梅花针叩刺治疗脾肾两虚夹瘀型糖尿病周围神经病变的临床观察

目的：探讨梅花针叩刺治疗脾肾两虚夹瘀型糖尿病周围神经病变(DPN)的临床效果。方法：选取2015年2月至2018年1月广州市番禺区中医院收治的脾肾两虚夹瘀型DPN患者110例作为研究对象，随机分为对照组(n＝50)与观察组(n＝60)。对照组给予硫辛酸+甲钴胺治疗，观察组在对照组治疗的基础上给予梅花针叩刺治疗，2组均治疗观察28 d，记录并观察2组的疗效和预后。结果：观察组的总有效率为98.3%，显著高于对照组的88.0%(P<0.05)。治疗后2组的神经电图潜伏期低于治疗前，且波幅高于治疗前，2组比较差异有统计学意义(P<0.05)。2组治疗后正中神经和腓总神经的MNCV、SNCV高于治疗前，且观察组高于对照组，差异均有统计学意义(P<0.05)。治疗后6个月随访，观察组的复发率为1.7%，显著低于对照组的14.0%，差异有统计学意义(P<0.05)。结论：梅花针叩刺治疗脾肾两虚夹瘀型DPN能改善神经功能指标，提高治疗效果，降低远期复发率。     

自拟降糖通脉汤治疗糖尿病足早期30例

自拟降糖通脉汤治疗糖尿病足早期属气阴两虚患者30例,方以黄芪、葛根为君药,并结合西药降糖降脂等综合治疗,能够有效的预防和治疗糖尿病足部病变,延缓并发症的发生和发展。     

吴玉生教授辨治肝癌经验介绍

[目的]总结吴玉生教授治疗肝癌的学术观点及临证经验,并在临床中进一步推广。     

Frequency of erythrocyte pyruvate kinase deficiency in Chinese infants

The incidence of deficiency of the enzyme pyruvate kinase (PK) in Chinese infants was determined. Both the standard assay of erythrocyte pyruvate kinase enzyme activity and a fluorescent screening test (standardized) were used. The results of these two tests were compared. Of 1,159 infant cord blood samples studied, 26 (or 2.2%) had abnormally low levels of PK activity using the screening test, as did 24 of the samples tested by the enzyme assay. The results indicate that the frequency of a defective PK gene in the population of Guangzhou is significantly lower (p less than .05) than the previously reported defective gene frequency of 3.4% in Hong Kong. They also demonstrate the critical importance of standardization of the screening test, if most accurate estimates of gene frequency are to be derived by using this test.     

人基因工程重组超氧化物歧化酶对骨髓造血干细胞的辐射防护作用

用照射小鼠的骨髓造血干细胞(CFU-S)外源性脾结节形成法,评价人基因工程重组SOD(rhSOD),聚乙二醇(PEG)修饰的长半衰期重组SOD(PEG-SOD)对CFU-S的辐射防护作用.结果显示:rhSOD和PEG-SOD均能明显提高CFU-S产率,其中rh SOD在照射前1h给药效果好,而PEG-SOD在照射前2～3h给药作用更为明显,化学修饰后SOD血浆半衰期延长,将使给药时机及药物作用持续时间得到改善.     

部分性脾栓塞术的临床应用：——附37例报告

应用部分脾栓塞术(PSE)治疗难治性原发性血小板减少性紫癜27例,血栓性血小板减少性紫癜1例;难治性再生障碍性贫血2例;Evan's 综合症2例;系统性红斑狼疮合并血小板减少性紫癜2例;继发性脾亢3例.获完全缓解者24例(64.9%);部分缓解者8例(21.6%),总有效率为86.S%.24例获完全缓解者18例追踪1年,6例复发,复发率为33.3%.与25例切脾对照组及文献报道比较,差异无显著性(P>0.05).本文对 PSE 术后外周血小板的变化进行讨论,并与脾切除作了对比。本文还对血小板破坏场、栓塞范围和方法等影响疗效的因素进行了探讨.作者认为 PSE 术可作为脾切除的替代术.     

