Effect of Yangyin Humo Decoction (养阴护膜饮) on oral mucomembranous reaction to radiotherapy

Objective:To observe the effect of Yangyin Humo Decoction(养阴护膜饮,YHD)on oral mucomembranous reaction in patients with head-neck tumor undergoing radiotherapy.Methods:Fortytwo patients with head-neck tumor undergoing radiotherapy were randomized equally into two groups.The conventional Western medical treatment was administered to all,including intravenous dripping of 2%lidocaine 20 mL,dexamethasone 5 mg,gentamycin 80 000 units,vitamin B_(12) 5 mg,dissolved in saline 250 mL,and 5% sodium bicarbonate soluti...     

Perioperative Cimetidine Application Modulates Natural Killer Cells in Patients with Colorectal Cancer: A Randomized Clinical Study

Cimetidine(CIM)isahistaminetype2receptorantagonistwidelyusedtotreatpepticulcersanditalsoexertseffectsontheimmunesystem.Theperioperativeadminis-trationofCIMhasbeenfoundtoprotect,tosomedegree,immunecapabilityofsurgicalp.ti..t.[i].However,whethertheuseofCIMcanpromoteNKce1lsinpatientswithcolorectalcancer(CRC)isstillopentoquestion.Thisstudywasconductedtoin-vestigatetheeffectofperioperativeuseofcimetidineonthenaturalkillercellsinpa-tientswithcolorectalcancer.1SUBJECTSANDMETHODS1'1Subjec…     

Clinical Study on sustained release tablet of tripterygium Wilfordii in treating rheumatoid arthritis

Adopting prospective, multi-center, random, single-blind and equal rank-control methods, 226 patients with rheumatoid arthritis (RA) were divided into two groups. The 114 patients of the test group were treated with oral sustained release tablets of Tripterygium Wilfordii (TW-SR), 2 tablets twice a day for 4 weeks, 112 patients of the control group received tablets of Tripterygium Wilfordii (TW) orally 2 tablets 3 times per day for 4 weeks. Testing results showed the total effective rates of the two groups were 92.11 % and 90.65 %, respectively (P>0.05). The adverse reaction rate of TW-SR was 20.18%, which was lower than that of TW group of 70.54% (P<0. 01). Results of pre-clinical pharmacologic experimental study demonstrated that TW-SR has obvious anti-inflammatory, analgesic and immunosuppressive actions the same as TW, while the toxicity of TW-SR was less than that of TW significantly.     

雷公藤对哮喘小鼠气道炎症的抑制作用

Objective: To investigate the effect of Tripterygium polyglycosid on establishing airway eosinophil infiltration and related airway hyperresponsiveness of asthmatic mice. Methods: A mature murine asthmatic model was made with ovabulmin sensitized and challenged C57BL/6 mice. Forty mice were divided into four groups with 10 mice in each group: mice sensitized and challenged with saline (WS group), mice sensitized and challenged with ovalbumin (WO group), mice sensitized and challenged with ovalbumin and treated with Tripterygium polyglycosid (TP group) and Dexamethasone (DXM group). The mice were intraperitoneally injected with 20 μg chicken ovabulmin emulsified in injected alum on days 0 and 14, then were challenged with an aerosol generated from 1% ovabulmin on days 24, 25 and 26. Tripterygium polyglycosid was injected intraperitoneally at 50 mg/kg on days 25, 26 and 27 after ovabulmin challenge. Dexamethasone was administrated to mice at 2 mg/kg on day 21, 23 before ovabulmin challenge. The airway hyperresponsiveness, mucus production, eosinophils in parabronchial area and bronchoalveolar lavage fluid and the level of interleukin-5, granulo-macrophage clone stimulating factor in bronchoalveolar lavage fluid were measured as indexes of inflammation. Results: Tripterygium polyglycosid treatment after ovabulmin challenge completely inhibited eosinophil in?ltration in bronchoalveolar lavage fluid [(0.63±0.34)×104 vs. (75.0±14.8)×104, P<0.05] and the peribrochial area (12.60±3.48 mm2 vs. 379.0±119.3 mm2, P<0.05),mucus overproduction in airway (2.8±1.7 vs. 7.1±5.6, P<0.05), and ncreased interleukin-5 levels in bronchoalveolar lavage fluid (28.8±2.8 pg/mL vs. 7.5±3.5 pg/mL, P<0.05). Meanwhile, Tripterygium polyglycosid treatment after ovabulmin challenge also partially inhibited airway hyperresponsiveness. The level of granulo-macrophage clone stimulating factor in bronchoalveolar lavage fluid didn''t change with drugs intervention. Conclusions: The administration of Tripterygium polyglycosid could inhibit the established airway inflammation and reduce the airway hyperresponsiveness of allergic asthmatic mice. It provides a possible alternative therapeutic for asthma.     

