“龙虎交战”针法针刺八脉交会穴对偏头痛患者头痛天数及血清CGRP表达的影响＊

目的 观察“龙虎交战”针法针刺八脉交会穴对无先兆偏头痛（Migraine without aura，MO）患者头痛天数及外周血降钙素基因相关肽（Calcitonin gene related peptide，CGRP）表达水平的影响。方法 按照头痛程度将90例MO受试者区层随机分为治疗Ⅰ组、治疗Ⅱ组和对照组各30例。治疗Ⅰ组施以“龙虎交战”针法针刺八脉交会穴（外关和足临泣），治疗Ⅱ组施以平补平泻针法针刺八脉交会穴（外关和足临泣），对照组施以平补平泻针法针刺非经非穴点，每次留针30分钟，5次/周，共治疗20次。于治疗前、治疗结束4周后的随访分别记录三组患者头痛天数的变化情况以判定疗效，并采集患者治疗前、治疗结束4周后随访的肘部静脉血用ELISA法检测血清中的CGRP含量的变化。结果 ①各组治疗前患者的头痛天数无显著差异（Ｐ > 0.05），治疗Ⅰ组、治疗Ⅱ组和对照组治疗结束4周后随访的头痛天数较治疗前均显著降低（Ｐ < 0.05）；治疗Ⅰ组头痛天数的降低显著优于治疗Ⅱ组和对照组（Ｐ < 0.001），治疗Ⅱ组头痛天数的降低显著优于对照组（Ｐ < 0.05）；②3组治疗前CGRP的表达无显著差异，治疗Ⅰ组、治疗Ⅱ组治疗结束4周后随访CGRP的表达较治疗前均显著下降（Ｐ < 0.001），对照组治疗结束4周后随访CGRP的表达较治疗前差异无显著性（Ｐ > 0.05）；治疗Ⅰ组CGRP治疗结束4周随访的表达较治疗Ⅱ组和对照组均显著下降（Ｐ < 0.01），治疗Ⅱ组CGRP的表达较对照组显著下降（P < 0.01）。结论 ①八脉交会穴施以“龙虎交战”针法针刺能明显改善MO患者的头痛天数，同时降低MO患者血清CGRP的表达水平，这可能是针刺八脉交会穴治疗MO的机制之一；②非经非穴点的针刺效应无持续性，而八脉交会穴的针刺效应具有持续性；③八脉交会穴可以充分发挥复式针刺手法的治疗效应，提示我们在临床上治疗疾病时不仅要注意腧穴配伍，恰当的针刺手法更是提高临床疗效、事半功倍的关键。     

Development and validation of a food frequency questionnaire for assessing dietary calcium intake in the general population

The aim of this study was to develop and evaluate a food frequency questionnaire (FFQ) for assessing dietary calcium intake in the general population, since all available questionnaires at present are age- and/or gender-specific. A total of 1001 individuals (including children, adults, and elderly people of both genders) were randomly recruited throughout Greece. Estimates of calcium intake from the 30-item FFQ were compared with those from a multi-pass 24-h recall. The FFQ underestimated mean calcium intake compared to the 24-h recall by (mean±SD) –133±333 mg/day or –5.4±47.6% (P<0.001). The two methods were strongly correlated (r=0.639, P<0.001), but the 95% limits of agreement for individual assessment were rather wide, as the FFQ could provide estimates of calcium intake from 533 mg/day above to 799 mg/day below the 24-h recall. Actual values for surrogate FFQ quartiles manifested a progressive increase, with significant differences between mean calcium intakes (P<0.001). The FFQ could identify individuals who consumed less calcium than 800 mg/day or less than the age-specific adequate intake with a relatively high sensitivity (82.8 and 95.5%, respectively), but low specificity (54.9 and 34.1%, respectively). Cross-classification analysis indicated that only 17 subjects (1.7%) were grossly misclassified (lowest quartile for one method and highest quartile for the other), while 827 subjects (82.6%) were correctly classified (into the same or adjacent quartiles). The FFQ could be used in population-based epidemiological studies or screening programs involving individuals of all ages and both genders, where the discrimination of subjects with relatively low (<500 mg/day) and relatively high (>1000 mg/day) calcium intakes is of primary interest. Results, however, do not support its use for the quantitative assessment of individual calcium intakes.     

Measuring behaviour: The tools and the strategies

Animal behaviour can be viewed as a stream of elements, which, once accurately described, can be counted and timed. Data acquisition techniques and tools are reviewed, and some strategies for collection and analysis of data using PC computers are suggested. Automated instruments are not satisfactory for the study of complex behaviour and as such systemic observation remains irreplaceable. IBM PC-type computers, with a wide range of analytical software (e.g., spreadsheets, statistical packages, technical graphics), are practical for data acquisition. Several systems which can satisfy different applications are reviewed. Some systems can communicate with a videorecorder, a facility which remarkably increases the accuracy of measurement; this is essential for meaningful analyses of the internal structure of behavioural streams (sequences, time patterns) or communication processes. The power of new tools enables behavioural measurement with the necessary complexity to allow a whole new set of questions to be addressed. However, it also increases demands for meaningful content and analysis of data.     

