肩关节周围炎的多种病因病理学说

目的:探讨引发肩关节周围炎的多种病因及病理变化学说。资料来源:应用计算机检索中国期刊全文数据库1994/2004的相关文章,限定文章语言为中文。检索词“肩周炎、肩关节周围炎、发病机制、病因、病理。资料选择:对资料进行初审,选取实验性研究,然后筛除低水平重复性文章和综述,对剩余文献进行全文阅读。纳入标准:①实验性研究。②临床治疗方法的研究。资料提炼:共收集了59篇文章,19篇符合纳入标准,其余40篇文章均为重复内容。资料综合:在19篇文章中,综合筛选出引发肩关节周围炎的7种病因(年龄因素、风寒湿侵袭、解剖学因素、肩部活动减少、肩部急慢性损伤、神经损伤因素和其他因素)和7种病理变化(慢性炎症学说、微循环障碍学说、退变性因素、纤维增生因素、肩周肌群痉挛、蛋白多糖成分改变和自由基代谢失调)。结论:肩关节周围炎临床症状明确,但所致疾病的病因病理复杂。

痛泻要方对醋酸-球囊扩张大鼠实验性肠易激综合征作用的研究

目的:探讨痛泻要方对醋酸-球囊扩张大鼠实验性肠易激综合征作用及机制。方法:将70只SD乳大鼠随机分成正常组、模型对照组、得舒特组、痛泻要方低浓度组、痛泻要方中浓度组、痛泻要方高浓度组。观察大鼠的粪便性状及含水量、体重的增长率、血浆SP及VIP含量的变化。结果:模型对照组大鼠与正常组比较,体重增长率无显著差异(P>0.05),粪便含水量显著增高(P<0.01),血浆SP增高(P<0.05),VIP无显著差异(P>0.05)。痛泻要方中、高剂量组可降低醋酸-球囊扩张大鼠实验性肠易激综合征粪便的含水量,痛泻要方中、高剂量组能降低血浆SP的含量。结论:痛泻要方疗对醋酸-球囊扩张大鼠实验性肠易激综合征具有治疗作用,其作用机制可能与通过调节血浆SP水平有关。

癌痛平对福尔马林致痛模型大鼠脊髓背角c-fos表达及P物质含量的影响

【目的】观察癌痛平对福尔马林致痛模型大鼠脊髓背角c-fos基因表达及P物质（SP）含量的影响。【方法】选用SD大鼠50只,随机分成5组：空白对照组,模型组,曲马多组（剂量为0.06 g/kg）,癌痛平高、低剂量组（剂量分别为36、18 g/kg）;采用福尔马林右侧后爪掌心皮下注射法复制致痛模型,取脊髓L3～L5节段,采用免疫组化法观测各组大鼠脊髓背角浅层fos蛋白表达及SP含量。【结果】模型组大鼠脊髓背角浅层中fos免疫反应阳性神经元数目及SP免疫阳性反应物的D值均显著增加（P〈0.01）;癌痛平高剂量组可显著降低fos免疫反应阳性神经数目及SP免疫阳性反应物的D值（P〈0.01）。【结论】癌痛平可能通过减少脊髓背角神经元对传入的伤害性刺激的反应发挥镇痛作用。

镇心痛口服液对冠心病血栓相关分子标志物水平的影响

目的研究镇心痛口服液对冠心病血瘀证血栓相关分子标志物水平的影响,佐证其活血化瘀的药理作用。方法采用连续8d腹腔注射地塞米松注射液(0.25mg/kg)制备血瘀模型,第9天腹主动脉取血,测定活化部分凝血活酶时间(APTT)、抗凝血酶Ⅲ(AT-Ⅲ)、组织型纤溶酶原激活物(t-PA)、组织型纤溶酶原激活物抑制物(PAI)的水平。结果AT-Ⅲ两个治疗组与丹参滴丸组均明显高于模型对照组(P<0.05)。高剂量组APTT明显高于模型对照组(P<0.01),亦高于丹参滴丸组(P<0.05);低剂量组、丹参滴丸组APTT均高于模型对照组(P<0.05);高剂量组t-PA明显高于丹参滴丸组(P<0.01);高剂量组PAI明显低于丹参滴丸组(P<0.01),两个治疗组与丹参滴丸组PAI均明显低于模型对照组(P<0.01)。结论镇心痛口服液可改善血栓相关分子标志物水平,可使APTT时间延长,AT-Ⅲ、t-PA升高,PAI降低,纠正血液的高凝状态,恢复抗凝系统活性,预防血栓形成。