模拟教学在护理学基础实训教学中的应用

目的 探讨模拟教学在本科护理学生护理学基础实训教学中的应用效果。方法 以2018级和2019级护理本科实习学生（共271人）为研究对象,将2018级的135名学生设为对照组,2019级的136名学生设为试验组。两组学生分别接受常规实训教学和模拟教学。实训结束后,比较两组学生成绩、自我效能评分,并调查学生对实训带教的满意度。采用SPSS 20.0进行t检验和卡方检验。结果 试验组学生理论考试成绩（88.78±5.17）分高于对照组（82.04±4.36）分,差异具有统计学意义（P<0.05）;试验组学生实践考试成绩（96.90±5.05）分高于对照组（90.48±5.34）分,差异具有统计学意义（P<0.05）;试验组学生自我效能得分（29.80±3.83）高于对照组（28.76±2.75）,差异有统计学意义（P<0.05）;试验组临床带教满意度高于对照组,差异有统计学意义（P<0.05）。结论 模拟教学能有效提高护理学生实训成绩,增强学生自我效能感,提高学生对实训教学的满意度。     

甲状腺癌全切术中应用精细化甲状腺被膜解剖技术对喉返神经的影响

目的 探究甲状腺癌全切术中应用精细化甲状腺被膜解剖技术对患者喉返神经的影响。方法 选取安徽理工大学第一附属医院普外科收治的甲状腺癌患者120例,采用随机数字表法分为研究组和对照组,每组60例。研究组实施精细化甲状腺被膜解剖技术行甲状腺全切术,对照组根据实际情况采用全甲状腺切除术。比较两组患者喉返神经功能的恢复时间、发生喉返神经功能损伤比例、并发症情况,以及复发或转移发生情况。结果 研究组患者喉返神经功能损伤的比例（3.81%）较对照组（21.67%）低（P <0.05）,喉返神经功能的恢复时间（22.41±2.17）d较对照组（63.53±10.13）d缩短（P <0.05）;研究组患者术后并发症发生率为10%,低于对照组的25%(P <0.05);研究组患者转移率0%及复发率0%均较对照组的10%和11.67%低（P <0.05）。结论 甲状腺癌全切术中应用精细化甲状腺被膜解剖技术对喉返神经有保护作用。     

椎间孔镜下“可视化椎间孔成形技术”治疗腰椎间盘突出症的安全性及临床疗效分析

探讨“可视化椎间孔成形技术”治疗腰椎间盘突出症的安全性及临床疗效。 方法 收集行椎间孔入路经皮内镜下髓核摘除术的患者71例,分为2组:经典TESSYS技术组29例(对照组)及可视化椎间孔成形技术组42例(观察组)。观察并记录治疗前、治疗过程中及治疗后的相关指标,并行统计学分析。 结果 2组患者的年龄、性别、腰椎间盘突出类型、术前VAS评分及Oswestry功能障碍指数(ODI)差别均无统计学意义(P>0.05); 手术操作时间、术中C臂透视次数,观察组均明显低于对照组(P<0.01); 2组患者术后住院时间、随访时间、末次随访时的VAS评分及ODI评分比较差别均无统计学意义(P>0.05)。根据改良Macnab评定标准评定优良率,对照组29例中,优22例、良5例、可2例,优良率93.1%; 观察组42例中,优31例、良8例、可3例,优良率为92.9%,2组比较,差别无统计学意义(P>0.05)。 结论 椎间孔镜下“可视化椎间孔成形技术”治疗腰椎间盘突出症安全、有效,与经典的TESSYS技术比较,具有操作简便、手术时间短、放射暴露少的优点。     

