经颅多普勒超声对脑小血管病的作用

目的探讨老年人群经颅多普勒超声搏动指数(PI)与脑小血管疾病各型之间的关系。方法对210例老年患者进行经颅多普勒超声(TCD)和磁共振成像(MRI)检查,评价大脑中动脉(MCA)PI与脑白质病变(WML)、小卒中和微出血之间的关系。结果多因素Logistic回归发现,MCA PI与WML有关(优势比,MCA PI每增加0.1增加1.13,95%置信区间为1.06~1.80;P=0.02)。就识别严重WML来说,在最佳MCA PI位点,曲线下面积、阳性预测值和阴性预测值分别为0.70(95%可信区间为0.60~0.80)、35.4%和86.6%。MCA PI与各种小卒中或微出血之间无明确相关性。结论 MCA PI与脑白质病变严重性相关,具有很高的阴性预测值,MCA PI正常时患严重WML的可能性低。在老年患者,TCD可用来指导进行选择性MRI扫描以发现WML。     

Vessel wall MRI for suspected isolated basilar artery dissection

Isolated basilar artery dissection is an uncommon intracranial vasculopathy with a poor prognosis. Digital subtraction angiography is considered the definitive modality for diagnosis. Vessel wall MRI (VW-MRI) is an emerging non-invasive technique for assessing the structural integrity of intracranial vessel walls and lumina. Recently, a small number of studies have described the vessel wall patterns of intracranial artery dissection. However, studies on vessel wall imaging of isolated basilar artery dissection remain limited. We describe a patient with suspected isolated spontaneous basilar artery dissection diagnosed using VW-MRI.     

Experience of Treatment of Depression by Acupuncture plus Medicine

Depression is a type of psychosomatic disorder that presents with persistent depressed emotion （or mood）, poor concentration and psychomotor inhibition. It is more than a psychological problem. However, with pathological changes of biology, depression can be either a major symptom of one condition or accompanying symptom of other conditions.     

益气通督手法治疗小儿脾虚泻的多中心随机对照研究

目的:对益气通督手法治疗小儿脾虚泻的疗效进行评价。方法:将275例患儿采用多中心、随机、对照方法分为观察组(n=137)和对照组(n=138),观察组采用益气通督手法治疗,对照组采用中医院校教材《推拿学》中所规定手法治疗。治疗7天后比较两组疗效。结果:观察组治愈率为83.2%,对照组治愈率为69.6%,差异有统计学意义(P<0.05),观察组疗效优于对照组。两组平均治愈时间比较,观察组平均治愈时间(3.22±1.04)天,对照组平均治愈时间(4.20±1.11)天,差异有统计学意义(P<0.05),观察组短于对照组。结论:益气通督手法治疗小儿脾虚泻疗效确切,起效快,适宜普及推广应用。     

浅刺调督法对老年性痴呆模型海马胆碱酯酶活性的影响

目的:探索连续30天对大白鼠腹腔注射氢溴酸东莨菪碱SCOP 3mg/kg能否作为老年性痴呆的造模方法,并探讨浅刺调督法对老年性痴呆的作用机制。方法:模型组、预防组及治疗组采用氢溴酸东莨菪碱腹腔注射3mg/kg,空白组予等量生理盐水腹腔注射,每日1次,连续30天,预防组在实验之日起针刺,治疗组在造模30天后,进行针刺治疗,连续30天。再采用Morris水迷宫检测各组大白鼠的学习与记忆行为。各组实验结束后,抽取大鼠腹腔静脉血5mL,完成后立即快速断头取脑,在冰盘上分离大鼠海马组织,保存在-75℃冰箱内,待进行生化测定。结果:海马胆碱酯酶(CHE)及血液中丙二醛(MDA)检测指标模型组与空白组有显著差别,说明了浅刺调督法对老年性痴呆的部分作用机制,及浅刺调督法对老年性痴呆模型有一定的作用效果。     

Coil Embolization Treatment in Pulmonary Artery Branch Rupture During Swan-Ganz Catheterization

Rupture of the pulmonary artery or one of its branches during Swan-Ganz catheterization is a complication that is rare but remains fatal in almost 50% of cases. The risk factors and mechanisms involved in the pathogenesis of this accident have been widely reported. Management is twofold: resuscitation procedures and specific medical or even surgical treatment. We report a case of pulmonary artery rupture occurring during Swan-Ganz catheterization that was treated by coil embolization. This technique, which is quick and simple to use, would appear to be very promising. This is the first case of successful emergency treatment of pulmonary artery rupture using an endovascular technique.     