nestin在胃肠道间质瘤病理诊断中的价值

目的探讨nestin在胃肠道间质瘤(gastrointestinal stromal tumors,GISTs)辅助诊断中的价值。方法用免疫组化EnVi-sion法检测96例CD117阳性、5例CD117阴性的GISTs,以及食管平滑肌瘤(10例)、消化道雪旺瘤(33例)、肠纤维瘤病(6例)以及腹腔平滑肌肉瘤(15例),观察这些肿瘤中nestin的表达状况。结果96例CD117阳性的GISTs中,94例表达nestin,其中70例弥漫强表达,21例中度阳性,3例局灶阳性,仅2例阴性;5例CD117阴性的GISTs中,4例表达nestin;33例消化道雪旺瘤中26例表达nestin;15例平滑肌肉瘤中3例局灶表达nestin;10例食管平滑肌瘤、6例肠纤维瘤病均为阴性。结论nestin是辅助诊断GISTs的新指标,可鉴别GISTs与平滑肌肿瘤和纤维瘤病,但在GISTs与雪旺瘤的鉴别中需结合S-100蛋白等指标。

非霍奇金淋巴瘤组织p53和p21ras的表达及其临床意义

目的 :研究非霍奇金淋巴瘤(non Hodgkin’slymphoma ,NHL )中 p5 3和p2 1ras蛋白的表达情况及相关性。 方法 :应用免疫组化法检测 5 8例NHL的 p5 3和p2 1ras蛋白表达情况 ,并作相关性分析。结果 :5 8例NHL中 ,阳性表达率 p5 3蛋白为 62 1%( 3 6/5 8) ,p2 1ras蛋白为 5 6 9% ( 3 3 /5 8)。p5 3蛋白在低度及高度恶性组表达率为 2 9 2 %( 7/2 4)和 85 3 % ( 2 9/3 4) ,P <0 0 5。p2 1ras蛋白在低度及高度恶性组表达率 2 0 8%( 5 /2 4)和 82 4% ( 2 8/3 4) ,P <0 0 1。结论 :在NHL发展中 ,p5 3和p2

冷饭团在实验性肝纤维化中抗氧化作用的实验研究

目的 :探讨冷饭团抗肝纤维化的作用机理。方法 :采用CCl4和高脂低蛋白等复合因素诱导大鼠实验性肝纤维化 ,以联苯双酯为对照 ,观察冷饭团对大鼠肝功能、肝组织羟脯氨酸 (Hyp) ,组织病理学改变与血清及肝组织中SOD、肝组织中MDA含量的影响。结果 :冷饭团能升高实验大鼠血及肝组织中SOD含量 ,降低实验大鼠肝组织中MDA含量 ,并与剂量有关。结论 :冷饭团降酶 。

青少年局部型颈椎病的发病机制与诊治体会

目的:探讨青少年局部型颈椎病的发病机制和诊治体会。方法:回顾分析56例青少年局部型颈椎病的临床症状、X线表现及诸多的自身因素,结合颈椎的生物力学、运动力学进行手法治疗。结果:56例均有不同程度的颈部不适或疼痛,单肩及双肩疼痛31例,枕后部疼痛24例,另外伴有眩晕16例,头胀痛14例,心悸10例,背部疼痛9例。颈部局限压痛35例,头颅后伸受限48例,前屈受限23例;生理曲度变直伴椎体旋转38例,反张成角13例,失稳12例,局部变直3例。手法治疗痊愈48例,占86%;显效5例,占9%;有效2例,占3%;无效1例,占2%;总有效率98%。结论:青少年局部型颈椎病的促发因素多种多样,发病机制异常复杂,其共同的规律为颈椎内外平衡失调,手法治疗,以松解复位为主。

