基于文献可视化软件的中药治疗糖尿病足知识图谱分析

目的:探索和发现中药治疗糖尿病足领域的热点话题和研究前沿。方法：检索中国知网已发表的中药治疗糖尿病足文献(日期:自建库至2019年6月3日),运用文献可视化软件(CiteSpaceⅤ)绘制中药治疗糖尿病足的知识图谱,进行文献关键词共现分析及聚类分析。结果:该关键词共现聚类网络由909个节点,1 241条边组成,被分成24个聚类。研究热点是:1)中西医结合疗法治疗糖尿病足;2)中药足浴。研究前沿是:1)穴位注射;2)活血化瘀清热解毒疗法。结论:中药治疗糖尿病足的未来之路是注重中医疗法的基础上进行中西医结合,且需更多高质量的证据支持。     

黄芪皂苷甲的镇痛、镇静作用

本文证实给小鼠黄芪皂苷甲后出现镇痛作用,其镇痛作用较度冷丁弱而短。根据对小鼠腹腔注射醋酸产生扭体反应抑制率测得静脉注射黄芪皂苷甲的ED50为47.8±3.4mg/kg;由热板法测得的ED50为25.4±1.5mg/kg。黄芪皂苷甲也能明显延长硫喷妥钠所致小鼠的麻醉时间。此外,黄芪皂苷甲还能使豚鼠离体回肠张力下降。     

辣椒油中酸价测定方法的探讨分析

目的:本文运用不同前处理方法进行比较,解决国家标准方法[1]测定辣椒油中的酸价时,由于辣椒油中的色素存在而影响滴定终点的判断问题。方法:利用添加适量中性饱和食盐水及用活性碳吸附两种方法前处理后再按照国标法测定酸价,其结果与准确度和精密度都较高的自动电位滴定法相比较。结果:用添加中性饱和食盐水法和活性碳吸附法都可以清晰观察到滴定终点;辣椒油试样量在3~4 g,用添加中性饱和食盐水法与自动电位滴定法结果无统计学差异,结果准确;活性碳吸附法测定低浓度酸价的油脂相对偏差较大,高浓度的与自动电位滴定法无统计学差异。结论:对于深色油脂如辣椒油中的酸价首选自动电位滴定法,如没有自动电位滴定仪的基层单位,低浓度的可以用添加中性饱和食盐水方法,中、高浓度的可以用活性碳吸附法和添加中性饱和食盐水方法,两种方法都可以清晰地观察到滴定终点,结果精密度都较好,准确度较高。可以作为国标法中测定辣椒油中酸价的有效补充。     

更年期妇女潮热的健康教育

目的探讨临床上在治疗更年期妇女潮热的同时进行健康教育指导的临床意义．方法将60例更年期妇女潮热的患者随机分成两组，健康教育组通过发放宣传小手册、举行健康教育讲座，让患者了解“潮热”发生的原因、治疗方法、治疗中的注意事项及治疗依从性对疗效的影响．并比较两组患者服药的依从性及疗效的差别．结果健康教育组对更年期妇女潮热的认知度高于对照组，两组比较P〈0．05．健康教育组病人服药依从性比对照组好，两组病人潮热治疗效果有显著性差异．结论对更年期妇女潮热的患者进行健康知识教育是非常必要的，它有利于提高患者对疾病的认知率，提高服药的依从性，缓解症状、改善生活质量，有着十分重要的意义．     

Antioxidant activity of different white teas: Comparison of hot and cold tea infusions

