背景:针灸及其联合其他疗法与标准西医疗法之间比较治疗骨质疏松有效性的研究结论存在争议,现有的原始研究和Meta分析多为单一针灸治疗、针灸联合西药治疗与标准西医疗法间的比较,缺乏针灸联合其他疗法之间的直接比较,使人们难以对针灸疗效有较清晰、全面的认识.目的:采用网状Meta分析技术,比较针灸联合其他疗法治疗骨质疏松疗效的差异.方法:在CNKI、维普、万方、SinoMed、PubMed、Cochrane Library数据库上进行检索,纳入不同针灸疗法对比治疗骨质疏松的临床随机对照试验(RCT).根据相关纳入与排除标准对文献进行筛选后提取相关资料,并对纳入文献进行质量评价.运用Stata 14.0软件进行文献数据分析及作图.结果 与结论:最终纳入34篇随机对照试验,共涉及7种干预措施,包括:单一针灸治疗,单一西药治疗,单一中药治疗,针灸+西药联合治疗,针灸+中药联合治疗,中药+西药治疗,针灸+中药+西药联合治疗.①在治疗有效率上,针灸+中药的疗效最佳,且针灸+中药、针灸+西药以及针灸+中药+西药,均显著比中药+西药治疗的有效率高(P＜0.05);②在增加患者骨密度方面,针灸+中药、针灸+西药以及针灸+中药+西药,均优于单一中药或西药组(P＜0.05);③在缓解患者疼痛方面,与单一西药治疗相比,针灸+西药治疗能缓解患者的疼痛(P＜0.05),但其余治疗方式之间,并无明显的差异(P＞0.05).在纳入的研究中,有极少数患者出现针刺后穴位瘀血现象,但均未出现晕针或未报道,也未发现其他毒副作用.提示:针灸联合其他疗法,可以提高有效率、增加骨密度、缓解患者疼痛.

篮球运动是学生喜爱的一项运动,在训练比赛中容易引起膝关节损伤、慢性劳损以及髌骨末端病的发生,加强大腿肌肉的锻炼对减少和预防篮球运动中膝关节损伤起到重要的作用.方法:从广州中医药大学体育健康学院篮球专业学生中挑选60名学生并随机分为实验组与对照组,实验组进行大腿肌肉组织的加强锻炼,对照组则进行常规热身活动,实验前和实验后分别对实验组和对照组学生进行大腿围度的测量,记录出现损伤的人数.结论:大腿肌肉的锻炼对篮球运动中膝关节损伤有预防作用.

目的:通过针刺对高脂血症模型大鼠进行干预,观察相关指标变化探讨其改善血管内皮功能的机制.方法:将SD大鼠按随机数字表法分为空白组、模型组、针刺组各10只,模型组、针刺组大鼠采用高脂乳剂灌胃方法建立高脂血症大鼠模型,空白组、模型组只固定不做其他治疗,针刺组采用“脂三针”治疗3周.实验过程中观察各组大鼠一般状态及体质量变化,实验结束测定血清、血脂水平,光镜下观察主动脉形态学改变,采用Western blot法检测主动脉RhoA、ROCK2、MLCP蛋白表达水平.结果:与模型组比较,针刺组大鼠一般状态明显改善,体质量降低,血脂TC、TG、LDL-C含量显著降低,HDL-C明显含量升高,血清NO含量升高、ET-1含量降低,主动脉病理损伤程度有较好改善,RhoA、ROCK2、MLCP蛋白表达显著降低,差异有统计学意义.结论:针刺可降低血脂,调节血管舒缩因子含量,降低相关蛋白表达,改善血管内皮损伤,推测其机制或许与抑制Rho/ROCK通路激活有关.

