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Objective:To investigate whether blood-brain barrier(BBB)served a key role in the edema-relief effect of bloodletting puncture at hand twelve Jing-well points(HTWP)in traumatic brain injury(TBI)and the potential molecular signaling pathways.Methods:Adult male Sprague-Dawley rats were assigned to the shamoperated(sham),TBI,and bloodletting puncture(bloodletting)groups(n=24 per group)using a randomized number table.The TBI model rats were induced by cortical contusion and then bloodletting puncture were performed at HTWP twice a day for 2 days.The neurological function and cerebral edema were evaluated by modified neurological severity score(mNSS),cerebral water content,magnetic resonance imaging and hematoxylin and eosin staining.Cerebral blood flow was measured by laser speckles.The protein levels of aquaporin 4(AQP4),matrix metalloproteinases 9(MMP9)and mitogen-activated protein kinase pathway(MAPK)signaling were detected by immunofluorescence staining and Western blot.Results:Compared with TBI group,bloodletting puncture improved neurological function at 24 and 48 h,alleviated cerebral edema at 48 h,and reduced the permeability of BBB induced by TBI(all P<0.05).The AQP4 and MMP9 which would disrupt the integrity of BBB were downregulated by bloodletting puncture(P<0.05 or P<0.01).In addition,the extracellular signal-regulated kinase(ERK)and p38 signaling pathways were inhibited by bloodletting puncture(P<0.05).Conclusions:Bloodletting puncture at HTWP might play a significant role in protecting BBB through regulating the expressions of MMP9 and AQP4 as well as corresponding regulatory upstream ERK and p38 signaling pathways.Therefore,bloodletting puncture at HTWP may be a promising therapeutic strategy for TBI-induced cerebral edema. 相似文献
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1临床资料 患者,男,22岁,活动后心悸、气促2年余,近半月加重来院诊治.查体:体温、脉搏、呼吸正常,心率90次·min-1,口唇无发绀,颈静脉无怒张,毛细血管搏动阴性,心前区无隆起,未扪及震颤;心界扩大,心音有力,二尖瓣听诊区可闻及肿瘤扑落音,无心包摩擦音. 相似文献
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Song Wu Feng Wan Yong-shun Gao Zhe Zhang Hong Zhao Zhong-qi Cui Ji-yan Xie 《中国医学科学杂志(英文版)》2014,29(4):208-213
Objective To assess clinical effectiveness of using bilateral pectoralis major or plus rectus abdominis muscle flaps in treating deep sternal wound infection (DSWI) following median sternotomy. Methods Between January 2009 and December 2013, 19 patients with DSWI after median sternotomy for cardiac surgery were admitted to our hospital, including 14 males (73.7%) and 5 females (26.3%), aged 55±13 (18-78) years. According to the Pairolero classification of infected median sternotomies, 3 (15.8%) patients were type II, and the other 16 (84.2%) were type III. Surgical procedure consisted of adequate debridement of infected sternum, costal cartilage, granulation, steel wires, suture residues and other foreign substances. Sternal reconstruction used the bilateral pectoralis major or plus rectus abdominis muscle flaps to obliterate dead space. The drainage tubes were placed and connected to a negative pressure generator for adequate drainage. Results There were no intraoperative deaths. In 15 patients (78.9%), bilateral pectoral muscle flaps were mobilized sufficiently to cover and stabilize the defect created by wound debridement. 4 patients (21.0%) needed bilateral pectoral muscle flaps plus rectus abdominis muscle flaps because their pectoralis major muscle flaps could not reach the lowest portion of the wound. 