目的:对中医治疗精神分裂症的临床效果进行探讨.方法:90 例精神分裂症患者,随机分为观察组和对照组,每组 45 例.对照组患者给予西药氯丙嗪片进行治疗,观察组患者给予中医方法进行治疗.对比两组治疗效果.结果:治疗后,观察组患者痊愈 10 例,进步显著 13 例,取得进步 21 例,无效 1 例,总有效率高达 97. 78%.对照组患者痊愈 7 例,进步显著 11 例,取得进步 18 例,无效 9 例,总有效率为 80.00%.两组总有效率比较,差异有统计学意义(P＜0.05).结论:采用中医方法对精神分裂症患者进行治疗,取得了较好的效果,并且安全性较高,能够降低药物的副作用,具有临床推广的意义.

目的 探讨中医辨证联合维思通综联合治疗精神分裂症的临床疗效,为患者寻找适宜的治疗方案.方法 本研究选择在我院2017年1月-2019年12月接受治疗的120名精神分裂症的患者,随机分为对照组和观察组各60例.两组患者均给维思通治疗,观察组另给予中医辨证治疗,比较两组患者临床治疗效果.结果 经过2个月的治疗,两组患者的症状都有改变,其中观察组治愈的人数为20人,显效人数为22人,有效人数为15人,无效人数为3人,观察组总有效率为95.0％,对照组治愈的人数为14人,显效人数为20人,有效人数为14人,无效人数为12人,总有效率为80.0％,观察组与对照组相比差异有统计学意义(χ2=6.171,P<0.05).结论 中医辨证联合维思通治疗精神分裂症,可明显提高治疗效果,值得推广应用.

Objective To investigate the effect of cluster needling of scalp point therapy on the activities of choline acetyltransferase (ChAT) and acety cholinesterase (AchE) in hippocampus and cerebral cortex of rats with Alzheimer's disease (AD). Methods Models of AD was established by injection of Aβ1-42 oligomer into bilateral hippocampues. Sixty Wistar rats were randomly divided into four groups including model group, sham operation group, control group and observation group, with 15 rats in each group. Model group and sham operation group were given the same way and fixed grip, but without any treatment. The control group received donepezil and the observation group was treated by cluster needling of scalp point as well as donepezil. After the treatment for four weeks, Morris water maze was used to monitor the spatial discrimination. Colorimetric method was used to detect the activity of ChAT and AchE, and the general structure of hippocampus was observed by HE staining. Results The level of ChAT in hippocampus and cortex of the control group were more significantly increased, and the level of AchE was decreased more significantly than those of the model group (P＜0.01); The level of ChAT was higher and the level of AchE was lower in treatment group than those in the control group (P＜0.05). Conclusions The treatment of cluster needling of scalp point therapy combined with Donepezil can increase the activity of ChAT and decrease the activity of AchE in hippocampus and cerebral cortex of rats with AD, which is better than the effect of donepezil lonely.

