Exploring the Dual Subjectivity of Kindergarten's Self-made Play and Teaching Aids Activities from the Perspective of Children's Play Development in China

The joint development of teachers and young children is the basis for promoting the development of high-quality preschool education in the new era,and encouraging early childhood teachers to make playthings according to local conditions is both the fine tradition of China's early childhood education and the direct orientation of China's preschool education policy.Homemade play and teaching aids are some of the methods often used in kindergartens,which skillfully combine young children's daily life objects with toys and early childhood teaching,not only enriching the collective activities of young children but also cultivating children's abilities in various aspects.Kindergarten homemade"play and teaching aids"for early childhood teachers and children have their special educational significance and value,therefore,this paper is based on the children and teachers double subject basis,discussing the homemade"play and teaching aids"for children and teachers of the double subject meanings,and puts forward the realization of the This paper discusses the double-subjective meaning of homemade teaching aids for children and teachers on the basis of the double-subjective foundation of children and teachers,and puts forward specific suggestions for realizing the double-subjectivity of kindergarten homemade teaching aids to enrich the theoretical value and practical significance of homemade teaching aids,to provide theoretical references and support for the relevant staff.

Observation on Curative Effect of Self-made Wubeizi Decoction Combined with rhaFGF in Promoting Postoperative Wound Healing in Patients with Anal Fistula

[Objectives]To explore the curative effect of Self-made Wubeizi Decoction combined with recombinant human acidic fibroblast growth factor(rhaFGF)in promoting postoperative wound healing in patients with anal fistula.[Methods]A total of 82 patients with anal fistula who underwent anal fistula resection+use of setons in Luodian Hospital during January and March of 2020 were randomly divided into observation group and control group with 41 cases in each group.The control group was given rhaFGF external application regimen,and the observation group was treated with Self-made Wubeizi Decoction on the basis of the control group.After 3 weeks of treatment,the differences in curative effects of TCM syndromes were compared between the two groups.Besides,the changes in TCM symptom scores,inflammatory mediators[interleukin-12(IL-12),tumor necrosis factor-α(TNF-α),interferon-γ(IFN-γ)],anorectal functions[anal resting pressure(ARP),maximal systolic pressure(MSP)and maximum tolerated volume(MTV)of the anal canal],quality of life[GQOLI-74 scores]were compared.[Results]After 3 weeks of treatment,the total effective rate of the observation group was significantly higher than that of the control group(P<0.05);the levels of TCM symptom scores,IL-12,TNF-α,IFN-γ,ARP,MSP,and MTV in both groups were significantly lower than those before treatment,and these levels in the observation group was significantly lower than that in the control group at the same time(P<0.05).The GQOLI-74 scores of both groups were significantly higher than those before treatment,and the observation group was significantly higher than the control group(P<0.05).[Conclusions]The Self-made Wubeizi Decoction combined with rhaFGF therapy has a significant effect in promoting postoperative wound healing in patients with anal fistula.It can effectively inhibit the local inflammation of patients,facilitate the recovery of anorectal function and improve the quality of life,thus has high clinical application value.

Severe skeletal bimaxillary protrusion treated with micro-implants and a self-made four-curvature torquing auxiliary: A case report

BACKGROUND Bimaxillary protrusion is a clinically common dentofacial deformity,particularly among Chinese patients.This kind of malformation can severely affect facial esthetics and,even in mild cases,is difficult to correct without surgery.Unfortunately,many patients abandon treatment because of fear of surgery.Here,we describe a case of severe skeletal bimaxillary protrusion treated with nonsurgical orthodontic treatments,highlighting an alternative treatment option.CASE SUMMARY A 31-year-old woman wished to address a severe protrusion profile(approximately 8 mm overbite)and gummy smile.Cephalometric analysis and superimposition showed a severe skeletal class II pattern with a mandibular retrusion,and proclined and protrusive mandibular incisors.Panoramic radiograph showed a missing mandibular right third molar.A diagnosis of severe bimaxillary dentoalveolar protrusion was made.Taking into account the patient’s fear of orthognathic surgery,she accepted the proposed alternative treatment using micro-implants and a self-made four-curvature torquing auxiliary.The treatment allowed for maximal en masse anterior tooth retraction,proper relocation of incisors,and alleviation of the skeletal class II pattern.Esthetically,the patient’s lip protrusion was significantly decreased as was the overjet(from 10.5 mm to 1.8 mm),and the results remained stable throughout the 2-year followup.CONCLUSION Nonsurgical treatment using micro-implants and a four-curvature torquing auxiliary may benefit severe cases of skeletal bimaxillary protrusion in adults.

