Journal of Hainan Medical University(中文版)

2019年第25卷第5期文章目次

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  • 1  Promotional effects of exogenous stimulation with pulsedelectromagnetic fields on skin wound healing in diabetic rats
    Yan Han Ze-Dong Yan Shu-Hua Ge
    2019, 25(5):1-5.
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    Objective: The current study aims to identify the effects of exogenous application of pulsed electromagnetic fields on skin wound healing in diabetic rats, and thus provides experimental evidence for its more scientific clinical application in the future. Methods: The diabetic animal models were established via intraperitoneal injection of streptozotocin in 4-monthold male rats. Fourth eight rats were randomly assigned into the diabetes group (DM) and diabetes coupled with pulsed electromagnetic fields (DM+PEMF) group. Another 24 normal rats were used as the blank control group (Control). Then, all the rats in the three groups were subjected to dorsal surgery for the establishment of soft tissue wound model (circular wound with the diameter of 2 cm). Then, the rats in the DM+PEMF group were subjected to pulsed electromagnetic fields stimulation. Then, 6 rats in each group were sacrificed at Day 5, 12 and 19 post surgery. The glucose levels, wound closure, wound healing time and tissue tensile strength were examined and analyzed. Results: Pulsed electromagnetic fields significantly increased the wound closure rate in diabetic rats at Day 5, 12 and 19 post surgery, decreased overall wound healing period in diabetic rats, and also enhanced tissue tensile strength in diabetic rats at Day 5, 12 and 19 post surgery. Conclusion: Low-intensity pulsed electromagnetic fields can significantly accelerate diabetic wound healing process, and also improve diabetic tissue repair capacity. This study may be helpful for providing more scientific and reasonable experimental evidence for the treatment of pulsed electromagnetic fields on diabetic wound healing in clinics.
    2  Research of the anxiolytic effect of Baihe Dihuang Decoction
    Fang Huan-Le Han Ning-Juan Li Xiao-Ming Niu Rui Chen Yan-Bin
    2019, 25(5):6-9.
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    Objective: To study the effect of Baihe Dihuang Decoction in improving anxiety and its mechanism of action. Methods: Male mice were randomly divided into 5 groups: blank control group, Baihe Dihuang Decoction high, medium, low-dose group and diazepam group. After continuous intragastric administration for 14 d, the behavioral test of the mouse elevated plus maze experiment and opening test was performed. The brain tissue GABA and Glu content was measured by immunosorbent assay (ELISA). Results: Compared with the blank control group, the middle and high doses of Baihe Dihuang Decoction could increase the time and frequency of movement of the mice in the open cross labyrinth in the open arm and increase the number of times that the mouse entered the central area in the opening test. The anti-anxiety effect also showed an increase in the brain tissue GABA content in mice, ignificantly decreased Glu contents in mice. Conclusion: Baihe Dihuang Decoction has some anxiolytic effect, and antianxiety effect may be related to increasing brain tissue GABA content, decreased Glu contents in mice.
    3  Effect of dexmedetomidine against liver ischemia-reperfusion injury in rats by reducing endoplasmic reticulum stress
    Quan-Sheng Wang Re-Ti Ai Fei-Fei Lu
    2019, 25(5):10-13.
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    Objective: To investigate the effect of dexmedetomidine against liver ischemia-reperfusion injury in rats by reducing endoplasmic reticulum stress. Methods: A total of 24 adult male Sprague-Dawley rats were randomly divided into sham operation group (6 rats, Sham group), liver ischemia-reperfusion injury group (6 rats, I/R group), and liver ischemia-reperfusion injury +dexmedetomidine pretreatment group (6 rats, I/R +Dex pretreatment group) (25 μg/kg intraperitoneally 30 min before ischemia), and liver ischemia-reperfusion injury +dexmedetomidine post-treatment group (6 rats, I/R +Dex post-treatment group) (25 μg/kg intraperitoneally 30 min after reperfusion). Hepatic ischemia-reperfusion injury model was performed by after clamping the hepatic hilum for 30 min and reperfusion for 6 h. Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels were measured by automatic biochemical analyzer. Malondialdehyde (MDA) and superoxide dismutase (SOD) activity were detected by enzyme-linked immunosorbent assay (ELISA). The pathological changes of each group were observed by HE staining. The expression of endoplasmic reticulum stress (P-PERK, P-IRE1α, CHOP) were detected by Western blot. Results: Compared with the Sham group, the serum levels of ALT and AST were significantly higher in the I/R group, compared with the I/R group, the serum ALT and AST in I/R+Dex pretreatment group and the I/R+Dex post-treatment group were significantly reduced; Compared with the Sham group, MDA activity in the liver tissue of the I/R group was significantly increased, while the SOD activity was significantly decreased, and the pathological score of the liver tissue was significantly increased; Compared with the I/R group, MDA activity and liver histopathology scores in I/R+Dex pretreatment group and the I/R+Dex post-treatment group were decreased, while SOD activity increased; The expression of P-PERK, P-IRE1α, CHOP in the I/R group were significantly higher than that in the Sham group, while the expression of the above indicators were reduced in I/R+Dex pretreatment group and the I/R+Dex post-treatment group. Conclusion: Dexmedetomidine can significantly attenuated liver ischemia-reperfusion injury in rats, which may be related to the reduction of endoplasmic reticulum stress.
    4  Preliminary study on the anti-inflammatory effect of magnolol on LPSinduced mice
    Si-Yu Mo Qi-Bing Zhong Zhao-Xu Cai Shao-Jun Lu Lin-Quan Zang
    2019, 25(5):14-17.
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    Objective: Investigating the anti-inflammatory effects of magnolol on lipopolysaccharide (LPS)-induced inflammation model mouse and its effect on NF-κB pathway. Methods: Mice were randomly divided into 5 group: normal control group, inflammatory model group, dexamethasone positive drug group and, magnolol group. After administrating for 7 d, LPS was intraperitoneally injected to induce inflammatory on the 8th day, and blood was taken 3 h later and the thymus and spleen were weighed. The levels of serum TNF-α, IL-22 and IL- 17 were detected by ELISA method. The expression levels of TNF-α, NF-κB p65 and IL- 17 in thymus were detected by immunohistochemistry. Results: Magnolol could evidently reduce the levels of serum TNF-α, NF-κB p65 and IL-17 and IL-22. Immunohistochemistry result showed that magnolol could down-regulate the expression of IL-17, TNF-α and p65. Conclusion: Magnolol can prevent and treat LPS-induced inflammation. Its anti-inflammatory effect is connected with the down-regulation of TNF-α and NF-κB p65 protein levels by IL- 17 inflammatory pathway. This experiment provides a theoretical basis for magnolol in antiinflammatory.
    5  Expression and significance of KAI1/CD82 and p27 in gastric carcinoma
    Rong-Hua Cui Mei-Qing Wang Shan-Shan Mao Xiao-Zhen Cheng Jian-Hua Yuan Xing Li
    2019, 25(5):18-21.
