精心打造公共卫生安全区

近年来，山东省东营市卫生工作在市委、市政府及山东省卫生厅的正确领导与指导下，认真贯彻预防为主的方针，坚持统筹城乡经济社会发展的思路，以创建公共卫生安全区为总抓手，在农村构建农民健康保障体系，在城工创建国家卫生城市，不断完善全市公共卫生服务网络，提高公共卫生服务水平，有力地保障了人民群众的身体健康，促进了经济社会的协调发展。     

腹部推拿配合针灸治疗瑞士人肝郁气滞型广泛性焦虑症80例临床观察

Objective To observe the clinical effect of abdominal Tuina and acupuncture in treating Swiss generalized anxiety disorder (GAD). Methods 80 patients of GAD caused by liver depression-qi stagnation were randomly recruited into a treatment group and a control group, 40 patients in each. The treatment group was treated with abdominal tuina & acupuncture; while the control group was treated with acupuncture exclusively. Clinical effects and hamilton anxiety scale (HAMA) score were observed in both groups before and after the treatment. Results ①There was significant difference in total efficacy between the two groups CP<0.05), and the treatment group was better than the control group. ②The HAMA score of the two groups after the treatment was lower than that before the treatment, and the difference was significant (P< 0.05). There was also significant difference of HAMA score between the two groups after the treatment (/><0.05), with the treatment group showing better results than the control group. Conclusion Abdominal tuina combined with acupuncture has sound effects in treating Swiss GAD due to liver depression-qi stagnation.     

谷雨节气的养生保健

谷雨是春季的最后一个节气.有雨水生百谷的含义,常言道,"清明断雪,谷雨断霜",谷雨后气温回升加快,雨量开始增多.《月令七十二候集解》:"三月中,自雨水后,土膏脉动,今又雨其谷于水也.盖谷以此时播种,自上而下也."     

尼可地尔术前干预对心脏病患者行髋关节置换术的心肌保护作用

目的探讨尼可地尔术前干预对心脏病患者行髋关节置换术的心肌保护作用。方法对2018年6月至2020年12月南通大学附属医院如皋分院117例行髋关节置换术患者的病历资料进行回顾性分析, 根据术前是否给予尼可地尔分为两组, A组常规术前全身麻醉, B组于术前给予尼可地尔。比较两组手术相关指标、炎性因子水平、心肌损伤及主要心血管不良事件(MACE)发生情况。结果两组手术时间、术中出血量、术中补液量、尿量、术后1 d Ramsay镇静评分、术后1 d视觉模拟量表评分、住院时间比较差异无统计学意义(P>0.05)。B组术后血清白细胞介素6、肿瘤坏死因子-α、C反应蛋白、心肌肌钙蛋白I、肌酸激酶同工酶、肌红蛋白、脂蛋白相关磷脂酶A2水平均低于A组[(388.15 ± 56.20)μg/L比(456.34 ± 65.18)μg/L、(34.24 ± 8.90)μg/L比(40.26 ± 10.22)μg/L、(27.54 ± 5.52)mg/L比(30.25 ± 5.61)mg/L、(0.10 ± 0.05)μg/L比(0.19 ± 0.08)μg/L、0.059 ± 0.019比0.099 ±...     

腹部推拿配合针灸治疗瑞士人肝郁气滞型广泛性焦虑症80例临床观察

Objective To observe the clinical effect of abdominal Tuina and acupuncture in treating Swiss generalized anxiety disorder (GAD). Methods 80 patients of GAD caused by liver depression-qi stagnation were randomly recruited into a treatment group and a control group, 40 patients in each. The treatment group was treated with abdominal tuina & acupuncture; while the control group was treated with acupuncture exclusively. Clinical effects and hamilton anxiety scale (HAMA) score were observed in both groups before and after the treatment. Results ①There was significant difference in total efficacy between the two groups CP<0.05), and the treatment group was better than the control group. ②The HAMA score of the two groups after the treatment was lower than that before the treatment, and the difference was significant (P< 0.05). There was also significant difference of HAMA score between the two groups after the treatment (/><0.05), with the treatment group showing better results than the control group. Conclusion Abdominal tuina combined with acupuncture has sound effects in treating Swiss GAD due to liver depression-qi stagnation.     

