2种方法预防压疮的效果分析

目的研究液体石蜡对脑血管疾病及颅脑损伤等压疮高危病员的预防效果。方法把120例患者随机分成实验组、对照组。实验组（61例）把石蜡熔化后冷却至40～50℃左右，放在易发生压疮的受压部位；对照组（59例）采取传统翻身按摩法预防压疮，观察2组压疮发生率。结果实验组61例有2例1期压疮发生，对照组59协有10例Ⅰ期压疮发生。通过检验，X^2：6．627，P〈0．05，2组结果差异有统计学意义。结论石蜡热敷预防压疮的发生明显优于翻身按摩法，值得在一临床中推广应用。     

Associative and behavioral tolerance to the analgesic effects of nicotine in rats: tail-flick and paw-lick assays

Rationale Theories of drug tolerance differentiate between associative and behavioral (instrumental) drug tolerance. However, there is little research comparing these two forms of drug tolerance beyond alcohol and morphine.Objective We examined the time course development of associative and behavioral tolerance to the analgesic effects of nicotine.Methods and results Associative tolerance was investigated by giving independent groups of rats one, five, 15, ten or 20 administrations of nicotine either explicitly paired or unpaired with a distinctive context. Associative tolerance, assessed in the tail flick, developed more rapidly and reached greater magnitude when nicotine and distinctive context were explicitly paired than when they were unpaired. This effect was evidenced after the fifth conditioning session and was maintained through the tenth, 15th, and 20th sessions. Contextual tolerance, assessed in the hot plate, was first evident after ten sessions. However, this effect disappeared safter 15 and 20 sessions. A second study examined the acquisition of behavioral tolerance to the disruptive effects of nicotine on the hot-plate response. Animals that practiced the test response while drugged developed greater tolerance than animals receiving as much nicotine and hot-plate practice but with these two conditions explicitly unpaired. This effect was evident in two different environments but did not generalize to the tail-flick test.Conclusions The findings suggest that contextual tolerance to drug effects is test specific, with tail-flick responses depending on cue-associative tolerance processes and hot-plate responses requiring procedures that allow the animal to practice the test response while drugged.     

Sitz Bath: Where Is the Evidence? Scientific Basis of a Common Practice

PURPOSE This study was designed to determine if evidence exists to justify and support the recommendation of sitz bath in the management of anorectal disorders. METHODS A Medline search was conducted using the key words “sitz bath” and “hot bath.” RESULTS Thirty-six articles were found which highlighted the physiology, benefits, risks, complications, and techniques of sitz bath. Most of the studies were published in gynecologic or nursing journals. One randomized study comparing sitz bath to placebo was found. Two articles speculated that sitz bath induces relaxation of the internal sphincter muscle. Cold sitz bath was reported to decrease perineal edema more than warm sitz bath, although patients tended to prefer the latter. Five articles reported complications of sitz bath, including dissemination of herpes, maternal–neonatal Streptococcus outbreak, and skin burns. CONCLUSION A review of the literature demonstrated a lack of scientific data to support the use of sitz bath in the treatment of anorectal disorders. Additional randomized and controlled clinical studies are needed to investigate whether this time consuming recommendation is beneficial to patients. Reprints are not available.     

Pilot evaluation of black cohosh for the treatment of hot flashes in women

Background. Hot flashes cause significant morbidity in postmenopausal women, including women with breast cancer. We undertook a pilot study to estimate the effectiveness of black cohosh to reduce hot flashes. Methods. Women who reported significant hot flashes (≥ 14 per week) were enrolled. Black cohosh was given in the form of the commercial product Remifemin. The first week was a no-treatment baseline period, and therapy was given for the subsequent 4 weeks. Hot flash data were collected by daily questionnaires during baseline and treatment weeks. Adverse effects were recorded. Results. Twenty-one women completed the study. Their mean age was 56 years (range, 38-80). Thirteen patients had a history of breast cancer. Six patients were taking tamoxifen or raloxifene. Patients reported an average of 8.3 hot flashes per day during the baseline week. The reduction in mean daily hot flash frequency was 50% (95% CI, 34%-65%), while weekly hot flash scores were reduced 56% (95% CI, 40%-71%) at completion of the study. Overall, patients reported less trouble with sleeping, less fatigue, and less abnormal sweating. No patients stopped therapy because of adverse effects. Conclusions. Black cohosh appeared to reduce hot flashes and had a low toxicity. The efficacy found in this trial seems to be more than would be expected by a placebo effect (20%-30% hot flash reduction in previous trials). These results suggest that further evaluation of this black cohosh preparation with a phase III randomized trial is indicated.     