OBJECTIVE:To explore the effects of cluster needling at the scalp points on the expression of choline acetyl transferase (ChAT) and choline cholinesterase (AchE). METHODS:A total of 60 Wistar rats were randomized into a sham-operation group, a model group, a medication group and a cluster needling group, 15 rats in each one. In the model group, the medication group and the cluster needling group, the models of Alzheimer's disease (AD) were established by the orienteering injection with Aβ1-42 in the bilateral hippocampal CA1 in the rats. In the sham-operation group, the distilled water was injected in bilateral hippocampus of rats. In the medication group, the lavage with aricept was adopted for the basic treatment, once a day, for 4 weeks consecutively. In the cluster needling group, on the base of the treatment as the medication group, the cluster needling at the scalp points was adopted, once a day, 6 times a week, for 4 weeks totally. In the sham-operation group and the model group, the normal feeding was provided. After intervention, the learning and memory ability was measured with Morris water maze in the rats of each group. The changes in the hippocampal gross structure were observed with HE staining. The changes in the positive expressions of hippocampal ChAT and AchE were determined with the immunohistochemical method. RESULTS:Compared with the sham-operation group, the escape latency was prolonged and the percentage of the second quadrant and the frequency of platform leaping were reduced in the rats of the model group (all P<0.01). Compared with the model group, the escape latency was shortened and the percentage of the second quadrant and the frequency of platform leaping were increased in the rats of the cluster needling group and the medication group (P<0.05, P<0.01). Compared with the medication group, the escape latency was shortened and the percentage of the second quadrant and the frequency of platform leaping were increased in the rats of the cluster needling group (all P<0.05). Compared with the sham-operation group, the expression of ChAT was decreased and that of AchE increased in the model group (both P<0.01). Compared with the model group, the difference was not significant in ChAT expression (P>0.05) and the expression of AchE was reduced (P<0.05) in the medication group; the expression of ChAT was increased (P<0.05) and that of AchE decreased (P<0.01) in the cluster needling group. Compared with the medication group, the expression of ChAT was increased and that of AchE decreased in the cluster needling group (both P<0.05). CONCLUSION:The effect mechanism of cluster needling at the scalp points on AD could be related to the up-regulation of ChAT expression and down-regulation of AchE expression in the hippocampus. The combined treatment with the cluster needling and aricept achieves the better therapeutic effect on AD.

目的:观察“神阙八阵穴”隔姜灸结合穴位埋线治疗单纯性肥胖的临床疗效.方法:将80例单纯性肥胖患者随机分为治疗组与对照组各40例.对照组患者予常规针刺治疗;治疗组患者予“神阙八阵穴”隔姜灸结合穴位埋线治疗.30 d后观察两组患者治疗前后臀围、腰围、体重指数(BMI)、血脂(TG、CHOL、LDL-C)的变化.结果:两组患者治疗后臀围、腰围、BMI、血脂均降低(P＜0.05),且治疗组患者治疗后臀围、腰围、BMI、血脂均低于对照组(P＜0.05).对照组总有效率为87.2％的,治疗组总有效率为94.7％,治疗组高于对照组,差异有统计学意义(P＜0.05).结论:“神阙八阵穴”隔姜灸结合穴位埋线治疗单纯性肥胖疗效显著.

目的:探讨头穴丛刺对阿尔茨海默病(Alzheimer's disease,AD)大鼠学习记忆能力和胆碱能系统的影响.方法:选取60只雄性Wistar大鼠,将其随机分成模型组、假手术组、治疗组、对照组四组,每组15只,通过海马区注射Aβ1-42寡聚体进行AD大鼠造模,造模成功后给予为期四周的治疗,治疗组采用头穴丛刺,对照组针刺百会、四神聪穴.四周后通过水迷宫实验观察AD大鼠行为学改变,免疫组化法观测海马区胆碱能系统相关指标的变化.结果:治疗组与对照组逃避潜伏期自第二天起即呈缩短趋势,与对照组相比具有极显著性差异(P＜0.01);治疗组第二象限时间百分比与对照组相比具有显著性差异(P＜0.05),二者穿越次数无显著性差异(P＞0.05).免疫组化结果显示,治疗组及对照组乙酰胆碱、ChAT表达较模型组显著提高,乙酰胆碱酯酶表达较模型组减低,治疗组优于对照组(P＜0.01).结论:头穴丛刺能够通过上调乙酰胆碱、ChAT表达,下调乙酰胆碱酯酶表达改善大鼠学习记忆能力.

Objective: To explore the effect of cluster needling of scalp point therapy on metabolites changes in hippocampus of Alzheimer's patients Methods: Forty - five Alzheimer's patients were randomized into three groups, including cluster needling of scalp point group, traditional acupuncture group and aricept group. The blank group contained fifteen healthy aging subjects. All Alzheimer's patients were treated for four weeks. The cluster needling of scalp point group was intervened by cluster needling of scalp point, the traditional acupuncture group was interbened by GV20 and EX-HNI, and the aricept group was offered aricept to take. After the treatment, the changes of MMSE, ADL grade and metabolites in hippocampus were measured. Results: After four weeks treatment, there was a significant improvement of MMSE and ADL grade in the three groups of Alzheimer's patients, and the cluster needling of scalp point group showed the best trend (P＜0.01, P＜0.05). It showed a remarkable increasing trend of NAA/Cr and Cho/Cr in three groups, and the cluster needling of scalp point group showed a better effect(P＜0.01, P＜0.05). Additionally, there was a decreased trend of mI/Cr in three groups, and the cluster needling of scalp point group showed a better effect (P＜0.01, P＜0.05). Conclusion: The cluster needling of scalp point therapy improved memory - maintaining ability of Alzheimer's patients by adjusting the metabolites changes in Hippocampus.