BACKGROUND: Pain caused by knee osteoarthritis is reflected in imaging. Change of radiographic parameters of the tibial axis slice can provide a reasonable assessment for the clinical pain symptoms of knee osteoarthritis. OBJECTIVE: To analyze the correlation between the change of the imaging indexes of patellar axial radiograph and pain area in the knee osteoarthritis, thus providing reference for the diagnosis and treatment of knee osteoarthritis. METHODS: Available samples were collected from the First Affiliated Hospital of Guangzhou University of Chinese Medicine between September 2014 and September 2016, where totally 80 knee osteoarthritis patients were selected as pain group and 30 healthy volunteers were selected as control group. All the participants took patellar axial radiograph with knee at 30° through PACS imaging systems to collect five imaging indexes, including patella exponent, femur trochlea angle, congruence angle, lateral patellofemoral angle and tilt angle. Knee osteoarthritis patients in the pain group were divided into four common clinical pain areas which were anterior, posterior, medial and lateral area. RESULTS AND CONCLUSION: (1) The patellofemoral pain index, congruence angle, and lateral patellofemoral angle in the pain group were significantly larger than those in the control group (P < 0.05). In the patellofemoral angle, patellofemoral subluxation and femoral trochlear angle parameters, there was no significant difference between two groups (P > 0.05). (2) Two logistic regression analysis showed that there was a correlation between knee osteoarthritis pain and lateral patellofemoral angle (P=0.01). (3) From one way-ANOVA LSD statistical analysis, the patellofemoral angle in patellofemoral anterior and posterior areas had significant difference (P=0.038), and there were no differences in the other imaging parameters between pain areas (P > 0.05). (4) In summary, compared with the health volunteers, in the patients with pain caused by knee osteoarthritis, patellofemoral joint disorder and patella angle affects the pain of anterior and posterior areas, which has a connection with the saphenous nerve, the branches of the sciatic nerve and peroneal nerve branch of conduction. Subject headings: Patella; Osteoarthritis, Knee; Pain; Tissue Engineering Funding: the National Natural Science Foundation of China, No. 81373655; the Natural Science Foundation of Guangdong Province, No. 2015A030310203; the Innovation Training Program of Guangdong Province, No. 201610572043; the High-Level University Construction Project of Guangdong Province, No. A1-AFD018171Z11057; the Talent Training Project of the First Affiliated Hospital of Guangxi University of Chinese Medicine, No. 2015QN01 0 引言 Introduction 膝关节骨性关节炎是一种退行性关节炎,以关节软骨 退行性病理改变为基础并伴有关节周围骨质增生的特点, 临床症状以疼痛为主诉。临床上膝关节相应的辅助检查 有X射线、MRI、关节镜、超声波等,其中,MRI被目前 国际骨关节炎研究协会(OARSI)推荐用于关节软骨形态 学检查,而超声检查则在骨关节炎尤其是膝关节骨性关 节炎相关研究中显示具出越来越多的潜力;相比前两 者,CT在早期骨性关节炎诊断中应用面相对较窄;而X 射线检查相对于其他影像学方法而言具有价格相对低廉 且空间对比度好等优点,目前是骨性关节炎诊断的最主要 辅助手段。