综述

经皮电刺激治疗胃食管反流病的研究进展

Advances in the treatment of gastroesophageal reflux disease by transcutaneous electrical stimulation

:1028-1034
 
        胃食管反流病是一种以烧心和反流为主要症状的胃食管动力障碍性疾病,现有的常规治疗存在药物依赖,手术风险高且易复发等局限性,而经皮电刺激作为一种新兴疗法,在治疗动力障碍性疾病时具有非侵入性、可逆性及调节生理功能的优势。因此本研究为了探讨经皮电刺激治疗胃食管反流病的进展,现从胃食管反流病的神经调控生理、不同经皮电刺激对治疗胃食管反流病的研究以及应用效果等方面进行综述,以期为胃食管反流病提供新的诊断思路和方法。
    In order to discuss the progress of transcutaneous electrical stimulation for the treatment of gastroesophageal reflux disease(GERD),the physiology of neuromodulation of GERD,the research on different transcutaneous electrical stimulation for the treatment of GERD,and the application effect were reviewed,with the aim of providing new diagnostic ideas and methods for GERD.
专家述评

糖尿病肾病的重要治疗进展:从基础研究到临床应用

Important advances in diabetic nephropathy treatment:From basic research to clinical application

:1006-1020
 
       糖尿病肾病(DN)是指由糖尿病所致的慢性肾脏疾病,是目前我国和全球范围内慢性肾脏疾病和终末期肾脏疾病的首位病因。DN发病率逐年攀升,且预后不良,已成为我国重大的公共卫生问题之一。DN不仅明显降低了患者的生活质量,还增加了心血管疾病的风险。随着对DN发病机制的深入研究,近十余年来在DN治疗手段方面取得了显著进展,包括新型药物的研发、生活方式的干预及各种新兴疗法的探索。本文旨在系统性综述近年来DN领域的重要治疗进展,阐明这些进展在临床应用中的有效性和适用性,并展望未来的研究方向,以期为临床实践提供参考和指导。
       Diabetic nephropathy(DN)is a form of chronic kidney disease(CKD)induced by diabetes.Diabetic nephropathy represents the leading cause of CKD and end-stage renal disease both in China and globally.The incidence of DN has been steadily increasing and its prognosis remains unfavorable.Diabetic nephropathy has become a major public health concern.Diabetic nephropathy not only significantly affects patients’ quality of life but also increases the risk of cardiovascular diseases.Recent advancements in our understanding of the pathogenesis of DN have facilitated significant progress in treatment options over the past decade.These developments include the introduction of novel pharmacological agents,the implementation of lifestyle modifications,and the exploration of various emerging therapeutic approaches.This  review aims to  systematically expound the significant therapeutic advancements in the field of DN in recent years,evaluate the efficacy and applicability of these advancements in clinical practice,and explore potential future research directions,thereby providing valuable insights andguidance for clinical practice.
论著

达格列净联合沙库巴曲缬沙坦治疗射血分数降低的心力衰竭患者的疗效

Efficacy of dapagliflozin combined with sacubitril/valsartan in the treatment of heart failure with reduced ejection fraction

:988-994
 
        目的   分析达格列净联合沙库巴曲缬沙坦治疗射血分数降低的心力衰竭(HFrEF)效果。方法  连续抽取2021年1月—2023年6月在广州市第一人民医院心内科住院的射血分数降低的心力衰竭(HFrEF)患者203例,随访至少6个月,按照接受的治疗进行分组。对照组予常规治疗和沙库巴曲缬沙坦治疗;观察组予常规治疗、沙库巴曲缬沙坦和达格列净治疗;对比两组疗效,观察指标包括住院时间,入院及出院后6个月的心功能状态(NYHA纽约心脏病协会心功能分级)、心脏超声指标左室射血分数(LVEF)、左室舒张末内径(LVEDD)、左室收缩末内径(LVSDD)、血液指标-端脑钠肽前体(NT-proBNP N)、糖化血红蛋白(HBA1c)、血肌酐(Cr)、6个月时的再住院率及全因死亡率。结果   观察组心脏监护病房(CCU)停留时间(2.54±1.26)d,短于对照组的(3.73±1.21)d;观察组6个月时观察组心功能NYHA改善≥2级比例为95.05%高于对照组的86.27%,差异有统计学意义(P<0.05);观察组6个月时的LVEDD、LVESD水平分别为(48.22±7.35)(34.61±4.32)mm,低于对照组的(51.47±8.02)(43.07±5.33)mm,LVEF为(51.49±5.40)%,高于对照组的(46.18±4.21)%,差异有统计学意义(P<0.05);6个月时观察组的NT-proBNP为(415.58±31.57)pg/mL,低于对照组的(520.23±385.56)pg/mL,差异有统计学意义(P<0.05);两组的住院时间、血清肌酐(Cr)、HBA1c、6个月时的再住院率、全因病死率对比,差异不显著(P>0.05)。观察组HBA1c值为(6.04±0.66)mmol/L,高于对照组的(5.20±0.56)mmol/L(P<0.05)。结论  HFrEF患者采取达格列净+沙库巴曲缬沙坦治疗,可通过协同作用,缩短CCU停留时间,改善患者6个月时的心功能状态,降低NT-proBNP值,减少心脏扩大趋势,提高LVEF水平。

