复方珍珠口服液的临床研究

复方珍珠口服液由珍珠、黄精、枸杞子、何首乌、熟地黄等多种补益中药材组成,提取制备而成的口服液,经临床144例验证表明,该口服液具有滋补肝肾、养血活颜、延缓衰老的功能。对肝肾两虚、头晕眼花、健忘、夜尿、病后体弱,高胆固醇、高血压症有较好的疗效;其中治疗肾虚证总有效率为95.83％,治疗高血压症总有效率为80.9％,治疗高胆固醇总有效率为71.47％。     

四逆汤提取工艺的筛选

四逆汤是中医临床上用于治疗亡阳厥逆证的传统有效方剂,由附子、甘草、干姜三味药组成。提取工艺的合理性对药物疗效的发挥起着关键性的作用。本研究以乌头碱类生物碱的含量作为指标,用高效液相色谱法作为检测方法,经过正交试验筛选,证明了：（１）全方的提取方法宜采用单煎混合法;（２）提取液的除杂最好采用超滤法;（３）干姜提取挥发油之后应保留水提液．     

中西医结合治疗新型甲型H1N1流感临床研究

【目的】比较中药、达菲及中药+达菲治疗新型甲型H1N1流感的疗效。【方法】将确诊的129例新型甲型H1N1流感患者随机分为中药组(29例)、达菲组(43例)、中药+达菲组(42例)及空白对照组(15例),以总住院天数、病毒转阴时间、发病到体温恢复正常时间及治疗到体温恢复正常时间等作为主要观察指标,比较各组临床疗效。【结果】在总住院天数、药物开始治疗到病毒转阴时间上,达菲组与空白对照组比较差异有显著性意义(P0.05);在发病到病毒转阴时间上,各组两两比较差异均无显著性意义(P0.05);在体温恢复正常时间上,仅中药+达菲组与其他组比较差异有显著性意义(P0.05)。【结论】中药联合达菲治疗新型甲型H1N1流感在快速降低体温方面有明显优势,而在控制病毒转阴方面各组无明显差异。     

Standardized criterion to analyze and directly compare various materials and models for peripheral nerve regeneration

Progress in understanding conditions for optimal peripheral nerve regeneration has been stunted due to lack of standardization of experimental conditions and assays. In this paper we review the large database that has been generated using the Lundborg nerve chamber model and compare various theories for their ability to explain the experimental data. Data were normalized based on systematic use of the critical axon elongation, the gap length at which the probability of axon reconnection between the stumps is just 50%. Use of this criterion has led to a rank-ordering of devices or treatments and has led, in turn, to conclusions about the conditions that facilitate regeneration. Experimental configurations that have maximized facilitation of peripheral nerve regeneration are those in which the tube wall comprised degradable polymers, including collagen and certain synthetic biodegradable polymers, and was cell-permeable rather than protein-permeable. Tube fillings that showed very high regenerative activity were suspensions of Schwann cells, a solution either of acidic or basic fibroblast growth factor, insoluble ECM substrates rather than solutions or gels, polyamide filaments oriented along the tube axis and highly porous, insoluble analogs of the ECM with specific structure and controlled degradation rate. It is suggested that the data are best explained by postulating that the quality of regeneration depends on two critical processes. The first is compression of stumps and regenerating nerve by a thick myofibroblast layer that surrounds these tissues and blocks synthesis of a nerve of large diameter (pressure cuff theory). The second is synthesis of linear columns of Schwann cells that serve as tracks for axon elongation (basement membrane microtube theory). It is concluded that experimental configurations that show high regenerative activity suppress the first process while facilitating the second.     

Brain retraction injury

Abstract

This paper reviews the literature of the brain retraction injury during the last century. The review focused on the instrument characteristic as well as the physiopathological and histopathological damage of the brain induced by brain retraction. It was found that lesions were induced by cerebral ischemia. We conclude that a better monitoring system needs to be developed to avoid brain injury.     

