刺五加注射液对急性血瘀症小鼠耳廓微循环的影响

目的观察刺五加注射液对急性血瘀症小鼠耳廓微循环的影响。方法采用耳廓微循环观察法观察剌五加注射液对正常和急性“血瘀症”小鼠耳廓微循环的影响。结果刺五加注射液能明显增大正常及急性“血瘀症”小鼠耳廓微细动静脉口径,增加毛细血管开放量。结论刺五加注射液具有改善急性血瘀症小鼠微循环作用。     

艾迪注射液治疗非小细胞肺癌系统评价

目的：评价艾迪注射液治疗非小细胞肺癌的有效性和临床研究质量。 方法：检索PubMed（1980～2008年）、Cochrane中心对照试验注册资料库（Cochrane Central Register of Controlled Trials,CENTRAL）2008年第3期、EMBASE（1984～2004年）、CancerLit（1996～2003年）、中国生物医学文献数据库（CBMdisc1980～2008年）、中国学术期刊网专题全文数据库（中国知网1980～2008年）、中文科技期刊全文数据库（重庆维普1980～2008年）、万方数据库（1980～2008年）,并根据文献中的参考文献进行文献追溯。手工检索四川大学医学图书馆部分相关期刊,纳入随机对照试验。使用国际Cochrane中心推荐的方法进行文献质量评价,并用RevMan5．0软件进行统计分析。 结果：共纳入14篇研究,且均为低质量研究。14项研究显示,在改善瘤体变化方面,艾迪注射液联合^60Co与单独应用^60Co比较,差异有统计学意义（P=0．0002）,相对危险度（relative risk,RR）为1．93,95％可信区间（confidence interval,CI）[1．36,2．72];艾迪注射液联合长春瑞滨和顺铂（navelbine and platinol,NP）与单用NP比较,差异亦有统计学意义（P=0．04）,RR=1．18,95％CI[1．00,1．38]。但艾迪注射液联合依托泊苷和顺铂（etoposideand and platinol,EP）、紫杉醇制剂和顺铂（taxinoland and platinol,TP）以及伽玛刀与单用EP、TP和伽玛刀比较,差异均无统计学意义（P=0．60,P=0．16,P=0．34）,其RR和95％CI分别为1．17[0．65,2．09],1．27[0．91,1．78]和1．08[0．92,1．26]。6项研究证实艾迪注射液联合NP或伽玛刀能够改善患者的生活质量。6项研究显示艾迪注射液具有保护骨髓造血功能的作用。3项研究显示可提高免疫功能。3项研究显示艾迪注射液未能提高1年及以上生存率。 结论：艾迪注射液对非小细胞肺癌可能具有一定的辅助治疗作用,但不排除与纳入文献质量较低,各种治疗方案纳入研究数量少和发表偏倚有关,尚需大样本多中心随机对照临床试验进一步证实其临床疗效。     

新注射吸毒者及长期注射吸毒者共用针具的影响因素分析

目的 了解新注射吸毒者和长期注射吸毒者共用针具的影响因素.方法 对四川省注射吸毒者进行社区横断面调查.结果 3852名被调查者中,注射吸毒史<1年、1～3年和>3年者最近6个月共用针具比例依次为19.9%、29.1%和36.3%.注射吸毒<1年的被调查者共用针具的独市影响因素包括女性、少数民族、注射吸毒频率高、共用注射器/针头以外其他吸毒用具、有非同定性伴、固定性伴注射吸毒、未自愿做过艾滋病检测、招募年、招募地区;注射吸毒1～3年的被凋查者共用针具的独立影响因素包括文化程度低、注射频率高、共用注射器/针头以外其他吸毒用具、有非固定性伴、固定性伴注射吸毒、未使用安全套、未参与技能培训、招募年、招募地区;注射吸毒>3年的被调奋者共用针具的独立影响因素包括文化程度低、注射频牢高、共用注射器/针头以外其他吸毒用具、有非同定性伴、有商业性伴、固定性伴注射吸毒、未使用安全套、未参与针具交换、招募年、招募地区.结论 新注射吸毒者和长期注射吸毒者共用针具及无保护性行为比例均较高,长期注射吸毒者较新注射吸毒者有更多共用针具行为和无保护性行为,针对两类人群的干预应有不同侧重.     