Protective Effects of Self-made Compound Taoren Danshen Decoction on Rats with Acute Liver Injury

[Objectives] To study the protective effects of self-made Compound Taoren Danshen Decoction( CTDD) on acute liver injury induced by D-galactosamine in rats,and to explore its mechanism. [Methods]An acute liver injury model was established by intraperitoneal injection of 500 mg/kg of D-galactosamine. The ALT,AST,MDA,SOD and GSH-Px in serum,as well as serum TNF-α,IL-1β and IL-6 levels were measured,and liver tissue lesions were observed under microscope. [Results] CTDD can significantly reduce ALT,AST and MDA levels,increase SOD,GSH-Px activity,and significantly reduce serum TNF-α,IL-1β and IL-6 levels,and improve liver tissue lesions.[Conclusions]CTDD has a protective effect on D-galactosamine-induced acute liver injury in rats,and its mechanism may be related to inhibition of oxidative stress and inflammatory reaction.

Self-made wire loop snare successfully treats gastric persimmon stone under endoscopy

BACKGROUND Large gastric persimmon stones are generally resistant to standard endoscopic treatments.We applied an alternative endoscopic method using a hand-made snare for the treatment of large gastric phytobezoars.AIM To explore the clinical efficacy of a self-made wire loop snare to treat giant gastric persimmon stones.METHODS A retrospective study evaluated the clinical data of 38 patients with gastroliths admitted to Taihe Hospital in Shiyan City,Hubei Province,China,between March 2015 and October 2020.The patients were divided into observation(n=23)and control(n=15)groups.Patients in the observation group were treated with selfmade wire loop snares for lithotripsy,and patients in the control group were treated with traditional foreign body forceps,snares,injection needles,and other tools.Successful stone removal,treatment time,and hospital stay were compared.RESULTS The average operating time was significantly shorter(P<0.001)in the observation group(53.4 min)than that in the control group(172.8 min).The average hospital stay of the observation group(5.4 d)was significantly shorter(P<0.001)than that in the control group(10.3 d).Successful one-time treatment was significantly more frequent(P<0.001)in the observation group(87%)than in the control group(7%).CONCLUSION Self-made guidewire loop snares were successfully used to treat gastrolithiasis, and were significantly more effective than foreign body forceps, snares, and other traditionalmethods.

Observation on the Effect of Umbilical Therapy of Herbal Medicine Combined with Self-Made Dysmenorrhea Paste on Primary Dysmenorrhea

Objective:To investigate the clinical effect of self-made dysmenorrhea paste combined with umbilical therapy of herbal medicine on primary dysmenorrhea.Methods:160 patients with primary dysmenorrhea were recruited from Changle People’s Hospital.Participants were randomly divided into control group and treatment group,with 80 cases in each group.The control group were administered the dysmenorrhea paste sold on the market for 5 days during three menstruation cycles,and the treatment group was given the umbilical therapy of herbal medicine combined with self-made dysmenorrhea paste.The outcome was the intensity of menstrual pain measured by using the visual analogue scale,TCM symptom score and dysmenorrhea symptom score of patients,responder rate.The clinical outcomes were measured on each menstrual cycle at baseline,treatment course(3 cycles),and follow-up period.Results:In this study,there was no significant difference in age and severity of disease between the two groups before treatment.After treatment,VAS score,TCM symptom score and dysmenorrhea symptom score of patients in both groups decreased.The total effective rate was 90.75%in the treatment group and 81.25%in the control group.Conclusion:The treatment of primary dysmenorrhea patients with self-made dysmenorrhea paste combined with application of drugs and moxibustion naval-button method has a significant clinical effect.This method can reduce the pain of patients,improve the quality of life of patients,and homemade dysmenorrhea paste has a good taste,long shelf life,easy to carry,and is worthy of promotion and application.

