股骨颈骨折几种闭合复位方法的评价(译文)

在股骨颈移位骨折的治疗中,试用了7种不同的闭合复位方法。其中Whitman's法在骨折床台上进行,正常肢体外展,患肢由屈曲牵引至完全伸直位后,维持牵引并外展到与对侧肢体相称位,单髋人字石膏外固定(1914年)。 Leadbetter's法也在骨折床台上进行。将患肢髋部屈曲90°,沿大腿轴线行手法牵引。同时股骨干稍内收,患肢缓慢行环形活动至外展、内旋位,患肢向下降至骨折床台面时,行跟掌试验以验证是否完全复位(1933年)。 Bozan's法利用骨折床台使双下肢维持在伸直位,大绷带放置在患肢髂嵴部位,小绷带放置在患肢腹股沟皱襞最高点处实施牵引。然后整个患肢极度内旋,在维持侧方牵引的同时,患肢外展并轻度过牵(1934年)。     

自杀基因联合中医药疗法治疗肿瘤的设想

自杀基因疗法是一种具有良好应用前景的肿瘤治疗新措施。但如何有效提高疗效是目前仍须解决的关键性问题。由于免疫机制在自杀基因疗法旁杀伤效应中的重要作用，激活荷瘤机体的免疫功能，改善自杀基因抗肿瘤作用的炎症免疫微环境，是提高肿瘤自杀基因疗法疗效的主要策略。中医中药在调节机体免疫状态方面具有肯定的作用，与其他方法比较具有明显优势。因而，将自杀基因疗法与中医中药联合应用，有可能起到提高肿瘤自杀基因疗法疗效，防止肿瘤复发的作用。提出了自杀基因联合中医药疗法治疗肿瘤的新设想，为肿瘤基因治疗提供了一种新的思路和模式。     

穴位敷贴对哮喘豚鼠引喘潜伏期及肺组织病理变化的影响

【目的】从微观病理探讨穴位敷贴治疗哮喘的机制。【方法】采用随机对照的研究方案 ,以自制敷贴方敷贴实验性哮喘模型颈背“穴位”。敷贴方由麻黄、细辛、甘遂、延胡、附片、防风、五味子、白芥子组成。【结果】从第 6天开始 ,贴药组点头呼吸的潜伏时间明显延长 ,与哮喘组比较差异有显著性 (P <0 .0 5) ;从第 9天始穴位敷贴组豚鼠发生点头呼吸的频度明显减少 ,与哮喘组比较差异有显著性 (P <0 .0 1) ;且贴药组有降低豚鼠炎性渗出及嗜酸性粒细胞数的作用 (与哮喘组比均P <0 .0 5)。【结论】提示穴位敷贴治疗哮喘可能是通过延长哮喘发作的潜伏期 ,减小哮喘发作的频度 ,减少肺组织水肿、渗出 ,降低嗜酸性粒细胞的肺系局部浸润而实现的。     

HNE1细胞株光动力学治疗前后形态学的动态变化

目的 探讨体外光动力学治疗（ＰＤＴ）引起鼻咽癌（ＮＰＣ）细胞死亡的作用机制。方法对鼻咽癌细胞株ＨＮＥ１体外光动力学治疗前后形态学变化进行动态观察。结果 对照组ＨＮＥ１细胞培养３ｈ,６ｈ,１２ｈ,２４ｈ和４８ｈ后细胞形态与正常培养组ＨＮＥ１细包开始变形皱缩,细胞界限模糊,细胞透光度和立体感较差,治疗２４～４８ｈ后细胞发生凋亡。结论 体外光动力学治疗对ＨＮＥ１具有明显的杀伤效应并ＨＮＥ１细胞凋亡。ＰＤ     

穴位注射加贴敷治疗乳腺增生的临床研究

97例患者随机分为穴位注射组 (31例 )、穴位贴敷组 (35例 )、穴位注射加贴敷组 (31例 )进行临床观察。结果穴位注射组与穴位贴敷组疗效相似 (P>0 .0 5 ) ,而穴位注射加贴敷组疗效明显优于单纯穴位注射组及穴位贴敷组 (P<0 .0 5 )。由此说明 ,穴位注射加贴敷这一综合疗法治疗乳腺增生病具有效佳、副作用小、取穴少、疗程短等优点。此外还证实这一疗法对卵巢激素有一定的影响。     

Review: Bioresorbable polymeric stents: current status and future promise

Metal stents and, more recently, polymer-coated metal stents are used to stabilize dissections, eliminate vessel recoil, and guide remodeling after balloon angioplasty and other treatments for arterial disease. Bioresorbable polymeric stents are being developed to improve the biocompatibility and the drug reservoir capacity of metal stents, and to offer a transient alternative to the permanent metallic stent implant. Following a brief review of metal stent technology, the emerging class of expandable, bioresorbable polymeric stents is described, with emphasis on developments in the authors' laboratory.     

Ethics knowledge in physical therapy: a narrative review of the literature since 2000

Abstract

Objective: The purpose of this narrative review is to assess current physical therapy ethics knowledge by synthesizing literature published since 2000.