       Objective  To analyze the efficacy of  dapagliflozin combined with  sacubitril/valsartan in the treatment of heart failure with reduced ejection fraction(HFrEF).Methods  A total of 203 patients with HFrEF who were hospitalized in the cardiology department of the hospital between January 2021 and June 2023 were enrolled and followed up for at least six months.Patients were divided into groups based on their treatment regimens:the control group received conventional treatment plus sacubitril/valsartan,while the observation group received conventional treatment plus sacubitril/valsartan and dapagliflozin.The two groups were compared for clinical outcomes,including length of hospital stay,cardiac function(NYHA classification)at admission and six months after discharge,echocardiographic indicators(LVEF,LVEDD,LVESD),blood indicators(NT-proBNP,HbA1c,creatinine),six-month rehospitalization rate,and all-cause mortality.Results  The observation group had a shorter CCU stay(2.54±1.26 days)compared to the control group(3.73±1.21 days).At sixth month,the proportion of patients in the observation group with an NYHA improvement ≥2 grades(95.05%)was significantly higher than that in the control group(86.27%)P<0.05).The observation group demonstrated lower LVEDD(48.22±7.35 mm)and LVESD(34.61±4.32 mm)levels and higher LVEF(51.49±5.40%)compared to the control group(LVEDD:[51.47±8.02] mm,LVESD:[43.07±5.33]mm,LVEF:[46.18±4.21]%)(P<0.05).NT-proBNP levels in the observation group([415.58±31.57] pg/mL)were significantly lower than those in the control group([520.23±385.56] pg/ml)(P<0.05).There were no significant differences between the two groups in length of total hospital stay,serum creatinine,HbA1c,six-month rehospitalization rate,or all-cause mortality(P>0.05).However,HbA1c levels in the observation group([6.04±0.66] mmol/L)were higher than those in the control group([5.20±0.56] mmol/L)(P<0.05).Conclusions  The combination of dapagliflozin and sacubitril/valsartan in the treatment of HFrEF patients can exert a synergistic effect,shorten CCU stay,improve cardiac function at sixth month,reduce NT-proBNP levels,mitigate cardiac dilation,and increase LVEF.

论著

LP-PRP 对比 LR-PRP 联合 ESWT 治疗慢性非止点跟腱腱病的对比研究

Comparative study of LP-PRP and LR-PRP combined with ESWT in the treatment of chronic non insertional Achilles tendinopathy