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    Objective: To study the expression and significance of KAI1/CD82, p27 proteins in gastric carcinoma. Methods: The expressions of KAI1/CD82, p27 proteins were detected by immunohistchemistry S-P method in 58 cases of gastric carcinoma tissues and 23 normal gastric tissues. Results: The positive rates of KAI1/CD82 and p27 proteins in gastric carcinoma tissues were 29.3% and 34.4%, but 90% and 85% respectively in normal gastric tissue. And there is a significant difference between the two groups. The expression level of KAI1/CD82 and p27 proteins was significantly related to tumor invasive depth, grade of tumor differentiation, the clinical stage and lymph node metastasis, And has nothing to do with age or gender. There was a positive correlation between the expression of KAI1/CD82 and P27 in gastric cancer tissues. Conclusion: The expression of KAI1/CD82 and p27 protein may be involved in the initiation and development in gastric carcinoma, and the combined detection of KAI1/CD82 and p27 proteins may be significant in predicting the invision and metastasis of gastric carcinoma.
    6  Best time for progesterone supplementation in aid ovulation induction cycles by letrozole
    Xue-Mei Wang Hua Lou Yuan-Rong Cui Xia Zhang Bo Dong Cai-Hong Chang
    2019, 25(5):22-25.
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    Objective: To explore the best time for progesterone supplementation in AID ovulation induction cycles by Letrozole. Methods: The data analysed in this study were collected from 509 patients who were performed AID (Artificial Insemination by Donor) administrated letrozole (LE) between 2014.8-2015.7. All patients were randomly divided into 4 groups by the time of progesterone administrated, including experimental group and the control group. The experimental group was divided into group 1-72 h after ovulation, group 2-48 h after ovulation, group 3-24 h after ovulation and control group—without administrated LE. The gestation and live birth rate were evaluated by monitoring vaginal ultrasound and HCG blood value 14 d after AID. Results: The pregnancy rate with administrated progesterone added 72 h after ovulation was 31.9%, which was significantly higher than those of other groups, the same situation as groups added progesterone was significantly higher than the control group. However, there was no significant difference in the numbers of abortions among the four groups. The LBR of group 4 was significantly lower than that of group 1. Conclutions: Progesterone administrated 72 h after ovulation can promoted the gestation rate, but did not affect the rate of miscarrage .
    7  Role of tumor associated macrophages in relapse of primary gastrointestinal diffuse large B cell lymphoma and their clinical significance
    Juan Meng Yuan-Hui Gao Hai-Xia Xu Mei-Qing Wang Zheng-Yi Chen
    2019, 25(5):26-30.
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    Objective: To investigate the correlation between the change in expression of the tumor associated macrophage (TAM) markers CD68 and CD206 and the clinicopathological parameters. Methods: We retrospectively analyzed 28 PGI-DLBCL patients by immunohistochemical stainning. The surface expression of biomarkers CD68 and CD206 on TAMs in samples obtained at diagnosis was compared with that in specimens obtained at first relapse. Based on the change in expression levels of CD68 and CD206 from diagnosis to relapse, patients were categorized into three groups: “increased”, “stable” and “decreased”. Results: A significant difference was observed between the three groups with respect to CD68 and CD206 expressions (P=0.012) and there existed a consistency between the two (P=0.008). The three groups showed a negative correlation with age, sex, stage, B symptoms, diagnosis, ECOG performance status, and IPI scores, while a positive correlation was observed with the site of lesion of CD206 expression (P=0.032). The time to relapse (TTR) in the three groups of CD68 and CD206 was not significantly different (P=0.23, P=0.818). Conclusion: Our study suggests that increase in CD206 and decrease in CD68 expression at relapse indicates M1-TAM polarization into M2-TAM, which plays an important role in PGI-DLBCL relapse. Furthermore, M2-TAM polarization may be associated with the site of Primary gastric diffuse large B lymphoma.
    8  Effects of sleep status on renal function in patients with chronic kidney disease: a systematic review
    Qiong Huang Tian Dai Chen-Di Dong Ding-Jun Zhang Bo Liu Min Zhang Zeng-Xin Yang Li Luo Bing-Qing Xia Yi-Fan Wu
    2019, 25(5):31-36.
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    Objective: To systematically evaluate the effects of sleep status on renal function in patients with chronic kidney disease (CKD). Methods: To search the relevant literature related to the effects of sleep status on renal function of CKD patients on PubMed database, EMBase database, the Cochrane Library database, CNKI database, Chinese Biomedical Literature Database, VIP and Wanfang database from the initial to June 2018, all literature that met the criteria were included. According to the type of studies, the quality of the literature was evaluated by NOS scale in the cohort study and AHRQ scale in the cross-sectional study, and systematically evaluated the outcome indicators, the main outcome indicators were estimated glomerular filtration rate (eGFR) and endogenous creatinine clearance rate (Ccr), while the secondary indicators were Pittsburgh Sleep Quality Index (PSQI), Sleep Quality (SQ), Serum Creatinine (Scr), Hemoglobin (Hb), Albumin (ALB) and Urine Protein/Creatinine Ratio (UPCR). Results: Four literature and one meeting abstract were included in this study, of which four were cohort studies, three of them the NOS quality evaluations were high, one of them was medium, the remaining one was cross-sectional study, and the AHRQ quality evaluation was medium. This study shows that sleep status has a certain correlation with renal function. Shorter sleep time or poor sleep quality can lead to deterioration of renal function. Among them, the research data of Sabbatinit research team in Italy showed that Ccr gradually decreased with the increased of the PSQI; studies of Cohen research team and the Ricardo research team in the United States showed that eGFR decreased with the increased of the PSQI; the study of Kumar research team in the United States showed that the lower SQ , the worse renal function; the study of Knutson’ research team in British showed that the shorter sleep time, the lower eGFR. In addition, studies showed that sleep index also has influence on Hb, ALB, Scr, UPCR and other indicators. Conclusion: Sleep status can affect the renal function of CKD patients in different degrees. Shorter sleep time and poor sleep quality will damage renal function and accelerate the progress of CKD.
    9  Effect of shexiangbaoxin pill combined with tirofiban hydrochloride on related factors in elderly patients with acute coronary symdrome
    Ya-Ning Xu Ling-Zhi Tang Xiao-Li Sun Chao Ruan Yue Wu Li-Li Li
    2019, 25(5):37-40.
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    Objective: To study the effect of shexiangbaoxin pill combined with tirofiban hydrochloride on related factors in elderly patients with acute coronary symdrome. Methods: A total of 96 elderly patients with acute coronary symdrome in our hospital from January 2015 to May 2018 were enrolled in this study. The subjects were divided into the control group (n=48) and the treatment group (n=48) randomly. The control group were treated with tirofiban hydrochloride, the treatment group were treated with shexiangbaoxin pill combined with tirofiban hydrochloride, and both the two groups were treated for 2 weeks. The PT, TT, APTT and serum FIB, CK-MB, cTnT, vWF, ET-1, NO, sICAM-1, MMP-9, hs-CRP of the two groups before and after treatment were compared. Results: There were no significantly differences of the PT, TT, APTT and serum FIB, CK-MB, cTnT, vWF, ET-1, NO, sICAM-1, MMP-9, hs-CRP of the two groups before treatment. The PT, TT, APTT and serum NO of the two groups after treatment were significantly higher than before treatment, the serum FIB, vWF, ET, sICAM-1, MMP-9, hs-CRP of the two groups after treatment were significantly lower than before treatment, and that of the treatment group after treatment were significantly better than the control group. The serum CK-MB, cTnT of the two groups after treatment were significantly higher than before treatment, but that of the treatment group after treatment were significantly lower than the control group. Conclusion: Shexiangbaoxin pill combined with tirofiban hydrochloride can significantly improve the blood coagulation function and reduce the Myocardial injury, vascular endothelial damage, inflammation of the elderly patients with acute coronary symdrome, and it was worthy clinical application.
