奇经理论的历代研究与发挥

奇经理论最早见载于《内经》,但内容古朴零散,并未冠以奇经之名,也未能形成全面系统的理论;《难经》首创"奇经"之名,并经丰富和创造性的发挥,建立了奇经理论体系;后世医家不断深化对奇经理论的研究,探索奇经临床应用的原则和方法,发挥其要旨大义,使奇经理论得以不断充实和完善。晋隋唐时期是奇经理论的整理充实阶段;宋金元时期是奇经理论的应用发挥阶段;明清时期是奇经理论的繁盛突破阶段;近现代是奇经理论的深化研究阶段。     

白虎汤加减灌肠对温病气分热证家兔内毒素清除作用研究

目的：研究白虎汤加减灌肠对家兔温病气分热证模型内毒素清除作用的效果。方法：采用内毒素静脉注射的方法制作温病气分热证动物模型,观察白虎汤加减灌肠对温病气分热证家兔内毒素清除作用,并与白虎汤腹腔注射组、非那根注射组对照观察。结果：腹腔注射组与模型组相比,有显著差异（P=0．035）,白虎汤灌肠组与其他各组相比,有显著差异（P-0.000）。白虎汤加减灌肠对温病气分热证内毒素有强大的清除作用。结论：白虎汤加减灌肠能够有效地治疗温病气分热证内毒素血症。     

Association of the methylenetetrahydrofolate reductase (MTHFR) gene variant C677T with serum homocysteine levels and the severity of ischaemic stroke: a case–control study in the southwest of China

ObjectiveTo determine whether the methylenetetrahydrofolate reductase (MTHFR) C677T gene polymorphism is linked to the risk of ischaemic stroke and circulating homocysteine (Hcy) levels in a Chinese population.MethodsThis case–control study recruited angiogram-diagnosed patients with ischaemic stroke and healthy control subjects. The plasma Hcy concentrations were measured and the MTHFR C677T gene polymorphism was genotyped. The National Institutes of Health Stroke Scale (NIHSS) was used to assess the severity of the ischaemic stroke.ResultsThis study recruited 198 patients with ischaemic stroke and 168 controls. The TT genotype conferred a higher risk for ischaemic stroke than the CC genotype (odds ratio of 3.563; 95% confidence interval [CI] 1.412, 4.350). The T allele was the predisposing allele for ischaemic stroke. Hcy had an area under the receiver operating characteristic (ROC) curve of 0.624 (95% CI 0.530, 0.758). The ROC for Hcy demonstrated its usefulness in predicting ischaemic stroke. Hcy levels were not associated with ischaemic stroke severity as measured by the NIHSS.ConclusionThe MTHFR C677T gene polymorphism affects circulating Hcy levels. The MTHFR C677T gene polymorphism and hyperhomocysteinaemia may play important roles in predicting the risk of ischaemic stroke.     

A comparative study of a nerve block therapy with and without a deeply inserted acupotomy applied to hyeopcheok points for lumbosacral radiculopathy: Safety,effectiveness, cost-effectiveness (a randomized controlled,two-arm,parallel study,pilot study,assessor-blind)

Introduction:The prevalence of lumbosacral radiculopathy is estimated to be approximately 3% to 5% in patient populations. Lumbosacral radiculopathy is largely caused by a complex interaction between biomechanical and biochemical factors. Nerve block therapy (NBT) mainly treats lumbosacral radiculopathy by improving the biochemical factors, whereas acupotomy mainly focuses on improving the biomechanical factors. Therefore, it is thought that synergistic effects may be obtained for the treatment of lumbosacral radiculopathy when both NBT and acupotomy are combined. However, no study in China and Korea, where acupotomy is majorly provided, has reported the effects of such a combination treatment. Therefore, this study aimed to evaluate the safety, effectiveness, and cost-effectiveness of the concurrent use of a deeply inserted acupotomy and NBT for the treatment of lumbosacral radiculopathy.Methods/design:This is an open-label, parallel, assessor-blinded, randomized controlled trial, which will include 50 patients with lumbosacral radiculopathy. After patients voluntarily agree to participate in the study, they will be screened, and will undergo necessary examinations and tests according to the protocol. Those who satisfy the selection criteria will be randomly assigned to either the NBT + acupotomy or NBT groups in a 1:1 ratio. Both groups will undergo 2 NBTs once every 2 weeks from 1 week after the screening test. The treatment group will receive additional acupotomy twice a week for 4 weeks. The primary endpoint is the Oswestry Disability Index, whereas the secondary endpoints are the Numeral Rating Scale, European Quality of Life 5-dimension, McGill pain Questionnaire, Roland-Morris Disability Questionnaire, safety assessment, and economic feasibility evaluation. The measurements will be made at 0, 2, 4, and 8 weeks.Ethics and dissemination:This trial has received complete ethical approval from the Ethics Committee of Catholic Kwandong University International St. Mary''s Hospital (IS20OISE0085). We intend to submit the results of the trial to a peer-reviewed journal and/or conferences.     