Effect of self-made exhaust plaster on patients with gastrointestinal dysfunction after gynecological operation

Objective:To explore the effect of self-made exhaust patch(SMEP)on gastrointestinal dysfunction after gynecological operation.Methods:A total of 200 patients with gynecological operation in the gynecological ward of Shandong Changle People's Hospital were randomly divided into the control group(n=100)and the treatment group(n=100).The recovery time of bowel sounds,the time of first anal exhaust,the duration of abdominal distention,the duration of abdominal pain,the incidence of abdominal distention and abdominal pain and linical efficacy of SMEP were observed.Results:Compared with the control group,the recovery time of gastrointestinal function and the first anal exhaust time in the treatment group were shorter;the duration of abdominal distention and abdominal pain in the treatment group were shorter than those in the control group(P<0.05);Cure rate of abdominal distention in the treatment is 62.5%and cure rate of abdominal pain in the treatment is 60%within 72 hours after operation,which is higher than that in the control group(44.%,45.9%).Conclusion:The results showed that the self-made exhaust patch can improve the clinical symptoms of patients after gynecological abdominal surgery,and the self-made exhaust patch had a significant effect on gastrointestinal dysfunction after gynecological surgery,which was worthy of clinical promotion.

Clinical observation on TCM fumigation and washing for treatment of diabetic peripheral neuropathy by self-made water-washing footbath

消渴痹症即糖尿病周围神经病(DPN)是临床上常见的一种疾病,给患者带来极大不适,严重者影响生活,甚至会导致更严重的并发症。治疗方案若能在控制血糖的同时,及时改善双下肢症状,对提高患者生活质量、预防四肢并发症具有积极意义。现就针对自制滤水式洗脚盆用于中药熏洗在治疗消渴痹症中的具体应用做一个全面的研究与分析。本文纳入从2018年3月到2018年4月就诊于我科的DPN患者20例,分为两组,治疗组使用滤水式洗脚盆进行沐足,对照组采用常规木桶进行沐足,每组各10例。研究的结果显示采用自制滤水式熏洗脚盆中药熏洗双足较常规木桶沐足能改善消渴痹症的临床症状,为有双下肢麻木的患者提供一种可选择的外治的方法,可减轻患者痛苦,提高患者生活质量。

自拟健脾除积方联合免疫检查点抑制剂治疗对晚期非小细胞肺癌患者的临床疗效及对其外周血管生长因子的影响

目的 探究自拟健脾除积方联合免疫检查点抑制剂治疗对晚期非小细胞肺癌患者的临床疗效及对其外周血管生长因子的影响。方法 选取2021年6月—2022年12月期间河北省沧州中西医结合医院收治的晚期非小细胞肺癌患者70例,按随机数字表法分为对照组和治疗组,每组各35例。对照组给予常规化疗方法,采用信迪利单抗联合含铂双药治疗,治疗组在对照组的基础上加用自拟健脾除积方治疗。每21 d(3周)为一个治疗周期,两组患者连续接受2个疗程的药物治疗,观察比较两组患者临床疗效、不良反应情况,治疗前后中医临床证候评分、KPS评分、血管生长因子(Vascular endothelial growth factor,VEGF)水平。结果 治疗后治疗组总有效率88.57%(31/35)明显高于对照组65.71%(23/35),差异有统计学意义(P<0.05)。治疗后两组患者中医证候评分均较治疗前降低,功能状态疗效KPS评分均较治疗前升高,差异有统计学意义(P<0.05);且治疗组中医证候评分明显低于对照组,功能状态疗效KPS评分明显高于对照组,差异有统计学意义(P<0.01)。治疗后两组患者血清VEGF水平均较治疗前降低,差异有统计学意义(P<0.05);且治疗组血清VEGF水平明显低于对照组,差异有统计学意义(P<0.05)。两组患者不良反应分级比较,差异无统计学意义(P>0.05)。治疗组白细胞计数降低、恶心/呕吐发生率明显低于对照组,差异有统计学意义(P<0.05)。结论 自拟健脾除积方联合免疫检查点抑制剂治疗晚期非小细胞肺可提高临床治疗效果,改善中医证候评分,提高生活质量,降低外周血血管生长因子含量,且具有相当的安全性,值得推荐使用。