临床用于诊断膝关节疾患的多为X射线正、 侧位片,然而,由髌骨轨迹运动发生改变导致的髌股关节 紊乱,正侧位片容易误诊、漏诊,而导致治疗的延误。因 此,如何及早地对髌骨关节紊乱导致的疼痛作出诊断及治 疗在临床工作中具有重要意义。 髌骨轴位片在发现早期髌股关节病变、髌骨的移位、 倾斜、脱位以及软化方面具有独特的优势。文章通过膝 骨关节炎患者行膝关节轴位片的拍摄和测量,分析髌骨轴 位片影像学参数(髌股指数、髌股协调角、外侧髌股角、髌 股倾斜角、股骨滑车沟角)与膝骨关节炎患者疼痛部位(膝 前区、膝后区、膝内侧和膝外侧)之间的相关性,以深入探 究相关指标在膝骨关节炎诊断与治疗中的意义,为临床上 诊断和治疗膝骨关节炎提供指导和参考。 1 对象和方法 Subjects and methods 1.1 设计 病例-对照试验。 1.2 时间及地点 病例来源于2014年9月到2016年9月广 州中医药大学第一附属医院。 1.3 对象 选择在广州中医药大学第一附属医院进行髌 骨轴位片拍摄的膝骨关节炎疼痛患者80例(疼痛组)和健康 志愿者30例(健康组)。疼痛组患者男32例,女48例;年龄 29-62岁,平均(34.21±29.58)岁。健康组男14例,女16例; 年龄22-57岁,平均(36.38±22.58)岁。其中疼痛组膝关节 前区疼痛28例,膝关节内侧疼痛25例,外侧疼痛13例,后 区疼痛14例。健康组和疼痛组患者的性别、年龄以及病程 比较差异无显著性意义(P > 0.05)。 1.3.1 膝关节炎诊断标准 遵循中华医学会骨科学分会 《骨关节炎诊治指南》的膝骨关节炎相关标准,结合国家 中医药管理局医政司22个专业95个病种中医临床路径(合 订本)。 1.3.2 膝骨关节炎疼痛组的纳入标准 1满足以上的诊 断标准;2患者具有膝部疼痛;3患者不曾患膝关节外伤 和接受膝关节手术;4X射线检查中显示清晰的髌骨及股 骨滑车轮廓;5同意参与此次调查并提交知情同意书。 1.3.3 膝骨关节炎疼痛组的排除标准 1患有较重的心、 脑等内科疾患和全身健康情况较差者;2存在继发因素(损 伤性半月板损伤、先天性膝关节内外翻、长期关节绞锁等); 3处于孕期、妊娠期或者哺乳期;4关节严重畸形如胫骨 Liu SF, Jiang YJ, Cen ZH, Ling M, Zhang T, Chen YX, Zhou C. Correlation of imaging indexes of patellar axial disorder with pain of knee osteoarthritis. Zhongguo Zuzhi Gongcheng Yanjiu. 2018;22(35):5655-5660. DOI:10.3969/j.issn.2095-4344.1012 P.O. Box 10002, Shenyang 110180 www.CRTER.org 5657 平台或股骨髁陈旧性骨折引起下肢力线不正者;5髌骨轮 廓模糊且髌骨轮廓难以辨别;6轴位线片的范围未完全包 括髌骨及股骨滑车轮廓;7前后交叉韧带存在损伤,膝关 节有肿块形成。 1.3.4 健康组的纳入标准 1排除膝骨关节炎疾病的健 康志愿者;2无髌骨的相关疾病;3行髌骨轴位片,影像 学髌骨及股骨滑车轮廓清晰。 1.3.5 膝骨关节炎患者疼痛部位的分类标准 1前区(股 骨内外侧髁、胫骨内外侧髁围成的区域);2后区(腘窝区); 3内区(胫侧副韧带附着区);4外区(腓侧副韧带附着区)。 1.4 方法 受试者均屈膝30°行髌骨轴位片的拍摄,具体 的操作方法:摄片膝关节放在30°木架上,下肢肌肉放松, 球管在足端X射线切线位穿过髌股关节。在髌骨轴位片上 进行影像学指标采集。 1.5 主要观察指标 对膝骨关节炎患者由受过专业培训 的同一名骨科医生在PACS影像学图片计算机处理系统上 分别采集以下影像学指标:1髌股指数:在屈膝30°轴位片 上,髌股关节内侧关节间隙最窄距离M与外侧关节间隙最 窄距离L的比值见图1;2股骨滑车沟角:股骨滑车凹最低 点与内外髁顶点形成的夹角,正常值应不大于140°,见图2; 3髌股协调角(适合角):画一线平分滑车沟角,再画第2条 线连接滑车凹最低点和髌骨嵴最低点,两线之间的夹角为 适合角,夹角在平分线的外侧为正值,在内侧为负值。正 常人群为(-8±9)°,> 16°为髌骨外侧半脱位,见图2;4外 侧髌股角:股骨内外髁最高点连线与髌骨外侧面切线延长 线的夹角。开口朝外为正值,正常人群为(7.8±3.1) °,见 图3;5髌股倾斜角:髌骨内外侧顶点连线和股骨内外侧髁 连线的夹角。开口向内为正值,向外为负值,正常人群为 (11.0±2.5)°。正常值不应大于15°,见图4。 1.6 统计学分析 采集到的数据用x _ ±s表示,差异比较用 成对资料均数的t 检验;对有显著性差异的数据采用二元 Logistic回归分析和Pearson相关分析;两两比较采用One Way-ANOVA LSD统计分析;以SPSS 21.0软件对数据进 行统计分析,P < 0.05为差异有显著性意义。 2 结果 Results 2.1 参与者数量分析 纳入膝骨关节炎疼痛(疼痛组)患者 83例,健康组32例;其中疼痛组失访3例,健康组失访2例。 试验流程图见图5。 2.2 两组基线资料比较 2组基线资料比较差异无显著性 意义(P > 0.05),见表1。 图 1 髌股指数测量示意 图 Figure 1 Schematic diagram of patella exponent 图注:髌股关节外侧关节 面距离为 AB,髌股关节内 侧关节面距离为 CD,CD 与 AB 之比即为髌股指数。 图 2 髌股协调角测量示 意图 Figure 2 Schematic diagram of patellofemoral congruence angle 图注:∠AOB 为股骨滑车 沟角,CO 为该角的平分 线;DO是滑车凹最低点和 髌骨嵴最低点的连线, ∠COD即为髌股协调角。 图3 外侧髌骨角测量示意图 Figure 3 Schematic diagram of lateral patellofemoral angle measurement 图注:AB 为髌骨外侧面切线 延长线;CD为股骨内外髁最 高点连线;二者所构成的夹角 ∠AOC,即为外侧髌骨角。 图4 髌股倾斜角测量示意图 Figure 4 Schematic diagram of patellofemoral tilt angle 图注:AB 为髌骨内外侧顶点 连线;CD 为股骨内外侧髁连 线;二者所构成的夹角 ∠AOC,即为髌股倾斜角。 80例进入结果分析 失访:3例 健康组 32例 疼痛组 83例

