中医正骨手法改善桡骨远端伸直型骨折患者腕关节功能的临床研究及疗效的影响因素分析

摘要 目的：观察中医正骨手法在桡骨远端伸直型骨折中的临床应用价值,并分析疗效的影响因素。方法：选择四川省骨科医院2020年1月~2022年1月期间收治的桡骨远端伸直型骨折患者152例,按照治疗方式的不同将患者分为对照组（给予石膏固定）和研究组（应用中医正骨手法治疗）,例数分别为77例和75例。对比两组优良率、临床指标、腕关节活动度和X线相关影像学指标。同时采用多因素Logistic回归分析影响研究组腕关节功能疗效的相关因素。结果：治疗后,研究组的优良率明显高于对照组（P<0.05）。研究组手背消肿时间、疼痛缓解时间、骨折愈合时间均短于对照组（P<0.05）。两组治疗后12周掌屈、背伸、桡偏、尺偏、旋前、旋后活动度均扩大,且研究组均大于对照组（P<0.05）。两组治疗后12周掌倾角、尺偏角、桡骨高度均增加,且研究组均大于对照组（P<0.05）。单因素分析显示,研究组腕关节功能优良率与年龄、性别、骨质疏松、功能锻炼、掌倾角、尺偏角、桡骨高度、骨折端稳定性、受伤能量、利手情况有关（P<0.05）,而与体质量指数、就诊时间、基础疾病、骨折类型、固定时间无关（P>0.05）。多因素Logistic回归分析显示：性别为女、骨质疏松、无功能锻炼、掌倾角偏小、桡骨高度偏短、骨折端不稳定、受伤能量为高能量、利手是影响腕关节功能优良率的危险因素（P<0.05）。结论：中医正骨手法可有效改善桡骨远端伸直型骨折患者腕关节功能,减少骨折愈合及疼痛缓解时间。此外,患者腕关节功能的优良率还受到性别、骨质疏松、功能锻炼、掌倾角、桡骨高度、骨折端稳定性、受伤能量、利手情况的影响,值得引起临床重视。     

A genome-wide perspective on the diversity and selection signatures in indigenous goats using 53 K single nucleotide polymorphism array

Tibetan goats, Taihang goats, Jining grey goats, and Meigu goats are the representative indigenous goats in China, found in Qinghai-Tibet Plateau, Western pastoral area, Northern and Southern agricultural regions. Very few studies have conducted a comprehensive analysis of the genomic diversity and selection of these breeds. We genotyped 96 unrelated individuals, using goat 53 K Illumina BeadChip array, of the following goat breeds: Tibetan (TG), Taihang (THG), Jining grey (JGG), and Meigu (MGG). A total of 45 951 single nucleotide polymorphisms were filtered to estimate the genetic diversity and selection signatures. All breeds had a high proportion (over 95%) of polymorphic loci. The observed and excepted heterozygosity ranged from 0.338 (MGG) to 0.402 (JGG) and 0.339 (MGG) to 0.395 (JGG), respectively. Clustering analysis displayed a genetically distinct lineage for each breed, and their Fst were greater than 0.25, indicating that they had a higher genetic differentiation between groups. Furthermore, effective population size reduced in all four populations, indicating a loss of genetic diversity. In addition, runs of homozygosity were mainly distributed in 5–10 Mb. Lastly, we identified signature genes, which were closely related to high-altitude adaptation (ADIRF) and prolificity (CNTROB, SMC3, and PTEN). This study provides a valuable resource for future studies on genome-wide perspectives on the diversity and selection signatures of Chinese indigenous goats.     

Treatment-resistant depression: definition,prevalence, detection,management, and investigational interventions

