推拿局部镇痛机制的概述

既往对推拿镇痛的研究多集中在脊髓或中枢水平对疼痛的调制方面,而中医经筋疾病的治疗原则是"以痛为腧",在患者的局部给予推拿治疗后,其疼痛往往能够得到减轻或消除,而其局部的某些物质究竟发生了如何的变化值得研究者进行观察,本研究就是探讨推拿手法与局部镇痛物质和致痛物质之间的关系,为中医"以痛为腧"的理论提供客观的依据。     

Seasonal and Geographic Patterns in Seeking Cardiovascular Health Information: An Analysis of the Online Search Trends

Objective

To ascertain whether temporal and geographic interest in seeking cardiovascular disease (CVD) information online follows seasonal and geographic patterns similar to those observed in real-world data.

关节镜微创手术配合复方丹红注射液及维生素B12局部穴位注射治疗膝骨关节炎疗效观察

目的：观察关节镜微创手术配合复方丹红注射液及维生素B12局部穴位注射治疗膝骨关节炎疗效。方法选取2012年2月—2013年3月诊断为膝关节骨关节炎90例患者的临床资料,根据治疗方法分为丹维治疗组、曲利治疗组、对照组。每组各30例。所有患者行关节镜下炎症滑膜清理术,丹维治疗组患者配合局部痛点注射复方丹红注射液（2 mL）及维生素B12注射液（0．5 mg）;曲利治疗组患者配合局部痛点注射醋酸曲安奈德注射液（2 mL）配伍盐酸利多卡因注射液（1 mL）;每周1次局部注射,3次为1疗程。对照组患者仅关节镜微创手术治疗。治疗出院后随访6个月。结果应用Lequsne疗效评定法来评定术后1周临床治疗效果,结果显示,丹维治疗组、曲利治疗组患者术后1周的有效率明显优于对照组（P＜0．05）;术后1周、术后3个月及术后6个月采用Ly-sholm法评分,丹维治疗组、曲利治疗组患者评分优于对照组（P＜0．05）;但丹维治疗组评分与曲利治疗组评分无明显差异（ P＞0．05）。结论关节镜微创手术配合复方丹红注射液及维生素B12局部穴位注射治疗膝骨关节炎具有较好的临床疗效,并且避免了因为应用糖皮质激素导致的多种并发症。     

明代地方医学存在的问题及其对策--以吕坤《振举医学》为中心

明中叶以后,随着商品经济的发展,地方医学的弊端逐渐显现,主要有：地方医官地位较低,被地方官员随意差遣;医药经费管理混乱,地方官员挪用药材银两,医官与药商串通骗价问题严重;医生治病不专业,医疗事故频频发生;医学场所荒废不修或变价不存的问题普遍存在。吕坤在《振举医学》中对医政管理、医学教育提出了一系列对策,包括：着力提高医官地位,要求精通医学的人担任医官;严格管理药材银两,保证药材经费的稳定性;强调医术的专与精,鼓励医生熟读医书;对医生的监督和管理更加严格,并将医疗事故纳入司法程序;借助民间社会力量进行医疗救助,使民间力量成为官办地方医学的重要补充。     

Estimating skin sensitization potency from a single dose LLNA

Skin sensitization is an important aspect of safety assessment. The mouse local lymph node assay (LLNA) developed in the 1990s is an in vivo test used for skin sensitization hazard identification and characterization. More recently a reduced version of the LLNA (rLLNA) has been developed as a means of identifying, but not quantifying, sensitization hazard. The work presented here is aimed at enabling rLLNA data to be used to give quantitative potency information that can be used, inter alia, in modeling and read-across approaches to non-animal based potency estimation. A probit function has been derived enabling estimation of EC3 from a single dose. This has led to development of a modified version of the rLLNA, whereby as a general principle the SI value at 10%, or at a lower concentration if 10% is not testable, is used to calculate the EC3. This version of the rLLNA has been evaluated against a selection of chemicals for which full LLNA data are available, and has been shown to give EC3 values in good agreement with those derived from the full LLNA.     

