中药结肠滴注治疗腹型过敏性紫癜腹痛患者97例临床研究

目的观察中药结肠滴注方法对腹型过敏性紫癜腹痛患者的疗效。方法 168例患者随机分为两组,中药组97例予以中药汤剂结肠缓慢滴入,西药组68例予西药常规治疗,10天内观察患者腹痛缓解情况及实验室指标。结果中药组在10天内腹痛缓解率为96%,西药组为85%。中药组1～3天腹痛缓解率不如西药组,但4～7天和8～10天腹痛缓解率均好于西药组,有统计学意义(P<0.01)。中药组实验室指标改善程度明显优于西药组(P<0.05),但血小板计数增高两组比较无统计学意义(P>0.05)。结论采用中药结肠缓慢滴注能明显缓解腹型过敏性紫癜患者腹痛症状和改善实验室指标,未发现不良反应。     

Meiotic failure in male mice lacking an X-linked factor

Meiotic silencing of sex chromosomes may cause their depletion of meiosis-specific genes during evolution. Here, we challenge this hypothesis by reporting the identification of TEX11 as the first X-encoded meiosis-specific factor in mice. TEX11 forms discrete foci on synapsed regions of meiotic chromosomes and appears to be a novel constituent of meiotic nodules involved in recombination. Loss of TEX11 function causes chromosomal asynapsis and reduced crossover formation, leading to elimination of spermatocytes, respectively, at the pachytene and anaphase I stages. Specifically, TEX11-deficient spermatocytes with asynapsed autosomes undergo apoptosis at the pachytene stage, while those with only asynapsed sex chromosomes progress. However, cells that survive the pachytene stage display chromosome nondisjunction at the first meiotic division, resulting in cell death and male infertility. TEX11 interacts with SYCP2, which is an integral component of the synaptonemal complex lateral elements. Thus, TEX11 promotes initiation and/or maintenance of synapsis and formation of crossovers, and may provide a physical link between these two meiotic processes.     

Exercise and quality of life after first-ever ischaemic stroke: a two-year follow-up study

Background: Quality of life (QoL) post-stroke is an important health outcome. Physical deconditioning and physical inactivity are highly prevalent in stroke survivors. This study aimed to assess the long-term trends in QoL and to explore the effect of exercise on the QoL of ischaemic stroke patients. Methods: Data for this prospective study were collected at baseline using face-to-face interviews, and telephone follow-ups were completed every three months from 2010 through 2014. QoL was evaluated with the 12-item Short-Form Health Survey (SF-12). The relationship between changes in exercise and QoL changes was analysed with a multi-level model.

Results: Exercise and QoL generally increased during the study period. After adjusting for covariates, the SF-12 Physical Component Summary (PCS) scores increased by 0.60 on average for each unit increase in exercise frequency and by 0.52 for each hour increase in weekly exercise time. For weekly exercise times ≤ 22.73 h, the PCS scores continued to increase with increasing exercise time. The Mental Component Summary scores increased by 0.51 on average for each unit increase in exercise frequency and by 0.35 for each hour increase in weekly exercise time. Furthermore, the standard deviations of exercise frequency and exercise time were inversely associated with changes in the PCS score.

Conclusions: Exercise is an important modifiable behaviour. Long-term regular mild exercise should be recommended to improve QoL among stroke survivors.     

机器人辅助和腹腔镜手术治疗直肠癌疗效与安全性比较的Meta分析

目的:系统评价机器人辅助直肠切除术(RP)与腹腔镜直肠切除术(LP)治疗直肠癌的疗效与安全性。方法:计算机检索多个国内外数据库,收集比较RP和LP治疗直肠癌的随机对照试验(RCT),检索时限均从建库至2018年3月28日。两名评价者严格按照纳入与排除标准筛选文献、提取资料,并进行文献质量评价,采用R 3.4.2软件进行Meta分析。结果:共纳入7个随机对照试验,共956例患者,其中RP组474例,LP组482例。Meta分析结果表明,与LP组比较,RP组的手术时间长(MD=28.88,95%CI=3.20～54.55,P=0.028)、中转开腹率低(RR=0.49,95%CI=0.31～0.78,P=0.003)、术后肠道功能恢复快(MD=-0.43,95%CI=-0.74～-0.13,P=0.006)、住院时间略短(MD=-0.95,95%CI=-1.84～-0.06,P=0.037)。在围手术期病死率、并发症发生率、近端及远端切缘距离、淋巴结清扫数目、术后开始流质饮食时间方面两组之间无统计学差异(均P0.05)。结论:RP的围手术期疗效优于LP;目前的数据无法准确判断两者远期疗效的优劣,比较RP与LP的远期疗效,有待高质量的RCT长期随访并记录两组的远期结果。     

