电针董氏奇穴联合生物反馈治疗功能性肛门直肠痛的疗效评价

ObjectiveTo investigate the clinical effect of electroacupuncture combined with biofeedback on functional anorectal pain.MethodsSixty patients diagnosed functional anorectal pain were divided into three groups by random number table, namely electroacupuncture group, biofeedback group, and combination group, with 20 patients in each. In the electroacupuncture group, the electroacupuncture at Dong's points Sānqí (三其穴), including Qímén (其门), Qíjiǎo (其角), and Qízhèng (其正), and Línggǔ (灵骨), Dàbái (大白), Chángmén (肠门) of both sides was given; in the Biofeedback group, the biofeedback therapy was adopted; in the combination group, the electroacupuncture and biofeedback therapy were used. All patients were treated once a day, 30 min each time, 10 consecutive treatments as one treatment course, and the therapeutic effect was evaluated after 3 treatment courses. The observation indexes after the intervention: Visual analogue Scale (VAS) score, SF-36 Quality of Life Scale score, Self-rating Anxiety Scale (SAS) score, Self-rating Depression Scale (SDS) score, Anorectal manometry, Clinical efficacy, and patients’ adverse reactions.ResultsAfter treatment, the pain of patients in the three groups was alleviated than that before treatment, VAS score, SAS score, SDS score, and anorectal pressure were decreased (P<0.05), and SF-36 Quality of Life Scale score was increased (P<0.05). After treatment, in the combination group, the VAS scores, SAS scores, SDS scores, and Anal-rectal pressure scores were lower than those in the other two groups (P<0.05), and SF-36 Quality of Life Scale scores were higher than those in the other two groups (P<0.05), the total effective rate was 80.0% (16/20), which was significantly higher than that of the electroacupuncture group (55.0%, 11/20) and the biofeedback group (40.0%, 8/20) (both P<0.05) . No adverse reactions occurred in all three groups.ConclusionElectroacupuncture at Dong's points combined with biofeedback therapy has a significant effect on functional anorectal pain. The combined application of electroacupuncture and biofeedback therapy has a synergic action, and the analgesic effect is better than that of only using electroacupuncture or biofeedback therapy.     

甲状舌管乳头状癌的临床病理观察

目的 探讨甲状舌管乳头状癌的组织学起源、分子分型、临床病理特征、治疗及预后,以提高对甲状舌管乳头状癌的认识.方法 对2017年9月收集的1例甲状舌管乳头状癌的病理特征、临床特点及预后等进行观察,并复习国内外相关病例资料.结果 患者男性,37岁,无意间发现颈部包块2月人院.大体检查:灰褐色软组织一块,大小为2 cm×1....     

Glycyrrhetinic acid prevents acetaminophen-induced acute liver injury via the inhibition of CYP2E1 expression and HMGB1-TLR4 signal activation in mice

Acetaminophen (APAP) is a widely used antipyretic and analgesic drug, which is safe and effective at the therapeutic dose. Unfortunately, excessive dosage of APAP could cause severe liver injury due to lack of effective therapy. Successful therapeutic strategies are urgently requested in clinic. Glycyrrhetinic acid (GA), derived from a traditional medicine licorice, has been shown to exert anti-inflammatory and antioxidant actions. In this study, the effect and the underlying mechanism of GA on APAP-induced hepatotoxicity were explored. Our results showed that pretreatment with GA significantly reduced serum ALT and AST activities, alleviated hepatic pathological damages with hepatocellular apoptosis, down-regulated expression of CYP2E1 mRNA and protein, increased GSH levels, and reduced reactive oxygen species (ROS) productions in the liver of APAP-exposed mice. Furthermore, GA obviously inhibited APAP-induced HMGB1-TLR4 signal activation, as evaluated by reduced hepatic HMGB1 release, p-IRAK1, p-MAPK and p-IκB expression as well as the productions of TNF-α and IL-1β. In addition, GA attenuated hepatic neutrophils recruitment and macrophages infiltration caused by APAP. These findings reflected that GA could alleviate APAP-induced hepatotoxicity, the possible mechanism is associated with down-regulation of CYP2E1 expression and deactivation of HMGB1-TLR4 signal pathway.     

