电针对大鼠脑局部缺血-再灌流损伤的保护作用

再灌流前电针“环跳”穴３０ｍｉｎ，观察对左大脑中动脉（ＭＣＡ）缺血 再灌流模型大鼠早期运动功能、自由基代谢、脑水肿及神经电生理活动的影响。结果：缺血再灌＋针刺组大鼠再灌流后神经功能缺损状况有较明显的改善，病灶侧脑组织过氧化物歧化酶（ＳＯＤ）活性及丙二醛（ＭＤＡ）含量恢复到接近假手术对照组的水平。皮层体感诱发电位（ＳＥＰ）测量表明缺血侧Ｐ１潜伏期及Ｐ１ Ｎ１波幅亦有显著性改善。结果表明：于再灌流前电针处理对本模型脑缺血 再灌流损伤有保护作用     

肝硬化患者的脑电活动地形图

对２０例无临床肝性脑病的失代偿期肝硬化患者进行脑电活动地形图（ＢＥＡＭ）检查，并与３３例正常人作对照，以探讨亚临床肝性脑病（ＳＨＥ）的诊断价值。结果表明，２０例肝硬化患者中，ＢＥＡＭ正常５例，轻度异常５例，轻￣中度异常５例，中度异常５例，总异常率为７５％（１５／２０）。ＢＥＡＭ异常的分布特点以弥漫性分布为主要表现，主要为慢频域（δ．θ．δ＋θ／α＋β）活动增强，Ｚ值增高，只有３例波及α频域。提示：     

Effect of verapamil on development of the pain syndrome in rats after sciatic nerve division

Laboratory of Pathophysiology of Pain and Laboratory of General Pathology of the Microcirculation, Research Institute of General Pathology and Pathological Physiology, Russian Academy of Medical Sciences, Moscow. Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 114, No. 9, pp. 229–231, September, 1992.     

Topographical analysis of the EEG effects of a subconvulsive dose of lidocaine in healthy volunteers

Background: The purpose of the present study was to assess the effects of intravenous lidocaine on spatial changes of electroen-cephalographic power and on psychomotoric status in conscious volunteers.
Methods: In 11 healthy volunteers lidocaine (2-min bolus, 100 mg; 15-min infusion, 40 μg kg^-1 min^-1) or placebo were given intravenously in a randomized, single-blinded, two-way crossover study. Haemodynamics and lidocaine plasma concentrations were measured at baseline and within a period of 30 min following bolus injection. Vigilance and emotional status were tested using visual analogue scales (VAS). Toxic CNS effects were evaluated by a questionnaire. The raw EEG (17 leads, reference C_z) and computed power spectra were continuously recorded.
Results: The chosen lidocaine dosage led to nearly constant plasma concentrations (unbound lidocaine 2.5 min and 15 min after bolus 0.36±0.14 μg/ml and 0.30±0.06 μg/ml, respectively [mean±SD]). The placebo caused no symptoms, changes in VAS-scores or EEG-parameters. Lidocaine induced pronounced subjective symptoms and significant increases in delta activity for 15 min, most dominant at the frontotemporal and occipital leads (max. +219% O₁). Frontal and occipital beta1 and beta2 power (max. +131% and +124% at O₁, respectively) was immediately increased after the bolus injection. No EEG changes occurred at central region C_z, and no interhemispheric EEG differences were noted. Theta, alphal, and alpha2 power remained unchanged.
Conclusion: The current data demonstrate simultaneous changes in psychomotoric status as well as delta and beta spectral power during lidocaine infusion. These data could be an indication that the pronounced frontotemporal and occipital EEG changes are the electroencephalographic expression of subjective sensations.     

Primary Prevention of Sudden Cardiac Death in Heart Failure: Will the Solution Be Shocking?

Sudden cardiac death (SCD) may occur in as many as 40% of all patients who suffer from heart failure. This review describes the scope of the problem, risk factors for SCD, the effect of medications used in heart failure on SCD and the potential effect of the implantable cardioverter-defibrillator in primary prevention.     

In vivo 31P NMR studies of paraplegics' muscles activated by functional electrical stimulation

The bioenergetics of paralyzed muscles of spastic paraplegic patients under functional electrical stimulation (FES) was studied in vivo using ³¹P NMR. The protocol included rest, 3 min of induced tetanic isometric contraction through surface electrodes and 40 min of recovery. The continuous stimulation, the force recording and the ³¹P NMR measurements were sampled simultaneously inside the whole body imager. Normal values were found for the phosphorous metabolite ratios at rest. During contraction, prominent changes were detected including: a) accumulation of inorganic phosphate (P) accompanied by an unusually strong signal in the phosphomonoester (PME) region, b) phosphocreatine (PCr) decline, and c) a decrease in the intracellular pH. In the following recovery period the physiological state of the muscle was monitored and quantitated by ³¹P NMR. No metabolic and mechanical irreversible damage was detected in the paraplegics' muscles activated by FES under our experimental conditions.     