Improved Fracture Risk Assessment Based on Nonlinear Micro‐Finite Element Simulations From HRpQCT Images at the Distal Radius

More accurate techniques to estimate fracture risk could help reduce the burden of fractures in postmenopausal women. Although micro‐finite element (µFE) simulations allow a direct assessment of bone mechanical performance, in this first clinical study we investigated whether the additional information obtained using geometrically and materially nonlinear µFE simulations allows a better discrimination between fracture cases and controls. We used patient data and high‐resolution peripheral quantitative computed tomography (HRpQCT) measurements from our previous clinical study on fracture risk, which compared 100 postmenopausal women with a distal forearm fracture to 105 controls. Analyzing these data with the nonlinear µFE simulations, the odds ratio (OR) for the factor‐of‐risk (yield load divided by the expected fall load) was marginally higher (1.99; 95% confidence interval [CI], 1.41–2.77) than for the factor‐of‐risk computed from linear µFE (1.89; 95% CI, 1.37–2.69). The yield load and the energy absorbed up to the yield point as computed from nonlinear µFE were highly correlated with the initial stiffness (R² = 0.97 and 0.94, respectively) and could therefore be derived from linear simulations with little loss in precision. However, yield deformation was not related to any other measurement performed and was itself a good predictor of fracture risk (OR, 1.89; 95% CI, 1.39–2.63). Moreover, a combined risk score integrating information on relative bone strength (yield load‐based factor‐of‐risk), bone ductility (yield deformation), and the structural integrity of the bone under critical loads (cortical plastic volume) improved the separation of cases and controls by one‐third (OR, 2.66; 95% CI, 1.84–4.02). We therefore conclude that nonlinear µFE simulations provide important additional information on the risk of distal forearm fractures not accessible from linear µFE nor from other techniques assessing bone microstructure, density, or mass. © 2013 American Society for Bone and Mineral Research.     

Increased cortical porosity in type 2 diabetic postmenopausal women with fragility fractures

The primary goal of this study was to assess peripheral bone microarchitecture and strength in postmenopausal women with type 2 diabetes with fragility fractures (DMFx) and to compare them with postmenopausal women with type 2 diabetics without fractures (DM). Secondary goals were to assess differences in nondiabetic postmenopausal women with fragility fractures (Fx) and nondiabetic postmenopausal women without fragility fractures (Co), and in DM and Co women. Eighty women (mean age 61.3 ± 5.7 years) were recruited into these four groups (DMFx, DM, Fx, and Co; n = 20 per group). Participants underwent dual‐energy X‐ray absorptiometry (DXA) and high‐resolution peripheral quantitative computed tomography (HR‐pQCT) of the ultradistal and distal radius and tibia. In the HR‐pQCT images volumetric bone mineral density and cortical and trabecular structure measures, including cortical porosity, were calculated. Bone strength was estimated using micro–finite element analysis (µFEA). Differential strength estimates were obtained with and without open cortical pores. At the ultradistal and distal tibia, DMFx had greater intracortical pore volume (+52.6%, p = 0.009; +95.4%, p = 0.020), relative porosity (+58.1%, p = 0.005; +87.9%, p = 0.011) and endocortical bone surface (+10.9%, p = 0.031; +11.5%, p = 0.019) than DM. At the distal radius DMFx had 4.7‐fold greater relative porosity (p < 0.0001) than DM. At the ultradistal radius, intracortical pore volume was significantly higher in DMFx than DM (+67.8%, p = 0.018). DMFx also displayed larger trabecular heterogeneity (ultradistal radius: +36.8%, p = 0.035), and lower total and cortical BMD (ultradistal tibia: ?12.6%, p = 0.031; ?6.8%, p = 0.011) than DM. DMFx exhibited significantly higher pore‐related deficits in stiffness, failure load, and cortical load fraction at the ultradistal and distal tibia, and the distal radius than DM. Comparing nondiabetic Fx and Co, we only found a nonsignificant trend with increase in pore volume (+38.9%, p = 0.060) at the ultradistal radius. The results of our study suggest that severe deficits in cortical bone quality are responsible for fragility fractures in postmenopausal diabetic women. © 2013 American Society for Bone and Mineral Research     