Objective To investigate the value of magnetic resonance imaging (MRI) elastography combined with serological markers in diagnosis of hepatitis B liver fibrosis. Methods Sixty-six patients with hepatitis B liver fibrosis treated in Heilongjiang Provincial Hospital from January 2017 to December 2017 were selected as research objects. All patients were determined by liver bispsy, and underwent hyaluronic acid (HA) test, procollagen Ⅲ (PCⅢ) test, IV collagen (IV-C) test, laminin (LN) test and MRI elastography to compare diagnosis accuracy of these methods. Results The diagnostic accuracy of serological markers, such as HA, PCⅢ, IV-C and LN, was 80.3%, and diagnostic accuracy of MRI elastography was 81.8%, and it was 93.9% of combination method. There was no significant difference in diagnostic accuracy between single serological markers test and single MRI elastography (P>0.05), but the diagnostic accuracy of MRI combined with serological markers was significantly higher than single tests (P<0.05). Severity of liver fibrosis was positively correlated with MRI elasticity value (P<0.05); MRI result was negatively correlated with serological markers, such as HA, PCⅢ, IV-C and LN (P<0.05). Conclusions Serological markers combined with MRI elastograohy is superior to single tests in the diagnosis of liver fibrosis, which is worthy of further promotion in clinical. Key words: Hepatitis B liver fibrosis; Serological markers; Magnetic resonance imaging

目的:探讨开心散对阿尔茨海默病大鼠学习记忆能力的影响.方法:清洁级Wistar大鼠60只,随机分为5组,空白组、模型组、开心散低剂量组、开心散中剂量组、开心散高剂量组,每组12只,采用Aβ1-42寡聚体注射大鼠双侧海马区进行造模,造模成功后进行4周的治疗,开心散组给予开心散低、中、高剂量灌胃治疗,空白组及模型组给予等量蒸馏水灌胃.各组经过治疗后,记录其逃避潜伏期、第2象限时间百分比、穿越次数的变化.结果:自定位航行实验第2天开始,开心散各剂量组逃避潜伏期均显著缩短,高剂量组下降趋势明显快于中、低剂量组,差异有统计学意义(P<0.05);第2象限时间百分比及穿越次数变化中,开心散各剂量组均有提高,但开心散高剂量组提高幅度较中、低剂量组显著,差异有统计学意义(P<0.05),低剂量组与中剂量组相比无显著差异(P>0.05).结论:开心散能够有效提高大鼠学习记忆能力,且高剂量开心散疗效最优.