血流动力学改变对动脉导管未闭早产儿脑白质损伤发生的影响

目的：探讨血流动力学改变对动脉导管未闭（PDA）早产儿脑白质损伤发生的影响。方法：具有血流动力学改变的PDA早产儿35例（hsPDA组）、没有血流动力学改变的PDA早产儿35例（非hsPDA组）、非PDA早产儿36例（对照组）分别于出生后3d、7d、14d检测血清神经特异性烯醇化酶（NSE）的水平，同时进行颅脑超声显像检查，作超声心动图显像PDA血流速度与颅脑超声显像侧脑室灰度值相关性分析。结果：出生后3d、7d、14d颅脑超声显像侧脑室灰度值hsPDA组均高于对照组（均P〈0．01），非hsPDA组与对照组差异均无统计学意义（均P〉0．05）；出生后3d、7d、14d血清NSE水平hsPDA组均高于对照组（均P〈0．01），非hsPDA组与对照组差异均无统计学意义（均P〉0．05）。早产儿PDA血流速度大小与超声显像侧脑室灰度值呈正相关（r=0．876，P〈0．01）。结论：hsPDA早产儿容易发生脑白质损伤，需要及时干预。

Experimental human pain models in gastro-esophageal reflux disease and unexplained chest pain

Methods related to experimental human pain research aim at activating different nociceptors, evoke pain from different organs and activate specific pathways and mechanisms. The different possibilities for using mechanical, electrical, thermal and chemical methods in visceral pain research are discussed with emphasis of combinations (e.g., the multimodal approach). The methods have been used widely in assessment of pain mechanisms in the esophagus and have contributed to our understanding of the symptoms reported in these patients. Hence abnormal activation and plastic changes of central pain pathways seem to play a major role in the symptoms in some patients with gastro-esophageal reflux disease and in patients with functional chest pain of esophageal origin. These findings may lead to an alternative approach for treatment in patients that does not respond to conventional medical or surgical therapy.

Deterioration of concrete in railway tunnel suffering from sulfate attack

For the sake of understanding the deterioration behavior of concrete in actual railway tunnel structures subjected to aggressive sulfate medium in practice,detailed field investigations and tested analysis on sprayed concrete linings of approximately 40-year-old railway tunnels in environments containing sulfate ion were carried out,respectively.The results show that the deterioration of concretes in the investigated area is serious,which involves complicated physicochemical process between the sulfate salt and concrete.Among them,the secondary sulfateminerals such as gypsum formation under very high concentration sulfate ion condition by accumulating and evaporation process dominate,followed by the crystallization of sulfate salt and formation of thaumasite.

Sensory testing of the human gastrointestinal tract

The objective of this appraisal is to shed light on the various approaches to screen sensory information in the human gut. Understanding and characterization of sensory symptoms in gastrointestinal disorders is poor. Experimental methods allowing the investigator to control stimulus intensity and modality, as well as using validated methods for assessing sensory response have contributed to the understanding of pain mechanisms. Mechanical stimulation based on impedance planimetry allows direct recordings of luminal cross-sectional areas, and combined with ultrasound and magnetic resonance imaging, the contribution of different gut layers can be estimated. Electrical stimulation depolarizes free nerve endings non-selectively. Consequently, the stimulation paradigm （single, train, tetanic） influences the involved sensory nerves. Visual controlled electrical stimulation combines the probes with an endoscopic approach, which allows the investigator to inspect and obtain small biopsies from the stimulation site. Thermal stimulation （cold or warm） activates selectively mucosal receptors, and chemical substances such as acid and capsaicin （either alone or in combination） are used to evoke pain and sensitization. The possibility of multimodal （e.g. mechanical, electrical, thermal and chemical） stimulation in different gut segments has developed visceral pain research. The major advantage is involvement of distinctive receptors, various sensory nerves and different pain pathways mimicking clinical pain that favors investigation of central pain mechanisms involved in allodynia, hyperalgesia and referred pain. As impairment of descending control mechanisms partly underlies the pathogenesis in chronic pain, a cold pressor test that indirectly stimulates such control mechanisms can be added. Hence, the methods undoubtedly represent a major step forward in the future characterization and treatment of patients with various diseases of the gut, which provides knowledge to dinicians about the underlying symptoms and treatment of these patients.