:963-967
 
       目的   对比乏白细胞富血小板血浆(LP-PRP)与富白细胞富血小板血浆(LR-PRP)联合体外冲击波疗法(ESWT)治疗慢性非止点跟腱腱病(NIAT)的临床价值。方法   选取2021年12月—2023年12月赣州市人民医院收治的80例慢性NIAT患者,以随机数表法分为两组,即对照组和观察组各40例,观察组予LP-PRP联合ESWT治疗,对照组予LR-PRP联合ESWT治疗;于治疗前、第一次治疗后1个月、3个月比较两组疼痛度[视觉模拟量表(VAS)评分]、跟腱病变程度[维多利亚体育研究所跟腱评估问卷(VISA-A)]、跟腱功能(Arner-Lindholm跟腱功能评分),并比较两组并发症的发生率。结果   两组在治疗后1个月、3个月的VAS评分下降,VISA-A评分升高,且观察组治疗后3个月的VAS评分(1.05±0.31)分低于对照组的(1.82±0.45)分,VISA-A评分(83.35±5.58)分高于对照组的(76.28±5.35)分(F组间与时点交互=338.478、106.663,均P<0.05);治疗后3个月,观察组跟腱功能(优、良、差各有24、13、3例)优于对照组(优、良、差各有14、16、10例),差异有统计学意义(Z=2.529,P=0.012)。两组治疗后1个月时VAS评分、VISA-A评分及跟腱功能比较差异无统计学意义(均P>0.05)。结论   与LR-PRP比较,LP-PRP联合ESWT治疗慢性NIAT更有利于减轻患者跟腱疼痛度及病变程度,改善患者跟腱功能。
       Objective  To compare the clinical value of leukocyte-poor platelet rich plasma(LP-PRP)and leukocyte-rich platelet rich plasma(LR-PRP)combined with extracorporeal shock wave therapy(ESWT)in the treatment of chronic non insertional Achilles tendinopathy(NIAT).Methods
Eighty patients with chronic NIAT admitted to Ganzhou People’s Hospital from December 2021 to December 2023 were randomly divided into two groups using a random number table method:a control group and an observation group,with 40 patients in each group.The observation group received LP-PRP combined with ESWT treatment,while the control group received LR-PRP combined with ESWT treatment.The pain level(Visual Analog Scale[VAS]score),degree of Achilles tendon lesion(Victorian Institute of Sports Assessment-Achilles tendinopathy questionnaire[VISA-A]),and Achilles tendon function(Arner Lindholm Achilles tendon function score)between the two groups were compared before treatment,one month after the first treatment,and three months after treatment,as well as the incidence of complications between the two groups.Results  The VAS scores of both groups decreased and the VISA-A scores increased at one and three months after treatment.The VAS score of the observation group(1.05±0.31)was lower than that of the control group(1.82±0.45)at three months after treatment,while the VISA-A score of the observation group(83.35±5.58)was higher than that of the control group(76.28±5.35)(interaction between group and time point F=338.478,106.663,both P<0.05).After three months of treatment,the Achilles tendon function of the observation group(24 cases of excellent,13 cases of good,and three cases of poor)was better than that of the control group(14 cases of excellent,16 cases of good,and  10 cases ofpoor),and the difference was statistically significant(Z=2.529,P=0.012).There was no  statistically  significant difference in VAS score,VISA-A score,and Achilles tendon function between the two groups one month after treatment(all P>0.05).Conclusions  Compared with LR-PRP,LP-PRP combined with ESWT was more beneficial in reducing the degree of Achilles tendon pain and lesions in patients with chronic NIAT,and improving Achilles tendon function.
论著

窄带成像结合放大内镜和超声内镜评估在早期结直肠癌内镜下治疗前的价值

Application value of magnifying endoscopy combined with narrow band imaging and ultrasonic endoscopy system before endoscopic treatment in patients with early colorectal cancer

