双极射频热凝术治疗腰椎间盘突出症的观察

目的:观察双极射频热凝术治疗腰椎间盘突出症的临床效果.方法:选择2006年3月至2008年4月江苏省如皋市人民医院收住的腰椎间盘突出症患者64例,分为单极射频热凝术组(对照组)和双极射频热凝术组(观察组).随访患者于治疗后7、30和180 d的改良MacNab评分状况.结果:两组治疗均未发生严重并发症,观察组在术后180d的优秀率明显高于对照组(P＜0.05).结论:双极射频热凝术治疗腰椎间盘突出症创伤小,近期疗效明显.     

靶点射频热凝联合臭氧注射治疗腰椎间盘突出症的临床观察

目的:观察C臂引导下靶点射频热凝联合臭氧注射治疗腰椎间盘突出症的临床效果及安全性.方法:将100例腰椎间盘突出症患者分为两组,A组在C型臂X光机定位下行靶点射频热凝联合臭氧注射治疗(n=50),B组在C型臂X光机定位下行胶原酶溶盘治疗(n=50).比较两组患者的住院时间、治疗前、治疗后第4天VAS变化、并发症发生率、治疗后1个月、6个月、12个月的疗效.结果:A组住院时间明显短于B组,两组治疗前及治疗后第四天VAS、治疗1、6、12个月的疗效、总并发症发生率相比均无显著统计学差异.结论:靶点射频热凝联合臭氧注射腰椎间盘突出症的临床疗效及安全性与胶原蛋白酶溶盘治疗相似,但接受靶点射频热凝联合臭氧注射治疗的患者住院时间更短.     

医用臭氧联合射频热凝微创治疗腰椎间盘突出症的疗效观察

目的 观察C型臂X线机引导下靶点射频热凝联合臭氧注射治疗腰椎间盘突出症(LDH)的临床疗效及安全性.方法 依照住院先后顺序将108例LDH患者分为A、B、C 3组(每组36例),分别接受射频热凝消融术、注射医用臭氧、臭氧联合射频热凝消融治疗LDH,分别于术后4d、7d、2个月、6个月观察并比较3组治疗前后VAS值的变化及术后疗效.结果 C组同期VAS值评分明显低于A、B2组(P均＜0.05);C组总有效率91.7％ (33/36),明显高于B组(69.4％,P＜0.05),稍高于A组(77.8％,P＞0.05).结论 经皮穿刺射频消融联合臭氧盘内外注射治疗LDH近、远期疗效显著.     

单极射频靶点热凝联合臭氧消融术对腰椎间盘突出症患者术后疼痛程度及JOA评分的影响

目的:探究单极射频靶点热凝联合臭氧消融术对腰椎间盘突出症患者术后疼痛程度、JOA评分的影响及疗效。方法:选取我院2017年2月～2018年2月腰椎间盘突出症患者92例,随机数字表法分为对照组(n=46)与观察组(n=46)。观察组给予单极射频靶点热凝、臭氧消融术治疗,对照组给予臭氧消融术治疗。观察比较两组治愈率、总有效率及治疗前后视觉模拟疼痛量表(VAS)、日本骨科协会(JOA)评分。结果:治疗后观察组VAS评分与对照组相比,明显降低(P0.05),观察组JOA评分与对照组相比,明显提高(P0.05);观察组治愈率84.78%高于对照组65.22%,总有效率97.83%高于对照组82.61%(P0.05)。结论:单极射频靶点热凝联合臭氧消融术治疗腰椎间盘突出症,能降低患者术后疼痛程度与功能性障碍,疗效显著。     