The study investigates the antioxidant characteristics of various white teas steeped in either hot or room-temperature water in relation to grade of tea and brewing conditions. Antioxidant activity, chelating activity, total phenol (TPC), flavonoids (TFC), theaflavins and individual catechin content were examined. The results confirm that extraction of tea leaves carried out with water at room temperature leads to the formation of infusions particularly rich in compounds with antioxidant activity. In fact, for all the white teas studied, cold infusions had a higher content of phenols (4.77–7.63 mmol/L Gallic Acid Equivalents, GAE), flavonoids (1.47–2.53 mmol/L Catechin Equivalents, CE) and catechins (441.5–1328.2 μg/mL) compared to hot infusions (1.43–4.02 mmol/L GAE, 0.70–1.13 mmol/L CE, 83.4–534.8 μg/mL, respectively). The same trend was also observed for antioxidant activities examined using the ABTS assay (cold: 17.09–34.23; hot: 5.26–17.07 mmol/L Trolox Equivalents) and by monitoring the effects of the infusions on LDL oxidation (lag time, cold: 172.4–271.2; hot: 88.4–145.9 min). A general trend in antioxidant activity and in polyphenolic compound content can be delineated between Chinese teas, i.e. Bai Mu Dan ≥ Xue Ya ≥ White Lung Ching > Anji Needle Mao Feng > Yhin Zhen Bai Hao and between African teas, i.e. White Salima Peony > Thyolo Bsp > Bvumbwe Bsp. Concerning metal chelating activity, all the white teas displayed similar levels (0.3–0.6 mmol/L EDTA Equivalents) with no significant differences between the hot and cold infusions (except Bvumbwe Bsp and Thyolo Bsp). This paper contains key information on the antioxidant properties, TPC, TFC, and individual catechin content of several white teas commercially available and the outcomes suggest that preparing tea infused in room temperature water for approximately 2 h may constitute an alternative tea beverage potentially richer in healthful bioactive compounds compared to the more commonly consumed hot tea infusions.     

From guidelines to standards of care for open tibial fractures

IntroductionThe standards for the management of open fractures of the lower limb published by the British Association of Plastic, Reconstructive and Aesthetic surgeons (BAPRAS) and British Orthopaedic Association (BOA) were introduced to improve the treatment received by patients after open injury to the lower limb. These Standards were released after BAPRAS/BOA published Guidelines for the management of open tibial fractures.MethodsWe wished to determine the impact of these Standards upon the surgical management of open tibial fractures by comparing patients admitted to an orthoplastic centre in the 45 months concluding December 2009 (the Guidelines era) with those admitted during 2011 (the Standards era). Surgical procedures required during the first 30 days and 12 months after injury were determined. Cases were divided into ‘directly admitted patients’ (DAP) and ‘transferred patients’ (TP). Standards-era patients were divided further into those who had surgery exclusively at the orthoplastic centre (orthoplastic patients (OPP)) and those transferred after surgery (TASP).ResultsThe number of TP trebled in frequency in the Standards era, 25% of whom were transferred before surgery. Significantly fewer surgical procedures were required for DAP and OPP groups compared with TP (and TASP) groups in both eras (Mann–Whitney U-test, p=0.05). DAP and OPP groups during the Standards era underwent the fewest procedures, with the vast majority of cases treated with two or fewer procedures in the first 12 months (88% and 80%, respectively, compared with 61% in the Guidelines era). In the Guidelines era, 44% of TP cases and in the Standards era 39% of TP and 29% of TASP groups underwent two or fewer procedures.Approximately two-thirds of open tibial fractures managed in our orthoplastic centre were patients transferred after surgery. The greatest impact of the Standards was evident for those who underwent surgery exclusively in the orthoplastic centre, reflecting a more deliberate combined strategy.ConclusionThese findings vindicate the Standards as well as mandating reorganisation and resourcing of orthoplastic services to ensure immediate transfer and early combined surgery. By increasing the capacity to deal with time-dependent initial surgery, the surgical burden that the patient must endure, and which the service must provide, are reduced.     