脾虚小鼠脏器组织学变化及强肌健力口服液的修复作用

【目的】观察脾虚证模型小鼠肝、脾、肾、胸腺等脏器组织形态学的变化及强肌健力口服液对其修复作用。【方法】将健康雄性NIH小鼠40只随机分为正常对照组、脾虚模型组、强肌健力口服液组和四君子汤组;除正常组外,其他3组均采用腹腔注射利血平法复制脾虚模型,强肌健力口服液组与四君子汤组均按26 g.kg-1.d-1剂量灌胃给药,其他2组灌服等容积蒸馏水,连续21 d;最后1次给药后12 h,各组动物称体质量,取肝、肾、脾、胸腺进行组织病理学观察。【结果】模型组小鼠体质量下降,肝、肾、脾、胸腺均有不同程度的组织损伤;强肌健力口服液与四君子汤均能使模型小鼠体质量增加,使已遭损伤的各脏器组织得以修复。【结论】脾虚模型小鼠的肝、脾、肾、胸腺均呈现不同程度的损伤,而健脾方药对其具有修复作用,验证了《内经》有关“脾主身之肌肉,”“脾为孤脏,中央土以灌四傍”的理论。     

Comparison of ventricular drainage in poor grade patients after intracranial hemorrhage

Abstract

Objectives: The selection of patients and treatment criteria for acute hydrocephalus and intracranial pressure (ICP) after intracranial hemorrhage remains unclear. In general neurosurgical practice, there is a tendency to use external ventricular drainage (EVD) for the patients. This study was undertaken to analyse the complications and efficiency of the different treatment modalities.

Methods: The effects, complications and outcome of ventricular drainage on high ICP and hydrocephalus were analysed retrospectively in 109 patients with intracranial hemorrhage. All the patients were assessed using the Glasgow Coma Scale, computed tomography and ICP monitoring. We excluded patients over the GCS of 8. All patients underwent a procedure for ICP monitoring plus ventricular cerebrospinal fluid (CSF) drainage. Sixty-one patients were managed with one (single) EVD system; 12 patients needed two EVD systems consecutively, while 23 patients underwent an EVD procedure followed by permanent ventriculoperitoneal (VP) shunt insertion. Thirteen patients were treated only by VP shunt for ventricular drainage. The infection rate and outcome 9 months after hemorrhage were analysed.

Results: The infection rates were 8.1% in the one-EVD group, 33.3% in the two-EVD group (one EVD versus two EVD, p<0.05), 8.6% in the EVD-VP group and 7.7% in the VP shunt group. The mortality rates were 73.7% in the one-EVD group, 83.8% in the two-EVD group, 47.8% (p<0.05) in the EVD-VP group and 53.8% (p<0.01) in the VP shunt group.

Discussion: This study indicates that single and short-term use of EVD and/or early VP shunting are associated with a low risk of infection. Furthermore, early VP shunting may protect the brain from the irregular control of intracranial hypertension and may allow more time for resolution of CSF circulation and significantly lowers the mortality rates.     

循经感传治疗胸痹的临床研究

应用声电针激发感传气至病所的方法治疗冠心病３０例，临床疗效和心电图疗效均优于药物对照组（Ｐ＜０．０５）。循经感传治疗能显著改善患者的左心功能状态和心肌复极电位，降低血液粘度。动物实验表明，声电针＂内关＂穴区能明显减轻家兔急性缺血心肌超微结构损伤的程度，改善缺血心肌的心电图，其机理可能与包括心钠素在内的心脏内分泌系统参与的全身性调整有关。