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。     

鼻咽癌癌变的分子机理

鼻咽癌是一种多基因遗传性肿瘤,在中国南方和国外中国南方移民及后裔中发病率极高,严重危害了我国南方地区人民生命健康.对于这样一种具有明显民族聚集现象和地域差异的恶性肿瘤,目前认为其病理发病机制与遗传和环境因素的共同作用密切相关.现主要阐述鼻咽癌作为一种多基因遗传性肿瘤的病因发病机制,初步建立鼻咽癌易感基因群的概念和鼻咽癌发生发展过程中易感基因群主导的多阶段性多米诺骨牌效应分子机制假说,为寻找鼻咽癌遗传易感风险因子,筛选鼻咽癌高危人群以及探索鼻咽癌靶向性及个体化的诊断和治疗手段奠定实验与理论基础.     

Revisiting the Holy Grail: using plant functional traits to understand ecological processes

One of ecology's grand challenges is developing general rules to explain and predict highly complex systems. Understanding and predicting ecological processes from species' traits has been considered a ‘Holy Grail’ in ecology. Plant functional traits are increasingly being used to develop mechanistic models that can predict how ecological communities will respond to abiotic and biotic perturbations and how species will affect ecosystem function and services in a rapidly changing world; however, significant challenges remain. In this review, we highlight recent work and outstanding questions in three areas: (i) selecting relevant traits; (ii) describing intraspecific trait variation and incorporating this variation into models; and (iii) scaling trait data to community‐ and ecosystem‐level processes. Over the past decade, there have been significant advances in the characterization of plant strategies based on traits and trait relationships, and the integration of traits into multivariate indices and models of community and ecosystem function. However, the utility of trait‐based approaches in ecology will benefit from efforts that demonstrate how these traits and indices influence organismal, community, and ecosystem processes across vegetation types, which may be achieved through meta‐analysis and enhancement of trait databases. Additionally, intraspecific trait variation and species interactions need to be incorporated into predictive models using tools such as Bayesian hierarchical modelling. Finally, existing models linking traits to community and ecosystem processes need to be empirically tested for their applicability to be realized.     

Light-dependent quenching of chlorophyll fluorescence in pea chloroplasts induced by adenosine 5′-triphosphate

Addition of ATP to chloroplasts causes a reversible 25–30% decrease in chlorophyll fluorescence. This quenching is light-dependent, uncoupler insensitive but inhibited by DCMU and electron acceptors and has a half-time of 3 minutes. Electron donors to Photosystem I can not overcome the inhibitory effect of DCMU, suggesting that light activation depends on the reduced state of plastoquinone. Fluorescence emission spectra recorded at ?196°C indicate that ATP treatment increases the amount of excitation energy transferred to Photosystem I. Examination of fluorescence induction curves indicate that ATP treatment decreases both the initial (F_o) and variable (F_v) fluorescence such that the ratio of F_v to the maximum (F_m) yield is unchanged. The initial sigmoidal phase of induction is slowed down by ATP treatment and is quenched 3-fold more than the exponential slow phase, the rate of which is unchanged. A plot of F_v against area above the induction curve was identical plus or minus ATP. Thus ATP treatment can alter quantal distribution between Photosystems II and I without altering Photosystem II-Photosystem II interaction. The effect of ATP strongly resembles in its properties the phosphorylation of the light-harvesting complex by a light activated, ATP-dependent protein kinase found in chloroplast membranes and could be the basis of physiological mechanisms which contribute to slow fluorescence quenching in vivo and regulate excitation energy distribution between Photosystem I and II. It is suggested that the sensor for this regulation is the redox state of plastoquinone.     

亚热带丘陵茶园间作白三叶草的生态效应

在亚热带丘陵区1a生幼龄茶园通过连续4a的大田对比试验,研究了茶园间作白三叶草的生态效应,结果发现：茶园间作白三叶草降低了土壤容重,提高了土壤孔隙度、有机质、全N、水解N的含量、K的活性、蚯蚓的数量和生物量,消耗了部分有效P;增加了土壤关键层次（0—20cm）和关键时期（4～6月）的水分含量,延缓和缩短了夏季高温干旱与秋季持续干旱时间;获得了土壤降温时增温、保温与升温时降温的双向动态调控效果,增加了同一层次土壤温度的稳定性,延缓了高温和低温的出现时间,缩短了过度高温时间,减少了高温对茶树生长产生的影响;抑制了杂草生长,增加了天敌的种类和种群数量,减少了虫害发生率。从而形成了立地环境．茶树．伴生生物群落系统自我调节的动态平衡,促进了茶树生长,改善了茶叶品质,显著增加了茶叶产量。与清耕茶园相比,茶园间作白三叶草后,春秋茶的酚氨比分别下降了17．10％和30．90％,产量提高了32．65％。     

Behavioral and Morphological Studies of Fetal Neural Transplants into SCN-Lesioned Rats

