益气养血法治疗眼病

凡眼病见少气懒言、身倦乏力、头晕目眩、面色淡白无华、劳累后加重或心悸、失眠、多梦,舌淡苔白,脉细弱等气血不足的表现,均可以益气养血法治疗,所谓"有是证,用是药"。益气养血法用药大多以补益药为主,略显滋腻,可适当加入枳壳、陈皮、佛手等行气健脾之品。还应注意余邪未尽时不宜应用,若虚实夹杂者,宜攻补兼施以免留邪。     

超声心动图评价 慢性肾功能衰竭患者血液透析前后右心室功能

目的应用超声心动图评价慢性肾功能衰竭患者血液透析前后右心室容量和心肌力学参数变化情况。方法选取经临床确诊为慢性肾功能衰竭并行血液透析的患者100例,于血液透析前后行超声心动图检测三尖瓣侧壁瓣环收缩期位移(TAPSE)、右心室面积变化分数(RV FAC)及收缩期二维右心室游离壁峰值应变(2D RVFWLS);组织多普勒测量舒张期三尖瓣环运动速度(e、a)和收缩期三尖瓣反流峰值速度(TRmax)。比较透析前后上述各参数的变化情况;分析上述参数与透析超滤量的相关性。结果血液透析后患者体质量较透析前明显减低,差异有统计学意义(P0.05);透析后肱动脉收缩压和舒张压与透析前比较差异均无统计学意义。透析后TAPSE为(21.36±2.35)mm,较透析前(20.23±2.30)mm增加,差异有统计学意义(P0.05);透析前后RV FAC、2D RVFWLS、e/a及TRmax比较,差异均无统计学意义。透析后仅肱动脉舒张压与透析超滤量具有相关性(r=0.304,P=0.002)。结论 TAPSE与右心室容量负荷(前负荷)改变有关,提示血液透析可增强右心室游离壁纵向收缩功能,但与血液透析超滤量无关;透析超滤量影响肱动脉舒张压。     

无创正压通气治疗慢性阻塞性肺疾病呼吸衰竭伴意识障碍的疗效观察

目的观察无创正压通气（NPPV）治疗慢性阻塞性肺疾病（COPD）呼吸衰竭伴意识障碍患者的疗效。方法将入选的16例COPD呼吸衰竭伴意识障碍患者分为A组,16例意识障碍不明显患者分为B组。在常规治疗的基础上行双水平无创正压通气（BiPAP）,动态观察治疗前后动脉血气、Glasgow昏迷评分、NPPV天数、住院天数、最高IPAP、NPPV成功率、住院病死率及不良反应情况。结果 A组NPPV成功率和住院病死率分别为68.75%（11/16）和18.75%（3/16）,B组分别为81.25%（13/16）和12.5%（2/16）,差异无统计学意义（P均〉0.05）。A组最高IPAP均值较B组高6 cmH2O,且NPPV和总住院时间也较B组长3和7 d（P〈0.05或P〈0.01）。A组胃肠胀气和面部皮肤损伤较B组发生率高（68.75%比18.75%,25.0%比6.25%,P〈0.05）。结论 NPPV对COPD呼吸衰竭伴意识障碍患者也有较好的疗效,意识障碍不是NPPV治疗的绝对禁忌症。     

Arthrocentesis followed by intra-articular autologous blood injection for the treatment of recurrent temporomandibular joint dislocation

Temporomandibular joint (TMJ) dislocation is an excessive forward movement of the condyle beyond the articular eminence with complete separation of the articular surfaces and fixation in that position. This study was conducted to assess autologous blood injection to the TMJ for the treatment of chronic recurrent TMJ dislocation. Fifteen patients with bilateral chronic recurrent condylar dislocation were included in the study. Bilateral TMJ arthrocentesis was performed on each patient, followed by the injection of 2 ml of autologous blood into the superior joint compartment and 1 ml onto the outer surface of the joint capsule. Preoperative and postoperative assessment included a thorough history and physical examination to determine the maximal mouth opening, presence of pain and sounds, frequency of luxation, recurrence rate, and presence of facial nerve paralysis. Eighty percent of the subjects (12 patients) had a successful outcome with no further episodes of dislocation and required no further treatment at their 1-year follow-up, whereas three patients had recurrent dislocation as early as 2 weeks after treatment. Autologous blood injection is a safe, simple, and cost-effective treatment for chronic recurrent TMJ dislocation.     

Nutrition and oxidative stress: a systematic review of human studies

Oxidative stress (OS) – defined as the imbalance between free radical production and antioxidant defences – is a condition associated with chronic-degenerative disease, such as cancer, metabolic and disease cardiovascular diseases (CVDs). Several studies have shown that diet and some of its components could influence the intensity of OS damage. The aim of this review was to critically examine some pieces of evidence from observational and intervention study in human beings to assess whether diet and its components can really modify OS in vivo. Furthermore, we tried to find out the possible mechanism behind this association. We considered all studies in MEDLINE which fitted with the following criteria: (1) adult subjects who were healthy or affected by metabolic disease and CVDs; (2) no food supplements, pillows, powder but only common foods and beverages and (3) OS assessment with well-known and validated in vivo biomarkers.     

中医药对慢性肾炎患者免疫功能的影响

慢性肾小球肾炎(CGN)是临床常见的肾脏疾病,由多种原因、多种病理类型组成的原发于肾小球的一组免疫性疾病。根据其病理类型和病期不同,临床表现各不相同,呈多样化表现。近期有学者采用中医药调节慢性肾炎患者的免疫功能,从而提高慢性肾炎的临床疗效,延缓其发展进程,取得了可喜的进展。