膝关节镜术后患者中药熏洗的应用和护理

目的探讨膝关节镜术后应用中药熏洗及护理的方法及效果。方法2007年8月至2009年2月收治38例膝关节镜术后病人,随机分为观察组和对照组,观察组除给予术后常规护理及功能锻炼外,加用中药熏洗,对比两组病人的治疗效果及并发症的发生情况。结果中药熏洗组患肢疼痛、肿胀及关节积液情况明显优于对照组,4周后膝关节功能评分高于对照组（P〈0．05）,两组均未出现术口感染、下肢静脉栓塞等并发症。结论膝关节镜术后患者应用中药熏洗配以正确护理和肢体功能锻炼可明显提高治疗效果,缩短治疗时间。     

有关创伤性膝关节功能障碍的治疗探讨

目的：评价中药熏洗在创伤性膝关节功能障碍治疗中的作用。方法选取2011年5月～2014年1月我院收治的创伤性膝关节功能障碍患者68例,随机分为两组,其中观察组35例,选用中药熏洗配合功能训练进行治疗,对照组33例,仅选用功能训练进行治疗,观察并比较两组患者临床疗效、治疗后VAS（视觉模糊评分法）评分与关节活动度。结果观察组临床疗效明显优于对照组,比较差异有统计学意义（P＜0.05）;治疗后观察组VAS评分、关节活动度均明显优于对照组,比较差异均有统计学意义（P＜0.05）。结论中药熏洗在创伤性膝关节功能障碍治疗中的临床疗效好,能有效提高患者关节活动度,降低疼痛程度,值得在临床上予以推广。     

自拟消痹熏洗方在膝半月板损伤关节镜下成形术后的临床疗效观察

目的 观察膝半月板损伤关节镜下成形术后应用消痹熏洗方的疗效.方法 将60例半月板损伤病人按就诊时间先后顺序分成两组,观察组和对照组各30例,两组病人先行关节镜下成形术并辅以常规功能锻炼,拆线后观察组予以消痹熏洗方进行熏洗,对照组局部单纯温开水熏洗.结果 经过治疗,观察组的疼痛视觉模拟(VAS)评分低于对照组,且均明显低于治疗前;观察组的膝关节Lysholm评分高于对照组,且均明显高于治疗前,均差异有统计学意义(P<0.05).对照组的临床总有效率为90.00%,观察组为96.67%,组间临床总有效率差异有统计学意义(P<0.05).结论 半月板损伤关节镜下成形术后以消痹熏洗方治疗效果更好,临床值得推广应用.     

中药熏洗治疗膝关节骨性关节炎的临床研究

目的:观察中药熏洗治疗膝关节骨性关节炎的临床疗效。方法:按病例诊断标准选择126例膝关节骨性关节炎患者,随机分为治疗组(中药熏洗组)和对照组(扶他林组),治疗3周,根据《中药新药临床研究指导原则》制定疗效标准。观察两组患者膝关节液中IL-1的含量变化,评价中药熏洗治疗膝关节骨性关节炎的临床疗效。结果:两组患者在药物的治疗下症状均有良好的改善,中药熏洗组总有效率为95.23%;扶他林组总有效率为85.71%,与扶他林组比较,P0.05。治疗组和对照组患者关节液中IL-1的含量较治疗前均减少,P0.01,治疗后两组患者关节液中IL-1的含量比较有显著性差异,P0.01,中药熏洗治疗效果优于扶他林。结论:熏洗治疗膝关节骨性关节炎疗效显著,并具有简便经济、安全等特点,适合在临床推广。     

中药熏洗配合功能锻炼治疗膝骨性关节炎的临床研究

目的观察中药熏洗配合功能锻炼治疗膝骨性关节炎的临床治疗效果。方法选择我院在2013年1月~2016年1月收治的100例膝骨性关节炎患者随机进行分组,分为观察组和对照组各50例。对照组给予单纯膝关节功能锻炼,观察组在给予膝关节功能锻炼基础上采用中药熏洗配合治疗,观察其对膝关节骨性关节炎患者疼痛的缓解程度。运用《中医病证诊断疗效标准》、膝关节骨性关节炎自评量表(WOMAC)分别在治疗前、治疗后对观察对象进行评估。结果两组患者治疗前疼痛、僵硬、功能WOMAC评分比较差异均无统计学意义(P>0.05),具有可比性。观察组WOMAC指数各项评分均显著降低,差异有统计学意义(P<0.05);对照组WOMAC指数各项评分均显著降低,差异有统计学意义(P<0.05),且观察组优于对照组(P<0.05);观察组总有效率为92.0%,对照组总有效率76.0%,两组比较差异有统计学意义(P<0.05)。结论中药熏洗配合功能锻炼治疗膝骨性关节炎疗效显著,值得临床推广。     