We have studied the effects of fetal neuronal grafts on the temporal pattern of drinking behavior of suprachiasmatic nuclei (SCN)-lesioned adult rats. Additionally, in an independent set of animals, the immunohistochemical staining for vasopressin, vasoactive intestinal polypeptide, and neuropeptide Y and the retinal connections to the hypothalamus were studied. The behavioral experiments indicate that anterior hypothalamic transplants induced reorganization of the temporal pattern of drinking behavior when placed in the third ventricle of adult hosts bearing complete SCN lesions, but not when placed in a cavity in the occipital cortex. Such rhythmicity persists only when the animals were recorded under constant darkness but not under constant light, indicating that the restored rhythmicity was generated endogenously but that the oscillator was extremely sensitive to light. Fetal occipital cortex induced reorganization of the temporal pattern of previously arrhythmic hosts, but it disappeared when the animals were recorded under constant light or constant darkness. It is clear that this rhythmicity was exogenous. In contrast to the cortical transplants, the hypothalamic transplants showed a morphological organization similar to that found in the normal hypothalamus regardless of their placement in the host brain. From these observations it is concluded that development of neocortex is more affected by environmental factors than that of the hypothalamus. Both hypothalamic and cortical transplants induced sprouting of retinal fibers into the anterior hypothalamus and the grafted tissue. It is possible that such fibers could be the neuroanatomical substrate by which rhythmicity is induced by cortical tissue.     

益生菌的多重抗病毒作用及其机制

病毒性疾病对人类和动物健康造成了重大威胁。由于现有的免疫接种和抗病毒疗法的局限性,开发安全、广谱、廉价的新型抗病毒制剂极为迫切。益生菌是摄入后能对机体产生多种有益作用的活性微生物,其抗病毒作用及潜在机制是当前的研究热点。本文介绍了益生菌通过促进肠道细胞的紧密连接和产生有利物质来维护机体黏膜屏障;与病毒竞争结合靶点或直接捕获并抑杀病毒;刺激机体免疫系统,调节固有免疫反应和适应性免疫反应;分泌具有抗病毒作用的代谢产物来发挥抗病毒作用及其作用机制,以期为益生菌的抗病毒相关研究提供参考。     

三峡库区消落带4种适生植物根际与非根际土壤养分与酶活性特征研究

三峡库区消落带植被修复过程中,物种的更替对库区土壤的地球化学循环产生潜在影响。以三峡库区忠县石宝寨汝溪河消落带植被修复示范基地165-170 m海拔段人工种植狗牙根、牛鞭草、落羽杉以及立柳根际与非根际土为试验对象,探究其根际与非根际土壤的养分含量及酶活性差异,以阐明不同物种的生长适应性及其根际养分利用策略,比较不同物种对库区土壤的营养改良作用。结果表明：（1）三峡库区消落带4种适生植物根系活动导致根际与非根际土壤养分因子以及土壤酶活性产生差异,不同物种的栽植均在一定程度上使库区土壤营养条件得以改善;（2）碳、氮两种元素在4种适生植物根际土壤中发生不同程度的富集,但磷素与钾素在不同物种根际与非根际土壤之间的变化不一致;（3）蔗糖酶、脲酶以及酸性磷酸酶在4种适生植物根际土中均表现出一定程度的根际正效应（R/S>1）,且狗牙根对3种土壤酶的根际活化效果最为明显,其根际效应分别高达2.39、1.89和2.7;（4）在植物根系的调控下,根际土中有机质与氮素、磷素以及钾素的相关性更为显著,而非根际土壤中,仅钾素与有效氮、有效磷呈显著负相关,其余各土壤养分因子之间均无显著相关性;（5）与落羽杉和立柳两木本植物相比,狗牙根与牛鞭草两草本植物根际具有更为合理的养分调节模式,对库区土壤的改良效果更好。     

初始小剂量甲巯咪唑对Graves病甲亢患者甲状腺功能和Visfatin、TNF-α、IL-6水平的影响

目的:分析初始小剂量甲巯咪唑治疗对Graves病甲状腺功能亢进症(甲亢)患者甲状腺功能和内脂素(Visfatin)、肿瘤坏死因子-α(Tumor necrosis factor-alpha, TNF-α)、白介素-6(Interleukin-6, IL-6)水平的影响。方法:选择我院2017年1月-2018年6月诊治的125例Graves病甲亢患者,根据入院编号随机数字表法分为两组。对照组63例给予甲硫咪唑15 mg/次,2次/d;研究组62例给予甲硫咪唑10 mg/次,2次/d,两组均连续治疗6个月,对比两组治疗总有效率、治疗前后甲状腺功能和血清Visfatin、TNF-α、IL-6水平的变化。结果:治疗后,研究组的治疗总有效率显著高于对照组(90.32%vs. 77.78%,P<0.05);两组患者的甲状腺功能指标血清游离三碘甲状腺原氨酸(Free triiodothyronine, FT3)、血清游离甲状腺素(FT4)水平均显著降低、敏感促甲状腺激素(Sensitive thyroid stimulating hormone, s TSH)水平均显著升高,且研究组以上指标变化较对照组更显著(P<0.05);两组患者的血清Visfatin、TNF-α、IL-6水平均较治疗前显著下降,且研究组以上指标均显著低于对照组(P<0.05)。结论:初始小剂量(10 mg/次)甲巯咪唑治疗Graves病甲亢的疗效显著优于甲硫咪唑15 mg/次治疗,可能与其有效改善患者的甲状腺功能和血清Visfatin、TNF-α、IL-6等炎症因子水平有关。