:957-962
 
       目的   分析早期结直肠癌内镜下治疗前行窄带成像结合放大内镜 (ME-NBI)和超声内镜技术的评估价值。方法   采用回顾性分析方法,以2021年1月— 2023 年 12月中山市第五人民医院收治的102例早期结直肠癌患者为观察对象,所有患者均接受内镜下黏膜切除术(EMR)或内镜黏膜下剥离术(ESD)治疗,根据内镜下治疗前是否进行ME-NBI和超声内镜检查分为研究组与对照组各51例。比较两组年龄、性别、肿瘤大小、直乙结肠占比及组织病理特征;比较两组治疗时间、ESD治疗后非治愈性切除发生率、治愈性切除率、并发症发生情况及再次ESD或外科手术治疗率。结果   两组年龄、性别、肿瘤大小、直乙结肠占比及组织病理比较差异均无统计学意义(P>0.05)。研究组中37例行ESD治疗,治疗时间为(120.6±140.3)min,12例行EMR治疗,治疗时间为(11.6±9.3)min,有2例不符合内镜下治疗指征,转外科手术治疗。对照组有38例行ESD治疗,治疗时间为(128.8±144.5)min,13例行EMR治疗,治疗时间为(12.5±9.5)min,两者治疗时间比较差异均无统计学意义(P>0.05)。研究组非治愈性切除率为7.84,低于对照组27.45;治愈性切除率为88.24,高于对照组72.55;研究组ESD手术并发症为8.11%,低于对照组31.58;ESD或外科手术率为6.12,低于对照组25.49P<0.05),结论  ME-NBI和超声内镜对早期结直肠癌患者行内镜下治疗指征评估更准确,可提高治愈性切除率
       Objective  To  study the application value of magnifying endoscopy combined with  narrow  band imaging (ME-NBI)and ultrasonic endoscopy system before endoscopic treatment in patients with early colorectal cancer.Methods  A retrospective analysis was carried out on  102  patients with early-stage colorectal cancer who were admitted to Zhongshan Fifth People’s Hospital from January 2021 to December 2023.All patients were treated with endoscopic mucosal resection(EMR)or endoscopic submucosal dissection(ESO).The patients were divided into study group(51 cases)and control group(51 cases)according to whether ME-NBI and ultrasonic endoscopy was performed before endoscopic treatment or not.The patient age,sex,volume of tumor,location of tumor and pathological result of the tumor were compared between two groups.Time for treatment,curative resection rate,non-curative resection rate and the complication incidence of ESD,incidences of second ESD or surgery were compared between the two groups.Results  There were no statistical differences in age,sex,volume of tumor,location of tumor and pathological result of the tumor(P>0.05).In the study group,37 patients received ESD treatment,operation time was(120.6±140.3)minutes,and 12 patients received EMR treatment,operation time was(11.6±9.3)minutes,two cases were transferred to surgery due to endoscopic ultrasonography combined with magnifying endoscopy showed that they did not meet the indications for ESD treatment.In the control group,38 patients received ESD treatment,operation time was(128.8±144.5)minutes,13 patients received EMR treatment,operation time was(12.5±9.5)minutes.There was no significant difference in treatment duration between the two groups.The non-curative resection rate of the study group was 7.84%,which was significantly lower than that in the control group(27.45%),and the curative resection rate(88.24%)was significantly higher than that in the control group(72.55%).The complications of ESD surgery in the study group were 8.11%,lower than 31.58% in the control group.The rate of second ESD or surgery was 6.12%,lower than 25.49% in the control group(P<0.05).Conclusions  ME-NBI and endoscopic ultrasound are more accurate in the evaluation of endoscopic indications for early colorectal cancer patients,and can improve the curative resection rate.
综述

妇科恶性肿瘤放疗后阴道损伤的治疗研究进展

Research progress in the treatment of vaginal injury after radiotherapy for gynecological malignancies

:880-884
 
        放射治疗(放疗)可以提高妇科恶性肿瘤患者的总体生存率,降低复发率,增加手术机会。但肿瘤周围的健康组织不可避免地会进入电离辐射区域从而导致阴道狭窄、缩短和失去弹性,文章结合近年来国内外的放疗后阴道损伤治疗方式进行综述,总结分析治疗的优缺点,旨在为放疗后阴道损伤的临床治疗提供帮助。
       Radiotherapy can improve the overall survival rate,reduce the  recurrence  rate and increase the chance of surgery in patients with gynecological malignant tumors.However,the healthy tissue around the tumor can inevitably be included the ionizing radiation area,resulting in vaginal stenosis,shortening and loss of elasticity.This paper reviews the treatment methods of post-radiotherapy vaginal injury at home and abroad in recent years,to summarize and analyze theadvantages and disadvantages of treatment,aiming to provide help for the clinical treatment of post-radiotherapy vaginal injury.
学术前沿

戊型肝炎病毒感染诊疗的研究进展

Research progress on diagnosis and treatment of hepatitis E virus infection

:735-745
 
       戊型肝炎病毒(HEV)是导致急性肝炎的重要病原体,部分HEV感染者可进展为肝衰竭,此外,慢性感染和肝外表现可也在HEV感染者中发生。全球每年感染HEV的患者数达2000万,其中330万例患者有肝炎相关的临床症状,年死亡例数约为4.4万(2015年数据)。在我国,HEV以散发流行为主。近年来由于对其研究的重视,HEV病原学、流行病学、临床诊疗和预防取得较大的进展,文章拟对目前HEV防治热点以及新进展进行总结和分析。
       Hepatitis E virus(HEV)is an important pathogen that causes acute hepatitis.Some HEV-infected individuals 
may progress to liver failure.In addition,chronic infection(including liver fibrosis and cirrhosis)and extrahepatic manifestations can also occur in HEV infection.Worldwide,there are 20 million cases of HEV infection each year,with  3.3 million cases presenting clinical symptoms related to hepatitis,and an annual death toll of approximately 44,000(data from 2015).In China,HEV mainly present as sporadic outbreaks.In recent years,there has been significant progress in the pathogenesis,epidemiology,clinical diagnosis and treatment,and prevention of HEV.This review aims to summarize and analyze the current hotspots and new developments in the prevention and treatment of HEV.
论著