观察头穴丛刺对AD大鼠cAMP、PKAc、CREB及血清Ache、CHAT含量的影响.方法:采用Aβ1-42双侧海马区注射建立AD大鼠模型,随机将大鼠分为空白组、模型组、头穴丛刺组、传统头针组和体针组.每组各12只,通过western blot及放免法观察大鼠海马区cAMP、PKAc、p-CREB/CREB的变化,采用固相夹心法酶联免疫吸附试验(ELISA法)测定血清Ache、CHAT含量.结果:各治疗组与模型组相比cAMP、P-CREB/CREB、PKAc/[β-action表达均具有显著性差异(P＜0.05),cAMP水平上:体针组与头穴丛刺组相比具有统计学差异(P＜0.05),头穴丛刺组与传统头针组相比有上升趋势,但无显著性差异(P＞0.05),体针组与传统头针组比较无显著性差异(P＞0.05);在p-CREB/CREB水平上:体针组与头穴丛刺组相比具有显著性差异(P＜0.05),头穴丛刺组与传统头针组相比有上升趋势,但无显著性差异(P＞0.05),体针组与传统头针组比较具有统计学差异(P＜0.05);在PKA/β-actin水平上:传统头针组、体针组与头穴丛刺组相比具有统计学差异(P＜0.05),体针组与传统头针组比较无显著性差异(P＞0.05).头穴丛刺组、传统头穴组、体针组与模型组相比(P＜0.05),Ache、CHAT表达具有统计学差异;Ache水平上:体针组与头穴丛刺组相比(P＜0.05),具有统计学差异,头穴丛刺组与传统头针组相比有下降趋势,但(P＞0.05),两者比较无显著性差异,体针组与传统头针组比较(P＞0.05),两者比较无显著性差异;在CHAT水平上:体针组与头穴丛刺组相比(P＜0.05),具有统计学差异,头穴丛刺组与传统头针组相比(P＜0.05),两者比较有显著性差异,体针组与传统头针组比较(P＞0.05),无统计学差异.结论:头穴丛刺可以提高cAMP、PKAc、p-CREB/CREB水平,明显降低血清中AchE的活性,增强ChAT的活性,进而改善大鼠学习记忆能力.

Objective To explore the effect of cluster needling of scalp point therapy on erk,jnk and p38 of MAPK signaling pathway of alzheimerˊs disease rats. Methods Establishing model with Alzheimerˊs disease by injec-ting Aβ1-42 oligomer into bilateral hippocampus. Sixty rats were randomized into five groups including blank control group,cluster needling of scalp point group,traditional head acupuncture group,body acupuncture group,and model group,which contains twelve rats in each group. To observe the changes of p-jnk / jnk,p-erk / erk and p-p38 / p38 through immunohistochemical staining. Results It showed marked differences between each treatment group,except-ing body acupuncture group,and the model group(P < 0. 05). While,there was no marked difference between the body acupuncture group and the model group(P > 0. 05). To observe the p-jnk / jnk:there was a statistical difference between each treatment group(P < 0. 05),and the cluster needling of scalp point group showed a better effect. To observe the p-erk / erk:it showed marked differences between body acupuncture group and the cluster needling of scalp point group,as well as the traditional head acupuncture group(P < 0. 05),and the cluster needling of scalp point group showed a better effect;it showed a rising trend comparing cluster needling of scalp point group and traditional head acupuncture group,but no marked differences between two groups(P > 0. 05). To observe the p-p38 / p38:tthere was a statistical difference between each treatment group(P < 0. 05),and the cluster needling of scalp point group showed a better effect. Conclusion The cluster needling of scalp point therapy can improve learning and mem-ory function of Alzheimerˊs disease rats through up-regulating the p-erk / erk and down-regulating the p-jnk / jnk and p-p38 / p38.

目的 探讨MRI检测患者颈动脉斑块成分与患者临床脑缺血症状间的关联.方法 选取2014年8月-2015年10月间本院行超声检测发现存在颈动脉粥样硬化斑块的患者共50例(存在斑块血管102支),将其以近期(4个月内)是否发生过不同程度与患侧颈动脉相关的脑缺血性症状分为有症状组(18例,40支)及无症状组(32例,62支),分别对两组患者行MRI扫描检测,分析检测结果与患者症状间关联.计量资料采用t检验,计数资料采用x2检验,同时对相关性因素进行Logistic回归分析,P＜0.05为差异有统计学意义.结果 有症状组患者平均狭窄程度为57.2％,无症状组患者平均狭窄程度为30.8％,有症状组患者检出纤维帽破溃血管26支,检出率为65.0％,无症状组患者检出12支,检出率为19.4％,有症状组患者纤维帽破溃情况明显多于无症状组,两组对比差异有统计学意义(P＜0.05);两组患者斑块钙化程度间对比差异无统计学意义(P＞0.05).结论 有症状组患者与无症状组患者MRI图像差异显著,可通过MRI检查对患者斑块成分进行分析,为医师及早制定相应治疗方案提供有利条件,值得在临床中进一步推广使用.

