纤维蛋白胶治疗角膜板栗刺伤的临床研究

目的　观察纤维蛋白胶治疗角膜板栗刺伤的临床效果。方法　采用前瞻性随机对照研究方法,选取年龄、病程等重要非试验因素,按不平衡指数最小的分配原则将２０１０年１月至２０１５年１月在顺德市第一人民医院和南昌大学第一附属医院确诊板栗刺导致的角膜深层异物患者６０例（６０眼）随机分为机械剔除组和纤维蛋白胶组（各３０例３０眼）。机械剔除组行裂隙灯下异物摘除术,纤维蛋白胶组于角膜表面注入纤维蛋白黏合胶。术后随访１个月,观察眼表指数、基础泪液分泌量、测量泪河高度和泪液蛋白含量变化,使用超声生物显微镜观察眼表愈合情况。结果　机械剔除组患者异物取出时间（１２±４）ｍｉｎ,显著高于纤维蛋白胶组的（３±２）ｍｉｎ,差异有统计学意义（ｔ＝９．４２６,Ｐ＜０．０５）。机械剔除组患者角膜上皮愈合时间为（１４±２）ｄ,长于纤维蛋白胶组的（５±１）ｄ,差异有统计学意义（ｔ＝１８．２６３,Ｐ＜０．０５）。术后１周两组患者眼表指数、泪河高度及基础泪液分泌量相比,差异均有统计学意思（均为Ｐ＜０．０５）;术后１周超声生物显微镜检查发现,机械剔除组角膜上皮仍未愈合,角膜基质水肿明显,刺伤区角膜反光明显,而纤维蛋白胶组角膜上皮已完全愈合,角膜基质水肿消退,刺伤区角膜反光接近正常角膜区域。结论　纤维蛋白胶治疗角膜板栗刺伤能减少手术时间,减轻角膜水肿,有益于角膜愈合,是一种安全有效的方法。     

Anti-Inflammatory Effects of Water Chestnut Extract on Cytokine Responses via Nuclear Factor-κB-signaling Pathway

Water chestnut (Trapa japonica Flerov.) is an annual aquatic plant. In the present study, we showed that the treatment of water chestnut extracted with boiling water resulted in a significant increase 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical-scavenging activity and decrease the intracellular H₂O₂-induced accumulation of reactive oxygen species. In addition, water chestnut extract (WCE) inhibited lipopolysaccharide (LPS)-induced nitric oxide production and suppressed mRNA and protein expression of the inducible nitric oxide synthase gene. The cytokine array results showed that WCE inhibited inflammatory cytokine secretion. Also, WCE reduced tumor necrosis factor-α-and interleukin-6-induced nuclear factor-αB activity. Furthermore, during sodium lauryl sulfate (SLS)-induced irritation of human skin, WCE reduced SLS-induced skin erythema and improved barrier regeneration. These results indicate that WCE may be a promising topical anti-inflammatory agent.     

马栗种子提取物治疗黄斑水肿的临床疗效观察

目的:观察口服马栗种子提取物对黄斑水肿的临床疗效。方法:将黄斑水肿患者47例50眼随机分为2组,对照组采用常规促吸收疗法(口服维生素C,E和芦丁片),治疗组在常规治疗基础上加用马栗种子提取物口服,4wk为1疗程。结果:治疗组黄斑水肿吸收优于对照组,两组差异有显著意义(P<0.05),治疗组患者无1例不良反应。结论:马栗种子提取物对黄斑水肿疗效确切,无不良反应,可在临床上推广应用。     

马栗树籽提取物（迈之灵）对肢体创伤患者血清细胞因子IL-6、IL-1β和TNF影响的研究

目的研究马栗树籽提取物（迈之灵）对肢体创伤软组织肿胀患者的血清细胞因子白细胞介素VI（IL-6）、白细胞介素1β（IL-1β）和肿瘤坏死因子（TNF）水平的影响。方法四肢骨折创伤患者120例采用双盲法,随机抽样分成观察组（60例）和对照组（60例）。观察组口服迈之灵片,对照组口服安慰剂片治疗,分别观察其肿胀和疼痛程度。2组均测量血清IL-6、IL-1β、TNF值。48例正常人测量血清IL-6、IL-1β、TNF值。结果骨折并软组织损伤患者血清IL-6水平在发病6 h内升高,24-36 h达到高峰,8 d后基本降至正常,重度组血清IL-6水平高于轻、中度组（6 h,P〈0.01;24-36 h,P〈0.05）,观察组用迈之灵治疗4 d后血清IL-6水平明显下降（P〈0.01）。创伤患者血清TNF、IL-1β水平升高,但持续时间短。结论迈之灵消除肢体骨折软组织肿胀效果明显,对轻、中度损伤患者的疗效优于重度损伤患者,能够明显降低患者血清IL-6水平,与其抗炎、抗渗出、抗氧自由基等作用相关,一定程度上减轻和保护了机体的应激反应。     