气囊面罩结合气管插管通气对急救心肺复苏结局及预后的影响

目的 探讨气囊面罩结合气管插管通气对急救心肺复苏结局及预后的影响。方法 选取2015年1月—2017年5月在重庆医科大学附属大学城医院接受急救心肺复苏患者102例，采用随机数字表法将分为观察组和对照组，每组51例。对照组给予气管插管通气治疗，观察组给予气囊面罩结合气管插管通气治疗。比较两组患者治疗前后的pH、氧分压（PO₂）、二氧化碳分压（PCO₂）水平变化；记录两组患者治疗后气道开放、呼吸恢复、心跳恢复及意识改善时间；比较两组患者治疗后生命体征指标恢复情况、复苏成功率、最终存活率及满意度情况。结果 治疗前，两组患者的pH、PO₂、PCO₂比较无统计学意义（P >0.05）。治疗后，两组患者的pH、PO₂均有所升高，但是观察组pH（7.29±0.12）mmHg低于对照组（7.53±0.22）mmHg（P <0.05），观察组PO₂（89.34±7.69）mmHg高于对照组（71.56±6.98）mmHg （P <0.05）；两组患者的PCO₂均有所降低，但是观察组的PCO₂（37.43±5.25）mmHg低于对照组（44.32±6.51）mmHg （P <0.05）。观察组气道开放、呼吸恢复、心跳恢复及意识改善时间都短于对照组（P <0.05）。观察组血氧饱和度（85.32±11.76）%高于对照组（43.54±9.12）% （P <0.05），平均动脉（72.32±9.56）mmHg高于对照组（36.78±7.32）mmHg （P <0.05）。观察组复苏成功率（52.94% VS 25.49%）、最终存活率均高于对照组（33.33% VS 11.76%） （P <0.05）。观察组总满意率高于对照组（86.27% VS 62.75%） （P <0.05）。结论 采用气囊面罩与气管插管通气结合进行急救心肺复苏，能有效改善患者的pH、PO₂、PCO₂，促进患者的各项生命体征的恢复，缩短患者气道开放、呼吸恢复、心跳恢复及意识改善时间，提高复苏成功率及最终存活率，从而提高患者的满意度。治疗效果显著，值得推广使用。     

虚拟现实技术联合案例教学在本科生前沿外科手术队基本技能教学中的应用

目的 探索虚拟现实技术联合案例教学在本科生前沿外科手术队（forward surgical team, FST）基本技能教学中的应用效果。方法 选取2020年1月至2021年1月在海军军医大学第二附属医院进行临床实习的42名本科学员作为研究对象,随机分为试验组和对照组,分别采用虚拟现实技术联合案例教学及传统教学进行FST基本技能教学。通过问卷调查和考核评估的方式评价教学效果。采用SPSS 23.0进行t检验、卡方检验或Fisher确切概率法。结果 问卷调查显示,两组学员对教学的整体满意度、学习中理解和实践情况、学习后记忆效果评分相近;而在理论知识提升、技能操作提升、分析解决实际问题能力的提高以及学习兴趣和积极性、学习注意力、学习互动等方面,试验组的评分优于对照组[（4.33±0.26） vs. （4.17±0.21）,（4.32±0.22） vs. （4.12±0.27）,（4.04±0.37） vs.（3.69±0.38）,（4.34±0.28） vs. （3.92±0.43）,（4.21±0.35） vs. （3.81±0.34）,（4.18±0.29） vs.（4.01±0.21）,P<0.05]。考核结果显示,试验组总评得分明显高于对照组[（85.96±5.35） vs. （77.03±7.29）,P<0.001],其中理论基础得分及技能操作得分均明显更优[（28.25±4.74） vs. （25.01±5.37）,（57.47±4.96） vs. （51.99±8.03）,P<0.05]。结论 虚拟现实技术联合案例教学对于本科生FST基本技能教学有独特优势,可进一步开展相关研究及应用。     

