先天性脊柱畸形——半椎体的分型进展

先天性脊柱畸形包括前凸、后凸、侧凸、侧后凸,是指先天性椎体发育异常引起脊柱在纵轴方向上生长不平衡导致的畸形[1]。半椎体是先天性脊柱畸形中最常见的类型,约占46%。所谓半椎体是指一侧椎体发育形成障碍而引起的椎体畸形[2]。对于此类脊柱畸形,     

口服降糖药和胰岛素对眼表治疗的影响（英文）

目的：描述和对比口服降糖药（OAD）和胰岛素治疗2型糖尿病患者眼表的效果。方法：在安卡拉卫生部培训和研究医院就诊的20例40眼口服降糖药患者,20例40眼胰岛素治疗患者,对照组的10例非糖尿病人作为研究对象。对所有患者进行常规眼科检查,Schirmer试验,泪膜破裂时间分析和结膜印迹细胞学分析.比较三组的泪液功能参数,杯状细胞密度和鳞状上皮化生等级。记录视网膜病变及眼表疾病之间的关系。结果：口服降糖药患者泪膜破裂时间值明显低于其他组（P〈0.05）。三组的杯状细胞密度和鳞状上皮化生等级相近。上皮细胞稍大,呈现更多的多边形的眼的中位数级为1级,并且嗜酸性染色胞浆和杯状细胞数量减少。视网膜病变与眼表疾病不相关。结论：口服降糖药患者的角膜前泪膜稳定性比其他组差。各组的印迹细胞学分析结果相似。     

药物化学探究性实验教学模式的探索

药物化学实验教学是药物化学课程的重要组成部分。传统的验证性实验教学方法和教学内容存在较大的缺陷,而探究性实验教学模式突出了学生在实验中的自主性,可以有效地弥补验证性实验教学的不足。实践证明,药物化学探究性实验教学模式不仅提高了学生的学习热情和主动性,同时还培养了学生的自学能力、创新思维和创新能力。     

Use of hybrid chitosan membranes and human mesenchymal stem cells from the Wharton jelly of umbilical cord for promoting nerve regeneration in an axonotmesis rat model

Many studies have been dedicated to the development of scaffolds for improving post-traumatic nerve regeneration. The goal of this study was to assess the effect on nerve regeneration, associating a hybrid chitosan membrane with non-differentiated human mesenchymal stem cells isolated from Wharton’s jelly of umbilical cord, in peripheral nerve reconstruction after crush injury. Chromosome analysis on human mesenchymal stem cell line from Wharton’s jelly was carried out and no structural alterations were found in metaphase. Chitosan membranes were previously tested in vitro, to assess their ability in supporting human mesenchymal stem cell survival, expansion, and differentiation. For the in vivo testing, Sasco Sprague adult rats were divided in 4 groups of 6 or 7 animals each:Group 1, sciatic axonotmesis injury without any other intervention (Group 1-Crush); Group 2, the axonotmesis lesion of 3 mm was infiltrated with a suspension of 1 250-1 500 human mesenchymal stem cells (total volume of 50 μL) (Group 2-CrushCell); Group 3, axonotmesis lesion of 3 mm was enwrapped with a chitosan type III membrane covered with a monolayer of non-differentiated human mesenchymal stem cells (Group 3-CrushChitIIICell) and Group 4, axonotmesis lesion of 3 mm was enwrapped with a chitosan type III membrane (Group 4-CrushChitIII). Motor and sensory functional recovery was evaluated throughout a healing period of 12 weeks using sciatic functional index, static sciatic index, extensor postural thrust, and withdrawal reflex latency. Stereological analysis was carried out on regenerated nerve fibers. Results showed that infiltration of human mesenchymal stem cells, or the combination of chitosan membrane enwrapment and human mesenchymal stem cell enrichment after nerve crush injury provide a slight advantage to post-traumatic nerve regeneration. Results obtained with chitosan type III membrane alone confirmed that they significantly improve post-traumatic axonal regrowth and may represent a very promising clinical tool in peripheral nerve reconstructive surgery. Yet, umbilical cord human mesenchymal stem cells, that can be expanded in culture and induced toform several different types of cells, may prove, in future experiments, to be a new source of cells for cell therapy, including targets such as peripheral nerve and muscle.     

