龙氏手法联合施罗斯疗法在特发性脊柱侧弯患者中的应用效果

目的：探讨龙氏手法联合施罗斯疗法对特发性脊柱侧弯患者竖直肌表面肌电、Cobb角及躯干畸形程度的影响。方法：选择2021年11月—2022年12月新余市中医院康复科收治的80例特发性脊柱侧弯患者为研究对象,采用硬币抛掷法分为联合组（n=42）与对照组（n=38）。对照组接受施罗斯疗法,联合组接受龙氏手法联合施罗斯疗法,两组患者治疗6个月。比较两组竖脊肌表面肌电相关指标、Cobb角、躯干畸形程度、总有效率及生活质量。结果：治疗后,联合组凹凸两侧竖脊肌中位频率（MF）、平均功率频率（MPF）及平均肌电值（AEMG）均明显高于对照组,差异均有统计学意义（P<0.05）;治疗后,联合组Cobb角、躯干倾斜角（ATI）、躯干旋转角度（ATR）均明显小于对照组,差异均有统计学意义（P<0.05）;联合组总有效率及治疗后健康调查量表36(SF-36)各维度评分均明显高于对照组,差异均有统计学意义（P<0.05）。结论：对特发性脊柱侧弯患者行龙氏手法联合施罗斯疗法能显著改善竖脊肌协调性与稳定性,使Cobb角降低,有助于恢复脊柱形态,改善躯干畸形,疗效显著,且能提升生活质量。     

施罗斯体操对中度女性青少年特发性脊柱侧凸患者的疗效观察

目的 探究施罗斯体操对佩戴支具的中度女性青少年特发性脊柱侧凸(AIS)患者的疗效.方法 将32例女性中度特发性脊柱侧凸患者分为施罗斯体操结合支具组(结合组)和支具组.支具组只佩戴支具,每天佩戴22 h;结合组在对照组的基础上,每周进行3次体操训练,每次训练90 min,两组患者治疗16周.比较治疗前、后两组的最大Cobb角、冠状位骨盆倾斜角(PO)、锁骨角(CA)、胸椎后凸角(TK)、腰椎前凸角(LL)、躯干旋转角(ATR)、顶椎旋转和生活质量改善情况.结果 与治疗前比较,两组患者在治疗后最大Cobb角、ATR均减小(P<0.05);治疗后支具组TK较治疗前减小,结合组TK与治疗前、后比较差异无统计学意义(P>0.05).结合组在功能活动、自我形象感知和心理健康维度得分均高于治疗前(P<0.05);支具组SRS-22各维度治疗前、后比较,差异无统计学意义(P>0.05);两组在治疗后疼痛感知维度得分差异有统计学意义(P<0.05).结论 对于中度脊柱侧凸患者,除佩戴支具外应结合施罗斯体操进行训练,可更有效地改善患者畸形程度,提高生活质量.     

杠杆定位手法治疗腰椎间盘突出症疗效与骨盆参数影响的研究

[目的]对比研究杠杆定位手法与斜扳法治疗腰椎间盘突出症(lumber disc herniation,LDH)的临床疗效与其对骨盆参数的影响。[方法]将符合纳入标准的67例LDH患者随机分为杠杆定位手法组(观察组)和斜扳法组(对照组),分别将两组治疗前后的临床疗效、症状体征评分,骨盆左右倾斜度、左右髂嵴距离差、髂后上棘距离差进行评估比较。[结果]①临床疗效:治疗组总有效率优于对照组,差异有统计学意义(P<0.01)。②临床症状体征评分:两组评分较治疗前均改善,观察组改善优于对照组,差异均有统计学意义(P<0.05)。③骨盆参数:与治疗前比较,治疗后两组患者骨盆参数均转佳,差异有统计学意义(P<0.01)。治疗后两组间比较,观察组骨盆参数变化优于对照组,差异有统计学意义(P<0.05),结果提示杠杆定位手法对骨盆参数的调节更佳。[结论]与斜扳法相比,杠杆定位手法能更有效地治疗腰椎间盘突出症,明显改善患者的临床症状与体征,且对腰椎间盘突出症患者的骨盆参数有较好的调节作用。     

