中医学对周围神经病的认识

通过对相关中医文献的研究以及现代医学的比较发现,中医治疗周围神经病具有悠久的历史,且在某些疾病的治疗上有着西医无法比拟的特长。希望通过对中医治疗周围神经病的陈述能够引起临床医生的足够重视,充分发挥中医在治疗周围神经病上的优势,将中西医结合,以期达到更好的临床治疗效果。     

VX2兔脑瘤模型三维放疗解剖学靶区灌注CT与增强CT对照研究

Objective To compare the accuracy of blood volume perfusion imaging (perfusion CT)with contrast enhanced 64-slice spiral computed tomography (CECT) in the evaluation of gross tumor volume (GTV) and clinical target volume (CTV) using rabbits with VX2 brain tumor. Methods Perfusion CT and CECT were performed in 20 rabbits with VX2 brain tumor. The GTV and CTV calculated with the maximal and minimal diameter of each tumor in the blood volume (BV) maps and CECT were measured and compared to those in pathological specimens. Results The mean value of the maximal and minimal diameter of GTV was (8.19 ± 2. 29) mm and (4.83 ± 1.31) mm in pathological specimens, (11.98 ±3.29) mmand (7.03±1.82) mm in BV maps, while (6.36±3.85) mm and (3.17±1.93) mm in CECT images, which were significantly different (pathological specimen vs. BV map, t = 7. 17,P =0. 000;pathological specimen vs. CECT, t = 8.37, P = 0. 000, respectively). The mean value of the maximal and minimal diameter of CTV in pathologic specimens was (12.87 ± 3.74) mm and (7.71 ± 2. 15) mm, which was significantly different from that of GTV and CTV in CECT (t = - 3. 18, P = 0. 005 and t = - 4. 24, P =0. 000;t= -11.59,P=0.000 and t= -9.39,P=0.000), while similar with that of GTV in BV maps (t = - 1.95,P = 0. 067; t = - 2. 06, P = 0. 054). For CECT, the margin from GTV to CTV was 81.83% ±40.33% for the maximal diameter and 276.73% ± 131.46% for the minimal. While for BV maps, the margin was 7.93% ± 17. 84% and 12.52% ± 27. 83%, which was significant different from that for CECT images (t=7.36,P=0. 000 and t= -8.78,P=0.000). Conclusions Compared with CECT, the BV map from 64-slice spiral CT peffusion imaging might have higher accuracy in target volume delineation for brain tumor.     

入境货物外包装作为引入和传播媒介的风险评估

本文以入境冷链货物外包装携带和传播新型冠状病毒为例,评价入境货物及外包装携带和传播呼吸道相关病原体的风险。监测发现,入境冷链货物外包装携带和传播新冠病毒等以呼吸道传播和接触传播的病原体的传播风险较高;入境非冷链货物携带病毒入境的风险很高,由于预防性消毒等措施,其传播风险不高。因此,应对冷链入境货物外包装可能携带和传播的高风险病原体加强监管和风险评估。对于疫区输入的高风险病原体如猴痘病毒,应对其宿主、传播媒介、传播方式、消毒效果等综合评估其传播风险。     

