胫骨应力骨折形成的力学分析

总结了３０例肥骨应力骨折病人的临床资料。发现新兵训练所致的胫骨应力骨折均发生在大负荷训练后，其正位Ｘ线片特点为骨折多发生在胫骨中上１／３内侧皮质，该部位与股肌纵轴延长线相交，提示膝关节正常轻微外翻可能与胫骨应力骨折的发生有关。由股骨纵轴下传给胫骨中上段内侧皮质的力可分解成两个力，一个是沿胫骨纵轴下传的力，另一个是使径骨向内移动的水平剪力，剪力的长期累加，可能与胫骨应力骨折的发生有关。另外，胫骨中，     

肱骨外髁的电测实验应力分析

采用电测实验方法探讨肱骨外髁翻转骨折的发生机制和合理的固定方法。取一具6岁儿童新鲜尸体的肘关节,处理后粘贴电阻应变片,模拟肘关节伸直和屈曲45°状态下前臂旋前、中立、旋后6种体位,和屈曲90°时前臂旋前、中立、旋后3种体位的应力测定,结果显示肱骨外髁前后部竖直方向的应变无论伸肘还是屈肘均为压应变,屈肘45°位为拉应变。肱骨外髁在屈肘90°前臂旋后位时,水平方向的压应变最大,中立位次之,旋前位时其前方呈拉应变。提示肱骨外髁骨折的好发部位是肘关节半屈曲位,骨折后最佳的固定体位是屈肘90°前臂旋后位。     

DEVELOPMENT OF A NOVEL QUESTIONNAIRE FOR THE TRADITIONAL CHINESE MEDICINE PATTERN DIAGNOSIS OF STRESS

Background: The term "stress" is a common diagnosis used by both patients and practitioners alike to describe a "condition" generally regarded as subjective in nature.That is each individual will report varying somatic or cognitive symptoms.Currently there are no definitive diagnosis or signs and symptoms for "stress" for both biomedicine and traditional Chinese medicine(TCM).Methods: Signs and symptoms for General Anxiety Disorder and commonly reported signs and symptoms for stress were cross-referenced against modern TCM textbooks to relate each sign and symptom to possible patterns(zheng) and then crossreferenced again against the signs and symptoms list to form two gender specific questionnaires.Pattern identification measurement was based on percentile rank of signs and symptoms present against possible number of signs and symptom per pattern for each gender.The questionnaires was administered at two separate time intervals on the same day to 20 participants(n=10 male, n=10 female) who identified themselves as stressed.Test-retest reliability and the most frequently scored patterns were then calculated.Results: Test-retest analysis found that the Pearson's correlation for females was 0.84 while for males was 0.85.In addition, the most common patterns reported were heart blood deficiency, heart qi deficiency and liver blood deficiency.Conclusion: Findings from this preliminary study show potential for this instrument as a novel diagnostic tool for the identification of the patterns associated with stress.     

CHANGES OF PSYCHOLOGICAL STRESS STATE AND THE EFFECT OF ACPUNCTURE INTERVENTION IN ARMED ANTI-TERRORISM POLICEMEN

Objective:To observe psychological changes of the armed policemen under stress state and the effect of acupuncture intervention for exploring possible measures in raising the armed policemen's capability in dealing with the suddenly-occurred accidents. Methods: In the first part of the study for observing psychological changes, a total of 90 volunteer armed policemen participating in anti-terrorism maneuver were randomly and evenly divided into anti chemical weapon group, flight reconnaissance group and hostage-rescuing group. 30 logistic personals were selected to form control group. Symptom Checklist-90 (SCL-90) questionnaire was used to assess the psychological state of these anti-terrorism policemen. In the second part of the study for observing the effect of acupuncture, 60 policemen with anxiety and depression who were determined by Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS) were randomly and evenly divided into non-acupuncture and acupuncture groups, and other 30 polic     

针刺胃俞、足三里抗急性应激性损害的实验研究

选用 SD 大鼠57只,观察了大鼠正常胃肠里浆膜电极引导的胃电情况,和经束缚-旋转后应激性胃肠里活动的变化。观察到针刺胃俞、足三里能减轻应激性的胃肠粘膜损害。并伴随着对于抑制性胃肠电反应的明显的去抑制作用。     