骨外露及皮肤软组织缺损的修复

目的　评价和探讨修复骨外露及皮肤软组织缺损的各种方法 ,使其更好地用于临床。方法　 3 5例不同部位的骨外露分别采用皮片移植、皮瓣及肌皮瓣转移、皮瓣及肌皮瓣游离移植等方法 ,覆盖外露的骨面。结果　 3 1例全部存活 ,1例皮瓣部分坏死 ,2例创口延迟愈合 ,1例游离皮瓣失败。结论　对骨外露及皮肤软组织缺损应尽量在早期修复 ,最常用的方法是皮瓣及肌皮瓣的转移或移植。     

不同穴位针刺蝶腭神经节深度及方向的研究

目的:观测下关、颧髎、"蝶腭"穴的体表位置,及各穴至蝶腭神经节的针刺深度和针刺方向.方法:15具成年男性尸体,面部左右共30侧,对其面侧区进行由浅入深的解剖.以下关、颧髎、"蝶腭"穴各穴针刺至蝶腭神经节方向为穿刺入路,电动钻带克氏针穿刺延伸至对侧区域,坐标定位法测量各穴的对应穿刺点.结果:①体表位置:"蝶腭"穴与颧髎的体表距离为21 mm,与下关的体表距离为17 mm.②各穴针刺蝶腭神经节的深度:下关为49.9 mm,"蝶腭"穴为46.9 mm,颧髎为46.6 mm.③对应穿刺点坐标定位:下关针刺方向为前内上,对应于对侧的太阳和瞳子髎的中点处附近区域,对应穿刺点距对侧丝竹空的距离为17.6 mm;"蝶腭"穴针刺方向为后内上,对应穿刺点与颧弓水平线的距离为33 mm,与目外眦垂直线的距离为42 mm;颧髎针刺方向为后内上,对应穿刺点与两外耳门连线的距离为28 mm,头部正中线旁开62 mm.结论:了解下关、颧髎、"蝶腭"穴的体表位置、针刺深度、针刺方向,为临床针刺蝶腭神经节提供了依据.     

一种较好的RNA分离制备方法及其在人胚RNA提取中的应用

以钒基核苷酸复合物为核酸酶抑制剂,从人胚组织中制备总RNA,所得产品几乎不含DNA和蛋白质,经过分离Poly(A)~ mRNA,证明制品有合成cDNA的完整功能,方法比较简捷,适于大量制备以满足分离mRNA 之需,并讨论了此法的优缺点。     

不同针刺深度对前列腺增生症大鼠重量指数的影响及形态学观察

目的与方法 采用深刺和浅刺对丙酸睾酮所致前列增生症（BPH）大鼠模型进行干预，研究其作用殊同。结果 针刺组前列腺，膀胱指数明显小于模型组；形态学观察，针刺组较模型组增生明显减轻，腺上皮呈单层柱状，腺体数目明显减少，间质充血，钙化明显减轻，结缔组织无增生，腺腔内分泌物减少。深刺组好于浅刺组。结论 深刺对实验性BPH大鼠的干预作用好于浅刺方法。     

17β-雌二醇对子宫内膜异位症患者在位子宫内膜间质细胞β-catenin mRNA和蛋白表达的影响

目的研究17β-雌二醇(17β-E2)对子宫内膜异位症(内异症)患者在位子宫内膜间质细胞β-catenin mRNA和蛋白表达的影响,探讨Wnt/β-catenin信号通路在介导雌激素促进内异症发生发展的作用。方法体外分离培养内异症患者在位子宫内膜间质细胞。用不同浓度17β-E2处理子宫内膜间质细胞48 h;此后选用10-10mol/L 17β-E2处理子宫内膜间质细胞12、24和48 h,逆转录聚合酶链反应(RT-PCR)和免疫印迹法(Western blotting)检测17β-E2处理前后子宫内膜间质细胞β-catenin mRNA和蛋白的表达水平。同法分析雌激素受体拮抗剂ICI182,780(10-6mol/L)对17β-E2促进β-catenin mRNA和蛋白表达的影响。免疫组织化学染色观察17β-E2作用后β-catenin在子宫内膜间质细胞中的定位。结果17β-E2能明显促进内异症患者在位子宫内膜间质细胞β-catenin mRNA和蛋白的表达,并呈剂量和时间依赖性,于10-10mol/L作用48 h最明显。雌激素受体拮抗剂ICI182,780能明显抑制17β-E2对子宫内膜间质细胞β-catenin mRNA和蛋白的表达。免疫组织化学染色发现17β-E2能促进β-catenin在子宫内膜间质细胞核内的表达。结论雌激素可能通过激活Wnt/β-catenin信号通路促进内异症在位子宫内膜的异位种植。     

连续硬膜外麻醉时异丙酚辅助用药及血药浓度监测

目的：探讨异丙酚连续硬膜外麻醉时辅助用药的方法及其药代动力学特性。方法：30例下腹部或下肢手术病人随机分为两组，在连续硬膜外麻醉下分别以不同速度静滴异丙酚，同时高压液相法测定血药浓度。结果：以10→8→5mg／（kg·h）方法给药，患者意识消失明显快于5mg／（kg·h）恒速给药组（P＜0.05）。平均意识消失及苏醒血药浓度分别为（2．1±0．7）mg／L及（1．0±0．5）mg／L。结论：连续硬膜外麻醉时辅助用药以10→8→5mg／（kg·h）的给药方法为佳。为避免术中病人觉醒，最低给药速度不得低于5mg／（kg·h）。