电针灸配合中药湿热敷治疗颈椎病的疗效观察

目的探讨电针灸配合中药湿热敷治疗颈椎病的临床效果。方法将我院收治的颈椎病患者60例随机分成观察组和对照组,各30例,观察组给予电针灸配合中药湿热敷治疗,对照组仅单独给予中药湿热敷治疗,观察两组治疗结果。结果观察组总有效率为100.0%,对照组总有效率为43.3%,两组比较差异有统计学意义(P<0.05)。结论电针灸配合中药湿热敷治疗颈椎病效果显著,值得临床推广应用。     

Efficacy and safety of a soy isoflavone extract in postmenopausal women: a randomized, double-blind, and placebo-controlled study

OBJECTIVE: To investigate the efficacy of soy isoflavone on climacteric symptoms in postmenopausal women. DESIGN: In this double-blind, randomized, placebo-controlled study, a total of 80 women (mean age = 55.1 years), who reported 5 or more hot flush episodes per day, were randomized to receive either 250 mg of standardized soy extract (Glycine max AT) a total of 100mg/day of isoflavone (n = 40) or placebo (n = 40). Exclusion criteria included: contra-indication for hormone therapy (HT), chronic gastrointestinal diseases, and users of HT within the preceding 6-months. For 10-months, climacteric symptoms were evaluated using a score card and the menopausal Kupperman index. Compliance and safety were also assessed. At baseline and the end of the study, lipid and hormonal profiles, as well as vaginal, mammographic and ultrasonographic parameters were measured. The t-test, Wilcoxon test and ANOVA were used in the statistical analysis. RESULTS: At baseline, the mean number of hot flushes was 9.6 +/- 3.9 per day in the isoflavone group and 10.1+/-4.9 in the placebo group (p>0.05). After 10 months, there was a significant reduction in frequency of hot flushes among isoflavone users when compared to those on placebo (3.1 +/- 2.3 and 5.9 +/- 4.3, respectively) (p<0.001). Kupperman index mean values showed a significant reduction in both groups. However, soy isoflavone was significantly superior to placebo, in reducing hot flush severity (69.9% and 33.7%, respectively) (p<0.001). Endometrial thickness, mammography, vaginal cytology, lipids and hormonal profile did not change in both groups. No serious adverse event related to isoflavone treatment was reported. CONCLUSIONS: The soy isoflavone extract exerted favorable effects on vasomotor symptoms and good compliance, providing a safe and effective alternative therapeutic for postmenopausal women.     

Hot flash severity in hormone therapy users/nonusers across the menopausal transition

OBJECTIVES: The purpose of this study was to examine the pattern of and factors that influence hot flash severity across the menopausal transition (MT) and early postmenopause (PM). METHODS: Women from the Seattle Midlife Women's Health Study (N=302) provided data for these analyses: at least one annual health questionnaire and a menstrual calendar. A subset of women provided a first morning voided urine specimen from 1997 through 2005. Urine samples were assayed for estrone glucuronide and FSH. Linear mixed effects modeling was used to identify change in hot flash severity scores over time, including the relationship to age, MT-related, psychosocial and lifestyle factors. RESULTS: Increases in hot flash severity were associated with late transition stage, early postmenopause, use of HRT, duration of early transition stage, age of entry into early PM and level of FSH. Age of entry into early transition and estrone levels were associated with decreased hot flash severity. Not associated with hot flash severity were being in early transition stage, age of entry into or duration of late transition stage and all of the psychosocial (anxiety, stress, depressed mood) and lifestyle variables (BMI, activity level, sleep, alcohol use). CONCLUSIONS: Variables associated with reproductive aging independently predicted changes in hot flash severity; psychosocial and lifestyle variables did not. The effect of age dropped out when factors associated with reproductive aging were considered. Use of HRT ameliorated but did not eliminate severe hot flashes suggesting that there is room for alternative approaches less likely to cause harm.     

Non-hormonal treatments for menopausal symptoms

Increasing numbers of women are requesting non-hormonal treatments for menopausal symptoms. Estrogen-containing HRT is the most effective treatment for menopausal symptoms in healthy women but is contraindicated for some women and avoided by many others. This review will assess the evidence regarding the safety and efficacy of non-hormonal treatments for menopausal symptoms. Relatively few high quality studies have addressed this issue, almost all have only addressed the treatment of hot flushes and there are few long-term data.