2 patients (10.5%) presented with subcutaneous infection, and 3 patients (15.8%) had hematoma. They recovered following local debridement and medication. 17 patients (89.5%) were examined at follow-up 12 months later, all healed and having stable sternum. No patients showed infection recurrence during the follow-up period over 12 months. Conclusion DSWI following median sternotomy may be effectively managed with adequate debridement of infected tissues and reconstruction with bilateral pectoralis major muscle or plus rectus abdominis muscle flap transposition. 相似文献
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病人,女,81岁.40年前在工作时双上肢不慎被火烧伤,当年在大连化工厂医院烧伤科给予取自体腹部皮肤行前臂植皮术,术后植皮区域皮肤成活修复良好.4年前无明显诱因双侧前臂植皮区域肤色逐渐变深,无意中发现皮肤明显松弛,无不适感.近3个月自觉植皮区域疼痛不适,局部无红肿等,轻微牵拉皮肤时疼痛明显.自发病起4年皮损未见扩大.患者既往体健,否认家族有类似病患者. 相似文献
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1 临床资料 患者,男,23岁,因左下肢疼痛20 d来医院就诊.询问病史:患者2 d前在上级医院诊断为坐骨神经痛.既往健康,无药物过敏史.门诊当日给予维生素B1 100 mg,维生素B12 250靏肌注,用药约5 min时患者感到头晕、胸闷、呼吸困难、寒战,面色苍白,脉搏105次·min-1,血压80/50 mmHg,考虑为药物所致过敏性休克,立即给予平卧,氧气吸入,肾上腺素1 mg肌注,地塞米松10 mg静注,5 min后患者恢复正常. 相似文献
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从病案信息利用的范围及病案信息利用的管理两大方面阐述了病案在信息时代所处的地位及其利用价值,同时就拓展病案利用价值提出了一些建议。 相似文献
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病案信息管理发展趋势 总被引:3,自引:5,他引:3
目的探索病案信息管理未来发展方向。方法将病案信息管理过程中所涉及的问题进行分析。结果病案信息管理在医疗、教学、科研、医院管理、医疗保险、法律等起着举足轻重的作用。结论病案信息管理发生显著的变化,向数字化、高智能化的电子病案方向发展。 相似文献
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目的:探讨认知行为心理治疗(CBT)在强迫症(OCD)患者各亚型治疗中的有效性和规律性。方法:本研究为临床对照研究。符合入组标准的强迫症患者按患者自愿原则分为两组,治疗观察3、6个月。疗效评定分别运用Yale-Brown强迫量表,自拟的自评好转程度量表和临床疗效评定。结果:认知行为心理治疗合并药物治疗组31例,临床有效率70.9%,其中治愈率1.8%。单纯药物治疗组24例,临床有效率33.3%。Yale-Brown强迫量表在6个月两组有显著性差异(P〈0.05)。其中强迫症亚型(怕脏型、反复检查型和反复担心型)的疗效比较,怕脏型在治疗3个月末两组间自评量表评分有显著性差异(P〈0.05);反复担心型在治疗6个月末两组间Yale-Brown强迫量表总分有显著性差异(P〈0.05);反复检查型两组间无统计学差异。结论:认知行为心理治疗合并药物治疗强迫症的疗效明显优于单纯药物治疗。强迫症的亚型在治疗中的有效性次序为:反复担心型〉怕脏型〉反复检查型。 相似文献
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文学是为满足人的审美需求而产生、存在和发展的。文学以其对美的寻求、揭示、建构和表现,丰富着人们的精神世界,彰显着自身存在的价值。正如席勒所说:"审美是人性的完成"。文学和医学是两种互补的认识方式,文学可以说是医学的原动力。文学审美过程是促使医务人员自我完善的过程,可以提高医务人员的综合素质;促进医务人员的医患伦理建构。 相似文献
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目的:探讨罗格列酮(Rosiglitazone)对有胰岛素抵抗的多囊卵巢患者促排卵治疗的影响.方法:133例临床上有PCOS(多囊卵巢综合征)表现的不孕患者通过OGTT(口服葡萄糖耐量实验)、胰岛素及C肽释放实验,检出胰岛素抵抗(IR)患者81例.将81例病人随机分为A、B、C三组,分别给予促排卵药、罗格列酮、罗格列酮与促排卵药合用,共治疗2个月经周期,比较三组用药前后及用药后三组间的Homa IR(胰岛素抵抗指数)、FFA(游离脂肪酸)、TNFα(肿瘤坏死因子)和排卵率的变化.结果:用罗格列酮治疗前后患者的Homa IR指数、血清FFA和TNFα明显下降(P<0.05).罗格列酮与促排卵药合用排卵率明显优于单用促排卵药(P<0.05)和单用罗格列酮(P<0.005).结论:罗格列酮能有效地改善胰岛素抵抗,提高促排卵成功率. 相似文献
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探索病案质检工作的新模式 总被引:1,自引:0,他引:1
目的通过探讨病案质检工作的新思路、新方法,以达到提高病案质量,从而提高医疗质量的目的。方法运用现代医院管理的理论知识,结合病案质检的实际将理论知识融于实践之中。结果改进了病案质检的工作模式,由单一质检转变为多元化工作模式。结论环节病历质量、终末病历质量都得到了很大提高,同时强化了临床的质量意识和自我保护意识。 相似文献
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对七情病因概念的形成分析 总被引:3,自引:0,他引:3
七情作为病因概念,首见南宋·陈无择<三因方>.一般对这一概念来源的讨论,多仅追溯到<黄帝内经>中有关情志致病的论述,而对于七情病因概念中可能存在的"非<内经>"内容,讨论甚少.通过分析<三因方>中与 "七情"有关的论述,笔者认为,陈无择的七情病因概念,由<素问·举痛论>"九气"、<诸病源候论>"七气"、<礼记>"七情"以及宋明理学心性论等多种元素构成.探讨这一问题,对于认识中医学概念的建构规律,正确理解和改造现代中医学七情概念有重大意义. 相似文献
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为了研究不同脉象与血管容积图的关系,应用“BC-4型”定量式光电血管容积仪对432例受检者(包括正常脉象和10种常见病脉)进行寸口脉光电血管容积图检测,同步进行血流动力学参数分析。结果表明,与正常脉象比较,种种病脉在寸口脉血管容积图上均显示出各种脉象的参数特征,而血流动力学指标的变化反映了不同脉象形成的心血管病理生理特点。提示寸口部光电血管容积图参数为各类病理脉象的临床诊断提供了客观化依据。 相似文献