牛痘疫苗接种家兔炎症皮肤提取物治疗腰椎管狭窄症术后残余神经症状的临床研究

目的:观察牛痘疫苗接种家兔炎症皮肤提取物(神经妥乐平)治疗腰椎管狭窄症术后残余神经症状的疗效.方法:随机将腰椎管狭窄症术后仍有残留神经症状的VAS评分在4分以上的患者40例,分为神经妥乐平组和安慰剂组各20例,神经妥乐平组给予10.8NU神经妥乐平+0.9%NS,250ml静脉点滴,连续14天;安慰剂组给予250ml NS静脉点滴连续14天.观察两组患者治疗后疼痛,麻木或冷感变化情况.结果:治疗7天,14天两组间疼痛及麻木等伴随症状VAS评分均有改善,神经妥乐平组VAS评分改善较安慰剂组有显著性差异(P＜0.05).术后14天两组间疼痛及麻木等伴随症状的改善率有显著性差异(P＜0.05).用药后患者无不良反应.结论:神经妥乐平对腰椎管狭窄症术后残留的疼痛、麻木、冷感等感觉异常的神经症状有较好的治疗作用,且使用安全.     

牛痘疫苗接种家兔炎症皮肤提取物治疗三叉神经痛射频热凝术后残余神经症状的疗效观察

目的:观察牛痘疫苗接种家兔炎症皮肤提取物(神经妥乐平)对原发性三叉神经痛射频温控热凝术后面部残余神经症状的疗效.方法:应用随机单盲对照的方法,选择原发性三叉神经痛射频温控热凝术后面部仍残留有神经症状,视觉模拟评分(VAS)在3分以上的患者30例,分成神经妥乐平组和安慰剂组各15例.神经妥乐平组给予神经妥乐平18AGC单位+生理盐水250 ml静脉滴注,连续7 d;安慰剂组给予生理盐水250 ml静脉滴注,连续7 d.观察两组患者用药后面部疼痛和麻木感改变情况.结果:术后1、3d神经妥乐平组疼痛评分和术后7、14 d神经妥乐平组麻木感评分改善率与对照组比较差异均有显著性,神经妥乐平组患者用药后未出现不良反应.结论:神经妥乐平静脉注射可有效治疗原发性三叉神经痛射频温控热凝术后面部残留的疼痛感和麻木感.     

神经妥乐平治疗腰椎间盘突出术后残余神经症状的临床观察

目的:观察神经妥乐平对腰椎间盘突出术后残余神经症状的疗效.方法:腰椎间盘突出术后患者仍有残留神经症状,VAS评分在5分以上的患者46例,分为神经妥乐平组和安慰剂组各23例.神经妥乐平组给予神经妥乐平7.2NU 0.9%NS 100ml静脉点滴,连续10天;安慰剂组患者给予0.9%NS 100ml静脉点滴,连续10天.观察两组患者在术后的疼痛和麻木感变化情况.结果:术后7、14、21、28天两组间疼痛有显著性差异.术后28天时两组的显效率为68.4%、33.2%;有效率为95.6%、55.6%;46例患者中有30例有麻木症状,术后7、14、21、28天两组间麻木有显著性差异,术后28天时两组的显效率分别为50.0%、18.0%;有效率为66.6%、25.0%.结论:神经妥乐平对腰椎间盘突出术后残留的疼痛感和麻木感有缓解的效果.     

