温经活血方足浴治疗糖尿病下肢周围神经病变的疗效观察

目的　观察温经活血方足浴治疗糖尿病下肢周围神经病变的疗效。方法　筛选同济大学附属东方医院胶州医院2019年4月至2021年10月收治的172例糖尿病下肢周围神经病变患者作为研究对象,随机分为对照组与治疗组,每组86例。其中对照组：男44例,女42例,年龄36～76岁,采用常规治疗+温水足浴。治疗组：男46例,女40例,年龄38～78岁,在常规治疗的基础上加用温经活血方足浴,于治疗前后行症状评分评估、神经传导速度检测、生化指标,比较两组患者的临床疗效。计量资料以均数±标准差（x±s）表示,采用t检验,计数资料用率（％）表示,采用χ²检验。结果　比较两组空腹血糖（FBG）、血糖（PBG）、糖化血红蛋白（HbA1c）、低密度脂蛋白胆固醇（LDL-C）等生化指标,对照组分别为（7.56+1.23）mmol/L、（9.86±0.89）mmol/L、（7.13±0.56）%、（3.05±0.57）mmol/L,治疗组分别为（6.62+0.58）mmol/L、（7.97±1.02）mmol/L、（6.27±1.11）%、（1.78±0.63）mmol/L,差异均有统计学意义（均P<0.05）。治疗组神经传导速度总有效率为89.5%（77/86）,明显优于对照组［69.8%（60/86）］,差异有统计学意义（χ²=10.366,P<0.05）。对照组多伦多临床评分系统（TCSS）、中医证候积分评分分别为（10.21±1.23）分、（2.21±0.18）分;治疗组分别为（8.15±1.28）分、（1.01±0.38）分。两组上述指标比较差异均有统计学意义（t=10.761、26.466,均P<0.05）。结论　温经活血方足浴治疗糖尿病下肢周围神经病变的临床疗效、改善神经传导速度及降低生化指标等方面效果理想,利于患者病情恢复。     

不同降温方式在发热患儿体温管理中应用效果

目的 分析不同降温方式在发热患儿体温管理中应用效果.方法 纳入2021年1月至2021年12月在本院儿科住院的发热患儿400例作为研究对象.随机将患儿分为药物降温组和混合降温组,每组200例.药物降温组采用口服药物布洛芬混悬液进行治疗,混合降温组采用布洛芬混悬液加温水擦浴组进行治疗.分析对比两组的降温幅度,疼痛情况和不良反应.结果 混合降温组在T1-T0、T2-T1、T3-T2时间点降温幅度均明显大于药物降温组(P＜0.05).两组降温前后VAS评分无明显差异(P＞0.05).混合降温组不良反应发生率比单纯药物降温组均较高,两组对比有明显差异(P＜0.05).结论 发热患儿体温管理采取布洛芬混悬液联合温水擦浴组效果更明显,能提高降温幅度,缓解疼痛,但降温过程中产生不良反应较多,应根据患儿病情及家属意愿选择.     

Correlation between bathing time and photosensitivity in 8-methoxypsoralen (8-MOP) bath PUVA

Bath PUVA (psoralen plus ultraviolet A) using 8-methoxypsoralen has become increasingly popular in recent years as an effective treatment option for a continuously expanding range of skin disorders. Among the various variables of bath PUVA treatment, the impact of bathing time on photosensitivity has never been investigated in detail. We therefore determined the threshold UVA dose for erythema induction after different bathing periods. A marked influence of bathing time on photosensitivity was found. Increasing the soaking period from 5 min to 30 min resulted in a greater than 60% reduction of the minimal phototoxic and minimal perceptible phototoxic dose. Our results demonstrate that the duration of the psoralen bath is a critical parameter in bath PUVA treatment and has a major influence on UVA dose requirements.     

