Diagnosis and Management of Bell’s Palsy in Primary Care

Bell’s palsy is characterized by rapid, unilateral paralysis of cranial nerve VII and is the most common cause of acute facial paralysis, although the pathogenesis of the condition is poorly understood. Bell’s palsy can be managed by the nurse practitioner in primary care, and the majority of clients achieve full recovery. Appropriate diagnosis through history and physical examination to exclude other causes allows for timely diagnosis, intervention, and patient reassurance. Pharmacologic and adjunctive treatment is available to shorten the duration and improve symptoms. Nurse practitioners should be able to identify circumstances in which referral to a specialist for intervention and follow-up may be appropriate.     

Prognostic value of the blink reflex test in Bell’s palsy and Ramsay-Hunt syndrome

Objective

This study was designed to evaluate the prognostic value of the blink reflex (BR) test in patients with Bell’s palsy (BP) or Ramsay Hunt syndrome (RHS).

针药结合治疗贝尔麻痹30例

[目的]观察针刺和西药结合在贝尔麻痹治疗中的疗效。[方法]将60例贝尔麻痹患者随机分为两组,对照组给予贝尔麻痹的西医常规治疗,治疗组在对照组的治疗基础上加针刺治疗,疗程为4周。[结果]治疗组总有效率93.33%,对照组总有效率70.00%,差异有显著性(χ~2=5.46,P<0.05)。[结论]针药结合治疗贝尔麻痹具有较好的疗效有效提高治愈率,降低病残率。     

Molecular characterization of Korean Pepper mottle virus isolates and its relationship to symptom variations

The symptom variations among Korean Pepper mottle virus (PepMoV) isolates infecting pepper, tomato and potato were described and the cause of variations in relation to molecular variability were investigated. In addition, the entire genome of the 13 PepMoV isolates, collected from five provinces (Kyonggi, Chungnam, Gyeongnam, Jeonbuk and Jeonnam) in Korea, were determined and compared including the previously reported Korean-Vb isolate and 2 other PepMoV isolates isolated from America (CA and FL). Our results showed that the nucleotide sequence of all Korean isolates tested were nearly identical (98–99%) and only 94% similar to American isolates. In general, the complete nucleotide sequences and deduced polyprotein sequences indicated low genetic variation among isolates showing 0.1–3% nucleotide changes per site. However, based on ratio between nucleotide diversity values in nonsynonymous and synonymous position (dN/dS ratio) surprisingly, P1 and 6K2 genes showed relatively high nucleotide substitution ratio (0.8 and 1.0 nucleotide, respectively). When the 6K2 amino acid were aligned, there were 15 amino acid substitutions found in PepMoV-infected potato and only 1 amino acid change from two isolates of PepMoV-infected bell pepper. Interestingly, three isolates including isolate numbers 731, 205135 and 205136 that possessed different aa changes at 6K2 region also showed distinct symptom differentiation in indicator hosts and cosegregated in the phylogenetic analysis. These results further proved previous studies that P1 and 6K2 genes with other proteins might have some involvement on host specificity and pathogenicity.     

五倍子配方颗粒的位点特异性PCR鉴别

目的:为保障临床用药的安全性和有效性,建立五倍子药材及其加工制品混伪、掺假特异性聚合酶链式反应(PCR)鉴定方法。方法:根据五倍子细胞色素C氧化酶亚基Ⅰ(COⅠ)基因序列设计引物,筛选出五倍子的稳定引物区间,并在区间内筛选获得五倍子的特异性单核苷酸多态性(SNP)位点,根据SNP位点设计五倍子特异性鉴别引物WBZ-F、WBZ-R,分别收集五倍子及其混伪品,建立五倍子配方颗粒特异性PCR鉴别方法并优化PCR体系,对该方法进行耐受性和适用性考察。结果:退火温度为53℃,循环36次,五倍子及其配方颗粒经PCR及凝胶电泳后,可在约138 bp处观察到单一明亮的特异性鉴别条带,伪品倍蛋蚜虫虫瘿无条带。结论:建立的特异性PCR鉴别方法可准确鉴别五倍子药材、标准汤剂冻干粉、配方颗粒中的五倍子蚜虫源性成分,也可为其他中药配方颗粒的质量标准研究提供参考。     

Hypertriacylglycerolemia in the chick: Effect of estrogen on hepatic microsomal enzymes of triacylglycerol and phospholipid synthesis

Hepatic microsomal enzymes of triacylglycerol and phospholipid synthesis were investigated in chicks made hyperlipidemic by estrogen treatment. The total activities of two liver microsomal enzymes common to the triacylglycerol and phospholipid biosynthetic pathways, the fatty acid CoA ligase (AMP) (EC 6.2.1.3) and the sn-glycerol 3-phosphate acyl-CoA acyltransferase (EC 2.3.1.15), and an enzyme unique to triacylglycerol synthesis, the diacylglycerol acyltransferase (EC 2.3.1.20), increased 2.5–3.6-fold, as did total liver protein, relative to the activities and protein from controls. Upon subcellular fractionation, little change in the specific activities of these biosynthetic enzymes was observed. The microsomal marker activity NADPH cytochrome C reductase (EC 1.6.2.a) also increased proportionately with liver protein. However, the total activity of a phospholipid biosynthetic enzyme, diacylglycerol cholinephosphotransferase (EC 2.7.8.2) increased only 32% after a 5-day diethylstilbestrol course, while the specific activity of this enzyme decreased 40%. The total activity of succinic dehydrogenase (EC 1.3.99.1), a mitochondrial marker activity, increased only 22%, further demonstrating the differential effect of estrogen on hepatic enzyme activities. The augmentation of triacylglycerol synthesis may be mediated, in part, by increases in total activities of two enzymes common to the triacylglycerol and phospholipid synthetic pathways and/or by regulation at the diacylglycerol branch point of triacylglycerol and phospholipid synthesis.     

吊钟花配合红砂糖治疗输液外渗的临床疗效研究

目的 探讨吊钟花配合红砂糖治疗输液外渗的临床效果.方法 选择60例肿瘤科输液外渗的患者随机分为观察组和对照组各30例,对照组采用50％硫酸镁外敷,观察组采用吊钟花配合红砂糖进行外敷,观察两组患者治疗3d后的临床效果.结果 观察组患者总有效率93.3％,对照组患者总有效率60.0％,两组患者临床疗效比较差异有显著意义(P＜0.01).结论 吊钟花配合红砂糖治疗输液外渗临床效果满意,无不良反应,值得在临床中推广应用.     

高压氧联合阿昔洛韦治疗Bell麻痹效果观察

目的探讨高压氧联合阿昔洛韦治疗Bell麻痹的效果。方法我院2008年12月～2010年12月收治Bell麻痹71例,随机分为治疗组和对照组。治疗组37例予高压氧治疗每日1次;对照组34例施以针灸治疗,每日1次。两组均予呋喃硫胺20 mg和维生素B120.5 mg肌内注射每日1次,阿昔洛韦6～10 mg/（kg.d）静脉滴注每日1次,地塞米松3～5 mg/（kg.d）静脉滴注每日1次,疗程10 d。结果治疗组治愈率51.35%,总有效率100%;对照组治愈率29.41%,总有效率94.12%。两组治愈率比较差异有统计学意义（P〈0.05）。结论高压氧联合阿昔洛韦治疗Bell麻痹安全有效,可作为Bell麻痹治疗首选方案。