孟鲁司特钠咀嚼片联合糠酸莫米松鼻喷雾剂治疗儿童过敏性鼻炎的临床研究

目的探讨孟鲁司特钠咀嚼片联合糠酸莫米松鼻喷雾剂治疗儿童过敏性鼻炎的临床疗效。方法选择2013年10月—2014年5月在重庆市中医院就诊的过敏性鼻炎患儿96例,随机分为对照组和治疗组,每组48例。对照组患儿使用糠酸莫米松鼻喷雾剂,每侧鼻孔100μg/次,1次/d。治疗组患儿在对照组的治疗基础上口服孟鲁斯特钠咀嚼片,5 mg/次,1次/d。两组患儿均连续治疗14 d。观察两组的临床疗效,比较两组患者鼻炎总体症状、流涕、鼻痒、喷嚏、鼻塞等评分的变化,同时检测两组白细胞介素10(IL-10)、干扰素γ(IFN-γ)、IL-4、Ig E的变化。结果治疗后,对照组和治疗组的总有效率分别为87.5%、100.0%,两组总有效率比较差异有统计学意义(P0.05)。治疗7、14 d两组患儿喷嚏、流涕、鼻塞、鼻痒评分、症状总评分均较治疗前显著降低,同组治疗前后差异有统计学意义(P0.05);且治疗组的改善程度优于对照组,两组比较差异有统计学意义(P0.05)。治疗后,两组患儿的IL-4、Ig E显著降低,IL-10、IFN-γ水平均有明显升高,同组治疗前后差异有统计学意义(P0.05);但治疗组这些检测因子的改善程度优于对照组,两组比较差异有统计学意义(P0.05)。结论孟鲁司特钠咀嚼片联合糠酸莫米松鼻喷雾剂治疗儿童过敏性鼻炎具有较好的临床疗效,可有效降低症状评分,调节鼻炎相关因子水平,值得临床推广应用。     

Phase Change Metasurfaces by Continuous or Quasi-Continuous Atoms for Active Optoelectronic Integration

In recent decades, metasurfaces have emerged as an exotic and appealing group of nanophotonic devices for versatile wave regulation with deep subwavelength thickness facilitating compact integration. However, the ability to dynamically control the wave–matter interaction with external stimulus is highly desirable especially in such scenarios as integrated photonics and optoelectronics, since their performance in amplitude and phase control settle down once manufactured. Currently, available routes to construct active photonic devices include micro-electromechanical system (MEMS), semiconductors, liquid crystal, and phase change materials (PCMs)-integrated hybrid devices, etc. For the sake of compact integration and good compatibility with the mainstream complementary metal oxide semiconductor (CMOS) process for nanofabrication and device integration, the PCMs-based scheme stands out as a viable and promising candidate. Therefore, this review focuses on recent progresses on phase change metasurfaces with dynamic wave control (amplitude and phase or wavefront), and especially outlines those with continuous or quasi-continuous atoms in favor of optoelectronic integration.     

多囊卵巢综合征中医证型与胰岛素抵抗的研究

目的探讨多囊卵巢综合征（polycystie ovary syndrome,PCOS）的不同中医证型及其内分泌代谢特征,提高中西医结合诊治水平。方法根据中医理论对510例PCOS患者辨证分型,回顾性分析入组患者的糖耐量试验（OGTF）、胰岛素释放试验、体重指数（BMI）等内分泌代谢指标,计算稳态模型胰岛素抵抗指数（HOMA/IR）、空腹胰岛素/空腹血糖（I/G）。结果肾阳虚组192例（37．7％）、脾阳虚组167例（32．8％）、肝郁化热组84例（16．4％）、肾阴虚组67例（13．1％）,肾阳虚、脾阳虚患者较多（P〈0．01）;PCOS患者中44％糖耐量异常,4个证型组糖耐量异常率差异无统计学意义。PCOS患者胰岛素抵抗者占62．7％,脾阳虚组胰岛素抵抗较其他三个证型组高（P〈0．01）。HOMA-IR、I／G诊断胰岛素抵抗的敏感性分别为89．4％、87．5％,差异无统计学意义（P〉0．05）;HOMA-IR、I/G诊断胰岛素抵抗的特异性分别为94％、75％,HOMA-IR的特异性较强（P〈0．01）。结论PCOS以肾阳虚证、脾阳虚证较常见,PCOS患者代谢异常的主要特征为胰岛素抵抗,HOMA-IR诊断胰岛素抵抗的特异性较好。     

柱层析-紫外分光光度法测定复方丹参片中丹参酮的含量

目的:建立复方丹参片中丹参酮含量的测定方法。方法:采用柱层析-紫外分光光度法。样品用甲醇提取,提取液经过氧化铝柱分离出丹参酮,于269nm波长处测定其含量。结果:以丹参酮ⅡA为对照品,其线性范围为2.00～10.00μg·mL-(1r=0.9995),回收率为99.30%,RSD=0.32%。结论:该方法简单、可靠,可作为该制剂质量控制方法之一。     