射频热凝靶点消融结合臭氧注射治疗不同类型腰椎间盘突出症的近期疗效

目的:观察射频热凝靶点消融术联合臭氧注射对不同类型腰椎间盘突出症患者的临床疗效.方法:选取符合条件的86例腰椎间盘突出症患者,利用美国矫形外科学会的建议进行分类,所有患者均采取小关节内侧缘进针方式进行射频热凝靶点消融术联合臭氧注射,观察各类腰椎间盘突出症的临床疗效.结果:Ⅰ、Ⅱ、Ⅲ型患者在治疗后的视觉模拟评分(VAS)较治疗前出现明显下降(P=0.00＜0.01);Ⅱ、Ⅲ型患者的直腿抬高试验角度明显改善(P=0.00＜ 0.01).Ⅳ型患者虽在治疗后3d的VAS评分较术前有所改善,但临床症状改善不明显(P=0.11＞ 0.05),且治疗后1月的VAS评分及改良MacNab标准较治疗后3d未见明显改善(P=0.414＞ 0.05),其治疗1月后的有效率为70％,优良率为50％.结论:射频热凝靶点消融术联合臭氧注射对Ⅰ、Ⅱ、Ⅲ型腰椎间盘突出症均具有显著疗效.Ⅳ型腰椎间盘突出症虽可减轻患者疼痛,但临床症状改善不明显,需临床医师酌情考虑.     

CT引导下三联微创介入治疗颈腰椎间盘突出症82例

【目的】探讨CT引导下以臭氧髓核消融术为基础的三联疗法对颈腰椎间盘突出症的临床疗效。【方法】选取陈旧性颈腰椎间盘突出症患者246例,按治疗方法分为试验组、胶原酶组和射频热凝术组,每组82例。试验组在CT引导下行臭氧髓核消融术联合应用胶原酶和射频热凝术,胶原酶组在CT引导下行臭氧髓核消融术联合应用胶原酶,射频热凝术组在CT引导下行臭氧髓核消融术联合应用射频热凝术。随访3个月后,比较三组临床疗效。【结果】试验组有效率显著高于胶原酶组和射频热凝术组,其差异有统计学意义（P ＜0．05）;但胶原酶组和射频热凝术组有效率比较差异无统计学意义（P＞0．05）。【结论】在CT引导下行臭氧髓核消融术联合应用胶原酶和射频热凝术治疗陈旧性颈腰椎间盘突出症患者,疗效满意,值得临床推广应用。     

经皮靶点射频热凝结合臭氧注射治疗腰椎间盘突出症的临床研究

目的:观察经皮靶点射频热凝结合臭氧注射治疗腰椎间盘突出症的疗效.方法:90例腰椎间盘突出症患者,分为靶点射频热凝治疗组(A组,n=30)、靶点射频热凝结合臭氧注射治疗组(B组,n=30);臭氧注射治疗组(C组,n=30).分别于术后1周、3个月和6个月进行疗效评价.结果:与术后1周相比,B组术后6个月的优良率显著提高(P<0.05);B组术后3个月及术后6个月的有效率及优良率均高于C组(P<0.05),B组术后6个月的优良率较A组高(P<0.05).各组无明显术后并发症发生.结论:经皮靶点射频热凝结合臭氧注射,利用高温射频热凝和臭氧溶核松解的不同作用,直接对腰椎间盘突出的髓核进行治疗,患者术后恢复迅速、疗效确切、并发症少,是治疗腰椎间盘突出症的有效方法.     

小关节内侧缘入路盘内胶原酶溶解联合射频热凝治疗二区C域Ⅲ层腰椎间盘突出症的临床研究

目的:观察小关节内侧入路盘内胶原酶溶解联合射频热凝治疗二区C域Ⅲ层腰椎间盘突出症的临床疗效.方法:336例二区C域Ⅲ层腰椎间盘突出症患者使用随机数字表进行完全随机分组的方法分为A、B二组,每组168例.A组采用小关节内侧 入路盘内胶原酶溶解联合射频热凝术治疗,B组采用小关节内侧入路盘内胶原酶溶解术治疗.采用MacNab疗效评定标准评估治疗效果.观察二组患者术后2周、3个月的治疗效果.结果:术后2周和3个月,A组治疗优良率高于B组.结论:小关节内侧 入路盘内胶原酶溶解联合射频热凝治疗二区C域Ⅲ层腰椎间盘突出症疗效优于单独应用椎板间孔入路盘内胶原酶溶解术.     