    10  Effects of gastrodin on neurotransmitter effect, stress response, blood vessel and nerve function in migraine patients
    Ling-Zhi Tang Xiao-Li Sun Chao Ruan Yue Wu Li-Li Li
    2019, 25(5):41-44.
    [摘要](225) [HTML](0) [PDF 0.00 Byte](235)
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    Objective: To investigate the effects of gastrodin on neurotransmitter effect, stress response, blood vessel and nerve function in migraine patients. Methods: A total of 90 patients with migraine admitted to our hospital from September 2016 to December 2017 were randomly divided into observation group and control group with 45 cases in each group. The control group was treated with flunarizine hydrochloride, while the observation group was treated with gastrodin based on the control group. The levels of neurotransmitter effect[including 5-serotonin (5-HT) and tumor necrosis factor alpha (TNF-alpha)], stress response[oxidized low density lipoprotein (ox-LDL) and paraoxonase-1 (PON-1)], vascular function[including nitric oxide (NO), endothelin-1 (ET-1)] and neurological function[including high brain-derived neurotrophic factor (BDNF) and calcitonin gene-related peptide (CGRP)] related indexes were observed and compared between the two groups. Results: The two groups showed significant changes in transmitter effect, stress response, blood vessel and nerve function. Before treatment, there was no significant difference in the levels between the two groups. After treatment, the levels of TNF-a, ox-LDL, NO, ET-1, BDNF and CGRP in the two groups were significantly lower than those before treatment, while the levels of 5-HT and PON-1 were significantly higher than those before treatment. And after treatment, the levels of TNF-a, ox- LDL, NO, ET-1, BDNF and CGRP in the observation group were significantly lower than those in the control group, while the levels of 5-HT and PON-1 were significantly higher than those in the control group. Conclusions: Gastrodin treatment can regulate oxidative stress level and improve vascular and neurological function in migraine patients.
    11  Effects of selenium supplementation on thyroid function, immune response and oxidative stress in HT patients
    Chun-Mei Qu? Ying Li Shu-Mei Chen
    2019, 25(5):45-48.
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    Objective: To explore the effect of selenium supplementation on thyroid function, immune response and oxidative stress in HT patients with normal thyroid function. Methods: A total of 120 Hashimoto's thyroiditis patients with normal thyroid function admitted to our hospital from June 2016 to March 2018 were randomly divided into treatment group and control group with 60 cases in each group. The control group was given oral placebo, while the treatment group was given selenium yeast. The expression levels of thyroid function [including thyroid stimulating hormone (TSH), free triiodothyronine (FT3) and free thyroxine (FT4)], immune response [including thyroid peroxidase antibody (TPOAb), thyroglobulin antibody (TGAb), interferon-γ (IFN-γ), interleukin-4 (IL-4)] and oxidative stress [including malondialdehyde (MDA), glutathione peroxidase (GPx) and superoxide dismutase (SOD)] were observed and compared between the two groups. Results: The two groups showed significant changes in auxiliary diagnosis, immune response and oxidative stress. Before treatment, there was no significant difference in the levels between the two groups. After treatment, there was no significant difference in the above indexes between the control group and that before treatment. There was no significant difference in thyroid function related indexes between the treatment group and the control group. The levels of TPOAb, TGAb, IFN-γ and MDA in the treatment group were significantly lower than those before treatment and in the control group, while the levels of IL-4, GPx and SOD were significantly higher than those before treatment and in the control group. Conclusions: Selenium supplementation can stabilize thyroid function, reduce the level of thyroid antibody production, and improve immune response and oxidative stress response in HT patients.
    12  Clinical efficacy of HEGU needling method combined with tendonstretching and plucking massage on trigger point in the treatment of acute thoracodorsal myofascitis
    Guang-Bao Lu Rong-Jun Mei Wen-Qiang Shi Hai-Zhou Liu Jing-Wen Huang Xue-Bo Li
    2019, 25(5):49-52.
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    Objective: To observe the effect of Hegu neediling method combined with tendon-stretching and plucking massage on trigger point in the treatment of acute thoracodorsal myofascitis. Methods: A total of 84 patients with acute thoracodorsal myofascitis who met the diagnostic and inclusion criteria were assigned into the treatment group and the control group randomly, the treatment group was treated with Hegu neediling method combined with tendonstretching and plucking massage, while the control group was treated with conventional electroacupuncture. Two groups of patients were treated for two weeks. VAS score and ODI were compared before treatment, after the first treatment and after the treatment course, and the clinical efficacy was evaluated after treatment. Results: The total effective rates of the treatment group and the control group were 97.62% and 80.95%, respectively. The treatment group was significantly better than the control group. The VAS and ODI scores of the treatment group decreased after the first treatment and the end of the treatment, and the treatment group was significantly better than the control group. Conclusion: Hegu neediling method combined with tendon-stretching and plucking massage can relieve pain and improve limb dysfunction in patients with acute thoracodorsal myofascitis.
    13  Clinical effect of under the diaphragm by stasis soup combinated with point thread-embedding on infertility patients with obesity-type polycystic ovary syndrome
    Lian-Di Zhang Bing Zhang Xiao-Lin Jiang Xiao-Qian Dong Cui-Jie Bao
    2019, 25(5):53-57.
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    Objective: To study the clinical effect of under the diaphragm by stasis soup combinated with point thread-embedding on infertility patients with obesity-type polycystic ovary syndrome (PCOS) and evaluate the the rate of ovulation and pregnancy. Method: Selecting 100 infertility patients with obesity-type PCOS, then they were randomly divided into control group (n=80) and observation group (n=80). The control group patients were given metformin+ under the diaphragm by stasis soup, the observation group were given metformin + exenatide + point thread-embedding, they were treated 3 months. Before and after treatment, we observed the changes of body mass index (BMI), waist-to-hipratio (WHR), fasting plasma glucose (FBG), 2-hour postprandial blood glucose (2hPBG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), homeostasis model assessment of insulin resistance (HOMA-IR), fasting plasma insulin (FINS), follicule-stimulating hormone (FSH), luteinizing hormone (LH), LH/FSH, estrogen (E2), and testosterone (T). At last, we assessed the rate of ovulation and pregnancy. Results: After the treatment, the FBG, 2hPBG, TC, LDL-C, TG, BMI, WHR, HOMA-IR, FINS, LH, LH/FSH, E2, and T were lower than before treatment in both groups, and the difference had statistical significance, and the observation group were lower than control group, and the difference had statistical significance; the HDL-C and FSH were higher than before treatment in both groups, and the difference had statistical significance, and the observation group were higher than control group, and the difference had statistical significance. The rate of ovulation and pregnancy in the observation group were higher than control group, and the difference had statistical significance. Conclusions: Under the diaphragm by stasis soup combinated with point thread-embedding can improve the metabolize of carbohydrate and lipid, and the abnormity of sex hormones, through this process, the rate of ovulation and pregnancy can be raised.
    14  Detection of Th17/Treg balance in peripheral blood of children with hemophilia syndrome and its correlation with severity
    Wei-Juan Lei Jie Pan
    2019, 25(5):58-56.