芪蛭汤对肾病综合征高凝状态的改善作用

目的观察芪蛭汤对肾病综合征高凝状态影响和临床疗效。方法将75例肾病综合征患者随机分为两组,均给予常规治疗和泼尼松加环磷酰胺治疗,不用抗凝药。治疗组予芪蛭汤口服;对照组予阿魏酸哌嗪片口服,均治疗1个月。比较两组治疗前后的全血黏度(高切、低切)、血浆黏度、红细胞聚集指数、红细胞电泳时间、纤维蛋白原、凝血酶原时间、血小板计数。结果治疗组临床疗效优于对照组。两组治疗后全血黏度(高切、低切)、血浆黏度、红细胞聚集指数、红细胞电泳时间、纤维蛋白原、血小板计数均降低,凝血酶原时间升高,治疗组改善程度优于对照组。结论芪蛭汤能改善肾病综合征患者高凝状态,改善微循环,保护肾功能,降低蛋白尿。     

艾灸配合耳穴压丸预防顺铂治疗后胃肠反应临床观察

目的 观察艾灸配合耳穴压丸预防顺铂引起恶心、呕吐的疗效.方法 将60例肺癌、头颈部恶性肿瘤患者随机分为两组,对照组化疗前给予甲磺酸托烷司琼注射液加地塞米松注射液静滴并在化疗后予甲氧氯普胺注射液肌注,治疗组化疗前给予艾灸配合耳穴压丸预防,并常规给予甲磺酸托烷司琼注射液加地塞米松注射液静滴.观察治疗期间两组患者恶心、呕吐的发生情况.结果 治疗组恶心、呕吐的防治效果明显优于对 照组.结论艾灸配合耳穴压丸预防顺铂引起恶心、呕吐疗效可靠,费用低廉,临床应用安全可靠.     

Early recovery of basic mobility under femoral nerve block after hip fracture surgery – A propensity score matched pilot study

Background: Previous studies have shown better pain reduction utilizing femoral nerve block (FNB) in patients who underwent hip fracture surgery. However, few studies have focused on the recovery of physical function after FNB, and most studies excluded patients with dementia. We investigated the association between FNB performed in the operating room and the recovery of physical function after hip fracture surgery, including patients with dementia.MethodsA total of 103 patients with a mean age of 87.4 years who underwent hip fracture surgery under spinal anesthesia between July 2015 and December 2017 (46 patients receiving a single injection of FNB and 57 standard care) were enrolled. Patients with FNB versus standard care were matched by a propensity score to adjust for patient characteristics. An anesthesiologist performed FNB with 20ml of 0.2% ropivacaine, and the standard care group received intravenous 1000 mg acetaminophen or 50mg flurbiprofen once after surgery. After matching, 78 patients were analyzed. Our primary outcome was 3-day cumulated ambulation score (CAS, 0-18 points) and secondary outcomes were 1-day CAS on postoperative day 1-3 and length of hospital stay. We also stratified patient groups based on the presence of dementia and fracture type.ResultsPatients undergoing FNB had significantly better 3-day CAS compared to standard care (mean [SD], 8.72 [3.42] vs 7.33 [2.62]; mean difference, 1.38 [95%CI; 0.03 - 2.74]; p = 0.048) and 1-day CAS on postoperative day two (mean [SD], 3.10 [1.39] vs 2.56 [0.94]; mean difference, 0.54 [0.01 - 1.07]; p = 0.049). Length of hospital stay did not significantly differ among the two groups (p = 0.65). Larger positive effect was likely to be seen for patients with a femoral neck fractures and for those without dementia.ConclusionsPatients who underwent surgery with spinal anesthesia plus FNB had better ambulatory status early after hip fracture surgery compared to patients not offered FNB. The beneficial association between FNB and ambulatory status was likely to be observed especially in patients with femoral neck fracture and without dementia.     

正交试验优选阿胶、龟甲胶、鹿角胶的微波炮制胶珠工艺的研究

目的优选微波炮制阿胶、龟甲胶、鹿角胶胶珠的工艺参数,规范胶类药材制珠工艺,提高并稳定胶珠质量。方法用多项指标评价胶珠质量,采用L4(23)正交优选法对炮制胶珠工艺参数进行筛选。结果获得了阿胶、龟甲胶、鹿角胶优化的炮制胶珠工艺参数。结论不同种类的胶材或不同批号、不同生产厂家的同类胶材都有其最适的工艺参数,可用正交试验优选法快速筛选。     

肠道菌群改变与儿童变应性鼻炎的相关性研究

目的 探讨肠道菌群改变与儿童变应性鼻炎(AR)的相关性。方法 纳入2021年10月—2022年6月确诊为AR的患儿38例,男21例,女17例,年龄5～7岁,平均年龄5.85岁;另纳入正常儿童38例作为健康儿童组,男23例,女15例,年龄5～7岁,平均年龄5.80岁。分别收集两组粪便进行高通量测序,并对两组的临床资料进行统计学分析。结果 AR患儿肠道菌群Alpha多样性Chao1、Observed species、Shannon、Simpson、Faith’s pd、Pielou_e指数较健康儿童明显降低。两组Beta多样性存在差异。两组在门水平放线菌门、拟杆菌门等,属水平拟杆菌属、双歧杆菌属等存在差异。体重(P=0.024)、被动吸烟(P=0.006)、变应性家族史(P＜0.001)、家庭居住地(P=0.017)、有无湿疹(P=0.011)、新生儿期是否使用抗生素(P＜0.001)、是否母乳喂养＞3个月(P=0.003)、是否为剖腹产(P=0.043)均有可能作为AR发病的影响因素。结论 AR患儿肠道菌群多样性与健康儿童相比发生了变化,肠道菌群生态系统的多样性、稳定性降低,多种特定菌种丰度显著改变。肠道菌群失衡可能是促进儿童AR发生发展的一个重要因素。