康复护理联合心理干预及康复功能训练治疗大面积烧伤患者的效果观察

目的:观察康复护理联合心理干预及康复功能训练对大面积烧伤患者的疗效。方法:选择我院69例大面积烧伤患者,随机分为2组,对照组34例采用常规护理,观察组35例采用常规康复护理联合心理干预及康复功能训练,入组时、出院3个月后采用Zung焦虑(SAS)、抑郁(SDS)自评量表评价患者心理状态,出院3个月后采用烧伤健康专用量表(BSHS-A)评价患者的生活质量,比较2组康复效果。结果:出院3个月后,观察组SAS、SDS评分明显低于入组时及对照组(P 0. 05),对照组治疗前后比较差异无统计学意义,治疗后,观察组疤痕增生程度明显低于对照组(P 0. 05),观察组心理功能、躯体功能、社会关系和一般健康状况评分均高于对照组(P 0. 05)。结论:康复护理联合心理干预及康复功能训练可明显改善大面积烧伤患者的心理状态,提高患者的康复效果和生活质量。     

大角度外斜视手术方法的对比分析

目的探讨大角度外斜视行外直肌悬吊后徙术与外直肌超常量后徙术的比较,观察手术效果。方法两组病例共42例,手术前后均采用角膜映光法、三棱镜遮盖试验测定眼位。一组实施外直肌悬吊后徙术,另一组则行外直肌超常量后徙术。结果两组术前斜视角大小无显著性差异。术后眼位:外直肌悬吊后徙组≤±10~Δ18例,正位率85.71%;外直肌超常量后徙组≤±10~Δ19例,正位率90.48%,两组正位率比较差异无显著性。结论采用外直肌悬吊后徙术矫正大角度外斜视,既可以达到外直肌超常量后徙术的效果,又降低了巩膜意外损伤的危险,具有合理、实用、安全、简便等特点。     

Expansion techniques after Mohs' surgery on the face

Mohs' surgery in the face has established itself as the optimal technique for a high cure rate of basal cell and squamous cell carcinoma occurring in the skin of the face. However, after the resection in Mohs' surgery, the defects, when extensive, require careful, planned reconstruction in order to produce a good cosmetic result. Although flap reconstruction is available for smaller lesions, larger defects can be covered often by expansion techniques. The expansion technique involves placing a silastic expander of various size and designs underneath the adjacent skin and, over a period of weeks, injecting saline into the expander in order to increase the amount of skin available for future flap reconstruction. This usually represents a two-stage procedure consisting of the insertion of the expander and, some weeks later, removal of the filled expander when there is sufficient tissue, and using this tissue to reconstruct the initial Mohs' defect by a flap. When defects are greater than half the aesthetic unit of the face, or greater than one-third in the forehead, or over 6 cm in the scalp, expansion techniques should be considered for reconstruction.     

从“肺肠合病”模型大鼠血清TNF-α、IL-1含量变化探讨“肺与大肠相表里”

目的:建立肺病、肠病、肺肠合病大鼠病理模型,通过观察其血清TNF-αI、L-1含量情况,探索肺与大肠相表里相关病理机制。方法:实验设正常对照组、肺病组(过敏性哮喘)、肠病组(便秘)和肺肠合病组(过敏性哮喘合便秘)共4组。结果:与正常对照组比较,肺病组、肠病组、肺肠合病组大鼠血清TNF-αI、L-1含量均呈显著性差异(P<0.01);与肺病组比较,肺肠合病组大鼠血清TNF-αI、L-1含量呈显著性差异(P<0.01);与肠病组比较,肺肠合病组大鼠血清TNF-αI、L-1含量呈显著性差异(P<0.01)。结论:肺肠合病组大鼠血清TNF-αI、L-1含量均明显高于肺病组及肠病组,证实TNF-αI、L-1可能是肺与大肠相关的共同物质基础,为肺与大肠相表里理论提供一定的现代医学实验依据。     

中药内服加灌肠治疗慢性溃疡性结肠炎31例临床观察

目的 观察中药内服配合灌肠治疗慢性溃疡性结肠炎(UC)大肠湿热证的临床疗效.方法 64例UC患者随机分为治疗组31例,给予中药汤剂内服并配合灌肠治疗;对照组33例,给予口服美沙拉嗪每次1g,每日4次.连续治疗8周后评价临床疗效、中医证候疗效、主要症状评分及肠黏膜评分,观察不良反应. 结果 治疗组临床疗效、证候疗效总有效率均为87.1％,对照组均为75.8％,两组比较差异均有统计学意义(P＜0.05).两组患者治疗后腹痛、腹泻、脓血便症状积分均明显降低(P＜0.05),并且治疗组治疗后腹痛、腹泻积分明显低于对照组(P＜0.05);治疗后治疗组肠黏膜积分改善优于对照组(P＜0.05).结论 中药内服配合灌肠治疗UC大肠湿热证疗效肯定,能明显改善临床症状,且无明显不良反应.     