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    Objective: To investigate the relationship between Th17/Treg balance in peripheral blood and severity of hemophagocytic syndrome in children. Methods: A total of 60 children with HLH diagnosed in our hospital were taken as HLH group during January 2015 to October 2018, 100 cases of healthy children underwent physical examination in our hospital were taken as Normal control group. Levels of Th17/Treg balance, ferritin (SF) and inflammatory mediators in peripheral blood were compared between two groups. Results: Ratio of Th17 cells and Th17/Treg ratio in peripheral blood of HLH group were higher than those of Normal control group, and ratio of Treg cells was lower than that of Normal control group. Levels of serum SF in HLH group were lower than those in Normal control group, and levels of inflammatory mediators such as PCT, IL-6, IL-10 and IFN-γ in peripheral blood were significantly higher than those in Normal control group. Correlation analysis showed that proportion of Th17 cells and the ratio of Th17/Treg in peripheral blood of children with HLH were positively correlated with the contents of SF, PCT, IL-6, IL-10 and IFN-γ, while proportion of Treg cells was negatively correlated with the contents of SF, PCT, IL-6, IL-10 and IFN-γ. Conclusion: Th17/ Treg imbalance exists in children with HLH, and there is a positive correlation between Th17/ Treg imbalance and the severity of the disease, which may have a certain clinical significance in disease evaluation.
    15  Effects of routine rehabilitation therapy combined with low frequency electrical stimulation on monoamine neurotransmitters, NSE, ET-1 and cerebral hemodynamics in children with cerebral palsy
    Sai Xun Pei-Pei Wang Nuan Yang Mei Hou Jun Chen Dian-Rong Sun Jian-HuiZhao Li-Ping Lyu
    2019, 25(5):61-64.
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    Objective: To investigate the effects of routine rehabilitation therapy combined with low frequency head stimulation on monoamine neurotransmitters, neuron-specific enolase (NSE), endothelin-1 (ET-1) and cerebral hemodynamics in children with cerebral palsy. Methods: From January 2017 to June 2018, 110 children with cerebral palsy were randomly divided into observation group (55 cases) and control group (55 cases). The control group received routine rehabilitation treatment, while the observation group received low-frequency head stimulation on the basis of routine rehabilitation treatment. The changes of dopamine (DA), norepinephrine (NE), serotonin (5-HT), NSE, ET-1 levels and mean blood flow velocity of anterior cerebral artery (ACA), middle cerebral artery (MCA), posterior cerebral artery (PCA) were compared in two groups. Results: Before treatment, there was no significant difference in DA, NE and 5-HT levels in two groups. After treatment, DA, NE and 5-HT levels in the observation group were (192.23±22.71) ng/mL, (98.02±11.71) ng/L, (210.07±25.03) ng/L, and in the control group. the DA, NE, 5-HT levels were (147.06±17.02) ng/mL, (83.07±11.15) ng/L, and (171.88±20.45) ng/L, respectively. The DA, NE and 5-HT levels in two groups were higher than those before treatment, and DA, NE and 5-HT levels in the observation group were higher than those in the control group. Before treatment, there was no significant difference in NSE and ET-1 levels between the two groups. After treatment, the NSE and ET-1 levels in the observation group were (7.97±2.07) μg/L and (41.01±10.07) pg/ mL, and the NSE and ET-1 levels in the control group were (10.38±3.02) μg/L, (58.46±15.02) pg/ mL, respectively. the NSE and ET-1 in two groups were lower than those before treatment, and the NSE and ET-1 of the observation group were lower than the control group. Before treatment, there was no significant difference in mean blood flow velocity between ACA, MCA and PCA. After treatment, the mean blood flow velocities of ACA, MCA, and PCA in the observation group were (46.88±7.72) cm/s, (59.85±10.18) cm/s, and (49.15±7.02) cm/s, respectively, which was significantly higher than before treatment and higher than that of the control group in the same period. Conclusion: Conventional rehabilitation combined with low-frequency electrical stimulation of the head can effectively increase the content of monoamine neurotransmitters in children with cerebral palsy, enhance cerebral blood circulation, and reduce brain damage
    16  CYP correlation study of refractory schizophrenia drug gene detection
    Qin-Wei Xu Xiang-Lai Liu Qian-Kun Yao Zai-Ji Zheng
    2019, 25(5):65-68.
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    Objective: To study the refractory factors associated with schizophrenia. Methods: 200 patients with refractory schizophrenia and 200 patients with non-refractory schizophrenia were selected. The CYP series of genes CYP1A2, CYP3A4 and CYP2D6 were detected by drug gene, and the rapid metabolic probabilities of the three genes were compared and analyzed. 200 patients with refractory schizophrenia were randomly divided into two groups: the combined drug treatment group and the single drug treatment group. The results were compared between the treatment of 0W and 4W for drug gene detection, 3 genes fast metabolizing type and BPRS scale. analysis. Results: The rapid metabolizing probability and non-refractory difference of CYP1A2, CYP3A4 and CYP2D6 genes in patients with refractory schizophrenia were significant. The comparison of fast metabotropic probabilities of CYP1A2, CYP3A4 and CYP2D6 genes in patients treated with 4W after treatment There was no significant difference in the single drug treatment group. The BPRS scale score was significantly higher in the drug-treated group than in the single-drug group. After logistic regression analysis, the refractory characteristics of schizophrenia and The CYP series of genes CYP1A2, CYP3A4, and CYP2D6 are rapidly metabolized. Conclusion: CYP series of genes CYP1A2, CYP3A4, CYP2D6 fast metabolites are related factors of refractory schizophrenia, antipsychotic drugs combined with CYP enzyme inhibitor treatment can improve the efficacy.
    17  Advances in endoscopic diagnosis of early gastric cancer
    Xia Li Hong-Gang Yu
    2019, 25(5):69-72.
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    Gastric cancer is one of common malignant tumors in clinic. It has high incidence, high mortality and poor prognosis. Generally, gastric cancer is divided into early gastric cancer (EGC) and advanced gastric cancer. The 5-year survival rate of EGC is higher than that of advanced gastric cancer. In recent years, with the continuous development of science and technology, a variety of medical instruments and technologies have been updated, greatly promoting the detection rate of EGC, reducing the rate of EGC missed diagnosis. This article reviews the progress of EGC endoscopic diagnosis.
    18  Development and prospects of cervical laminoplasty
    Wen-Xuan Wang Bin Zhao Xiao-Feng Zhao Shao-Wei Wang
    2019, 25(5):73-76.
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    Cervical laminoplasty surgery is an alternative to laminectomy. It can increase the space of the spinal cord available by raising the lamina, and achieve the indirect decompression effect to treat cervical spondylosis. Various techniques of laminoplasty have since been developed after two prototype techniques: Hirabayashi’s open-door laminoplasty and Kurokawa’s double-door laminoplasty. Several studies report superior biomechanical stability of the cervical spine after laminoplasty compared with laminectomy. Recent development in laminoplasty is preservation of muscle attachment, which enabled dynamic and static stabilization of the cervical spine by neck extensor muscles. After treatment with new laminoplasty techniques with active postoperative neck muscle exercises, postoperative instability, kyphosis, axial neck pain, and loss of ROM become minimal. The development,complications and future trends of cervical laminoplasty are summarized below.