为了研究双合汤对大鼠膝骨性关节炎的作用及可能机制,通过膝关节腔注射木瓜蛋白酶法建立膝骨性关节炎大鼠模型(2周),将57只造模成功大鼠随机分为模型组(2 mL/kg·d)、氨基葡萄糖组(86.4 mg/kg·d)和双合汤组(12 g/kg·d),20只膝关节腔注射等量生理盐水大鼠为假手术组(2 mL/kg·d).共用相应药物灌胃4周.检测各组大鼠2周和6周关节活动范围、关节滑膜厚度和关节液中IL-1β、IL-6、NO、一氧化氮合酶(iNOS)的水平.结果表明,与假手术组比较,模型组关节活动范围减少(P＜0.05),关节滑膜厚度增加(P＜0.05),关节液IL-1β、IL-6、NO、iNOS水平显著升高(P＜0.05);与模型组比较,双合汤组关节活动范围增加(P＜0.05),关节滑膜厚度减少(P＜0.05),关节液IL-1β、IL-6、NO、iN-OS水平显著降低(P＜0.05).说明双合汤能有效治疗膝骨性关节炎,其机制可能与抑制关节液中IL-1β、IL-6、NO、iNOS的表达有关.

目的 系统评价温针灸治疗肱骨外上髁炎的临床疗效.方法 计算机检索Cochrane Library、Embase、PubMed、中国生物医学文献数据库(CBM)、中国期刊全文数据库(CNKI)、维普数据库(VIP)和万方数据库(WanFang),收集关于温针灸治疗肱骨外上髁炎的临床随机对照试验(RCT),对符合纳入标准的临床研究进行资料提取和质量评价后,用Revman5.3统计软件进行Meta分析.结果 最终纳入13项RCT,共计639例患者.Meta分析结果显示,试验组患者的总有效率高于对照组[RR=1.15,95％ CI(1.10,1.21),P＜0.00001];试验组患者治疗后VAS评分[MD=1.18,95％ CI(1.01,1.35),P＜0.00001]低于对照组.结论 温针灸与普通针刺相比,对肱骨外上髁炎的总体疗效较好,镇痛效果较理想.但所纳入的临床研究质量相对偏低,需要更多高质量、多中心的随机双盲临床研究进一步补充验证.

