预制装配式混凝土箱涵设计与施工研究

预制装配式混凝土箱涵技术手段在实践中应用可以转变传统施工弊端与不足,具有环保、快速、高质量的特征。分析预制装配式混凝土箱涵设计与施工要点,可以为预制装配式混凝土箱涵的合理应用提供技术参考与支持。基于此,主要探究了预制装配式混凝土箱涵设计要点,分析了其施工技术手段。

Clinical Study on CT-guided Modified Akupotomye in the Treatment of Lumbar Nerve Posterior Branch Compression

Objective: To observe the clinical effect of modified akupotomye closed lysis under CT guidance on compression of posterior lumbar nerve branch.Methods: Patients were diagnosed by HRCT 3-D reconstruction combined with clinical symptoms and signs.After HRCT three-dimensional reconstruction combined with clinical symptoms and signs, the patients were confirmed as posterior lumbar nerve compression.After CT accurate surface positioning, CT-guided modified akupotomye was used for closed lysis of the posterior lumbar nerve branch.Oswestry Dysfunction Index Questionnaire(ODI) was used for quantitative scoring, 7 days before and after treatment and 6 months after treatment.Results: In 62 cases, 20 cases were cured, with 25 cases markedly effective, 11 cases effective, and 36 cases ineffective.The total effective rate was 90.3%.ODI score: Self-paired t test 7 days before after treatment, P < 0.01;Before treatment and 6 months after treatment, self-paired t test(P < 0.01);Self-paired t-test was performed 7 days after treatment and 6 months after treatment(P > 0.05).Conclusion: With CT precise positioning, the modified akupotomye can be used to do closed lysis, to relieve the adhesion and compression, so that the low back pain can be relieved, with good clinical.The akupotomye closed lysis, combined with modern imaging technology has not only achieved good clinical effect, but also can improve the accuracy, safety and scientificity of akupotomye treatment.

针刺治疗中风后失眠有效性及安全性的Meta分析

目的对针刺治疗中风后失眠的有效性及安全性进行客观评价。方法检索中国知网(CNKI)、维普数据库(VIP)、万方数据库、中国生物医学数据库(CBM)、PubMed、Cochran library、Embase等数据库从建库至2019年4月1日所收录的针刺治疗中风后失眠的随机对照试验。2名研究者独立进行文献筛选、数据提取,运用Cochran handbook对纳入文献偏移风险和文献质量进行评估,采用Revman5.3软件对文献主要结局指标进行分析。结果研究纳入文献33篇,共2331例患者,Meta分析显示纳入的33个研究间无异质性(P=0.98,I^2=0%)。针刺与其他治疗方法比较,结果表明针刺治疗中风后失眠的疗效优于[OR=5.27,(95%CI 3.96~7.03)]其他方法。亚组分析结果显示针刺治疗本病20次以上疗效优于20次以下,且单独针刺疗效优于耳穴疗法。结论依据目前证据显示:针刺治疗中风后失眠疗效优于口服西药且安全性良好。但由于纳入研究样本的数量有限,文献质量一般,故该研究结论还有待高质量临床研究验证。

头穴丛刺联合运动疗法治疗中风后肢体痉挛疗效观察

目的:在常规运动疗法基础上,观察头穴丛刺治疗中风后肢体痉挛的临床疗效。方法:将72例中风后肢体痉挛患者随机分为观察组(36例,脱落5例)和对照组(36例,脱落6例)。对照组采用运动疗法治疗,观察组在对照组基础上选取前顶向百会、囟会向前顶等穴线透刺,每日1次,每周连续治疗5 d,共治疗4周。治疗前后观察两组患者改良Ashworth评分表(MAS)、简化Fugl-Meyer运动功能评定表(FMA)、改良Barthel指数(MBI)评分变化。结果:治疗后,两组患者上肢及下肢MAS评分较治疗前降低(P<0.05),观察组上肢及下肢MAS评分低于对照组(P<0.05)。治疗后,两组患者FMA、MBI评分较治疗前升高(P<0.05),观察组MBI评分高于对照组(P<0.05)。结论:在常规运动疗法基础上,头穴丛刺可降低中风后肢体痉挛患者痉挛程度,提升其运动功能及日常生活能力。