目的探讨针刺配合促进技术对脑梗死患者上肢功能及日常生活活动能力(ADL)的影响。方法将114例脑梗死上肢瘫患者随机分为针刺配合促进技术组(A组)、针刺组(B组)、促进技术组(C组)和对照组(D组),应用针刺疗法和促进技术康复治疗。观察治疗前后简式Fugl-Meyer评分(FMA),Barthel指数 (MBl)和简易上肢功能评分的改变。 结果治疗后A组明显优于其他3组,B组和C组无差异,A、B、C各组治疗后优于D组。结论早期针刺和促进技术联合治疗是急性脑梗死上肢瘫早期康复治疗较为理想的方法。

目的探讨急性卒中单元联合康复卒中单元对重症脑卒中的影响。方法卒中单元的急性重症脑卒中患者54例为治疗组,神经科常规病房的急性脑卒中患者52例为对照组。比较两组Fugl-Meyger评分、美国卫生研究院脑卒中量表(NIHSS)评分、日常生活活动能力(ADL)评分以及3周感染率、其他并发症发病率、死亡率。结果两组入院时Fugl-Meyger评分、NISHH评分、ADL评分无显著性意义(P>0.05);第3周Fugl-Meyger评分、NISHH评分、ADL评分无显著性差异(P>0.05);第6周出院时或随访两组Fugl-Meyger评分、NISHH评分、ADL评分有非常显著性差异(P<0.01);三周感染率、其他并发症发病率、死亡率有显著性差异(P<0.05)。结论采用急性卒中单元联合康复卒中单元能促进急性重症脑卒中患者运动功能恢复,降低其神经功能缺损程度,提高其日常生活能力。

The effects of cyclosporine A on matrix metalloproteinases(MMP)-2 and-9 expressions in the cardiac muscle of streptozocin-induced diabetic rats were investigated.The expressions of MMP-2 and MMP-9 mRNA and proteins in the cardiac muscle of diabetic rats were significantly upregulated,which could be decreasedby cyclosporine A(P＜0.05 or P＜0.01).The results suggest that cyclosporine A may effectively ameliorate the injuries of diabetic cardiomyopathy.

Objective To study the autoimmune injuries on diabetic retinopathy(DR)and the protective effects of immunosuppre8sive therapy with eyelosporine A(CsA) on the DR of streptozotocin(STZ)-induced diabetic rats.Methods STZ-induced diabetic rats were randomly divided into 3 groups: group 1:diabetic group without any treatment;group 2:insulin-treated group;group 3:CsA-treated group which was further divided into 2 subgroups:subgroup A:CsA was given 1 week before hyperglycemia appeared and subgroup B:CsA was given one week after hyperglycemia appeared.Subgroup A and subgroup B were further subdivided into 3 groups respectively,based on the dose of CsA(1,4 and 8 mg·kg-1·d-1).As a control group,normal rats were also simultaneously monitored.The pathologic changes in the retina were investigated with HE stain and the deposition of immunoglobulins was detected with immunohistochemistry and immunofluorescent microscopy.Results After 8 week,the deposition of IgG, IgA and IgM was quite significant in the retina of diabetic rats.The data also suggested that insulin treatment had no effects on the DR.In contrast,with CsA intervention,the deposition of immunoglobulins on the retina of diabetic rats vanished.Conclusions Autoimmune injuries were shown,in the present study,to play a critical role in the pathogenesis of diabetic retinopathy.Immunosuppressive treatment with CsA showed protective effects by inhibiting the deposition of immunoglobulins in the retina of diabetic rats.

Objective To investigate the methods of reducing radiation dose in CT coronary angiography through optimizing individualized scan dosage protocol.Methods Two hundred patients (group A)underwent coronary CTA examination which was performed with fixed 120 kV and variable mA according to their BMI.The mA was set as 150-300 mA(BMI ＜ 18.5 kg/m2),300-500 mA (18.5 kg/m2 ≤ BMI ＜ 25.0 kg/m2),and 500-800 mA(BMI ≥ 25.0 kg/m2).When all examinations were finished,a linear regression was employed to analyze the correlation between mA and BMI,body surface(Suf),image noise(SD)respectively.The results of the analysis were used to formulate a regression equation,which was further used to establish a table list for quick search on how much mA that individualized coronary CTA scan would need.Another 200 patients(group B)enrolled for the individualized scan were scanned under new protocol that previous study established.The tube voltage was 100 and 120 kV.The tube current was variable according to the data in the table list.One-way ANOVA and Kruskal-wallis H test were used for statistics.Results Regression equation between mA and BMI,Suf,SD was:mA =17.984 × BMI + 169.149 × Suf-2.282 × SD-361.039.The SD(group A:32.08 ± 5.80,group B:28.60±4.47),dose index volume(CTDIvol)[group A:(41.97 ± 11.37)mGy,group B:(33.18±10.07)mGy],effective dose(ED)[group A:(10.91 ±3.07)mSy,group B:(8.83 ±2.72)mSv]had significant differences between the two groups(F =43.45,63.71,49.07 respectively,P ＜0.01 for all).The SD and ED results obtained in group B were better than those in group A.Conclusion Better performances were obtained when BMI combined Suf was used as a new individualized protocol than when BMI was used only,which means good image quality and lower radiation dosage in coronary CTA examination.

In order to improve the research and innovation ability of medical undergraduates, this article summarizes the main problems in the cultivation of innovation ability among medical undergraduates through literature research and the authors' experience in the teaching and research from the three aspects of limited knowledge system, a lack of professional guidance for research training, and poor integration of scientific research into clinical practice. It is proposed that the methods of developing the ability to search and read scientific literature among undergraduate students, enhancing interdisciplinary activities and joint training, and building a teaching team of clinicians with extensive research experience can help to achieve a more effective integration of theoretical research and clinical practice and thus cultivate the research and innovation ability among medical students. These initiatives have made significant achievements and provide a reference for decision making in undergraduate research training in medical colleges and universities, as well as guidance for talent cultivation in medical colleges and universities in China.

Objective To combine the functional quantitative indicators with the morphological imaging diagnosis by quantitative CT on chronic obstructive pulmonary disease ( COPD) patients, so as to provide the objective and quantitative indicators for TCM differentiation and for degrees of lung parenchyma inju-ry. Methods A total of 75 COPD patients at stable stage with syndrome of lung-qi deficiency were di-vided into three groups ( mild, moderate, severe) in accordance with Clinical Guideline of New Drug for Traditional Chinese Medicine, and 20 more healthy people were recruited into healthy group. After lung CT scan, the multi-range imaging quantitative analysis was carried using the post-proceeding three-dimen-sion technology. Then the CT quantitative indicators and the integral and rating of symptoms of patients were compared with the healthy subjects. Results Compared with the healthy group,the mean volume of each lung lobe, and proportion of emphysema volume increased in all three COPD groups. Furthermore,the more serious the symptoms were, the larger volumes of lung lobes and the more proportion of emphy-sema volume were. The proportion of emphysema volume in upper lobes or in right middle lobe were lar-ger. Conclusion The correlation between the volume of lung lobes and emphysema and the degrees of integral of TCM symptoms were proved. And the introduction of the quantitative indicators could increase the objectivity and reliability of TCM treatment on COPD.