Objective To explore the effect of cluster needing of scalp point of SOD,MDA and GSH-Px on alzhei-mer’s disease(AD)patient. Methods Selected met the inclusion criteria 60 AD patients,according to randomly divid-ed the treatment group treated by cluster needling of scalp point therapy,the control group treated by conventional scalp acupuncture and the blank group treated by no special treatment. All the patients had treated by Aricept. Treatment course is 4 weeks. And detect the level of SOD,GSH-Px and MDA in fast venous blood in the morning. Results Before treatment the level of oxidative stress of three groups hah no significant differences(P > 0. 05). The level of oxidative stress result show that after treatment the level of SOD and GSH-Px of the treatment group improve significantly(P <0. 01),the level of MDA of the treatment group after treatment decreased significantly(P < 0. 01). After treatment the level of SOD and GSH-Px of the control group were improved(P < 0. 05),and the level of MDA of the control group were decreased(P < 0. 05). After treatment the level of SOD,GSH-Px of the blank group had increased and the level of MDA had decreased,compared with before treatment had no significant differences(P > 0. 05). After treatment&nbsp;compare to other groups the level of SOD and GSH-Px of the treatment group were increased(P < 0. 05)and the level of MDA were decreased(P < 0. 05). Conclusion The cluster needling of scalp point therapy can block the generation of free radicals and elevate the ability of antioxidation,it effectively improve the AD patients’oxidative stress level.

Objective To observe the effect of cluster needling of scalp point therapy on neuron apoptosis of Alzheimer’s disease rats. Methods Forty eight wistar rats were randomized into four groups including model group, sham operation group,observation group and control group. Establish model with Alzheimer ’s disease by injecting Aβ1-42oligomer into bilateral hippocampus. After successful modeling,the observation group was intervened by cluster needling of scalp point,the control group only received traditional needling of scalp,and the model group and the sham operation group took no treatment. All rats were treated once a day. One course of treatment was comprised of six days and one day interval. After four courses of treatment,observe the changes of bcl-2,bax and caspase-3 by immunohisto-chemistry. Results Compared with the model group,the expression of bax and caspase-3 of the observation group and the control group decreased significantly(P ﹤0. 01). While,there was a lower expression in the observation group than in the control group(P﹤0. 05). Compared with the model group,the expression of bcl-2 of the observation group and the control group increased significantly(P ﹤0. 01). While,there was a higher expression in the observation group than in the control group( P﹤0 . 05 ). Conclusion The cluster needling of scalp point therapy could improve cognitive level by effectively inhibiting neuron apoptosis in hippocampus area of Alzheimer’s disease rats.

Objective:To observe the effect of monkshood-cake-separated moxibustion on shenque in treating urinary retention after stroke.Method:Forty patients with urinary retention were randomly divided into treatment group and control group.The control group was treated with needling Guanyuan,Zhongji and Qihai as major points.The treatment group was treated with needling the same points as the control group plus monkshood-cake-separated moxibustion on shenque.After 2 times’treatments to evaluate bladder function,and efficacy evaluation.Result:After 2 times’ treatments, both of the two groups were effective.Curative and obvious effective rate and the average working time between the two groups had significant differences(P<0.05).Compared bladder function of the two groups,differences had statistical significance(P<0.05).The average working time between the two groups had significant differences(P<0.05). Conclusion:Efficiency of urinary retention after stroke treated by needling certain points plus monkshood-cake-separated moxibustion on Shenque is better than merely treated by needling certain points.

目的：观察滞提针松解法治疗肩关节周围炎的临床疗效。方法：将48例肩周炎患者随机分为2组，治疗组采用滞提针松解法治疗，对照组采用传统针刺方法治疗，每组各24例，1天1次，7次为1疗程，共治疗3个疗程。结果：对照组在肩关节活动度，疼痛指数比较具有显著性差异（P＜0.05），治疗组治疗前后比较具有极显著性差异（P＜0.01），治疗组与对照组疗后比较具有显著性差异（P＜0.05），2组之间总有效率比较具有显著性差异（P＜0.05）。结论：滞提针松解法在改善患者肩关节活动度，减轻肩部疼痛及临床疗效上均优于传统针刺组。

