消麻汤治疗糖尿病周围神经病变临床研究

目的:观察消麻汤治疗糖尿病周围神经病变气阴两虚夹瘀证的临床疗效。方法:120例符合标准患者随机分为两组,每组60例。对照组给予甲钴胺片口服;观察组对照组治疗基础上给予消麻汤口服,连续服用4周。比较两组患者中医证候评分、神经传导速度及临床疗效。结果:观察组有效率86.7%,显著优于对照组的60.0%(P0.05)。两组患者治疗后运动传导速度以及感觉传导速度较治疗前均显著提高(P0.05);观察组治疗后神经传导速度显著高于对照组(P0.05)。观察组中医证候肢体疼痛、肢体麻木、感觉减退等主要临床症状改善程度优于对照组(P0.05)。结论:消麻汤能有效改善糖尿病周围神经病变患者临床症状,改善神经功能,疗效确切。     

伤寒差后更发热及选方辨证探析

各医家对伤寒差后更发热原因的认识主要有:余热未尽、劳复、邪在少阳、重感于邪。对脉浮和脉沉实选用方剂的观点主要有:脉浮用枳实栀子豉汤,脉沉实者加大黄;脉浮用麻桂剂,脉沉实用承气剂;脉浮用柴胡桂枝汤,脉沉实用大柴胡汤。本文认为,伤寒差后更发热应为劳复使然,无明显表里症状者,用小柴胡汤和解之;如脉浮,为病后正气尚虚,重感于寒,可用柴胡桂枝汤微发汗解之;如脉沉实,为饮食失节,里有宿食,可用大柴胡汤下之。     

Laparoscopic Resection of a Small Bowel Lipoma with Incidental Intussusception

Background:

Small bowel tumors are rare entities that often present with nonspecific symptoms. The diagnosis is more likely in patients with occult gastrointestinal bleeding of unknown origin or in adults with small bowel intussusception. Even with exhaustive diagnostic testing, small bowel tumors are often not diagnosed preoperatively. Because 60% to 70% of small bowel tumors are malignant, surgical excision is always recommended.

Methods:

We report the case of a 73-year-old man with occult gastrointestinal bleeding. A small bowel tumor was discovered only after video capsule endoscopy, computed tomography, and multiple endoscopies were performed.

Results:

The patient underwent laparoscopic exploration. An incidental intussusception made the tumor simple to identify. By extending the umbilical port, the tumor was easily removed. The final pathology demonstrated a submucosal lipoma.

Conclusions:

Small bowel lipomas can cause intussusception and gastrointestinal bleeding. When diagnosed preoperatively, laparoscopic resection is feasible.     

海昆肾喜胶囊对维持性血液透析患者脂质代谢及微炎症状态的影响

目的探讨海昆肾喜胶囊对维持性血液透析患者脂质代谢及微炎症状态的影响。方法选择2010年4月至2010年6月我院维持性血液透析患者40例,随机分为治疗组和对照组,各20例。选择30名健康体检者为正常组。治疗组和对照组均行规律血液透析及常规药物治疗,治疗组加用海昆肾喜胶囊,每天3次,每次2粒,疗程2个月。检测3组治疗前、后血红蛋白（Hb）、血浆白蛋白（Alb）、总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、超敏C反应蛋白（hs-CRP）、白细胞介素6（IL-6）、肿瘤坏死因子a（TNFa）和24h尿量,并进行比较。结果与治疗前相比,治疗组治疗后Alb、尿量升高,TC、TG、血清hs—CRP、TNF-α、IL-6降低（P〈0．05）;治疗后,治疗组Alb、尿量较对照组升高,TC、TG、血清hs—CRP、TNF-α、IL-6较对照组降低（P〈0．05）。结论海昆肾喜胶囊可调节脂质代谢,改善微炎症状态,从而有效改善维持性血液透析患者的生存质量。     

肾组织移植对慢性肾功能衰竭大鼠促红细胞生成素的调节作用

目的研究鼠婴肾组织移植于肾包膜下对促红细胞生成素的调节作用,为临床应用治疗肾性贫血提供理论依据。方法以Wistar雄性大鼠建立慢性肾功能衰竭动物模型为受体,将鼠婴肾组织块多点植入受体肾包膜下。治疗期间用EPO酶联免疫(ELISA)试剂盒测定血清EPO水平;观察肾组织病理改变,用免疫组化方法检测EPO在移植物中的表达。结果①60d时D组血清促红细胞生成素(1.768±0.140)mu/mL高于B组(1.160±0.324)mu/mL(P<0.01),与C组(2.329±0.125)mu/mL也有差异(P<0.05)。②移植后60d,移植物的体积由1mm3增至3-4mm3大小,表面血管网丰富,光镜下见肾小球、肾小管结构正常;③移植物EPO免疫组化,发现移植物EPO着色颗粒主要分布于肾皮质的肾小管,明显多于病例对照组大鼠肾组织(P<0.05)。结论通过对移植物的形态观察和功能测定,证明肾组织移植是一种有效的治疗手段,有可能为慢性肾性贫血提供一种新的途径。     