自拟清热润目汤联合朱氏风池三针法配合眼周取穴对老年睑板腺功能障碍致干眼的治疗效果

目的探究自拟清热润目汤联合朱氏风池三针法配合眼周取穴对老年睑板腺功能障碍致干眼的治疗效果。方法将2021年8月至2023年8月浙江省丽水市中心医院眼科收治的109例老年睑板腺功能障碍致干眼患者作为研究对象。根据患者接受的不同治疗方式进行分组,将接受常规西药治疗的患者纳入A组(53例),将接受西药治疗和自拟清热润目汤联合朱氏风池三针法配合眼周取穴治疗的患者纳入B组(56例),2组均治疗3个月。对比2组患者的治疗有效性、干眼程度[国际标准眼表疾病指数(OSDI)]、睑板腺功能(睑脂排出能力、眼睑分泌物性状)、角膜染色情况、非入侵泪膜破裂时间和并发症发生率(角膜溃疡、角膜穿孔、继发细菌感染)。结果B组的治疗有效率(95%)高于A组(81%)(P<0.05);B组患者的干眼程度[正常(63%)、轻度干眼(32%)、中度干眼(5%)、重度干眼(0)]低于A组[正常(41%)、轻度干眼(47%)、中度干眼(8%)、重度干眼(4%)](P<0.05);B组患者的睑脂排出能力正常率(73%)高于A组(51%),眼睑分泌物性状正常率(68%)高于A组(47%)(P<0.05);B组患者的角膜染色评分(4.6±0.7)分低于A组(6.5±0.8)分,非入侵泪膜破裂时间(11.0±1.3)s长于A组(10.3±1.1)s(P<0.05);B组并发症发生率(13%)与A组(8%)差异无统计学意义(P>0.05)。结论自拟清热润目汤联合朱氏风池三针法配合眼周取穴对老年睑板腺功能障碍致干眼的疗效显著,可有效缓解干眼症状、恢复眼睑功能、增强泪膜稳定性。

市售餐饮自制发酵乳卫生质量状况调查分析——以扬州市为例

以扬州市餐饮环节抽取的餐饮自制发酵乳为研究对象,采用国家标准方法对其卫生指标进行检测,并运用基质辅助激光解吸电离飞行时间质谱法、分子生物学方法和传统形态学方法对污染微生物指标不合格产品中的污染菌进行分离纯化和鉴定。结果表明:25批次餐饮自制发酵乳的产品不合格率为36%,不合格项目均为微生物指标,其中大肠菌群不合格率为20%、霉菌计数不合格率为8%、酵母计数不合格率为32%。不合格样品的大肠菌群阳性菌株中包含了肺炎克雷伯菌、阴沟肠杆菌等多种条件致病菌;不合格样品的霉菌和酵母菌以曲霉属、青霉属、念珠菌属等发酵乳中常见的污染菌为主。调查表明:餐饮企业应重视加工制作过程中的微生物污染问题,监管部门应制定和实施有针对性的餐饮食品抽检计划,同时加强对餐饮自制发酵乳的食品安全监管。

自拟利胆经验方治疗慢性胆囊炎临床观察

目的观察孙晓生教授自拟利胆1号方治疗慢性胆囊炎的临床疗效和安全性。方法选取108例慢性胆囊炎患者为研究对象,利用随机数字表法分为2组,各54例。对照组采取常规西医治疗,观察组加用自拟利胆1号方治疗,4周后对比2组临床疗效。结果治疗前2组患者的中医症状积分、肝胆功能指标、免疫指标、炎性细胞因子相比,组间差异无统计学意义(P>0.05),治疗4周后均较治疗前改善且观察组改善效果优于对照组(P<0.05);观察组不良反应发生率与对照组相比,差异无统计学意义(P>0.05)。结论自拟利胆1号方对慢性胆囊炎有效,不良反应发生率低,使用前景广阔。

