老年人日常生活能力调查分析

目的 调查老年人日常生活能力(ADL)状况，分析其影响因素。方法 采用日常生活能力(ADL)量表，对500名60岁以上老年人进行ADL调查，分析年龄、性别、常见慢性病对老年人ADL的影咱。结果 ADL功能依赖发生率60—69岁组为6．4％，70—79岁组为15．4％，80岁以上组为28．6％。对老年人ADL影响最甚的疾病为脑卒中、痴呆综合征。结论 脑卒中、痴呆综合征是影咱老年人ADL的严重疾病，亟待引起重视，应加强这类疾病的综合防治，以提高老年人的生活质量。     

不同治疗时间的脉冲电磁场对去势大鼠股骨生物力学性能的影响

目的通过采用不同治疗时间的脉冲电磁场（PEMFs）干预去势大鼠骨质疏松模型，观察各组大鼠的股骨生物力学性能的变化，以探索PEMFs治疗骨质疏松的最适治疗时间。方法按随机分组原则用密闭信封法将雌性3个月龄SD大鼠50只分为5组：假手术对照组10只，卵巢切除对照组10只，卵巢切除Ⅰ组10只，卵巢切除Ⅱ组10只，卵巢切除Ⅲ组10只。除假手术对照组以外，对所有动物按文献方法去势造模。卵巢切除Ⅰ组、卵巢切除Ⅱ组和卵巢切除Ⅲ组大鼠每天在强度为3．8mT，频率为8Hz的电磁场环境中分别照射20，40，60min，共30d。假手术对照组和卵巢切除对照组不干预。各组动物均在满30d后，行股动脉放血处死，取右侧股骨作生物力学性能测定。结果卵巢切除对照组大鼠的股骨结构力学指标（包括最大位移、最大载荷及最大能量吸收）和材料力学指标（包括最大应力、最大应变及弹性模量）显著低于其它4组大鼠（P〈0．05或P〈0．01），而假手术对照组、卵巢切除Ⅰ组、卵巢切除Ⅱ组及卵巢切除Ⅲ组4组大鼠的股骨生物力学指标之间的差异无统计学意义（P〉0．05）。结论PEMFs能阻止大鼠在卵巢切除后的股骨生物力学性能下降，对去势大鼠的骨质疏松症有肯定的预防作用。在磁场强度（3．8mT）和脉冲频率（8Hz）相同的前提下3种治疗时间的PEMFs均能使卵巢切除大鼠股骨生物力学性能维持在接近正常的水平，但3种治疗时间之间的差异无统计学意义，说明每日用PEMFs对去势大鼠治疗20—60min，对其骨生物力学性能的维持效果相同。     

基于LF-NMR/MRI的维C银翘片制粒中润湿剂评价方法研究

目的应用低场核磁共振时域技术(low field nuclear magnetic resonance time domain technique,LF-NMR)、低场核磁成像技术(low field nuclear magnetic resonance imaging,LF-MRI)对高剪切制粒中润湿剂(乙醇)进行定性、定量分析。方法以维C银翘片高剪切湿法制粒为研究对象,采用LF-NMR建立润湿剂用量测定方法,结合横向弛豫时间(T2)和LFMRI测得的二位影像图对润湿剂分布与变化进行定性分析,探讨峰面积(A₂)与颗粒得率的关系。结果润湿剂用量与A₂呈现良好的相关性(R²=0.9575)。随着润湿剂用量增加,T2向右移动,A₂逐渐增加,质子在增加;LF-MRI表明随着润湿剂用量增加,影像图逐渐清晰,即非结合态质子(束缚态质子及自由态质子)在颗粒中逐渐增加。当润湿剂用量增加至20%~25%时,结合态质子含量不再增加,此时颗粒得率最高。结论LF-NMR和LF-MRI能快速、准确检测制粒中润湿剂用量变化和分布状态,为阐明润湿剂对颗粒性质的影响和成型机制提供评价方法。     

“因时制宜”对针灸临床诊疗思维的指导意义

"因时制宜"作为针灸治疗的关键原则之一,针灸临床中应充分理解"时"的内涵,把握四时、昼夜作用于人体而呈现出的生理、病理上的时间性规律,基于气血阴阳的变化规律及邪正盛衰的进退规律,抓住时机、适时干预。将腧穴的动态性规律与病机病位的变化规律相结合,精准取穴、施术、起针;将时间因素贯穿针灸临床诊疗的全过程,为临证分析和临床实践提供一定的指导。     

电针联合生化汤加减治疗药物流产不全临床研究

目的:研究电针联合生化汤加减治疗药物流产不全的临床效果。方法:选取81例早孕后药物流产确诊为药物流产不全的患者,按信封随机法分为三组,生化汤组27例、电针组27例、针药组27例,分别给予生化汤、电针治疗及生化汤结合电针联合治疗。三组患者均在治疗后7 d复查B超,随访至下次月经来潮,观察三组患者流产不全的临床疗效,阴道出血时间,转经时间及痊愈时间等,并随访至各组患者月经来潮。结果:经治疗,①针药组总有效率(96.3%)及治愈率(74.1%)和生化汤组(77.8%,44.5%)、电针组(81.4%,48.1%)比较,差异均有统计学意义(P<0.05); ②针药组和生化汤组、电针组比较,阴道出血量减少,阴道出血时间缩短,差异均有统计学意义(P<0.05); 生化汤组与电针组比较,差异无统计学意义(P>0.05),三组转经时间比较均无统计学意义(P>0.05)。③针药组平均痊愈时间和生化汤组、电针组比较明显缩短,差异均有统计学意义(P<0.05)。④针药组和生化汤组、电针组比较,并发症发生率明显降低,差异有统计学意义(P<0.05)。结论:电针联合生化汤加减治疗药物流产不全可减少阴道出血时间,缩短药物流产不全的治疗疗程。     