Stress Urinary Incontinence at Rest

We retrospectively identified 37 cases in which urinary incontinence occurred at rest during urodynamic testing in the absence of a coincident detrusor contraction or urethral relaxation. This phenomenon, genuine stress incontinence at rest, was observed during 9.6% of multichannel cystometrograms performed at our institution. The observed urine loss occurred at bladder volumes between 145 ml and 800 ml. Loss occurred with bladder overdistension (overflow incontinence) in only 3 subjects (8%). Decreased bladder compliance was observed in 11 (30%) and decreased outlet resistance was demonstrated in 24 (65%). Our findings suggest that genuine stress incontinence at rest is relatively common in a referred population of incontinent women. This phenomenon is associated with impaired urethral function and/or decreased bladder compliance.     

A NEW LIVER TRANSPLANTATION MODEL: POSTSPLENECTOMIC ECTOPIC AUXILIARY LIVER TRANSPLANTATION IN PIGS

Objcctive:To inquire into the possibility and reliability of newly estab-lished liver transplantation model-postsplenectomic ectopic auxiliary liver transplantationin pigs.Methiods:Thirty-six male domestic pigs were used(the recipients and donorseach 18).Donor liver was removed and cold Collins solution perfused.In the recipient pig,the portal vein was constricted by 1/3 original diameter,then the spleen resected.Afterthat,the donor liver was transplanted on the splenic bed.The anastomotic procedure wasdone as following:hepatic artery-splenic artery anastomosis(HA-SA), hepatic vein-left re-nal vein anastomosis(HV-RV),and portal vein-splenic vein anastomosis(PV-SV).Commonbile duct was intubated and bile was collected with an extracorporeal bag.Pre-and Post-operative determinations were carried out,including serum biochemistry,hepatic patho-logical examination(microscopy and electroscopy),and anastomotic stoma pressure,etc.Results:Of the 18 recipient pigs,four died during operation(22.2%).Postoperative ob     

Survey of Vitamin and Mineral Supplementation after Gastric Bypass and Biliopancreatic Diversion for Morbid Obesity

Background: The authors investigated whether practice patterns of bariatric surgeons correlate with published data regarding metabolic deficiencies after Roux-en-Y gastric bypass (RYGB) and biliopancreatic diversion (BPD). Methods: 109 surgeons completed a questionnaire to determine use of supplements and frequency of lab tests. Results: Regarding supplements routinely prescribed after RYGB, 96% of surgeons gave multivitamins, 63% gave iron, and 49% gave vitamin B₁₂. After BPD, 96% of surgeons gave multivitamins, 67% gave iron, 42% gave vitamin B₁₂, 97% gave calcium, 63% gave fat-soluble vitamins, and 21% gave protein supplements. Regarding laboratory tests obtained routinely after RYGB, 95% of surgeons do complete blood counts, 56% do iron determinations, 66% do vitamin B₁₂ determinations, 58% do folate determinations, 76% do electrolyte determinations, and 8% test for proteins. After BPD, 96% of surgeons do complete blood counts, 80% do iron determinations, 67% do vitamin B₁₂ determinations, 71% do folate determinations, 88% do electrolyte determinations, 84% do protein determinations, and 46% test for fat-soluble vitamins. Regarding frequency of blood tests, after RYGB, 22% of surgeons obtain them after 3 months, 33% after 6 months, and 41% after 12 months; 4% do not routinely obtain postoperative laboratory tests. After BPD, 46% of surgeons obtain them after 3 months, 33% after 6 months, and 16% after 12 months; one does not obtain laboratory tests. Surgeons estimated these deficiencies after RYGB: 16% iron, 12% vitamin B₁₂, 14% anemia, 5% protein, and 3% calcium. They estimated these deficiencies after BPD: 26% iron, 11% vitamin B₁₂, 21% anemia, 18% protein, 16% calcium, and 6% fat-soluble vitamins. The estimated incidence of deficiencies after RYGB was considerably lower than the published incidence. Unnecessary tests were commonly performed (electrolytes after RYGB). Conclusion: Despite wide variations in the performance of laboratory tests and the use of supplements, the practice patterns of most surgeons protect patients from developing severe metabolic deficiencies after RYGB and BPD.