推拿手法对家兔骨骼肌失神经支配后雪旺氏细胞S-100蛋白表达的影响

目的通过观察推拿家兔骨骼肌失神经支配后肌湿重、雪旺氏细胞S-100蛋白表达水平,探讨推拿手法对受损神经及失神经支配骨骼肌的影响。方法新西兰家兔120只,分为正常对照组、模型组、神经生长因子(NGF)治疗组、手法治疗组,每组30只,分别于手法干预2周、3周、1个月、2个月、4个月后,每组各取6只家兔,称量腓肠肌肌湿重,计算术侧与健侧的肌湿重比值;测定雪旺氏细胞S-100蛋白表达水平。结果 (1)腓肠肌肌湿重比:与模型组比较,手法治疗组各时间点均增加[2周:(0.72±0.05)%比(0.53±0.01)%,3周:(0.55±0.04)%比(0.41±0.03)%,1个月:(0.55±0.99)%比(0.40±0.03)%,2个月:(0.49±0.03)%比(0.38±0.05)%,4个月:(0.50±0.03)%比(0.38±0.05)%,P均0.05]。手法治疗组4个月时则显著高于NGF治疗组[(0.50±0.03)%比(0.42±0.02)%,P0.05]。(2)雪旺氏细胞S-100蛋白表达:手法治疗组在各时期均高于模型组[2周:(27.00±6.29)比(10.33±1.51),3周:(33.17±5.27)比(20.83±3.87),1个月(51.00±4.56)比(21.17±4.62),2个月:(75.83±9.66)比(30.67±3.27),4个月:(116.67±3.10)比(53.17±7.52),P均0.05]。手法治疗组在1个月、2个月均高于NGF治疗组[1个月:(51.00±4.56)比(32.83±4.12),2个月:(75.83±9.66)比(47.00±5.06),P均0.05]。结论推拿手法可以延缓周围神经损伤后骨骼肌萎缩、变性,促进损伤神经的修复。     

手法对家兔骨骼肌失神经支配后雪旺氏细胞S-100蛋白表达的影响

目的：通过观察推拿手法家兔骨骼肌失神经支配后肌湿重、雪旺氏细胞S-100蛋白表达水平,探讨推拿手法对受损神经及失神经支配骨骼肌的影响。方法：新西兰家兔120只,分为四大组：正常对照组30只、模型观察组30只、神经生长因子(NGF)治疗组30只、手法治疗组30只,分别于手法干预2周、3周、1月、2月、4月后,每组各取6只家兔,称量肌湿重,计算术侧与健侧的肌湿重比值;测定雪旺氏细胞S-100蛋白表达水平。结果：①腓肠肌肌湿重比：NGF治疗组在2周、3周、1月、2月及手法治疗组在2周、3周、1月、2月、4月均高于模型观察组(P＜0.05)。手法治疗组在2周、3周低于NGF治疗组(P＜0.05),4月时则高于NGF治疗组(P＜0.05)。②雪旺氏细胞S-100蛋白表达：NGF治疗组、手法治疗组在各个时期均高于模型观察组(P＜0.05)。手法治疗组在1月、2月均高于NGF治疗组(P＜0.05)。结论：推拿手法可以延缓周围神经损伤后骨骼肌萎缩、变性,促进损伤神经的修复。     

手法对家兔失神经骨骼肌收缩力的影响

目的观察手法对失神经状态下家兔骨骼肌收缩力的影响。方法 6月龄新西兰兔108只,随机分为模型观察组、手法治疗组以及正常对照组,各36只,各组再分为6个小组。模型观察组、手法治疗组建立兔失神经动物模型,手法治疗组在造模后第2天开始手法治疗,其余两组均不干预。对3组动物骨骼肌收缩力进行连续动态测试。结果正常对照组家兔腓肠肌收缩力(6.85±0.57)N,手法治疗组家兔腓肠肌收缩力分别为:1周:(4.22±0.15)N、2周:(3.53±0.11)N、3周:(3.69±0.13)N、2个月:(3.83±0.11)N、4个月:(2.58±0.21)N、6个月:(2.12±0.23)N,模型观察组家兔腓肠肌收缩力分别为:1周:(4.20±0.14)N、2周:(3.06±0.22)N、3周:(2.79±0.22)N、2个月:(3.06±0.22)N:4个月:(1.92±0.14)N、6个月:(1.52±0.21)N。手法治疗组、模型观察组大鼠腓肠肌收缩力均明显低于正常对照组(P0.01)。治疗第2周后手法治疗组大鼠腓肠肌收缩力明显优于模型观察组(P0.01)。结论推拿手法对失神经状态下家兔骨骼肌收缩力有促进作用,但只是减缓失神经骨骼肌收缩力下降的趋势。     

