中药药浴治疗类风湿性关节炎的疗效与护理

目的:观察中药药浴对RA患者关节症状的缓解效果。方法:将60例RA患者随机分为研究组和对照组各30例,对照组采用常规药物治疗,研究组在此基础上加用中药药浴,用视觉模拟评分法(VAS)、关节肿胀指数法、关节功能指数法以及晨僵时间来评定疗效,同时观察中药药浴的不良反应。结果:1个疗程结束后,研究组患者关节疼痛、关节肿胀、关节功能障碍评分和晨僵时间均较治疗前显著下降,且显著低于同期对照组,P<0.01或P<0.05,未发现中药药浴有明显的毒副作用。结论:对RA患者在常规药物治疗的基础上加用中药药浴能显著缓解症状,提高疗效,临床使用安全。     

高压电烧伤家兔球结膜微循环变化和己酮可可碱干预作用

Objective To study the changes in bulbar conjunctiva microcirculation (BCM) and the therapeutic effect of Pentoxifylline on BCM disturbance after high-voltage electrical burn (HEB) in rabbits. Methods Forty-five rabbits were divided into control group (C) , electrical burn group (EB) , and Pentoxifylline treatment group (PT) according to random number table, with 15 rabbits in each group. Model of HEB was reproduced in rabbits from EB and PT groups with voltage regulator and experimental transformer. Rabbits in C group were sham injured with the same devices without electrification. Changes in BCM were observed with microcirculation microscope at 15 minutes before HEB and 5 minutes, 1, 2, 4, 8 hour (s) post HEB (PHM or PHH) , including: (1) morphology of microvessels, such as the descemibleness, diameters of arterioles, venules, and capillaries, the unevenness in caliber, and ischemic area; (2) dynamic changes in microvascular blood flow, such as blood flow speed in arterioles, venules, and capillaries, erythrocyte aggregation, and microthrombi formation; (3) condition of tissues surrounding microvessel, such as bleeding and exudation. Measurement data were processed with t test; enumeration data were processed with Fisher's exact test. Results (1) Morphology of microvessel: descernibleness of microvessels in EB and PT groups was decreased, but that of PT group was better than that of EB group. At PHM 5 , diameter of ar-terioles, venules and capillaries was respectively (7. 3 ± 2. 5) , (12. 3 ± 2. 4) , (3. 5 ± 0. 7) μm in EB group, all narrower than those of the control group [(14.6 ±3. 1) , (27.2±3.5), (9.0±1.4) μm, with t value respectively 5. 23 , 13. 66, 14. 04, P values all below 0. 05]. Diameters of the microvessels in PT group [(10. 2 ±3.8) , (21.5±3.1), (7. 1 ±1.2) μm] were larger than those in EB group (with t value respectively 2. 21 , 8. 99, 10. 18, P values all below 0. 05). Diameters of arterioles, venules and capillaries in EB and PT groups recovered to the before HEB size at PHH 1. From PHH 2 to 8, arterioles and capillaries decreased gradually in caliber, venules dilated gradually in EB and PT groups, but the changes in PT group were not obvious. Thickness of microvessel was observed uneven in EB group at PHM 5, which lasted until PHH 8. Ischemia of the tissue was observed in EB group at PHM 5, which improved at PHH 2. Situation in PT group was better. (2) Dynamic changes in microvascular blood flow; at PHM 5, blood flow speed in arterioles, venules and capillaries was respectively (202 ±53), (198 ± 44) , (46 ±12) μm/s in EB group, all slower than those of the control group [(544 ± 37) , (359 ± 32) , (220 ± 19) μm/s, with t value respectively 20.47, 11. 51, 30. 02, P values all below 0.05] , and those of PT group [(335 ± 42) , (260 ± 35), (119 ± 23) μm/s] were faster than those of EB group (with t value respectively 7. 55 , 4. 26, 14. 85, P values all below 0.05). Blood flow speed in EB and PT groups recovered to the before HEB level at PHH 1. From PHH 2 to 8, blood flow speed decreased gradually in EB and PT groups, but that of PT group was faster than that of EB group. Erythrocyte aggregation in venules and capillaries was observed in EB group at PHM 5, which eased up at PHH 1 , but aggregated at PHH 2, lasting until PHH 8. Obvious microthrombi were observed in EB group at PHH 2, which increased gradually. These changes were less obvious in PT group. (3) Condition of surrounding tissues of microvessel: in EB group, exudation was observed around microvessels at PHH 1, bleeding at PHH 2, with a worsening tendency. Changes in those in PT group were less obvious. Conclusions HEB causes disturbance in BCM, but it can be ameliorated by Pentoxifylline.     

