小针刀松解联合痛点阻滞治疗第三腰椎横突综合征的临床观察

目的探讨小针刀松解联合痛点阻滞治疗第三腰椎横突综合征的临床疗效。方法 80例第三腰椎横突综合征患者随机分为小针刀松解联合痛点阻滞组(A组)和小针刀松解组(B组),每组40例。两组均以每周治疗1次,3次为1个疗程。采用疼痛视觉模拟评估法(VAS)对治疗前后VAS评分进行统计分析。结果①疼痛视觉模拟评估法(VAS)治疗前后比较:两组疼痛均较治疗前有明显缓解。②经治疗后,小针刀松解联合痛点阻滞组(A组)总有效率高于小针刀松解组(B组)。结论小针刀松解联合痛点阻滞可明显改善患者疼痛症状,其临床疗效优于小针刀松解。     

灌注疗法在输卵管介入治疗中的应用

目的探讨灌注疗法在输卵管介入治疗中的应用。方法回顾性分析2010年4,5月间行导丝再通术的30例不孕症患者的临床资料,观察灌注疗法治疗输卵管性不孕症的疗效。结果本组30例患者,采用导丝介入再通成功15例,灌注疗法再通成功8例。结论输卵管壶腹部、伞端阻塞者不适宜行导丝再通术,输卵管灌注疗法则有一定的疗效。     

超声心动图评价相同剂量左旋布比卡因与罗哌卡因对血流动力学的影响

目的探讨相同剂量左旋布比卡因与罗哌卡因在蛛网膜下腔阻滞中分别对中老年患者的血流动力学的影响。方法30例择期下肢或下腹部手术患者（ASAⅠ～Ⅱ级,年龄〉40岁）,分为两组,每组15例,分别接受左旋布比卡因15mg及罗哌卡因15mg蛛网膜下腔阻滞。监测患者心电图（ECG）、血压（MAP）、心率（HR）、脉搏血氧饱和度（SpO2）,并应用sonosite彩色超声诊断仪,采用单平面simpson′s法,即取心尖二腔或四腔观,勾画心内膜,按simpson′s规则,将左室按长轴方向分为若干个小圆柱体,这些圆柱体的体积之和为左室容积,公式为：V=∑A.△h,计算每搏输出量（SV）、心输出（CO）等血流动力学参数,记录时点分别为：注药前（TO）、注药后6min（T1）、12min（T2）和18min（T3）,同时记录感觉阻滞平面、双下肢运动阻滞情况。结果给罗哌卡因中老年组T1、T2、T3时点为TO相比,HR左室舒张末期容积（VD）、左室收缩末期容积（LVS）、SV、CO均下降明显（P〈0.05）,左旋布比卡因中老年组,LVD、LVS、SV、CO有不同程度的下降（P〉0.05）,HR无明显变化。组间比较,罗哌卡因中老年组变化更为显著（P〈0.05）。结论相同剂量左旋布比卡因与罗哌卡因对中老年人的血流动力学的影响较小。     

Modification of motor activity, passive avoidance conditioning and evoked potentials by microinjections of picrotoxin in both caudate nuclei in cats

Inhibition of movements is the result of the caudate nucleus (CN) activity. This action seems to be necessary for passive avoidance conditioning (PAC). Much data indicates that GABA has inhibitory effects in the CN. The present report provides further evidence for GABA inhibition in th4 CN. In cats, the acquisition session of a PAC response was carried out following the bilateral administration of 6 microgram of picrotoxin or saline in the CN. Twenty four hours later (1st test session) the animals were placed in the security compartment and remained there during 600 sec. In the second test, the cats injected with picrotoxin crossed to the other compartment while the subjects injected with saline did not move. Another series of acute experiments were also carried out. Evoked potentials (EP) were recorded in the CN produced by nucleus centralis medialis electrical stimulation. After picrotoxin application the first and second peaks, which could represent EPSPs, incraeased while the third peak, which could represent IPSPs, decreased. In conclusion, it seems that GABAergic intracaudate transmission maintains a lower level of neuronal discharges and probably participates in the maintenance of a PAC but not in its acquisition.     

Laparoscopic blockage of uterine artery and myomectomy

Background The goal of this study was to evaluate the effects of laparoscopic coagulation or blockage of the uterine arteries and myomectomy in treating symptomatic myomas. Methods A total of 142 women with symptomatic fibroids warranting surgical treatment and wanting to retain their uteri were treated by laparoscopic coagulation or blocking of the uterine arteries and myomectomy. Results Most of the 142 patients had multi-myomas of the uterus, as intramural myomas (54), subserous myomas (65), and submucosal myomas (25). The number of myomas in each patient varied from 1 to 4. The size of the myomas in all patients ranged from 2 to 12 cm. In 86 cases (60.4%) the uterine wall was sutured in one layer. Average operating time was 124.2 ± 33.1 min, and average blood loss was 117.8 ± 48.6 ml. Mean postoperative hospital stay was 4.8 ± 1.2 days. All patients underwent technically successful laparoscopic coagulation or blocking of uterine arteries and myomectomy without intraoperative complications. The mean follow-up time was 16.2 months (16–26). Symptomatic improvement was achieved in all patients. Five patients experienced recurrence of myomas. Conclusions Laparoscopic coagulation or block of the uterine arteries and myomectomy appears to be a safe, effective, and promising new method for treating symptomatic uterine myomas.     