MSC介导CD30L等4种炎症相关因子在治疗DMD中发挥作用

目的 研究mUCMSC移植治疗DMD标准模型mdx小鼠后炎症相关因子变化,探讨MSC治疗DMD相关机制。方法 PCR鉴定出mdx小鼠随机分为两组:生理盐水组和治疗组;另取正常C57小鼠作为正常对照组。治疗组腹腔注射mUCMSC的生理盐水细胞悬液,生理盐水组和对照组输入等体积生理盐水,检测血清CK值;对各组小鼠的腓肠肌进行HE染色,显微镜下观察病理变化并计数CNF;采集mdx小鼠腓肠肌组织用QAM-INF-1蛋白芯片测定小鼠肌组织炎症因子含量。结果 治疗组与生理盐水组相比具有差异明显:(1)Mdx小鼠血清CK值生理盐水组为(1374.60±127.13)U/L,治疗组为(434.60±19.39)U/L,显著低于生理盐水组(P<0.05);(2)治疗组mdx小鼠腓肠肌切片显示细胞间炎性细胞浸润减轻,细胞大小趋于统一,核中心移位现象减少;(3)生理盐水组mdx小鼠腓肠肌细胞CNF可达(94.37±11.65)%,治疗组CNF为(80.37±7.65)%,显著减少(P<0.05);(4)mdx小鼠后肢腓肠肌组织中CD30L、IL-21、MIP-1a、PF4含量明显较低(P<0.05)。结论 mUCMSC治疗后,腓肠肌组织中CD30LIL-21、MIP-1a、PF4含量较低,血清CK值降低,细胞损伤减少。肌组织炎症表现减轻,在mUCMSC治疗DMD中发挥作用。     

黄芪与丹参联合对大鼠失神经骨骼肌萎缩的作用

目的探讨黄芪与丹参联合应用对失神经骨骼肌萎缩的作用。方法健康成年雄性SD大鼠72只,随机分为3组:阴性对照组(A组,n=24)、失神经对照组(B组,n=24)、黄芪丹参治疗组(C组,n=24)。A组仅暴露右侧坐骨神经,但不切断;B、C两组切断右侧坐骨神经1 cm,建立右下肢失神经腓肠肌萎缩模型;B组腹腔注射3 mL生理盐水;C组采用黄芪、丹参各1.5mL混合腹腔注射给药,分别于术后第2、3、4、6周每组各处死6只大鼠进行腓肠肌肌湿重比值和肌纤维横切面积检测。结果在第2、3、4周,治疗组的肌湿重比值、肌纤维横截面积均显著高于模型组(P<0.05);在第6周时,治疗组肌湿重比值、肌纤维横截面积与模型组相比无显著性差异(P>0.05)。结论在失神经早期,黄芪丹参联合应用能有效延缓大鼠因失神经所致的骨骼肌萎缩,其发生的机制有待进一步研究。     

失神经支配骨骼肌的实验观察

目的切断新西兰大白兔腓肠肌神经后,观察肌内神经、肌梭、运动终板带、肌湿重等的变化,探讨其规律。方法将25只新西兰大白兔随机分成对照组（5只）和神经切断组（20只）。术后2,4,8,12,16周,称肌湿重后用S ihler’s肌内神经染色法染色肌内神经;用乙酰胆碱脂酶整肌染色法染肌运动终板;用HE染色法染肌梭。结果①失神经2周肌湿重为正常的65%,两组比较P〈0.05,肌内神经染色变浅,运动终板带及断面切片上显示数目正常,肌梭形态及梭内肌纤维无改变;②4周肌湿重为正常的53.2%,运动终板带变模糊,数目与正常比较无差别,肌内神经三级分支消失,肌梭数量正常,部分肌梭出现变形;③8周肌肉大量纤维化,湿重为正常的43.97%,运动终板带不连续,数目减少为正常76.2%,两组比较P〈0.05,肌内神经二、三级均无染色,仅留有鞘管样结构,肌梭大部分变形,数量为正常的81%,与正常组比较P〈0.05;④12周肌湿重为正常的42%,与8周相比P〉0.05,运动终板更加分散,形态不规则,数目为正常的54.4%,肌内仅一级神经有部分淡染,肌梭仅为正常的50%。⑤16周肌湿重为正常的41.6%,与12周相比P〉0.05,运动终板无聚合态,一级神经淡染存在,肌梭为正常的48.6%,与12周相比P〉0.05。结论新西兰大白兔腓肠肌失神经支配后,肌湿重、肌内神经、运动终板、肌梭变化有一定规律性,肌萎缩发生最早。     