督脉导气法治疗抑郁症睡眠障碍临床观察

目的：观察用督脉导气针法合并抗抑郁药物治疗抑郁症睡眠障碍的临床疗效，寻找治疗抑郁症睡眠障碍的有效方法。方法：将45例抑郁症睡眠障碍患者随机分为两组，治疗组23例用督脉导气针法合并抗抑郁药物治疗，取神庭、百会、大椎、神道、至阳为主穴，同时内服抗抑郁药物；对照组22例采用单纯抗抑郁药物治疗。疗程均为4周。观察两组汉密尔顿（HAMD）量表及匹兹堡睡眠质量指数（PSQI）量表治疗前后的变化情况。结果：HAMD量表分值在两组治疗前后差异均有非常显著性意义（P〈0．01），但PSQI量表分值仅在治疗组治疗前后差异有非常显著性意义（P〈0．01），而对照组治疗前后差异无显著性意义（P〉0．05）;治疗后治疗组与对照组相比，HAMD和PSQI量表分值差异均有非常显著性意义（P〈0．01）。结论：督脉导气针法合并抗抑郁药物治疗可显著改善抑郁症睡眠障碍。     

Structural airway abnormalities in infants and young children with cystic fibrosis

OBJECTIVES: To determine whether the airway structure of infants and young children with cystic fibrosis (CF) differs from that of normal children by using high-resolution computed tomography (HRCT) imaging. Study design Full-inflation, controlled ventilation HRCT images of the lungs were obtained at four anatomic levels in 34 infants with CF (age, 2.4+/-1.4 years) and 20 control infants (age, 1.8+/-1.4 years). Short axis diameters of all clearly identifiable, round airway/vessel pairs were measured to obtain airway wall thickness (AWT), airway lumen diameter (ALD), and vessel diameter (VD). RESULTS: In infants with CF, mean AWT (+/-SD) was 0.58+/-0.13 mm, ALD was 1.31+/-0.56 mm, and VD was 1.62+/-0.58 mm. In control infants, mean AWT was 0.49+/-0.13 mm, ALD was 1.07+/-0.42 mm, and VD was 1.86+/-0.64 mm. Mean AWT and ALD were greater in children with CF than in normal subjects (P<.001). ALD:VD ratios increased with age in patients with CF compared with control subjects (P=.026). CONCLUSIONS: The airways of infants and young children with CF have thicker walls and are more dilated than those of normal infants.     

经络的内涵与神经的联系

经络学说起源于对“脉”的解剖生理学认识 ,以脉行的路径为经脉 ,以脉行的分支横出的径路为络脉 ,从而逐渐形成了经脉和络脉的概念。“经络”两字的字源学含义也具有神经系功能。对经络学说提出挑战的是来自西方医学的传入 ,即人们在认识神经学说的结构与功能之后 ,来阐释经络沟通人体体表与体表上、下之间 ,体表与内脏内、外之间特异联络、调控和反应功能。在明末传入的西方解剖生理学 ,或是在晚清西方医学科学的东传过程中 ,与经络功能相关的中医词汇如“细筋”、“系”等曾作为“nerve”的汉译名词 ,从而在中西医汇通的初创阶段 ,奠定了经络与神经功能活动相关的文字转换基础。     

艾灸对亚急性衰老小鼠抗氧化酶活性影响的实验研究

目的通过测定亚急性衰老小鼠红细胞中SOD、血浆中CAT、肝组织中GSH-PX的活力,探讨艾灸督脉经穴的延缓衰老作用.方法以D-半乳糖造成的亚急性衰老小鼠为实验对象,艾灸"大椎"、"命门"、"足三里"穴,治疗结束后测定SOD、CAT、GSH-PX等酶的活力.结果各治疗组与模型组比较,各抗氧化酶的活力明显上升,有显著性或非常显著性意义(P<0.05,P<0.01);各治疗组与空白组比较,各酶的活力接近空白组,无显著性意义(P>0.05);各治疗组间比较,无显著差异(P>0.05).结论提示艾灸大椎、命门穴具有延缓衰老的作用.