膝关节镜清理术配合中药熏洗治疗膝骨性关节炎

目的:探讨膝关节镜清理术配合中药熏洗治疗膝骨性关节炎的临床疗效。方法:随机将62例患者分为治疗组和对照组,治疗组采用膝关节镜清理术治疗,术后予中药熏洗治疗治疗组,对照组仅采用膝关节镜治疗,经过治疗,术后6个月的随访,采用JOA膝关节炎治疗效果评判标准,对两组患者进行疗效比较。结果:治疗前两组患者的膝骨性关节炎严重指数差异无显著意义(P>0.05),通过观察患者治疗后总体疗效,治疗组效果明显高于对照组,差异有显著性意义(P<0.05)。结论:采用膝关节镜清理术治疗配合中药熏洗治疗效果优于单纯关节清理术治疗,术后疗效满意。     

中西医结合治疗创伤性膝关节强直的临床疗效

目的探讨中西医结合在创伤性膝关节强直患者中的治疗效果。方法 86例创伤性膝关节强直患者随机分为观察组(n=43)与对照组(n=43),观察组给予关节镜松解术+功能锻炼+中药熏洗治疗,对照组仅给予关节镜松解术+功能锻炼治疗,对比两组患者临床疗效。结果治疗后观察组膝关节功能优良率及有效率分别为93.0%(40/43)与95.3%(41/43),均显著高于对照组的67.4%(29/43)与74.4%(32/43),差异有统计学意义(P0.01)。结论中西医结合用于创伤性膝关节强直的治疗,疗效确切,能够有效改善膝关节功能,值得推广。     

痹通散中药熏洗配合功能锻炼护理Ⅱ区屈指肌腱损伤晚期修复术后患者的疗效观察

目的观察痹通散中药薰洗配合功能锻炼护理Ⅱ区屈指肌腱损伤晚期修复术后患者的临床疗效。方法将符合要求的86例患者按护理方法不同随机分成实验组与对照组各43例。实验组采用痹通散熏洗配合功能锻炼护理,对照组行常规护理配合指导功能锻炼。结果随访6个月～2年,实验组功能恢复优良率达88.37%,对照组为69.77%,两组比较差异有统计学意义(P0.05)。结论对Ⅱ区屈指肌腱损伤晚期修复的患者采用痹通散中药熏洗配合功能锻炼的护理方法可促进手部功能恢复。     

中药薰洗联合功能锻炼治疗髌骨骨折术后膝关节僵硬的临床疗效

目的探讨中药薰洗联合功能锻炼治疗髌骨骨折术后膝关节僵硬的临床疗效。方法选取髌骨骨折术后膝关节僵硬的患者62例,随机分为观察组和对照组,每组31例。对照组患者行膝关节功能锻炼治疗,观察组在对照组患者的基础上行中药薰洗联合功能锻炼进行治疗。评价2组患者的临床疗效。结果观察组关节恢复情况(93.55%)明显优于对照组(70.97%),观察组疼痛缓解情况明显优于对照组(P<0.05)。结论中药薰洗联合功能锻炼能够有效治疗髌骨骨折术后膝关节僵硬,效果显著,值得临床推广。     

中药熏洗治疗膝关节骨关节炎临床疗效分析

目的:对膝关节骨关节炎应用中药熏洗治疗的临床效果进行探讨分析。方法:选取2014年1月~2015年2月某院收治的膝关节骨关节炎患者400例,将其随机分为对照组和治疗组,每组各200例,对照组给予口服药物消炎、止痛常规治疗,治疗组在常规治疗基础上采用自拟中药熏洗治疗。治疗周期结束后观察两组患者临床疗效。结果:两组患者进行3个疗程的治疗,对照组治疗有效率为82.0%,治疗组治疗有效率为91.5%,两组比较P0.05差异有统计学意义。结论:中药熏洗治疗膝关节骨关节炎的临床效果可靠,值得临床推广应用。     