低频脉冲电刺激联合摄食-吞咽训练在AIS后吞咽障碍的应用及疗效

探讨低频脉冲电刺激联合摄食-吞咽训练在急性缺血性脑卒中（AIS）后吞咽障碍的应用及对呼吸能力、吞咽功能、营养指标的影响。方法 选取本院2019年6月—2021年8月107例AIS后吞咽功能障碍患者,随机分为观察组（n=54）和对照组（n=53）,对照组给予摄食-吞咽训练,观察组在对照组的基础上使用低频脉冲电刺激治疗,两组均持续治疗1个月,比较两组治疗前后吞咽功能、舌骨喉复合体动度、喉镜吞咽功能(FEES)评估结果、呼吸功能、营养指标以及并发症发生情况。结果 观察组治疗后洼田饮水试验评定、标准吞咽功能评价量表（SSA）评分、吞咽功能初筛量表（EAT-10）评分低于对照组（P＜0.05）;观察组治疗后舌骨喉复合体动度包括舌骨向前、上移以及喉向前、喉上移最大幅度均大于对照组（P＜0.05）;观察组治疗后FEES评价中声带麻痹、食物渗漏、食物潴留、误吸比例低于对照组（P＜0.05）;观察组治疗后肺功能指标最长呼气时间、第一秒用力呼气容积（FEV1）、用力肺活量（FVC）以及最大吸气压（PImax）均大于对照组（P＜0.05）;观察组治疗后营养指标BMI指数、血清总蛋白（TP）、白蛋白（ALB）、转铁蛋白（TRF）、前白蛋白（PALB）水平均高于对照组（P＜0.05）;观察组吸入性肺炎发生率低于对照组,营养不良发生率为低于对照组（均P＜0.05）。结论 低频脉冲电刺激联合摄食-吞咽训练治疗AIS后吞咽障碍,可有效促进吞咽功能恢复,改善舌骨喉复合体动度,增强呼吸功能,提高营养状态,降低并发症发生风险     

调和阴阳法针灸对老年不寐患者睡眠质量及MT、NE、5-HT水平的影响

目的 探讨调和阴阳法针灸对老年不寐患者睡眠质量及褪黑素（MT）、去甲肾上腺素（NE）、5-羟色胺（5-HT）水平的影响。方法 选取2020年7月—2022年7月河北医科大学第一医院收治的老年不寐患者120例,采用随机数表法分为观察组和对照组,每组60例。对照组采取常规药物治疗,观察组在对照组基础上联合调和阴阳法针灸。比较两组临床疗效,同时评估其中医证候积分和匹兹堡睡眠质量指数（PSQI）评分,测定MT、NE、5-HT、多巴胺（DA）、γ-氨基丁酸（GABA）水平,观察记录不良反应发生情况。结果 观察组总有效率高于对照组（P <0.05）;观察组治疗前后入睡困难、多梦易醒、神疲食少、目赤口苦、舌红少津、脉弦数、舌苔黄评分的差值均高于对照组（P <0.05）。观察组与对照组治疗前及治疗后2、4周的PSQI评分比较,结果 ①不同时间点PSQI评分比较,差异有统计学意义（F =17.894,P =0.000）;②两组PSQI评分比较,差异有统计学意义（F =26.894,P =0.000）,观察组PSQI评分较低,相对睡眠质量较好;③观察组与对照组PSQI评分变化趋势比较,差异有统计学意义（F =45.247,P =0.000）。观察组治疗前后睡眠总时间、快速眼动睡眠期、睡眠潜伏期、醒觉时间、睡眠效率的差值均高于对照组（P <0.05）;观察组治疗前后MT、NE、5-HT的差值均高于对照组（P <0.05）;观察组治疗前后DA、GABA的差值均高于对照组（P <0.05）;两组不良反应总发生率比较,差异无统计学意义（P >0.05）。结论 调和阴阳法针灸治疗老年失眠症疗效显著,不仅能有效改善患者中医症状、睡眠质量及睡眠结构,还能改善血清MT、NE、5-HT、DA、GABA水平,安全性较高。     

方剑乔教授针药结合治疗类风湿性关节炎的临床思辨特色与治疗经验

[目的] 介绍方剑乔教授针药结合治疗类风湿性关节炎的临床思辨特色及其临证经验。[方法] 通过整理、回顾、分析方教授治疗类风湿性关节炎的相关文献及医案,从中医病因病机和治则治法等方面,总结归纳方教授治疗类风湿性关节炎的学术经验,并列举医案一则予以佐证。[结果] 临床思辨上,方教授认为“痰、瘀、虚交错”为该病的基本病机,治疗宜针药结合,主要起到同效相须、异效互补和反效制约的作用。临证治疗上,方教授强调,针刺宜整体治疗与局部穴位兼顾,须重视经络辨证。合理应用电针,疼痛急性发作期电针频率多选择“先高后低”,先100 Hz/10～15 min,后2 Hz/30 min;慢性疼痛期电针治疗多选择疏密波(2/100 Hz)。用药强调精准辨证,在该病四种基本证型的基础上提出了阴虚湿热兼证的概念,确立了滋阴清热、通络止痛的治疗大法。倡导适时采用经皮穴位电刺激治疗,其操作简单,携带方便,在镇痛方面具有明显的优势。所举病案采用西药甲氨蝶呤片抑制免疫,稳定病情;中药以祛风除湿为主,佐以藤类药通络行窜、祛风止痛;电针治疗选择频率为2/100 Hz的疏密波调和气血、通络止痛。经治疗后,患者症状缓解,相关指标趋于正常。[结论] 方剑乔教授根据本病的病因病机及临床特点进行辨证论治,针药并重,中西医取长补短,临床特色鲜明,治疗效果显著,值得临床借鉴和推广。