基于电刺激的大鼠肌筋膜疼痛触发点的发生机制

目的:探究电刺激下肌筋膜疼痛触发点肌纤维的兴奋性和耐疲劳表现。方法:将48只雄性SD大鼠随机分为对照组(CG1、CG2、CG3)和触发点组(TG1、TG2、TG3)。CG1和TG1测试刺激阈值强度和最大收缩力量(MCF)以及其最适刺激强度;CG2和TG2测试不同刺激强度下MCF的变化;CG3和TG3测试不同刺激频率下MCF的变化。钝性打击结合离心运动造模8周,恢复4周后将大鼠接入生物机能测试系统,给予肌纤维一系列电刺激,测量比较各组引起肌肉收缩的阈值强度、MCF、刺激强度和频率诱导的肌肉疲劳等指标。结果:TG1组引起肌肉开始收缩的阈值强度和最大收缩力量(MCF)的最适刺激强度比CG1组低,具有显著性差异(P0.05);TG1组与CG1组的MCF无显著性差异(P0.05)。TG2组电刺激引起的MCF第15、20次增量电刺激低于第1、5、10次增量,具有高度显著性差异(P0.01);TG2组电刺激引起的MCF第10、15、20次增量CG2组,具有高度显著性差异(P0.01);TG2组电刺激引起的MCF第1、5、10次增量无显著性差异(P0.05);TG2组电刺激引起的MCF第1、5次增量与CG2组相比无显著性差异(P0.05)。TG3组电刺激引起MCF所需的刺激频率比CG3组低,呈高度显著性差异(P0.01);TG3组电刺激引起的MCF比CG3组低,具有显著性差异(P0.05)。结论:与正常肌纤维相比,触发点肌纤维对电刺激反应更敏感,受到连续电刺激时更易疲劳。     

一次性根充法治疗牙髓炎的疗效思路构建

目的：本文就一次性根充法应用于牙髓炎临床治疗中的价值进行了浅显的研究和探析。方法选择我单位口腔中心自2013年7月~2014年7月期间收治的牙髓炎患者68例,将其平均分为观察组和对照组,两组患者均34例,观察组行一次性根充法治疗,对照组行分次根充法治疗,对两组患者的治疗效果,疼痛程度及舒适程度进行观察和统计。结果观察组患者治疗总有效率明显高于对照组患者(<0.05);观察组患者疼痛评分明显低于对照组患者(<0.05);观察组患者舒适评分明显高于对照组患者(<0.05)。结论一次性根充法应用于牙髓炎临床治疗中的效果显著,有效减轻了患者的疼痛程度,值得推广。     

家庭康复护理对脑瘫患儿的意义及实施要点探析

目的：探讨家庭康复护理对脑瘫患儿的意义以及实施要点。方法选取脑瘫患儿患者80例,随机分为观察组和对照组,各40例。对照组出院后给予患儿家长常规健康宣教,观察组出院后对患儿家长实施专业培训,以确保患儿接受有效的家庭康复护理,并比较2组效果。结果观察组适应行为、大运动行为、精细运动行为、语言行为以及个人-社交行为评分分别为（67.9±5.3）、（70.2±4.6）、（64.3±7.1）、（62.5±4.3）、（60.3±4.7）,对照组分别为（48.6±6.7）、（58.9±5.2）、（41.2±5.3）、（41.6±5.1）、（41.2±5.9）,差异有统计学意义（P<0.05）。结论家庭康复护理在脑瘫患儿护理中的应用效果显著,对提高患儿康复效果具有重要作用,值得推广应用。     

气机升降针法治疗肝郁型失眠的临床观察

【目的】观察气机升降针法治疗肝郁型失眠患者的临床疗效。【方法】将符合纳入标准的60例失眠患者随机分为治疗组和对照组各30例。治疗组给予气机升降针法治疗,对照组给予常规针法治疗。观察2组治疗前后多导睡眠图（PSG）、匹兹堡睡眠质量指数（PSQI）及临床疗效变化情况。【结果】（1）治疗后,2组患者睡眠总时间、深睡眠时间及快速眼球运动（REM）睡眠时间均有所延长,睡眠潜伏期缩短,觉醒次数减少（P<0.05）。治疗组睡眠总时间、深睡眠时间以及REM睡眠时间改善作用优于对照组（P<0.05）。（2）治疗后,2组患者PSQI评分均降低（P<0.01）,治疗组降低作用优于对照组（P<0.01）。（3）治疗组和对照组总有效率分别为93.33%和76.67%,治疗组疗效优于对照组（P<0.01）。【结论】气机升降针法治疗肝郁型失眠与常规针法比较疗效更为显著,其操作简便,方法新颖。     

Evidence for Dry Needling in the Management of Myofascial Trigger Points Associated With Low Back Pain: A Systematic Review and Meta-Analysis

Objective

To evaluate the current evidence of the effectiveness of dry needling of myofascial trigger points (MTrPs) associated with low back pain (LBP).

