由风琴修理的故事看内关风皮的故障及对策

在风琴修理中,由于对它的原理、结构不太了解,造成对隐蔽部位的内关风皮故障诊断不准,致使修理人员既费工时又感尴尬.怎样才能诊断故障发生的准确位置?又怎样用最简便有效的方法排除故障?这不是一个轻而易举就能作好的事情.现用三个修琴者的不同修理方法和结果证明这个问题.

《凡物流形》“(風皮)飁”解

本文结合古书文献所述及简文的逻辑关系,推测上博简《凡物流形》中的"(風皮)飁"应为"纳敛气体"之意,并据其声韵读为"闭歙"。

308 nm准分子激光联合中药治疗白癜风疗效评价

白癜风是一种后天进行性色素脱失性皮肤病,为皮肤科常见疾病之一,在我国人群中的发病率为0.09%~0.50%,本病为皮肤黏膜局限性和泛发性色素脱失,严重影响病人工作、生活和身心健康。白癜风病因机制复杂,容易诊断,但是却难于治疗。

MOTOR CORTEX NETWORKS IN STROKE PATIENTS DURING RECOVERY WITH fMRI

To investigate changes of functional activation areas of the cerebral cortex and the connectivity of motor cortex networks （MCNs） in stroke patients during the recovery, five patients with the infarct in their left hemispheres are recruited. Functional magnetic resonance imaging （fMRI） is performed in the second, fourth, eighth, and sixteenth weeks after the stroke. Images are analyzed using the professional software SPM5 to obtain the bilateral activation of the motor cortex in left and right handgrip tests. MCN data are extracted from the active areas, and the structural and functional characteristic parameters are computed to indicate the connectivity of the network. Results show that the ipsilesional hemisphere recruits more areas with less active extent during the handgrip test, compared with the contralesional hemisphere. MCN shows a higher overall degree of statistical independence and more statistical dependence among motor areas with the gradual recovery. It can help physicians understand the recovery mechanism.

Leprosy without typical skin involvement but with concurrent tuberculosis: a case report

Leprosy is characterized by skin lesions and peripheral nerve damage. It may take a long time before the diagnosis can be confirmed if the patients have no typical skin involvements. Here we report an unusual case. A 40-year-old male with lepromatous leprosy showed a gradual onset of bilateral symmetrical neuropathies without characteristic skin manifestations seven years after onset and with pulmonary tuberculosis simultaneously. He was misdiagnosed as having Guillani-Barr6 syndrome and systemic necrotizing vasculitis for 10 years until the skin biopsy was performed. This case indicates that the risk of leprosy exists, though new cases being detected have significantly declined over the last 50 years; neurologists need to pay more attention to leprosy with various manifestations .

Cardiac toxicity of trastuzumab in elderly patients with breast cancer

Breast cancer （BC） is diagnosed in 〉 65 year old women in about half of cases. Experts currently recommend that systemic therapy is offered to elderly patients with BC, if, based on their overall conditions and life expectancy, it can be reasonably anticipated that the benefits will outweigh the risks of treatment. Like for young subjects, the monoclonal antibody against human epidermal growth factor receptor-2 （HER-2）, trastuzumab, represents a valid therapeutic option when BC over-expresses this receptor. Unforttmately, administration of trastu- zumab is associated with the occurrence of left ventricular dysfunction and chronic heart failure （CHF）, possibly because of interference with the homeostatic functions of HER-2 in the heart. Registry-based, retrospective analyses have reported an incidence of CHF around 25% in elderly women receiving trastuzumab compared with 10%-15% in those not given any therapy for BC, and the risk of CHF has been estimated to be two-fold higher in 〉 60455 year old trastuzumab users vs. non-users. Extremely advanced age and preexisting cardiac disease have been shown to predispose to trastuzumab cardiotoxicity. Therefore, selection of older patients for treatment with trastuzumab should be primarily based on their general status and the presence of comorbidities; previous chemotherapy, especially with anthracyclines, should be also taken into account. Once therapy has started, efforts should be made to ensure regular cardiac surveillance. The role of selected biomarkers, such as cardiac troponin, or new imaging techniques （three-dimension, tissue Doppler echocardiography, magnetic resonance imaging） is promising, but must be further investigated especially in the elderly. Moreover, additional studies are needed in order to better understand the mechanisms by which trastuzumab affects the old heart.

Study of neuropeptide Y in the plasma and skin tissue of patients with vitiligo

Objective: To study the role of neuropeptide Y (NPY) in the pathogenesis of vitiligo. Methods: The levels of NPY in the plasma from patients with vitiligo and healthy volunteers were measured by 125I RIA Kit. The expression of NPY in normal skin tissues, uninvolved tissues and lesional tissues of vitiligo was detected by immunohistochemistry. Results: The levels of NPY in the patients with vitiligo of all types were significantly higher than that in the normal controls. In all types, the levels in active stage were significantly higher than those in stable stage. The expression of NPY was upregulated in lesions of patients with active vitiligo (P<0.01) compared with those in normal skin tissues and uninvolved tissues. There was significant difference of NPY expression between active stage and stable stage (P<0.01). Conclusion: These findings support the concept of neuropeptide involvement in vitiligo, especially in active vitiligo, and suggest that NPY may play a role in the pathogenesis of this disease.