旨在探讨教育信息技术背景下,如何利用新的手段和方法改变单一的课堂教学与训练,建立教学信息技术背景下学生的课内外结合的自主学习,探讨更适合游泳学习认知规律的个性化教学模式.研究运用文献资料法、探索性研究法、问卷调查法.研究结果表明:基于现代信息技术包括水上水下摄录资料和网络讨论空间等的课内外教学模式,激发学生的学习兴趣,促进学生游泳技术掌握,为学生进行自主合作学习提供平台,为体育专业学生的学习和训练能力的提升提供更大空间.

湿邪致病范围广泛,证候多样,根据病因可分为外湿致病与内湿致病,临床内湿致病更为多见.水液代谢与肺、脾、肾三脏关系极为密切,若三脏功能失调,水液代谢失常则会导致水湿病证,根据湿邪停留的部位不同提出相应治疗湿邪的方法,从脏腑和经络辨证论治,大体遵循“肺宜宣,脾宜健,肾宜温”的治疗原则,针药相配,综合运用以治湿,以期提高临床疗效.

Rapid economic development in the Yellow River basin has inevitably resulted in increase of pollution in the estuary, and concern for both the environment and protection against pollutants is increasing. Contents of trace metals (Cu, Pb Zn, Cr, Cd, As, Hg), Fe, Al, total organic carbon (TOC), and their granulometry were determined in surface sediment samples from the Yellow River estuary and its adjacent areas. Metal contents were significantly correlated each other. Clay, TOC and heavy metal contents showed similar distribution characteristics, with concentrations increased from the land to the sea. The distribution of grain size plays an important role in influencing the distribution of trace metals. Heavy metal concentrations showed a significant relationship with Fe and Al content, while most heavy metals were not enriched. These results were also confirmed by the analysis of enrichment factors and principal component analysis of the metals. The metal content of the Yellow River Estuary sediments was similar to the content observed 20 years ago, but the concentrations of most metals in Laizhou Bay decreased. The decrease in the carrying sediment of the Yellow River might be responsible for this pattern.

当前发展足球运动已提升为我国的战略化策略.主要解决如何从管理机制上重新布局,释放潜力,来推动我省足球运动的发展.采用文献资料法,借鉴巴西足球的州联赛体制,提出构建我省的区域性赛制的设想,为我省足球领先全国和可持续发展搭建平台.作为高水平足球俱乐部发展的重要领头兵,广东具有经济实力、交通便利、气候宜人的特点,具有广大的群众基础和青训基地等有利条件.建议首先建立筹备小组,做好顶层设计,争取政策支持,率先在广东省建立高水平的区域联赛,带动我省足球普及层面、竞技层面以及足球相关体育产业的发展.

