先天性马蹄内翻足动物模型胚胎后肢(芽)评分系统的建立

Objective Quantification of the severity of congenital clubfoot is essential for its re-search and treatment. Up to date, no scoring system is available for hind limb bud development. In this study,a scoring system was established based on a murine model Methods Sixty female Wistar rats weighing 220～250 g were randomized into the six control groups and six experimental groups. Vaginal sperm plug detection day was considered to be day 0 of gestation. Hind limb buds from fetuses of E13, 14, 15,16,17 and 18 days were removed and processed. Results Morphogenetic differentiation changes were detected in the experimental groups. According the new scoring system, clubfoot-like deformity was present in 80.9% of the experimental fetuses. We were able to quantify the extent morphogenetic diffcrentiation of the hind limb accordingly. Conclusions Congenital clubfoot deformities begin at early developmental stage and become exaggerated as the fetuses mature. The scoring system can quantify the extent of congenital clubfoot deformity and facilitate its management.     

目前医院中药制剂质量存在的若干问题

中药制剂是医院制剂的重要组成部分，在医院担负着医疗、保健、科研的特殊需要，在弥补中药商品制剂不足方面也起到了很大的作用。近几年来，医院自制中药制剂发展很快，并取得了明显的经济效益，也成为新药开发的摇蓝。笔者认为在医院特别是中小医院，中药制剂普遍存在着一定问题，并提出相应解决办法。     

类先天性马蹄足动物模型胚胎病理初步研究及病因学意义

目的分析在肢体发育不同时段综合多基因相互作用条件下最终导致先天性马蹄内翻足（CCF）发生的原因。方法77只大白鼠从怀孕第10天起，将维甲酸石蜡油混悬液经胃管单次注入，建立CCF动物模型；应用光镜、电镜及分子生物学方法检测胎鼠后肢芽（后肢）、胸腰段脊髓。结果动物模型的CCF发病率为61．8％，距骨发育停滞，距骨、跟骨间重叠不良和跟骨内翻，后肢芽及脊髓前角细胞均有凋亡现象。结论CCF在胚胎发育期即有畸形，且程度随生长发育而逐步加重，后肢芽及脊髓前角细胞在胚胎早期即出现凋亡现象。     

全椎板切除并全颈椎弓根钉棒系统重建治疗急性多节段脊髓损伤

目的探讨经颈椎后路行全椎板切除减压、颈椎弓根螺钉三维钉棒系统重建治疗伴或不伴颈椎后凸畸形的多节段急性脊髓损伤的疗效。方法对27例伴或不伴颈椎后凸畸形的多节段急性脊髓损伤的患者,行后路颈椎全椎板切除减压、小关节植骨融合、颈椎弓根钉棒系统内固定重建。根据术前、术后3个月随访时颈椎的标准侧位X光片、颈椎CT,以ASIA评分评估脊髓功能改善情况。术后随访3～24个月,平均10个月。结果所有病例均获骨性融合。术后3个月ASIA评分与术前比较均有提高。由于解剖的因素,应用颈椎弓根螺钉重建在术中较易损伤椎动脉。结论一期行颈椎后路椎板切除减压、椎弓根钉棒系统内固定重建颈椎序列是治疗伴或不伴颈椎后凸畸形的多节段急性脊髓损伤的有效方法。     

甲状旁腺素测定方法及其在肾性骨病诊断上的应用

肾性骨病是慢性肾功能不全患者的常见并发症,目前多应用甲状旁腺素（PTH）的测定来诊断肾性骨病。本文简要介绍了PTH的测定方法,并对其在肾性骨病诊断上的应用进行分析。     

某中医院中成药处方分析与改进措施

目的 对某医院中成药处方存在的问题进行分析并提出改进措施。方法 依据相关法规、中成药处方点评细则及药品说明书,选取并分析2019年1月至2020年1月德州市中医院的4 128张门急诊中成药处方,对不合理处方进行统计分析,并针对出现的问题制订改进措施。结果 在4 128张处方中,不合理处方330张,占总处方的7.99%,其中不规范处方占25.46%(84/330),用药不适宜处方占66.96%(221/330),其他处方占7.58%(25/330)。不合理类型主要表现为诊断内容不全、用药与诊断不符、用法用量不适宜、重复用药、存在配伍禁忌等方面。结论 该院中成药处方开具和中成药使用方面还存在一定的不合理性,医师、药师应加强培训,医院应制订措施促进中成药处方质量的提升和中成药的合理使用。     

浅议通法治疗慢性肾功能衰竭

基于慢性肾衰竭本虚标实的病理特点,脏腑亏虚为本、湿浊瘀阻为标的基本病机,提出应用通法治疗该病,使气血津液畅通,脏腑功能协调,为慢性肾衰竭提供治疗思路。     

肌萎缩型颈椎病

颈椎病引起的神经损害一般是感觉与运动同时受累。但有一种特殊型颈椎病,它没有明显的感觉障碍,也不伴疼痛,主要症状只是肩胛带肌肉萎缩无力。1952年Ｂｒａｉｎ曾有报告,1965年Ｋｅｅｇａｎ将此现象称之为运动分离丧失(ｄｉｓｓｏｃｉａｔｅｄｍｏｔｏｒｌｏｓｓ),认为是骨棘选择性压迫颈神经前根所致。其后有人将此病命名为Ｋｅｅｇａｎ型颈椎病。然而也有很多报告认为受累部位并不仅仅是在前根。关于此病的定义各报告者也不一致。发病率为22%～10%[1]。1　发病机制1965年Ｋｅｅｇａｎ、1975年大田宽根据解剖所见,提出发病机制是选择性颈神…     

先天性马蹄内翻足动物模型胚胎后肢(芽)评分系统的建立

Objective Quantification of the severity of congenital clubfoot is essential for its re-search and treatment. Up to date, no scoring system is available for hind limb bud development. In this study,a scoring system was established based on a murine model Methods Sixty female Wistar rats weighing 220～250 g were randomized into the six control groups and six experimental groups. Vaginal sperm plug detection day was considered to be day 0 of gestation. Hind limb buds from fetuses of E13, 14, 15,16,17 and 18 days were removed and processed. Results Morphogenetic differentiation changes were detected in the experimental groups. According the new scoring system, clubfoot-like deformity was present in 80.9% of the experimental fetuses. We were able to quantify the extent morphogenetic diffcrentiation of the hind limb accordingly. Conclusions Congenital clubfoot deformities begin at early developmental stage and become exaggerated as the fetuses mature. The scoring system can quantify the extent of congenital clubfoot deformity and facilitate its management.     

一套式固定法在鼻饲患者中的应用效果观察

目的探讨一套式固定法在鼻饲患者中的应用效果。方法将112例鼻饲患者随机分为对照组和观察组各56例。对照组采用传统胶布法固定鼻饲管道,观察组采用一套式固定法固定鼻饲管道。比较两组患者鼻饲管脱出率、皮肤过敏发生率及舒适度情况。结果观察组患者鼻饲管脱出率、皮肤过敏发生率低于对照组;舒适度优于对照组,两组比较,均P0.05,差异具有统计学意义。结论应用一套式固定法固定鼻饲管道,可以减少鼻饲管脱出及皮肤过敏的发生率,增加患者舒适度,值得临床推广应用。