Simulation and analysis of airflow stability during fire in mine belt roadway

According to fluid dynamics analysis during the fire, the criteria k-ε two-equation model for solving three-dimensional turbulence was determined, the pollutants generated in the fire disaster were set by adopting Mixture multiphase flow, and the SIMPLE algorithm was used for solving on the basis of comprehensive consideration on the heat radia- tion and components transmission during fire. By simulating the airflow flowing state inside the tunnel during fire disaster of downward ventilation, drift ventilation, and ascensional ventilation, respectively, with regard to the actual situation of No.l, No.3, and No.5 belt roadway in Kongzhuang Coal Mine, the velocity vector distributions of pollutants under different inlet air volumes were obtained, and the damage degree and influential factors of disaster were also clear, which is helpful to control and avoid disaster during belt roadway fire.

OBSERVATION ON THE THERAPEUTIC EFFECT OF ENCLOSING NEEDLING UNDER CT ORIENTATION FOR TREATMENT OF ISCHEMIC CEREBRAL STROKE AND ITS INFLUENCE ON PLASMA NO

In the present paper, 61 cases of ischemic cerebral apoplexy were randomly divided into enclosing needling group (n=31) and scalpacupuncture group (n=30). After 30 sessions of treatment, there was a significant difference between the two groups in the therapeutic effect (P<0.05), indicating enclosing needling being superior to scalpacupuncture. Both enclosing needling and scalpacupuncture could lower plasma NO content while the former was more apparent in lowering plasma NO level.

Clinical observation of body acupuncture combined with FANG’s scalp acupuncture for limb dysfunction in the remission stage of stroke

Objective:To observe the clinical efficacy of body acupuncture combined with FANG’s scalp acupuncture in treating limb dysfunction in the remission stage of stroke and explore the mechanism.Methods:Sixty patients in the remission stage of stroke with limb dysfunction were divided into a control group and a treatment group using the random number table method,with 30 cases in each group.The control group was treated with ordinary acupuncture based on the conventional rehabilitation treatment,and the treatment group was additionally offered FANG’s scalp acupuncture.The interventions were conducted once daily with 10 sessions as 1 course.The Fugl-Meyer assessment(FMA)and Barthel index(BI)scores and serum malondialdehyde(MDA)and superoxide dismutase(SOD)levels were compared after 2 treatment courses,and the clinical efficacy was evaluated.Results:After treatment,the FMA and BI scores increased in both groups(P<0.05)and were higher in the treatment group than in the control group(P<0.05).Both groups showed a decreased MDA level and an increased SOD level after the intervention,all showing statistical significance(P<0.05);there were significant differences between the two groups(P<0.05).Conclusion:Based on the conventional rehabilitation treatment,ordinary acupuncture used alone or in combination with FANG’s scalp acupuncture can lower the oxidative stress level and improve limb function in treating limb dysfunction in the remission stage of stroke;body acupuncture plus FANG’s scalp acupuncture can produce better results.

Clinical observation on row needling at the Governor Vessel on the head for poststroke insomnia

Objective:To observe the clinical efficacy of row needling at the Governor Vessel on the head for poststroke insomnia,analyze the changes of sleep structure,serum amino acid neurotransmitters,vascular endothelial cell function and cognitive function,in order to explore the mechanism of this therapy.Methods:A total of 41 patients with poststroke insomnia were included in an observation group and treated with row needing at the Governor Vessel on the head;33 patients with poststroke insomnia were included in a control group and given routine acupuncture treatment.The patients in both groups were treated consecutively for one month.The efficacy was observed and the changes of related indicators were compared.Results:After treatment,the efficacy of the observation group was better than that of the control group(P<0.05).The sleep latency in the observation group was shorter than that in the control group(P<0.05);the total sleep duration,deep sleep duration,light sleep duration and rapid eye movement sleep duration in the observation group were significantly longer than those in the control group(P<0.05);the total waking duration and the waking times over 5 min were significantly less than those in the control group(P<0.05).The serum glutamic acid,γ-aminobutyric acid,calcitonin gene-related peptide,brain-derived neurotrophic factor,nerve growth factor and nitric oxide levels were significantly higher than those in the control group(P<0.01).The tumor necrosis factor-α,interleukin-6,bradykinin,and endothelin-1 levels were lower than those in the control group(P<0.01).The Pittsburgh sleep quality index score in the observation group was lower than that in the control group(P<0.01),and the mini-mental state examination score was higher than that in the control group(P<0.05).Conclusion:Row needling at the Governor Vessel on the head can effectively improve the sleep structure,cognitive function,and sleep quality of patients with poststroke insomnia.The possible mechanisms are regulating serum amino acid neurotransmitters and improving the function of vascular endothelial cells.

