慢性肾功能衰竭与心率变异性时域分析的相关性研究

目的 :评价慢性肾功能衰竭患者自主神经损伤及其相关因素。方法 :选择肾内科住院患者及健康体检人员共 40例 ,按肾功能水平分为正常对照组、肾功能正常组、氮质血症组和尿毒症组 ,分别检测患者心率变异性 (HRV )时域指标并同步监测患者动态血压 ,进行显著性差异检验。 结果 :(1)尿毒症组 HRV时域指标中主要观察指标显著低于其余各组 (P<0 .0 1或P<0 .0 5 ) ,而其余各组间 HRV时域指标均无显著性差异 ;(2 )尿毒症肾性高血压患者 HRV时域指标显著低于尿毒症正常血压患者 (P<0 .0 5 )。 结论 :(1)随着慢性肾功能衰竭病程进展 ,患者逐步出现心脏自主神经系统损害及功能失调 ;(2 )慢性肾功能衰竭患者心脏自主神经系统损害与肾功能水平呈正相关 ;尿毒症本身即为心脏自主神经系统损害的独立因素。 (3)尿毒症肾性高血压将加重患者心脏自主神经系统损害     

脉冲多普勒超声定量检测狭窄管流中流动指标的方法学探讨

目的　探讨狭窄管流中一系列流动指标的定量检测方法 ,包括 Reynolds数、相对频带展宽度(RSB)、层流剪应力、法向雷诺应力 (RNS)等。方法　采用临床使用的脉冲多普勒血流仪在狭窄前后多个位点进行多时点检测 ,得出流场特征 ,再分别评价各项指标。结果　定性评价见狭窄下游呈现鲜亮的“烛焰形”花色镶嵌湍流流型 ,狭窄后 1.0 cm处得到较大的 RSB、RNS等 ,1/ 2 R取样容积处湍流指标大于相应的轴心处。结论　狭窄后1.0 cm1/ 2 R取样容积处存在最大的湍流度 ;狭窄后各位点的数据离散度大于狭窄前。该研究为进一步在不同流场中开展生物力学的在体研究奠定了前期工作基础     

氟伐他丁对血管损伤后内皮素、血栓素A2和前列环素的作用

目的探讨兔髂动脉急性损伤后,血清中内皮素(ET)、血栓素A2(TXA2)和前列环素(PGI2)水平的变化及氟伐他丁的作用. 方法 12只新西兰大耳白兔行右髂动脉球囊导管内膜剥脱术.6只予氟伐他丁8 mg·kg-1·d-1灌胃治疗,余6只作对照,术前、术后3 h及3天放射免疫法测定血清中ET、TXA2和PGI2浓度. 结果兔髂动脉损伤后血清ET即明显增加,氟伐他丁治疗显著抑制血管损伤后ET水平的升高;血管急性损伤后,血清中TXA2浓度明显增加,PGI2水平则显著下降,氟伐他丁治疗在明显提高血清PGI2水平的同时,抑制了TXA2的升高. 结论氟伐他丁抑制血清ET和TXA2的升高、促进PGI2的生成,可能减轻血管损伤后血栓形成和内膜肥厚.     

Effect of Wuzi Yanzong Pills on Sertoli cells and blood–testis barrier in heat-stressed rats based on Akt signalling pathway

The blood–testis barrier (BTB) of Sertoli cells (SCs) is an important biological barrier that maintains spermatogenesis and provides a favourable microenvironment for spermatogenesis. However, heat stress can directly damage the BTB structural proteins of testicular SCs, leading to dyszoospermia. Wuzi Yanzong Pills (WYP) is a traditional Chinese medicine formula used to treat male reproductive diseases. However, whether WYP could ameliorate heat stress injury in primary SCs extracted from rat testes and BTB proteins remains unknown. Here, treatment with WYP (low, medium and high dose) increased the SC viability and the proliferation of cell antigen Ki67 significantly. Additionally, it promoted SC maturation, which presented in the form of increased androgen receptors (ARs) and decreased cytokeratin 18 (CK-18) in three WYP dose groups. WYP upregulated BTB proteins such as zonula occludens 1 (ZO-1) and occludin across all WYP groups and decreased phosphorylated Akt (p-Akt) in the middle and high-dose groups; however, ZO-1 and occludin recovery were reduced with the presence of Akt inhibitor in WYP groups. WYP improved SC viability and proliferation, and ameliorated dedifferentiation and BTB-proteins damaged by heat stress via Akt signalling. The findings present theoretical support for the effects of WYP in the management of dyszoospermia and male infertility.     