观察舒血宁穴位注射在早中期膝骨性关节炎的临床应用。方法：选取符合条件的60例院住院患者随机分为观察组与对照组各30例，分别进行治疗，分别在治疗前、治疗过程中及治疗结束后进行膝关节WOMAC评分。结果：舒血宁注射液穴位注射对缓解膝关节骨性关节炎疼痛的疗效更显著。

The essential oil and fatty acid composition of Malania oleifera were determined by GC–MS techniques. The yield of essential oils was 0.1±0.02%, 0.2±0.03% and 1.1±0.12%, respectively from seeds, branches with leaves and outer part of pericarp (exocarp and mesocarp) of M. oleifera. Seventeen compounds were identified in the essential oils of seeds with benzyl alcohol (58.42%), benzaldehyde (29.66%) and benzoic acid (1.49%) as main constituents. Both branches with leaves and outer part of pericarp, the major constituents include benzaldehyde (87.15% and 90.68%), benzyl alcohol (6.51% and 2.95%), benzeneacetonitrile (5.66% and 0.07%) as the most abundant components. These results indicated that benzaldehyde and benzyl alcohol were found as the main essential oils obtained from the different parts of M. oleifera. The yield of fatty acids extracted from the seeds was 60.5±2.5%, which contains fourteen chromatographic components, of which 10 compounds were identified, representing 98.98% of the lipids; the major components were nervonic acid (55.70%), octadecenoic acid (23.81%), docosenoic acid (13.13%), tetracosanoic acid (2.65%), dodecenoic acid (1.28%), tricosadienoic acid (0.99%) and hexadecanoic acid (0.45%). The results demonstrated that the quantities of unsaturated fatty acids were higher than that of saturated analog.

竞赛规则是竞技体育比赛的规范和准则,它规定了参赛者的条件,制约着参赛者的行为,是任何项目产生、发展的基础和依据。作为难美评分类项目之一的艺术体操,其竞赛基础是以若干个连贯的身体、器械技术动作组合而成的集合体。所以规则就是成套动作选编的依据,相对体能性竞技体育项目来说,规则的演变对其项目的创新和发展方向起着更为至关重要的作用。

According to the characteristics of basketball shot technique, this paper developed a CAI courseware about basketball shot technique with graphics, words, sounds and video. By utilizing High-tea-ching physical education, it can offer a scientific, efficient and practical method to the reform of the college physical education in the 21st century.

篮球运动是当代大学生最为喜欢的运动项目之一,电是普通高校体育教学的重要内容.随着篮球运动的广泛发展、普及、提高,已越来越被各级教育行政部门和各级学校领导重视.然而在普通高校的篮球选项课的教学实践中,尽管大家付出了很大的努力,做了许多工作,但我们还是能够明显地感觉到学生对我们教学工作并不十分满意,教学也未达到预期的理想效果.

Personalization is an increasingly important ingredient of Web applications. Personalization techniques and mechanisms can be used to tailor information services to personal needs of users. Increasing user performance is the goal of personalization. It is motivated by the recognition that a user has needs, and meeting these needs successfully is likely to lead to a satisfying relationship and re-use of the Web services offered. In e-commerce, Web personalization aims to identify and understand customers online, predict their buying patterns, identify what they want or need, and deliver appropriate products/services in personalized formats directly to them. Thus, personalization can create an important source of competitive advantage by providing relevant information to simplify customers' decision processes. Beyond the common goal, however, there is a large degree of variety and diversity in how personalization can be achieved. In this research, we carried out an experimental study to examine how task complexity and levels of Web content personalization influence user's decision quality, decision satisfaction, and decision switching.

Knowledge management is vital to a company's success in this e-commerce era. Not only has the topic of knowledge management attracted much research attention lately, but the management of customer knowledge is also becoming increasingly important. Despite its significance, few research studies have systematically investigated knowledge management in the e-commerce context. None of the studies we reviewed looked at how knowledge management mechanisms were employed in e-commerce. This research presents a comprehensive analysis of the knowledge management mechanisms employed by 14 e-commerce sites that were rated as being the best by Gomez.com, an independent Internet quality measurement firm. Specifically, we analyzed the knowledge acquisition, knowledge dissemination, and knowledge sharing mechanisms employed by these leading e-commerce sites. As a pioneering research in this area, the findings have important implications for e-commerce companies seeking to enhance their knowledge management practices.