北京城、郊区儿童哮喘及相关过敏疾患的室内环境因素比较

Objective To study the indoor environmental factors associated with the prevalence of asthma and related allergies among school children.Methods A cluster sampling method was used and the ISAAC questionnaire was conducted.A total of 4612 elementary students under Grade Five of 7 schools were enrolled in the survey for the impact of indoor environmental factors on the prevalence of asthma and related allergies in several urban and suburban schools of Beijing.Results A total of 4060 sample were finally analyzed including 1992 urban and 2068 suburban.The prevalence of wheeze, allergic rhinoconjunctivitis and atopic eczema in the past 12 months was 3.1% (61/1992) ,5.3% (106/1992) ,1.1% (22/1992) among urban children while 1.3% (27/2068) ,3.1% (65/2068), 1.0% (22/2068) among suburban children respectively.The prevalence of wheeze and allergic rhinoconjunctivitis of the past 12 months in urban were both significantly higher than that in suburban ( χ2 = 14.77, 11.93, P ＜ 0.01 ).The incidences of having asthma and eczema ever among urban children (5.3% (105/1992) ,29.4% (586/1992))were significantly ( χ2 = 39.03, 147.22, P ＜ 0.01 ) higher than that among suburban ( 1.7% ( 35/2068 ), 13.8%(285/2068)).Atlthough the distributions of indoor environmental factors were similar in both areas, passivesmoking and interior decoration had different influence on the prevalence of asthma and related allergies among school children in the two areas.The significant impact of passive smoking on having asthma ever among suburban children was observed ( OR = 2.70,95% CI = 1.17 - 6.23 ) while no significant result in urban ( OR = 1.06,95% CI = 0.71 - 1.58 ); the percentage of interior decoration was 84.0% ( 1673/1992 )among urban children and 80.0% (1655/2068)among suburban children, there was significant impact of interior decoration on the prevalence of having eczema ever among urban children ( OR = 1.57,95% CI =1.17-2.10) but no significant results were found in suburban sample (OR= 1.06,95% CI =0.76-1.48).Conclusion The prevalence of asthma and related allergies among school children is much higher in urban areas than that in suburban areas and the indoor environmental factors such as passive smoking and interior decoration may differently explain the prevalence of asthma and related allergies in the two areas.     

True FISP序列对梗阻性黄疸的诊断价值

目的：探讨真稳态进动快速成像（True FISP）序列对梗阻性黄疸病因学及定位诊断的价值和限度。方法：分析经临床证实的32例梗阻性黄疸惠者的MR表现,由3名医生分别采用3种序列组合（True FISP序列冠状位扫描,MRI胆管成像,MRC、True FISP结合常规MR平扫及增强扫描）进行病变的定位及病因学诊断,并与临床及病理结果进行对比分析。结果：三种序列组合均作出了准确的定位诊断。对于胆道及胆道内病变所致梗阻性黄疸,True FISP序列的诊断符合率为78．9％,MRC为84．2％,两者间差异无显著性意义（P〉0．05）。对于胆道外病变所致梗阻性黄疸,True FISP序列的诊断符合率为84．6％,MRC为30．0％,前者优于后者（P＜0．05）。对于各种原因所致梗阻性黄疸,联合运用3种成像方法（MRC、True FISP、常规MR平扫及增强扫描）的诊断符合率为93．8％,明显优于MRC（62．5％,P〈0．01）,但与True FISP序列（81．2％）比较,差异无显著性意义（P=0．1）。结论：TrueFISP序列能准确定位梗阻性黄疸的梗阻部位;对于胆外病变所致梗阻性黄疸能提供MRC所不能提供的病变信息,能较准确地对梗阻原因作出定性诊断;如果结合常规平扫及增强扫描,将获得更高的诊断符合率。     

64层灌注CT评价兔VX2体部肿瘤模型氧分压的实验研究

目的:利用64层灌注CT评价兔VX₂肿瘤模型氧分压并与氧微电极法对照。方法:对45只成功建模兔VX₂脑瘤模型行灌注CT检查。测量脑瘤兴趣区灌注值（perfusion）、血容量（blood volume,BV）、达峰时间（time to peak TTP）、最大峰值（peak enhancement intensity,PEI）。结果与该兴趣区氧微电极法测得氧分压（PO₂）对照。结果:45例成功建模兔VX2脑瘤兴趣区灌注值范围为1.3 ml/min～127.0 ml/min,平均为27.102 ml/min±26.723 ml/min;BV为1.2 ml/100g～53.1ml/100g,平均为22.196 ml/100g±13.680ml/100g,PEI为8.7 HU～124.6HU,平均为43.456 HU±28.73 HU;TTP为8.2 sec～62.5 sec,平均为38.823 sec±14.759 sec;对应区域PO₂为0.14 mmHg～46.70mmHg,平均为15.981 mmHg±14.815mmHg。灌注值与对应区域PO₂相关系数为0.673,有统计学意义（P=0.00）。BV、PEI、TTP与与对应区域PO₂相关系数分别为0.271、0.253、-0.18,均无统计学意义（P=0.071,P=0.094,P=0.237）。结论:64层灌注CT有预测肿瘤氧分压的能力。     