免疫及靶向药物联合肝动脉灌注化疗治疗晚期肝癌的临床分析

Clinical analysis of immune and targeted drugs combined with hepatic artery infusion chemotherapy in the treatment of advanced liver cancer

:662-668
 
       目的   探讨免疫及靶向药物联合肝动脉灌注化学治疗(化疗)治疗晚期肝癌的临床疗效。方法   选取甘肃省武威市人民医院2021年1月—2024年1月收治的78例晚期肝癌患者进行回顾性分析,其中20例患者采取单纯肝动脉灌注化疗(HAIC)治疗为单化疗组,30例患者采取HAIC联合程序性细胞死亡受体-1(PD-1)抗体治疗为免疫组,28例患者采取HAIC联合PD-1抗体免疫治疗与甲磺酸仑伐替尼胶囊靶向治疗为联合组。对比三组临床疗效、治疗前后胚抗原(CEA)、糖类抗原125(CA125)、甲胎蛋白(AFP)表达水平,不良反应发生率,并采用Piper疲乏修正量表(PFS-R)、世界卫生组织生存质量量表简表(WHOQOL-BREF)对两组癌因性疲乏程度及生存质量进行评价。结果   单纯化疗组、免疫组、联合组客观缓解率分别为15.00%、40.00%、64.29%,疾病控制率为30.00%、66.67%、82.14%,联合组高于单纯化疗组与免疫组(χ 2 =11.720,P=0.003;χ 2 =13.890,P<0.001);治疗后三组患者CEA、CA125、AFP水平均降低,且联合组[CEA:(13.62±4.24)ng/mL、CA125:(31.62±13.66)U/mL、AFP:(35.21±5.93)ng/mL]低于免疫组[(17.85±3.32)ng/mL、(59.26±9.35)U/mL、(42.12±4.12)ng/mL]及单纯化疗组[(23.73±4.79)ng/mL、(64.57±5.23)U/mL、(47.46±5.32)ng/mL],对比差异有统计学意义(F=7.698,P<0.001;F=11.480,P<0.001;F=14.952,P<0.001;P<0.05);所有患者均无5级不良反应及严重肝功能损害出现,且三组血小板减少、白细胞减少、腹痛、呕吐、消化道出血、厌食等不良反应发生率对比差异无统计学意义(P>0.05);治疗后三组患者PFS-R评分均降低,联合组(3.85±1.13)分低于免疫组(5.39±1.25)分及单纯化疗组(6.33±1.26)分,WHOQOL-BREF评分均升高,联合组(348.58±66.12)分高于免疫组(297.24±72.21)分及单纯化疗组(256.35±41.67)分,对比差异有统计学意义F=2.526,P=0.014;F=2.167,P=0.033)。结论   免疫及靶向药物联合肝动脉灌注化疗治疗晚期肝癌疗效显著,可有效控制疾病进展的同时,降低机体肿瘤标志物水平,安全性可控,同时可改善患者生存质量,减轻癌因性疲乏程度。
       Objective  To explore the clinical efficacy of immune and targeted drugs combined with hepatic artery infusion chemotherapy(HAIC)in the treatment of advanced liver cancer.Methods  A retrospective analysis was conducted on 78 patients with advanced liver cancer admitted to our hospital from January 2021 to January 2024.Among them,20 patients were treated with simple HAIC and divided into a single chemotherapy group.Thirty patients were treated with HAIC combined with PD-1 antibody,and divided into an immune group.Twenty-eight patients were treated with HAIC combined with PD-1 antibody immunotherapy and lenvatinib mesylate capsule targeted therapy,and divided into a combination group.The clinical efficacy of three groups,the expressionlevels of CEA,CA125,AFP,and incidence of adverse reactions before and after treatment were compared.Piper Fatigue Correction Scale(PFS-R)and the WHO QOL-BREF were used to assess cancer-related fatigue in both groups.The degree of fatigue and quality of life were assessed.Results  The objective response rates of the simple chemotherapy group,the immune group,and the combination group were 15.00%,40.00% and 64.29%,respectively.The disease control  rates were 30.00%,66.67% and 82.14%,respectively.The indicators above of the combination group was significantly higher than those in the simple chemotherapy group and the immune group(χ 2 =11.720,P=0.003;χ 2 =13.890,P<0.001;P<0.05).After treatment,the levels of CEA,CA125 and AFP were all decreased in the three groups,and those in the combined group (CEA[13.62±4.24]ng/mL,CA125[31.62±13.66]U/mL,AFP:Ng/mL[35.21±5.93])were lower than those in the immune group(17.85±3.32 ng/mL,59.26±9.35 U/mL,/ 42.12±4.12 ng/mL)and single chemotherapy group(23.73±4.79 ng/mL,64.57±5.23 U/mL47.46±5.32]ng/mL),the differences were statistically significant(F=7.698,P<0.001;F=11.480,P<0.001;F=14.952,P<0.001;P<0.05).All patients had no grade 5 adverse reactions or severe liver function damage,and there was no statistically significant difference in the incidence adverse reactions such as thrombocytopenia,leukopenia,abdominal pain,vomiting,gastrointestinal bleeding,and anorexia among the three groups(P>0.05).After treatment,the PFS-R score of the three groups was decreased,and the combined group(3.85±1.13)score was lower than that of the immune group(5.39±1.25)and the chemotherapy group(6.33±1.26).While the WHOQOL-BREF score was increased,the score of combination group(348.58±66.12)was higher than that of immune group(297.24±72.21)and chemotherapy group(256.35±41.67),and the difference was statistically significant(F=2.526,P=0.014;F=2.167,P=0.033;P<0.05).Conclusions  The combination of immune and targeted drugs with hepatic artery infusion chemotherapy has a significant therapeutic effect on advanced liver cancer.It can effectively control disease progression,reduce tumor marker levels in the body,improve patient quality of life,and alleviate cancer-related fatigue,with controllable safety
论著

