补泻手法辨证治疗腰背痛临床观察

根据中医基本理论,将120例腰背痛患者分为虚证和实证两大类,并分组进行疗效对比手法治疗。观察组60例,辩证施治,补虚泻实;对照组60例,平补平泻,不辩证施治。结果显示观察组痊愈率明显高于对照组,疗程也较对照组短(虚证P<0.05,实证P<0.01)。表明手法的补泻作用是客观存在的,且具有一定的临床应用价值。     

Modification of porous aminopropyl-silicate microcapsule membrane by electrically-bonded external anionic polymers

Biocompatibility and permeability of a microcapsule membrane governs the function of a microcapsule-shaped bioartificial pancreas. We have previously developed an alginate/sol-gel-synthesized aminopropyl-silicate/alginate microcapsule (Alg/AS/Alg), which had insufficient biocompatibility. The purpose of this study was to investigate whether the biocompatibility could improve by modifying the external surface with other anionic polymers and to investigate an influence of the modification on the permeability of the membrane. Four kinds of anionic polymers, poly(oxyethylene)diglycolic acid (3 kDa), heparin (15 kDa), Alg (54 kDa) and carboxymethylcellulose (CMC, 60 kDa) were used as the external anionic polymers. The heparin-bonded gel bead had the largest resistance to the diffusion of small molecules. The molecular mass cut-off point of 150 kDa required for immunoisolation was maintained for all anionic polymers. Cellular overgrowth to the implanted islet-enclosing microcapsule, a sign of insufficient biocompatibility, was suppressed by altering the external surface material from Alg to CMC. These results suggest that the biocompatibility of the Alg/AS/anionic polymer membrane can be improved by using a biocompatible anionic polymer. At the same time, it is suggested the influence on the permeability has to be investigated to develop an optimal microcapsule for bioartificial pancreas.     

Hydrogel-microsphere-enhanced surface plasmon resonance for the detection of a K-ras point mutation employing peptide nucleic acid

Highly-sensitive detection of a K-ras point mutation in codon 12, frequently found in pancreatic cancer, based on DNA-carrying hydrogel microspheres as a response enhancer for surface plasmon resonance (SPR), is described. Acrylamide-based microspheres with carboxyl groups were conjugated with DNA probes. Use of the DNA-carrying microsphere in the sandwich method, that is, binding of the microspheres with target DNAs at the sensor surface, enhanced the SPR response as a combined result of increased dielectric constant by the DNA-carrying microspheres. Microspheres lead to response enhancement, as shown by a 100-fold increase in sensitivity compared to that of non-amplified DNA target hybridization. In addition, the advantage of peptide nucleic acid (PNA) in the detection of a K-ras point mutation at the sensor surface by increasing temperature and flow rate is discussed. Results illustrate that the sandwich method through DNA-carrying microspheres for a SPR sensor is a promising approach for ultrasensitive DNA detection.     

Study of cellular responses to polymeric biomaterials using the differential display method

In this study, we attempted to detect altered gene expressions in the cells that had adhered to various surfaces using the differential display method. Thioglycollate-elicited peritoneal exudate cells (PEC) and mouse fibroblast (L929) cells were cultured on the polymer films. After a predetermined time, the total RNA was isolated from cells and the differential mRNA expressions were evaluated by RT-PCR method. As a result, in the differential display of amplified cDNA from PEC, the different patterns of cDNA fragments among the samples were obtained. This indicates that there were many different mRNA expressions depending on the polymer surfaces. The use of differential method was proven to be useful for studying cell-polymer interaction.     

Adhesion and Proliferation of Human Adipo-Stromal Cells for Two- or Three-Dimensional Poly(ethylene terephthalate) Substrates with or without RGD Immobilization

The adhesion and proliferation of human adipo-stromal cells was investigated for poly(ethylene terephthalete) (PET) films of two-dimensional (2D) substrate and non-woven fabrics of three-dimensional (3D) substrate after seeding at the same cell density and culturing at the same medium volume to surface area of the substrates ratio. When seeded by a static seeding method, more cells adhered on the film than on the non-woven fabric. However, the number ratio of cells proliferated to those initially adhered was similar. For the non-woven fabric, cell proliferation was enhanced by an agitated culture method. NaOH treatment introduced carboxyl groups into the surface of substrates, irrespective of the substrate type. Cell adhesion of a peptide (Arg-Gly-Asp, RGD) was chemically immobilized through the carboxyl groups on the non-woven fabric surface at a density of 10 pmol/cm². RGD immobilization significantly increased the number of cells adhered after the agitated seeding method, but did not affect the cell proliferation. Phosphorylation of focal adhesion kinase (FAK) was also enhanced by the RGD immobilization on the PET non-woven fabrics.     