良性前列腺增生合并迟发性性腺功能减退大鼠模型的构建

目的 探讨良性前列腺增生(BPH)合并迟发性性腺功能减退症(LOH)动物模型的建立方法,并分析其特点.方法 选取80只SD大鼠,随机分为对照组、BPH合并LOH组、BPH组、LOH组,每组均为20只.BPH合并LOH组给予环磷酰胺[20 mg/(kg·d)]腹腔内连续注射5d,而后给予丙酸睾酮[50 mg/(kg·d)]腹腔内连续注射28 d;BPH组以同等体积生理盐水代替环磷酰胺,LOH组以同等体积橄榄油代替丙酸睾酮,对照组以同等体积生理盐水代替环磷酰胺、同等体积橄榄油代替丙酸睾酮,给药方法同BPH合并LOH组.停药2d后,进行悬尾实验、负重游泳实验及交配实验,并通过断尾法取血以检测血清睾酮含量.完成全部操作后,通过颈椎脱臼法处死全部实验动物,解剖观察前列腺、称量并行组织病理学检查.结果 LOH组、BPH合并LOH组、对照组、BPH组大鼠平均前列腺指数分别为1.58±-0.13、2.93±0.19、2.33±0.13、3.23土0.11,血清睾酮含量分别为(4.91±1.06)、(9.52±1.02)、(12.59±0.70)、(19.69±0.56) ng/mL,悬尾挣扎次数分别为(97.40±15.86)、(120.40±14.06)、(223.83±16.51)、(235.29±18.77)次,各组间差异均有统计学意义(P＜0.05,P＜0.01);LOH组、BPH合并LOH组、对照组、BPH组大鼠平均负重游泳时间分别为(74.27±9.29)、(167.47±23.35)、(302.33±30.10)、(261.59±35.13)s,嗅阴次数分别为(1.53±0.52)、(3.07±0.88)、(9.17±1.30)、(9.59±1.12)次,除对照组和BPH组差异无统计学意义外,其余各组间差异均有统计学意义(P＜0.01);LOH组、BPH合并LOH组、对照组、BPH组大鼠平均骑跨次数分别为(0.33±0.49)、(0.47-±-0.52)、(2.11±0.47)、(2.29±0.47)次,除对照组与BPH组、BPH合并LOH组与LOH组差异无统计学意义外,其余各组间差异均有统计学意义(P＜0.01).结论 通过腹腔注射环磷酰胺及丙酸睾酮可获得BPH合并LOH大鼠模型.     

脑卒中标准化病人结合SOAP评估记录法在《物理治疗学》教学中的应用研究

目的 探讨脑卒中标准化病人（standardized patients,SP）结合以问题为导向的医学记录法[主观资料（Subjective,S）,客观资料（Objective,O）,评估（Assessment,A）和计划（Plan,P）,SOAP]在《物理治疗学》实践教学的应用效果。方法 采用随机对照研究,选取本校康复治疗学本科班116人作为研究对象。对照组采用传统教学,试验组采用脑卒中SP结合SOAP评估记录法的教学模式。授课结束后,比较两组学生的教学效果。采用SPSS 24.0进行统计分析,计数资料采用卡方检验,组间比较采用配对样本t检验。结果 试验组学生实践操作能力得分（85.97±3.19）、基础理论知识得分（86.00±3.74）、康复治疗记录撰写得分（85.74±4.76）均高于对照组[（78.14±3.86）、（84.07±5.24）、（66.86±4.16）],两组比较差异有统计学意义（P<0.05）。试验组学生在知识自信（12.55±1.30）、技能自信（10.86±1.51）、沟通自信（11.69±1.71）等多维度自信心方面得分高于对照组[（8.79±1.59）、（7.45±1.27）、（7.83±1.44）],两组比较差异有统计学意义（P<0.01）。结论 脑卒中SP结合SOAP评估记录法运用到《物理治疗学》的实践教学中,可以有效提高学生的专业素质和临床思维能力,增强学生的专业自信心,弥补了传统教学方法的不足,促进了康复医学教育教学的改革。     