The efficacy of a network intervention to reduce HIV risk behaviors among drug users and risk partners in Chiang Mai,Thailand and Philadelphia,USA

This HIV Prevention Trials Network study assessed the efficacy of a network-oriented peer education intervention promoting HIV risk reduction among injection drug users and their drug and sexual network members in Chiang Mai, Thailand and Philadelphia, USA. The study was designed to test impact on HIV infection, but the infection rate was low and the study was terminated early. This paper reports efficacy on outcomes of self-reported HIV risk behaviors. We enrolled 414 networks with 1123 participants. The experimental intervention consisted of six small group peer educator training sessions and two booster sessions delivered to the network index only. All participants in both arms received individual HIV counseling and testing. Follow-up visits occurred every six months for up to 30 months. There were 10 HIV seroconversions, 5 in each arm. The number of participants reporting injection risk behaviors dropped dramatically between baseline and follow-up in both arms at both sites. Index members in the intervention arm engaged in more conversations about HIV risk following the intervention compared to control indexes. There was no evidence of change in sexual risk as a result of the intervention. Reductions in injection risk behaviors were observed: 37%, 20%, and 26% reduction in odds of sharing cottons, rinse water and cookers, respectively, and 24% reduction in using a syringe after someone else. Analysis of the individual sites suggested a pattern of reductions in injection risk behaviors in the Philadelphia site. In both sites, the intervention resulted in index injection drug users engaging in the community role of discussing reduction in HIV injection risk behaviors. The intervention did not result in overall reductions in self-reported sexual risk behaviors, and although reductions in injection risk behaviors were observed, the overall efficacy in reducing risk was not established.     

侧隐窝注射与大推拿整复术治疗腰椎间盘突出症的疗效分析

目的评价侧隐窝注射与大推拿整复术治疗腰椎间盘突出症的效果。方法腰椎间盘突出症患者,观察组48例采用侧隐窝注射与大推拿整复术治疗;对照组67例采用后正中人路硬膜外注射与大推拿整复术治疗。两组住院期间均行一次性麻醉下大推拿整复术治疗。结果两组患者平均住院10d,随访时间6个月。观察组麻醉效果的优良率为100％、治愈率为58．3％均优于对照组（P〈0．05）。观察组麻醉平面〉T10的病例为12．5％,低于对照组的52．2％（P〈0．05）。结论侧隐窝注射联合大推拿整复术治疗腰椎间盘突出症更有优势。     

Hydroxy-propyl-methyl-cellulose is a safe and effective lifting agent for endoscopic mucosal resection of large colorectal polyps

Background  Endoscopic mucosal resection (EMR) is today the treatment of choice for flat and sessile colorectal lesion, the only concern being completeness of resection. One of the major issues is the choice of the infiltrating substance to enable a long-lasting cushion under the lesion. The aim of this study was to prospectively evaluate safety and efficacy of hydroxy-propyl-methyl-cellulose (HPMC) injection for this purpose. Patients  All flat and sessile lesions of the colon and rectum larger than 20 mm and considered suitable for EMR were included. In all cases 0.8% HPMC solution was injected through a 23G needle, in quantity according to the endoscopist’s indication. Primary endpoints of the study were: (1) ability to perform en bloc resection of the lesions by using this new injection means, (2) complete resection rate, and (3) early and late complication rate. Results  We resected 27 flat, sessile, or laterally spreading lesions up to 60 mm (28 mm average). Mean dose of HPMC injected was 10.2 ml (range 8–40 ml). Median procedure time was 32 min (range 15–105 min). En bloc resection was achieved in up to 21 cases (78%). Histologically detected complete tumour removal was achieved in 23 lesions, whereas lateral margins could not be properly evaluated in 4 cases due to coagulation artefacts. No perforation was observed. Procedural spurting bleeding was managed by epinephrine injection in one case and clip application in the remaining. Two case of local recurrence of adenomatous tissue were observed at 3 and 12 months, and treated by EMR. No complication related to the use of HPMC was observed. Conclusions  Injection of HPMC for EMR resulted safe and effective, allowing en bloc resection in the majority of cases with a limited number of complications. Continued progress in the field will include more outcomes research and techniques simplification. None of the authors have any conflict of interest to declare.     