论扶阳学派理论基础与核心思想

任何一个学派的形成,都有它的理论基础和核心思想,而且是维系和推进其存在与发展的基石。扶阳学派作为中医学众多学术流派之一,与其它学派一样,其理论基础无疑是《内经》的重要思想,并与《易经》、《伤寒论》等有十分密切的关系。其核心思想就是重视阳气,推崇阳气,力主阳主阴从。深入研究扶阳学派理论,对于繁荣中医学术,提高中医临床疗效,维护人民健康,促进中医药事业发展,具有重要的现实意义和深远的历史意义。     

路艺主任医师糖尿病足治验

糖尿病足是糖尿病常见的并发症,其中医病因病机主要是湿热、痰浊循经脉下行于足部,久而引起局部组织损害。路艺主任医师将糖尿病足坏疽辨为湿热蕴结及热盛伤阴两种证型,采用药物外敷法及针灸治疗有明显效果。     

腹腔镜肝切除技术的优化

目的通过动物实验优化腹腔镜肝切除中入肝血流阻断技术及肝实质离断技术。方法以10头猪为实验动物,以肝门阻断钳或可拆卸肝门阻断钳及鞘内解剖优化腹腔镜下入肝血流阻断技术;在没有任何入肝血流阻断的情况下,分别进行肝脏局部切除、左外侧叶及左内侧叶的序贯切除,肝实质离断采用超声刀、LigaSure、微波刀、双极电凝、外科夹及内镜切割闭合器完成,比较不同器械离断肝实质的效果和安全性。结果肝门阻断钳或可拆卸肝门阻断钳行入肝血流全部阻断或部分阻断后,缺血部分肝脏颜色变化明显;鞘内解剖左半肝入肝血流阻断后,左、右半肝间的缺血线明显;各种常用肝实质离断器械均有其适用范围,对其的优化使用可提高断肝效率,减少出血。结论通过动物实验优化的腹腔镜入肝血流阻断技术以及肝实质离断技术,可为腹腔镜解剖性广泛肝切除的临床应用提供依据。     

生物反馈仪治疗功能性便秘的疗效观察

目的探讨生物反馈训练对功能性便秘治疗的疗效。方法对门诊30例功能性便秘患者进行生物反馈训练治疗,治疗前后进行临床评估、肛管测压、结肠通过时间检查和肌电图检查。结果出口梗阻型便秘及混合型便秘患者(22例),临床症状改善,结肠通过时间较治疗前明显缩短(P<0.05);肌电图检查显示腹部和肛门外括约肌的收缩幅度均有不同程度的增加,松弛幅度降低(P<0.05)。慢传输性便秘(8例)临床症状亦改善,结肠通过时间较治疗前亦明显缩短,肌电图检查显示腹部和肛门外括约肌的收缩幅度均有不同程度的增加,松弛幅度降低,但无显著性差异(P>0.05)。结论生物反馈治疗各种类型的功能性便秘均有效,可作为功能性便秘的治疗方法之一。     

六味地黄汤的临床应用举隅

六味地黄汤出自北宋钱乙《小儿药证直诀》 ,为六味地黄丸改为汤剂。方由熟地黄 ,山药 ,山茱萸 ,牡丹皮 ,泽泻 ,茯苓诸药组成。主治肝肾阴虚 ,虚火上炎所致的腰膝软 ,头晕目眩 ,耳鸣耳聋 ,盗汗遗精或骨蒸潮热 ,手足心热等病症。笔者以本方为基础加味 ,辨证治疗多种病症 ,收效满意 ,现举例如下。1　皲裂陈某 ,女 ,4 2岁 ,1998年 6月 1日初诊。患者双足皮肤粗糙 ,裂口出血 ,灼热而痛 ,以足跟部尤重。伴双足燥热 ,行走不便 ,曾用中药外洗 ,西药软音外敷治疗无效。其症腰膝酸软无力 ,两目干涩 ,心烦耳鸣 ,手足皮肤粗糙 ,双足跟部有纵横裂口渗血…     

《伤寒论》之病位研究

《伤寒论》是一部对外感病进行辨证论治的专著,但其中涉及内科杂证者甚多。如本文所及之"蓄血证"、"热入血室"证、"结胸"证、"脏结"证,既可见无外感变证中,又可于杂病中出现。这四个病证于临床中经常见到,虽然依张仲景之法论治,每获捷效,但究其所以,却不能了了。首先是这几种病的病位问题,自古迄今,无人指点明白。笔者对此谨抒自见,以"蓄血证"蓄于肠道与冲脉,以"热入血室"为热在血分,以"结胸"证为邪结胸膈胃肠,以"脏结"证为邪结在肝。