不同针刺手法对健康人经穴氧分压的影响

本文采用氧分压（ＰＯ２）传感针，对２０例健康男性的手阳明大肠经上臂穴、曲池穴的ＰＯ２与相应非穴位的ＰＯ２值进行了测定。结果显示针刺合谷穴时，臂与曲池穴ＰＯ２升高，分别与针刺前比较，其１０＇、１５＇、２０＇的ＰＯ２值均有显著性差异（ＰＭ＜Ｏ．０５），而相应非穴位ＰＯ２变化不显著。在应用补法与泻法（提插捻转）运针后发现，施行补法时曲池穴Ｐ０２上升，泻法时ＰＯ２下降。     

“徐而疾则实,疾而徐则虚”释义

目前通常此言作为两种徐疾补泻的方法来解释，笔者认为是指脉象，是通过针刺治疗前后对脉象的徐疾诊察，来预测和判断疾病的虚实转归。     

以压迫阻滞针效定位的方法测试人体体表心包经的循行路线

以心功能和心电图为指标,以机械压迫阻滞针效为手段,比较压迫心包经穴位、经线上非穴位点和该穴点两侧对照点对针刺内关穴针效的影响,检测心包经在体表的循行轨迹。结果,压迫经上穴点针后各项指标变化微小,针效显著降低;压迫两侧对照点则对针效无明显影响。两者比较,差异非常显著。证明上肢屈侧确有一条与心包经一致的机能路线,并与心脏机能活动调节密切相关。     

Constitutive model development and micro-structural topology optimisation for Nafion hydrogel membranes with ionic clustering

The deployment of electroactive ionic polymer hydrogel-metal composites in artificial muscle and BioMEMS applications has recently been intensively investigated. In order to analyse their electromechanical responses to externally applied electrical fields, it is critical to develop a constitutive model linking the macro-mechanical moduli with the micro-mechanical characteristics, and to determine the geometric size and shape of the micro-structural cluster and investigate the effect of cluster morphology on the effective electro-elastic moduli of the polymer hydrogels. As a typical ionic polymer-based hydrogel, the Nafion membrane is studied in this work. Based on the Biot poroelasticity theory, a multi-scale constitutive model which includes both macro and micro characteristics is developed using an asymptotic homogenisation method. The effect of water-volume fraction on the effective elastic moduli of the hydrogel membrane is examined for different equivalent weights. Numerical investigations show that the simulated effective constitutive moduli agree well with experimental data. The presently developed constitutive model is thus validated. In order to determine the micro-structural shape of the polymer skeleton subject to fluid pressure, a representative volume element (RVE) is designed by topology optimisation of the periodic microstructures of the Nafion hydrogels, through the minimisation of the electro-elastic interaction energy between the polymer-based fluorocarbon matrix and the surrounding fluid. This optimal RVE correctly predicts the geometric shapes of the clusters.     

The Comparative Prognostic Value of Directional Preference and Centralization: A Useful Tool for Front-Line Clinicians?

Abstract

A large number of prognostic factors have been associated with recovery from an episode of back pain, and much emphasis has been placed on psychosocial prognostic factors. The large number of prognostic factors and the lack of comparative analysis of different factors make use of these difficult in clinical practice. The aim of this study was to evaluate the comparative usefulness of a range of factors to predict outcome using data from a randomized controlled trial (RCT) in which 312 patients with sub-acute to chronic back pain received a mechanical evaluation and were sub-grouped based on the presence or absence of directional preference (DP). Patients were then randomized to treatment that was matched or unmatched to that DP. Patients with a minimal reduction of 30% in Roland-Morris Disability Questionnaire (RMDQ) score were defined as the good outcome group. Seventeen baseline variables were entered into a step-wise logistic regression analysis for the ability to predict a good outcome. Of the patients, 84 met the good outcome criteria and had a mean RMDQ decrease of 58.2% (9.8 points) in 4 visits. Leg pain, work status, depression, pain location, chronicity, and treatment assignment were significant predictors of outcome in univariate analysis. Only leg bothersomeness rating and treatment assignment survived multivariate analysis. Subjects with DP/centralization who received matched treatment had a 7.8 times greater likelihood of a good outcome. Matching patients to their DP is a stronger predictor of outcome than a range of other biopsychosocial factors.