中医药在糖尿病胃轻瘫治疗中的应用及思考

糖尿病胃轻瘫（DGP）发病率较高,药物治疗存在一定的局限性,部分患者可能出现一定的不良反应,这影响糖尿病的治疗。中药治疗DGP可以有效缓解患者症状,降低现有药物不良反应,辅助控制血糖。现代医家多利用辨证分型组方、经方验方及中成药进行辨病辨证治疗相结合,运用单味药、药对、中药提取物进行个体化治疗。现通过概述中药的多种组方思路,总结其优势,并对中药治疗DGP的现状进行思考与总结,以期中医药治疗DGP得到更好的发挥。     

"互联网+医疗"背景下的腰椎间盘突出症医院-家庭康复模式研究

目的 探讨基于"互联网+医疗"背景下的腰椎间盘突出症(lumbar disc herniation,LDH)医院-家庭康复模式的优势.方法 纳入本院2018年1月～2018年12月门诊收治的80例LDH患者,采用随机数字表法分成"互联网+医疗"模式组(观察组)与传统医疗模式组(对照组)各40例.观察组采用"互联网+医疗"康复治疗模式,对照组采用传统医疗康复模式.比较两组治疗前、治疗后1个月、3个月、6个月腰腿疼痛VAS评分、腰椎JOA评分,治疗后6个月临床疗效及患者满意度.结果 两组患者均完成治疗.两组治疗后各时间点腰部及腿部VAS评分、腰椎JOA评分均优于治疗前(P<0.05);观察组治疗后各时间点的腰腿VAS评分、腰椎JOA评分均优于对照组(P<0.05).观察组优良率为87.50％,对照组为62.50％,观察组优良率明显高于对照组(P<0.05).观察组满意度明显优于对照组(P<0.05).结论 基于"互联网+医疗"的医院-家庭康复模式能缓解临床症状,获得较好的疗效,提升患者的满意度,该模式为传统医疗模式的升级和转型提供了方向和依据.     

人脐血间质干细胞条件培养基在受损成骨细胞中的作用与机制

目的探讨线粒体活性在人脐带间充质干细胞(human umbilical cord mesenchymal stem cells,HUMSCs)条件培养基修复受损成骨细胞中的作用及其机制。方法提取、培养HUMSCs及制作其条件培养基,建立成骨细胞氧化损伤模型。实验分组:无血清DMEM培养基组、晚期氧化蛋白(advanced oxidation protein products,AOPPs)刺激组、常规培养基组、条件培养基组,培养1 h后用流式细胞仪以及Mito Tracker Red分析成骨细胞凋亡率、线粒体活性,并用蛋白-凝胶成像法(western-blot,WB)分析Caspase-3凋亡蛋白表达差异,从而评价HUMSCs条件培养基对遭受氧化损伤的成骨细胞的保护、修复、逆转作用,以及线粒体在其中发挥的作用及其机制。结果HUMSCs条件培养基可以增加氧化应激作用下成骨细胞内线粒体活性;HUMSCs条件培养基可降低成骨细胞凋亡率,减少Caspase-3凋亡蛋白表达。结论HUMSCs条件培养基通过缓解氧化应激(oxidative stress,OS)导致的线粒体功能与结构损伤,并下调Caspase-3凋亡蛋白的表达,抑制OB凋亡。     

