透明质酸修护生物膜辅助治疗干燥性湿疹的多中心对照研究北大核心CSCD

目的探讨透明质酸修护生物膜辅助治疗干燥性湿疹的结果。方法5家医院82例干燥性湿疹分为试验组和对照组。试验组外搽糠酸莫米松乳膏和透明质酸修护生物膜,对照组仅外搽糠酸莫米松乳膏,每天2次,14d后停用糠酸莫米松乳膏,试验组继续外搽透明质酸修护生物膜,分别于首诊、治疗后7、14、28、42、56d随访。比较两组皮损SCORAD评分、总改善率、受试者自评、复发率、经皮水分丢失（TEwL）值及角质层含水量。结果①试验组比对照组皮损SCORAD评分显著改善,42d时SCORAD评分,试验组（4．42±2．64）、对照组（6．03±4．02）,56d时试验组（3．49±2．78）,对照组（6．06±4．28）,两组比较,差异有统计学意义（P均〈0．05）;②试验组改善率高于对照组,停用糠酸莫米松乳膏后,试验观察56d时,差异有统计学意义（均P〈0．05）;③停用糠酸莫米松乳膏后,观察28、42、56d时试验组均无复发,对照组复发率分别为11.4％、11．4％、20％,两组比较,差异有统计学意义（均P〈0．05）;④试验组TEWL下降低于对照组,56d时,试验组TEWL（10．35±2．02）与对照组TEWL（17．28±4．06）比较,差异有统计学意义（P〈0．05）;试验组角质层含水量高于对照组,42d时试验组角质层含水量（29．10±5．39）、对照组（23．12±4．76）,56d时,试验组角质层含水量（31．79±4．09）、对照组（22．87±4．85）,两组比较,差异有统计学意义（均P〈0．05）。试验组未发生不良反应。结论透明质酸修护生物膜可以辅助治疗干燥性湿疹,降低复发率,促进皮肤屏障功能的恢复,安全性高。     

社区老年妇女COPD患者营养状况对生活质量评分的影响

目的 了解社区老年慢性阻塞性肺部疾病(COPD)女性患者生活质量,研究营养状况对生活质量评分的影响.方法 选取2014年1月至2017年1月经内蒙古医科大学附属医院诊断的314例社区COPD老年妇女以微型营养评定法(MNA)行营养评定并进行分组,营养良好组164例,营养一般组73例,营养缺乏组77例,比较三组肺功能分级、6min步行及圣乔治问卷生活质量评分差异.结果 不同营养COPD患者FEV1/FVC、FEV1比较有显著性差异(F值分别为34.144、43.646,均P<0.05),进一步每两组之间比较发现,营养良好组患者FEV1/FVC、FEV1均显著高于营养一般组、营养缺乏组(t值分别为3.457、4.021、5.236、5.897,均P<0.05),营养一般组患者FEV1/FVC、FEV1均显著高于营养缺乏组(t值分别为3.034、2.908,均P<0.05).不同营养COPD患者肺功能分级有显著性差异(χ2=70.244,P<0.05),随着营养状况的下降,肺功能分级也处于下降趋势.不同营养COPD患者Borg评分、mMRC评分、步行距离比较有显著性差异(F值分别为7.929、4.198、8.386,均P<0.05),随着营养状况的下降,Borg评分、mMRC评分呈上升趋势,而步行距离呈下降趋势.不同营养COPD患者生活质量中症状评分、活动评分、心理社会评分、总评分比较有显著性差异(F值分别为11.677、6.757、9.240、8.862,均P<0.05),随着营养状况的下降,各评分项目均呈上升趋势.结论 慢性阻塞性肺部疾病患者的营养状况与患者的生活质量关系密切.     

Experimental study on the effect of moxibustion at Shenque (CV 8) for long-term exercise-induced fatigue

Objective

To investigate the effect of moxibustion at Shenque (CV 8) on fatigue in rats with chronic exercise-induced exhaustion.

