A型肉毒毒素治疗面肌、眼睑痉挛59例临床观察

目的探讨A型肉毒毒素治疗面肌、眼睑痉挛的疗效。方法采用A型肉毒毒素局部注射治疗偏侧面肌痉挛51例、眼睑痉挛8例,并使用Cohen和Albert量表进行评估。结果症状完全缓解占51.45%,明显改善占37.5%,部分改善占11.2%,疗效平均持续约3～6个月,复发者重复注射仍有效,出现眼睑闭合不全、面肌无力、眼睑下垂共18例,均恢复。结论局部注射A型肉毒毒素确为一种安全有效、简便易行的治疗面肌、眼睑痉挛的方法。     

The undesirable wink

Background:Marin-Amat syndrome is a rare acquired oculofacial synkinesis first reported in 1918. It manifests as involuntary eyelid closure on jaw opening or on lateral movement of the jaw following a peripheral facial nerve palsy. The increased orbicularis tone due to aberrant connections between the cranial nerve (CN) V and CN VII results in an undesirable wink with major psychosocial impact.Purpose:Most cases in literature were either observed or administered botulinum toxin injection to the orbicularis muscle. There are few sporadic reports of surgical interventions with successful outcomes.Hence there was a need to generate awareness regarding various modes of management of this rare entity.Synopsis:We present a video on the clinical presentation and management of six such patients, of whom one was bilateral. Five patients were females. Traumatic facial nerve paralysis and Bell’s palsy was previously diagnosed in one and five patients respectively. The mean age was 52 ± 9.48 years. The mean MRD (margin reflex distance) 1 and MRD 2 was 3.17 ± 0.60 and 5.33± 0.65 mm respectively. On smiling or on movement of the jaw the MRD 1 and 2 was reduced by 2. 50±0.40 and 1.50+/-0.40 mm respectively. Of the six patients four patients opted for nil intervention.Highlights:Botulinum toxin injection and preseptal orbicularis resection in the upper and lower eyelid along with blepharoplasty was performed in 1 patient each. Satisfactory reduction in the synkinetic movement was achieved in both. Marin-Amat syndrome is a rare often underdiagnosed synkinetic disorder following peripheral facial nerve palsy. Botulinum toxin injection and preseptal orbicularis resection are viable management options.Video link: https://youtu.be/YQbRecp449w     

结直肠癌前病变中医病机探讨

在癌毒病机理论的指导下,提出结直肠癌前病变的共性病机为湿热毒蕴,脾气亏虚.湿、热之邪在脾虚的基础上产生并相互胶结于肠腑,日久内生癌毒.脾气亏虚是结直肠癌前病变发生的根本病机,湿热蕴结是其发展条件,癌毒内生是癌变的关键所在.结合内镜下病理分级,根据癌毒内生与否可将结直肠癌前病变的演变过程分为无癌毒期及癌毒期.癌毒致病的过...     

Botulinum Toxin Injection for the Treatment of Upper Esophageal Sphincter Dysfunction

Dysphagia associated with upper esophageal sphincter (UES) dysfunction remarkably affects the quality of life of patients. UES injection of botulinum toxin is an effective treatment for dysphagia. In comparison with skeletal muscles of the limb and trunk, the UES is a special therapeutic target of botulinum toxin injection, owing to its several anatomical, physiological, and pathophysiological features. This review focuses on (1) the anatomy and function of the UES and the pathophysiology of UES dysfunction in dysphagia and why the entire UES rather than the cricopharyngeal muscle before/during botulinum toxin injection should be examined and targeted; (2) the therapeutic mechanisms of botulinum toxin for UES dysfunction, including the choice of injection sites, dose, and volume; (3) the strengths and weaknesses of guiding techniques, including electromyography, ultrasound, computed tomography, and balloon catheter dilation for botulinum toxin injection of the UES.     