经尿道国产1470nm激光汽化术治疗<30g小体积前列腺增生的临床体会

目的探讨经尿道国产1470nm激光汽化术治疗<30g小体积前列腺增生患者的安全性、有效性和远期并发症情况。方法回顾性研究2017年10月至2018年9月我院45例<30g小体积前列腺增生患者的临床资料,其中TURP组20例,1470 nm激光组25例。详细记录两组患者的临床资料、围手术期并发症和随访情况。结果45例患者手术均成功,术后平均随访时间12.6个月(9~16个月)。两组患者年龄、前列腺体积和IPSS、RUV、Qmax和QOL基线资料差异无统计学意义(P>0.05)。TURP组和1470 nm激光组患者术后3个月IPSS、RUV、Qmax和QOL均较术前改善(P<0.05),组间比较差异无统计学意义(P>0.05)。1470 nm激光组患者手术时间([48.6±13.6)min vs(56.8±11.7)min,P=0.038]、术后膀胱持续冲洗时间[(0.8±0.5)d vs(1.5±0.9)d,P=0.001]、导尿管留置时间([2.7±0.6)d vs(4.7±0.9)d,P<0.001]和住院时间([4.2±1.2)d vs(5.2±1.9)d,P=0.036]较TURP组患者明显缩短,术前术后血红蛋白浓度变化更小([5.5±2.4)g/L vs(11.6±2.7)g/L,P<0.01]。随访发现TURP组有2例出现尿道狭窄,1470 nm激光组无尿道狭窄病例发生。结论经尿道国产1470 nm激光汽化术治疗<30 g小体积前列腺增生安全有效,与传统TURP比较术中出血少,术后恢复时间更短,无尿道狭窄并发症发生,为BPH的个体化治疗提供了新的思路。     

The Effect of a PEEK Material‐Based External Fixator in the Treatment of Distal Radius Fractures with Non‐Transarticular External Fixation

ObjectiveTo explore the effect of a PEEK material‐based external fixator in the treatment of distal radius fractures with non‐transarticular external fixation.MethodsThere were 48 patients in this prospective comparative study. They were divided into two groups according to the materials used: the PEEK group and the titanium group. Wrist dorsiflexion, palmar flexion, pronation, supination, radial deviation, ulnar deviation, grip strength of the palm on the affected side, kneading force, Visual Analogue Scale/Score (VAS), Disabilities of the Arm, Shoulder, and Hand (DASH) score, operation time, frequency of fluoroscopy procedures, and X‐ray results were compared between the two groups. Functional recovery was evaluated at the last follow‐up according to the wrist joint evaluation criteria.ResultsThe baseline data were comparable between the two groups, and no significant differences were found in age, sex, fracture types (P > 0.05). There was no significant difference between the two groups in the results of DASH, grip strength, and recovery of pinch force and wrist function (dorsiflexion, clavicle, ulnar deviation, deviation, pronation, and supination) (P > 0.05). Normal limb function was achieved in the two groups of patients at an average of 6 weeks after surgery, and there was no significant difference in X‐ray examination radial height (10.60 ± 1.59 vs 11.00 ± 1.53, P = 0.687), radial inclination (1.11 ± 0.24 vs 1.12 ± 0.24, P = 0.798), volar tilt (10.33 ± 2.13 vs 10.00 ± 2.08, P = 0.660), ulnar variance (20.87 ± 3.00 vs 20.38 ± 3.04, P = 0.748), and step‐off persistence (1.73 ± 0.69 vs 1.68 ± 0.72, P = 0.425) between the two groups (P > 0.05). However, the operation time (54.80 ± 12.20 vs 85.23 ± 15.14, P = 0.033) and number of fluoroscopy procedures (36.93 ± 6.89 vs 64.77 ± 9.74, P = 0.000) in the PEEK group were significantly reduced compared with those in the titanium group.ConclusionCompared with the traditional titanium external fixator, the PEEK composite external fixator has advantages, such as a shorter operation time and fewer fluoroscopy procedures when used to treat different types of distal radius fracture.     

Influences of Heavy Metals and Salt on Seed Germination and Seedling Characteristics of Halophyte Halogeton glomeratus

Bulletin of Environmental Contamination and Toxicology - Heavy metals pollution and salinization of soils are widely distributed in agricultural soils. This study investigated the effects of five...