腕踝针联合揿针治疗带状疱疹后遗痛的临床疗效观察

Clinical efficacy of wrist and ankle acupuncture combined with thumbtack needle in the treatment of postherpetic herpes zoster pain

:650-655
 
       目的   探究腕踝针联合揿针治疗带状疱疹后遗痛的临床疗效观察。方法   选取上海市黄浦区中西医结合医院2021年10月—2024年4月收治的80例带状疱疹后遗神经痛患者为研究对象,按随机数表法分为研究组、对照组,各40例。对照组采用口服甲钴胺治疗;研究组采用腕踝针联合揿针治疗。比较两组治疗疗效;治疗前后采用视觉模拟评分(VAS)与阿森斯失眠量表评分(AIS)、皮肤病生活质量指数(DLQI)、汉密尔顿抑郁量表评分(HAMD)、汉密尔顿焦虑量表评分(HAMA)。结果   研究组治疗总有效率为92.5%,对照组治疗总有效率为75%。比较差异有统计学意义(P<0.05)。两组患者治疗后VAS、AIS均比治疗前改善,研究组VAS评分为(1.00±0.45)、AIS评分为(7.15±0.89),优于对照组VAS(2.15±0.36)和AIS(5.65±0.70),比较差异有统计学意义(P<0.05)。相较于治疗前,两组患者DLQI评分均有改善,研究组[休闲活动评分(1.73±0.45)、人际交往评分(1.13±0.34)、工作学习评分(0.94±0.25)、自觉症状评分(1.83±0.38)、日常活动评分(0.98±0.28)]优于对照组[休闲活动评分(2.06±0.40)、人际交往评分(1.81±0.39)、工作学习评分(1.08±0.38)、自觉症状评分(2.01±0.34)、日常活动评分(1.10±0.30)],差异有统计学意义(P<0.05)。两组患者HAMD评分、HAMA评分,相较于治疗前均有改善,研究组HAMD评分为(34.63±2.61)、HAMA评分为(35.75±2.48),优于对照组HAMD评分(47.68±3.21)和HAMA评分(46.90±3.31),差异有统计学意义(P<0.05)。结论   腕踝针联合揿针治疗带状疱疹后遗神经痛的临床疗效显著,可有效改善患者生活质量、疼痛程度、焦虑及抑郁程度,提升患者睡眠质量。
       Objective  To investigate the clinical efficacy of wrist and ankle acupuncture combined with thumbtack needle in the treatment of postherpetic herpes zoster pain.Methods  Eighty patients with postherpetic neuralgia admitted to Shanghai Huangpu District Hospital of Integrative Medicine from October 2021 to April 2024 were selected for the study,and were divided into a study group and a control group of 40 cases each according to the random number table method.The control group was treated with oral mecoblamin tables;the study group was treated with wrist and ankle acupuncture combined with thumbtack needle.The efficacy of treatment between the two groups was compared;before and after treatment,the visual analogue score(VAS)and Asens Insomnia Scale(AIS),Dermatological Quality of Life Index(DLQI),Hamilton Depression Scale(HAMD),Hamilton Anxiety Scale(HAMA)were compared.Results  The treatment efficiency was 92.5% in the study group and 75% in the control group.The difference was statistically significant(P<0.05).VAS scores and AIS scores of patients in both groups improved after treatment,and VAS score(1.00±0.45),AIS score(7.15±0.89)of the study group were better than VAS score(2.15±0.36),AIS score(5.65±0.70)of the control group.The differences were statistically significant(P<0.05).The DLQI scores of both groups improved after treatment,and the score of study group(leisure activity score[1.73±0.45],interpersonal interaction