ACE基因突变致遗传性肾小管发育不良1例并文献复习

目的：提高对遗传性RTD的认识和早期诊断水平。方法：报告1例确诊的遗传性RTD患儿的一般情况、肾脏病理、实验室检查和基因测序结果，系统检索文献并复习已报道的类似病例，总结遗传性RTD的遗传和临床特征。结果：患儿女，因“早产后15 min，气促、发绀5 min”入重庆市妇幼保健院，胎龄28+2周，出生体重1 090 g，羊水0 mL，生后Apgar评分1和5 min分别为8和9分。母孕期正规产检，孕23+5及26+1周因“羊水少”行2次羊膜腔穿刺及0.9%生理盐水灌注术。母不良孕产史3次，均因“羊水少”，或早产生后1 d夭折，或孕5月引产。患儿生后反应欠佳，轻度吸气性三凹征，心音有力、律齐，腹软，肝脾肋下未扪及，原始反射均减弱。予呼吸机辅助通气，予2次肺表面活性物质替代治疗，扩容和多巴胺应用下平均血压22~28 mmHg。应用呋塞米后尿量0.14~0.31 ml·kg－1·h－1，患儿日龄44 h时家属放弃抢救治疗后死亡，尸体泌尿系组织病理诊断：肾小管大小不一，近端小管缺乏，部分远端小管及集合管发育不良。患儿为ACE基因复合杂合突变：c.538C>T来源于母亲，c.3073_3074delTC来源于父亲。共检索到11篇文献，报道了36个家系，加上本文共37个家系的64例ACE基因突变胎儿和婴儿，共发现40个ACE基因突变位点。9个家系为近亲结婚。每个家系均有1~4例母孕期羊水少的受累胎儿，羊水少开始于孕中期，早至18周；终止妊娠10例，死胎7例，出生后死亡39例（<3 d死亡33例，~28 d死亡6例；早产儿37例，足月儿2例），存活>1年8例（慢性肾疾病6例，肾移植1例，正常肾功能1例）。新生儿主要以呼吸困难、低血压、无尿为主要表现，部分病例伴有颅骨发育不良、小结肠（结肠直径0.5~0.6 cm）。结论：对于遗传性RTD，完善基因检测对提高产前诊断及RTD早期诊断有重要意义。     

纳米声敏剂在声动力疗法中的研究进展

声动力疗法是一种极具前景的治疗新方法。然而,由于传统声敏剂的缺陷,导致其在运用过程中受到许多限制。纳米技术是当前非常热门的研究领域,将其引入声动力疗法,有效地改善了当前声动力疗法的应用限制。因此,本文拟对纳米声敏剂在声动力疗法中的应用进行综述,以改善当前对声动力疗法的研究。     

双J管在体外冲击波碎石治疗输尿管中上段结石中的合理应用

目的评估留置双J管在体外冲击波碎石治疗输尿管中上段结石中的有效性及安全性,探索双J管的合理应用。方法统计在我院治疗的输尿管中上段结石患者511例,留置双J管后再施行体外碎石患者161例,直接施行体外冲击波碎石患者350例,分为置管和未置管2组。分析2组间结石X光显示定位满意率、碎石效果及不良反应发生率。结果置管组X光结石显示定位满意率高于未置管组(P=0.025)。置管组、未置管组结石清除率比较有统计学意义(P=0.041)。置管组患者血尿、下尿路症状发生率明显高于未置管组(P0.05)。置管组患者肾绞痛发生率低于未置管组(P=0.001)。结论双J管置入对结石显示及定位有帮助,可提高结石清除率。对直径小于1 cm的输尿管阳性结石,是否置双J管对结石清除率影响不大,但可减少剧烈肾绞痛的发生率。     

Time-effect Relationship of Extracts from Ginseng, Notoginseng and Chuanxiong on Vascular Endothelial Cells Senescence

Objective:To observe the time-effect relation of extracts from ginseng,notoginseng and chuanxiong on angiotensin II(AngⅡ)-induced senescence of vascular endothelial cells and explore the feature of Chinese medicine against vascular diseases.Methods:Human umbilical vein endothelial cells(HUVECs)cultured in vitro were stimulated with 10~(-6) mol/L Ang Ⅱ to induce cell senescence,which were divided into 4groups,the blank control group,the Ang Ⅱ model group,the extracts group and the telmisartan group.The(J-gal was used to identify senescence of cells,the cell counting kit-8 method was applied to assess the cell viability,the cell function was examined with the level of endothelial nitric oxide synthase(eNOS) and the flow cytometry was used for analyzing the cell cycle changes.Results:Compared with the control cells,the cells positive for β-gal staining was significantly increased in the Ang Ⅱ model group,and showed cell cycle arrest at G_0/G_1 phase with decreased S and G_2/M phase ceil percentage,eNOS expression and cell viability(P0.05).The extracts and telmisartan treatment of Ang II-induced cells resulted in decreased β-gal positive cells with a reduction in G_0/G_1phase cells and an increasing in S,G_2/M phase ceils and eNOS expression(P0.05).At 24 h,the extracts were more effective than telmisartan(P0.05);while telmisartan was more effective at 48 h(P0.05).Conclusion:Extracts from ginseng,notoginseng and chuanxiong can delay Ang II-induced aging of HUVECs and may play an important role in early senescence.     

孕11~13+6周胎儿后脑结构经后脑横断面的超声观察

目的探讨超声经后脑横断面观察孕11~13+6周胎儿后脑结构的可行性。方法随机选择2695例孕11~13+6周胎儿,行颅脑正中矢状面及经后脑横断面超声检查,观察后脑结构并测量后脑透明层厚度;分析两切面检测颅内透明层厚度的一致性。结果 2695例胎儿中,2402例均获得颅脑正中矢状切面及经后脑横断面(其中1例两切面后脑结构均显示异常),239例仅获得经后脑横断面,54例未获得两切面。正常胎儿后脑在颅脑正中矢状切面及经后脑横断面均显示为"二高三低回声带"结构。两切面所测的胎儿透明层厚度一致性较好(一致性偏倚为0.0219,一致性界限为-0.2740~0.2874)。结论孕11~13+6周经后脑横断面观察胎儿后脑结构可作为一种安全、快速、有效的方法筛查胎儿神经系统畸形。