敛疮膏治疗热毒壅滞型褥疮验案评析

文章列举自拟敛疮膏治疗热毒壅滞型褥疮验案两则,阐述热毒炽盛、气血壅滞是褥疮形成的重要病理变化。自拟敛疮膏方能清热凉血、解毒化瘀、敛疮生肌,是治疗热毒壅滞型褥疮的良方,其治疗热毒壅滞型褥疮的脉证特点为口干、发热、局部红肿热痛、皮肤破溃、舌红苔少或苔黄、脉数或滑。文章详述自拟敛疮膏治疗热毒壅滞型褥疮的内在机制并附验案两则,供同仁参考。同时,着重讨论了大黄在该方中的应用,提出大黄外用能清热解毒、活血通经、调和气血,药力平和而非寒凉过度,可以解毒、活血而不留瘀,即使是治疗高龄、体虚老人,只要用之合宜,亦能取得良效。

自拟降火滋阴方配合醋酸亮丙瑞林治疗女童中枢性性早熟临床研究

目的探讨自拟降火滋阴方配合醋酸亮丙瑞林治疗女童中枢性性早熟的临床疗效。方法选取86例中枢性性早熟女童,将其随机分为对照组和试验组,每组43例。对照组予以醋酸亮丙瑞林治疗,试验组予以自拟降火滋阴方配合醋酸亮丙瑞林治疗。治疗6个月后,比较2组治疗总有效率,子宫容积、最大卵泡直径、卵巢容积等超声检查指标,以及黄体生成素(luteinizing hormone,LH)、雌二醇(estradiol,E 2)、卵泡刺激素(follicle-stimulating hormone,FSH)等血清性激素水平。结果治疗后,试验组总有效率为90.70%,对照组为72.09%;组间比较,差异具有统计学意义(P<0.05)。2组子宫容积、最大卵泡直径、卵巢容积均较治疗前降低(P均<0.05),且试验组上述超声指标明显小于对照组(P均<0.05)。2组血清LH、E 2、FSH水平均较治疗前下降(P均<0.05),且试验组上述血清性激素水平明显低于对照组(P均<0.05)。结论自拟降火滋阴方配合醋酸亮丙瑞林治疗女童中枢性性早熟可显著增强疗效,改善相关超声指标,并能有效调节性激素水平。

自拟参芪消癌方联合替吉奥维持治疗老年晚期胃癌患者的疗效观察

目的探讨自拟参芪消癌方联合替吉奥维持治疗老年晚期胃癌(Gastric cancer)的临床疗效。方法选取2021年6月-2022年6月期间河南省南阳市第二人民医院收治的晚期胃癌患者90例,采用随机数字表法分为对照组和观察组,每组各45例。两组患者均采用SOX方案进行化疗,化疗结束后4周,对照组给予替吉奥胶囊口服,观察组在对照组基础上给予参芪消癌方口服。观察比较两组患者临床疗效、毒副反应,治疗前后中医证候积分、KPS评分及肿瘤标志物[癌胚抗原(Carcinoembryonic antigen,CEA)、糖类抗原199(Glycoantigen 199,CA199)、糖类抗原724(Glycoantigen 724,CA724)]水平。结果治疗后两组患者中医证候积分较治疗前明显降低,KPS评分较治疗前升高,差异有统计学意义(P<0.05);观察组中医证候积分明显低于对照组,KPS评分明显高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者CEA、CA199、CA724水平均较治疗前明显降低,差异有统计学意义(P<0.05);且观察组肿瘤标志物水平明显低于对照组,差异有统计学意义(P<0.05)。治疗后观察组临床控制率75.56%(34/45)明显高于对照组48.89%(22/45),差异有统计学意义(P<0.05)。治疗期间,观察组在恶心呕吐、腹泻、血小板减少等毒副反应程度均好于对照组,差异有统计学意义(P<0.05)。结论自拟参芪消癌方联合替吉奥维持能有效改善晚期胃癌患者临床症状及生活质量,延缓瘤体进展,有助于降低晚期胃癌患者肿瘤标志物水平,增强抗肿瘤效果,同时还能减轻因化疗而产生的毒副作用,安全性较高,耐受性较好。

