脉冲激光射线强化金属材料的几个问题

本文讨论了激光脉冲射线强化金属材料的几个问题:强化图形,材料性能,加工用量及表面涂层对被强化表面性能的影响。     

健脾化痰法在针刺治疗中风(风痰阻络型)中的作用及其机理研究

目的:观察健脾化痰法在针刺治疗中风风痰阻络型中的作用,并初步探讨其机理。方法:将中风风痰阻络型患者随机分为观察组和对照组各30例,观察组以健脾化痰合祛风通络法、对照组仅以祛风通络法针刺治疗,各30次后观察疗效及检测血脂情况。结果:治疗后观察组总有效率为86.67%,对照组为73.33%;痰证辨证积分观察组比对照组显著减低;血脂分析,观察组总胆固醇、载脂蛋白B水平比对照组显著减低,高密度脂蛋白比对照组显著升高。结论:健脾化痰法能有效提高针刺治疗中风风痰阻络型的临床疗效,其机理可能与调节脂代谢有关。     

滋阴补阳益气活血方治疗慢性乙型肝炎贫血评析

目的:观察滋阴补阳益气活血方治疗慢性乙型肝炎贫血的疗效.方法:用滋阴补阳益气活血中药组方,结合冲服紫河车、五谷虫等中药散剂治疗70例,设常规西药治疗组作对照35例,观察其肝功能及血象变化情况.结果:治疗组总有效率为91.43%,对照组总有效率为80%,两组治疗结果比较P＜0.01,明显优于对照组.结论:滋阴补阳益气活血方是治疗慢性乙型肝炎贫血的有效方法之一.     

壮阳药效动物实验评价方法的改进

目的 对壮阳药效评价方法进行优化,以探求更为有效的候选药物筛选方法.方法 模型组大鼠均灌胃给予西地那非10 mg/kg,对照组大鼠给予相同容量的生理盐水灌胃,每天1次,连续灌胃给药14 d.每次给药后连续记录2h内大鼠阴茎勃起、阴部理毛、爬背次数和参与动物数,并计算PEI值.采用改良的壮阳药效评价方法,整个过程采用摄像头观察并在不同时间段给予雌鼠诱导.结果 在雌鼠诱导组中,模型组大鼠给药后2 h PEI值较对照组明显升高(P＜0.05).在模型组中,与人为观察组相比,摄像头观察组大鼠给药后2 h PEI值明显升高(P＜0.05)；与非雌鼠诱导组相比,雌鼠诱导组大鼠给药后2 h PEI值明显升高(P＜0.05)；与持续诱导组相比,间断诱导组2h PEI值无明显差异,但60 ～ 120 min时间段PEI值明显升高(P＜0.05).结论优化后的壮阳药效评价方法能更为有效的评价候选药物的壮阳药效.     

非体外循环冠状动脉搭桥术合并糖尿病患者的强化护理干预

目的观察强化护理应用于非体外循环冠状动脉搭桥术合并糖尿病患者的效果。方法选择本院2013年1-12月收治的需行非体外循环冠状动脉搭桥术合并糖尿病的患者42例作为研究对象,随机分为两组,每组21例,对照组采取常规护理,观察组给予强化护理模式,比较两组患者疗效差异。结果观察组血糖、血肌酐、24h尿蛋白水平均低于对照组,差异有统计学意义,P<0.05;观察组住院期间焦虑程度重度1例(4.8%),中度7例(33.3%),轻度13例(61.9%),焦虑程度显著轻于对照组,P<0.05。观察组术后并发症发生率3例(14.3%),明显低于对照组9例(42.9%),P<0.05。结论强化护理应用于非体外循环冠状动脉搭桥术合并糖尿病患者效果较佳,血糖控制好,术后并发症发生率较低。     

Effect of exercises according to the circadian rhythm in type 2 diabetes: Parallel-group,single-blind,crossover study

Background and aimTo evaluate the effectiveness of structured exercise appropriate the circadian rhythm in terms of blood sample test (BST), functionality and quality of life (QoL) in individuals with type 2 diabetes.Methods and resultsThis was a parallel-group, single-blind, crossover study. Thirty individuals with type 2 diabetes aged 35–65 years were enrolled in the study and allocated into 2 groups as the Morning Chronotype (MC) Group (n = 15) and the Evening Chronotype (EC) Group (n = 15) using Morningness-Eveningness Questionnaire which was used to determine the chronotypes. Participants were evaluated in terms of BST, functionality and QoL at the beginning of the study (T0), at 6 (T1), 12 (T2), and 18 (T3) weeks after the study started. A structured exercise program for 3 days a week over 6 weeks was applied in accordance with the chronotypes (T1-T2) and cross-controlled for the chronotypes (T2-T3). Significant differences were found in favor of the exercise given at the appropriate time for the chronotype in all parameters in both groups within groups (T0-T1-T2-T3) (p < 0.05). In the time1group interactions, exercise in accordance with the appropriate chronotype in both groups provided the highest statistical improvement in all parameters (p < 0.05).ConclusionIt was concluded that structured exercise performed at the appropriate time for chronotype improves HbA_1c, fasting blood glucose, HDL-LDL cholesterol, triglyceride, total cholesterol, functionality and quality of life in type 2 diabetes. This variation in blood values was observed to reflect the quantitative effects of exercise administered according to the circadian rhythm in individuals with type 2 diabetes.Trial registrationClinicalTrials.gov (NCT04427488). The protocol of the study was registered at ClinicalTrials.gov (NCT04427488).     