(-)-Linalool produces antinociception in two experimental models of pain

Linalool is a monoterpene compound commonly found as a major component of the essential oils of several aromatic plant species, many of which are used in traditional medical systems as analgesic and anti-inflammatory remedies. We previously reported that (-)-linalool, the natural occurring enantiomer, plays a major role in the anti-inflammatory activity displayed by different essential oils, suggesting that linalool-producing species are potentially anti-inflammatory agents. In this study, the antinociceptive activity of (-)-linalool was examined in two different pain models in mice: the acetic acid-induced writhing response, a model of inflammatory pain, and the hot plate test, a model of supraspinal analgesia. Moreover, the effect of (-)-linalool on spontaneous locomotor activity (25, 50, 75 and 100 mg/kg) was evaluated. The results show that this compound induced a significant reduction of the acid-induced writhing at doses ranging from 25 to 75 mg/kg. Such effect was completely reversed both by the opioid receptor antagonist naloxone and by the unselective muscarinic receptor antagonist atropine. In the hot plate test, only the dose of 100 mg/kg of (-)-linalool resulted in a significant effect. (-)-Linalool induced a dose dependent increase of motility effects, thus ruling out the confounding influence of a possible sedative effect. The more pronounced effect of (-)-linalool on the writhing test with respect to the hot plate test is consistent with the observation that (-)-linalool possesses anti-inflammatory activity. Finally, the activation of opioidergic and cholinergic systems appears to play a crucial role in (-)-linalool-induced antinociception.     

The role of serotonin in hot flushes

Hot flushes are experienced in those periods of the female life when estrogen levels are low. Hormone replacement therapy is thus the first choice for treatment of hot flushes. However this treatment is not always accepted or contraindicated for a variety of reasons. Estrogen (and progestogen) strongly interact with a number of neurotransmitters and this has led to a range of non-hormonal treatments including compounds that act via the noradrenergic or dopaminergic systems as well as herbal remedies. These treatments (which are shortly reviewed) are not always successful. Surprisingly, apart from treatment with some selective serotonin (5-HT) reuptake inhibitors (SSRI's), up till now, little attention is given to the strong interaction of estrogens with the serotonergic system. These interactions are shortly reviewed. Based on these interactions, a hypothesis on the genesis of hot flushes is postulated. Especially the 5-HT_2A receptor subtype may play a key role in the occurrence of hot flushes. A number of arguments that support this hypothesis are discussed.     

在电力隧道加固工程上钢绞线-聚合物砂浆加固法 的应用研究

试验研究了在发动机喷管中加装金属辐射板前后,喷管壁面温度、热喷流温度与喷管红外辐射特征的变化。结果表明,加装金属辐射板后,热喷流与喷管壁面之间的热量传递显著增强,热喷流中心温度降低,壁面温度明显升高,在90°方向上,热喷流3～5μm波段的红外辐射强度降低了38.5%。文中从热喷流、喷管壁面以及金属辐射板等相关部件的温度变化情况对红外辐射强度的变化原因进行了解释。      

角膜共焦显微镜对于肌萎缩侧索硬化症小纤维神经病变的临床研究

目的通过角膜共焦显微镜(CCM)评价肌萎缩侧索硬化症患者小纤维病变情况及其诊断价值。方法肌萎缩侧索硬化症患者57例, 为2015年6月至2016年2月北京大学第三医院神经内科门诊和住院患者, 男性37例、女性20例, 年龄24～80(52±11)岁。健康对照组30名, 男性21名、女性9名, 年龄23～76(55±13)岁。采用CCM量化分析角膜神经纤维的角膜神经纤维长度(NFL), 神经分支密度(NBD), 神经纤维密度(NFD), 神经纤维弯曲度(NFT), 并同时进行接触性热痛诱发电位(CHEP), 皮肤交感反射(SSR)等检查。计量资料用xˉ±s或M(Q₁, Q₃)表示;计量资料符合正态分布者组间比较用t检验, 偏态分布计量资料可用秩和检验等非参数检验, 计数资料分析用χ2检验。多因素计量资料相关分析用简单相关分析。所有统计分析采用SPSS 12.0软件处理。结果肌萎缩侧索硬化症组角膜NFL、NFD均显著低于健康对照组[(12.2±4.4)mm/mm2比(15.1±4.5)mm/mm2, P=0.028;(50.8±24.0)个/mm...     

Relationships among sexual behavior,hot flashes,and hormone levels in perimenopausal women

Forty-three perimenopausal women kept daily records of menstrual cycles and sexual activity. Data on hot flashes and plasma estradiol and testosterone levels were obtained at two points during the menopausal transition. The prospective data yielded a significant negative association between hot flash ratings and regularity of sexual intercourse at both time points. A significant negative correlation was found between estradiol (in the early part of the cycle) and hot flashes ratings at the first data point only, and positive correlations were found between hot flashes and ratio of testosterone to estradiol (T/E) at both. Frequency of sexual intercourse and level of plasma estradiol were higher, and T/E and hot flash ratings were lower in early perimenopausal women who were still having cycles at least once every 30 days, as compared with late perimenopausal women who were cycling less often. It was concluded that a close association exists between increasing irregularity of menstrual cycles, hot flashes, declining estradiol levels, and declining frequency of intercourse during the perimenopause. Causal relationships remain to be established.Supported by NIH Grant AG1437.     

手部热压伤后临床治疗

目的 总结38例手部热压伤创面治疗方法选择的临床体会.方法 对38例手部热压伤患者,根据临床伤情特点使用相应的治疗方法.结果 33例皮瓣手部功能完全或部分恢复,5例无功能.结论 根据不同外伤程度、部位,选择适当的治疗方法是手部热压伤治疗的关键.适合的治疗可以确保手部最大程度的功能恢复.