加味桃红四物汤对骨髓基质干细胞体外诱导的实验研究

目的研究加味桃红四物汤对骨髓基质干细胞早期促缺氧诱导因子（HIF-1）与血管内皮生长因子（VEGF）分泌的影响。方法骨髓基质干细胞取材,设置中药组及生理盐水组,观察HIF-1、VEGF表达。结果中药组对骨髓干细胞培养第2d HIF-1α表达量开始出现,第5、7天后中药组HIF-1α mRNA的表达量显著低于生理盐水组。而第3、5、7、14天VEGF表达中药组表达较生理盐水组强,在第5、7天VEGF表达达到峰值。结论加味桃红四物汤可以诱导骨髓基质干细胞向血管祖细胞分化,并促相关生长因子表达。     

丹红注射液治疗糖尿病合并冠心病心绞痛疗效观察

目的探讨丹红注射液治疗糖尿病合并冠心病的临床疗效。方法125例糖尿病合并冠心病心绞痛患者随机分为对照组和治疗组。在常规降糖、冠心病治疗的同时,治疗组加用丹红注射液。观察两组患者用药前后自觉症状、心绞痛发作、心电图,血糖等指标。结果治疗组患者自觉症状好转,其心绞痛缓解和心电图改善总有效率分别为91%和72%,优于对照组（68%和53%）,两组比较有显著性差异（P〈0.05）。结论丹红注射液是治疗糖尿病合并冠心病心绞痛明确有效的药物。     

柴胡止痫汤治疗癫痫30例

目的:观察柴胡止痫汤治疗癫痫的临床疗效。方法:自拟柴胡止痫汤加减治疗原发性癫痫30例。结果:痊愈23例,好转5例,无效2例。总有效率94%,痊愈率76%。结论:柴胡止痫汤治疗癫痫疗效较佳。     

A comparison of intra-articular hyaluronan injection accuracy rates between three approaches based on radiographic severity of knee osteoarthritis

OBJECTIVE: To compare the accuracy rates of intra-articular hyaluronic acid (HA) injections for osteoarthritis (OA) of the knee between the modified Waddell approach (an anteromedial approach with manipulative ankle traction at 30 degrees of knee flexion), an anteromedial approach with the subjects seated (hereinafter the seated anteromedial approach) and a lateral patellar approach based on the Kellgren-Lawrence (K-L) radiographic grade (II, III and IV). DESIGNS: Fifty patients with knee OA received HA injections through the three approaches. The accuracy rates were confirmed with a single radiograph after injections of a mixture of radiographic contrast medium. RESULTS: In the K-L grade IV cases (n=11), the accuracy rates through the modified Waddell approach (11 out of 11, 100%) were significantly higher than those through the seated anteromedial approach (six out of 11, 55%) and the lateral patellar approach (six out of 11, 55%) (P=0.035). No significant differences were detected in the accuracy rates of the participants classified as grade II (n=21) or III (n=18) cases between the modified Waddell approach (86% and 78%, respectively), the seated anteromedial approach (71% and 56%, respectively) and the lateral patellar approach (86% and 61%, respectively) (P>0.05). CONCLUSION: Although previous studies have been conducted on the accuracy of needle placement into the intra-articular space of the knee, no evaluations were performed with the results categorized by radiographic severity. This study highlighted the need for clinicians to change the approach employed for HA injections, according to the severity of knee OA.