针刀与封闭比较对肩关节周围炎的系统评价

目的:系统评价针刀与局部痛点封闭疗法治疗肩关节周围炎的安全性和有效性。方法:计算机检索中国生物医学文献数据库CBM(1978—2013年)、中国知网CNKI(1979—2013年)、维普数据库VIP(1989—2013年)、PubMed(1966—2013年)和Cochrane Library(2013年第5期),辅以手工检索相关期刊,纳入封闭与针刀比较治疗肩周炎的随机对照试验。由2名评价者按照Cochrane系统评价员手册的要求独立提取资料并交叉核对,如果有必要,将采用RevMan5.2.5软件进行Meta分析。结果:共纳入2个随机对照试验,包括115例患者,均为低质量文献。Meta分析结果显示:封闭组与针刀组相比,在治疗后痊愈率方面[OR=0.50,95%CI(0.16,1.63),P=0.25]无统计学意义。但在远期总有效率方面[OR=0.09,95%CI(0.01,0.93),P=0.04],在远期痊愈率方面[OR=0.07,95%CI(0.02,0.26),P0.0001]均有显著的统计学意义。结论:针刀治疗肩周炎的远期有效率和痊愈率的疗效可能更优于封闭。但本研究纳入试验数有限且文献质量较低,需设计更严格的随机对照试验来进一步验证上述结论。     

滨海核电厂冷源取水口海生物堵塞事件原因与对策分析

核电厂冷源系统是核电工程的重要组成部分,对保障核电厂安全运行具有重要意义。近年来,我国滨海核电厂发生多起冷源取水口海生物堵塞事件,对核电厂的安全性与经济性造成不利影响。根据我国滨海核电厂冷源安全研究成果,结合核安全监管要求与工程实践经验,对冷源取水口海生物堵塞事件的原因与对策进行分析,进一步提高核电厂的安全性与经济性。     

Unilateral auditory neuropathy spectrum disorder

A polymerase chain reaction (PCR)-based genotyping of the penicillin-binding protein (PBP) genes pbp1a , pbp2x and pbp2b was used to characterize Streptococcus pneumoniae isolated from the nasopharynx of children with acute otitis media (AOM). Mutations were observed in pbp1a , pbp2x and pbp2b genes in 36.5% of the strains. Decreased susceptibility to &;#103 -lactam antibiotics was closely associated with the frequency of mutations in the three PBP genes. Of penicillin-intermediately-resistant S. pneumoniae strains, 54.5% appeared to be genetically similar to penicillin-resistant S. pneumoniae strains. Of penicillin-susceptible S. pneumoniae strains, 33.3% had mutations in the pbp2x gene and showed relatively high MICs to cephalosporins. Strains with mutations in the three PBP genes were often isolated from children &;#104 2 years old. Evaluation of mutations in PBP genes using PCR will prove useful for studying the epidemiology of antibiotic resistance.     

论产后抑郁症“补虚祛瘀,颐脑醒神”治法

产后抑郁症是女性精神障碍中最为常见的类型之一,应用中医药针对本病的防治已成为目前医学界和社会普遍关注的课题。文章对古籍医典中有关产后抑郁的论述进行总结,阐述其"多虚多瘀"的病机特点,并在此基础上强调调整脑神在本病论治中的重要性,同时分析现代医家对本病治疗用药的特点,阐释现代基础研究中中医药对本病有关神经递质及激素的影响作用。提出"气血亏虚,瘀浊闭阻,脑神失司"为产后抑郁症的基本病机,"补虚祛瘀,颐脑醒神"乃本病的根本治疗大法。     

先天性鼻泪管阻塞不同年龄采用不同方法的治疗效果

目的探讨先天性鼻泪管阻塞根据不同年龄采用不同方法治疗效果。方法选取在本院接受治疗并有随诊记录的先天性鼻泪管阻塞的患儿97例（117眼）。根据年龄大小的不同而分别采取泪囊按摩、加压冲洗及泪道探通3种治疗方法并行疗效统计。结果年龄1～3个月患儿42例（52眼）,选用泪囊挤压按摩法,31眼治愈,占59．62％。4个月～1岁患儿34例（41眼）,选用加压冲洗法,一次治愈36眼,占87．80％。1～2岁患儿21例（24眼）,选用泪道探通法,一次治愈18眼,占75．00％。结论根据年龄大小,选择性采取泪囊挤压按摩、加压冲洗及泪道探通更为合理而有效治疗先天性鼻泪管阻塞。