Network pharmacology-based approach to investigate the mechanisms of Yiyi Fuzi Baijiang Powder in the treatment of malignant tumors

Objective:To systematically investigate the main active components,targets,target-related diseases and action mechanism of Yiyi Fuzi Baijiang powder(YFBP)of Zhang Zhongjing,a Chinese physician of Eastern Han Dynasty of China(3 century A.D.)using the method of network pharmacology.Methods:The active components of YFBP were identified from several databases(TCMSP,TCM Database@Taiwan and TCMID).The potential active compounds were screened based on oral bioavailability and drug-like index in the TCMSP database.DrugBank,TCMSP,and TCMID database searches were performed to predict target-related diseases.Biological functions and KEGG pathway outcomes of all potential targets were analyzed using the DAVID database.Results:A total of 24 active compounds of YFBP,133 related targets,and 305 potential related diseases were obtained.These results showed that YFBP may treat inflammation,pain,and cancer.The functional enrichment analysis indicated that YFBP probably exerts its therapeutic effects by regulating neuroactive ligand-receptor interactions,the TNF signaling pathway,and the PI3K-Akt signaling pathway.Conclusion:This study provides preliminary confirmation that YFBP has the great potentials to treat inflammation,pain,and tumors,which supports Zhang Zhongjing’s original intention to treat intestinal carbuncle with ancient prescription YFBP,but also provides a scientific basis for its treatment in the malignant tumors.

Curcumin prevents indomethacin-induced gastropathy in rats

AIM： To investigate the effects of curcumin on gastric microcirculation and inflammation in rats with indo- methacin-induced gastric damage. METHODS： Male Sprague-Dawley rats were randomly divided into three groups. Group 1 （control group, n = 5） was fed with olive oil and 5% NaHCOf （vehicle）. Group 2 [indomethacin （IMN） group, n = 5] was fed with olive oil 30 min prior to indomethacin 150 mg/kg body weight （BW） dissolved in 5% NaHCO3- at time 0th and 4th h. Group 3 （INN ± Cur group, n = 4） was fed with curcumin 200 mg/kg BW dissolved in olive oil 0.5 mL, 30 min prior to indomethacin at 0th and 4th h. Leukocyte-endothelium interactions at postcapillary venules were recorded after acridine orange injection. Blood samples were determined for intercellular ad- hesion molecule （ICAM）-1 and tumor necrosis factor （TNF）-a levels using enzyme linked immunosorbent assay method. Finally, the stomach was removed for histopathological examination for gastric lesions and grading for neutrophil infiltration. RESULTS： In group 2, the leukocyte adherence in postcapillary venules was significantly increased com- pared to the control group （6.40±2.30 cells/frame vs 1.20 ± 0.83 cells/frame, P = 0.001）. Pretreatment with curcumin caused leukocyte adherence to postcapil- lary venule to decline （3.00±0.81 cells/frame vs 6.40 ± 2.30 cells/frame, P = 0.027）. The levels of ICAM-1 and TNF-aincreased significantly in the indomethacin- treated group compared with the control group （1106.50 ± 504.22 pg/mL vs 336.93 a= 224.82 pg/mL, P = 0.011 and 230.92±114.47 pg/mL vs 47.13±65.59 pg/mL, P = 0.009 respectively）. Pretreatment with curcumin sig- nificantly decreased the elevation of ICAM-1 and TNF-a levels compared to treatment with indomethacin alone （413.66 ± 147.74 pg/mL vs 1106.50 ± 504.22 pg/mL, P = 0.019 and 58.27 ± 67.74 pg/mL vs 230.92 ± 114.47 pg/mL, P = 0.013 respectively）. The histological appear- ance of the stomach in the control group was normal. In the indomethacin-treated group, the stomachs showed a mild to moderate neutrophil infiltration score. Gastric lesions were erosive and ulcerative. In rats treated with indomethacin and curcumin, stomach histopathology improved and showed only a mild neutrophil infiltration score and fewer erosive lesions in the gastric mucosa. CONCLUSION： The results indicate that curcumin pre- vents indomethacin-induced gastropathy through the improvement of gastric microcirculation by attenuating the level of ICAM-1 and TNF-a,