微信结合TBL教学在康复治疗专业临床带教中的应用研究

目的 探讨微信结合TBL教学在康复治疗专业临床带教中的应用效果。方法 以我科实习的40名康复治疗专业学生为研究对象,分为对照组（n=20）和试验组（n=20）。对照组采用传统讲授式教学,试验组采用微信结合TBL教学。所有学生在临床实习轮转结束后统一进行出科考试及满意度调查。使用SPSS 26.0进行t检验和卡方检验。结果 试验组出科考试成绩优于对照组[（74.3±4.9） vs. （62.4±5.2）,P<0.001],主要体现在病例分析[（18.3±2.1） vs. （15.2±1.9）,P<0.001]、实践操作[（19.3±2.1） vs. （14.8±2.4）,P<0.001]、医患沟通[（17.8±2.4） vs. （14.1±2.4）,P<0.001] 3个方面。试验组实习生满意度调查总分优于对照组[（79.6±4.8） vs. （71.2±3.5）,P<0.001]。结论 微信结合TBL教学能显著改善康复治疗专业临床带教教学效果,有利于提高学生病例分析、实践操作和医患沟通能力。     

谦卑型导师模式在手术室带教中的应用及分析

目的 探讨谦卑型导师模式在手术室实习护生带教中的应用效果。方法 选择济宁医学院附属医院总院区手术室 2020年8月至2021年6月40名实习护生作为对照组,2021年8月至2022年9月46 名实习护生作为试验组。对照组接受常规导师模式带教,试验组采用谦卑型导师模式带教。比较两组护生理论知识与操作技能考核成绩,以及建言行为、自我效能感、谦卑型导师感知教学效果。采用SPSS 19.0进行t检验、卡方检验和相关分析。结果 出科时,试验组护生理论知识（93.86±3.53）分、操作技能考核成绩（90.90±5.68）分,均高于对照组（P<0.001）。护生建言行为评分试验组（35.22±7.60）分,高于对照组的（30.43±5.96）分（P=0.002）。护生自我效能感评分试验组（28.17±5.03）分,高于对照组的（24.38±3.39）分（P<0.001）。护生谦卑型导师感知评分试验组（37.04±4.34）分,高于对照组的（26.33±6.63）分（P<0.001）。护生谦卑型导师感知与建言行为（r=0.89,P<0.001）、自我效能感（r=0.72,P<0.001）、操作技能成绩（r=0.66,P<0.001）、理论知识成绩（r=0.39,P=0.007）呈正相关。结论 谦卑型导师模式在手术室带教中应用效果显著,提高了护生的理论知识与操作技能考核成绩,促进了谦卑型导师的形成,加强了护生建言行为和自我效能感的教学效果。     

Ultrafiltration in control of hematocrit and blood volume during cardiopulmonary bypass

Summary Ultrafiltration as a means to control hematocrit and blood volume during cardiopulmonary bypass was evaluated in two groups of 15 mongrel dogs. In both groups, the fluid input and urinary output were similar (P> 0.20). The amount of filtrate ranged from 950 to 2600 ml (mean 1740.0±426.5 ml), and resulted in an average intraoperative fluid balance of +424.9±131.4 ml. In the control group the fluid balance was +2693.6±222.4 ml, more than in the Ultrafiltration group (P< 0.00l). The mean hematocrit and hemoglobin before ultrafiltration amounted to 13.22% and 4.96g% respectively, whereas after ultrafiltration the variables increased to 23.33g% and 8.28g% respectively (P< 0.00l). Our results suggest that ultrafiltration is a relatively simple, safe and effective method of hemoconcentration during cardiopulmonary bypass.     

Increased Neuronal Hypoxic Tolerance Induced by Repetitive Chemical Hypoxia

Repetitive administration of 3 - nitropropionate(3 - NP) ,a selective inhibitor of succinic dehydroge-nase,has been shown to cause chronic hypoxia fol-lowed by widespread neurodegeneration in centralnervous system,which further develops a pharmaco-logical animal model of Huntington' s disease[1] .Many scholars reported that single or repeated ad-ministration of 3 - NP causes widespread cerebral bio-chemical and morphological impairment[2 ] .On theother hand,it is well known that transient is…     

Clinical implication of the changes of cAMP,TXA<Subscript>2</Subscript> and PGI<Subscript>2</Subscript> in CSF of asphyxiated newborns

