慢性阻塞性肺疾病稳定期中医证型分布规律研究

[目的]通过对403例COPD稳定期患者的中医证型分布特点的研究,从而对COPD稳定期患者的中医预防和治疗提供依据。[方法]收集2008年9月至2009年12月在新疆医科大学附属中医医院呼吸科住院及门诊COPD稳定期患者403例;记录患者一般资料、病史、诱因、证型要点等,明确中医分型、病程及吸烟之间关系。所有数据应用SPSS13.0统计软件软件处理。[结果]①403例COPD稳定期患者男女比为2.73∶1;病程在10年以下的198例,占总人数的49.13%,比例最高;危险因素中吸烟占总人数的39.45%。②中医证型出现频次依次为:肺气虚证>血瘀证>肾气虚证>脾气虚>痰热证>痰浊证。[结论]COPD稳定期患者证属本虚标实,本虚多为肺、肾、脾气虚为主,实证多为血瘀、痰浊证。这为中医防治COPD稳定期提供了一定的客观依据。     

中药镇痛实验的研究进展

随着科技的进步,人们在分子和细胞水平、神经递质等多方面,对疼痛病理的认识不断深入,中药镇痛研究取得了新的进展,并以动物疼痛模型为基础筛选和研究了中药镇痛活性成分及其作用机制,为新型镇痛药的创制开发提供了科学依据。本文总结了中药镇痛实验研究中常见的动物疼痛模型,着重探讨了镇痛机制相关物质及其测定,以期为今后中药镇痛研究提供参考。     

疼痛模型大鼠血清单胺类递质的测定

目的:研究疼痛对大鼠血清单胺类递质含量的影响。方法:大鼠左后足跖底部皮下注射5%甲醛建立动物疼痛模型,进行行为学观察,采用荧光分光光度法测定正常和模型大鼠血清中去甲肾上腺素(NE)和多巴胺的含量,NE的激发/发射波长分别为384/483 nm,多巴胺的激发/发射波长分别为324/373 nm。结果:NE线性范围是:0.01~0.25μg/ml(r=0.996 5,n=7);多巴胺线性范围是:0.01~0.20μg/ml(r=0.993 5,n=7)。NE和多巴胺的日内、日间RSD均<20%,相对回收率分别为99.8%~113.5%和99.4%~106%。正常组大鼠血清NE和多巴胺含量分别为(0.088±0.030)(、0.047±0.005)μg/ml,模型组则分别为(0.122±0.010)、(0.064±0.010)μg/ml。结论:荧光分光光度法测定大鼠血清中NE、多巴胺含量准确、灵敏。皮下注射5%甲醛可致疼痛症状产生,疼痛可能引起大鼠血清中NE和多巴胺水平升高。     

Extra physical therapy reduces patient length of stay and improves functional outcomes and quality of life in people with acute or subacute conditions: a systematic review

Peiris CL, Taylor NF, Shields N. Extra physical therapy reduces patient length of stay and improves functional outcomes and quality of life in people with acute or subacute conditions: a systematic review.

Objectives

To investigate whether extra physical therapy intervention reduces length of stay and improves patient outcomes in people with acute or subacute conditions.

Data Sources

Electronic databases CINAHL, MEDLINE, AMED, PEDro, PubMed, and EMBASE were searched from the earliest date possible through May 2010. Additional trials were identified by scanning reference lists and citation tracking.

Study Selection

Randomized controlled trials evaluating the effect of extra physical therapy on patient outcomes were included for review. Two reviewers independently applied the inclusion and exclusion criteria, and any disagreements were discussed until consensus could be reached. Searching identified 2826 potentially relevant articles, of which 16 randomized controlled trials with 1699 participants met inclusion criteria.

Data Extraction

Data were extracted using a predefined data extraction form by 1 reviewer and checked for accuracy by another. Methodological quality of trials was assessed independently by 2 reviewers using the PEDro scale.