The Chinese version of the revised Diabetes Distress Scale for adults with type 2 diabetes:Translation and validation study

Objectives:This study aimed to translate the revised 17-item Diabetes Distress Scale(DDS17,2017)into mandarin(simplified)Chinese and validate the Chinese version of DDS17(C-DDS17,2021)among adult patients with type 2 diabetes in China.Methods:A scale translation and cross-sectional validation study was conducted.The DDS17 was translated into mandarin(simplified)Chinese through a five-step process:authorization,forward translation,synthesis,back translation,and amendment.During this session,59 patients assessed the understandability and readability of the translated scale.From June 7 to September 4,2021,a cross-sectional study that adhered to the COSMIN checklist was conducted with 400 individuals with type 2 diabetes from three Class A tertiary comprehensive hospitals in Beijing,China.The content,construct,convergent,discriminant validity,and reliability(Cronbach’s a coefficient and item-total correlation coefficients)of the C-DDS17 were evaluated.This study was a part of a project registered in the Chinese Clinical Trial Registry(no.ChiCTR2100047071).Results:Among the participants,33.3%(133/400)of them experienced moderate to high diabetes distress.The content validity indices of the C-DDS17 equaled 1.00.The scale yielded a four-factor structure.The average variances extracted were 0.42e0.57,which was lower than squared correla-tions.Cronbach’s a coefficient was 0.88 for the overall scale and ranged from 0.76 to 0.81 for sub-scales.Corrected item-total correlation coefficients ranged from 0.42 to 0.61.The eighth item(“Feeling that I am often failing with my diabetes routine”)was better fit to physician distress than regimen distress but had little influence on the validation results.Conclusions:The C-DDS17 is a reliable and valid instrument for assessing diabetes distress in patients with type 2 diabetes.It is a promising instrument for early identification and management of diabetes distress in clinical practice and trials.

A survey of advanced medical students’ knowledge towards cancer pain management

Objective: The aim of the study was to investigate advanced medical students' knowledge towards cancer pain management, and understand the effect of specialisms and duration of oncology rotation on the advanced medical students' cognitive level towards cancer pain management. Methods: Randomly selected the respondents from a medical school in Wuhan, China. The educational background of the respondents should belong to one of these conditions: (1) clinical master degree candidate; (2) clinical doctor degree candidate; (3) the sixth or seventh year of clinical medicine for seven years. The respondents should also spend more than one year on internship. The self-developed questionnaire papers were distributed to respondents in the unit of dorms selected randomly and recovered them immediately after they're finished. The categori- cal data were expressed at the form of frequency (rate or constituent ratio). Chi-square test was required only as needed. Results: The survey was anonymous. We distributed 300 papers, recovered 300 papers and weeded out 8 invalid papers. Finally there were 292 valid papers, and the valid recovery rate was 97.3%. The 96.7% of oncological medical students and 47.6% non-oncological medical students relied on patients' description for cancer pain assessments; 90.0% of oncological medical students and 53.0% of non-oncological medical students prescribed strong opioid drugs firstly for patients suffering severe cancer pain; only 24.1% of non-oncological medical students recognized that pethidine was not safe and effective to treat cancer pain, which was much lower than oncological medical students (90.0%); 73.3% of oncological medical students and 28.9% of non-oncological medical students had the correct impression of drug addiction; 85.5% of non-oncological medi- cal students worried about the drug addiction, while 60.0% of oncological medical students worried about the strict control over opioid. In respect of the details of cancer pain management, only 66.7% of oncological medical students recognized that there was no upper limit of opioid prescribed clinically, and 16.3% of oncological medical students recognized that there was no psychological dependence if patients took opioid orally. The 69.8% of the students from no-less-than-two-week group relied on patients' description for cancer pain assessments, 76.7% prescribed strong opioid drugs firstly for patients suffer- ing severe cancer pain, 69.8% recognized that pethidine was not safe and effective to treat cancer pain, and 55.8% had the correct impression of drug addiction. All of the data were higher than that in no-rotation group and that in less-than-two-week group. The 51.2% of the students from no-less-than-two-week worried about drug addiction, which was the lowest of all. Conclusion: The cognitive level of advanced medical students towards cancer pain management is so low that it could not satisfy the clinical requirement, especially for the non-oncological medical students and the students spending little time on oncology rotation. Though the oncological medical students know something about cancer pain treatment, they know little about the details.