score[1.13±0.34],work-study score[0.94±0.25],self-perceived symptom score[1.83±0.38],daily activities score[0.98±0.28])were higher than those of the control group(leisure activity score[2.06±0.40],interpersonal score[1.81±0.39],work-study score[1.08±0.38],conscious symptom score[2.01±0.34],daily activity score[1.10±0.30]).The differences were statistically significant(P<0.05).HAMD scores and HAMA scores of patients in both groups,showed significant improvement after treatment,and HAMD scores(34.63±2.61)and HAMA scores(35.75±2.48)of the study group were better than HAMD scores(47.68±3.21)and HAMA scores(46.90±3.31)of the control group.The difference was statistically significant(P<0.05).Conclusions  The clinical efficacy of wrist and ankle acupuncture combined with thumbtack needle in the treatment of postherpetic pain is remarkable,effectively improving the quality of life,pain,anxiety and depression,and enhancing the quality of sleep of patients.
论著

可注射型载阿霉素水凝胶治疗胶质瘤的实验研究

Experimental study on the treatment of glioma with injectable doxorubicin hydrogel

:616-621
 
       目的   初步探讨可注射型载阿霉素水凝胶对胶质瘤的治疗作用。方法   使用透析法检测载阿霉素水凝胶在体外释放药物的情况。构建大鼠皮下C6胶质瘤模型,按不同给药途径分为空白对照组、经静脉注射组、水凝胶组。给药15 h后,经免疫荧光检测阿霉素在肿瘤内部的分布情况。给药7 d后,计算出各组的抑瘤率;并对肿瘤组织进行苏木精-伊红染色。结果   在体外,载阿霉素水凝胶具有缓释药物的性能。在体内,与经静脉给药相比,局部注射载阿霉素水凝胶使瘤内分布更多阿霉素,抑瘤率更高(42% vs 64%),肿瘤细胞坏死更明显。结论   载阿霉素水凝胶可为胶质瘤局部化学治提供新的载体。
      Objective  To investigate the therapeutic effect of injectable doxorubicin-containing hydrogel on glioma.Methods  The release of doxorubicin hydrogel in vitro was detected by dialysis.The subcutaneous C6 glioma model of  rats was constructed and divided into blank control group,intravenous injection group and hydrogel group according to different administration methods.The distribution of doxorubicin in the tumor was detected by immunofluorescence 15 hours after administration.After 7 days of administration,the tumor inhibition rate of each group was calculated.The tumor tissue was stained with hematoxylin eosin.Results  In vitro,doxorubicin-containing hydrogels had sustained drug release properties.In vivo,compared with intravenous administration,local injection of doxorubicin-containing hydrogel resulted in more doxorubicin distribution,higher tumor inhibition rate(42% vs 64%)and more obvious tumor cell necrosis.Conclusions  Doxorubicin-containing hydrogel can provide a new carrier 
for local chemotherapy of glioma.
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