Data Synthesis

Pooled analyses with random effects model to calculate standardized mean differences (SMDs) and 95% confidence intervals (CIs) were used in meta-analyses. When compared with standard physical therapy, extra physical therapy reduced length of stay (SMD=−.22; 95% CI, −.39 to −.05) (mean difference of 1d [95% CI, 0–1] in acute settings and mean difference of 4d [95% CI, 0–7] in rehabilitation settings) and improved mobility (SMD=.37; 95% CI, .05–.69), activity (SMD=.22; 95% CI, .07–.37), and quality of life (SMD=.48; 95% CI, .29–.68). There were no significant changes in self-care (SMD=.35; 95% CI, −.06–.77).

Conclusions

Extra physical therapy decreases length of stay and significantly improves mobility, activity, and quality of life. Future research could address the possible benefits of providing extra services from other allied health disciplines in addition to physical therapy.     

The histone deacetylase inhibitor, sodium butyrate, alleviates cognitive deficits in pre-motor stage PD

Parkinson's disease (PD) patients often times experience impairment in their cognitive abilities early on in the progression of the disease. The reported deficits appear to mainly involve functions that are associated with frontal lobe and frontal-striatal pathways subserving attentional set-shifting, working memory and executive function. The current study explored executive function deficits in a rat model of PD in the pre-motor deficit stage. The rats were lesioned with 12 μg of 6-hydroxydonpamine (6-OHDA) in the striatum in a two step process (10 μg/μl followed by 2 μg/μl) 48 hours apart. Executive function was tested at 3 weeks post-surgery using a rat analogue of Wisconsin card sorting test called the Extra Dimensional/Intra Dimensional (ED/ID) set-shifting task. The results demonstrated that performance by the pre-motor rat model of PD was equivalent to that of the control groups in the simple and the compound discriminations as well as the intra-dimensional set-shifting. However the PD group exhibited attentional set-shifting deficits similar to those observed in PD patients. Additionally, sodium butyrate, a short chain fatty acid derivative and inhibitor of class I and II histone deacetylase (HDACi), was tested as a potential therapeutic agent to mitigate the pre-motor cognitive deficits in PD. The results indicated that the sodium butyrate treatment not only effectively alleviated the set-shifting deficits, but also improved the attentional set formation in the treated rats.     

Detection of synthetic cannabinoids in herbal incense products

Objective

We investigated the ability of clinical drug of abuse tests to detect synthetic cannabinoids.

Results

A broad class GC/MS drug screening method detected JWH-018 and JWH-073 in methanolic extracts and teas steeped from herbal incense products in three of four products tested.

Conclusions

Synthetic cannabinoids are present in herbal incense purchased over the internet.     

Interactions between parents and staff of hospitalised children

The Platt report (Ministry of Health 1959) recommended that hospitals provide for parents to stay with sick children. This review, of how hospitals have or have not followed this guidance, assesses the literature and includes insights into research on the theory of attachment. The authors conclude that, although parents are commonly to be found on wards with sick children, this is not often systematically encouraged or even understood. However, recent initiatives to improve communication between staff and the parents of children admitted to hospital are encouraging.     

皮肤点刺试验在皮肤科的应用及护理

目的 总结1232例皮肤点刺试验的应用经验.方法 应用德国Allergopharma标准变应原液在前臂屈侧皮肤进行皮肤点刺试验,同时应用0.1%组胺和生理盐水分别作为阳性和阴性对照试验,判断阴性或阳性结果及阳性强度.结果 在1232病例中,过敏原阳性率为81.33%;尘螨(屋尘螨+粉尘螨)阳性率(57.00%)明显高于其它过敏原,其次阳性率较高的有虾(18.34%).结论 尘螨是慢性过敏性皮肤病常见的首要过敏原;为提高皮肤点刺试验的准确性,要注意操作细节(用生理盐水擦拭清洁代替皮肤消毒;刺入皮肤的深度为恰好刺破真皮;注意动态观察:各种测试液不能混合;保证生理盐水不被尘螨污染).