172例慢性乙肝患者血清乙肝病毒外膜大蛋白检测结果分析

目的：探讨乙肝患者血清中乙型肝炎病毒大蛋白（LHBs）检测的意义。方法：收集172例患者HBsAg阳性血清,应用ELISA方法检测LHBs、实时荧光法检测乙型肝炎病毒DNA,对相同乙型肝炎标志物模式血清LHBs阳性率与乙型肝炎病毒DNA阳性率结果进行分析。结果：相同乙型肝炎标志物模式血清LHBs阳性率与乙型肝炎病毒DNA阳性率差异无显著性（均P〉0.05）。结论：LHBs和乙型肝炎病毒DNA的检出具有一致性,能够反映患者体内病毒复制情况,对诊断有较好的应用价值。     

原发骨髓弥漫大B细胞淋巴瘤1例报告及文献复习

目的：分析1例原发骨髓弥漫大B细胞淋巴瘤（DLBCL）的诊断和治疗情况为该病的诊治提供参考。方法：结合本例患者病史及其他辅助检查结果,高度怀疑为原发骨髓淋巴瘤（PBML）。经骨髓病理检查及免疫组织化学染色确诊为DLBCL,并给予化疗。结果：本例患者符合PBML诊断标准,根据骨髓免疫组织化学染色结果将其划分至DLBCL亚型。患者接受利妥昔单抗+环磷酰胺、表柔比星、长春新碱及泼尼松（R-CHOP）方案化疗1个周期后达骨髓细胞形态学完全缓解,又行该方案化疗5个周期,现停药随访3个月仍为完全缓解。结论：骨髓病理及免疫组织化学染色对原发骨髓DLBCL具有重要的诊断价值,含利妥昔单抗的化疗方案近期疗效理想。     

基于“肺与大肠相表里”探索肺肠的共振机制

本文通对"肺与大肠相表里"相关古代文献的梳理、观察,并应用现代计算机数据挖掘手段,对所收集的肺肠合病的相关古代临床文献进行挖掘。对其中的病位、症状之间的关联进行分析。得出肺与大肠在生理和病理信息的表达上存在共振现象。并且这种共振现象是由其他脏腑共同参与作用。其中又与脾、肝关系最为密切。提示临床在肺肠合病的辨证时,应注重其他脏腑的影响。     

Standardized flavonoid-rich fraction of Artemisia princeps Pampanini cv. Sajabal induces apoptosis via mitochondrial pathway in human cervical cancer HeLa cells

Ethnopharmacological relevance

Artemisia princeps Pampanini is widely used in Eastern traditional medicine for the treatment of circulatory disorders, such as, dysmenorrhea, hematuria, hemorrhoids, and inflammation, and is also used to treat chronic conditions, such as, cancers, ulcers, and digestive disorders.

Aim of the study

The purpose of this study is to investigate the effect of a standardized flavonoid-rich fraction of Artemisia princeps Pampanini cv. Sajabal (FRAP) on the induction of apoptosis and the molecular mechanism involved in human cervical cancer HeLa cells.

Materials and methods

Human cervical cancer HeLa cells were treated with FRAP and apoptosis was detected by cell morphologic observation, annexin-V-PI staning and western blot analysis on the expression of protein associated with cell death.

Results

FRAP led to the cleavages of caspase-3, -8, and -9 and the cleavage of poly (ADP-ribose) polymerase (PARP) in HeLa cells. Caspase-3 inhibitor (z-DEVD-fmk), caspase-8 inhibitor (z-IETD-fmk), caspase-9 inhibitor (z-LEHD), and broad caspase inhibitor (z-VAD-fmk) significantly suppressed the FRAP-induced accumulation of annexin V positive cells. Furthermore, it was found that FRAP caused a loss of mitochondrial membrane potential (MMP) and the release of cytochrome c to the cytosol. Furthermore, the overexpression of Bcl-xL significantly prevented FRAP-induced apoptosis, MMP changes, and the activations of caspase-3, -8, and -9. Interestingly, pretreatment with caspase-8 inhibitor significantly reduced the FRAP-induced activation of caspase-3 but not that of caspase-9, whereas the caspase-3 inhibitor, z-DEVD-fmk, markedly attenuated the FRAP-induced activation of caspase-8. In BALB/c^nu/nu mice bearing a HeLa xenograft, FRAP dosed at 25 or 50 mg/kg significantly inhibited tumor growth.

Conclusion

Our results indicate caspase-mediated activation of the mitochondrial death pathway plays a critical role in the FRAP-induced apoptosis of HeLa cells and that FRAP inhibits the in vivo tumor growth of HeLa xenograft mice.