精制E型肉毒类毒素免疫原不同配制比例实验

目的为获得高效价的马血浆,选择最佳E型肉毒类毒素免疫原配制比例。方法用3种不同配制比例配制E型肉毒类毒素免疫原,免疫原1、2、3分别为V（羊毛脂）：V（液体石蜡）：V（精制E型肉毒类毒素抗原）=1：2：6,1：2：3,1：2：2。将24匹马分为3组,分别用3种免疫原按常规法免疫,采用小鼠中和试验方法检测马血浆效价。结果用免疫原2免疫的马匹,马血浆平均效价比用免疫原1、3平均效价提高了36．3％,且马匹表现状况好于免疫原1、3。结论免疫原2的配制比例使用安全、稳定性良好、马匹免疫效果较好,为目前抗毒素生产用免疫原最佳配制比例。     

胃癌的病机演变与治疗初探

论述了胃癌的病因病机及治疗,认为癌毒留滞胃腑,易于搏结痰瘀,阻遏气机,耗伤正气,治疗宜抗癌解毒、化痰软坚、调理脏腑、扶正补虚。     

浅析“存津液”思想在急性白血病治疗中的重要性

探讨"存津液"思想在急性白血病治疗中的地位和作用。认为急性白血病多见热毒炽盛、阴虚血热等,属于"温病""急劳"等范畴。治疗应重视养阴救津。并附验案1则。     

Chicken nucleated blood cells as a cellular model for genotoxicity testing using the comet assay.

Mycotoxins can frequently occur in animal feed and human food. T-2 toxin, as the most toxic trichothecene, has been implicated as the causative agent in a variety of animal diseases and is associated with some human diseases. The comet assay was performed as a test for detection of DNA damage caused by T-2 toxin in peripheral blood cells of chicken. The suitability of the comet assay as a biomarker for genotoxic analysis has been applied in studies using human white blood cells. It can be applied to any tissue from which a single cell suspension can be obtained. The method has already been applied to chicken as a foodstuff for detection of irradiation of food containing DNA. However, application of the method on chicken blood cells has not been set up yet. The aim of this research was to develop a protocol for detection of DNA damage induced by T-2 toxin in chicken blood cells. Chickens were administered orally with T-2 toxin and the samples of whole blood were collected at 24 h post treatment. The DNA damage was determined by an increase in the comet parameters in tested animals. Our results show that T-2 toxin had induced significant DNA damage in treated chicken as compared with control animals, indicating that the assay can be used for the assessment of primary DNA damage caused by mycotoxins.     

苦参颗粒与苦参煎剂药效及毒性的对比性研究

目的:对苦参颗粒与苦参煎剂的药效及毒性进行对比研究,探讨苦参配方颗粒的可行性。方法:选用醋酸致小鼠腹腔毛细血管通透性增加及二甲苯致小鼠耳廓炎症模型,观察苦参颗粒的抗炎作用;采用鸡红血球致敏法观察苦参颗粒对免疫功能的影响,采用改良寇氏法观察苦参颗粒的毒性作用。结果:苦参颗粒能减少醋酸致小鼠腹腔毛细血管通透性增加时伊文思蓝的渗出量(P<0.05~0.01),减轻二甲苯致小鼠耳朵炎症反应的肿胀度(P<0.05);能降低小鼠溶血素的含量(P<0.05~0.01),能降低小鼠吞噬细胞的吞噬指数及吞噬活性,(P<0.05~0.01);结论:苦参颗粒有抗炎及抑制免疫的作用,且其作用与苦参煎剂的作用差别不显著(P(0.05)。小鼠一次灌服苦参颗粒溶液的LD50是:(51.14±9.0827)g生药/kg体重。     

浊毒论治溃疡性结肠炎临证举隅

胡根和从浊毒方面论治溃疡性结肠炎的经验。认为浊毒贯穿本病的始末,并运用解毒化浊方法结合临床病案治疗该病,取得不错的疗效。