承山穴按压联合针灸治疗急性腰扭伤

目的 观察承山穴按压联合针灸治疗急性腰扭伤的临床疗效.方法 选取收治的急性腰扭伤患者100例,随机分为观察组与对照组,各50例,观察组采用承山穴按压联合针刺眉间3穴治疗,对照组仅采用常规针刺法治疗,对比2组治疗前及治疗1疗程后视觉模拟评分(VAS)、腰痛功能障碍评分(RDQ)、腰椎活动度(ROM)变化情况及临床疗效.结果 2组治疗后各项指标较治疗前显著改善(P＜0.05);观察组治疗后各项指标改善显著优于对照组(P＜0.05);观察组治疗总有效率为100％,对照组为86.0％(P＜0.05);且观察组1次治愈率显著高于对照组(P＜0.05).结论 承山穴按压联合针灸可有效缓解急性腰扭伤患者临床疼痛症状,改善患者活动功能,是治疗急性腰扭伤的有效治疗方案.     

《针灸逢源》耳病辨治规律探析

对《针灸逢源》中耳病相关内容进行整理分析,归纳该书耳病辨治规律。《针灸逢源》记载的耳病主要有耳聋、耳鸣、耵耳、聤耳、耳疮、耳衄,书中认为耳病由脏腑或经络异常导致,且有虚实之分。在治疗上以针灸为主,对耵耳、聤耳、耳衄还可运用中药治疗。取穴上阳经腧穴多于阴经腧穴,使用频次最多的穴位为听会穴,特定穴中五输穴使用频次较高,选穴分布以上肢部和头面颈项部为主。     

Fluid perfused urethral pressure profilometry and Valsalva leak point pressure: a comparative study in a biophysical model of the urethra

In patient studies the correlation between maximum urethral closure pressure (MUCP) and Valsalva leak point pressure (LPP) is meagre at best (r = 0.22–0.50). We therefore studied the relation between MUCP and LPP in a flexible and extensible model urethra. We applied differently sized pressure zones and different degrees of resistance to a biophysical model urethra by stepwise inflating three types of blood pressure cuff placed around the model. At each degree of resistance we measured detrusor LPP, an in vitro equivalent of Valsalva LPP. Subsequently, we recorded the Urethral Pressure Profile using a water-perfused 5F end-hole catheter at four withdrawal rates and five perfusion rates and calculated MUCP. We tested the dependence of LPP on pressure zone length and MUCP on perfusion rate, withdrawal rate and pressure zone length using analysis of variance. We tested the correlation between LPP and MUCP using Pearson’s correlation coefficient and Linear Regression. LPP did not significantly depend on the pressure zone length (P = 0.80) and increased linearly with increasing cuff pressure. MUCP also increased with increasing cuff pressure, however, MUCP significantly depended (P < 0.01) on perfusion rate, withdrawal rate and pressure zone length. MUCP increased with increasing perfusion rate, and decreased with increasing withdrawal rate. In our model urethra MUCP only accurately reflected urethral resistance for a very limited number of combinations of perfusion rate and withdrawal rate. LPP reflected urethral resistance independent of the type of pressure zone.     

The combined use of non-radioactive in situ hybridization and real-time RT-PCR to assess gene expression in cryosections

Gene expression changes in pathophysiological states can be spatiotemporally monitored by in situ hybridization and reliably quantified by real-time RT-PCR. Here we developed a new method whereby adjacent slides of frozen sections can be used for gene expression analysis by in situ hybridization and real-time RT-PCR. We applied this method to assess the mRNA expression of connexin 43 (Cx43), the major astrocytic connexin, after kainate-induced seizures in rat hippocampus. Gap junction-building connexins play a role in the pathogenesis of several diseases of the brain, including epilepsy. The number of Cx43 mRNA-positive cells in the hippocampus of kainate-treated and control rats was automatically quantified by computerized image analysis of brain sections hybridized with DIG-labeled RNA probes. In parallel, real-time RT-PCR was used to examine the relative Cx43 mRNA levels in hippocampal tissue from adjacent brain sections. Applying these two very sensitive methods we showed that kainate induced seizures do not affect hippocampal connexin 43 mRNA expression.     

电针足三里穴对致死性失血性休克延迟补液大鼠生存率和脏器功能指标的影响

目的:研究电针足三里穴对致死性失血性休克延迟补液大鼠生存率和脏器功能指标的影响,探讨其对液体复苏疗法的替代作用.方法:36只SD雄性大鼠,体重(270±20)g,按全血容量的45%放血制成致死性失血性休克模型.随机分为3组:即刻补液组、非经非穴+延迟补液组和足三里+延迟补液组,每组12只.即刻补液组于失血后10 min...     