Affective and Anxiety Disorders and Alcohol and Drug Dependence:

Depression and anxiety frequently coexist in patients with substance use disorders. This clinically-oriented article examiens the relationship between these conditions and emphasizes data showing that substances of abuse can cause signs and symptoms of both depression and anxiety. These substance-related syndromes appear to have a different course and prognosis than uncomplicated, independent anxiety and major depressive disorders, and clinicians should consider the role of alcohol and other drugs in all patients presenting with these complaints. The authors will also outline an approach for diagnosing and managing patients with the combination of a substance use and depressive or anxiety disorder.     

Synthesis and anti-nociceptive and anti-inflammatory effects of gaultherin and its analogs

The synthesis of gaultherin (1) and its analogs was carried out to provide 11 glycosides under phase-transfer catalytic conditions. The activities of all synthesized compounds were evaluated by nitric oxide production inhibitory assay in vitro. Methyl 2-O-(4-O-β-d-galactopyranosyl)-β-d-glucopyranosylbenzoate (5f) showed significantly anti-nociceptive and anti-inflammatory effects by the evaluation in vivo. Structure–activity relationships within these compounds were discussed.     

Modelling and simulation of variability and uncertainty in toxicokinetics and pharmacokinetics

Two important methodological issues within the framework of the variability and uncertainty analysis of toxicokinetic and pharmacokinetic systems are discussed: (i) modelling and simulation of the existing physiologic variability in a population; and (ii) modelling and simulation of variability and uncertainty when there is insufficient or not well defined (e.g. small sample, semiquantitative, qualitative and vague) information available. Physiologically based pharmacokinetic models are especially suited for separating and characterising the physiologic variability from the overall variability and uncertainty in the system. Monte Carlo sampling should draw from multivariate distributions, which reflect all levels of existing dependencies in the intact organism. The population characteristics should be taken into account. A fuzzy simulation approach is proposed to model variability and uncertainty when there is semiquantitative, qualitative and vague information about the model parameters and their statistical distributions cannot be defined reliably.     

成骨细胞的功能与损伤和骨质疏松的防治

骨质疏松是一种全身性骨骼疾病,导致骨折风险增加。成人的骨量通过破骨细胞的骨吸收和成骨细胞的骨形成作用来维持动态平衡,治疗骨质疏松症的理想策略是抑制破骨细胞的骨吸收和/或增强成骨细胞的骨形成功能。目前针对保护成骨细胞及增强其功能的骨质疏松疗法相对较少。因此,本文针对成骨细胞相关功能蛋白、各种细胞损伤机制（内质网应激、氧化应激、机械过载、微小RNA和长链非编码RNA的影响等）及骨质疏松的治疗与预防作一综述,以期为针对增强成骨细胞功能的骨质疏松治疗策略提供新思路。     

益生菌与肿瘤防治

益生菌广泛存在于自然界中,通过维持宿主体内菌群平衡、影响肠屏障功能和调节免疫应答等作用,提高宿主健康水平,被公认为"肠道健康卫士".一些益生菌可以增强机体的免疫功能,抑制致癌物质,影响肿瘤细胞的基因表达,对肿瘤具有拮抗作用.大量研究表明,益生菌在未来的肿瘤防治中有很好的应用和发展前景.     

Self-stimulation and amphetamine: Tolerance to d and l isomers and cross tolerance to cocaine and methylphenidate

The effects of the d and l isomers of amphetamine on self-stimulation responding were tested following acute and chronic administration. Tolerance and post-drug depression of responding occurred in tests with both isomers, indicating no role for p-hydroxynorephedrine (PHN) which is one of the metabolites of d-amphetamine. In the second experiment, d-amphetamine, methylphenidate and cocaine all produced quantitatively and qualitatively similar effects on self-stimulation responding following acute administration. Following chronic administration of d-amphetamine, animals showed tolerance to all three drugs, indicating cross-tolerance among them. These data are consistent with an hypothesis that tolerance and post-drug depression following chronic amphetamine treatment are the result of decreases in postsynaptic receptor sensitivity, which would lead to a decreased effectiveness of all three drugs, regardless of their pre-synaptic mechanisms.     