Methods

Thirty male Sprague-Dawley (SD) rats were randomly divided into a blank group, a model group and a moxibustion group, 10 rats in each group. Except rats in the blank group, the remaining rats were subjected to create long-term exhaustion models by repeated swimming. After successful modeling, rats in the moxibustion group received mild moxibustion at Shenque (CV 8) for 15 min, once every other day with a total of 10 times. Rats in the model group and the blank group did not receive moxibustion. At the end of the treatment, the exhausted times, and the body weight of rats before and after the experiment were compared among groups. The levels of blood malondialdehyde (MDA) and urea nitrogen (BUN), as well as the activities of aspartate transarninase (AST), alanine aminotransferase (ALT) and lactate dehydrogenase (LDH) were also measured by the automatic biochemical analyzer, 24 h after the exhausting excise.

Results

The 10th swimming time was significantly longer in the moxibustion group than that in the model group (P<0.01). The increase rate of the body weight was lower in the rats of the moxibustion group than that in the model group before the 7th and the 10th exhausting excise (P<0.05, P<0.01). The levels of serum MDA and BUN, as well as the activities of AST, ALT and LDH in the model group were higher than those in the blank group (all P<0.01). The levels of serum MDA and BUN, as well as the activities of AST, ALT and LDH in the moxibustion group were lower than those in the model group (P<0.01).

Conclusion

Moxibustion at Shenque (CV 8) can decrease the serum levels of MDA and BUN, as well as activities of AST, ALT and LDH in the long-term fatigue rats, thus to improve the symptoms of fatigue.

     

中医药基于核因子κB信号通路调控破骨细胞分化的研究进展

中医药治疗骨相关疾病疗效显著,其分子生物学机制研究也成为热点,破骨细胞分化异常导致一系列骨相关疾病发生,中医药通过核因子κB(NF-κB)信号通路调控破骨细胞分化的研究取得不少进展。本文对中医药基于NF-κB信号通路的调控破骨细胞分化的研究现状进行归纳总结,阐明分子生物学机制,指出目前研究不足及未来研究方向,为中医药治疗骨相关疾病拓展思维。     

胰岛移植现状

<正> 随着全胰或胰片段移植的开展,一些学者又进行了胰岛移植的研究。一、胰岛的分离与提纯最初获取胰岛是用手工进行分离,这种方法费工而且效率低。Moskalewski利用胶元酶(collagenase)破坏豚鼠胰腺的纤维结构。1967年Lacy和Kostianovsky把胶元酶消化技术用于大鼠,并成功地应用蔗糖梯度离心使胰岛组织与胰的腺泡组织进一步分     

贵州地区人群下颈椎后路经椎弓根置钉的相关解剖学观察

目的通过对贵州地区大样本成人下颈椎椎弓根的解剖学观察,为后路经椎弓根置钉技术提供临床相关解剖学参数。方法在我院门诊对排除颈椎骨质破坏性疾病的本地区成人患者中,随机选取100例进行颈椎薄层CT扫描,收集图像原始数据导入Mimics软件行三维重建,并利用其软件功能在三维重建图像上测量经椎弓根置钉的相关解剖学参数,包括C3-7椎弓根最窄处的高度、宽度,椎弓根通道长度(轴线长度),椎弓根内倾角及头倾角。结果通过100例成人活体下颈椎CT图像重建测量结果,我们可以得出:下颈椎椎弓根最窄处的高度大于宽度,C3-7平均椎弓根高度为7.24～7.42mm,平均椎弓根宽度为4.94～7.11mm,平均椎弓根轴线长度为31.98～34.01mm,椎弓根外倾角平均值分别为C346.3°、C447.2°、C548.8°、C640.1°、C737.5°,椎弓根头倾角平均值分别为C311.2°、C46.8°、C5-1.8°、C6-6.9°、C7-10.8°。结论大样本下颈椎椎弓根螺钉置入相关参数CT测量对该术的临床运用具有一定的参考价值,但发现椎弓根形态个体差异大,术前必须制定个体化置钉参数。     