自制垫板承托施源管导管联合改进的止血方法在宫颈癌插植后装放疗中的应用研究

探究自制垫板承托施源管导管联合改进的止血方法在宫颈癌插植后装放疗中的应用效果。选取梧州市红十字会医院2021年7月—2023年6月收治的200例患者为研究对象,采用随机数字表法将患者分为两组,每组各100例。对照组患者实施常规宫颈癌插植后装放疗,研究组患者实施改进后宫颈癌插植放疗。保证所有患者进行插植后装放疗5次。比较两组患者心理状态、生活质量、并发症情况、满意度和依从性。结果显示,干预后,研究组患者SDS评分、SAS评分均低于对照组(P<0.05)。干预期间研究组并发症的总发生率低于对照组(P<0.05),且各项生活质量评分均高于对照组(P<0.05)。同时,干预后研究组总满意度和总依从性均高于对照组(P<0.05)。研究发现,自制垫板承托施源管导管联合止血方法改进能降低宫颈癌插植后装放疗患者并发症发生率,可改善患者心理状态,提高患者生活质量和满意度,提升患者治疗依从性。

针刺内迎香加自拟鼻炎方联合西药治疗肺气虚寒型鼻鼽的临床观察

【目的】观察针刺内迎香加自拟鼻炎方联合西药治疗肺气虚寒型鼻鼽的临床疗效。【方法】将60例肺气虚寒型鼻鼽患者随机分为观察组与对照组,每组各30例,对照组给予地氯雷他定片联合糠酸莫米松鼻喷雾剂治疗,观察组在对照组治疗的基础上,给予针刺内迎香联合自拟鼻炎方治疗。2组均治疗14 d。治疗14 d后,评价2组临床疗效。观察2组患者治疗前后鼻部症状评分的变化情况,以及视觉模拟量表(VAS)和鼻结膜炎生活质量调查问卷(RQLQ)评分的情况。比较2组患者治疗前后中医证候积分以及血清免疫球蛋白E(IgE)的变化情况。并评价2组的安全性。【结果】(1)观察组总有效率为93.33%(28/30),对照组为73.33%(22/30)。观察组疗效优于对照组,差异有统计学意义(P<0.05)。(2)治疗后,2组患者鼻塞、喷嚏、流涕及鼻痒症状均明显改善(P<0.01),且观察组在改善鼻部症状方面明显优于对照组,差异有统计学意义(P<0.05)。(3)治疗后,2组患者VAS评分明显改善(P<0.01),且观察组在改善VAS评分方面优于对照组,差异有统计学意义(P<0.05)。(4)治疗后,2组患者PQLQ评分明显改善(P<0.01),且观察组在改善PQLQ评分方面明显优于对照组,差异有统计学意义(P<0.05)。(5)治疗后,2组患者中医证候积分均明显改善(P<0.01),且观察组在改善中医证候积分方面明显优于对照组,差异有统计学意义(P<0.05)。(6)治疗后,2组患者血清IgE水平明显改善(P<0.01),且观察组在改善血清IgE水平方面明显优于对照组,差异有统计学意义(P<0.05)。(7)观察组与对照组的不良反应发生率比较,差异无统计学意义(P>0.05)。【结论】针刺内迎香加自拟鼻炎方联合西药治疗肺气虚寒型鼻鼽,可明显改善患者的临床症状,从而提高患者的生活质量,疗效显著。