高压电烧伤家兔皮肤微循环灌流量变化及己酮可可碱的干预作用

目的观察高压电对家兔皮肤微循环灌流量(MPD)的影响并探讨己酮可可碱(PTX)的干预作用。方法将45只家兔按完全随机设计方法分为对照组、电伤组和治疗组,每组15只。电伤组和治疗组家兔用调压器和实验变压器制成高压电烧伤模型,对照组家兔接相同装置但不通电,致假伤。用激光多普勒微循环图像仪检测3组家兔伤前5min、伤后5min、1h、2h、4h、8h皮肤MPD。检测部位为左前肢和右后肢创面皮肤、右前肢和左后肢正常皮肤。结果 (1)电伤组和治疗组伤后四肢正常皮肤及创面MPD均较电伤前下降。伤后5min,电伤组及治疗组右前肢皮肤MPD分别是(0.66±0.13)V、(1.62±0.27)V,左后肢皮肤MPD分别是(0.59±0.12)V、(1.50±0.23)V,均小于伤前的(3.21±0.22)V、(3.24±0.25)V、(3.06±0.24)V、(3.01±0.22)V,在伤后各时相点中下降的幅度最大,之后虽有所回升,但一直低于伤前;伤后5min,电伤组及治疗组左前肢创面MPD分别是(0.16±0.10)V、(0.17±0.13)V,左后肢创面MPD分别是(0.18±0.11)V、(0.19±0.11)V,均小于伤前的(3.19±0.27)V、(3.23±0.24)V、(3.09±0.22)V、(3.03±0.25)V,之后持续降低。(2)电伤组和治疗组组内左右肢体比较,伤后各时相点创面MPD均明显低于对侧皮肤MPD。(3)组间同肢体同时相点与对照组比较,电伤组伤后各时相点皮肤和创面MPD均低于对照组;治疗组变化同电伤组。(4)组间同肢体同时相点治疗组与电伤组比较,治疗组伤后各时相点皮肤MPD高于电伤组;而创面MPD与电伤组差异无统计学意义。结论高压电烧伤导致家兔远隔皮肤及创面皮肤MPD下降,PTX可提高电伤后远隔皮肤MPD,对创面MPD无明显作用。     

合并2型糖尿病恶性肿瘤患者化疗前后血清TGF-β1的表达变化

目的: 探讨化疗对合并2型糖尿病(T2DM)恶性肿瘤患者血清TGF-β1水平的影响。方法: 按配对设计入选80例分为实验组(合并T2DM恶性肿瘤)40例, 对照组(非合并T2DM恶性肿瘤)40例, 均给予2个周期化疗, 采集每个周期化疗前1天和化疗结束后第2天早晨空腹静脉血2mL, 分离血清, ELISA法检测血清TGF-β1的含量。结果: 实验组2个周期化疗前后血清TGF-β1的表达水平与对照组相比, 差异无统计学意义(P > 0.05)。实验组第1个周期化疗后血清TGF-β1含量降低, 而第2个周期化疗后含量却较第2个周期化疗前升高, 差异有统计学意义(P < 0.05);对照组第1、2个周期化疗后血清TGF-β1含量呈持续降低趋势, 差异有统计学意义(P < 0.05)。结论: 第1个周期化疗可促进合并/非合并T2DM恶性肿瘤患者血清TGF-β1水平下降。第2个周期化疗可促进合并T2DM恶性肿瘤患者血清TGF-β1水平升高。      

人结肠癌细胞系SP细胞microRNA表达谱的初步分析

 目的：探讨结肠癌侧群（SP）细胞在结肠癌多药耐药性中的作用及其microRNA生物标志。方法：结肠癌SP细胞的分选采用流式细胞术,细胞活力的测定采用MTT法,microRNA表达谱的检测采用microRNA芯片,microRNA表达的验证采用实时荧光定量PCR。结果：（1）HCT-15、HT-29及LoVo结肠癌细胞系中SP细胞的比例分别为16.75%、13.02%及9.52%。（2） 化疗药（5-氟尿嘧啶、草酸铂及阿霉素）对3种结肠癌细胞系SP细胞的 IC50均明显高于对非SP细胞的IC50（P<0.05）。（3）microRNA芯片检测表明miR-5000-3p、miR-5009-3p及miR-552在3种结肠癌细胞系的SP细胞中表达均上调,实时荧光定量PCR亦证实此结果。结论：miR-5000-3p、miR-5009-3p及miR-552在结肠癌细胞系的SP细胞中表达上调,有可能成为结肠癌SP细胞的潜在microRNA生物标志。     