突出物靶点射频消融联合臭氧盘内外注射治疗腰椎间盘突出症的临床研究

目的:观察突出物靶点射频消融联合臭氧盘内外注射治疗腰椎间盘突出症的临床疗效.方法:经CT或MRI诊断为腰椎间盘突出症的患者128例,根据入院先后分成两组.对照组64例椎间盘内、椎间孔注射臭氧组;试验组64例突出物靶点射频消融联合椎间盘内、椎间孔注射臭氧组.临床疗效采用MacNab评分及VAS评分,分别评价术后1天、5天,电话随访6个月疗效.结果:术后1天、5天的有效率分别为:对照组92.19%,90.63%;试验组:93.75%,90.63%.组间比较差异无显著性(P>0.05).术后6个月的有效率为对照组:70.31%,试验组:92.19%,组间比较差异有显著性(P<0.05).结论:突出物靶点射频消融联合臭氧盘内外注射是治疗腰椎间盘突出症的有效方法,6个月疗效高于单纯臭氧盘内外注射.     

补肾通痹汤联合靶点射频热凝术对腰椎间盘突出症患者JOA评分及炎症指标的影响

目的 探讨补肾通痹汤联合靶点射频热凝术对腰椎间盘突出症(LDH)患者日本骨科学会(JOA)颈椎病疗效评定标准评分及炎症指标的影响.方法 选择2018年2月至2019年6月某院收治的LDH患者104例,根据抽签法将其分为两组,各52例.对照组采用靶点射频热凝术治疗,观察组在对照组基础上采用补肾通痹汤治疗,比较两组JOA、...     

LEUCOPROTEASE AND ANTI-LEUCOPROTEASE OF MAMMALS AND OF BIRDS

The inhibiting action of the blood serum upon the enzyme of the polynuclear leucocytes, leucoprotease, is exerted by the albumin fraction of the serum. The albumin fraction contains no proteolytic enzymes. The globulin fraction of the serum contains no anti-enzyme for leucoprotease; it contains, on the contrary, an enzyme which digests proteids in a neutral or alkaline medium. This enzyme resembles leucoprotease which is present in the polynuclear leucocytes of an inflammatory exudate and in the bone marrow from which these cells are derived, and is doubtless identical with the similar enzyme occurring in smaller quantity in the spleen. This enzyme which is present in the blood serum is held in check by its anti-enzyme, but the latter is in such excess that the serum as a whole is capable of checking the action of leucoprotease when added in considerable quantity. Leucoprotease of one mammalian species is inhibited by sera of other mammalian species, but the anti-enzymotic activity of various sera differs; the anti-enzyme of the rabbit''s serum is stronger than that of dog''s serum, when tested either with dog''s or with rabbit''s leucoprotease. The co-existence in the rabbit of leucoprotease with feeble strength and anti-body of great activity may explain the absence in these animals of typical suppuration with liquefaction of tissues. The serum of birds which have been tested, namely, pigeon and hen, almost completely fails to inhibit mammalian leucoprotease (of dog). The polynuclear leucocytes, the bone marrow and the spleen of the hen do not contain an enzyme resembling leucoprotease of mammals. The absence of anti-enzyme in the serum is associated with absence of a corresponding enzyme in the leucocytes.     

环胞霉素A、亲合素和钙调磷酸酶复合物的结构特性与免疫抑制及其毒理作用机理

钙调磷酸酶（calcineurin，CN）是亲免素（immunophilin）-免疫抑制药物（immunosuppressant）复合物-环胞霉素A（cyclosporin A，CsA）、环胞霉素A亲合素（cyclophilin，CyP）和FK506结合蛋白（FK506-bindingprotein，FK BP-506）、FK506的共同靶目标。这些药物蛋白的复合物都能特异地抑制CN的生物活性，但是两种结构完全不同的亲免素-免疫抑制药物复合物为何能够作用同一靶目标目前仍不清楚。     