Clinical Study on Acupuncture and Ischemic Stroke

Objective： To study the clinical efficacy of acupuncture for ischemic stroke and its effect on ET-1 levels in IS cases. Method： The 63 cases were randomized into a treatment group （31 cases）, receiving acupuncture and routine method, and control group （32 cases）, receiving routine method alone. Seven days constitute a course of treatment, a 2-day interval between two courses. The clinical efficacy and ET-1 level in two groups were compared after four weeks. Result： The total effective rate in the treatment group and control group were 96.8% and 75% respectively, with a statistical significance （P〈0.05）; the ET-1 level in blood plasma also with a statistical significance after the treatment （P〈0.05）; the pre-treatment and post-treatment ET-1 level in the treatment group showed a statistical significance （P〈0.01）, whereas the control group didn＇t. Conclusion： Acupuncture is effective for ischemic stroke and can lower the ET-1 level in ischemic stroke cases.

Clinical observation of scalp acupuncture plus speech rehabilitation for Broca's aphasia after cerebral stroke

Objective：To explore the clinical efficacy of scalp acupuncture plus speech rehabilitation in treating Broca＆#39;s aphasia after cerebral stroke, for providing novel evidences for the treatment. Methods：Ninety-one eligible patients with Broca＆#39;s aphasia after cerebral stroke were randomized into an observation group and a control group. Forty-six cases in the observation group were intervened by scalp acupuncture plus speech rehabilitation, while 45 cases in the control group were treated by speech rehabilitation alone. The aphasia battery of Chinese （ABC） and Boston diagnostic aphasia examination （BDAE） were adopted to evaluate the clinical efficacy. Results：After the treatment, the scores of oral expression, reading and writing and global score in the observation group were significantly higher than those in the control group （allP〈0.05）. There was a significant difference in comparing the BDAE grading between the two groups after the treatment （P〈0.05）. After intervention, the basically-recovered plus markedly-effective rate was 45.7% in the observation group versus 24.4% in the control group, and the between-group difference was statistically significant （P〈0.05）. Conclusion：Scalp acupuncture plus speech rehabilitation is effective in treating Broca＆#39;s aphasia after cerebral stroke, and worth promoting.

Effects of acupuncture plus language training on language function and cerebral blood flow in patients with motor aphasia after ischemic stroke

Objective:To observe the effects of acupuncture at the Governor Vessel acupoints plus language training on the language function and cerebral blood flow in patients with motor aphasia after ischemic stroke.Methods:Eighty-six patients were randomized into a control group and an observation group,with 43 cases in each group.Conventional symptomatic treatment was offered to both groups.Besides,the control group received language training,while the observation group received language training plus additional acupuncture at the Governor Vessel acupoints.Before and after treatment,the aphasia battery of Chinese(ABC)and Chinese functional communication profile(CFCP)were tested,and the mean velocity(Vm)and resistance index(Rl)of the left middle cerebral artery(MCA)were detected.Results:The total effective rate was higher in the observation group than in the control group(P<0.05).After treatment,the observation group gained higher scores in oral expression,comprehension,repeating,naming objects,reading,and writing,as well as the general score of ABC(all P<0.Q5)f higher than those in the control group(all P<0.05).The CFCP score increased in both groups after intervention,showing significant intra-group differences(both P<0.05),and the CFCP score was higher in the observation group than in the control group(P<0.05).After treatment,Vm of the left side MCA in creased in the con trol group(P<0.05),while no significant change was observed in Rl(P>0.05);in the observation group,Vm of the left side MCA increased and Rl decreased signfiicantly compared with the baseline(both P<0.05),and were markedly different from those in the control group(both P<0.05).Conclusion:Acupuncture at the Governor Vessel acupoints plus language training can produce valid efficacy in treating motor aphasia after ischemic stroke;it can notably improve the language function,everyday oral communication ability,and in crease cere bral perfusion of the patients.

Effect of row needling in muscle regions combined with seven-star needle tapping on cognitive function and quality of life in patients with post-stroke upper limb spasticity

Objective：To observe the effect of row needling in muscle regions combined with seven-star needle tapping on cognitive function and quality of life （QOL） in patients with post-stroke upper limb spasticity. Methods： A total of 448 eligible cases were randomly allocated into a treatment group and a control group, 244 in each group. Based on standard conventional treatment, cases in the treatment group received row needling in muscle regions combined with seven-star needle tapping, whereas cases in the control group took oral Western medication. After 3 weeks of treatment, the cognitive functions were assessed using comprehensive functional assessment （CFA） and mini-mental state examination （MMSE）. The O,OL was evaluated using the Chinese-version 36-item short-form health survey （SF-36）. Results： After treatment, the CFA and MMSE scores were significantly improved in both groups （P〈0.05）; and there were between-group statistical differences （P〈0.05）, showing a better effect in the treatment group than that in the control group. In addition, there were between-group statistical significances in scores of QOL （P〈0.05, P〈0.01）. Conclusion： Row needling in muscle regions combined with seven-star needle tapping can significantly improve the cognitive function and O, OL of patients with post-stroke upper limb spasticity.