神经生长因子治疗脑出血的临床疗效研究

目的观察神经生长因子(NGF)治疗脑出血的疗效。方法选取2013年5月至2013年11月中国医科大学附属第一医院鞍山医院神经内科收治的76例脑出血患者作为研究对象,按照随机数字表法分为两组,每组38例。常规治疗组给予常规治疗,NGF组在常规治疗基础上给予NGF治疗,每次30μg肌内注射,每日1次,连续2周为1个周期。以美国国立卫生研究院卒中量表(NIHSS)为标准评价患者的神经功能缺损情况;2周后观察记录并对比两组患者疗效。结果治疗2周后,NGF组NIHSS评分从治疗前的(20±4)分恢复至(8±2)分;常规治疗组NIHSS评分从治疗前(20±3)分恢复至(12±3)分;NGF组临床疗效好于常规治疗组(P<0.05)。两组患者在治疗前后所检测的肝、肾功能各指标均无异常。结论 NGF对脑出血患者的神经损伤具有一定的保护和促进恢复作用,且未出现明显不良反应。     

头针联合任务导向训练治疗脑卒中弛缓性瘫痪的临床观察

【目的】观察头针联合任务导向训练治疗脑卒中弛缓性瘫痪的临床疗效。【方法】将80例脑卒中弛缓性瘫痪患者随机分为观察组和对照组,每组各40例。对照组采用任务导向训练治疗,观察组在对照组的基础上给予头针针刺治疗。连续治疗4周。治疗4周后,评价2组患者的临床疗效,观察2组患者治疗前后简式Fugl-Meyer运动功能评分(FMA)、巴塞尔指数(BI)评分、Berg平衡量表评分以及生存质量测定量表(QOL-BREF)评分的变化情况,比较2组患者治疗前后屈伸最大等长收缩(MIVC)状态下腓肠肌和胫前肌的积分肌电值(iEMG)、均方根值(RMS)及足背伸协同收缩率(CR)的变化情况。【结果】(1)观察组总有效率为95.00%(38/40),对照组为77.50%(31/40)。观察组疗效优于对照组,差异有统计学意义(P0.05)。(2)治疗后,2组患者的FMA、BI及Berg评分均明显改善(P0.05),且观察组在改善FMA、BI及Berg评分方面明显优于对照组,差异有统计学意义(P0.05)。(3)治疗后,2组患者的腓肠肌iEMG、RMS,胫前肌iEMG、RMS及CR均明显改善(P0.05),且观察组在改善腓肠肌iEMG、RMS,胫前肌iEMG、RMS及CR方面明显优于对照组,差异有统计学意义(P0.05)。(4)治疗后,2组患者的生存质量评分生理、心理、社会、环境方面均明显改善(P0.05),且观察组在改善生存质量评分生理、心理、社会、环境方面明显优于对照组,差异有统计学意义(P0.05)。【结论】头针联合任务导向训练治疗脑卒中弛缓性瘫痪,能够有效改善患者表面肌电参数,提高患者运动功能、平衡能力、日常生活能力,从而提高患者生活质量,临床疗效显著。     

树鼩断尾后运动及生长发育状况观察

目的 探索性进行树鼩断尾试验,初步探讨断尾对实验室驯养树鼩运动状况及生长发育的影响.方法 选取45只树鼩随机均分成3组,组1（断尾后饲养3个月）与组2（断尾后饲养6个月）从第2、3尾椎或3、4尾椎间实施断尾手术,分别饲养3个月、6个月后,用生理仪测定树鼩腓肠肌肌张力增量,与组3（对照组）腓肠肌肌张力增量进行比较.光镜检查各组腓肠肌组织机构;各组内动物雌雄以1∶1交配（每组雌雄各5只）,观察记录树鼦受孕、产仔及离乳情况.结果 断尾树鼩全部存活;组1和组2,与对照组腓肠肌肌张力增量比较差异显著（P＜0.05）;各组树鼩实验结束体重与增量无显著性差异（P＞0.05）;各组树鼩受孕率无显著性差异（P＞0.05）.结论 断尾对实验室驯养树鼩的运动有一定抑制作用,断尾树鼩可以正常生长发育.     

神经生长因子促进大鼠胫骨骨折愈合的实验研究

目的 观察神经生长因子对大鼠胫骨骨折愈合以及胰岛素样生长因子表达的影响.方法 建立标准大鼠胫骨骨折模型,分别给予生理盐水和神经生长因子,术后1、2、4周分别进行X线骨痂评定、胫骨湿重称量以及半定量RT-PCR检测胰岛素样生长因子-1 mRNA的表达.结果 术后4周时,神经生长因子组骨痂量(132.63±5.98)mm3和胫骨湿重(0.98±0.12)g,对照组骨痂量(85.22±6.23)mm3和胫骨湿重(0.84±0.04)g,NGF组显著多于对照组(P<0.05);神经生长因子组的胰岛素样生长因子-1 mRNA的表达术后1周时为(0.82±0.17),术后2周时为(0.54±0.08),对照组分别为(0.55±0.20)、(0.41±0.09).NGF组显著高于对照组(P<0.05).结论 应用神经生长因子可以促进大鼠胫骨各组愈合,同时促进骨折愈合过程中IGF-1表达.     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.