AR体感运动结合对侧控制型功能性电刺激治疗青少年特发性脊柱侧弯效果观察

目的探讨增强现实（AR）体感运动结合对侧控制型功能性电刺激（CCFES）治疗青少年特发性脊柱侧弯（AIS）的效果。方法选取浙江医院2020年1月至2021年7月收治的121例AIS患者为研究对象,其中采取施罗斯运动结合AR体感运动+CCFES治疗41例（AR+CCFES组）,仅模拟施罗斯运动为主的AR体感运动治疗38例（AR组）,常规施罗斯运动治疗42例（对照组）;均予以1h/次,1次/d,5d/周,共治疗8周。比较3组患者治疗前及治疗4、8周后躯干旋转角、Cobb角、躯干额状面倾斜距离、顶椎偏移距离。结果3组患者治疗前躯干旋转角、Cobb角、冠状面躯干偏移距离、顶椎偏移距离比较,差异均无统计学意义（均P＞0.05）;治疗4、8周后,3组患者躯干旋转角和Cobb角均明显减小（均P＜0.05）,冠状面躯干偏移距离、顶椎偏移距离均明显缩短（均P＜0.05）,其中AR+CCFES组均明显小于AR组、对照组（均P＜0.05）。结论AR体感运动结合CCFES在AIS患者中的应用效果良好,在脊柱两侧运动均衡性方面具有明显优势。     

邵瑛教授治疗小儿胃强脾弱证经验撷萃

[目的]观察龙氏正骨手法治疗老年性神经根型颈椎病的临床疗效。[方法]将符合纳排标准的180例老年性神经根型颈椎病患者随机分为两组,每组各90例。龙氏手法组予龙氏正骨手法治疗,常规推拿组予传统推拿治疗,隔日1次,10次为1个疗程,疗程间隔3～5d,共治疗两个疗程。观察两组患者症状变化情况及疗效,并记录治疗前视觉模拟评分(visual analogue score,VAS)、颈椎功能障碍指数(the neck disability index,NDI)、颈椎病临床评价量表(clinical assessment scale for cervical spondylosis,CASCS)评分变化情况,并进行统计学比较。[结果]治疗后两组患者VAS、NDI、CASCS评分均较治疗前改善,差异具有统计学意义(P＜0.05)。治疗后两组间比较,龙氏手法组患者VAS、NDI、CASCS评分均较常规推拿组改善,差异有统计学意义(P＜0.05)。龙氏手法组有效率为95.6%,常规推拿组有效率为75.6%,组间临床疗效比较,差异具有统计学意义(P＜0.05)。[结论]与常规推拿治疗比较,龙氏正骨手法能明显缓解老年性神经根型颈椎病患者的疼痛症状,改善功能活动,改变脊柱形态,提高生存质量,疗效显著。     

经皮椎体成形术与保守法治疗老年骨质疏松性胸腰椎压缩骨折的疗效比较研究

目的 比较经皮椎体成形术(PVP)与保守法治疗老年骨质疏松性胸腰椎压缩骨折的疗效.方法 选择2009年7月-2010年10月我院收治的老年骨质疏松性胸腰椎压缩骨折患者38例,采用随机数字表法并结合患者自身要求分为对照组(17例)和治疗组(21例),分别采用保守法和PVP进行治疗.比较两组患者治疗前后疼痛视觉模拟评分(VAS评分)、椎体高度及Cobb角、椎体再骨折情况.结果 对照组和治疗组组内治疗前、治疗后1周、治疗后1个月、末次随访时VAS评分比较,差异均有统计学意义(P＜0.05);组间同期比较,仅治疗后1周时VAS评分差异有统计学意义(P＜0.05).两组患者治疗前椎体前缘、中线、后缘高度及Cobb角比较,差异均无统计学意义(P＞0.05);治疗后比较,除椎体后缘高度外,其他指标间差异均有统计学意义(P＜0.05).对照组治疗前后椎体前缘、中线高度及Cobb角比较,差异均有统计学意义(P＜0.05);椎体后缘高度比较,差异无统计学意义(P＞0.05).治疗组治疗前后椎体前缘、中线、后缘高度及Cobb角比较,差异均无统计学意义(P＞0.05).对照组有2例、治疗组有4例患者出现椎体再骨折.结论 PVP止痛效果显著且持久,但较难恢复椎体高度,术后椎体再骨折发生率较高;保守法治疗止痛周期较长,椎体高度恢复情况较好,术后椎体再骨折发生率较低.     

经皮椎体成形术治疗老年骨质疏松性胸腰椎压缩性骨折临床效果观察

目的探讨经皮椎体成形术治疗老年骨质疏松性胸腰椎压缩性骨的折临床效果。方法抽取我院2015年1月至2016年1月接收的108例老年骨质疏松性胸腰椎压缩性骨折患者,随机分组,各54例,对照组给予传统治疗,观察组给予经皮椎体成形术治疗,比较两组治疗前后椎体前缘高度、Cobb角及机体功能恢复情况。结果治疗前,两组患者Cobb角、椎体前缘高度相比较,差异无统计学意义(P0.05),治疗后,观察组Cobb角明显小于对照组,观察组椎体前缘高度明显高于对照组,差异有统计学意义(P0.05);治疗前,机体功能评分两组间比较,差异无统计学意义(P0.05),经治疗,观察组机体功能评分明显低于对照组,差异有统计学意义(P0.05)。结论对老年骨质疏松性胸腰椎压缩性骨折患者给予经皮椎体成形术治疗,可降低Cobb角,提高椎体前缘高度,改善机体功能。     

