目的:探讨小青龙汤联合三子养亲汤治疗小儿咳嗽变异性哮喘的临床效果.方法:收集2020年1月—2020年12月我院诊治的小儿咳嗽变异性哮喘患儿80例,采用数字随机分组的方式将患儿分为对照组和观察组各40例.对照组患儿采用小青龙汤治疗,观察组则采用小青龙汤联合三子养亲汤治疗,比较两组患儿的临床疗效、临床症状缓解时间及痰液量.结果:观察组患儿临床治疗总有效率为92.50％,高于对照组患儿的75.00％(P＜0.05);观察组患儿的各项症状缓解时间均短于对照组患儿(P＜0.05);观察组患儿的痰液量少于对照组患儿(P＜0.05).结论:采用小青龙汤联合三子养亲汤治疗小儿咳嗽变异性哮喘疗效较好,不仅能改善患儿的病情,还能促使患儿加快康复,值得临床推广应用.

目的 探讨皮内针法对气阴两虚型干燥综合征患者的疗效.方法 选择本院接诊的气阴两虚型干燥综合征患者79例进行研究,根据治疗方法分为两组,对照组39例行常规西医治疗,观察组40例在对照组基础上加以皮内针治疗.对比两组临床疗效、中医证候积分、口干眼干客观指标、免疫功能、炎症因子.结果 观察组总有效率为82.50％,明显高于对照组的61.54％(P<0.05);治疗后两组患者中医证候积分明显下降,且观察组低于对照组(P<0.05);治疗后两组患者唾液流率及Schirmer氏泪液试验结果 均明显升高,且观察组高于对照组(P<0.05);治疗后两组患者IgG、补体C3、补体C4均明显升高,且观察组高于对照组(P<0.05);治疗后两组患者TNF-α、CRP及IL-6均明显下降,且观察组低于对照组(P<0.05).结论 皮内针法联合常规西医治疗较单独使用常规西医治疗气阴两虚型干燥综合征患者,可明显提高疗效、改善其中医证候及临床症状、提高免疫功能、降低炎症反应.

目的:探讨一贯煎对干燥综合征模型大鼠及颌下腺PI3K/Akt/eNOS通路的影响.方法:制备干燥综合征大鼠模型,随机分为模型组、硫酸羟氯喹(40 mg/kg)组及一贯煎低(7.1g/kg)、中(14.2 g/kg)、高(28.4 g/kg)剂量组,每组12只,另取12只设为正常对照组.检测各组大鼠唾液流率、饮水量;以血液黏度测试仪测定各组大鼠血液流变学指标;HE染色检测各组大鼠颌下腺组织病理形态变化;以酶联免疫吸附实验(ELISA)试剂盒检测各组大鼠血清IL-6、IL-17、IgG、NO水平;免疫印迹实验检测各组大鼠颌下腺组织中PI3K/Akt/eNOS通路相关蛋白表达.结果:与正常对照组比较,模型组大鼠唾液流率、大鼠血清NO水平及大鼠颌下腺组织中p-PI3K/PI3K、p-Akt/Akt、p-eNOS/eNOS水平显著降低(P＜0.05),饮水量、组织病理评分、全血高切及低切黏度、血浆黏度、大鼠血清IL-6、IL-17、IgG水平显著升高(P＜0.05).与模型组比较,一贯煎各剂量组及硫酸羟氯喹组大鼠唾液流率、大鼠血清NO水平及大鼠颌下腺组织中p-PI3K/PI3K、p-Akt/Akt、p-eNOS/eNOS水平显著升高,饮水量、组织病理学评分、全血高切及低切黏度、血浆黏度及血清IL-6、IL-17、IgG水平显著降低(P＜0.05).一贯煎高剂量组与硫酸羟氯喹组差异元统计学意义(P＞0.05).结论:一贯煎可缓解干燥综合征模型大鼠颌下腺损伤,修复腺体分泌功能,改善其临床症状,可能是通过激活PI3K/Akt/eNOS通路实现的.

目的:观察当归拈痛汤加减内服外洗治疗膝骨性关节炎风湿热痹证的近期疗效.方法:选取我院2018年3月份至2019年6月份收治的膝骨关节炎患者88例,采用随机数字表法将其均分为对照组(接受常规治疗)和实验组(加用当归拈痛汤加减内服外洗治疗),两组患者均为44例,比较两组患者的近期疗效.结果:实验组患者治疗后的晨僵时间、VAS评分均优于对照组患者,差异均具有统计学意义(P＜0.05).结论:疗膝骨性关节炎风湿热痹证患者在进行治疗时,若能接受当归拈痛汤加减内服外洗治疗,其膝骨关节的健康情况能够得到明显的改善,病症的负面影响也会明显降低.