ACUPUNCTURE FOR TREATMENT OF COOCCURRING PAIN AND STRESS AMONG WOMEN:A MIXED-METHOD CASE SERIES

Objective: Women are disproportionately affected by chronic pain and chronic stress, both of which represent significant public health problems.Chronic pain and stress often co-occur which can exacerbate the deleterious effects of each.Conventional treatment modalities(SSRIs, analgesics) have potentially serious side effects, especially when taken long term.The purpose of this study was to assess objective(including biomarkers) and subjective assessment of pain and stress improvement in women over an 8-week course of acupuncture treatment.Methods: Study design: case series of 3 women.Enrollment criteria: 3 women(ages 30-65) were recruited from large acupuncture practice.Must report:(1) consistent pain for 3+ months,(2) VAPS 6,(3) Cohen Perceived Stress Scale(PSS)21.Protocol: 3 women were assessed, treated, and prospectively followed weekly for 8 weeks.TCM principles and differential diagnoses were employed.Individualized treatments were used; needles were left in place for 30 min, with De-qi.At baseline, week 4, and week 8, diurnal cortisol(8 am and 4 pm) was assessed(buccal swab) and CBC(for ESR) and CRP were evaluated based on blood analysis.PCORI measures were evaluated weekly.Results: All women reported subjective improvements in pain and reduction of stress(self-report VAPS and PSS).Several PCORI measures trended in appropriate direction.Biomarker measures were more stable, although suggestive(reduction in inflammatory markers, and modified diurnal cortisol patterns).Conclusion: This small case-series pilot study demonstrated clinical and patient-centered improvements in pain and stress reduction and suggestive biomarker findings.Implications for clinical practice and future research designs will be discussed.     

无应力遮挡外固定器治疗尺骨鹰嘴骨折临床观察

为了解自行研制的尺骨鹰嘴骨折无应力遮挡外固定器的性能及临床疗效，应用WD-10E型万能电子力学试验机进行生物力学测试，并对运用该外固定器治疗的笠例尺骨鹰嘴骨折患者进行临床疗效观察。术后随访3个月～1．5年，结果22例骨折均解剖对位愈合，功能完全恢复，无任何并发妒和后遗症。表明本外固定器具有微创、固定可靠、早期关节活动、无须行内固定取出术、操作简便安全、并发症少等优点，同时还具有设计原理新颖、拓展性强等特点。从骨折治疗的进展看，无应力遮挡外固定器疗法将成为主要方法之一。     

推拿对异常应力下兔颈椎间盘蛋白多糖变化的影响

为观察中医推拿手法对异常应力环境下兔颈椎间盘基质蛋白多糖变化的影响 ,将 32只家兔随机分为对照组、模型组和治疗组 ,后两组家兔每天 1次保持颈椎低头屈曲 4 5°位 5小时 ,治疗组分别于造模开始及造模 2个月后施以推拿手法。取C5～ 6椎间盘生化测定椎间盘的蛋白多糖总量、硫酸软骨素和硫酸角质素比值及透明质酸含量 ,比较各组间可能存在的差异。结果显示 ,对照组蛋白多糖总量和成分含量均无显著变化 ,模型组和治疗组蛋白多糖总量及硫酸软骨素和硫酸角质素比值明显下降 ,治疗组家兔颈椎间盘蛋白多糖含量明显高于模型组 ,但各成分含量无明显差异。表明推拿手法能够一定程度减少异常应力环境下颈椎间盘中蛋白多糖的丢失 ,其作用的机制可能与抑制蛋白多糖降解有关。     

EFFECT OF ELECTROACUPUNCTURE OF ZUSANLI ON PLASMA EGF, CGRP AND GASTRIC MUCOSA IN STRESS RATS

Ｒｅｃｅｎｔｒｅｓｅａｒｃｈｅｓｉｎｄｉｃａｔｅｔｈａｔｅｌｅｃ ｔｒｏａｃｕｐｕｎｃｔｕｒｅ (ＥＡ)ａｔＺｕｓａｎｌｉ(ＳＴ 3 6)ｃａｎｅｆ ｆｅｃｔｉｖｅｌｙ ｐｒｏｔｅｃｔｔｈｅ ｇａｓｔｒｉｃｍｕｃｏｓａｆｒｏｍｉｎ ｊｕｒｙ[1 ,2 ] .Ｎｅｖｅｒｔｈｅｌｅｓｓ,ｔｈｅｕｎｄｅｒｌｙｉｎｇｍｅｃｈａ ｎｉｓｍｓｒｅｍａｉｎｕｎｋｎｏｗｎｕｐｔｏｎｏｗ .Ｍｏｄｅｒｎｒｅ ｓｅａｒｃｈｅｓｄｅｍｏｎｓｔｒａｔｅｔｈａｔｕｎｄｅｒｎｏｒｍａｌｃｉｒｃｕｍ ｓｔａｎｃｅｓ,ｔｈｅａｔｔａｃｋｉｎｇｆａｃｔｏｒｓ…     

