耳穴压豆疗法对老年髋部骨折患者术后谵妄、睡眠时间及焦虑水平的影响

摘要 目的：探讨耳穴压豆疗法对老年髋部骨折患者术后谵妄、睡眠时间及焦虑水平的影响。方法：选择2019年12月至2020年12月我院收治的老年髋部骨折患者70例为受试对象,根据患者入院先后顺序编号,随机分为观察组和对照组各35例。对照组行临床路径常规处理,观察组在对照组基础上加用耳穴压豆疗法。入院后每天使用谵妄量表分析系统（CAM-CR）对所有患者进行评估,若确诊为谵妄,则进行谵妄评定量表-98修订版（DRS-R-98）评定,并记录首次及末次DRS-R-98分值及谵妄持续时间;记录患者每天睡眠时间;同时在入院当天、术前1天及术后1周采用焦虑自评量表（SAS）及汉密顿焦虑量表（HAMA）进行焦虑评分。结果：对照组术后13例发生谵妄,发生率为37.14%;观察组术后5例发生谵妄,发生率为14.29%,两组术后谵妄发生率比较差异有统计学意义（P＜0.05）。两组患者术后谵妄持续时间比较差异有统计学意义（P＜0.05）。两组患者每天睡眠时间比较差异有统计学意义（P＜0.05）。两组患者术后1周的SAS评分和HAMA评分比较差异有统计学意义（P＜0.05）。结论：老年髋部骨折患者应用耳穴压豆疗法可缓解患者的焦虑水平,改善睡眠,降低术后谵妄的发生率,减少谵妄的持续时间,促进患者的早期恢复。     

耳穴贴压联合莫沙必利对便秘型肠易激综合征患者肠道菌群及脑肠肽的影响

目的探讨耳穴贴压联合莫沙必利对便秘型肠易激综合征(IBS-C)患者肠道菌群及脑肠肽的影响,为该疾病的治疗提供参考。方法选取2018年1月至2019年8月我院门诊治疗的92例IBS-C患者为研究对象,随机分为联合组(n=46例)和单用组(n=46例)。单用组患者予莫沙必利片5 mg/次,3次/d,饭前30 min口服。联合组患者在单用组基础上加耳穴贴压治疗。两组患者均连用8周。观察两组患者治疗前后肠道菌群数量(乳杆菌、双歧杆菌和大肠埃希菌)、血清脑肠肽[一氧化氮(nitric oxide,NO)、P物质(substance P,SP)和生长抑素(somatostatin,SS)]水平的变化,并比较其临床效果。结果治疗8周后,两组患者肠道大肠埃希菌数量较治疗前显著下降,乳杆菌和双歧杆菌数量显著上升,且治疗后联合组患者下降或上升幅度大于单用组(均P0.05)。治疗后两组患者血清NO和SS水平较治疗前显著下降,SP水平显著上升,且治疗后联合组患者下降或上升幅度大于单用组(均P0.05)。联合组患者临床总有效率优于单用组(95.65%vs 80.43%,χ~2=5.06,P=0.024 9)。结论耳穴贴压联合莫沙必利治疗IBS-C患者的效果较确切,不仅能纠正肠道菌群紊乱,重建肠道菌群平衡,而且能调节脑肠肽的分泌,加快肠道传输功能的恢复。     

Effects of intracellular superoxide removal at acupoints with TAT-SOD on obesity

TAT-SOD is a recombinant protein of superoxide dismutase fused with TAT peptide. By pure accident, we discovered that topical application of TAT-SOD to acupoints could result in acupuncture-like action. This study aimed to validate the accidental discovery by investigating the effect on simple obesity of the topical application of TAT-SOD to acupoints in comparison with acupuncture. 90 subjects were divided into 3 groups for 12-week treatments. Regular hospital acupuncture treatment was given to Acupuncture Group 3 times a week. TAT-SOD Group were instructed first to locate acupoints and apply 0.1 ml of 5000u SOD/ml TAT-SOD cream in an area of 1 cm² to each of the same set of acupoints, which they then conducted at home three times daily. Placebo Group applied the vehicle cream the same manner as TAT-SOD Group. Both TAT-SOD and acupuncture treatments decreased adiposity with overall clinical effective rates of 60.0% and 76.7%, respectively. The placebo group showed no improvement. The results validate that the enzymatic removal of the intracellular superoxide at acupoints could generate acupuncture-like effects, and indicate a possibility of the new method as a simple substitute to acupuncture and an insight of superoxide modulation along meridians for acupuncture mechanism.     

黑木耳多糖提取物对肝纤维化大鼠肝功能及MPO, MDA, TGF-beta的影响

目的：探究黑木耳多糖提取物对肝纤维化大鼠血清髓过氧化物酶(MPO)、丙二醛(MDA)及转化生长因子beta(TGF-beta)的影响及 肝功能的保护作用。方法：将健康的Wistar大鼠30 只随机分为3 组：对照组、模型组、黑木耳多糖提取物组,利用胆总管结扎术制 备肝纤维化动物模型,术后分别用生理盐水0.1 mL/(kg·d)、黑木耳多糖提取物0.1 mg/(kg·d)灌胃1 次/d。21 d后腹主动脉采血,测 肝功能指标,取肝组织测MDA、MPO、TGF-beta,Masson 染色。结果：肝纤维化动物模型成功制备。黑木耳多糖提取物组总胆红素 (STB)、谷氨酸转移酶(ALT)、天门冬氨酸转移酶(AST)、MPO、MDA较模型组明显降低,TGF-茁含量降低。Masson 染色可见：模型 组肝小叶结构破坏,较对照组汇管区可见大面积胶原纤维的形成;黑木耳多糖提取物组肝细胞轻度水肿、肝索排列欠整齐,肝汇 管区及各部位胶原纤维形成量略少。结论：黑木耳多糖提取物可减轻胆总管结扎大鼠脂质过氧化损伤,MPO 含量使TGF-beta因子 释放减少,从而减少胶原纤维形成,减轻或延缓大鼠肝纤维化。     