传统中医方法与胶原酶溶解术治疗腰椎间盘突出症的临床疗效比较

目的比较传统中医方法与胶原酶溶解术治疗腰椎间盘突出症的临床疗效和安全性.方法将1232例腰椎间盘突出症患者按自愿原则分为对照组(609例)和治疗组(623例).对照组运用针灸、牵引、推拿手法等传统中医方法康复治疗;治疗组采用盘外穿刺术进行胶原酶溶解术.运用视觉模拟评分法(VAS)和MacNab 疗效评定标准评价临床疗效,观察两组患者治疗前及治疗后1周和1、6、12个月的临床疗效,以及不良反应发生情况.结果治疗前两组患者 VAS 评分比较差异无统计学意义(P>0.05).与治疗前比较,治疗组随治疗时间延长 VAS 评分均明显降低(均 P<0.05),对照组无明显变化(均 P>0.05);且治疗组治疗1、6、12个月后 VAS 评分较对照组降低更显著(1个月:3.82±1.33比5.22±1.29,6个月:1.21±1.14比6.74±1.39,12个月:0.76±1.02比7.24±1.65,P<0.05或P<0.01).治疗组治疗1周后有效率与对照组比较差异无统计学意义(42.86%比40.72%,P>0.05),治疗1、6、12个月后有效率均明显高于对照组(1个月:67.09%比54.35%,6个月:82.82%比53.04%,12个月:85.71%比38.59%,均 P<0.01).对照组未发现与治疗相关的不良反应;治疗组出现尿潴留32例(5.14%),腰痛47例(7.54%),未见其他与治疗相关的不良事件.结论盘外穿刺进行胶原酶溶解术治疗腰椎间盘突出症优于传统中医方法,并具有微创、安全、操作简便、疗程短、远期效果好等优点.     

神经妥乐平治疗腰椎术后综合症疗效观察

目的:评价神经妥乐平治疗腰椎术后综合症的疗效.方法:将36例腰椎术后综合症患者随机分为两组,治疗组应用神经妥乐平,共21例;对照组应用基础治疗,共15例.应用NRC评价患者疼痛程度、Oswestry Disability Index(ODI)量表评估患者生活质量,分别在治疗前、治疗后2个月、6个月及12个月进行.结果:治疗组在治疗后2个月NRC、ODI评分优于对照组(P<0.05).治疗后6个月及12个月治疗组与对照组之间无明显差别.结论:神经妥乐平治疗腰椎术后综合症有效,可以短期内缓解疼痛、麻木等不适,减轻活动障碍,提高患者生活质量,其疗效维持至少2个月.     

围术期联合应用牛痘疫苗接种家兔炎症皮肤提取物与自控镇痛药物对腰椎患者术后疼痛的影响

目的:比较围术期联合使用牛痘疫苗接种家兔炎症皮肤提取物(神经妥乐平)和自控镇痛药物与单纯自控镇痛药物对腰椎患者术后疼痛的影响。方法:根据入院先后顺序把40例择期行腰椎后路椎板切除减压内固定手术的患者随机分为两组,单数入院者为神经妥乐平组,偶数入院者被纳入对照组,两组均为20例。神经妥乐平组术前连续3 d肌注神经妥乐平3.6 Nu/次,2次/天;手术当日至术后第7天,每日7.2 Nu+0.9%NS(生理盐水)100 ml静滴。对照组术前不接受任何药物,术前、术后不应用神经妥乐平。两组术后均使用自控电子镇痛输注泵(舒芬太尼1μg/ml,共100 ml)。结果:腰椎术后48 h镇痛泵有效按压次数、舒芬太尼消耗量,神经妥乐平组与对照组比较,差异无统计学意义(P>0.05);两组患者术前第3天视觉模拟评分(visual analogue scale,VAS)比较,差异无统计学意义,术前第1天、术后第1天、第3天、第5天、第7天神经妥乐平组的VAS评均低于对照组,差异有统计学意义(P<0.05);术后第5天两组肢体麻木感比较,差异无统计学意义(P>0.05);第7天神经妥乐平组改善更显著,差异有统计学意义(P<0.05)。两组的不良反应比较,差异无统计学意义(P>0.05)。结论:腰椎围术期联合应用神经妥乐平与静脉自控镇痛效果明显优于单纯静脉自控镇痛,并一定程度改善肢体的麻木感。     