目的:观察温阳补肾法对高原类风湿关节炎患者血清25羟维生素D3水平的影响.方法:选取2015年7月至2017年8月青海省中医院收治的高原类风湿关节炎患者132例作为研究对象,随机分为对照组和观察组,每组66例.对照组应用常规西医治疗,观察组在对照组治疗基础上应用温阳补肾法治疗,2组均连续治疗3个月.比较2组治疗后临床疗效,统计2组治疗前后主要临床症状与体征、健康状况评定量表(HAQ)评分和DAS28评分,检测2组治疗前后实验室检查指标、血清25羟维生素D3以及血液流变学指标水平.结果:治疗后,观察组临床治疗总有效率显著高于对照组(P<0.05);2组关节肿胀指数、关节疼痛指数、关节压痛指数、晨僵时间、关节功能分级和20 m步行时间均较治疗前显著降低(P<0.05),且观察组均显著低于对照组(P<0.05);2组HAQ评分、DAS28评分、类风湿因子(RF)、C反应蛋白(CRP)和红细胞沉降率(ESR)水平均较治疗前显著降低(P<0.05),且观察组均显著低于对照组(P<0.05);2组血清25羟维生素D3水平均较治疗前显著升高(P<0.05),且观察组显著高于对照组(P<0.05);2组红细胞电泳指数、红细胞压积、血浆黏度、全血低切黏度、全血高切黏度水平均较治疗前显著降低(P<0.05),且观察组均显著低于对照组(P<0.05).结论:温阳补肾法治疗高原类风湿关节炎,疗效满意,同时能明显增加血清25羟维生素D3水平.

目的:研究中药当归拈痛汤联合西药治疗早期类风湿性关节炎湿热痹阻证临床疗效及不良反应发生率.方法:选取自2014年9月～2016年9月入青海省中医院接受治疗的类风湿性关节炎患者188例为研究对象,随机分为研究组97例和对照组91例,对照组患者给予布洛芬片,研究组患者给予中药当归拈痛汤,同时服用布洛芬片,7周为1个疗程.治疗期间观察两组患者的疼痛时间、肿胀数、晨僵时间、C-反应蛋白(C-reactive protein,CRP)等症状体征的情况,治疗前后进行对比.观察两组患者的CRP、类风湿因子(Rheumatoid factor,RF)、血沉(erythrocyte sedimentation rate,ESR)、抗环瓜氨酸(Cyclic citrullinated peptide,CCP)等理化指标,治疗前后进行对比.观察两组患者的不良反应情况.结果:两组患者的症状、体征在治疗后和治疗前对比,差异明显有统计学意义(P＜0.05).治疗后,在症状和体征方面,研究组患者和对照组患者对比,差异明显有统计学意义(P＜0.05).两组患者的CRP、RF、ESR、抗CCP值在治疗后和治疗前对比,差异明显有统计学意义(P＜0.05).治疗后,研究组患者和对照组患者的CRP、RF、ESR值对比,差异明显有统计学意义(P＜0.05),研究组患者和对照组患者的抗CCP值对比,无差异没有统计学意义(P＞0.05).两组患者在观察期间,大小便正常,心肝肾等功能正常.不良反应主要表现在消化方面,两组患者在消化道的不良反应率方面的比较,研究组小于对照组,且差异明显有统计学意义(P＜0.05).结论:中药当归拈痛汤和西药都具有治疗早期类风湿性关节炎湿热痹阻证的效果,但中西药结合更具有有效性和安全性,可以更有效地改善患者的主要症状体征,改善患者的主要理化指标,不良反应也较少,对治疗早期类风湿性关节炎有较好的疗效,值得推广.