经络腧穴的光学特性研究进展

现已成熟并仍有巨大潜力的光子学技术与热、电、磁等一起成为研究经络腧穴的热门手段,经络腧穴光学特性的探索不仅为其存在提供了客观依据,而且为其实际应用提供了生物物理学依据。总结目前用于经络腧穴研究的光学检测方法原理,重点综述了经络腧穴的超微弱发光、经脉红外辐射路线的客观显示、腧穴的红外辐射光谱及循经激光传输等方面的最新研究进展,以期对光子学手段在经络腧穴的研究上有一个全面的认识。     

Chronological metamorphosis of the auricular surface of the ilium: a new method for the determination of adult skeletal age at death

A new method for the determination of adult skeletal age at death based upon chronological changes in the auricular surface of the ilium is presented. Formal stages have been constructed following extensive tests and refinements in observations made of such changes. Two completely "blind" tests were conducted to assess the accuracy and bias of the new method. Results show that the system is equally accurate to pubic symphyseal aging (although somewhat more difficult to apply), and also carries the advantages of a higher preservation rate for the auricular surface in archaeological populations and continued age-related change beyond the fifth decade.     

Concept formation based on value relations evaluated with a matching-to-sample procedure

To study concept formation based on relations, adults were taught and tested on complex discriminations involving figures that varied in colors, forms, and orientations. In Experiment 1, participants learned to select figures with values A1 and B1 or values B1 and C1; thereafter, they consistently selected figures with values A1 and C1. Selections were based on the relations among the values, rather than on perceptual properties. Experiments 2 and 3 studied generalization with a matching-to-sample procedure: participants learned to select "yes" in the presence of the positive figures, such as A1B1, and "no" in the presence of the negative figures. Thereafter, all figures that resulted from combining three values of the three relevant dimensions were probed. Participants typically selected "yes" in the presence of the novel figures that had two or three values related to one another and selected "no" in the presence of the other figures. Finally, two participants learned a simple discrimination. They did not generalize responding to other figures with the same values; instead, their performance in the generalization test remained almost unaltered. Thus, the concept based on relations was not affected by the simple discrimination. These results showed some unique properties of the concept based on relations and challenge previous theories on concept formation.     

经皮电穴位电刺激足三里穴对胃癌患者术后血清IgG、IgM水平的影响

目的:观察经皮穴位电刺激对胃癌根治术患者术后血清免疫球蛋白M(Ig M)、免疫球蛋白G(Ig G)水平的影响。方法:选择全麻择期行胃癌根治术的患者102例(男88例,女14例),年龄40~75岁,将其随机分为经皮穴位电刺激组、假电刺激组和对照组。经皮电刺激双侧"足三里"(ST 36)、"三阴交"(SP 6)穴,于手术当日、术后第1日和术后第2日进行经皮电刺激治疗。于术前30分钟、术后24 h、术后72 h采集静脉血标本,测定免疫球蛋白G(Immunoglobulin G,Ig G)、免疫球蛋白M(Immunoglobulin M,Ig M)的水平。术后监测和记录肛门的排气时间。结果:在术后第1天,对照组外周血Ig G水平显著低于术前30分钟(P0.05),TEAS组外周血Ig M水平显著高于术前30分钟(P0.05),TEAS组外周血Ig G和Ig M水平显著高于对照组(P0.05)。在术后第3天,对照组外周血Ig G、Ig M水平显著低于术前30分钟(P0.05),TEAS组外周血Ig G、Ig M水平均显著低于术后1天(P0.05)。三组患者术后肛门排气时间比较无统计学差异(P0.05)。结论:经皮穴位电刺激可以升高胃癌根治术患者术后1天降低的外周血Ig G和Ig M水平,减轻其术后免疫抑制。     

经皮穴位电刺激治疗术后疼痛的研究进展

术后疼痛是术后常见的一种伤害性疼痛,随着舒适化医疗的倡导,经皮穴位电刺激因其无创、安全等优点受到关注。经皮穴位电刺激是将经皮神经电刺激与针灸穴位理论相结合的一种方法,虽有研究证实其频率、波形、强度、刺激时间的设定及不同穴位的配伍对镇痛效果均可产生较大的影响,但在规范化方面仍有不足。本文总结其使用方法及镇痛疗效,以期对经皮穴位电刺激应用于临床提供最优参数及穴位配伍,使之规范化,从而发挥出最佳镇痛效果。     

氧化锆基台的制作及其与钛基台抗折强度的比较

目的：制作氧化锆基台并将其与钛基台的抗折强度相比较,从而探讨其临床应用的可行性。方法：选用纳米氧化锆粉,采用冷等静压成型和二次烧结工艺制作0sstem USⅡ系统氧化锆基台;选取氧化锆基台和成品钛基台（OSSTEM公司,韩国）各10枚,分别与0sstem USⅡ种植体装配,然后固定于不锈钢夹具中置于万能试验机,将万能试验机压头与种植体长轴成90°角施加压力,记录基台损坏时的加载力值,比较分析两组试件的强度差异。结果：氧化锆基台和钛基台的平均抗折强度分别为（540.5±84.6）N和（753.9±160.8）N,差别有统计学意义（P〈0.05）。氧化锆基台组10枚基台全部颈部折裂;钛基台组2枚种植体损坏,6枚中央固位螺钉损坏,2枚基台颈部折裂。结论：本研究制作的0sstem USⅡ系统的氧化锆基台的抗折强度虽然低于钛基台,但尚能满足临床应用要求。