Acamprosate and naltrexone treatment effects on ethanol and sucrose seeking and intake in ethanol-dependent and nondependent rats

Rationale  Two pharmacotherapies are approved for treating alcohol craving (acamprosate and naltrexone), but both have shown mixed findings in animals and humans. Objectives  The present experiments utilized a “reinforcer blocking” approach (i.e., rats were able to consume ethanol during treatment) to better understand the efficacy of these treatments for ethanol seeking and drinking using ethanol-dependent and nondependent rats. Materials and methods  In “nondependent” experiments, drugs (acamprosate 50, 100, and 200 mg/kg; naltrexone 0.1, 0.3, and 1.0 mg/kg) were administered over 3-week periods prior to operant sessions with a low response requirement to gain access to reinforcers for 20 min. For “dependent” experiments, rats were made dependent in vapor/inhalation chambers. Results  Acamprosate and naltrexone had similar effects on intake in nondependent and dependent rats; neither drug was selective for ethanol over sucrose drinking. In nondependent animals, naltrexone was more efficacious at more doses than acamprosate, and acamprosate’s effects were limited to a dose that also had adverse effects on body weight. Both pharmacotherapies showed more selectivity when examining reinforcer seeking. In nondependent rats, acamprosate and naltrexone had response-attenuating effects in ethanol, but not sucrose, groups. In dependent animals, acamprosate had selective effects limited to a decrease in sucrose seeking. Naltrexone, however, selectively decreased ethanol-seeking in nondependent rats. Conclusions  The naltrexone-induced decreases in seeking suggested a change in incentive motivation which was selective for ethanol in nondependent rats. The “nondependent” paradigm may model early stages of “problem drinking” in humans, and the findings suggest that naltrexone could be a good intervention for this level of alcohol abuse and relapse prevention.     

Antiinfective and encrustation-inhibiting materials--myth and facts

Catheters, urethral and ureteral stents and other urological implants are frequently affected by encrustration and infection due to their permanent contact with urine. Indwelling urinary catheters provide a haven for microorganisms and thus require extensive monitoring. Several surface modification techniques have been proposed to improve the performance of devices including the immobilization of biomolecules, the incorporation of hydrophilic grafts to reduce protein adsorption, the creation of hydrophobic surfaces, the creation of microdomains to regulate cellular and protein adhesion, new polymers and antimicrobial coatings. Physico-chemical explanation to elucidate the mechanism of such encrustation or infection inhibiting materials is still not available. Our series of experiments showed a marked decrease of silver-activity in biological fluids which corresponds with the controversial clinical results obtained with silver coated urinary catheters. Rifampicin/minocycline coated catheters had very low activity against Gram-negative rods, enterococci and Candida spp., the main causing organisms of urinary catheter infection. Surface engineered materials and antimicrobial drug delivery systems will be the next generation of sophisticated urinary catheters and stents, if both efficacy as well as efficiency has been proved clinically.     

Alprazolam and lorazepam single and multiple-dose effects on psychomotor skills and sleep

Summary The effects of alprazolam 0.5 mg and lorazepam 2 mg on cognitive and psychomotor skills were assessed in twelve normal volunteer subjects in a randomised, double-blind, crossover design. Single and multiple dose effects were monitored using a battery of tests comprising critical flicker fusion threshold (CFFT), choice reaction time (CRT), simulated car tracking, and subjective ratings of perceived sedation (LARS) and of sleep behaviour (LSEQ). Compared with placebo baseline scores, treatment with lorazepam 2 mg (both single and multiple doses) resulted in a widespread impairment of CRT, tracking accuracy, and CFFT. Single doses of alprazolam 0.5 mg reduced CFFT with respect to the placebo baseline. Single and multiple dose treatment with both drugs resulted in subjective reports of sedation, a reduction of sleep onset latency, and improved sleep quality. Only lorazepam 2 mg significantly disrupted the integrity of behaviour on waking from sleep. These results suggest important pharmacodynamic differences between the two drugs in the doses used.