腰2交感阻滞联合牛痘疫苗接种家兔炎症皮肤提取物治疗糖尿病神经病变的观察

目的:评价腰2交感阻滞联合牛痘疫苗接种家兔炎症皮肤提取物(神经妥乐平)治疗糖尿病神经病变的疗效。方法:2型糖尿病神经病变患者60例,随机分两组,一组腰2交感阻滞+神经妥乐平(实验组),另一组仅行腰2交感阻滞(对照组)。两组均在C型臂下行双侧腰2交感神经阻滞,神经妥乐平口服为神经妥乐平片(4.0 U/片),每次2片,每天2次。治疗1、4、8周后观察疼痛、麻木改善情况。结果:治疗8周后,两组的痛觉VAS评分皆明显降低,实验组总有效率83.3%,对照组总有效率76.7%,两组无统计学意义(P>0.05);而两组的麻木改善总有效率存在明显差异:实验组63.3%,对照组26.7%(P<0.01)。结论:腰2交感阻滞联合神经妥乐平治疗糖尿病神经病变,与单用腰2交感阻滞相比,二者均能镇痛,但前者对麻木症状改善显著优于后者。     

佳士比注射泵注入胶原酶治疗腰椎间盘突出症

目的 :观察佳士比注射泵注入胶原酶治疗腰椎间盘突出症的临床疗效。方法 :随机将 2 8例胶原酶盘外溶解术治疗的患者分为两组 :观察组 18例 ,使用佳士比 310 0型注射泵注入胶原酶行盘外溶解治疗 ;对照组 10例 ,一次性注入胶原酶行盘外溶解治疗。结果 :术后 7天疗效观察 ,观察组总优良率为 83.3% ,总有效率为 10 0 %。对照组优良率为 4 0 % ,总有效率为 80 %。两组优良率、有效率比较有显著性差异 (P <0 .0 5 )。术后 3月观察组总优良率为 88.9% ,总有效率为 10 0 % ;对照组优良率为 80 % ,总有效率为 90 %。两组比较优良率、有效率均无显著性差异 (P >0 .0 5 )。结论 :佳士比注射泵注入胶原酶盘外溶解治疗腰椎间盘突出症是一种安全有效的治疗方法 ,其近期疗效优于一次性注入胶原酶盘外溶解治疗。     

神经妥乐平治疗糖尿病神经病变的研究

目的：评价神经妥乐平治疗2型糖尿病周围神经病变的疗效。方法：74例糖尿病神经病变患者随机进入神经妥乐平组（38例）和胰激肽原酶组（36例）。神经妥乐平组每天1次静脉点滴神经妥乐平针，每次2支（3．6u／支），14天后口服神经妥乐平片，每次2片，每天2次，共14天。胰激肽原酶组每天1次肌肉注射胰激肽原酶针，每次2支（10u／支），14天后口服胰激肽厚酶肠溶片，每次2片，每日三次，共14天。结果：治疗后，两组的感觉VAS评分皆有明显降低。疼痛改善神经妥乐平组显效率及总有效率明显高于胰激肽原酶组。神经妥乐平组麻木感改善显效率明显高于胰激肽原酶组。结论：神经妥乐平对2型糖尿病神经损害的自发性疼痛，感觉障碍有较好疗效。     

区域神经阻滞联合神经妥乐平治疗带状疱疹神经痛

目的:观察区域神经阻滞联合神经妥乐平治疗带状疱疹神经痛的疗效.方法:带状疱疹神经痛患者60例,随机分为2组,各30例.对照组给予阿昔洛韦片200 mg/次,5次/d,口服;甲钴胺胶囊0.5 mg/次,3次/d,口服;双氯芬酸钠胶囊75 mg/次,1次/d,口服;外涂阿昔洛韦软膏3次/d.治疗组在对照组治疗基础上给予肋间神经或腰椎旁神经阻滞,每点注药3～5 mL,每5 d 1次,共3次,并给予神经妥乐平注射液静脉滴注,1次/d.2组疗程均为15 d.比较2组疗效及治疗前、后第1,5,10天VAS评分.结果:治疗组总有效率96.7%,对照组总有效率60.0%,2组比较差异有统计学意义(P<0.05);2组治疗后第1,5,10天VAS评分均较治疗前降低(P<0.05),治疗组降低优于对照组(P<0.05).结论:区域神经阻滞联合神经妥乐平治疗带状疱疹神经痛疗效满意,并可防止带状疱疹后神经痛发生.     