Comparison of isometric and anatomical graft placement in synthetic ACL reconstructions: A pilot study

Correct graft placement is critical to the success of anterior cruciate ligament reconstructions (ACLR). Whilst current trend is to insert the graft in an anatomical location, synthetic grafts have shown to better perform when they are located in an isometric position. Placement, however, is largely dependent on the surgeon and no consensus has been reached for synthetic grafts.Kinematic flexion-extension data of four separate cadaveric knees was obtained using an optical tracking system. Knees were CT-scanned and computer models were developed for each specimen. Three different graft insertion techniques were simulated in each of the computer models. Kinematic data obtained from the optical tracking was applied to the 3D computer models to simulate knee flexion-extension, and virtual change in ACL graft length was measured over the cycle for each insertion technique. Length changes were plotted onto the Radiological-Quadrant.The isometric region on the femur was found to be a band spreading from the mid to deep end of the Blumensaat's line down to the shallow-inferior end of the femoral condyle. The JP Laboureau isometric point technique was consistently located in the isometric zone, with the following coordinates on the Radiographic-Quadrant: t=0.375 (SD 0.0066), h=0.227 (SD 0.0266). The Bernard–Hertel and Charlie Brown anatomical placement methods were located (13%, ?6%) and (8%, ?15%) away, from the JP Laboureau isometric point, respectively, based on t- and h- coordinates of the Radiographic-Quadrant.This study has determined the isometric region using three-dimensional analysis relative to the Radiographic-Quadrant. The JP Laboureau method best finds the isometric point. This information is useful for synthetic graft placement.     

HDR brachytherapy well chamber calibration and stability evaluated over twenty years of clinical use

PurposeThe purpose of the study was to establish, using a retrospective analysis of existing hospital records, the long-term stability and accuracy of a high-dose-rate brachytherapy well chamber. This should be assessed to determine reliability and appropriate calibration frequency. The accrual of long-term data that demonstrates the stability of our chamber may inform others of the performance they might expect from similar equipment.Methods and MaterialsWe evaluated air kerma strength measurements made with the PTW 32002 (Nucletron 077.091) high-dose-rate well chamber on 72 ¹⁹²Ir sources over an 18-year period and the seven calibrations of that chamber which span a 27-year period.ResultsConsecutive air kerma strength measurements agreed within 0.01% on average. The chamber measurement agreed with the source specification within 0.02% on average, but was up to 1.4% during some calibration periods. The chamber calibration coefficient varied by a maximum of 5% over seven chamber calibration measurements.ConclusionsThe constancy of the well chamber current compared with the source manufacturer suggests that our chamber has been stable to better than 2% over a period of 18 years. Although the chamber has received different calibration coefficients over time, these coefficients are within the combined uncertainties of any two calibrations and are consistent with the chamber being stable. The agreement we have observed between clinical measurements and the source manufacturer would justify an action level for further investigation of 1%, for this specific chamber.     

针刺夹脊穴结合温针灸治疗原发性面肌痉挛临床疗效观察

目的:比较针刺夹脊穴结合温针灸与常规针刺治疗原发性面肌痉挛的疗效差异。方法:选择60例符合纳入标准的原发性面肌痉挛病人随机分成两组,每组各30例。对照组用常规针刺治疗,治疗组在对照组的针刺选穴基础上取颈部夹脊穴(C3-C6棘突下旁开0.5寸,左右各4穴)和温针灸养老穴。结果:两组患者的面肌痉挛强度和频率均降低(P<0.05)。总有效率比较,治疗组(90%)>对照组(63.3%),(Z=-2.815,P=0.005<0.01)。结论:针刺夹脊穴结合温针灸与常规针刺均可改善患者面肌痉挛症状,且夹脊穴结合温针灸治疗疗效更佳。     

《中药学》与《中国药典》中药名称差异探究

目的:规范中药材(饮片)名称,使处方名称大众化、科学化、合理化,减少因因人、因地而异发生的中药材(饮片)名称差异。方法:参考《中国药品通用名称命名原则》,以《中药学》教材记录的中药材(饮片)品种为基数,与《中国药典》中药材(饮片)进行统计、对比、分析,整理《中药学》教材与《中国药典》收录中药材(饮片)描述不一致的现象。结果:通过对比,本文总结出9方面存在不一致现象。结论:统一中药材(饮片)名称,可使中药更好的服务于临床,减少处方应付差错率,提高中医药疗效,有利于推进我国中药处方的合理化、规范化、统一化,为走向世界奠定基础。