Objective:To study the efficacy and safety of using Xiaochaihu Decoction in the treatment of SLE.Methods:A total of 218 patients with SLE who were treated in our hospital from June 2012 to June 2016 were selected.They were divided in to treatment group (109 cases) and controlled group (109 cases).The treatment group was treated with Xiaochaihu Decoction and Prednisone Acetate Tablets.The controlled group was treated with Chloroqaine,Prednisone acetate and Methotrexate.The two groups of patients were treated two courses,each course of 4 weeks.Results:After treatment,the serum WBC,RBC,PLT and HGB of the treatment group were significantly different from the controlled group (P ＜ 0.05).After treatment,the SLEDAI index of the two groups decreased,(P ＜ 0.05).In the controlled group,the total effective rate was 88.1％ and the total effective rate was 90.8％ in the treatment group.There was no significant difference between the two groups (P ＜ 0.05).There was significant difference between the two groups (P ＜ 0.05).After treatment,the total effective rate of TCM syndromes in the controlled group was significantly lower than that in the controlled group 61.5％.The total effective rate was 91.7％.There were significant difference between the two groups (P ＜ 0.05).There were 6 cases in the treatment group and 27 cases in the controlled group.The incidence of the controlled group was higher than that of the treatment group.Conclusion:Xiaochaihu Decoction can improve physical symptoms and serum indexes of SLE patients,decrease the activity index of SLE,improve TCM syndrome score and treatment effect,and have fewer side effects in treatment.

Objective:To study the effect of using Xijiao Dihuang Decoction combined with low-dose corticosteroids on the clinical curative effect and the regulation of serum markers for patients with systemic lupus erythematosus (LPS).Methods:A total of 426patients with SLE were enrolled in our hospital from June 2014to June 2016.The patients were randomly divided into treatment group (213cases) and controlled group (213cases).The patients in the treatment group were treated with prednisone and prednisone.The two groups of patients were treated for 12weeks.Results:The total curative effect was 64.32％ in the controlled group and 86.38％ in the treatment group,the difference was significant (P＜0.05).The total curative effect of the TCM group in the controlled group was 69.48％,the treatment group was 90.61％ (P＜0.05).There was significant difference in serum IgG,ANA,WBC and PLT between the treatment group and the controlled group (P＜0.05),and the difference was significant (P＜0.05).There were 9cases in the controlled group,6cases in the treatment group,the treatment group was less than the controlled group,and the treatment group was less than the controlled group,and the treatment group was less than the controlled group,and the other side was no difference;the treatment of adverse reactions occurred mainly in patients with acne,lung infection,gastrointestinal bleeding,patients after symptomatic treatment did not affect their follow-up treatment.Conclusion:The combination of prednisone and Xijiao Dihuang Decoction can effectively treat patients with systemic lupus erythematosus,enhance the clinical and TCM syndromes and improve the serum indexes.

Objective:To investigate the effect of self-made shengjin decoction combined with iguratimod on the serum levels of anticardiolipin antibody and rheumatoid factor of patients with primary dry syndrome and its clinical efficacy.Methods:82 patients with primary dry syndrome who were treated in our hospital were selected and randomly divided into two groups.41 cases in the control group were treated with iguratimod,and another 41 cases in the experiment group were treated with self-made shengjin decoction on the basis of the control group.Then the serum levels of anticardiolipin antibody (ACL) and rheumatoid factor (RF) in the two groups were observed and compared before and after the treatment.Results:The total effective rate in the treatment group was higher than that of the control group (P＜0.05).After treatment,the serum levels ofACL,RF,IL-10 and IgG in the two groups were lower than before,and the experiment group was lower than that of the control group,and the differences were statistically significant (P＜0.05).Conclusion:Self-made shengjin decoction and iguratimod can effectively improve the syndrome of primary sjogren's and reduce the serum levels of ACL,RF,IL-10 and IgG of patients.

Transcription factors can combine with the specific nucleotide sequence upstream from target genes,activating or repressing the gene expression level.The regulation of gene expression in transcription level controls many biological processes.In this paper,the structure and classification of transcription factor were reviewed and the role of transcription factors in drought-tolerance of plants was also discussed.

高等职业教育的最基本的目标就是使学习者具备能够胜任工作岗位的能力并顺利就业,这就决定了高等职业教育课程开发的内涵和外延与普通教育课程的不同,由于高职学生的认知结构和思维方式上大多数具有形象思维倾向;课程设计时应该以工作过程为引导,以典型工作任务为载体,以学生为主体,整合课程教学内容,优化教学资源,旨在培养和锻炼学生的实际应用能力。本文将对基于工作过程项目导向课程设计的思路进行深入探讨。

我院自1999年以来,应用股中间肌蒂骨膜瓣治疗16例股骨中、下段骨折,取得满意效果.现报道如下.