Synthetic Cathinone Exposures Reported to Texas Poison Centers

Background: Among the novel classes of synthetic “designer” drugs that have become increasingly popular among recreational drug users are synthetic cathinones. There is limited information on exposures to these substances. Objective: The objective of this investigation was to describe the pattern of synthetic cathinone exposures reported to a statewide poison center network. Methods: Synthetic cathinone exposures reported to Texas poison centers during 2010–2011 were identified and the distribution by various demographic and clinical factors determined. Results: Of 362 total calls, 84.5% of the patients were 20 years or older and 74.0% male. The route of exposure was 47.8% by inhalation alone and 28.7% by ingestion alone. Other substances were involved in 19.3% of the exposures. The patient was already at or en route to a health-care facility in 75.1% of the exposures. The outcome was serious (moderate, major, potentially toxic, or death) in 74.0% of the exposures. The most frequently reported clinical effects were tachycardia (45.9%), agitation (39.2%), hypertension (21.0%), hallucinations (17.7%), and confusion (13.0%). The most common treatments were IV fluids (53.6%), benzodiazepines (40.9%), oxygen (11.0%), and other sedatives (7.5%). Conclusion: Synthetic cathinone exposures reported to Texas poison centers tended to occur through inhalation or ingestion, involve adult and male patients, be managed at health-care facilities, and involve potentially serious outcomes. Scientific Significance: This study adds to the limited information currently available on synthetic cathinone exposures.     

Children in Sauna: Electrocardiographic Abnormalities

ABSTRACT. We studied changes in ECG in 81 children and 20 adolescents and young adults when they were exposed to heat stress in a climatic chamber, which resembled an ordinary Finnish sauna. Changes were similar to those caused by increased sympathetic activity in 57% of the subjects during the bath and in 23% during the recovery period. Three children had extrasystoles during and four after sauna. One previously healthy 5-year-old girl with wandering pacemaker sacred a 3.3 sec sinus arrest and had reversible junctional rhythm during the heat exposure. We conclude that, although these changes were transient and benign, the sinus arrest suggest that heat stress in sauna is considerable and may be risky for those children who have disorders of the sinoatrial node.     

六神曲炮制工艺研究

以饥饿小鼠胃中游离酸、总酸含量、胃蛋白酶活性和胃肠推进功能为指标,对六神曲生品和不同炮制品进行了比较,初步认为用于健脾消食以麸炒或炒焦为好。     

香波、浴液等化妆品中二(口恶)烷含量监测及人群接触量的估算

[目的 ]调查香波、浴液化妆品中二口恶烷的含量及人群接触量。 [方法 ]二口恶烷含量测定采用顶空 -气项色谱法 ,人群接触量调查采用讯问调查和推算相结合的方法。 [结果 ]1 2 2件国产香波中二口恶烷检出率为 63 9% ,95 %位数为 1 73 42 μg/g ;64件进口香波中二口恶烷检出率 5 6 2 % ,95 %位数为 34 68μg/g。两样本有显著性差异 (P <0 0 5 )。 5 6件国产浴液中二口恶烷检出率为 47 0 6% ,95 %位数为 1 1 1 6μg/g;进口、合资浴液中二 口恶烷检出率 42 4% ,95 %位数为 1 4 0 2μg/g。两样本有显著性差异 (P <0 0 5 ) ,沐浴时二 口恶 烷接触量为 0 0 0 1mg/(kg·d)。 [结论 ]本研究调查结果表明 ,二口恶烷检出率高达 63 9% ,国产香波、浴液中二口恶烷含量高于进口及合资产品 ,最高含量为 40 0 μg/g。但是通过人群对香波、浴液中二 口恶 烷的接触量的调查结果 ,与资料报道的危险度评估结果 ( 0 8mg/kg·d- 1 )相比较 ,本研究认为 :不会对人体产生危害。由于考虑二口恶烷具有致癌活性 ,为严格管理洗涤类化妆品卫生质量 ,减少其危害程度 ,建议进行动态监督、检测。     

益气化瘀方对体外培养的大鼠颈椎间盘软骨细胞超微结构的影响

研究益气化瘀方 (主药 :黄芪、丹参、川芎等 )对体外培养的大鼠颈椎间盘软骨细胞超微结构的影响。 8～ 10周龄SD大鼠 70只 ,随机均分为生理盐水对照组 ,芬必得组 ,中药低、中、高剂量组 ,每组 14只。定时、定量胃饲相应药物 ,4天后分别处死大鼠取血清 ,相同条件下制备益气化瘀方含药血清和对照血清 ,取体外培养的大鼠颈椎间盘软骨细胞进行研究 ,采用透射电镜及流式细胞仪检测软骨细胞超微结构及细胞凋亡率。结果显示 ,中药组能促进细胞DNA合成(S期 ) ,与对照组相比 ,差异有非常显著的意义 (P <0 0 1)。表明益气化瘀方具有促进大鼠颈椎间盘软骨细胞生长、增殖及促进细胞DNA合成的作用。