The “self‐treatment of wounds for venous leg ulcers checklist” (STOW‐V Checklist V1.0): Part 2—The reliability of the Checklist

The “Self‐Treatment of Wounds for Venous Leg Ulcers Checklist” (STOW‐V Checklist V1.0) is an evidence‐based, standardised tool designed to assist nurses to appraise the conduct of wound treatment when undertaken by patients who have venous leg ulcers. A prospective reliability study was conducted to determine the reliability of the STOW‐V Checklist V1.0. Video‐recordings of patients who self‐treated their leg ulcer were obtained (n = 5) and nurses (n = 15) viewed each video‐recording three times and concurrently completed the Checklist. Internal consistency, inter‐rater reliability and intra‐rater reliability were evaluated. Cronbach''s alpha for items in the Checklist was 0.792, 0.791 and 0.783 for Occasions 1, 2 and 3, respectively, indicating good reliability. Inter‐rater reliability was 0.938, 0.958 and 0.927 for Occasions 1, 2 and 3, respectively; these results were statistically significant and indicative of excellent reliability. Intra‐rater reliability was 0.403 to 0.999; these results were statistically significant and meeting or exceed adequacy in the case of all except two raters. The study provides preliminary evidence that the Checklist is measuring the concepts that it intends to measure and that there is a high level of agreement among raters. It is recommended that the STOW‐V Checklist V1.0 is utilised with patients in a shared‐care model, with nurses and other healthcare professionals providing supervision and oversight of self‐treatment practices whenever this is feasible and acceptable to the patient.     

降钙素原半定量和定量法检测的比较研究

目的比较半定量和定量法检测血清降钙素原水平的差异。方法选取2011年6月至2012年6月中国人民解放军第三○二医院送检的全身性炎症反应患者的血液样本100份,分别采用半定量和定量法进行检测,比较两种方法所得结果的差异。结果定量检测法与半定量检测法比较,差异有统计学意义(P<0.05)。结论两种检测方法对临床诊断均具有积极意义,对于结果准确度要求不高的样本可采用半定量检测方法。     

帕罗西汀与联用丁螺环酮对抑郁症患者性功能康复的对比研究

目的:观察并探讨帕罗西汀联合丁螺环酮对抑郁症患者性功能的变化情况。方法:选取2015年6月至2016年6月于我院进行治疗的100例抑郁症男性患者为研究对象,将其随机分为治疗组和对照组,每组各50例,对照组采用帕罗西汀治疗(帕罗西汀20mg/d),治疗组帕罗西汀与丁螺环酮联合用药(帕罗西汀20mg/d,丁螺环酮30mg/d),疗程2个月,治疗前后以汉密顿抑郁量表(HAMD)和亚利桑那性经验量表(ASEX)评价疗效,并且比较治疗前后孕酮(PROG)、雌二醇(E2)、睾酮(T)、黄体生成素(LH)、促卵泡激素(FSH)、催乳素(PRL)水平的变化情况,并对尿常规,肝、肾功能,心电图及血糖检测,随时记录不良反应,将两组患者的临床效果进行统计及分析。结果:治疗组的临床疗效和性功能改善情况均优于对照组,两者之间具有显著性差异(P0.05);且两组均没有严重的不良反应发生。结论:帕罗西汀联合丁螺环酮治疗抑郁症患者性功能障碍疗效显著,且不良反应较小,值得临床推广应用。