CLINICAL APPLICATION OF ACUPUNCTURE ON ALLEVIATION OF STRESS REACTION INDUCED BY TRACHEAL INTUBATION IN GENERAL ANESTHESIA

Acupuncturehasbeenappliedinanesthesiaforover40years,especiallyinanalgesia.Therearemanyreportsof itonsingleanesthesiaorcompoundmedicinalanesthesia.Forinstance,Qin,etal.[1]summarize174relevant paperspublishedon23kindsofmagazinesinrecent10years.Inrecentsever…     

纳米氧化锆梯度复合羟基磷灰石内固定材料的应力遮挡

目的：探讨氧化锆梯度复合羟基磷灰石内固定材料的应力遮挡率的变化。方法：将Beagle犬制成双侧股骨中段横断骨折模型后，分别以氧化锆梯度复合羟基磷灰石内固定材料和有限接触不锈钢接骨板固定，观察其应力遮挡率的变化。结果：不同材料内固定的应力遮挡率分别随着固定时间6、8、12周而逐渐降低，且前者要低于后者，但无统计学差异。结论：说明内固定应力遮挡率的下降与固定时间具有相关性，氧化锆梯度复合羟基磷灰石内固定材料是一种可靠的内固定材料。     

EFFICACY OF ELECTROACUPUNCTURE IN WOMEN WITH MILD TO MODERATE STRESS URINARY INCONTINENCE:A PHASE I CLINICAL TRIAL

Objective: To preliminarily evaluate the efficacy of electroacupuncture at Zhongliao(BL33) and Huiyang(BL35), and to exclude the placebo effect.Methods: Seventy women with mild to moderate stress urinary incontinence were randomly assigned to two groups: a treatment group and a control group, with 35 cases per group.The treatment group received electroacupuncture with deep needling at acupuncture points BL33 and BL35.The control group received sham electroacupuncture with non-penetrating needling at sham locations for the acupuncture points of BL33 and BL35.Participants were given three sessions a week for 6 weeks.The change in amount of urine leakage measured by a one-hour pad test, the 72-hour incontinence episode frequency, and the score of ICIQSF questionnaire from baseline to post-treatment were analyzed.Results: Compared with the baseline, the median amount of urine leakage measured by the one-hour pad test in the treatment group decreased from 6.00 to 3.10 g after treatment; while the control group decreased from 7.50 to 6.00 g; the median decrease of the treatment group(2.3 g) was larger than that of the control group(0.30 g, Z=-2.17, P=0.03).Compared with the baseline, the median decrease of the 72-hour incontinence episode frequency from baseline to post-treatment was 2.00 in the treatment group, significantly higher than 0.70 of the control group(Z=-2.45, P=0.014).The median decrease of ICIQ-SF score from the baseline to post-treatment was much higher in the treatment group(3.50) than the control group(0.50, Z=-4.173, P0.001).Both groups showed a good treatment compliance and no obvious adverse event happened.Conclusion: Electroacupuncture with deep needling at BL33 and BL35 is effective for women with mild to moderate stress urinary incontinence, which has a curative efficacy rather than a placebo effect.The study protocol, safe and feasible, shows a good treatment compliance, laying a good foundation for further phase II studies.     

ROLE OF ACUPUNCTURE IN THE REGULATION OF PRO- AND ANTI-INFLAMMATORY CYTOKINES IN A CHRONIC STRESS RAT MODEL OF DEPRESSION

Objective: Depression, a common affective disorder, is one of the leading causes of the global burden of diseases.It has been thought that chronic stress could be the main factor of inducing depression.Acupuncture in traditional Chinese medicine has been found to alleviate depression.However, it remains unknown whether acupuncture could affect the inflammatory response in a chronic stress rat model of depression.Methods: In the present study, rats were randomly assigned to the control group, the chronic unpredictable stress(CUS) group and the acupuncture group(CUS+Acu).The serum contents of interleukin-1β(IL-1β), IL-6, tumor necrosis factor-α(TNF-α), interferon-γ(IFN-γ), IL-4 and IL-10 were measured by ELISA.Results: We found that CUS markedly increased the serum levels of pro-inflammatory cytokines(IL-1β, IL-6, TNF-α, and IFN-γ), and decreased the serum levels of anti-inflammatory cytokines(IL-4 and IL-10).Acupuncture treatment significantly reduced the serum levels of IL-1β, IL-6 and TNF-α, while increased IL-4 level in CUS rats.However, the levels of IFN-γ and IL-10 were not significantly affected by acupuncture.Conclusion: The antidepressant effect of acupuncture might be mediated by reducing the pro-inflammatory cytokines and increasing the anti-inflammatory cytokines, and modulating the balance between pro-and anti-inflammatory cytokines.     