Influence of Rifampin on Capsule Formation Around Silicone Implants in a Rat Model

This study investigated the effect of rifampin on the thickness of capsules around silicone implants by bactericidal activity against Stapylococcus epidermidis. Silicone blocks (1 × 1 cm) were placed into pockets created for each of the 40 rats included in the study. In group 1, the operation was performed under aseptic conditions. In group 2, standard S. epidermidis was inoculated into the pocket, whereas rifampin and S. epidermidis were applied in group 3. In group 4, only rifampin was applied topically on implants. After 12 weeks, the peri-implant capsules were removed and examined under a photomicroscope and a scanning electron microscope. The mean thickness of the capsules was 63.307 μm in group 1, 111.538 μm in group 2, 43.076 μm in group 3, and 30.384 μm in group 4. The differences between groups 2 and 3 and groups 2 and 4 were found to be statistically significant (p < 0.001). Rifampin appears to be an agent for preventing peri-implant capsule formation.     

通心络胶囊对实验性偏头痛大鼠CGRP及α-CGRP基因表达的影响

目的研究通心络胶囊对硝酸甘油性偏头痛大鼠模型血浆降钙素基因相关肽(CGRP)、脑干及三叉神经节αCGRP基因mRNA表达的影响,以探讨通心络治疗偏头痛的可能机制。方法50只SD大鼠随机分为空白对照组、生理盐水组、模型组、苯噻啶防治组、通心络防治组。模型组和药物干预组用硝酸甘油10mg/kg皮下注射造模,每周1次,连续4周,第2次造模后每天分别灌服通心络1.5g/kg/d(通心络组)或苯噻啶0.5mg/kg/d(苯噻啶组)进行干预。第4次造模后用放射免疫法测定血浆CGRP、RTPCR技术测定脑干及三叉神经节区αCGRP基因mRNA的表达。结果与空白对照组比较,反复硝酸甘油造模后,通心络组血浆CGRP水平明显升高(55.63±9.01ng/Lvs45.23±1.79ng/L,P<0.05);苯噻啶组和通心络组αCGRP基因mRNA表达分别为0.67±0.12和0.64±0.12,与空白对照组的0.88±0.09比较,明显下调(P<0.05)。结论通心络胶囊下调了脑干及三叉神经节αCGRP基因mRNA的表达,增加了血浆CGRP含量,提示通心络胶囊不是通过下调血浆CGRP含量而起到预防偏头痛的作用。     

清斑胶囊对ICR鼠皮肤色素生成及抗氧化作用的实验研究

目的：探讨清斑胶囊对黄体酮诱导的孕期全身色素加深小鼠血液和肝脏中的SOD、MDA、GSH的影响,以及对小鼠皮肤组织黑色素的影响。方法：制备黄体酮体内注射诱导小鼠全身色素加深模型,给药治疗后采用SOD、MDA、GSH试剂盒检测血清和肝脏中相关指标的变化;体外观察清斑胶囊对酪氨酸酶活性影响;免疫组化法观察对小鼠皮肤组织黑色素的影响。结果：清斑胶囊低中高三剂量组可以明显提高SOD、GSH活力,降低MDA含量;体外实验表明,清斑胶囊明显抑制酪氨酸酶活性,有效抑制皮肤组织黑色素的形成。结论：清斑胶囊具有良好的抗氧化作用及抑制小鼠皮肤黑素生成的作用。     

Defining the Origins of the Iliofemoral, Ischiofemoral, and Pubofemoral Ligaments of the Hip Capsuloligamentous Complex Utilizing Computer Navigation

Purpose  

To use computer navigation software to investigate the specific origins of the hip capsuloligamentous complex.     

扩张囊外纤维包膜的组织学结构及其意义

目的研究扩张囊外纤维包膜的组织结构和转归.方法用12只白色小家猪制作常规间断扩张(CITE)和持续恒压扩张(CPTE)动物模型,取纤维包膜做测量和组织学检查.结果CPTE纤维包膜的组织厚度和收缩率明显小于CITE组(P＜0.05).纤维包膜有4层结构,其中含大量的胶原纤维和弹力纤维,另含有发育良好的小动脉、小静脉和毛细血管.皮瓣移植后,皮瓣侧纤维包膜大部退化,弹力纤维层和纤维板层仍存.创基侧的纤维包膜则基本完全退化.结论纤维包膜具有收缩和供血能力.去纤维包膜可减轻皮瓣回缩,但制作较大的扩张皮瓣最好保留纤维包膜.扩张器底部的纤维包膜可不处理.