ON THE PHYSICOCHEMICAL REGULATION OF THE GROWTH OF TISSUES : THE EFFECTS OF THE DILUTION OF THE MEDIUM ON THE GROWTH OF THE SPLEEN.

It may be concluded that the degree of dilution of the culture medium has a marked influence on the rate of growth of splenic tissue. The maximum acceleration was obtained in a medium composed of three volumes of normal plasma and two volumes of distilled water. The growth in this hypotonic plasma was very much larger than in normal plasma. On the contrary, the growth of the spleen in hypertonic plasma was always less than in normal plasma. In other experiments, we found that in diluted plasma there was also an acceleration of the growth of the skin, the heart, and the liver of chickens. The skin of adult frogs also grew more actively in this plasma. The optimum degree of dilution varied according to the nature of the tissues and to the species of the animals. While the plasma containing two fifths distilled water produced the largest growth of splenic tissue, a slightly less diluted medium was more favorable for the liver and the heart, and generally for the skin also. The action of hypertonic plasma varied also in a large measure. While the spleen did not grow at all in the medium containing 0.0124 and 0.0144 sodium chlorid, the skin, on the other hand, could stand a high concentration of the sodium chlorid. Even its growth was activated in media containing 0.0094 and 0.0124 sodium chlorid and was greater than with normal plasma. The spleen of kittens was very easily affected by the changes of the dilution of the plasma, while the skin of the frog presented its best growth in plasma containing one half distilled water. Marked variations in the sensitiveness of tissues to hypertonic and hypotonic media will probably be observed in animals of different species. From these experiments, three conclusions can be drawn: namely, that certain laws of growth, discovered by Loeb, in lower organisms are true also for higher organisms; that normal plasma is not the optimum medium for the growth of tissue; and that each tissue has probably its optimum medium. The growth of the spleen is, without doubt, considerably modified by the variations of the dilution and perhaps of the osmotic tension of the plasma. It is possible then that the influence of osmotic tension, discovered by Loeb, in the growth of certain organisms, is a general law applicable as well to higher forms of life— frogs, cats, and chickens—as to lower organisms—tubularia and sea-urchins. In placing tubularia in different dilutions of sea-water and distilled water, Loeb found that the greatest rate of regeneration was observed when two volumes of distilled water were added to three volumes of sea-water. But fertilized eggs of sea-urchins were more sensitive to the action of hypertonic plasma, and they all died in a dilution of sea-water with two fifths distilled water. If only one fifth distilled water was added to the sea-water they developed normally. We found that the cells of certain tissues of the chicken follow a similar rule, since the maximal growth of the spleen is obtained in plasma containing two fifths distilled water, while other tissues grow better in a less hypotonic medium. Normal plasma is certainly not the ideal medium for the growth of tissues, since slight modifications of the tension, the alkalinity, or the addition of certain inorganic salts to normal plasma, increase the rate of the growth of tissues.     

THE PATHOGENESIS OF THE HEMORRHAGIC DISEASES OF THE NEW-BORN

Those conditions of the new-born characterized by a hemorrhagic tendency, icterus, and fatty changes, are probably all syndromes which may occur as the result of a number of toxic agents. All of them, however, have been produced, in these experiments, by the action of a single experimental agent. Thus, a picture indistinguishable from that called Buhl''s disease has been obtained by the use of chloroform, as have also the pictures known as Winckel''s disease, melæna neonatorum, etc. Chloroform is not held to be the only substance that has this power. It stands rather as one member of a group of agents, the effects of which in general and in individual organs are similar to those caused by lack of oxygen. The essential features of these conditions have also been produced by direct asphyxiation of the fetus. The suggestion is therefore made that underlying all these symptoms and pathological complexes, there is a deficiency of oxidation, general, local, or selective, thus bringing this group of diseases into the general category of acute yellow atrophy of the liver, eclampsia, pernicious vomiting, cyclic vomiting, phosphorus poisoning, etc. In human beings, chloroform and asphyxia must, in many instances, be the determining causes. There remain, however, other cases in which different factors are to be sought.     

