情志护理联合早期功能锻炼对老年全膝关节置换术后谵妄及关节功能恢复的影响

目的：探讨情志护理联合早期功能锻炼对老年全膝关节置换术后谵妄及关节功能恢复的影响。方法选择接受膝关节置换术的86例患者为研究对象,采用随机数字表法分为观察组和对照组各43例,观察组患者接受情志护理联合早期功能锻炼,对照组患者接受常规护理联合早期功能锻炼,比较两组患者心理状态、谵妄状态、膝关节功能。结果心理状态：观察组焦虑(SAS)、抑郁(SDS)评分明显低于对照组(t=6.866~7.655,P<0.05);谵妄状态：观察组谵妄分级量表(DRS-R-98)评分均明显低于对照组(t=13.824~16.874,P<0.05);关节功能：观察组患者的Lysholm评分、Tenger评分均明显高于对照组(t=8.205~7.662,P<0.05)。结论情志护理联合早期功能锻炼有助于化解负性情绪,减轻术后谵妄状态,改善膝关节功能,是老年全膝关节置换术后理想的护理方法。     

复方益肾胶囊对糖尿病肾病大鼠血清AGEs表达影响的实验研究

1实验材料复方益肾胶囊：哈尔滨医科大学大庆校区药理教研室提供。链脲佐菌素（Strptoxotocin,STZ）：美国Sigma公司。58只清洁级雄性Wistar大鼠体重200～230g,由哈尔滨医科大学大庆校区提供。OneTouchII型强生血糖仪,岛津RF-5300型荧光分光光度计,全自动生化分析仪。     

射频热疗联合化疗对肺癌的疗效观察

目的 评价射频热疗联合化疗治疗肺癌的疗效,毒副反应及对生活质量的影响.方法 40例肺癌病人随机分为两组.治疗组20例采用射频热疗联合化疗药物,根据不同病种选择不同用药方案,TF,TB,CAP,NB.热疗5次/周,电脑实时测温温度控制在40℃～43℃,并维持45～60min.对照组20例采用化疗药物治疗,方法 同治疗组.结果 治疗组与对照组总有效率分别为75%和45%,两组比较差异有显著性(P＜0.05);治疗组KPS评分与对照组比较差异有显著性(P<0.05).急性毒性反应比较差异没有显著性,均可耐受.结论 射频热疗联合化疗药物能显著提高肺癌的治疗效果,改善了病人的生存质量,是一种安全有效的方法.     

体外诱导骨髓间充质干细胞向肾小管上皮样细胞分化

Objective To investigate the differentiation of rat bone marrow mesenchymal stem cells (MSCs) to renal tubular epithelial-like cells under different conditions. Methods MSCs were obtained from rat marrow. MSCs were isolated by gradient density centrifugation and plastic adherence and then purified. Surface markers were identified with flow cytometry after amplification in vitro. The purified MSCs of the third passage were cultured respectively as follows: (1) control group: DMEM medium with fetal bovine serum(FBS). (2) all-trans retinoic acid (ATRA) group: DMEM medium with FBS, ATRA and ischemic reperfusion-injured kidney tissue homogenate. (3)combination group: DMEM medium with FBS, ATRA, ischemic reperfusion-injured kidney tissue homogenate, epidermal growth factor (EGF) and bone morphogenetic protein 7 (BMP-7). After 7 days, the MSCs were collected for alkaline phosphatase (AKP) staining, cytokeratin-18 and E-cadherin immunocytochemical analysis. Results The positive rates of the third passage MSCs in CD44, CD90 and CD29 were 97.8%±0.9%, 96.8%±1.4% and 97.6%±2.4%,respectively, but in CD11b/c and CD34 were only 13.2%±0.6% and 1.2%±0.5%. The MSCs in control group were spindle. The MSCs in ATRA group were round and elliptic. The MSCs in combination group became cobblestone-like cells after 7 days. AKP staining showed that tubular epithelial-like cells from MSCs in control group were negative, some above cells in ATRA group were positive and number of above cells increased in combination group. Compared with negative control group, the ratios of cytokeratin-18 positive cells in ATRA group and combination group were respectively increassed by 29.47%±1.08% and 47.52%±2.13% (all P<0.05), the ratios of E-cadherin positive cells in ATRA group and combination group were respectively increased by 14.88%±2.46% and 36.15%±1.13% (all P<0.05). Conclusion MSCs may differentiate by renal tubular epithelial-like cells under the induction of ischemic reperfusion-injured kidney tissue homogenate and ATRA in vitro, which are further differentiated under the combined induction of EGF and BMP-7.     