３种手术方式在腰椎结核治疗中的疗效对比

目的：探讨3种手术方式在腰椎结核中的应用价值。方法选择我院2010年4月至2013年1月收治的182例腰椎结核患者作为研究对象,按手术方案分为A组、B组和C组。A组患者采用后路术式治疗,B组患者采用前后路联合术式治疗, C组患者采用前路术式治疗,比较3组患者术中出血量、手术时间、住院时间、Cobb角、血沉（ESR）以及并发症发生情况。结果治疗后3组患者Cobb角和ESR较术前均有较大程度改善,与术前比较差异有统计学意义（P＜0.05）。但3组间Cobb角和ESR比较差异均无统计学意义（P＞0.05）。3组患者Cobb角变化量和ESR变化量比较差异无统计学意义（P＞0.05）,但手术时间、术中出血量和住院时间比较差异有统计学意义（P＜0.05）。组间比较发现A组患者手术时间、术中出血量和住院时间均低于B组和C组,差异有统计学意义（P＜0.05）。B组与C组比较差异无统计学意义（P＞0.05）。3组患者并发症发生率比较差异无统计学意义（F＝0.382,P＞0.05）。结论3种手术方式治疗腰椎结核均能取得良好治疗效果,但后路术式具有术中出血量少、手术时间和住院时间短等特点,可作为腰椎结核治疗的首选术式。     

不同非手术治疗对儿童青少年特发性脊柱侧弯效果的对比研究

目的 探讨医疗体操、手法治疗、矫形支具治疗对儿童青少年特发性脊柱侧弯的临床效果。方法 选择2008年11月～2013年9月通过特发性脊柱侧弯普查发现及在自贡市第一人民医院就诊的特发性脊柱侧弯患者80例,分为医疗体操组（30例）、手法治疗组（25例）及矫形支具组（25例）,医疗体操组采用自编医疗体操进行干预,手法治疗组根据解剖学特点采用综合性手法进行操作;矫形支具组应用矫形支具进行干预;疗程9～12月。观察并比较三组Cobb角变化情况。结果 治疗后三组Cobb角分别为：医疗体操组（17．00±8．00）°,手法治疗组（20．15±7．75）°,矫形支具组（11．86±5．07）°。医疗体操组治疗前后Cobb角比较差异有统计学意义（P=0．031）;矫形支具组治疗前后Cobb角比较差异有高度统计学意义（P=0．000）;而手法治疗组治疗前后比较差异无统计学意义（P=0．325）。治疗后医疗体操组与手法治疗组间Cobb角比较差异有统计学意义（P〈0．05）;治疗后矫形支具组与手法治疗组之Cobb角比较差异有高度统计学意义（P〈0．01）;治疗后医疗体操组与矫形支具组间Cobb角比较差异有高度统计学意义（P〈0．01）。结论 自编医疗体操、矫形支具对儿童青少年特发性脊柱侧弯疗效显著。     

传统推拿手法结合杠杆扳法治疗粘连期肩周炎30例临床观察

[目的]阐述传统推拿手法结合杠杆扳法治疗粘连期肩周炎的方法,观察疗效并分析其作用原理。[方法]将60例粘连期肩周炎患者随机等分成对照组和治疗组,对照组采取传统推拿手法治疗,治疗组采取传统推拿手法结合杠杆扳法治疗,疗程为4周,诊疗前后利用《肩关节疾患治疗成绩判定标准(Assessment Criteria for Shoulder Pain of Japanese Orthopedic Association,以下简称JOA)》量表进行评定,对比两组诊疗前后在疼痛、功能、活动度、X线评价和关节稳定性方面的差异,并比较两组疗效。[结果]治疗前后利用JOA量表评分进行比较,两组在疼痛、功能、活动度和关节稳定性指标方面均有明显进步,其中治疗组在疼痛、功能和活动度指标的进步都较对照组明显,且差异具有统计学意义(P0. 01),而在关节稳定性指标方面的进步,两组差异无统计学意义(P0. 05),治疗前后两组X线评价指标无明显改变,且差异无统计学意义(P0. 05)。两组治疗后治愈率、总有效率比较,治疗组均明显优于对照组,且差异有统计学意义(P0.05)。[结论]传统推拿手法结合杠杆扳法较单纯的传统推拿手法在粘连期肩周炎的疗效上具有明显优势,值得临床推广。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.