Treatment-resistant depression (TRD) is common and associated with multiple serious public health implications. A consensus definition of TRD with demonstrated predictive utility in terms of clinical decision-making and health outcomes does not currently exist. Instead, a plethora of definitions have been proposed, which vary significantly in their conceptual framework. The absence of a consensus definition hampers precise estimates of the prevalence of TRD, and also belies efforts to identify risk factors, prevention opportunities, and effective interventions. In addition, it results in heterogeneity in clinical practice decision-making, adversely affecting quality of care. The US Food and Drug Administration (FDA) and the European Medicines Agency (EMA) have adopted the most used definition of TRD (i.e., inadequate response to a minimum of two antidepressants despite adequacy of the treatment trial and adherence to treatment). It is currently estimated that at least 30% of persons with depression meet this definition. A significant percentage of persons with TRD are actually pseudo-resistant (e.g., due to inadequacy of treatment trials or non-adherence to treatment). Although multiple sociodemographic, clinical, treatment and contextual factors are known to negatively moderate response in persons with depression, very few factors are regarded as predictive of non-response across multiple modalities of treatment. Intravenous ketamine and intranasal esketamine (co-administered with an antidepressant) are established as efficacious in the management of TRD. Some second-generation antipsychotics (e.g., aripiprazole, brexpiprazole, cariprazine, quetiapine XR) are proven effective as adjunctive treatments to antidepressants in partial responders, but only the olanzapine-fluoxetine combination has been studied in FDA-defined TRD. Repetitive transcranial magnetic stimulation (TMS) is established as effective and FDA-approved for individuals with TRD, with accelerated theta-burst TMS also recently showing efficacy. Electroconvulsive therapy is regarded as an effective acute and maintenance intervention in TRD, with preliminary evidence suggesting non-inferiority to acute intravenous ketamine. Evidence for extending antidepressant trial, medication switching and combining antidepressants is mixed. Manual-based psychotherapies are not established as efficacious on their own in TRD, but offer significant symptomatic relief when added to conventional antidepressants. Digital therapeutics are under study and represent a potential future clinical vista in this population.     

安息香科植物地理分布研究

安息香科植物共１２属,约１５０种,分布于亚洲和美洲的热带亚热带地区及欧洲南部的温暖地区。亚洲是现代安息香科植物的主要分布区,有１１个属,集中分布于中国南部和西南部附近。中国南岭山地及其附近汇集了８属２０多种,包括中国特有的陀螺果属、秤锤树属和长果安息香属以及东亚北美间断分布的银钟花属。这些呈星散分布的残余成分是从当地起源的。中国西南地区的安息香科植物仅云南一地就达８属３０余种,其中不少为局部分化形成的狭域分布特有种。这里是安息香科植物的分化中心,茉莉果属和歧序野茉莉属可能即是由此发端的。后者和安息香属经中南半岛一直分布到热带亚洲地区,并在马来西亚地区形成一次生分化中心。欧洲安息香科植物可能来自亚洲,并于第三纪得到发展。安息香科植物在欧洲的衰落,可能是遭到第四纪冰川严重破坏的结果。北美安息香科植物和欧亚大陆的有着共同起源,主要分布于东南部,并通过中美向南美发展。南美安息香科植物达５０余种,集中分布于亚马逊河流域。这里是安息香科植物的另一次生分化中心。特产巴西的花弄蝶属即是从当地分化出来的。     

Glutamine repeats and inherited neurodegenerative diseases: molecular aspects

Several dominantly inherited, late onset, neurodegenerative diseases are due to expansion of CAG repeats, leading to expansion of glutamine repeats in the affected proteins. These proteins are of very different sizes and, with one exception, show no sequence homology to known proteins or to each other; their functions are unknown. In some, the glutamine repeat starts near the N-terminus, in another near the middle and in another near the C-terminus, but regardless of these differences, no disease has been observed in individuals with fewer than 37 repeats, and absence of disease has never been found in those with more than 41 repeats. Protein constructs with more than 41 repeats are toxic to E. coli and to CHO cells in culture, and they elicit ataxia in transgenic mice. These observations argue in favour of a distinct change of structure associated with elongation beyond 37–41 glutamine repeats. The review describes experiments designed to find out what these structures might be and how they could influence the properties of the proteins of which they form part. Poly- -glutamines form pleated sheets of β-strands held together by hydrogen bonds between their amides. Incorporation of glutamine repeats into a small protein of known structure made it associate irreversibly into oligomers. That association took place during the folding of the protein molecules and led to their becoming firmly interlocked by either strand- or domain-swapping. Thermodynamic considerations suggest that elongation of glutamine repeats beyond a certain length may lead to a phase change from random coils to hydrogen-bonded hairpins. Possible mechanisms of expansion of CAG repeats are discussed in the light of looped DNA model structures.     

