Evolution of casting techniques in early-onset and congenital scoliosis

Casting is being utilized as a therapeutic strategy in some mild to moderate cases obviating surgical intervention for management of early-onset scoliosis (EOS). Bracing, another conservative modality, applies comparable correcting forces on chest wall and axial skeleton. But cast application carries additional advantage of sustained restorative force which bypasses issue of compliance seen with brace wear. There is no specific blanket treatment, conservative or surgical, for the early-onset spinal deformities. Serial cast application provides near total correction of less severe curves (less than 50⁰ to 60⁰) if treatment is initiated before age of 2 yrs. In this review article, we will assess the evolution of plaster cast application in management of EOS and also describe technique of EDF (Elongation- Derotation- Flexion) casting.     

通络止痛方治疗带状疱疹后遗神经痛的临床观察

目的 观察中药通络止痛方治疗带状疱疹后遗神经痛的临床疗效和安全性。方法 150名病人随机分为治疗组和对照组各75例,两组在同时口服甲钴胺的基础上,治疗组用自拟的通络止痛方,一日一剂；对照组用加巴喷丁胶囊,一日三次,每次300mg。两组均治疗二月,每半月观察一次,详细记录视觉模拟评分法(VAS)的分值与不良反应。结果 疗程结束时治疗组有效率为60%,对照组为58.7%,差异无统计学意义(P＞0.05)；VAS的分值组内前后下降差异有统计学意义(P＜0.05),组间下降无统计学意义(P＞0.05)；治疗组不良反应发生率为21.3%,而对照组为57.3%,差异有统计学意义(P＜0.05)。结论 通络止痛方治疗带状疱疹后遗神经痛比加巴喷丁更具有优势。     

针刺联合自拟消瘤止痛汤改善癌性疼痛的作用

目的探讨针刺联合自拟消瘤止痛汤改善癌性疼痛的作用。方法选定2017年2月—2018年12月本院收诊的102例癌性疼痛患者,分层随机法分为观察组51例(针刺联合自拟消瘤止痛汤)与对照组51例(三阶梯癌痛疗法),比较两组镇痛持续时间、镇痛起效时间与不良反应发生率指标。结果治疗结束,观察组镇痛持续时间长于对照组且差别有统计学意义(P<0.05);观察组镇痛起效时间短于对照组且差别有统计学意义(P<0.05);观察组不良反应发生率(1.96%)低于对照组(15.69%)且差别有统计学意义(P<0.05)。结论针刺联合自拟消瘤止痛汤方法可有效减轻癌性疼痛患者疼痛感。     

生肌止痛熏洗剂对肛周脓肿术后疼痛的疗效观察

目的:探讨生肌止痛熏洗剂对肛周脓肿术后疼痛的临床疗效。方法:选取2021年4月—10月在乌鲁木齐市中医医院一、二部肛肠科行肛周脓肿手术的患者72例。按随机数字表法分为试验组与对照组，每组36例。试验组采用生肌止痛熏洗剂熏洗，对照组采用高锰酸钾熏洗。比较两组患者术后3 d、5 d、7 d的疼痛评分、疼痛消失、住院时间。结果:与对照组比较，试验组术后3 d、5 d的疼痛评分无明显差异(P>0.05)，术后7 d，试验组的疼痛评分明显低于对照组，差异有统计学意义(P<0.05)。与对照组比较，试验组术后疼痛消失时间明显短于对照组，差异有统计学意义(P<0.05),但两组住院时间差异无统计学意义(P>0.05)。结论:肛周脓肿患者术后采用生肌止痛熏洗剂熏洗，可有效缓解患者的疼痛，缩短疼痛时间。     

Exercise handout and one-on-one hand therapy for management of stiffness after plaster cast immobilization of simple phalangeal and metacarpal fractures in children: A randomized,noninferiority trial

Study DesignThis is a noninferior, single-blind, randomized controlled trial.IntroductionJoint stiffness is common after plaster cast immobilization for simple phalanx and metacarpal fractures in children. The limited literature suggests this joint stiffness in children resolves without one-on-one therapy; however, without robust studies confirming that there is no detrimental effect from withdrawing treatment, many children are still referred.Purpose of the StudyThe purpose of this study was to determine if an educational handout for self-management of stiffness is noninferior to one-on-one hand therapy for achieving full range of motion (ROM).MethodsParticipants were randomly assigned to group one who received the handout or group two who received hand therapy in addition to the handout. The ROM was measured by composite flexion and total active motion (TAM). The noninferiority margin was 10% difference between the two groups in the proportion of participants who achieved full ROM at two weeks after cast removal.ResultsSixty participants in each group completed the study. Group difference for composite flexion was 1.7% (95% CI: −3.9% to 7.2%), demonstrating noninferiority. Group difference for TAM was inconclusive at 8.3% (95% CI: −2.1% to 18.7%). Sensitivity analysis adjusting for participants with full composite flexion at the baseline resulted in the group difference for composite flexion of 3.1% (95% CI: −3.6% to 9.8%), maintaining noninferiority, but group difference for TAM at 10.4% (95% CI: 0.0% to 20.9%), was inconclusive with the handout group significantly worse.ConclusionAn educational handout is noninferior to hand therapy for achieving full ROM in composite flexion but not TAM. This needs to be taken into consideration for changing clinical practise.     

