目的:分析探讨终末期慢性肾衰竭(CRF)并急性左心衰的发病机制及救治措施。方法:对36例各种原因所致的终末期CRF患者并急性左心衰采用药物控制血压,降低外周血管阻力,减轻心脏后负荷及采用血液透析等方法,减轻心脏前负荷,控制心衰。结果:36例患者2286次来院救治并发急性左心衰1144次,抢救成功1138次,成功率99.5%。结论:终末期CRF并急性左心衰据发病机理不同,给予不同处理,关键是尽快控制血压,脱水,降低外周血管阻力和控制血容量,降低心输出量。
Objective To explore the effect of deep muscle stimulation (DMS) combined with exercise therapy on morphological changes of the trapezius muscle assessed by musculoskeletal ultrasound and the function for patients with neck and shoulder myofascial pain syndrome (MPS). Methods One hundred and twenty patients with neck and shoulder MPS admitted to the First People’s Hospital of Shuangliu District, Chengdu between August 2021 and December 2022 were randomly selected and divided into 4 groups. There were 30 cases in each group. Group A received modulated middle frequency electrotherapy, group B received modulated middle frequency electrotherapy combined with DMS, group C received modulated middle frequency electrotherapy combined with exercise therapy, and group D received modulated middle frequency electrotherapy, DMS combined with exercise therapy. Before treatment and after 4 weeks of treatment, shear wave elastography was used to detect the shear wave velocity (SWV) of the four groups, high frequency ultrasound was used to detect the muscle thickness of the trapezius muscle. The Visual Analogue Scale (VAS) scores, Neck Disability Index (NDI), modified Barthel Index (MBI), Instrumental Activities of Daily Living Scale (IADL), World Health Organization Quality of Life-BREF (WHOQOL-BREF), Self-rating Anxiety Scale (SAS), and Self-rating Anxiety Scale (SDS) were also assessed to compare the therapeutic effects among the four groups of patients under different intervention methods. Results Before treatment, there was no significant difference in trapezius muscle SWV, trapezius muscle thickness, VAS, NDI, MBI, IADL, WHOQOL-BREF, SAS or SDS among the four groups (P>0.05). After 4 weeks of treatment, there were significant differences in trapezius muscle SWV, VAS, NDI, WHOQOL-BREF in the physiological domain and psychological domain, SAS and SDS among the four groups (P<0.05), and the improvements of trapezius muscle SWV, WHOQOL-BREF in the physiological domain and psychological domain, and SDS in group D were more obvious than those in other groups (P<0.05). After 4 weeks of treatment, there was no significant difference in MBI, IADL, or WHOQOL-BREF in the society domain and environmental domain among the four groups (P>0.05). Conclusion DMS combined with exercise therapy can significantly improve trapezius muscle elasticity, psychological state and quality of life of patients with neck and shoulder MPS.