维持性血液透析患者透析低血压的护理

目的探讨血液透析中低血压发生的可能原因和护理对策。方法监测69例维持性血液透析患者在透析过程中透析低血压的症状及其发生次数。结果69例15957次的血液透析,低血压发生率为8.7%,其中<60岁组的发生率为5.5%,≥60岁组为16.3%,差异有统计学意义(p<0.01);糖尿病组为15.6%,非糖尿病组为5.2%,差异有统计学意义(p<0.01)。结论透析中低血压是由多种因素造成的,应该具体分析病情,采用个体化透析及护理对策,提高护理质量。     

局部温度变化对人体足甲襞微循环的影响

目的探讨足趾局部温度变化对足甲襞微循环（FNM）的影响。方法将受试者左足分别浸入温度为5℃、15℃、25℃、35℃、45℃的自来水内各5min,用WX．9B型微循环显微镜和LISCA激光多普勒微循环血流图像仪（LDPI）检测不同温度下FNM变化,观测对象为20名健康成人,观察指标包括管襻数目、管襻长度、管襻直径、血液灌流量。结果管襻数量在15℃-35℃范围内变化不大,当温度为5℃时,管襻数量明显减少,当温度为45℃时,管襻数量则明显增加;管襻长度和直径以25℃为准,低温时（5℃、15℃）时管襻缩短、管径变细,高温时（45℃）襻长伸长、管径变粗;灌流量主要表现为低温时灌流减少（5℃、15℃）,高温时（45℃）灌流增多。结论足趾局部温度的变化对FNM有影响,临床检测FNM时,应控制检查室的温度。     

青春期青少年足甲襞微循环观测方法及结果

目的 探讨青春期青少年足甲襞微循环（FNM）的观测方法、指标及正常参考值.方法 采用WX-9B型多部位微循环显微镜及微循环图像分析系统,观测200名青春期青少年FNM的形态、血流动态及管周状态,并计算FNM各项指标的正常值,同时对观测前准备、观测体位、观测方法进行探讨.结果 观测指标及正常值：清晰度（清晰）、管襻数目（7.00±3.74条/mm）、输入枝长度（89.57±46.20μm）、输出枝长度（106.45±62.30μm）、输入枝直径（6.74±4.08μm）、输出枝直径（8.69±4.26μm）、襻顶直径（10.89±4.02μm）、管襻形状（发卡型和交叉型）、血流速度（线流、线粒流及粒线流）、红细胞聚集（无）、血色（玫瑰红）、白细胞计数（1～30个/15s）、血管运动性（0～1次/min）、白微栓（无）、渗出（无）、出血（无）、乳头下静脉丛（11%可见）、皮肤乳头（波纹状及浅波纹状）、汗腺导管（0～2个/1趾甲襞）.结论 足甲襞是青春期青少年活体微循环观测的良好部位,其各项指标与成人和儿童有所不同,建立青春期青少年FNM正常参考值,对规范FNM检测标准有重要意义.     

葡萄糖和胰岛素对Colon26肿瘤细胞分泌TGF-β1的影响

 目的 探讨葡萄糖和胰岛素浓度的变化对Colon26肿瘤细胞分泌TGF-β₁的影响。 方法 体外常规培养Colon26肿瘤细胞,根据所用培养液外加葡萄糖和胰岛素浓度的不同,将实验所用细胞分为12组,培养48小时后收集上清液,ELISA法检测TGF-β₁的浓度。 结果 (1)D组上清液TGF-β1的浓度明显高于A组,差异有统计学意义(P<0.01);而B、C组上清液TGF-β1的浓度与A组相比差异均无统计学意义(P>0.05)。（2）E、F、G组上清液TGF-β₁的浓度与A组相比,对Colon26肿瘤细胞上清液TGF-β₁的分泌差异无统计学意义(P>0.05)。（3）L、M、N组上清液TGF-β₁的浓度均明显高于A组,差异有统计学意义(P<0.01); 而H、K组上清液TGF-β₁的浓度与A组相比差异无统计学意义(P>0.05)。 结论 （1）高浓度的葡萄糖能够增加Colon26肿瘤细胞培养上清TGF-β₁的分泌。（2）不同浓度的胰岛素不影响Colon26肿瘤细胞TGF-β₁的分泌。