Objective:To explore the effect of cluster needling at scalp point on learning and memory function of Alzheimer ' s rats.Methods:Forty eight Wistar rats were randomized into four groups including a model group ,a sham operation group ,an observation group and a control group .Establish models with Alzheimer ' s dis-ease by injecting Aβ1-42 oligomer into bilateral hippocampus .After the successful modeling ,all rats were treated by acupuncture for four weeks .The observation group was intervened by cluster needling at scalp point , and the control group only received needling at bilateral BL 23 and ST36 .After the treatment for four weeks , observe the changes of escaping latency , percentage of the second quadrant time and traversing times .Results:From the second day of water maze test ,it was significantly shorter of escaping latency in the observation group ,with sig-nificant differences compared with the control group (P<0.01).It showed a markedly faster downward trend in the observation group compared with the control group .In the observation of percentage of the second quadrant time, it showed marked differences between the observation group and the control group (P<0.05).While, there was no statistical difference in traversing times between the observation group and the control group ( P>0 .05 ) .Conclusion:The cluster needling at scalp point has a marked effect on ameliorating learning and memo-ry function and improving memory -maintaining ability of Alzheimer ' s rats.

Objective To discuss the application of the bronchoscope in the preoperative diagnosis of bladder tumor, and to explore the feasibilityandclinicalsignificance.Methods 40patientswhowerediagnosedwithbladdertumorwerecollected.Patientswererandomly divided into bronchoscope group and cystoscopy group.Differences of visual grade of pain scale, operation time, and occurrence of bleeding were compared.Results The operation of bronchoscope and cystoscope were successfully completed.The operation time of bronchoscope were 5~10 min, with (6.6 ±1.3) min as the mean time, which was longer than cystoscope examination time (5.2 ±1.1)min, t=2.71 (P<0.01);Bronchoscopic VAS score was (1.6 ±0.4)min,which were lower than cystoscopy VAS score(4.2 ±1.2)min (P<0.01). The difference was statistically significant.The incidence of bleeding was 10%, which was lower than of cytoscopy (30%).Conclusion Bronchoscope can relieve pain of patients obviously, and reduce urethrorrhagia and urinal retention.Bronchoscope can replace flexible cys-toscopy to diagnose bladder tumor.So it is worthy of clinical promotion.

肩手综合征(Shoulder—bandsyndrom,SHS)又称反射性交感神经营养不良综合征,是脑卒中后偏瘫病人的常见合并症.临床主要表现为偏瘫侧肩痛、手肿及被动活动时疼痛加剧,严重影响偏瘫肢体功能的恢复,导致肩、手、指的永久性畸形.其发病率占偏瘫患者的12.5％～74.1％左右[1],常在脑卒中后1～3个月内发生,最早可在发病后第3天出现,最迟可在6个月后出现.给患者身心造成极大的伤害,以至对康复失去信心.早期治疗和精心护理具有可逆性,所以,早期发现、早期诊断,采取积极的治疗和护理措施,对SHS的防治和促进脑卒中康复均有重要意义.

Objective:To observe the effect of different acupuncture methods at Zusanli point on exercise-in-duced fatigue Methods:Create the rat models with exercise fatigue by 4-week incremental swimming exercise, and randomly divide the rats into 5 groups: blank group, model group, nomal-acupuncture group,electric-acupuncture group and needle warming moxibustion group.Adopt the method of“preventive acupuncture”.De-tect the changes of the whole blood lactate, creatine kinase, urea nitrogen, hemoglobin in rats after incremental swimming exercise.Results:All of the treatment groups could increase Hb level,and BUN,LA,CK were de-creased (P<0.05).The effect of needle warming moxibustion group was remarkable (P<0.01).Conclusion:Nomal-acupuncture group, electric-acupuncture group and needle warming moxibustion group can effectively improve the symptoms of exercise-induced fatigue of rats on biochemistry indexes and thus effectively alleviate the level of fatigue in rats.Among these groups, needle warming moxibustion group is the best.