经筋理论对针刺治疗颈型颈椎病的启示

颈型颈椎病是临床常见的脊柱退行性疾病,属于经筋病的范畴.以经筋理论的内涵、经筋与颈型颈椎病的相关性为切入点,发现经筋损伤是造成颈型颈椎病的重要原因.阐释了基于经筋理论指导治疗颈型颈椎病的理论依据,以\"在筋守筋\"为原则,联合针刺的作用与优势,证实针刺\"结筋病灶点\"疗效确切,可以解除卡压、疏通气血、缓解疼痛,以期为颈型颈椎...     

Can Vco2‐Based Estimates of Resting Energy Expenditure Replace the Need for Indirect Calorimetry in Critically Ill Children?

Background: Optimal energy provision, guided by measured resting energy expenditure (REE), is fundamental in the care of critically ill children. REE should be determined by indirect calorimetry (IC), which has limited availability. Recently, a novel equation was developed for estimating REE derived from carbon dioxide production (Vco ₂). The aim of this study was to validate the accuracy of this equation in a population of critically ill children following cardiopulmonary bypass (CPB). Methods: This is an ancillary study to a larger trial of children undergoing CPB. Respiratory mass spectrometry was used measure oxygen consumption (Vo ₂) and Vco ₂. REE was then calculated according to the established Weir equation (REE_W) and the modified, Vco ₂‐based equation (REE_CO2). The agreement between the 2 measurements was assessed using Bland‐Altman plots and mixed‐model regressions accounting for repeated measures. Results: Data from 104 patients, which included 575 paired measurements, were included. The agreement between REE_W and REE_CO2 was biased during the 72‐hour observation period post CPB, with a mean percentage error between measurements of 11% (±7%). The most important determinant of the bias with the Vco ₂‐based equation was the respiratory quotient (RQ). The percentage error between REE_W and REE_CO2 dropped to 4.4% (±2.4%) in those with an RQ between 0.8 and 1. The within‐subject variability for RQ in this cohort was wide (11%). Conclusions: IC remains the most accurate method to determine the REE of critically ill patients. Widespread availability of Vco ₂ data renders Vco ₂‐based approaches to measurement of REE attractive; however, further research is needed to ensure that REE is estimated accurately.     

Prognostic value of Bcl-2 and Bax tumor cell expression in patients with non muscle-invasive bladder cancer receiving bacillus Calmette-Guerin immunotherapy

Apoptosis is the distinctive form of programmed cell death that complements cell proliferation in maintaining normal tissue homeostasis. The significance of constitutive apoptosis in the recurrence of Non Muscle Invasive Bladder Cancer has yet to be investigated. The aim of this study is to investigate the prognostic significance of Bax and Bcl-2 in terms of recurrence after BCG immunotherapy. Immunohistochemical analysis was performed on frozen biopsies to evaluate bcl-2 and Bax proteins expression in 28 cases of NMIBC. All patients with confirmed NMIBC were treated with intravesical BCG-immunotherapy. The follow up was performed for 26 months. The correlation between clinicopathological, immunohistochemical data and the response to BCG therapy was performed. Univariate analysis showed that, PT1 stage, High grade and Bax expression increased significantly the risk of recurrence (P = 0.015, P = 0.015 and P= 0.034 respectively). In addition, multivariate analysis selected the model involving stage, age, Bax and Bcl-2 expression as the best independent variables of recurrence. In conclusion, the expression of Bcl-2 and Bax in NMIBC could have a prognostic value in assessing the risk of recurrence after BCG immunotherapy. These findings require further investigations on larger cohort in order to ascertain new molecular markers of the response to BCG immunotherapy.