Summary To evaluate the changes of 3′, 5′-cyclic adenosine monophosphate (cAMP), thromboxane A₂(TXA₂) and prostacyclin (PGI₂) in cerebrospinal fluid (CSF) in the asphyxiated newborn and explore their roles in hypoxic-ischamic brain damage (HIBD). Thirty-six full term newborns were divided into 3 groups, including 12 with moderate-severe hypoxic-ischaemic encephalopathy (HIE), 13 with mild HIE, 11 without HIE (control group). The levels of cAMP, TXB₂ (TXA₂ metabolite) and 6-keto-PGF_1α (PGI₂ metabolite) in CSF and plasma were measured 36–72 h after birth by RIA, and the concentrations were expressed as nM/L (cAMP), ng/L(TXB₂ and 6-keto-PGF_1α). The infants were followed-up at 6 and 12 month of age and Mental Development Index (MDI) and Psychomotor Development Index (PDI) were measured using Bayley Scales of Infant Development (BSID). The CSF cAMP level in moderate-severe HIE group was 8.60±2.40, significantly lower than that of the mild HIE group (14.83±2.84) and the control group (24.43±2.39) (for bothP<0.01). The levels of TXB₂ and 6-keto-PGF_1α in CFS in the moderate-severe HIE group (206.06±29.74, 168.47±23.02, respectively) were significantly higher than in the mild HIE group (83.37±28.57, 131.42±16.57, respectively,P<0.01) and the control group (41.77±21.58, 86.23±13.05, respectively,P<0.01). The level changes of cAMP, TXB₂ and 6-keto-PGF_1α in plasma in all groups were similar to those in CSF, but no significant difference was found between mild HIE group and the control group (P>0.05). The follow-up results showed that MDI and PDI of the moderate-severe HIE group were the lowest (84.79±13.34, 83.50±13.28, respectively), followed by mild HIE group (102.19±7.02, 99.94±9.08, respectively), with the control group being the highest (116.63±12.08, 116.69±10.87, respectively). Univariate analysis showed some significant difference (the moderate-severe HIE group vs. the mild HIE group or the control group,P<0.01; the mild HIE group vs. the control groupP<0.05). The results suggested that the concentration of cAMP, TXA₂ and T/K ratio in CSF after neonatal asphyxia might be sensitive markers in evaluating the severity of brain damage in early stage and predicting the future outcome. LIU Hanchu, male, born in 1959, Associate Professor     

Expression of Platelet Membrane Glycoprotein Ib/Ⅸ/Ⅴ Complex,a Receptor of Thrombin,in Patients with Hemorrhagic Thrombopathy

To investigate the role of platelet membrane glycoprotein （GP） Ib/Ⅸ/Ⅴ complex and its subunit GP Ibα in patients with hemorrhagic thrombopathy （HT）, the expressions of GP Ib/Ⅸ/Ⅴ complex and GP Ibα,defined as mean fluorescence intensity （MFI）, were assessed by flow cytometry. The maximum aggregation of platelet was determined by turbidity method. These indicators were compared among 68 HT patients with the presenting complaint of hemorrhage, 33 well-controlled HT patients and 32 normal healthy subjects. The results showed that the MFI of GP Ib/Ⅸ /Ⅴ complex and GP Ibα was markedly lower in HT patients with current hemorrhage than that in the healthy subjects, with difference being statistically significant （P〈0.05）. There was no significant difference in the expressions of GP Ib/ Ⅸ/ Ⅴ complex and GP Ibα between well-controlled HT patients and normal healthy subjects （P〉0.05）. It was concluded that the expression of GP Ib/Ⅸ /Ⅴ complex, the receptor of thrombin and von Willebrand factor, was down-regulated in HT patients with current hemorrhage, which might result in the dysfunction of platelet aggregation and recurrence of HT.     

Study on the effects of losartan on cardiomyocyte apoptosis and gene expression after ischemia and reperfusion in vivo in rats

Along with the thrombolysis therapy, PTCAand the coronary artery bypass graft are used inthe treatment of acute myocardial infarction(AMI), these method played the important rolesfor restoring the myocardial perfusion, rescuingagonal cardiomyocyte or reducing the extension ofthe myocardial infarctlon and protecting the cardiacfunction, but ischemia/reperfusion can cause themyocardial injury. Therefore the study of the myocardial ischemia and reperfusion injury become theclinical hotspot. It …