The closing survival gap after liver transplantation for hepatocellular carcinoma in the United States

BackgroundSocio-economic inequalities among different racial/ethnic groups have increased in many high-income countries. It is unclear, however, whether increasing socio-economic inequalities are associated with increasing differences in survival in liver transplant (LT) recipients.MethodsAdults undergoing first time LT for hepatocellular carcinoma (HCC) between 2002 and 2017 recorded in the Scientific Registry of Transplant Recipients (SRTR) were included and grouped into three cohorts. Patient survival and graft survival stratified by race/ethnicity were compared among the cohorts using unadjusted and adjusted analyses.ResultsWhite/Caucasians comprised the largest group (n=9,006, 64.9%), followed by Hispanic/Latinos (n=2,018, 14.5%), Black/African Americans (n=1,379, 9.9%), Asians (n=1,265, 9.1%) and other ethnic/racial groups (n=188, 1.3%). Compared to Cohort I (2002-2007), the 5-year survival of Cohort III (2012-2017) increased by 18% for Black/African Americans, by 13% for Whites/Caucasians, by 10% for Hispanic/Latinos, by 9% for patients of other racial/ethnic groups and by 8% for Asians (All P values<0.05). Despite Black/African Americans experienced the highest survival improvement, their overall outcomes remained significantly lower than other ethnic∕racial groups (adjusted HR for death=1.20; 95%CI 1.05-1.36; P=0.005; adjusted HR for graft loss=1.21; 95%CI 1.08-1.37; P=0.002).ConclusionThe survival gap between Black/African Americans and other ethnic/racial groups undergoing LT for HCC has significantly decreased over time. However, Black/African Americans continue to have the lowest survival among all racial/ethnic groups.     

Electromyographic activity of posterior kinetic chain muscles during hamstring strengthening exercises

ObjectivesTo compare the muscle activation of the biceps femoris (BF), semitendinosus (ST), gluteus maximus (GM), and contralateral erector spinae (ES) in four specific eccentric hamstring-oriented exercises using overground maximal sprints as an EMG normalization method.Designcross-sectional study.Participantstwenty-four healthy athletes participated in this study.Main outcome measuresThe maximum EMG activation of all targeted muscles was measured during maximal sprints and four hamstring exercises: Nordic hamstring (NH), Russian belt (RB), glider (GL) and lying kick (LK). Maximum EMG activation during sprints were used to normalize EMG muscle activation.ResultsRB and GL showed lower hamstrings activation (from 15.71% to 39.23% and from 26.34% to 31.23%, respectively), so these exercises may be used as the first step of the retraining. The higher hamstring activation was reached in the NH (from 20.15% to 66.81%) and the LK (from 50.5% to 61.2%). Regarding muscles comparison, BF and ST were the most dependent on the exercise ranging from 26.67% to 62.22%, and from 26.34% to 66.81%, respectively.ConclusionsMuscle activation is dependent on the exercise procedure. RB and GL should be used as a first step because of their low activation. Instead, NH and LK should be used at the last phases of retraining process. Considering the synergistic activation of the PKC muscles during LK, and because of its unilateral and explosive characteristics, LK seems a suitable exercise for retraining PKC muscles in general.     

从“伏邪”论治系统性红斑狼疮

本文基于"伏邪"理论探讨系统性红斑狼疮的病因病机、发病特点和论治规律。笔者认为正气亏虚为系统性红斑狼疮的发病之本,而正虚使致病之邪内伏,六淫、疫气、情志等因素引动伏邪而发病。根据系统性红斑狼疮症状特点可分为急性期和缓解期,在急性发作期以清热解毒、活血祛瘀为主;缓解期以补益肝肾、滋阴祛邪为主,根据不同分期辨证审因,灵活选方用药进行论治,以期提高临床疗效。     

预防医院感染中强化护理管理的价值体会

目的探讨在预防医院感染中应用强化护理管理的价值。方法遵循护理管理差异分组原则,选择我院2019年9月～2020年3月68例患者分为对照组(32例,常规护理管理)和观察组(36例,强化护理管理);观察管理前后两组护理质量、医院感染发生率及护理满意度。结果管理后观察组环境质量、基础护理、服务态度、消毒灭菌护理质量各指标评分较高(P0.05)。管理后观察组呼吸道感染、泌尿系统感染等医院感染发生率较对照组低(5.5%vs 25.0%)(P0.05)。管理后观察组患者护理满意度各指标评分较高(P0.05)。结论在预防医院感染中应用强化护理管理价值显著,可有效改善护理质量、降低医院感染发生率并提升患者护理满意度。