    19  外源性的脉冲电磁场刺激对于糖尿病皮肤创伤愈合作用的实验研究
    韩燕 颜泽栋 葛淑华
    2019(5):321-325. DOI: 10.13210/j.cnki.jhmu.20190128.001
    [摘要](59) [HTML](0) [PDF 3.02 M](53)
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    目的:阐明通过外源性施加脉冲电磁场刺激对于糖尿病大鼠皮肤创伤修复的作用效果,为其未来的更科学临床应用提供实验依据。方法:使用腹腔注射链脲佐菌素对4月龄雄性大鼠构建糖尿病动物模型,取48只糖尿病大鼠随机等分为糖尿病组(DM)和糖尿病协同脉冲电磁场刺激组(DM+PEMF),另取24只作为对照组(Control)。随后在3组大鼠背部通过手术构建皮肤损伤模型(直径2 cm的圆形损伤),随后对DM+PEMF组大鼠施加脉冲电磁场刺激,分别在手术后的第5、12、19天每组处死6只大鼠,进行血糖、伤口闭合率、伤口愈合时间、组织抗张强度的检测分析。结果:脉冲电磁场在术后的第5、12、19天糖尿病伤口的闭合率显著增加,糖尿病创伤的愈合时间缩短,并且在术后的第5、12、19天糖尿病伤口外周组织的力学抗张强度均提升,差异均具有统计学意义(P<0.01)。结论:低强度脉冲电磁场刺激能够显著加速糖尿病伤口的愈合进程,提高糖尿病软组织的损伤修复能力。本研究有望为脉冲电磁场对糖尿病创伤的更科学、合理的临床应用提供有力的实验依据。
    20  百合地黄汤抗焦虑作用的研究
    方欢乐 韩宁娟 李晓明 牛睿 陈衍斌
    2019(5):326-329. DOI: 10.13210/j.cnki.jhmu.20190124.005
    [摘要](116) [HTML](0) [PDF 2.45 M](68)
    摘要:
    目的:研究百合地黄汤改善焦虑的作用及作用机制。方法:雄性小鼠随机分为5组,即空白对照组,百合地黄汤高、中、低剂量组,地西泮组。连续灌胃给药14 d后,进行小鼠高架十字迷宫实验和开场实验的行为测试,用酶联免疫吸附法(ELISA) 测定小鼠脑内γ-氨基丁酸(GABA) 、谷氨酸(Glu)的含量。结果:和空白对照组比较,百合地黄汤高剂量组能增加小鼠在高架十字迷宫实验中进入开臂内运动时间和次数百分率,提高小鼠在开场试验中进入中央区的次数(P<0.05~0.01),表现出一定的抗焦虑作用;同时显示和空白对照组比较,百合地黄汤中、高剂量组小鼠脑组织内GABA含量增加、Glu的含量降低(P<0.05~0.01)。结论:百合地黄汤具有一定的抗焦虑作用,抗焦虑作用可能与提高小鼠脑内GABA含量、降低Glu的含量相关。
    21  右美托咪定通过降低内质网应激改善大鼠肝缺血再灌注损伤
    王全胜 艾热提 路菲菲
    2019(5):330-334. DOI: 10.13210/j.cnki.jhmu.20190121.001
    [摘要](34) [HTML](0) [PDF 4.61 M](54)
    摘要:
    目的:探讨右美托咪定通过降低内质网应激改善大鼠肝缺血再灌注损伤中的作用。方法:清洁级成年雄性Sprague-Dawley 大鼠24只,采用随机数字表法分为假手术组(6只,Sham组)、肝缺血再灌注损伤组(6只,I/R组)、肝缺血再灌注损伤+右美托咪定预处理组(6只,I/R+Dex预处理组)(于缺血前30 min腹腔注射右美托咪定25 μg/kg)和肝缺血再灌注损伤+右美托咪定后处理组(6只,I/R+Dex后处理组)(于再灌注后30 min腹腔注射右美托咪定25 μg/kg)。肝缺血再灌注损伤模型采用夹闭肝门30 min后,恢复灌注6 h。采用全自动生化分析仪检测各组血清谷丙转氨酶(ALT)和谷草转氨酶(AST)水平;酶联免疫吸附法(ELISA )检测肝组织丙二醛(MDA)和超氧化物歧化酶(SOD)活性;HE染色观察各组病理学改变;Western blot检测内质网应激指标(P-PERK、P-IRE1α、CHOP)的表达。结果:与Sham组比较,I/R组血清ALT和AST水平明显升高(P<0.05),与I/R组比较,I/R+Dex预处理组和I/R+Dex后处理组血清ALT和AST水平明显降低(P<0.05);与Sham组比较,I/R组肝组织MDA活性明显升高,而SOD活性显著降低,同时伴肝组织病理学评分显著升高,与I/R组比较,I/R+Dex预处理组和I/R+Dex后处理组MDA活性和肝组织病理学评分下降,而SOD活性升高(P<0.05);I/R组肝组织P-PERK、P-IRE1α 及CHOP表达明显高于Sham组,而I/R+Dex预处理组和I/R+Dex后处理组可显著降低上述指标的表达(P<0.05)。结论:右美托咪定可显著减轻大鼠肝缺血再灌注损伤,其可能与降低内质网应激有关。
    22  厚朴酚对LPS致炎小鼠抗炎效应的初步研究
    莫斯喻 钟淇滨 蔡肇栩 陆少君 臧林泉
    2019(5):335-338, 342. DOI: 10.13210/j.cnki.jhmu.20190128.002
    [摘要](52) [HTML](0) [PDF 4.04 M](55)
    摘要:
    目的:探究厚朴酚对脂多糖 (LPS) 诱导的小鼠炎症模型的抗炎效果及其对NF-κB通路的影响。方法:将昆明小鼠随机分为5组,分别为正常对照组、炎症模型组、地塞米松阳性药物组(10 mg/kg)以及厚朴酚药物组(50 mg/kg)。每组动物先连续给予药物7 d, 在第8天用腹腔注射LPS诱导产生炎症, 3 h后取血、称重胸腺与脾脏。用ELISA法对血清中的肿瘤坏死因子-α(TNF-α)、白介素-17F(IL-17 F)、白介素-22(IL-22)及白介素-23(IL-23)的含量进行分析,探讨厚朴酚对小鼠血清细胞因子水平变化的影响。用免疫组化法检测胸腺组织中TNF-α、核转录因子-κB(NF-κB) 与IL-17的蛋白表达水平。结果:厚朴酚能显著降低药物组中血清TNF-α、IL-17、IL-22水平(P<0.05); 通过免疫组化检测,厚朴酚能降低IL-17、TNF-α和核转录因子-κB(NF-κB)p65蛋白表达水平, 对比于模型组具有不同程度的下降 (P<0.01)。结论:厚朴酚对于由LPS诱导的炎症具有抑制作用, 而其产生的抗炎效果与下调NF-κB p65炎症通路的TNF-α和IL-17蛋白质水平的表达水平有关,本实验为厚朴酚在抗炎方面的运用提供了理论依据。
    23  KAI1/CD82和P27在胃癌中的表达及临床意义
    崔荣花 王美清 毛山山 程小珍 元建华 李兴
    2019(5):339-342. DOI: 10.13210/j.cnki.jhmu.20190124.007
    [摘要](61) [HTML](0) [PDF 2.65 M](53)
    摘要:
    目的:研究KAI1/CD82和P27蛋白与胃癌临床病理特征之间的关系。方法:运用免疫组织化学SP法检测58例胃癌组织与23例正常胃组织中KAI1/CD82、P27蛋白的表达。结果:在胃癌组织中KAI1/CD82蛋白和P27蛋白的阳性表达率分别为29.3%、34.4%,在正常胃组织中KAI1/CD82蛋白和P27蛋白阳性表达率分别为90%、85%,两组之间差异均有统计学意义(P<0.05);并且KAI1/CD82蛋白和P27蛋白的阳性表达率在肿瘤的浸润深度、组织的分化程度、临床分期和淋巴结是否转移间差别具有统计学意义(P<0.05);而与年龄、性别无关(P>0.05)。KAI1/CD82与P27蛋白在胃癌组织中的表达呈正相关(r=0.286,P<0.05)。结论:KAI1/CD82蛋白和P27蛋白可能参与了胃癌的发生发展过程,联合检测KAI1/CD82与P27可能成为胃癌诊断及预后评估的新的分子标记物。
    24  黄体酮补充时机对曲唑诱排供精人工授精妊娠结局的影响
    王雪梅 娄华 崔元戎 张霞 董波 常彩红
    2019(5):343-346. DOI: 10.13210/j.cnki.jhmu.20190212.001
    [摘要](65) [HTML](0) [PDF 2.48 M](61)
    摘要:
    目的:研究黄体酮补充时机对来曲唑诱导排卵供精人工授精妊娠结局的影响。方法:本研究选取在生殖中心进行供精人工授精的509名患者,用来曲唑诱排卵,根据排卵后补充黄体酮的时间随机分成4组:排卵后72 h补充黄体酮为组1,排卵后48 h补充黄体酮为组2,排卵后24 h补充黄体酮为组3,未补充黄体酮为组4。通过监测人工授精后14天B超及HCG值评估黄体酮补充时机对妊娠结局的影响。结果:排卵后72 h补充黄体酮的妊娠率为31.9%,显著高于其它各组(31.9% vs.19.3%,18.0%,11.4%,P均<0.05),补充黄体酮组妊妊娠率显著高于未补充组(31.9% ,19.3%,18.0% vs.11.4%,P<0.05),未补充组足月分娩率显著性低于排卵后72 h补充黄体酮组(61.1% vs.89.2%,P<0.05),四组流产率比较无统计学差异(P>0.05)。结论:供精人工授精中,来曲唑诱排卵后72 h补充黄体酮能显著提高患者妊娠率,且不增加患者流产率。
    25  肿瘤相关巨噬细胞的极化与原发性胃肠道弥漫大B细胞淋巴瘤复发的相关性分析
    孟娟 高元慧 徐海霞 王美清 陈正义
    2019(5):347-350, 357. DOI: 10.13210/j.cnki.jhmu.20190110.003
    [摘要](69) [HTML](0) [PDF 5.26 M](54)
    摘要:
    目的:检测肿瘤相关巨噬细胞(TAM)分子表面标志物CD68、CD206在胃肠道弥漫大B细胞淋巴瘤(PGI-DLBCL)初诊和首次复发的表达变化,分析其变化与临床相关参数的关系,探讨TAM的极化在PGI-DLBCL复发中的作用。方法:收集28例PGI-DLBCL患者初诊和首次复发后淋巴瘤标本,采用免疫组织化学法分别检测TAM的分子标志物CD68和CD206的表达变化。根据CD68和CD206 初诊至首次复发后表达的变化,将28例患者分为"增强"、"稳定"和"减弱"3种情况,分析其变化与临床病理参数、疾病复发的相关性。结果: CD68和CD206不同程度表达的病例所占比例间存在显著差异(P<0.05),且CD68和CD206间存在一定相关性(P=0.008)。CD68和CD206表达变化与患者年龄、性别、分期、有无B症状、病理类型、ECOG评分和IPI评分无关,CD206的表达变化与原发部位有关(P<0.05)。CD68(P=0.23)和CD206 (P=0.818)变化与肿瘤复发时间无关。结论: M2-TAM的极化促进了PGI-DLBCL复发,可能成为预测PG-DLBCL复发的相关指标。
    26  睡眠情况对慢性肾脏病患者肾功能影响的系统评价
    黄琼 董陈娣 张鼎君 张敏 罗立 夏冰清 吴一帆
    2019(5):351-357. DOI: 10.13210/j.cnki.jhmu.20181213.001
    [摘要](34) [HTML](0) [PDF 4.35 M](65)
    摘要:
    目的:系统评价睡眠情况对慢性肾脏病 (chronic kidney disease, CKD)患者肾功能的影响。方法:计算机检索数据库PubMed、EMbase、The Cochrane Library,中国知网、中国生物医学文献数据库、维普和万方数据库, 检索睡眠情况对CKD患者肾功能影响的相关文献,均从最初检索至2018年6月,纳入符合标准的文献,根据研究类型,队列研究采用 NOS量表、横断面研究采用 AHRQ量表对文献进行质量评价,对主要结局指标:估算肾小球滤过率(eGFR)、内生肌酐清除率(Ccr),次要指标:匹兹堡睡眠质量指数(PSQI)、睡眠质量(SQ)、血肌酐(Scr)、血红蛋白(Hb)、白蛋白(ALB)、尿蛋白/肌酐比值(UPCR)等进行系统评价。结果:4篇文献和1篇会议摘要纳入本次研究,其中4篇为队列研究,其中3篇NOS质量评价均为高等,1篇为中等,剩下1篇为横断面研究,AHRQ质量评价为中等。本研究表明睡眠情况与肾功能有一定的相关性,较短的睡眠时间或较差的睡眠质量会导致肾功能的恶化,其中,意大利的Sabbatinit研究团队的研究数据表明Ccr随着PSQI的值升高而逐渐降低;美国的Cohen研究团队和Ricardo研究团队的研究表明eGFR值随着PSQI值的升高而下降;美国的Kumar研究团队的研究表明SQ值越低,肾功能越差;英国的Knutson研究团队的研究表明睡眠时间越短,eGFR越低。另外,各项研究表明睡眠指数对Hb、ALB、Scr、UPCR等指标也有所影响。结论:睡眠情况会对CKD患者肾功能产生不同程度的影响,较短的睡眠时间和较差的睡眠质量会损害肾功能,加快CKD 的进展。
    27  麝香保心丸联合盐酸替罗非班治疗老年急性冠状动脉综合征患者的相关因子水平的影响
    徐亚宁 代天 刘波 杨增芯
    2019(5):358-361, 366. DOI: 10.13210/j.cnki.jhmu.20190114.003
    [摘要](35) [HTML](0) [PDF 3.30 M](60)
    摘要:
    目的:探讨麝香保心丸联合盐酸替罗非班治疗老年急性冠状动脉综合征患者的相关因子水平的影响。方法:选择收治于我院的96例ACS老年患者,随机分为对照组(48例)和治疗组(48例)。对照组给予盐酸替罗非班治疗,治疗组给予麝香保心丸联合盐酸替罗非班治疗,两组均连续给予治疗2周。检测并比较两组治疗前后凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)及血清纤维蛋白酶原(FIB)、肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白T(cTnT)、血管性假血友病因子(vWF)、内皮素-1(ET-1)、一氧化氮(NO)、可溶性细胞黏附分子-1(sICAM-1)、基质金属蛋白酶9(MMP-9)、超敏C反应蛋白(hs-CRP)水平。结果:两组治疗前PT、TT、APTT及血清FIB、CK-MB、cTnT、vWF、ET-1、NO、sICAM-1、MMP-9、hs-CRP水平比较,差异无统计学意义(P>0.05)。两组治疗后PT、TT、APTT及血清NO水平均高于治疗前,血清FIB、vWF、ET、sICAM-1、MMP-9及hs-CRP水平均低于治疗前,且治疗组PT、TT、APTT及血清NO、FIB、vWF、ET、sICAM-1、MMP-9、hs-CRP水平变化优于对照组(P<0.05)。两组治疗后的血清CK-MB、cTnT水平相比治疗前均明显偏高,治疗组的血清CK-MB、cTnT水平均低于对照组,差异均具有统计学意义(P<0.05)。结论:麝香保心丸联合盐酸替罗非班能够明显改善老年急性冠状动脉综合征患者的凝血功能,减轻心肌损伤和血管内皮损伤,降低炎症反应,值得在临床上推广应用。