自动调节压力和固定压力持续正压通气呼吸机在阻塞性睡眠呼吸暂停低通气综合征治疗中的对比研究

目的观察自动调节压力持续正压通气呼吸机(A-CPAP)和固定压力持续正压通气呼吸机(F-CPAP)在治疗阻塞性睡眠呼吸暂停低通气综合征(OSAHS)中平均压力的对比。方法选择100例诊断为OSAHS的患者随机单盲分成两组,分别使用A-CPAP和F-CPAP呼吸机,观察治疗前后的平均血氧饱和度,以及两种呼吸机的平均压力值。结果两组呼吸机治疗前后的平均血氧饱和度明显升高(P<0.01),A-CPAP治疗组平均压力较低,差异有统计学意义(P<0.01)。结论A-CPAP和F-CPAP呼吸机在治疗OSAHS中均有明显疗效,A-CPAP有更好的舒适性和耐受性。     

芎芍胶囊对人脐静脉内皮细胞分泌血管新生因子的影响

目的探讨芎芍胶囊对人脐静脉内皮细胞（HUVEC）分泌血管新生因子影响的机制。方法采用血清药理学和体外干预培养HUVEC的方法,通过MTF法和酶联免疫吸附分析法观察芎芍胶囊低、中、高剂量对HUVEC的体外增殖和分泌Ang、Ang-2、VEGF、bFGF、EGF和TGF-β1的影响。结果芎芍胶囊各剂量组均有促HUVEC增殖的作用。低剂量组有促进HUVEC分泌Ang、Ang-2、EGF和VEGF的作用,而对bFGF、TGF-β1分泌的影响无明显差异;中剂量组有促进HUVEC分泌Ang、Ang-2、EGF和bFGF的作用,抑制TGF-β1的分泌,对VEGF的分泌无明显影响;高剂量组有促进HUVEC分泌Ang、EGF和bFGF的作用,并抑制VEGF与TGF-β1的分泌,而对Ang-2的影响无明显差异。结论芎芍胶囊能促进HUVEC的增殖,增加HUVEC分泌促血管新生因子和降低抑血管生成因子表达,且与剂量有一定的关系。     

Modulation of γ-aminobutyric acid on painful sense in central nervous system of morphine-dependent rats

OBJECTIVE: To observe the effects of gamma-aminobutyric acid (GABA) on the electric activities of pain-excited neurons (PEN) in nucleus accumbens (NAc) in central nervous system (CNS) of morphine-dependent rats. METHODS: After GABA or the GABA(A)-receptor antagonist, bicuculline (Bic), was injected into cerebral ventricles or NAc, right sciatic nerve was stimulated by electrical pulses, which was considered as traumatic pain stimulation. Extracellular recordings methods were used to record the electric activities of PEN in NAc. RESULTS: When GABA was injected into intracerebroventricle (ICV) as well as NAc, it could decrease the pain-evoked discharge frequency and prolong the latency of PEN. Bic could interdict the above effects of GABA on the electric activities of PEN. CONCLUSION: Exogenous GABA might have an inhibitory effect on the central pain adjustment. Furthermore, GABA and GABA(A) receptor participate and mediate the traumatic information transmission process in CNS.     

分娩动因研究进展

早产与先兆早产是围产学中的一个相当重要的课题,目前尚无有效的治疗方法,主要是因为对分娩时子宫及宫颈的调控机制不清.本文对近年来有关分娩动因的研究进展作一回顾,以助探讨.     

尿路感染病原菌分布及耐药性分析

目的探讨尿路感染病原菌分布特点及细菌耐药情况。方法对392例尿路感染患者尿标本进行细菌培养,用K-B法进行药物敏感试验。结果共检出病原菌392株,其中,革兰阴性菌占69.1%,革兰阳性菌占29.1%,真菌占1.8%。对常用抗生素耐药情况:42.6%病原菌出现多重耐药,革兰阴性菌对亚胺培南耐药率最低,革兰阳性菌对万古霉素耐药率最低。结论对尿路感染患者进行耐药性监测,可为临床合理用药提供依据。     

经络疗法配合按摩治疗颈椎骨质增生疗效观察

颈椎骨质增生是临床常见疾病,以中老年患者居多。症见颈项强直,肩臂疼痛,上肢麻木无力,头痛眩晕等。目前除少数病例需手术治疗外,多采用牵引、理疗、针灸等,其疗效各有差异。近年来笔者应用经络疗法配合按摩治疗78例,疗效满意,现介绍如下: 1 临床资料 本组78例,男性45例,占57.69%,女性33例,占42.31%。年龄在25～65岁之间,其中<30岁2例,占2.56%;30～39岁8例,占10.26%;40～49岁18例,占23.08%;50～59岁36例,占46.15%;〉60岁14例,占17.59%。其诊断依据病史、临床表现及X线片。 2 治疗方法 2.1 经络疗法 取穴:风池、大杼、风门、肩中俞…