THE INDUCED SUSCEPTIBILITY OF THE GUINEA-PIG TO THE TOXIC ACTION OF THE BLOOD SERUM OF THE HORSE

Following the divisions before used, the results presented in the preceding pages may be briefly stated. I. The particular method of sensitization and the place where the test injection is made have an important bearing on the results obtained by various workers. Comparing the results obtained by the various methods, we may conclude that the incubation period of the hypersensitive reaction is not sharply limited, but that there is a progressive increase in sensitiveness from the sixth day, and presumably before that, extending over a period of several weeks. It seems very probable that the degree of hypersensitiveness attained where the sensitizing dose consists of a mixture of diphtheria toxin and serum is greater than when a single dose of the same small quantity of serum is given alone. II. Our early experiments, the first in this field, are in thorough agreement with those first reported by Otto, and shortly after him by Rosenau and Anderson. III. This hypersensitive reaction is transmissible from mother to offspring. The transmission is probably not equally effective in all cases, and individual young guinea-pigs probably vary greatly in the rate with which they lose their ability to react. As a result not all of the young of a hypersensitive mother react to a subcutaneous dose of five cubic centimeters of serum given when they are four or five weeks old. The reaction in the young animals differs quite markedly from that in those actively sensitized. These differences are such as to indicate that in the mother there is a considerable localization of the reaction in tissues and organs whose destruction does not cause sudden death. This local reaction is a protective factor and is not transmitted to the same degree as the factors involved in the fatal acute reaction. IV. The hypersensitive reaction to horse serum depends on the development of a special anti-body during the incubation period, which anti-body may be passively transferred to a fresh animal. If the dose of hypersensitive serum be sufficient, and the intoxicating injection be given directly into the circulation, this passive hypersensitiveness may be enough so that the animal will die when tested. There is also in the serum of hypersensitive guinea-pigs an uneliminated horse serum element or "rest," which is distinct from this antibody, and probably without influence on the course of the acute reaction. V. The anti-body on which the hypersensitive reaction depends may be entirely neutralized by horse serum without causing symptoms. The gradual introduction of increasing doses over a total period of twenty-four hours suffices for this. The animal is then, properly speaking, neither immune nor refractory, but is essentially in the condition of a normal animal which has recently had a large dose of horse serum. This rapid neutralization is made possible by the great binding power which the subcutaneous and other relatively unimportant tissues have for the toxic element of the serum. The so-called "Phenomenon of Arthus" is probably the same reaction for the rabbit that we have here dealt with in the guinea-pig. The fact that the manifestation is more prominently a local one depends on racial differences. I have encountered cases in the guinea-pig in which the conditions in the rabbit are closely simulated.     

THE EXTENT OF THE CAPILLARY BED OF THE HEART

By means of injections made into the coronary arteries of beating hearts it has been possible to determine the number of capillaries in the normal heart muscle. This study has shown a very rich blood supply with an average of approximately one capillary for each muscle fibre in the ventricular walls and papillary muscles, and a less abundant supply in the auricular muscle and Purkinje system. The number of capillaries per sq. mm. of ventricular wall or papillary muscle is about twice that found by Krogh in skeletal muscle. Capillaries were not found constantly in the valves of hearts in which there was apparently a complete injection of the capillary bed. The method described for injecting the capillaries of the heart also provides a means of studying the blood supply to the muscle, valves and aortic wall in pathological hearts.     

THE INFLUENCE UPON THE SPLEEN AND THE THYROID OF THE COMPLETE REMOVAL OF THE EXTERNAL FUNCTION OF THE PANCREAS

The complete removal of the function of the pancreas concerned in digestion is followed by marked changes in the spleen and in the thyroid apparatus. Second, the spleen shows an extreme simple atrophy. Third, the thyroid apparatus exhibits a constant change shown by the macroscopic transparency of the gland, by the microscopic increase in the amount of colloid, by the chemical increase of the iodine content of the gland, and by the functional test of the delayed appearance of tetany after the complete removal of the thyroid apparatus.     

学生健康体检结果分析

在校学生进行健康体检,对常见病患病率进行统计分析,提议在体检 中应加入血液流变学指标。