SIMPLE OBESITY AND OBESITY HYPERLIPEMIA TREATED WITH OTOACUPOINT PELLET PRESSURE AND BODY ACUPUNCTURE

161 cases of simple obesity with or without hyperlipemia were treated by pellet pressure onauricular acupoints plus body acupuncture for 3 months in a single-blind experiment.Pa-tients on Capsulae Oiei Oenothera Erythrosepalae were taken as positive controls.Bodyweight,circumference of chest,abdomen,arms and legs,the appetite,sleep,bowelmovement,blood TC,TG and HDL-C were recorded for comparison.The results indicatedthat treatment in the auricular and body acupoint group was superior to treatment in thecontrol group.In the acupoint group body weight dropped by an average of 5.04 kg in84.55% of the patients,who also showed decreased appetite,blood TC and TG.     

人工膝关节置换髌骨处理的对比分析

目的总结髁型人工膝关节置换髌骨处理原则。方法通过回顾性分析，对比人工膝关节置换术髌骨成形组与髌骨置换组间的临床效果差别。结果36例（47膝）行髌骨成形术，20例（24膝）行髌骨置换术。随访18～60个月，平均48．8个月，两组患者的HSS评分、屈膝角度以及髌前疼痛情况无差别。结论在目前的技术水平条件下，对形态和运动轨迹都良好的髌骨，仅行髌骨成形术可取得良好临床效果。对行髌骨置换的患者，正确的假体安放以及各部件之间的良好匹配是取得良好效果的关键。     

摩腹法对肠易激综合征模型结肠组织脑肠肽表达的影响

[目的]从脑肠肽角度探讨摩腹法干预肠易激综合征(IBS)的作用机制。[方法]把新西兰白兔随机分为正常组、模型组和手法组,模型组和手法组用0～2℃冰水灌胃21 d以建立肠易激综合征,手法组运用摩腹法操作10 d,采用免疫组化方法对以上3组结肠组织P物质(SP)、血管活性肠肽(VIP)、胆囊收缩素(CCK)进行半定量分析。[结果]模型组结肠黏膜SP表达的阳性面积、不透光率密度值明显减少,VIP增多(P<0.05),经摩腹干预后,SP表达升高,VIP降低,与正常组比较无显著性差异(P>0.05),3组CCK表达无显著性差异(P>0.05)。[结论]结肠SP和VIP表达异常可能是IBS的致病因素之一,摩腹法可以通过调节局部肠道SP和VIP的功能来治疗IBS。     

综合分期疗法对急性期腰椎间盘突出症神经肌电作用影响

[目的] 分析比较综合分期法和整复手法对急性期腰椎间盘突出症的神经肌电作用和量表评价。[方法] 180例腰椎间盘突出症急性期患者随机分为综合分期疗法治疗组、传统推拿手法组(以整复手法为主)和西医非手术常规治疗组3组,对以上患者治疗前和急性期后进行胫骨前肌和腓肠肌肌电和腰痛量表评估。[结果] 治疗后各组肌电和腰痛评估表评分较治疗前均有所下降(P<0.01),其中以综合分期疗法组改善作用最为明显,传统推拿手法组改善作用最差(P<0.01,P<0.05),肌电和腰痛量表评分两者呈正相关。[结论] 综合分期法对腰椎间盘突出症急性期神经肌电和腰痛量表评分有较好的改善作用,整复手法不适宜在急性期应用。     

江苏省预防出生缺陷健康教育效果评价

目的通过生育健康知识、态度和行为（knowledge，attitude and practice，KAP）问卷调查，评价预防出生缺陷知识宣传的干预效果。方法选择全省13个市18个项目点，项目干预前后每一个项目点各选取100个家庭共3600个家庭，作为调查对象进行相关知识宣传，由培训人员进行KAP问卷调查，了解干预前后群众对出生缺陷知识、态度、行为的变化，并以问卷评分得分情况判定教育效果。结果年龄、性别、文化程度、职业、初婚年龄、家庭经济收入／人均年收入（〈1500元以及〉1．5万元）对干预效果都有明显的影响。年青人比老人，女性比男性，小学以上文化程度比文盲半文盲，干部、教师和医务人员比其他职业，对知识的掌握明显增多，差异有统计学意义（P〈0．05）。干预后，群众对预防出生缺陷相关知识知晓率平均提高13．77分，95％CI：（5．41～22．32），干预前后比较差异有统计学意义（P〈0．05）。干预后19项题目全答对的比例高于干预前。结论本项目实施后社区群众在预防出生缺陷的知识比干预前明显提高，态度和行为比干预前有很大转度，但应加强对职业为工人、农民、文化程度偏低、家庭收入较少的育龄群众的知识普及。