Variable hemodynamic response to sodium nitroprusside in hypertensive crisis

Five patients, three males and two females, admitted with severe hypertensive crisis underwent hemodynamic investigations before and during vasodilator therapy with sodium nitroprusside. In three hypervolemic patients with congestive heart failure and/or renal insufficiency, the drug induced a rapid fall in systemic arterial pressure and a beneficial effect on cardiac performance, as shown by a shift of the ventricular function curves to the left. In two hypovolemic patients, the hemodynamic response was quite different; vasodilator therapy induced a confusing clinical picture characterized by significant fluctuations in blood pressure, a severe fall in cardiac output and clinical signs of shock in spite of normal blood pressure. Hemodynamic response to vasodilator therapy with sodium nitroprusside in hypertensive crisis appears to be directly related to the circulating blood volume. The syndrome of hypertension associated with hypovolemia needs to be recognized promptly in order to avoid inappropriate therapyl; in such cases volume expansion under precise hemodynamic monitoring appears to be an effective means of stabilizing the cardiocirculatory conditions.     

便秘主导型肠易激综合征患者结、直肠肛门动力学的临床研究--附50例检测分析

目的:研究便秘主导型肠易激综合征患者的结肠、直肠动力和直肠感觉功能.方法:用不透X线法的结肠传输试验检测50例便秘主导型肠易激综合征(constipation predominant irritable bowel syndrom,C-IBS)患者及42名正常受试者(对照组)的结肠传输时间(colonic transit time,CTT)和结肠传输指数(transit index,TI),并用结肠传输指数分型;同时用肛门直肠测压方法测定C-IBS患者和对照组的肛门直肠压力、直肠感觉阈值和直肠顺应性.结果:C-IBS患者的全结肠及各节段结肠传输时间均高于对照组,C-IBS患者的肛管静息压、直肠静息压与对照组比较差异均无统计学意义(P＞0.05),肛门括约肌最大收缩压低于对照组,最大耐受容量及直肠顺应性均明显高于对照组(P＜0.01),且发现不同传输类型的C-IBS患者的肛门直肠测压的结果不尽相同.结论:C-IBS患者存在结肠、肛门直肠动力及直肠感觉功能异常,结肠传输试验与肛门直肠测压相结合,更有助于明确便秘的类型.     

Diastolic function in neonates after the arterial switch operation: effects of positive pressure ventilation and inspiratory time

Received: 27 July 1999/Final revision received: 21 January 2000/Accepted: 26 January 2000     

经典名方中茯苓的本草考证

通过查阅历代本草、医籍等古代资料,结合中国知网、万方等数据库收录的现代文献,对《古代经典名方目录（第一批）》中方剂涉及的茯苓药材的基原、产地与品质、采收期、加工炮制方法、栽培技术等方面进行全面梳理与考证,为包含茯苓药材的经典名方品种开发与研究提供参考。经考证可知,古代茯苓入药的基原应为多孔菌科茯苓Poria cocos的干燥菌核。其产地在我国分布广泛,主产于安徽、湖北、河南、云南,以云南所产品质较佳,安徽、湖北产量较大。茯苓古今品质评价结论基本一致,均以块大、质重、皮薄多皱、断面白色细腻者为佳。采收期多为阴历八月,初加工经历古代阴干到现代“发汗”后阴干的演变;茯苓从古至今炮制方法主要为切制,可将其加工成“茯苓块”和“茯苓片”。栽培技术经历了“野生茯苓-活体松根接种-段木接种”的演化过程,目前茯苓主要以人工段木栽培为主,技术方法成熟、产量丰富,可以满足经典名方的研发需求。     

Development of a novel quantitative real‐time PCR assay with lyophilized powder reagent to detect African swine fever virus in blood samples of domestic pigs in China

African swine fever (ASF) is a devastating disease, which is causing huge economic losses in China. Therefore, it is urgent to provide a rapid, highly specific and sensitive diagnostic method for the detection of African swine fever virus (ASFV), the ASF infectious agent. In this study, a novel quantitative real‐time polymerase chain reaction (qPCR) assay with lyophilized powder reagents (LPR), targeting the major structural protein p72 gene, was established for the detection of ASFV. This assay had many advantages, such as saving time and money, good sensitivity and repeatability. The sensitivity of this assay was 100 copies/μl of ASFV plasmid templates, and the assay showed 10‐fold greater sensitivity than a qPCR assay recommended by OIE. Furthermore, specificity analysis showed that qPCR with LPR for ASFV had no cross‐reactivity with other important swine pathogens. In clinical diagnoses of 218 blood samples of domestic pigs in China, the positive rate of the diagnosis of ASFV by qPCR with the LPR and commercial kit reached 80.73% (176/218) and 76.61% (167/218) respectively. The coincidence rate between the two assays is 92.20% (201/218), and kappa value is 0.768 (p < .0001) by SPSS analysis. The overall agreement between the two assays was 95.87% (209/218). Further Pearson correlation and linear regression analysis showed a significant correlation between the two assays with an R² value of 0.9438. The entire procedure, from specimen processing to result reporting, can be completed within 2 hr. Our results demonstrated that the qPCR‐LPR assay is a good laboratory diagnostic tool for sensitive and efficient detection of ASFV.