EFFECT OF ACUPUNCTURE ON PLASMA STRESS HORMONE LEVELS OF HYPOTHALAMUS-PITUITARY-ADRENAL AXIS IN TYPE II DIABETES WITH CONCURRENT ACUTE CEREBRAL INFARCTION PATIENTS

Ｗｅｈａｖｅｒｅｐｏｒｔｅｄｔｈｅｔｈｅｒａｐｅｕｔｉｃｅｆｆｅｃｔｏｆａｃｕｐｕｎｃｔｕｒｅｉｎｔｒｅａｔｍｅｎｔｏｆｃｅｒｅｂｒａｌｃｅｒｅｂｒｏｖａｓ ｃｕｌａｒｄｉｓｅａｓｅ[1 ,2 ] .Ｉｎｏｒｄｅｒｔｏｓｔｕｄｙｔｈｅｍｅｃｈａ ｎｉｓｍｓｏｆａｃｕｐｕｎｃｔｕｒｅｉｎｔｒｅａｔｍｅｎｔｏｆｃｅｒｅｂｒａｌａｐｏｐｌｅｘｙ ,ｗｅｏｂｓｅｒｖｅｄｔｈｅｅｆｆｅｃｔｏｆａｃｕｐｕｎｃｔｕｒｅｏｎｓｔｒｅｓｓｈｏｒｍｏｎｅｓｏｆｔｈｅｈｙｐｏｔｈａｌａｍｕｓ ｐｉｔｕ ｉｔａｒｙ ａｄｒｅｎａｌａｘ…     

THE EFFECTS OF ELECTROACUPUNCTRURE ON CHRONIC COLD STRESS-INDUCED INCREASES IN PERIPHERAL AND CENTRAL HYPOTHALAMUS(PARAVENTRICULAR NUCLEUS-PVN) PITUITARY AXIS HORMONES IN A RAT MODEL OF CHRONIC STRESS

Objective: There is a growing body of evidence that links chronic stress to the development of numerous disease processes, and a reduction in overall wellbeing.Electroacupuncture(EA) has been used treating stress.However, its general mechanism of action with regards to chronic stress has not yet been elucidated.Our laboratory hypothesized that EA lessens the stress response by affecting the body's class stress pathway, the hypothalamicpituitary-adrenal axis(HPA).Thus, we investigated the potential role of EA in lowering stress-induced HPA hormones.Methods: Adult male SD rats with jugular catheters were subjected to 14 d of cold stress.EA(Sham-EA and EA ST36) was performed each day following stress in one protocol.In a separate protocol, stress followed an initial treatment with ShamEA or EA ST36.Blood was collected at days 0 and 14; PVN tissues were collected on day 14.Blood samples were analyzed by ELISA, and PVN tissue was analyzed using IHC and qRT-PCR.Results: Compared to non-stressed controls((0.52±0.15) ng/mL), stress and stress+sham EA increased plasma ACTH(stress:(0.70±0.08) ng/mL; stress+sham:(0.75±0.09) ng/mL; P0.05 and cont) and corticosterone(CORT)(control:(70.1±26.9) ng/mL; stress:(317.2±49.1) ng/mL; and stress+sham:(555.2±61.5) ng/mL; P0.01).In sharp contrast, EA ST36 prevented these increases(ACTH:(0.40±0.09) ng/mL; CORT:(233.6±39.5) ng/mL).Blocking CORT receptors with RU486 resulted in suppression of CORT with exaggerated increases in ACTH indicating higherlevel control.Thus, the PVN was analyzed by IHC and qPCR for CRH levels, and mirrored our findings.Behavioral studies further confirmed these results.Conclusion: The current study demonstrates for the first time that EA ST36 is effective in preventing the chronic stress-induced increase in circulating and central HP hormones.In addition, this effect was long lasting after EA ceased.This ability to block HPA has elucidated a potential mechanism of action for acupuncture's efficacy in treatment of chronic stress.