Mechanism of volatile oil from Chuanxiong(Chuanxiong Rhizoma)-Suhexiang(Styrax)-Bingpian(Borneolum)in treating angina pectoris based on network pharmacology and its protective effects on myocardial damage in rats

Objective To explore the pharmacodynamic material basis and mechanism of action of volatile oil from Chuanxiong(Chuanxiong Rhizoma)-Suhexiang(Styrax)-Bingpian(Borneolum)(hereinafter referred to as C-S-B volatile oil)in treating angina pectoris based on network pharmacology and to detect its protective effects against rat myocardial damage.Methods Gas chromatography-mass spectrometry(GC-MS)was used to determine the constituents of volatile oils from Chuanxiong(Chuanxiong Rhizoma),Suhexiang(Styrax),and Bingpian(Borneolum),and the targets of the three main constituents were found predicted and screened using the PharmMapper server,and Gene Cards and Coo LGe N databases.The STRING database and Cytoscape software were used to draw the protein-protein interaction(PPI)network,RStudio software was used to analyze Gene Ontology(GO)and Kyoto Encyclopedia of Genome and Genome(KEGG)pathways,and Cytoscape software was used to construct the component-target-pathwaydisease network.The rat model of myocardial injury was established by intraperitoneal injection of a large dose of isoprenaline hydrochloride.After continuous intervention with C-S-B volatile oil for 14 d,the ejection fraction(EF)and short axis shortening rate(FS)of the left ventricle were detected.The indices of myocardial damage were detected after hematoxylin-eosin(HE)staining.Results Fifteen volatile oil components from the C-S-B formula were identified.There are 470 targets of these volatile oil components and 401 angina-related genes.There are 28 core targets,including CHRM4,ADRA1 A,FGFR1,CHRM2,CYP2 A6,CHRM5,CHRM1,CHRM3,HDAC2,and MPO,etc..The results of the KEGG analysis indicated that the C-S-B formula probably interferes with the following pathways:neuroactive ligand-receptor interactions,calcium signaling,cytochrome P450 metabolism of heteropoietin,among others.The results of animal experiments showed that the C-S-B formula essential oil could significantly improve the following myocardial indices in rats with myocardial injury:EF,FS,left ventricular end-systolic diameter(LVIDs),left ventricular end-diastolic diameter(LVIDd),and stroke volume(SV),and all the differences were statistically significant(P<0.01).Conclusion The mechanism of action of volatile oil components in the C-S-B formula in treating angina pectoris was analyzed using multi-component,multi-target and multi-pathway systems,which has laid a foundation for further revealing its mechanism of action.Animal experiments have shown that the volatile oil of the C-S-B formula can improve EF,FS,and other indices of myocardial damage in a rat model,thus relieving myocardial damage caused by heart hyperactivity,improving cardiac function,and protecting against myocardial damage.

社会心理因素对退变性下腰痛手术治疗效果的影响调查

目的:探讨社会心理因素对退变性下腰痛患者手术治疗效果的影响。方法:手术治疗退变性下腰痛患者86例,术前及术后3个月行VAS评分,JOA下腰痛评分,汉密尔顿抑郁量表,焦虑量表评分及社会因素调查表问卷。结果:退变性下腰痛手术治疗效果抑郁组与非抑郁组,焦虑组与非焦虑组有统计学差异(均P<0.01)。结论:以抑郁和焦虑为主的心理因素对退变性下腰痛手术治疗效果有明显影响。