活血化瘀通络方联合火针刺法对急性脑梗死患者脑血流动力学及血清D-二聚体、IL-6、TNF-a的影响

目的 探究活血化瘀通络方联合火针刺法对急性脑梗死患者脑血流动力学及血清D-二聚体、白介素-6(interleakin-6,IL-6)、肿瘤坏死子-α(tumor necrosis factor-α,TNF-α)的影响。方法 收集2021年2月—2022年2月惠州市中心人民医院神经内科及中医康复科就诊的急性脑梗死患者100例,随机分为试验组和对照组,各50例,两组患者均根据病情给予常规药物治疗,对照组予以常规药物治疗(包含阿司匹林肠溶片、依达拉奉、复方甘露醇、胞二磷胆碱注射液),试验组在对照组的基础上予以活血化瘀通络方联合火针刺法,对比两组临床疗效、神经功能缺损程度、脑血流动力学指标、D-二聚体、IL-6、TNF-α、认知功能、生活质量及不良反应发生情况。结果 治疗后与对照组相比,试验组临床总有效率较高,差异具有统计学意义(P<0.05)。治疗后两组患者最大峰值流速(spectral atlas systolic peak velocity, Vs)、舒张末流速(end diastolic velocity, Vd)、平均流速(mean velocity, Vm)、血管搏动指数(pulsatile index, PI)、血管阻力指数(resistant index, RI)等水平升高(P<0.05);与对照组相比,试验组Vs、Vd、Vm、PI、RI等水平较高(P<0.05)。治疗后两组神经功能缺损评分(neural function defect score, NFDS)、生活质量量表(quality of life scale, SS-QOL)评分降低,简易精神状态量表(mini-mental state examination, MMSE)评分增高(P<0.05);治疗后与对照组相比,试验组NFDS评分、SS-QOL评分降低,MMSE评分较高(P<0.05)。治疗后两组血清D-二聚体、IL-6、TNF-α水平降低(P<0.05);治疗后与对照组相比,试验组血清D-二聚体、IL-6、TNF-α水平较低(P<0.05)。两组不良反应相比差异无统计学意义(P>0.05)。结论 活血化瘀通络方联合火针刺法能显著改善急性脑梗死患者脑血流动力学指标,促进认知功能的恢复,其作用机制与抑制血清D-二聚体、TNF-α和IL-6的合成与释放具有密切相关性,适宜临床应用推广。

自制穿孔球囊行Marshall静脉无水乙醇消融联合个体化消融策略治疗持续性心房颤动1例

在射频消融术治疗持续性心房颤动(房颤)时常需要在环肺静脉电隔离的基础上增加肺静脉外触发灶的消融,包括线性消融、BOX消融及碎裂电位消融等。二尖瓣峡部是线性消融最重要的组成部分,但传统射频消融很难将二尖瓣峡部进行彻底阻滞。经下腔静脉送入指引导管至冠状静脉窦,Marshall静脉注入无水乙醇消融可实现二尖瓣峡部心外膜和心肌阻滞,再联合二尖瓣峡部心内膜补点消融能显著提升消融效果,但存在Marshall静脉、冠状静脉损伤、手术费用高昂、耗时长等弊端。本文报道1例经自制穿孔球囊行Marshall静脉无水乙醇联合个体化消融策略治疗的持续性房颤患者,出院后随访6个月,无主要不良心血管事件的发生及房颤的复发。

自拟全虫散对腰椎间盘突出症患者下肢疼痛麻木症状的影响

目的探讨自拟全虫散对腰椎间盘突出症患者下肢疼痛麻木症状的影响。方法选取2022年4月至9月上海市嘉定区中医医院收治的80例腰椎间盘突出症伴下肢疼痛麻木患者作为研究对象,按照随机数字表法分为观察组(40例)和对照组(40例),观察组脱落2例,对照组脱落3例,最终纳入观察组38例,对照组37例。观察组采用自拟全虫散联合甲钴胺口服治疗,对照组采用甲钴胺口服治疗,两组患者均治疗30 d。比较两组患者治疗前及治疗后30、60 d的视觉疼痛模拟评分法(VAS)及麻木评分,并观察两组患者的不良反应发生情况。结果两组患者治疗后30、60 d的VAS评分均低于本组治疗前,麻木评分均优于本组治疗前,差异有统计学意义(P<0.05);观察组治疗后30、60 d的VAS评分均低于对照组,麻木评分均优于对照组,差异有统计学意义(P<0.05)。两组患者均未发生严重不良反应。结论自拟全虫散对腰椎间盘突出症患者下肢疼痛麻木症状的临床效果较好,具有重要的临床价值和推广意义。