Pharmacokinetics of continuous subcutaneous insulin infusion

Summary One of the reasons for the variability of blood glucose regulation in Type 1 (insulin-dependent) diabetic patients is the huge variation in subcutaneous absorption of intermediate-acting insulin. We have investigated the variation in insulin absorption during continuous subcutaneous insulin infusion in eight such patients. The content of insulin in the subcutaneous tissue was measured using ¹²⁵I-labelled insulin. The concentration of free serum insulin and blood glucose was followed from 1 h before and from 7 h after breakfast on two consecutive days. The amount of insulin absorbed during 24 h differed in all cases by less than 3% from the daily insulin dose given by the pumps. Mean insulin absorption rates and mean free insulin concentration showed peak values 30–90 min after meal bolus injections; this was sufficient to maintain near-normal blood glucose. Mean free serum insulin correlated strongly with disappearance of insulin from the subcutaneous tissue (r=0.98). From the insulin absorption rates and free insulin concentrations during basal constant insulin infusion, the half-time of serum insulin was calculated as 6 min. Compared with the known large variability in the absorption of intermediate-acting insulin, continuous subcutaneous insulin infusion offers a precise and reproducible way of insulin administration resulting in post-prandial serum insulin peaks sufficient to maintain near-normal blood glucose levels. The half-time of serum insulin during subcutaneous infusion corresponds to values for intravenous infusion given in the literature, indicating that local degradation of insulin in subcutaneous tissue is of minor importance.     

Percutaneous radiofrequency ablation with cooled electrodes combined with hepatic arterial balloon occlusion in hepatocellular carcinoma

Background We have reported that percutaneous radiofrequency ablation (RFA) with balloon occlusion of the hepatic artery (balloon-occluded RFA), using an expandable electrode, increases the coagulation area. In this study, we investigated the efficacy of balloon-occluded RFA and balloon-microcatheter-occluded RFA, using a cool RF single electrode.Methods We studies 41 patients with 47 hepatocellular carcinoma (HCC) lesions. We treated 28 patients (32 nodules) with balloon-occluded RFA, 5 patients (6 nodules) with balloon-microcatheter-occluded RFA, and 8 patients (9 nodules) with standard RFA. Initial therapeutic efficacy was evaluated with dynamic computed tomography performed 1 week after one session of treatment.Results One session of treatment was done for 20 nodules (62.5%) in the balloon-occluded RFA group and for 4 nodules (66.7%) in the balloon-microcatheter-occluded RFA group. We compared the coagulation diameter for balloon-occluded RFA (7 nodules), balloon-microcatheter-occluded RFA (6 nodules), and standard RFA (9 nodules) after one application cycle (12min). The greatest dimension of the area coagulated by balloon-occluded RFA was significantly larger (greatest long-axis dimension, 47.6 ± 7.8mm; greatest short-axis dimension, 33.4 ± 7.5mm) than that coagulated by standard RFA (greatest long-axis dimension, 35.3 ± 4.7mm; greatest short-axis dimension, 25.9 ± 3.7mm; P = 0.002 for greatest long-axis dimension; P = 0.041 for greatest short-axis dimension). However, there was significant difference only in the greatest short-axis dimension of the area coagulated comparing balloon-microcatheter-occluded RFA and standard RFA.Conclusions We consider balloon-occluded RFA using a cool RF electrode to be superior to standard RFA for the treatment of HCC, especially when larger coagulation volumes are required.     

Efficient transposition of the Tol2 transposable element from a single-copy donor in zebrafish

The Tol2 transposable element is a powerful genetic tool in model vertebrates and has been used for transgenesis, insertional mutagenesis, gene trapping, and enhancer trapping. However, an in vivo transposition system using Tol2 has not yet been developed. Here we report the in vivo Tol2 transposition system in a model vertebrate, zebrafish. First, we constructed transgenic zebrafish that carried single-copy integrations of Tol2 on the genome and injected transposase mRNA into one-cell stage embryos. The Tol2 insertions were mobilized efficiently in the germ lineage. We then mobilized an insertion of the Tol2 gene trap construct in the nup214 gene, which caused a recessive lethal mutant phenotype, and demonstrated that this method is applicable to the isolation of revertants from a transposon insertional mutant. Second, we constructed transgenic fish carrying the transposase cDNA under the control of the hsp70 promoter. Double-transgenic fish containing the transposase gene and a single-copy Tol2 insertion were treated with heat shock at the adult stage. We found that transposition can be induced efficiently in the male germ cells. We analyzed new integration sites and found that the majority (83%) of them were mapped on chromosomes other than the transposon donor chromosomes and that 9% of local hopping events mapped less than 300 kb away from the donor loci. Our present study demonstrates that the in vivo Tol2 transposition system is useful for creating genome-wide insertions from a single-copy donor and should facilitate functional genomics and transposon biology in vertebrates.