    28  天麻素治疗对偏头痛患者神经递质效应、应激反应、血管及神经功能的影响
    唐灵芝 孙晓莉 阮超 武岳 李黎黎
    2019(5):362-366. DOI: 10.13210/j.cnki.jhmu.20190102.003
    [摘要](41) [HTML](0) [PDF 3.12 M](51)
    摘要:
    目的:探讨天麻素治疗对偏头痛患者神经递质效应、应激反应、血管及神经功能的影响。方法:选择2016年9月~2017年12月间在本院收治的90例偏头痛患者作为研究对象,随机分为观察组与对照组,每组各45例。对照组采用盐酸氟桂利嗪治疗;观察组在对照组的基础上联合天麻素治疗。观察比较两组神经递质效应[包括5-羟色胺(5-HT)、肿瘤坏死因子-α(TNF-α)]、应激反应[氧化型低密度脂蛋白(ox-LDL)、对氧磷酶-1(PON-1)]、血管功能[包括一氧化氮(NO)、内皮素-1(ET-1)]及神经功能[包括脑源性神经营养因子(BDNF)、降钙素基因相关肽(CGRP)]相关指标的表达水平并进行分析。结果:两组研究对象在经递质效应、应激反应、血管及神经功能方面变化明显。治疗前,两组患者各项指标水平无显著差异(P>0.05);治疗后,两组患者TNF-α、ox-LDL、NO、ET-1、BDNF及CGRP水平均较治疗前显著降低(P<0.05),5-HT及PON-1水平则较治疗前显著升高(P<0.05);且治疗后观察组TNF-α、ox-LDL、NO、ET-1、BDNF及CGRP水平较对照组明显下降(P<0.05),5-HT及PON-1水平则较对照组升高明显(P<0.05)。结论:天麻素治疗可调节偏头痛患者氧化应激水平,改善其血管及神经功能。
    29  补硒治疗对HT患者甲状腺功能、免疫应答及氧化应激的影响
    屈春梅 李颖 陈书梅
    2019(5):367-370. DOI: 10.13210/j.cnki.jhmu.20190124.001
    [摘要](73) [HTML](0) [PDF 2.48 M](75)
    摘要:
    目的:探讨补硒治疗对甲状腺功能正常的HT患者甲状腺功能、免疫应答及氧化应激的影响。方法:选择我院收治的120例甲状腺功能正常的桥本甲状腺炎患者作为研究对象,随机分为治疗组与对照组,每组各60例。对照组给予口服安慰剂(临床随访);治疗组给予口服硒酵母。观察比较两组甲状腺功能促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)及游离甲状腺素(FT4)、免疫应答甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TGAb)、干扰素-γ(IFN-γ)及白介素-4(IL-4)]及氧化应激包括丙二醛(MDA)、谷胱甘肽过氧化物酶(GPx)、超氧化物歧化酶(SOD)相关指标的表达水平并进行分析。结果:两组研究对象在免疫应答及氧化应激方面变化明显。治疗前,两组患者各项水平无显著差异(P>0.05);治疗后,对照组患者上述相关指标水平与治疗前相比仍无显著差异(P>0.05);治疗组甲状腺功能相关指标水平与治疗前及对照组相比无显著差异(P>0.05),TPOAb、TGAb、IFN-γ及MDA水平与治疗前及对照组相比显著降低(P<0.05),IL-4、GPx及SOD水平与治疗前及对照组相比显著升高(P<0.05)。结论:补硒治疗可稳定HT患者甲状腺功能,降低甲状腺抗体生成水平,并改善免疫应答及氧化应激反应。
    30  基于激痛点的合谷刺法结合舒筋弹拨法治疗急性胸背肌筋膜炎临床疗效的观察
    鲁光宝 梅荣军 史文强 刘海洲 黄敬文 李续博
    2019(5):371-374. DOI: 10.13210/j.cnki.jhmu.20190128.005
    [摘要](98) [HTML](0) [PDF 2.46 M](58)
    摘要:
    目的:观察基于激痛点理论的合谷针刺法结合舒筋弹拨法对急性胸背肌筋膜炎的疗效;方法:84例符合诊断及纳入标准的急性胸背肌筋膜炎患者随机分为治疗组和对照组,其中治疗组给予合谷针刺法结合舒筋弹拨推拿法治疗,对照组采用常规电针疗法。两组疗程均为2周,分别比较两组治疗前、第一次治疗后及疗程结束后VAS评分、ODI,并评价其临床疗效;结果:治疗组和对照组总有效率分别为97.62%和80.95%,治疗组明显优于对照组(P<0.05);治疗组第一次治疗及疗程结束后VAS和ODI评分与本组治疗前比较均明显下降(P<0.01),且治疗组明显优于对照组(P<0.05和P<0.01);结论:合谷刺法结合舒筋弹拨推拿法能够减轻急性胸背肌筋膜炎患者的疼痛和改善其肢体功能障碍,疗效显著。
    31  膈下逐瘀汤联合穴位埋线对肥胖型多囊卵巢综合征不孕症的临床疗效观察
    张连娣 张兵 姜晓琳 董晓茜 包翠杰
    2019(5):375-379, 383. DOI: 10.13210/j.cnki.jhmu.20190124.009
    [摘要](64) [HTML](0) [PDF 3.88 M](62)
    摘要:
    目的:膈下逐瘀汤联合穴位埋线治疗肥胖型多囊卵巢综合征(PCOS)不孕症患者,总结其对糖脂代谢、排卵、妊娠情况的影响。方法:选择我院160例PCOS不孕症患者,随机分为对照组(n=80)与观察组(n=80)。对照组给予二甲双胍+膈下逐瘀汤口服,观察组在对照组的基础上给予穴位埋线治疗。两组均给予3个月的治疗周期。测量并比较两组治疗前与治疗结束后的体重指数(BMI)、腰臀比(WHR)、外周血清血脂[低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、总胆固醇(TC)、甘油三酯(TG)]、血糖[空腹血浆胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、空腹血糖(FPG)、餐后2 h血糖(2 hPG)]、激素水平[雌激素(E2)、睾酮(T)、卵泡雌激素(FSH)、黄体生成素(LH)],并评估患者的妊娠情况。结果:治疗后两组外周血清LH、LH/FSH、E2、T、TG、LDL-C、TC、FPG、2 hPG、BMI、WHR均较治疗前有所降低,且观察组低于对照组,差异均有统计学意义(P<0.05);治疗后两组外周血清HDL-C、FSH较治疗前有所升高,且观察组高于对照组,差异均有统计学意义(P<0.05);观察组的排卵率及其临床妊娠率均高于对照组,差异均有统计学意义(P<0.05)。结论:在膈下逐瘀汤治疗的基础上给予穴位埋线能通过改善PCOS不孕症患者的糖脂代谢异常与外周血清性激素水平而提高患者的排卵率与临床妊娠率。