Study of gypsum-bonded casting investments. Part 1

In order to develop analytical methods for identifying plaster or dental stone (calcium sulphate hemihydrate) and quantifying its content in gypsum-bonded dental casting investments, six dental gypsum products were studied by means of simultaneous differential thermal analysis-thermogravimetry (DTA-TG). Under the same analytical conditions employed in the present study, a phase change in calcium sulphate anhydrite (III-CaSO₄ to ll-CaSO₄) was shown to occur at about 220°C for four dental stones manufactured by various wet methods and at about 350°C for two plasters manufactured by dry methods. This confirms the general view that the two types of calcium sulphate hemihydrate manufactured by dry or wet method could be identified by the DTA method. A reasonable estimate of chemically bound water could be made from the TG results at 300°C. The present DTA-TG method can be used to identify the plaster or dental stone and calculate its content in gypsum-bonded casting investments.     

活络止痛凝胶剂的质量标准

目的:建立活络止痛凝胶剂的质量标准。方法:采用薄层色谱法对活络止痛凝胶剂中的肉桂、草乌、延胡索3味中药进行定性鉴别;采用GC-MS对方剂中提取的挥发油部位进行定性鉴别;并采用HPLC测定了活络止痛凝胶剂中桂皮醛、新乌头碱、次乌头碱、乌头碱的含量。结果:活络止痛凝胶剂供试品薄层色谱中,与对照药材色谱相应的位置上显相同斑点,且阴性无干扰;GC-MS定性分析表明肉桂醛是挥发油中的主要成分,其次是丁香酚;HPLC测定中,新乌头碱进样量在0.48~2.88μg与峰面积积分值的线性关系良好(r=1),次乌头碱进样量在0.16~0.96μg与峰面积积分值的线性关系良好(r=1),乌头碱进样量在0.34~2.04μg与峰面积积分值的线性关系良好(r=1),桂皮醛进样量在0.268~1.608μg与峰面积积分值的线性关系良好(r=0.999 1)。结论:该文所建立的定性定量方法简便,准确,分离度好,适用于活络止痛凝胶剂的质量控制。     

止痛化癥胶囊联合亮丙瑞林治疗子宫内膜异位症的疗效观察

目的 探究止痛化癥胶囊联合亮丙瑞林治疗子宫内膜异位症的临床疗效。方法 选取2014年1月-2014年7月鄂州市中医医院妇产科收治的子宫内膜异位症患者98例,随机分为对照组和治疗组,每组各49例。对照组皮下注射注射用醋酸亮丙瑞林微球,3.75 mg/次,4周/次,若患者体质量<50 kg,则注射剂量减少50%。治疗组在对照组基础上口服止痛化癥胶囊,4粒/次,2次/d,月经期间停止服用。3个月为1个疗程,连续治疗2个疗程。观察两组的临床疗效,同时比较两组治疗前后促卵泡生成素(FSH)、黄体生成激素(LH)、雌二醇(E₂)、子宫体积、CA₁₂₅、Kupperman评分的变化。比较两组患者绝经症状发生情况。结果 治疗后,对照组和治疗组的总有效率分别为77.55%、91.84%,两组比较差异具有统计学意义(P < 0.05)。治疗后,两组FSH、LH、E₂、子宫体积、CA₁₂₅水平、Kupperman评分均显著降低,同组治疗前后差异具有统计学意义(P < 0.05);且治疗组这些指标的降低程度优于对照组,两组比较差异具有统计学意义(P < 0.05)。治疗组潮热出汗、感觉异常、失眠、情绪波动、抑郁、眩晕、疲乏、骨关节痛、头痛、心悸、皮肤蚊走感、泌尿感染、性生活障碍发生例数均显著低于对照组,两组比较差异具有统计学意义(P < 0.05)。治疗后,两组患者痛经、盆腔痛、性交痛的VAS评分均显著降低,同组治疗前后差异具有统计学意义(P < 0.05);且治疗后,治疗组痛经、盆腔痛的VAS评分低于对照组,两组比较差异具有统计学意义(P < 0.05)。结论 痛化癥胶囊联合亮丙瑞林治疗子宫内膜异位症具有较好的临床疗效,可降低患者FSH、LH、E₂水平和VAS评分,改善患者绝经症状,具有一定的临床推广应用价值。     

基于整合药理学策略的元胡止痛方研究进展

中药方剂是中医临床治疗的主要形式和手段,探索中药方剂的化学物质实体与机体生命活动的交互规律,是中药研究的关键科学问题之一。目前,中药研究存在整体与局部脱节、宏观与微观脱节、体内过程与活性评价脱节,整合药理学的提出,为解决中药研究"碎片化"问题提供了一条切实可行的途径。近年来,该课题组采用整合药理学策略,对元胡止痛方进行了系统研究,建立了"化学指纹-代谢指纹-网络靶标"和"肠吸收-活性评价-数据挖掘"2个研究模式,从计算、体外和体内多个层次建立了该方剂的化学成分与生物活性之间的交互规律,为该方剂的质量控制、药效物质基础及其药理作用机制提供了依据,该文对相关研究进展进行综述。     

温经止痛凝胶膏剂的促渗剂优选

目的:优选温经止痛凝胶膏剂中促渗剂的种类及用量。方法:采用改良Franz扩散池,以离体小鼠腹部皮肤为屏障,采用HPLC检测不同促渗剂种类、比例及用量对温经止痛凝胶膏剂中藁本内酯累积透皮量、透皮吸收速率、增渗倍数等参数的影响,流动相甲醇-水(80∶20),检测波长328 nm。结果:氮酮和丙二醇联用的促渗效果明显优于其他几种促渗剂,确定氮酮与丙二醇的用量比(2∶1),总用量4%。藁本内酯24 h的累计透皮量84.16μg·cm-2,透皮速率常数3.28μg·cm-2·h-1,增渗倍数3.33。结论:氮酮和丙二醇组合的透皮促渗效果显著,可作为温经止痛凝胶膏剂的促渗剂。