旅店业卧具污染及清洗消毒效果调查

通过对宾馆和小型招待所卧具(被罩、床单、枕套)抽样检测,了解细菌污染程度及其消毒效果。结果,使用过的卧具细菌总数超标率为50％,大肠菌群检出率为28.8％,以招待所床单污染最严重,细菌总数超标率达到72％。宾馆卧具污染程度较小型招待所轻,两者有显著差异。清洗消毒后的卧具(备用品)细菌总数超标率为5％,大肠菌群检出率为2.5％,说明清洗消毒效果显著。为此提示,对旅店业卧具的监督管理重点是小型招待所,主要是抓好卧具的清洗消毒,以保障卧具安全卫生。     

Fraxiparin对巨核细胞－血小板系统刺激增生作用的研究

Ｆｒａｘｉｐａｒｉｎ是一种小分子量肝素。研究结果表明，Ｆｒａｘｉｐａｒｉｎ可刺激鼠巨核细胞－血小板系统增生。在体外试验，Ｆｒａｘｉｐａｒｉｎ可刺激鼠巨核系祖细胞的增生和巨核细胞的成熟，其刺激增生作用与其中和血小板第４因子的作用有关。鼠的体内研究结果进一步证实Ｆｒａｘｉｐａｒｉｎ对巨核细胞有刺激增生作用。小剂量Ｆｒａｘｉｐａｒｉｎ也有刺激作用，但其刺激增生作用持续时间较短。Ｆｒａｘｉｐａｒｉｎ注射后５天，血小板计数较对照组略有升高，但无统计学意义。无论体内或体外，Ｆｒａｘｉｐａｒｉｎ对ＣＦＵ－ＧＭ均无刺激作用。     

思瑞康和维思通治疗精神分裂症的临床研究

目的　以维思通为对照组 ,探讨思瑞康治疗精神分裂症的疗效和副作用。方法　将 65例符合CCMD 3的精神分裂症患者随机分为两组 ,分别给予思瑞康和维思通治疗 8周。采用阳性症状和阴性症状量表 (PANSS)评定临床疗效 ,副反应量表 (TESS)评定副反应。结果　治疗 8周后的疗效相当 (P >0 .0 5 ) ;思瑞康组和维思通组的显效率差异无显著性 (P >0 . 0 5 ) ;思瑞康组的副反应发生率低于维思通组 ,但差异无显著性 (P >0 . 0 5 ) ;维思通组锥体外系副反应和内分泌改变的发生率均明显高于思瑞康组 (P <0. 0 5 ) ,但两药引起的副反应一般为轻度或中度 ,患者耐受性较好。结论　思瑞康和维思通对精神分裂症的疗效相当 ,但副作用有所不同。     

DETECTION OF THE VIRUS OF POLIOMYELITIS IN THE NOSE AND THROAT AND GASTRO-INTESTINAL TRACT OF HUMAN BEINGS AND MONKEYS

Five strains of virus were recovered from nasal washings and feces. Four strains were of human origin, the fifth strain came from a monkey sacrificed at the height of the disease. Of the four human strains the first was isolated from the feces of a 14 year old child 7 days after the onset of illness. The second strain was from the nasal washings of a 6½ year old child, 5 days after the onset of illness. The third and fourth strains were recovered from the same patient, a 2½ year old child, 9 days after the onset of illness. One of these strains was obtained from nasopharyngeal washings and the other from the feces. The single monkey strain was isolated from the upper intestinal segment and appears to be the only instance of its isolation from this source in the literature. We believe that the detection of the virus in the nasal washings of two additional patients during convalescence lends further support to the belief that the virus of poliomyelitis is spread by human contact. Furthermore, the recovery of the virus from the gastro-intestinal tract with as great or greater frequency as from the upper respiratory tract, need not, it appears to us, alter our concept of the mode of entrance of the virus into the body, namely, by way of the upper respiratory tract. If the presence of the virus is conceded, then a consideration of the physiologic passage of nasal and oral secretions into the gastro-intestinal tract by reflex swallowing would serve to explain adequately the presence of the virus in those organs. It might even be further predicated that since the gastro-intestinal tract functions as a temporary reservoir for secretions from the upper respiratory tract, the gut should, after a time, contain the virus in higher concentration than any single sample of secretion obtained from the upper respiratory tract by nasal washing. It appears to us that failures to detect the virus in the gastro-intestinal tract are perhaps more indicative of inadequate procedures for its detection than of its absence. The recovery of the virus from the feces 7 and 9 days after the onset of illness takes on added significance. It indicates first, that the virus withstands the gastric acidity which under normal physiological conditions tends to keep gastric contents relatively free of bacteria. It further suggests that improper disposal of feces from patients with poliomyelitis may have serious public health consequences, particularly in smaller communities where inadequate sewage disposal may result in contamination of surrounding beaches or even local water systems.     

