电生理检测对贝耳麻痹患者的预后评估

INTRODUCTIONBellpalsyisoneofthemostcommondiseasesinneurologicalde－partment．HowtopredicttheprognosisofBellpalsyiswhatdoctorsandpatientsareconcernedabout．MATERIALSANDMETHODSMaterialsClinicalmaterialswerecollectedfromFebruary１９９６toDecember２０００．４２caseswereselectedfrom１０６casesofBellpalsywhosemanifestationsandelectrophysiologicaltestwerefollowedupcontinuously．Patientssex：２２menand２０women；Agerang：１８－７４yearsold，averageage：３８yearsold；Thefirsttestingtimew…     

打造新时期过硬监管队伍

新时期的食品药品监管工作，对执法队伍的要求越来越高，也越来越严格。树立新时期监管新形象，打造过硬执法队伍，笔者认为，应该在树立以下五个方而形象，提高五个方面能力上入手，切实把基层执法队伍建设工作推上一个新台阶。     

基于主动脉内血泵的集中参数模型研究

目的为研究主动脉内血泵出入口的压力差和血液流率之间的关系,并以此预测血泵的血流动力学参数,建立主动脉内血泵非线性集中参数模型。方法该模型依靠血泵本体参数,不包含循环系统的血流动力学参数。模型包括:电流源,与血泵转速相关,表示被血泵叶轮推出的流率;内阻,用来模拟主动脉内血泵径向间隙之间的阻力;电感,表示流过主动脉内血泵径向间隙的血液的惯性。结果模型可模拟从肺淤血到心室塌陷等各种心脏的生理状态。通过模型得到了血泵的特征方程,方程中参数值由体外循环实验确定。结论通过比较预测血泵压力差和实际测量压力差验证特征方程准确性,结果显示误差小于5%,因此该模型能够准确预测血泵压力差。     

儿科专家自摘招牌

儿科名医徐小圃的幼儿在一年夏季患了伤寒病.徐小圃亲自为之诊治,但病情加重,几濒于危,全家焦急,徐小圃亦感棘手.当时,家属及诸亲好友,均向徐小圃建议,恳请其医友祝味菊先生会诊一决.徐小圃慨然叹曰:"我与祝君虽属莫逆之交,但学术观点不同,他擅温阳,人称‘祝附子’.今孩子患的是热病,若祝君来诊,无非温药而已,此明知其‘抱薪救火’,我孰忍目睹其自焚耶?"又过了几天,患儿几将奄奄一息,亲友竭力敦促,与其束手待毙,何妨一试究竟.徐小圃无奈之下,恳请祝味菊来治病.     

Electrophsiological study in the prognosis of Bell palsy

AIM:To estimate the prognosis of Bell palsy,METHODS:Blink relex (BR),electromyography(EMG),motor latency(ML) and amplitude (AMP) of facial nerve were performed in 42 patients with Bell‘‘‘‘s palsy.The patients were followed about half a year.RESULTS:(1) When 1 of the 3R waves related with the ill side existed or appeared in 3 weeks after onset,97% patients could recover completely.THe recovery time was realted to the time of the occurrence of R wave.(2) When 1 of the 3R waves appeared in the 4th week.60% patients could recover completely,When none of the 3 wasves appeared after the 4th week,100% patients could not recover completely.EMG showed spontaneous activities in 3 of the 6 patients in the 4th week.(3) Motor latency and amplitude of facial nerve were examined when the illness stopped developing.All patients had normal lalencies,5 patinets‘‘‘‘ amplitudes reduced more than 90%.3 of the 5 patients did not appear the related R waves after the 4th week.CONCLUSION:BR might provide the early sign of good prognosis of Bell‘‘‘‘s palsy ,BR together with EMG and ML and AMP of facial nerve might provide the later sign of poor prognosis.     

针刺治疗慢性咽炎临床观察

【目的】比较针刺与药物治疗慢性咽炎的临床疗效。【方法】将60例患者随机分成治疗组和对照组各30例。治疗组给予滋阴降火、清利咽喉针刺疗法治疗,取穴照海、列缺、天突、廉泉、天容、合谷、鱼际,并依据证候体征加减配穴,每日1次,每周治疗6次;对照组给予西药治疗,包括咽部涂10 mg/L碘甘油制剂和含服西地碘口含片。2组治疗均以4周为1个疗程,共治疗2个疗程。评价2组临床疗效,观察2组治疗前后症状体征积分和慢性咽炎证候不适感等级问卷表评分(VAS)变化。【结果】(1)治疗组总有效率为93.3%,优于对照组的73.3%,组间比较,差异有统计学意义(P0.05)。(2)治疗后,2组的症状体征积分和VAS评分较治疗前均显著降低(P0.05或P0.01);且治疗组在改善各项症状体征积分和VAS评分方面均优于对照组,差异均有统计学意义(P0.05或P0.01)。(3)在治疗过程中,治疗组除轻微针刺疼痛、出血外,无晕针、滞针等任何不良反应,对照组也未发现过敏及毒副反应。【结论】针刺疗法可明显改善慢性咽炎患者各项症状体征和不慢性咽炎是咽部黏膜及黏膜下组织、淋巴组织的弥漫性慢性炎症,以咽中不适为主症,咽部常有异物感或干燥灼热感,咽痒欲咳,痰涎黏稠不易咳出,易引起恶心、干呕,偶有轻微咽痛,一般晨轻夜重。本病多因急性咽炎治疗不当、反复发作或邻近组织的慢性炎症所致。此外,过多吸烟、饮酒,粉尘、烟雾及环境污染和有害气体的刺激,教师、演员长期用声过度也是常见的致病因素。本病症状顽固,病程长,缠绵难愈,易反复,对患者生活和工作造成了严重影响。笔者根据多年临床经验发现,在治疗本病过程中,采用滋阴降火、清利咽喉针刺疗法常取得较好的临床疗效,现报道如下。1对象与方法1.1研究对象选择2013年1月至2014年1月在天津中医药大学第一附属医院门诊就诊的明确诊断为慢性咽炎的患者,共60例。其中男性37例,女性23例;年龄20~65岁,平均(44.08±11.81)岁;病程6个月至10年,平均病程(26.20±18.87)个月。按照就诊顺序随机分为治疗组和对照组,每组各30例。适感,其疗效优于药物治疗。     

Study of repeated nerve stimulation in myasthenia gravis

AMI：To investigate normal value range of low-frequent repeated nerve stimulation (RNS): whether different low-frequent stimulation and different muscles have different normal value rang.METHODS:Low-frequent(3c/s and 5c/s) RNS of 30 healthy people and 27 myasthenia gravis (MG) patients were rest. RESULTS:Superior limit of amplitude of wave attenuation value of low-frequent RNS(x^-&;#177;2.5s) of different muscles (orbicularis oculi muscle, deltoid muscle and abductor muscle of little finger) of healthy people was 5.45%-7.55%. According to our normal value standard, RNS positive rate of MG group was 85%; according to the current criteria (amplitude of wave attenuation value&;gt;10%), positive rate of MG group was 70%, there was no apparent difference in RNS positive rate (P&;gt;0.1). Some labs adopted the criteria that amplitude of wave attenuation value&;gt;15%, according to this criteria, positive rate of MG group was 51%. Compared with positive rate (85%) obtained according to our criteria, there was apparent difference(P&;lt;0.01).CONCLUSION:Each labs should establish their own normal value standard according to difference muscle and different frequent. If adopt universal standard,amplitude of wave attenuation value 8% or 10% was suggested.