目的 研究薏苡仁水提液对受辐射小鼠外周血白细胞、骨髓有核细胞数量及微核率变化的影响，并检测白细胞介素（IL）-1、IL-2、超氧化物歧化酶（SOD）基因的变化以探讨其抗辐射损伤的作用机制。 方法 用薏苡仁水提液在受辐射前后对小鼠进行灌胃，对辐射后小鼠外周血白细胞、骨髓有核细胞计数，计算微核率，逆转录-聚合酶链反应（RT-PCR）检测IL-1、IL-2、SOD基因的变化，对实验结果进行统计学分析。 结果 随薏苡仁水提液剂量的加大，受照射小鼠骨髓有核细胞数不断增多，且微核数呈降低趋势；高剂量组与空白对照组相比，照射后第7天小鼠外周血白细胞数差异无统计学意义（P＞0.05），且3个剂量组外周血白细胞数均高于辐射对照组，差异有统计学意义（P＜0.01）；薏苡仁水提液高、中剂量组IL-1、IL-2、SOD基因的相对表达量均高于空白对照组和辐射对照组（P＜0.01）。 结论 薏苡仁水提液可能具有促使骨髓有核细胞快速释放、加快外周血白细胞数量恢复进度的作用，且具有降低受辐射小鼠骨髓有核细胞和外周血淋巴细胞微核率的作用；再者，薏苡仁水提液可上调受辐射小鼠机体SOD、IL-1、IL-2的表达水平，具有增强自由基清除、抗辐射和免疫保护调节的作用。
【摘要】 目的 制备小鼠肾炎模型并观察双氢青蒿素（dihydroartemisinine，DHA）对模型小鼠细胞因子肿瘤坏死因子-α（tunor necrosis factor，TNF-α）和白细胞介素-6（inter leukin-6，IL-6）的影响以及小鼠肾脏的病理变化。 方法 取雄性昆明种小鼠120只， 随机分为正常对照组、脂多糖（lipopolysaccharides，LPS）组、LPS+肾匀浆组及DHA治疗组；分别于12、24、48 h取血，酶联免疫吸附试验检测血清中TNF-α和IL-6的含量，苏木精-伊红染色法观察小鼠肾脏的病理变化。 结果 造模48 h LPS+肾匀浆组小鼠肾小球出现炎性细胞浸润，而正常对照组未见异常；LPS组及 DHA治疗组仅有轻微的病理改变。LPS刺激使小鼠血清TNF-α和IL-6含量高于正常水平（Plt;0.01），但有随时间不断下降的趋势；LPS+肾匀浆组较正常对照组TNF-α和IL-6含量升高（Plt;0.01）；DHA可显著下调模型小鼠血清TNF-α的水平（Plt;0.01），但对IL-6的影响相对较小（Pgt;0.05）。 结论 运用改良的造模方法LPS+肾匀浆建立肾炎模型效果良好；DHA可以调节模型小鼠炎症因子TNF-α和IL-6的释放，具有一定的改善模型小鼠肾炎症状的作用。【Abstract】 Objective To establish mice nephritis models, detect the serum level changes of cytokines tumor necrosis factor α (TNF-α) and interleukin-6 (IL-6) in the model mice treated by Dihydroartemisinin (DHA), and observe the physiological changes of the mice kidneys. Methods One hundred and twenty male Kunming mice were randomly divided into 4 groups: control group, lipopolysaccharides (LPS) group, LPS plus kidney homogenate group, and DHA treated group. The level of cytokines TNF-α and IL-6 in the serum were detected by enzyme-linked immunoabsordent assey at hour 12, 24, and 48, respectively. Pathological changes were observed by hematoxylin: eosin staining. Results At the time hour 48 after the establishment of the model, inflammatory cell infiltration was observed in the glomerulus of the LPS plus kidney homogenate group, but no abnormality was found in the control group. There were only slight pathological changes in mice models of the LPS group and the DHA treated group. The serum level of TNF-α and IL-6 increased remarkably after the treatment of LPS (Plt;0.01), but declined as time went by. The level of TNF-α and IL-6 increased significantly in LPS plus kidney homogenate group compared with the control group (Plt;0.01). DHA could significantly decrease the TNF-α level in the serum (Plt;0.01), but had a low influence on IL-6 (Pgt;0.05). Conclusion The modified LPS plus kidney homogenate has a good result in model establishing. DHA can regulate the release of TNF-α and IL-6 in the model mice, and may have certain good effects on ameliorating the nephritis pathological changes.
As an important component of the healthcare system reform, the regional rehabilitation medical alliance aims to integrate medical resources within the region, promote standardization, specialization, and accessibility of rehabilitation medical services, and achieve efficient collaboration and resource sharing among medical institutions at all levels. This article comprehensively and systematically reviews and analyzes the current situation of the construction of regional rehabilitation medical alliance in China. At the same time, combined with the construction practice of West China Airport Hospital of Sichuan University, it summarizes experience and puts forward suggestions, providing a reference for the development of regional rehabilitation medical alliance.