Tachykinin NK-1 receptor probed with constrained analogues of substance P

The action of rotameric probes introduced either in position 7 or 8 in the sequence of substance P (SP) was investigated, i.e. -tetrahydroisoquinoleic acid (Tic), -fluorenylglycine (Flg), -diphenylalanine (Dip), the diastereoisomers of -1-indanylglycine (Ing) and -benz[ƒ]indanylglycine (Bfi), the Z- and E-isomers of dehydrophenylalanine and dehydronaphthylalanine (Δ^ZPhe, Δ^EPhe, Δ^ZNal, Δ^ENal) and (Dmp). The aim of this study was the topographical characterization of the binding subsites of human NK-1 receptor expressed in CHO cells, especially the S₇ and S₈ subsites, corresponding to residues Phe⁷ and Phe⁸ of substance P. According to the binding potencies of these substituted-SP analogues, the S₇ binding subsite is smaller than the S₈ subsite: the S₇ subsite accepts only one aromatic nucleus, while the S₈ can accommodate three coplanar nuclei altogether. These findings are compatible with the idea that the S₈ binding subsite may reside in the extracellular loops of the hNK-1 receptor. NK-1 agonists bind to human NK-1 receptor and activate the production of both inositol phosphates and cyclic AMP. As already quoted for septide, [pGlu⁶, Pro⁹]SP(6–11), discrepancies are observed between affinity (K_i) and activity (EC₅₀) values for IPs production. While a weak correlation between K_i and EC₅₀ values for IPs production could be found (r = 0.70), an excellent correlation could be demonstrated between their affinities (K_i) and their potencies (EC₅₀) for cAMP production (r = 0.97). The high potency (EC₅₀) observed for ‘septide-like’ molecules on PI hydrolysis, compared to their affinity is not an artefact related to the high level of NK-1 receptors expressed on CHO cells since a good correlation was found between EC₅₀ values obtained for PI hydrolysis and those measured for spasmogenic activity in guinea pig ileum bioassay (r = 0.94).

According to the binding potencies of constrained analogues of phenylalanine, the S₇ binding subsite of human NK-1 receptor is small, whereas the S₈, which can accommodate three coplanar nuclei, might probably reside in the extracellular loop. The discrepancies observed between affinity (K_i) and activity (EC₅₀) values for IPs production are not an artefact of CHO cells since a good correlation was found between EC₅₀ for PI hydrolysis and those measured in guinea pig ileum bioassay.     

长吻对鱼粉等六种商品饲料中粗蛋白和能量的消化率

本试验以三氧化二铬（Ｃｒ２Ｏ３）为指示物测定Ⅰ龄长吻对鱼粉、猪血粉、豆饼粉、菜籽饼粉、小麦粉和玉米蛋白粉等六种商品饲料原料粗蛋白和总能量的消化率。试验饲料由参考饲料和试验原料以７０∶３０的比例混合挤压制成颗粒饲料。试验鱼粪便样品用虹吸方式收集,并将测试的消化率结果经过降低１０％的校正。由此所得消化率值更能反应长吻的消化生理状况。另外本文对六种饲料的消化率结果进行了讨论。     

具有竞争指针的短时记忆神经网络模型

在我们以前提出的短时记忆神经网络模型基础上［３］,我们在新模型中引入突触竞争机制,提出了一个新的短时记忆神经网络模型。模型仍由两个神经网络所组成;其一为与长时记忆共有的信息内容表达网络,另一个为指针神经元环路。由于表达区神经元与指针神经元间的突触权重的竞争,使得模型可以表现出由干扰引起的短时记忆的遗忘。相应于自由回忆序列位置效应和汉字组块两个心理学实验,对模型做了计算机仿真。仿真结果显示模型的行为与两个心理实验定量地符合得很好。由此表明现在的模型更合适于作为短时记忆的模型。     

韭菜病毒分离物初步鉴定

韭菜病毒分离物初步鉴定房德纯,王振东,佟成富,陆庆轩（沈阳农业大学植保系,沈阳１１０１６１）（辽宁省风沙地改良利用研究所,阜新１２３０００）（沈阳市园林科学研究院,沈阳１１００１５）关键词韭菜病毒病,毒原鉴定,韭菜萎缩病毒１９９３年在辽宁省阜新市韭菜...     

ELISA技术筛选200种中草药抗HBsAg的实验研究

使用ＥＬＩＳＡ技术对２００种中草药水提取物进行抗ＨＢｓＡｇ的实验研究,共筛出有效药物７种（占总数的３．５％）。若按５种不同剂量（０．３、０．６、１．２、２．５、５．０ｍｇ／１００μｌ）的药物、２种不同浓度的ＨＢｓＡｇ（１０．９２、１４．２６Ｐ／Ｎ值）与３种不同接触时间（立即、１ｈ、２ｈ）的１０项Ｐ／Ｎ值均数来综合评价药效指数时,７种有效药物的次序为青蒿（１．６７Ｐ／Ｎ值）、大蒜（２．１９Ｐ／Ｎ值）、红孩儿（２．３１Ｐ／Ｎ值）、仙鹤草（２．３１）、魔芋（２．３２Ｐ／Ｎ值）、冬瓜皮（２．６３Ｐ／Ｎ值）和猕猴桃（２．８９Ｐ／Ｎ值）。