鞘内注射U0126对吗啡戒断大鼠脊髓神经元Fos表达的影响

目的:研究鞘内注射U0126对吗啡依赖大鼠戒断反应中Fos表达的影响。方法:采用大鼠吗啡依赖及戒断模型,分为正常对照组、吗啡依赖组、吗啡戒断组、U0126组、DMSO组,运用免疫组织化学法(n=6)和Westernblot(n=4)方法观察鞘内注射U0126对吗啡戒断大鼠脊髓神经元Fos表达的影响。结果:鞘内注射U0126可明显减少L5节段脊髓背角Fos阳性神经元的数目,U0126组为287±54,低于戒断组380±71,两者差异有显著性(P<0.05)。Western blot显示U0126组Fos蛋白的表达与戒断组相比也明显减少。结论:鞘内注射U0126能明显抑制吗啡戒断大鼠脊髓神经元Fos表达。     

骨骼肌肌电激活脊髓背根和腹根神经——“循经感传”机制研究

目的研究骨骼肌肌电激活脊髓背根和腹根神经,探讨这种继发性兴奋与循经感传的关系。方法实验记录大鼠支配腓肠肌相应脊髓节段的背根和腹根神经,并将离体的神经——肌肉标本置于上述动物的腓肠肌上。电刺激离体的神经——肌肉,可在脊髓背根和腹根上记录到诱发反应。结果骨骼肌的动作电位形成的电流能继发性兴奋相邻的感觉神经和运动神经,引起沿肌肉排列方向出现的位移性感觉和步进性运动反应。结论这种继发性的感觉和运动神经的激活可能与循经脉感觉迁移现象有关。     

基于ERK表达探讨针刺干预大型实验动物猪心肌缺血效应的初步观察

目的：观察埋置电针对慢性心肌缺血模型猪心肌ERK表达的影响,探讨针刺应用于干预大型实验动物猪心肌缺血的方法可行性。方法：实验采用普通级巴马小型猪,分为三组：正常对照组、慢性心肌缺血模型 组、针刺组,造模方法为于中华小型猪左冠状动脉左前降支放置Ameroid缩窄环,造模术后4周进行穴位埋针2 周并加2次20分钟的电针治疗。术后六周后心脏取材,进行ERK表达及电镜检测。结果：针刺组与模型组比 较,ERK1/2的表达均显著增强（**P < 0.01）;模型组和针刺组比较心肌细胞线粒体损伤评分没有显著性差异; 模型组与正常组比较心肌细胞线粒体损伤评分升高（**P < 0.01）。结论：手术放置蛋白缩窄环于左前降支制备 大型实验动物猪心肌缺血模型方法可行,针刺可能通过调节ERK通路发挥增强机体保护细胞缺血损伤的能力。     

抑郁与慢性疼痛共病动物模型的研究进展

抑郁与疼痛是严重困扰人类的两大类疾病,临床上抑郁和慢性疼痛常常相伴随发生,两者存在复杂的相互促进关系,抑郁与慢性疼痛共病造成了巨大的社会和经济负担。动物模型是研究疾病发病机制与验证干预有效性的前提和基础,本文就目前常用且得到广泛认同的抑郁与慢性疼痛共病的动物模型进行分析总结,以期为今后的抑郁与慢性疼痛共病的实验研究提供参考。     

模块化设计在脉搏血氧监护仪中的应用

介绍脉搏血氧监护仪的功能模块化设计思想,模块化功能板的硬件组成及其软件编程,指出模块化设计所具有的提高整机可靠性、方便整机功能升级换代等优点。     

针刺治疗脑损伤后的痉挛状态研究概述

脑损伤后痉挛状态是脑损伤引发的,以大脑皮层为主的高级中枢丧失调控随意性运动的能力,产生由低级中枢控制的肌张力增高及协调能力失常的异常运动模式。脑损伤是世界范围内发病率和死亡率较高的疾病,而脑损伤后的痉挛状态是一种常见的并发症,严重影响患者的生活质量,且尚无有效的神经保护药物,而针刺具有促进神经重塑及缓解痉挛的作用,为临床治疗脑损伤提供一种可行方法。研究已证明各类针刺方法对脑损伤后痉挛状态有积极作用。该文将阐述脑损伤后痉挛状态的发病病机,不同针刺方法对脑损伤后痉挛状态的改善作用,并对目前存在的问题及未来研究方向进行展望。