)。两组患者的不良反应无统计学差异(P0.05)。结论抗氧化治疗不仅能显著降低糖尿病性骨质疏松患者的血糖水平,还能有效提高患者的骨密度,减少疼痛,改善患者的生活质量。     

TAGLN真核表达载体pcDNA6.2/EmGFP-Bsd/V5-TAG-LN-mut及稳定转染细胞株的构建

目的:构建携tagln基因的真核表达载体,建立稳定转染该质粒的人结肠癌细胞株RKO并鉴定.方法:通过Gateway克隆技术,使用pOTB7-TAGLN-mut与pDONR221进行BP重组反应产生入门克隆,再与pcDNA6.2/EmGFP-BsdV5-DEST空载体进行LR重组反应,生成目的质粒pcDNA6.2/EmGFP-Bsd/V5-TAGLN-mut通过测序验证目的质粒的插入序列.将携带tagln的真核表达载体和对照质粒稳定转染至人结肠癌细胞株RKO.通过实时荧光定量PCR和免疫印迹检测tagln的mRNA和蛋白表达水平.通过细胞侵袭实验了解transgelin在结肠癌细胞RKO中的作用.结果:携带tagln的真核表达载体测序分析显示插入序列及位点正确;实时荧光定量PCR及免疫印迹结果显示,稳定转染重组目的质粒的细胞株(RKO-TAGLN细胞)中tagln的表达水平与转染对照质粒的细胞株(RKO-CTRL细胞)及野生型RKO细胞相比明显上调,差异具有统计学意义(mRNA相对表达水平分别为45.58±12.79、1.32±0.43和1,P<0.01;蛋白质灰度定量值为1.69±0.04、0.29±0.05和0.29±0.04,P<0.01).细胞侵袭实验提示,RKO-TAGLN细胞较RKO-CTRL细胞的侵袭能力提高(161.76%±61.18%,P<0.01).结论:成功构建携tagln基因的真核表达载体并建立过表达transgelin的稳定细胞株和对照细胞株,为研究transgelin在结肠癌中的作用奠定基础.