    32  噬血细胞综合征患儿外周血Th17/Treg平衡状态检测及其与病情严重程度的相关关系
    雷伟娟 潘洁
    2019(5):380-383. DOI: 10.13210/j.cnki.jhmu.20190124.003
    [摘要](63) [HTML](0) [PDF 2.56 M](55)
    摘要:
    目的:探讨噬血细胞综合征(HLH)患儿外周血Th17/Treg平衡状态检测及其与病情严重程度的相关关系。方法:选取在本院确诊的小儿HLH 60例作为HLH组,同期在本院进行体检的健康小儿100例作为正常对照组。对比两组小儿外周血Th17/Treg平衡状态、铁蛋白(SF)、炎症介质水平的差异。结果:HLH组患儿外周血中Th17细胞比例及Th17/Treg比值均高于对照组,Treg细胞比例低于对照组(P<0.05)。HLH组血清中SF的含量低于对照组;外周血中炎症介质PCT、IL-6、IL-10、IFN-γ的含量显著高于对照组(P<0.05)。相关性分析发现,噬血细胞综合征患儿外周血Th17细胞比例及Th17/Treg比值与SF、PCT、IL-6、IL-10、IFN-γ的含量呈正相关,Treg细胞比例与SF、PCT、IL-6、IL-10、IFN-γ的含量呈负相关(P<0.05)。结论:噬血细胞综合征患儿存在Th17/Treg免疫失衡,且与疾病严重程度间存在肯定相关关系,可能在疾病病情评估方面具有一定临床意义。
    33  常规康复治疗联合头部低频电刺激对脑瘫患儿单胺类神经递质、NSE、ET-1及脑血流动力学的影响
    郇赛 王佩佩 杨暖 侯梅 陈军 孙殿荣 赵建慧 吕丽萍
    2019(5):384-387. DOI: 10.13210/j.cnki.jhmu.20190115.002
    [摘要](42) [HTML](0) [PDF 2.48 M](57)
    摘要:
    目的:探讨常规康复治疗联合头部低频电刺激对脑瘫患儿单胺类神经递质、神经元特异性烯醇化酶(NSE)、内皮素-1(ET-1)及脑血流动力学的影响。方法:选取2017年1月至2018年6月我院收治的110例脑瘫患儿作为研究对象,随机分为观察组55例和对照组55例,对照组患儿接受常规康复治疗,观察组患儿在常规康复治疗的基础上接受头部低频电刺激,比较两组患儿多巴胺(DA)、去甲肾上腺素(NE)、5-羟色胺(5-HT)、NSE、ET-1的水平变化及大脑前动脉(ACA)、大脑中动脉(MCA)、大脑后动脉(PCA)的平均血流速度。结果:治疗前,两组患儿的DA、NE、5-HT水平均无统计学差异(P>0.05);治疗后两组的DA、NE、5-HT均升高,且观察组的DA、NE、5-HT高于对照组(P<0.05)。治疗前,两组患儿的NSE、ET-1水平均无明显差异(P>0.05);治疗后两组的NSE、ET-1均降低,且观察组的NSE、ET-1低于对照组(P<0.05)。治疗前,两组ACA、MCA、PCA的平均血流速度均无统计学差异(P>0.05);治疗后,观察组比治疗前显著升高,且高于同期对照组(P<0.05)。结论:常规康复治疗联合头部低频电刺激可有效提高脑瘫患儿的单胺类神经递质含量,增强脑血流循环,并减轻脑损伤。
    34  难治性精神分裂症药物基因检测CYP相关性研究
    许勤伟 刘向来 姚乾坤 郑在激
    2019(5):388-391. DOI: 10.13210/j.cnki.jhmu.20190130.001
    [摘要](115) [HTML](0) [PDF 2.46 M](66)
    摘要:
    目的:研究精神分裂症的难治性相关因素。方法:选取200例难治性精神分裂症患者和200例非难治性精神分裂症患者,药物基因检测他们的CYP系列基因CYP1A2、CYP3A4、CYP2D6,对3个基因的快代谢型概率进行比较分析;再将200例难治性精神分裂症患者随机分为合并药物治疗组、单一药物治疗组各100例,分别于治疗的0W、4W进行药物基因检测3个基因快代谢型以及BPRS量表评分疗效进行比较分析。结果:难治性精神分裂症患者CYP1A2、CYP3A4、CYP2D6基因快代谢型概率与非难治性差异具有显著性(P<0.05);治疗4 W后合并药物治疗组CYP1A2、CYP3A4、CYP2D6基因快代谢型概率对比单一药物治疗组差异无显著性(P>0.05);BPRS量表评分合并药物治疗组疗效显著高于单一药物治疗组 (P<0.05);经过Logistic回归分析,精神分裂症的难治性与CYP系列基因CYP1A2、CYP3A4、CYP2D6快代谢型相关。结论:CYP系列基因CYP1A2、CYP3A4、CYP2D6快代谢型是精神分裂症难治性的相关因素,抗精神病药物合并CYP酶抑制剂治疗能够提高疗效。
    35  内镜诊断早期胃癌的新进展
    李夏 于红刚
    2019(5):392-395. DOI: 10.13210/j.cnki.jhmu.20190124.002
    [摘要](117) [HTML](0) [PDF 2.31 M](60)
    摘要:
    胃癌是临床上常见的恶性肿瘤之一,其具有高发病率、死亡率,预后差的特点。临床上一般将胃癌分为早期胃癌(early gastric cancer,EGC)和进展期胃癌,早期胃癌的5年生存率高于进展期胃癌。近年来,随着科技的不断发展,各种医疗仪器与技术亦相继更新换代,促进EGC检出率的提高,降低EGC漏诊率。本文就对早期胃癌内镜诊断进展进行综述。
    36  椎管扩大成形术-发展及展望
    王文轩 赵斌 陆向东 王永峰 赵轶波 赵晓峰
    2019(5):396-400. DOI: 10.13210/j.cnki.jhmu.20190129.001
    [摘要](149) [HTML](0) [PDF 2.86 M](86)
    摘要:
    颈椎椎管扩大成形术作为椎板切除术的替代术式,通过将椎板抬高从而扩大脊髓可用空间,达到间接减压效果以治疗颈椎病。在Hirabayashi的单开门及Kurokawa的双开门两种原型技术基础上,各种椎管扩大成形术得以不断发展。相比于椎板切除术,多项研究表明椎板成形术后颈椎表现出更好的生物力学稳定性。椎管扩大成形术的最新研究进展围绕保留肌肉、韧带附着点,从而使由颈伸肌群控制的颈椎保持动态及静态稳定。接受了新型椎板成形术治疗的患者,结合术后积极的颈部肌肉功能锻炼,术后颈椎失稳、后凸畸形、轴性症状以及颈椎活动度的下降都进一步减少。多项临床试验表明这种新型术式可以保证患者术后疗效的同时提供颈椎的即刻稳定性。现就对颈椎椎管扩大成形术的发展、并发症以及未来趋势综述如下。

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