复方苦参注射液联合中药防治急性放射性食管炎19例

目的 探讨复方苦参注射液联合中药防治胸部肿瘤急性放射性食管炎的疗效.方法 非小细胞肺癌（NSCLC）39例,随机分为治疗组和对照组.治疗组予以复方苦参注射液联合中药复方养阴减毒合剂治疗,对照组采用生理盐水＋利多卡因＋庆大霉素＋地塞米松治疗.比较两组急性放射性食管炎的发生率、症状出现时间.结果 与对照组比较,治疗组非小细胞肺癌患者急性放射性食管炎的发生率显著降低,放射性食管炎症状发生时间延长,差异均有统计学意义（P〈0.05）.结论 复方苦参注射液联合中药可有效预防非小细胞肺癌（NSCLC）放疗患者急性放射性食管炎的发生.     

左归丸对去卵巢大鼠股骨中核心结合因子α1 mRNA表达的影响

目的:观察左归丸对去卵巢骨质疏松大鼠股骨中核心结合因子α1 mRNA表达的影响,探讨其对骨质疏松的防治机制.方法:280只SPF级SD雌性大鼠,分为3组:正常组40只、假手术组40只、其余采取双侧背部卵巢切除术进行绝经后骨质疏松症造模.21 d后,随机分为5组:模型组、尼尔雌醇组、左归丸高、中、低剂量组.左归丸高、中、低剂量组分别给予ig6.4,3.2,1.6 g·kg-1剂量的左归丸混悬液,1次/d;尼尔雌醇组ig尼尔雌醇混悬液0.21 mg·kg-1,每周1次.于连续给药60,120,180 d,分别取大鼠左后肢股骨近端1/3部分,采用RT-PCR方法测定核心结合因子α1的mRNA表达水平.结果:与正常组比较,模型组股骨中核心结合因子α1 mRNA水平明显降低(P＜0.01);和模型组比较,给药60,120,180 d的左归丸各剂量组,股骨中核心结合因子α1 mRNA水平显著升高(P＜0.05).结论:骨组织中核心结合因子α1 mRNA表达水平的下调可能是PMOP发生的重要机制之一,左归丸能够上调骨组织中核心结合因子α1 mRNA表达,从而有效防治骨质疏松.     

针刺为主治疗颈椎病眩晕疗效观察

目的观察针刺配合脑病康复治疗仪治疗椎动脉型颈椎病患者的眩晕症状的临床疗效。方法将椎动脉型颈椎病患者90例随机分为治疗组和对照组,每组45例。治疗组采用针刺配合脑病康复治疗仪治疗,对照组采用单纯药物治疗,治疗2个疗程后对比疗效。结果两组患者头晕症状的缓解差异无统计学意义（P〉0．05）,但治疗组的副反应明显小于对照组。结论针剌配合脑病康复治疗仪是治疗椎动脉型颈椎病患者眩晕症状的一种有效方法,副反应较小。     

左归丸防治去卵巢大鼠骨质疏松症的实验研究

目的探讨左归丸对去卵巢所致骨质疏松大鼠的防治作用。方法 手术切除大鼠双侧卵巢建立绝经后骨质疏松大鼠模型,用左归丸(高、中、低剂量)进行灌胃,120 d后,取大鼠左后肢股骨远端1/3做病理切片,光镜下观察骨组织形态学变化,测定骨小梁面积百分比(%Tb.Ar)、骨小梁厚度(Tb.Th)、骨小梁分离度(Tb.Sp);采用双能X线骨密度仪测定右后肢离体股骨近端1/3骨密度(BMD);采用酶联免疫吸附法(ELISA)检测大鼠血清骨钙素(BGP),用比色法测定血清抗酒石酸酸性磷酸酶(TRAP)。结果切除大鼠双侧卵巢后,骨小梁明显紊乱,变细且较稀疏,缺少连接,断端增多,%Tb.Ar、Tb.Th显著降低,Tb.Sp明显升高,BMD下降,血清BGP及TRAP水平显著升高,统计学显示有显著性差异(P0.01);去卵巢大鼠灌服左归丸后,与模型空白组比较,左归丸各剂量组均能不同程度地改善骨小梁变化,增加BMD,降低血清BGP及TRAP,统计学显示有显著性差异(P0.01),各用药组之间比较无显著性差异(P0.05)。结论 左归丸对去卵巢所致绝经后骨质疏松大鼠有一定的防治作用。