An unusual journey of a periocular date palm thorn

An 8-year-old boy presented with a left lower lid swelling of one month duration. His parents gave a history of date palm thorn injury on left side of the forehead three months back which was removed partially by a local doctor. On examination, there was a left infraorbital swelling with diffuse oedema of the left sided cheek and temporal fossa. A scar mark (entry wound) was detected over the left eyebrow. Three-D configuration of contrast enhanced computed tomography (CECT) of the orbit showed a linear foreign body behind the zygomatic bone. The lower lid mass was excised, the date palm thorn was recovered from a pocket behind the zygomatic bone. Histopathology of the excised mass showed presence of granulation tissue. We describe the management of such a rare case along with review of literature.     

浅探“巨刺”与“缪刺”

巨刺与缪刺在临床治疗中运用广泛,二者存在相同之处,却适用于不同的病证,为此易为人误用。应从理论上区别二者,以指导临床应用,提高疗效。     

梅花针叩刺与生姜片涂擦联合自体静脉血患处皮下与穴位注射治疗白癜风观察

[目的]观察梅花针叩刺与生姜片涂擦联合自体静脉血患处皮下与穴位注射治疗白癜风疗效。[方法]将26例门诊患者取卧位或坐位。治疗区皮肤常规消毒,采用梅花针在白斑区域按照从外向内呈同心圆样叩刺,以皮损部位潮红并伴有少量出血为度,叩刺后取生姜片2～3mm薄片涂擦患处,以局部发热发红为度。梅花针叩刺完成后,用2.5～5mL注射器于肘静脉取静脉血2.5～5mL(视皮损面积定量)将病变部位消毒,在白斑区分点皮内或皮下注射静脉血1～2mL/每点(以白斑区均匀分布为度),针孔处用干棉球压迫止血,每周2次,10次为1疗程;另取双侧肺俞、脾俞、肾俞、膈俞、曲池、足三里、血海、三阴交分成两组,每周分2次治疗,以上每组每个穴位注射0.5～1.0mL。每周治疗2次,10次(5周)为1个疗程,疗程间隔1个星期。[结果]痊愈16例,显效6例,有效2例,无效2例,总有效率92.31%。最短治疗1个疗程,最长8个疗程,平均3～5个疗程。[结论]梅花针叩刺与生姜片涂擦联合自体静脉血患处皮下与穴位注射治疗白癜风疗效满意。     

纪青山教授雷火灸热敏配合围刺治疗带状疱疹

目的：探讨采用纪青山教授雷火灸热敏操作配合围刺手法治疗带状疱疹的临床疗效。方法将60例带状疱疹患者按随机数字表法分为治疗组和对照组,各30例,治疗组以雷火灸热敏操作配合围刺为治疗方法,对照组辨证属肝经郁热证用龙胆泻肝汤加减,脾虚湿蕴证用除湿胃苓汤加减,气滞血瘀证用柴胡疏肝散合桃红四物汤加减。结果治疗组总有效率为93.33％,对照组76.67％,2组比较,P﹤0.05。结论雷火灸热敏操作配合围刺治疗带状疱疹,能直达疱疹病变部位,清泄热毒,活血止痛,使邪毒随针孔和热能而外泄。     

The Effect of Traditional Remedies (Camel's Thorn,Flixweed and Sugar Water) on Idiopathic Neonatal Jaundice

Objective

Jaundice is the most common reason of newborn''s admission to neonatal ward. Many Iranian families give traditional remedies like sugar water, camel''s thorn and flixweed extracts to breast-fed babies for reducing jaundice. This study investigated the effect of traditional remedies on idiopathic neonatal jaundice.

Methods

This prospective study has been performed on 336 babies with idiopathic jaundice in a four year period (2005-2009) at Ghaem hospital, Mashhad, Iran. The babies were divided into two groups. In case group (n=234) breast-fed babies received no remedy and in control group (n=102), traditional remedies were given additional to breast milk and the results recorded and compared.

Findings

In the present study significant differences were observed between the two groups in age of admission (6.8±3.2 vs 9.2±3.7 day, P<0.001), serum bilirubin values (17.8 vs 21.3 mg/dl, P<0.001) and percent of weight loss (P<0.01). There were no significant differences between the two groups in birth weight, sex, gestational age and duration of hospitalization, age at jaundice remission, hematocrit value and maternal factors (age, gestational order, pregnancy and labor problems)(P>0.05).

Conclusion

Traditional remedies (camel''s thorn, flixweed and sugar water) cause more weight loss and delayed reexamination of newborns leading to increased hyperbilirubinemia. These remedies may raise pseudo confidence in parents, which postpones reexamination and follow up of the newborns.