ENHANCEMENT OF ANTIBIOTIC ACTIVITY OF COLICINE K AND ALTERATION OF SEROLOGICAL PROPERTIES OF COLICINE K AND ENDOTOXINS

Hemoglobin, its chains, and myoglobin enhance the antibiotic activity of colicine K. These proteins also interact with colicine K and other O antigens to alter their serological activity. The hemoglobin proteins did not alter the serological activities of three Pneumococcus polysaccharides or T4 bacteriophage DNA antigens but did alter the antigenic activity of fetuin. Interaction of hemoglobin and colicine K resulted in a retardation of colicine K antibiotic moiety as measured by gel filtration but did not affect the gel filtration properties of the lipopolysaccharide moiety.     

《疼痛知信行调查问卷》的研制及信效度检验

目的:编制适合全髋关节置换术患者疼痛知识、疼痛信念、疼痛控制行为问卷,检测其信效度。方法:采用知信行理论为问卷构架,在文献阅读、专家咨询、专题小组讨论的基础上初步编制疼痛知信行问卷。采取方便抽样法抽取盐城某三甲医院骨科75名拟行全髋关节置换术的患者,并进行问卷调查。采用Cronbach'α系数、分半信度进行信度检测,选用内容效度、探索因子分析检验问卷效度。结果:本问卷编制了36个条目,包括疼痛知识、疼痛信念、疼痛控制行为三个子问卷。问卷总的内部一致性信度为0.853,子问卷的内部一致性信度分别为0.817、0.814、0.919,子问卷的内容效度系数分别为0.837、0.946、0.902。对子问卷进行因子分析,累积贡献率分别为53.33%、61.26%、71.33%,每个项目的共性方差均超过0.4。结论:编制的《疼痛知信行调查问卷》具有良好的信效度,可以作为评鉴全髋关节置换术患者疼痛认知、疼痛信念、疼痛控制行为现状以及调查影响因素的可靠工具。     

PATHOGENESIS OF EXPERIMENTAL CHOLERA : PREPARATION AND ISOLATION OF CHOLERAGEN AND CHOLERAGENOID

Choleragen, a diarrheagenic protein enterotoxin elaborated by Vibrio cholerae, has been isolated from the supernate of fermenter cultures by steps involving ammonium sulfate precipitation, DEAE cellulose, Sephadex G-75, and Agarose A-5m chromatography. The resulting product appears to be pure according to immunoelectrophoretic, disc electrophoretic, ultracentrifugal, and immunologic criteria. Sephadex gel filtration and membrane filtration studies suggest a molecular size of 61,000. The isolated product is highly active in inducing experimental cholera in infant and adult rabbit models. It also elicits, in small dosage, an increased vascular permeability in skin. These observations indicate that choleragenicity and increased vascular permeability are intimately associated phenomena and may be manifestations of the same basic mechanism. An additional, antigenically identical, protein has also been isolated by the same procedures. The latter substance, termed "choleragenoid", lacks the permeability effect and choleragenicity of the choleragen moiety. Its size (estimated from Sephadex gel filtration at 42,000) is smaller than that of choleragen and it also differs in charge. Choleragenoid may prove useful as a nontoxic immunogen to protect against pathologic effects of V. cholerae infection.