Transobturator slings for stress incontinence: using urodynamic parameters to predict outcomes

The purpose of this study is to evaluate the ability of preoperative urodynamic urethral function parameters to predict the success rate of transobturator slings (TOS). Seventy women urodynamically diagnosed with stress incontinence with urethral hypermobility underwent a Monarc™ TOS (American Medical Systems, Minnetonka, USA). Postoperative continence status was correlated with preoperative urodynamic urethral function parameters. Mathematical modeling was used to determine whether urodynamic parameters can be used to predict postoperative continence. Average follow-up was 8.1 (6–12) months; 56 (80%) patients were continent based on a standardized stress test and subjective report. The median Valsalva leak point pressure at 150 cc (VLPP₁₅₀) in the failures and successes was not different (p = 0.12). The median VLPP at cystometric capacity (VLPP_cap) in the failures was 32 cmH₂O compared to 71 cmH₂O in the successes (p < 0.001). The maximum urethral closure pressure (MUCP) had a median of 20 cmH₂O in the failures and 45 cmH₂O in the successful patients (p < 0.001). No correlation existed between the degree of urethral hypermobility, as measured by the cotton swab test, and surgical success (p = 0.17). There was no correlation between level of preoperative urethral function and persistent overactive bladder symptoms, post-void residual, voids/day, and nocturia. Using a combined model, the cutoff values of VLPP_cap > 60 cmH₂O and MUCP > 40 cmH₂O were the most predictive of surgical success, revealing a sensitivity of 83% (0.55, 0.95) and specificity of 79% (0.67, 0.88). A combination of urodynamic parameters can be used to predict continence rates after a TOS. A TOS should be used with caution in women with impaired urethral function. G. Willy Davila is a consultant to American Medical Systems.     

虚拟现实互动技术在交叉韧带等长重建计算机辅助设计中的应用

目的 利用虚拟现实技术还原膝关节骨性结构在屈伸运动过程中的三维空间形态，为观测膝关节面交叉韧带附丽区的相对位置变化和进一步研究前、后交叉韧带等长重建最佳等长点提供计算机辅助设计新方法。方法 采用实验与计算机仿真相结合的方法，对新鲜人体膝关节标本进行屈伸运动实验，并通过激光三维扫描方法记录、计算膝关节的空间活动指标，然后重建膝关节计算机三维模型。通过实验中的空间活动指标控制此模型虚拟运动，再现膝关节各屈伸角度下股骨、胫骨和腓骨的空间位置。结果 计算机还原出各运动角度下膝关节骨性结构（股骨、胫骨及关节面）的空间形态，利用软件Geomagic的几何计算功能可分别测量模型中各个运动状态交叉韧带附丽区两点间的三维空间距离。讨论本研究方法可以真实地记录和再现膝关节三维运动过程，从空间结构上更精确、合理地寻找重建等长点，对膝关节交叉韧带手术重建有重要临床意义。     

脊柱结核临床治疗要点回顾分析

目的 探讨脊柱结核临床治疗的要点。方法 回顾性分析2001-01-2010-01,我科收治的脊柱结核并脊髓损伤患者105例。化疗后3-4周手术,采用一期前路病灶清除、植骨、内固定手术治疗,术后严格强化四联抗结核治疗,术后3个月改三联化疗9-15个月。神经功能障碍改善情况采用ASIA神经功能评价,对其神经功能恢复、病灶愈合及内固定情况等进行分析研究。结果 1例术后3月后因结核性脑膜炎医治无效死亡。1例术后4月出现臀部脓肿复发,原发病灶未复发,再次手术清除后治愈。所有患者获随访4-12年,平均7.8年。脊柱病灶无复发。血沉均恢复正常,随访末期X线片均获骨性融合。结论 脊柱结核临床治疗要点应在标准化疗基础上尽早手术,一期病灶清除、植骨、内固定治疗,效果满意。     

肛裂术后复方丹参注射液长强穴封闭促进创面愈合的观察

为探寻肛裂术后复方丹参注射液长强穴封闭对创面愈合的临床疗效,研究其作用机理。将60例肛裂患者随机分为治疗组和对照组,治疗组30例在肛裂术后每日换药时给予复方丹参注射液2ml长强穴封闭。对照组30例单纯换药。结果显示,术后第14天,总有效率治疗组与对照组分别为100％和86．7％,术后第21天总有效率分别为100％、90％。结果表明,将复方丹参注射液封闭于长强穴中能明显缩短肛裂术后创面愈合时间,且无明显不良反应。     

耳穴贴压法改善大肠癌术后化疗患者胃肠道反应的临床观察

为观察耳穴贴压法对改善大肠癌术后化疗患者胃肠道反应的效果,将80例大肠癌术后化疗患者随机分为治疗组和对照组,各40例,治疗组在常规治疗的基础上于化疗当天给予耳穴贴压,对照组给予常规治疗。根据NCI分级标准对80例患者化疗期间每天的恶心、呕吐、食欲分级进行记录。结果显示,治疗组恶心程度、呕吐程度、食欲下降程度明显低于对照组。结果表明,耳穴贴压法能明显降低大肠癌术后化疗患者的恶心、呕吐、食欲下降程度,疗效满意。