硬膜外血肿增大的回顾性分析

目的 研究硬膜外血肿增大的临床规律.方法 回顾性地总结硬膜外血肿增大的发生率、对病情变化及近期疗效的影响,分析硬膜外血肿增大的预测因素.结果 24例(20 3%)患者发生血肿增大.血肿增大的患者病情加重及最终需要手术治疗的比例均明显高于无血肿增大的患者,两组患者出院时的治疗结果差异无统计学意义.血肿增大患者受伤到首次CT检查的时间、首次CT血肿量、入院时的血凝检查结果异常及饮酒嗜好者的比例均与无血肿增大患者存在明显差异.结论 急性硬膜外血肿增大的发生率较高,血肿增大对患者病情可造成不利影响,但不影响近期疗效,血肿增大预测因素有受伤到首次CT检查的时间、首次CT血肿量、血凝检查结果异常及饮酒嗜好.

Abstract：

Objective To study the clinical issues of progressive epidural hematoma ( PEDH ) .Method The incidence, impacts on clinical course and short-term outcomes and predictors of PEDH were retrospectively studied.Results PEDH occurred in 20.3% of the patients.The rates of neurological deterioration and surgical treatment due to the deterioration in patients with PEDH were significantly higher than those in patients without PEDH.There was not a significantly difference in short-term outcome between patients with and without PEDH.There was a significantly difference in the timing from injury to first CT scanning,volume of the hematoma on the first CT,rate of other intracranial injuries, hypocoagulability and heavy alcohol consumption between patients with and without PEDH.Conclusions The incidence of PEDH is 20.3% or more.PEDH is associated with neurological deterioration.But there is not a association between hematoma growth and poor clinical outcome.The time interval between injury and first CT scanning, volume of the hematoma on the first CT, hypocoagulability, heavy alcohol consumption appear to be independent predictors of hematoma growth.     

围术期磁共振成像神经外科麻醉的安全问题

目的 结合133例进行围术期磁共振成像的神经外科手术患者处理体会,初步探讨该类手术的安全问题.方法 观察在术中磁共振成像手术室(iMRI-OR)进行术前、术中扫描及术后进入检查室进行扫描的患者,记录围术期与扫描相关的安全问题.结果 所有患者顺利完成了术前、术中及术后扫描,未发生与围术期扫描相关的意外及并发症.结论 围术期磁共振成像安全问题至关重要,其顺利进行需要团队成员的通力合作,麻醉医生的首要职责是保障患者围术期的安全平稳,严格的安全防范措施及细致的工作制度必不可少.     

球后视神经炎的中医药针灸治疗进展

<正>球后视神经炎一般可分为急性和慢性2类,以后者多见。由球后视神经炎受累部位不同,可将其分为以下几种类型:①病变最先侵犯乳头黄斑束纤维,因该束纤维在球后眶内段视神经轴心部分,故称轴性球后视神经炎;②病变主要侵犯球后视神经鞘膜及其周围神经纤维束时,则称球后视神经周围炎,以梅毒多见,特征为视野呈向心性缩小,临床上难确诊;③病     

参精护心汤对心肌缺血大鼠的保护作用研究

目的:观察参精护心汤对实验性心肌缺血大鼠的保护作用。方法:采用结扎冠脉左前降支的方法复制大鼠心肌缺血模型,造模成功的大鼠随机均分为模型组、阳性对照组(复方丹参滴丸0.145 8g.kg-1)、参精护心汤高、中、低剂量组(4.683 6,2.341 8,1.170 9g.kg-1),每组10只,另取10只为假手术组,连续ig给药28d。分别监测各组大鼠手术前及手术后即刻,1,3,7,14,21,28d的心电图(ECG)ST段动态变化,并测定给药28d后的心肌梗死率及血清中一氧化氮(NO)、内皮素(ET)、乳酸脱氢酶(LDH)、肌酸磷酸激酶(CK)含量的影响。结果:参精护心汤各剂量组大鼠ECG-ST段的抬高程度均显著下降,心肌梗死范围明显缩小,血清NO的含量显著升高,ET、LDH、CK含量显著降低。结论:参精护心汤对心肌缺血大鼠有保护作用,可改变酶含量,对抗自由基氧化,维持心血管系统的稳态。