Method: This review builds on an earlier analysis.6 A rigorous search of major databases (including Medline, CINAHL, and PubMed) was conducted using specific keywords and explicit inclusion and exclusion criteria. The final review included 27 peer-reviewed articles and three editorials/lectures.

Results: Four themes of papers were identified that focused on (1) development of physical therapy ethics knowledge, (2) ethical issues related to conducting research, (3) how ethical issues are identified and managed and how ethical practice is taught, and (4) development of theoretical ethical decision-making models.

Discussion: The literature reflects a steady growth in interest in physical therapy ethics. Some 'gaps' in knowledge have been addressed but others have not, such as the impact of the institutional environment and cultural dimensions of practice on ethical reasoning. Research studies, using mostly qualitative approaches, identify similar issues but a synthesis of the findings is made difficult by lack of consistency in purpose and study design. While inclusion of ethics content in physical therapy curricula is recommended, little is known about how this is currently being achieved. Ethical theories are poorly integrated into the discussion of ethics in practice.

Conclusion: This review reveals the continuing need to ensure the development of physical therapy ethical knowledge by consistently incorporating both ethical theories and practice knowledge in education curricula and establishing a rigorous research agenda that accurately reflects the unique and multidimensional nature of clinical practice.     

益肾活血法联合中医周期疗法治疗抗精子抗体阳性不孕患者的临床观察

【目的】观察益肾活血法联合中医周期疗法治疗抗精子抗体(AsAb)阳性不孕的临床疗效。【方法】采用随机数字表法将86例患者随机分为治疗组和对照组各43例。治疗组采用益肾活血法联合中医周期疗法治疗,对照组采用强的松治疗,2组均以治疗1个月为1个疗程,共治疗3个疗程。观察2组AsAb转阴时间、转阴率及转阴后1年内的妊娠情况。【结果】治疗组转阴率为72.50%,对照组为78.95%,2组比较,差异无统计学意义(P>0.05)。治疗组的妊娠率为45.0%,对照组为23.7%,治疗组妊娠率显著高于对照组,2组比较差异有统计学意义(P<0.05)。【结论】益肾活血法联合中医周期疗法治疗抗精子抗体阳性不孕患者疗效显著,值得进一步研究。     

Preliminary investigation of adherence to antiretroviral therapy among children in Aminu Kano Teaching Hospital,Nigeria

Treatment of HIV with highly active antiretroviral therapy (HAART) has resulted in declining morbidity and mortality rates from HIV-associated diseases, but concerns regarding access and adherence are growing. To determine the adherence level and the reasons for non-adhering to antiretroviral therapy (ART) among children attending the clinic for infectious diseases at Aminu Kano Teaching Hospital in Nigeria, a cross-sectional study using the selfreport tool was carried out among 40 children with HIV infection who had been on ART for at least six months. Thirty-two patients (80%) were 95% or more adherent to their medications. The most common reasons for nonadherence were running out of medicines and the inability to purchase more due to financial constraints; other barriers were non-availability and inaccessibility to medications. Eighty-five percent of the paediatric patients took their medications at the same time everyday, and scheduled appointments were kept by 87.5%. The social class of the patients did not significantly affect adherence level. The level of adherence to ART was comparable to levels reported from other developing and developed countries. The cost of ART, and availability and accessibility to medications were the most significant barriers to adherence. Expanded access to subsidised antiretroviral drugs should improve adherence — and consequently treatment outcomes — for patients receiving this treatment in resource-poor settings.     

A Comparative Evaluation of Disulfide-Linked and Hydrophobically-Modified PEI for Plasmid Delivery

Non-viral gene therapy has become an important approach for treatment of hereditary and acquired diseases as a result of better understanding of molecular mechanisms involved in disease development. To design more effective gene carriers, plasmid DNA (pDNA) delivery to 293T cells was investigated by using two types of polymeric carriers; polymer constructed with disulfide (–S–S–) linkages and polymers modified with hydrophobic moieties. The base polymer used for this study was 2-kDa poly(ethylene imine) (PEI2), a relatively cell-compatible but ineffective gene carrier. The –S–S– linking was achieved via Michael addition reaction using cystamine bisacrylamide (CBA), whereas hydrophobic modification by N-acylation of PEI2 amines with palmitoyl chloride (PA). The cytotoxicity of the polymers was found to be lower than that of the 25-kDa branched PEI, but both types of modifications increased the toxicity of PEI2 to some extent. The polymers were able to form polyplexes with pDNA with variable hydrodynamic sizes (130–600 nm) and ζ-potential (3.6–20.9 mV). Based on the expression of the reporter gene Enhanced Green Fluorescent Protein (EGFP), disulfide linking significantly increased the efficiency of native PEI2, which was not effective on its own. The PA-modified PEI2 was also effective for gene delivery, but disulfide linkage of this polymer did not increase its efficiency any further. Our results showed that hydrophobic modification of 2-kDa PEI significantly improved its transfection efficiency but improvements in transfection efficiency as a result of disulfide linking was dependent on the nature of the polymeric building blocks.