金钱白花蛇药酒对小鼠镇痛作用的实验研究

目的:研究金钱白花蛇药酒的镇痛作用。方法:用小鼠热板致病法、小鼠酒石酸锑钾致扭体反应法,观察颈舒康颗粒的镇痛作用。结果:颈舒康颗粒能对抗用热板法、酒石酸锑钾所致的疼痛。结论:颈舒康颗粒有较好的镇痛作用。     

唯物辩证法在医学检验形态学实验教学中的应用与思考

本文探讨了在医学检验形态学实验教学中应用内因与外因、局部与整体、一般与特殊、量变与质变、认识论与方法论等唯物辩证法哲学范畴和观点,融知识传授与哲学思维的培养于一体,不断提高学生的学习兴趣和分析问题、解决问题的能力,同时培养学生的科学辩证思维,使他们学会用科学的态度和方法指导自身的工作、学习,逐步成为具有创新精神和实践能力的高素质应用型检验医学人才.     

实验动物和脏器标本的摄影方法

文章结合实践介绍了实验动物和脏器标本的摄影方法及注意事项,为从事这方面工作的科技人员提供了技术支持。     

乐胃饮干预功能性消化不良大鼠SP和VIP的研究

[目的]通过实验研究,揭示乐胃饮治疗功能性消化不良的作用机制。[方法]Wistar大鼠随机分为正常对照组、自然恢复组、吗叮啉组、参苓白术丸组、乐胃饮低剂量组、乐胃饮中剂量组、乐胃饮高剂量组等7组,每组6只。分别给予各组按2ml/100g按组分别灌服蒸馏水、吗叮啉、参苓白术丸液、乐胃饮低中高剂量液,每天1次,自造模结束后一天起连续给药14天。观察胃黏膜形态,检测胃肠激素SP和VIP。[结果]乐胃饮能有效增加实验鼠胃窦组织中SP和降低VIP含量。[结论]乐胃饮能提高胃肠道神经兴奋性,调节胃肠道平滑肌的收缩,这可能是乐胃饮治疗FD的主要作用机制。     

Lasting changes in NMDAR1 mRNA level in various regions of cerebral cortex in epileptogenesis of amygdaloid-kindled rat

The involvement of NMDA receptor subunit, NR1, with kindling phenomenon has been reported, but the role of NR1 in epileptogenesis is still unknown. We have examined the expression levels of NR1 mRNA in the cerebral cortices of amygdaloid-kindled rats. Northern blot analysis showed a significant increase in NR1 mRNA expression level in the ipsilateral frontal and temporal cortices at 4 weeks after the last generalized seizure. At the same time, NR1 mRNA decreased in the bilateral piriform cortices. These data suggest that NR1-mediated transmission may have an impact in the neurobiological basis of enduring epileptogenesis.     

Outpatient initiation of the ketogenic diet in children with pharmacoresistant epilepsy: An effectiveness,safety and economic perspective

BackgroundChildren with pharmacoresistant epilepsy usually receive ketogenic diet (KD) as an inpatient, which makes it an expensive treatment.ObjectiveTo compare the effectiveness, safety, and costs of outpatient versus inpatient initiated KD.DesignRetrospective observational non-inferiority study.Patients/settingPatients (1–18 years of age) who started KD either inpatient or outpatient.Main outcome measuresEffectiveness was defined as ≥50% seizure reduction. Safety was measured by the numbers of emergency visits and complications. Economic impact was analyzed by calculating total costs of treatment.Statistical analysesNon-inferiority of outpatient initiation was tested using 95% confidence intervals of the differences in effectiveness and safety endpoints between groups with non-inferiority margins of 10%. Nonparametric bootstrap techniques were used to derive a 95% confidence interval for the mean difference in total costs between the groups.ResultsHundred and five patients started KD in the period 2001 to 2017: 43 inpatient and 62 outpatient. At three months, the KD was effective in 61% of outpatients versus 63% of inpatients. The KD was considered safe in 36% of the outpatients, as compared to 29% in the inpatients. Outpatient initiation was shown to be non-inferior to inpatient initiation in terms of safety. Total health care costs of outpatient initiation were € 2901, as compared to € 8195 of inpatient initiation per patient (mean difference € 5294, 95% CI; -€ 7653 to -€ 2935).ConclusionsOur study suggests that outpatient KD initiation is no worse than inpatient initiation in terms of effectiveness and safety, while carrying lower health care costs.     

眼外伤的临床及实验研究概况

随着中国建设和发展,日常生活及工作中眼外伤的发生率不断上升。本文从眼外伤流行病学检查、眼外伤实验模型的设计与制作、眼外伤实验动物的选择及眼外伤实验研究进行综述。眼外伤成因大致相似,以钝挫伤、穿通伤为多。实验观察从以前的单纯临床大体观察,到目前的细胞分子水平观察,能更好地更深入地揭示眼外伤本质,从而进一步指导临床治疗。     

颅内电极脑电图监测对癫(癎)致(癎)灶的定位作用

目的探讨颅内电极脑电图(EEG)监测对癫致灶的定位作用。方法对经临床、影像学和常规EEG检查不能确定致灶部位的20例难治性颞叶癫患者,应用立体定向技术,经双侧颞叶植入硬膜下条状电极进行长时间EEG监测,观察发作期及发作间期EEG变化,结合常规EEG、MRI检查结果对癫灶进行综合定位;术后随访,评估致灶定位的准确性。结果20例患者颅内电极埋藏时间为1～5d,每例监测到≥2次临床发作并记录发作间期和发作期的异常放电活动。20例患者发作期颅内电极EEG均能准确定位,15例致灶发作间期与发作期一致,2例发作间期为双侧棘波,3例发作间期定位与发作期不一致。术后按Engel疗效分级:发作消失13例(65%),显著改善3例(15%),良好3例(15%),无效1例(5%)。未出现因颅内电极安置所致的并发症。结论颅内电极EEG监测可为癫手术治疗提供可靠的病灶定位依据。     

病毒性脑炎 217例症状性癫痫发生风险的预测研究

目的分析病毒性脑炎并发症状性癫痫的风险因素,据此构建列线图预测模型。方法回顾性分析 2018年 2月至 2022年 5月汕头市中心医院收治的 217例病毒性脑炎病人临床资料,抽取 70%为建模集(152例),30%为验证集(65例)。根据病人是否合并症状性癫痫,将建模集进一步分为发生组和未发生组,比较两组病人一般资料,选择差异有统计学意义的指标用逐步向前回归法进行非条件多因素 logistic分析病毒性脑炎病人症状性癫痫发生的影响因素,并采用 R3.4.3软件包绘制基于多因素分析结果的列线图模型。采用 Bootstrap法分别对建模集和验证集进行验证,并绘制受试者操作特征曲线(ROC曲线)和决策曲线(DCA)以评估列线图模型的预测效能和临床净获益率。结果 217例病毒性脑炎病人中,共 46例病人合并症状性癫痫(21.20%),其中建模集中有 32例合并症状性癫痫,验证集中有 14例合并症状性癫痫;发生组昏迷、大脑皮质损坏、脑电图重度异常、颅脑核磁共振成像(MRI)有责任病灶、累及颞叶或额叶、脑脊液单纯疱疹病毒(HSV)(+)占比及脑脊液压力均高于未发生组(P<0.05); logistic多元回归分析,昏迷、大脑皮质损坏、脑电图重度异常、颅脑 MRI有责任病灶、累及颞叶或额叶、脑脊液压力、脑脊液 HSV(+)均是病毒性脑炎合并症状性癫痫的影响因素(P<0.05);经 Bootsrap法进行验证,建模集其一致性指数( C-index)为 0.833,验证集的 Cindex则为 0.830,校正曲线和标准曲线拟合度较好。建模集 ROC曲线下面积(AUC)、灵敏度、特异度分别为 0.84［98%CI:(0.78,0.89)］、79.17%、84.04%,验证集则为 0.81［98%CI:(0.76,0.86)］,83.04%,73.64%,提示模型区分度良好。 DCA曲线显示病人根据列线图模型进行风险评估可获得满意的净收益。结论昏迷、大脑皮质损坏、脑电图重度异常、颅脑 MRI有责任病灶、累及颞叶或额叶、脑脊液压力、脑脊液 HSV(+)均是病毒性脑炎合并症状性癫痫的影响因素,综合上述因素针对病毒性脑炎病人构建的列线图预测模型可以较好地个体化预测症状性癫痫的发生,对临床防治症状性癫痫提供指导。