Postmenopausal osteoporosis is the main cause of fractures in women. Resistance exercise has a positive effect on bone mineral density in postmenopausal osteoporosis patients, but its mechanism is unclear. The purpose of this study was to explore the mechanism of resistance exercise in improving ovariectomized osteoporotic rats based on the transcriptome sequencing technique. Eighteen female Sprague-Dawley rats were randomly divided into the sham-operated group, the non-exercise group, and the resistance exercise group. The rat model of postmenopausal osteoporosis was established by bilateral ovariectomy. Ten weeks after the operation, the resistance exercise group received 2 weeks of adaptive training, and 12 weeks of resistance exercise began in the 13th week. The rats were trained 5 days per week, in 4 sets of 3 repetitions per day. After the intervention, all rats were sacrificed, and the body weight, bone mineral density, trabecular bone microarchitecture, and bone biomechanics were examined. At the same time, RNA-seq and enrichment analysis of gene ontology and Kyoto Encyclopedia of Genes and Genomes were performed on the left tibias, followed by Elisa and RT-qPCR verification. It had been found that resistance exercise can effectively counteract the weight gain of ovariectomized osteoporotic rats, and has a good effect on bone mineral density and trabecular bone microarchitecture. Enrichment analysis showed that regulation of gene expression and osteoclast differentiation is the most closely related biological process and signaling pathway shared by RE/Ovx and NE/Ovx groups. Our results revealed that resistance exercise can play a role in inhibiting osteoclast activation and preventing the enhancement of osteoclast bone resorption function in ovariectomized osteoporotic rats by inhibiting Fos/Fosb-regulated TRAP activation and relieving Calcr inhibition, which has important application value in preventing bone loss caused by estrogen deficiency.

目的 观察刮痧对鱼藤酮诱导的帕金森病(PD)模型大鼠行为学及黑质酪氨酸羟化酶(TH)、核因子 κB(NF-κB)、γ 干扰素(IFN-γ)、白细胞介素-1β(IL-1β)的影响,探究刮痧干预PD可能的作用机制.方法 32只SD雄性大鼠随机分为假手术组、模型组、药物组和刮痧组,每组8只.模型组、药物组和刮痧组大鼠采用颈背部皮下注射鱼藤酮(1 mg·kg-1)建立PD大鼠模型.药物组每天给予美多芭灌胃(50 mg·kg-1),刮痧组隔日刮痧1次,刮12次,共计23 d.造模前、造模后、干预结束观察大鼠行为学改变;干预结束,采用Western blot和免疫荧光检测黑质区TH表达,免疫组化法检测黑质TH、NF-κB表达,ELISA法检测中脑黑质NF-κB、IFN-γ、IL-1β 含量,HE染色观察纹状体区细胞形态.结果 与假手术组相比,模型组大鼠行为学评分(3.42±1.248),5 min内运动总距离缩短(P<0.0001),起点停留时间延长(P<0.05),悬尾5 min内静止时间明显延长(P<0.001),中脑黑质TH表达减少(P<0.001),黑质NF-κB、IFN-γ、IL-1β 含量均增加(P<0.0001),纹状体区细胞肿胀明显(P<0.05).与模型组相比,刮痧组大鼠5 min内运动总距离增加(P<0.05)、起点停留时间缩短(P<0.05)、悬尾5 min内静止时间缩短(P<0.05),黑质区TH表达增加(P<0.05),黑质NF-κB、IFN-γ、IL-1β含量均下降(P<0.05),纹状体区细胞肿胀情况改善(P<0.0001).刮痧组与药物组相比,各项指标差异均无统计学意义.结论 刮痧可改善鱼藤酮诱导的PD大鼠的运动功能障碍,其机制可能与下调炎性因子表达,抑制神经炎性反应,减少多巴胺能神经元丢失,发挥神经保护作用有关.

目的:探讨经皮穴位电刺激对阿尔茨海默病(AD)大鼠学习记忆能力、氧化应激和神经元凋亡的影响.方法:SPF级SD雄性大鼠48只,随机分为空白组(Control)、模型组(AD)、电针组(AD+EA)和经皮穴位电刺激组(AD+TEAS),每组12只.空白组颈背部皮下注射生理盐水,其余各组颈背部皮下注射D-半乳糖联合Aβ1-42建立AD大鼠模型.空白组与模型组正常喂养,定时抓取以及固定于鼠套中20 min/d,但不给予干预;电针组给予电针干预;经皮穴位电刺激组给予经皮穴位电刺激干预.各组均连续干预4周.Morris水迷宫检测大鼠空间学习记忆能力;尼氏染色检测海马神经元损伤状况;酶联免疫吸附法(ELISA)检测大鼠皮层超氧化物歧化酶(superoxide dismutase,SOD)、丙二醛(Malondialdehyde,MDA)的表达;实时荧光定量PCR和蛋白质印迹法(Western blot)分析检测大鼠海马、皮层组织中氧化应激与凋亡相关表达.结果:与电针组相比,经皮穴位电刺激组治疗效果更好,AD大鼠找到平台的时间缩短,穿越平台次数增加,停留在目标象限的时间延长;且经皮穴位电刺激治疗后显著增加了AD模型大鼠海马区尼氏小体的数量且病理结构明显改善,增加抗氧化应激产物,下调凋亡因子和氧化应激的表达,上调了抗凋亡因子和抗氧化还原保护因子的表达.结论:经皮穴位电刺激治疗可能通过抗氧化应激,抑制神经元凋亡,从而改善大鼠的学习记忆能力.

Objective To determine the collagen content in Fuzheng Buxue dietary supplement based on the RP-HPLC method and to optimize the best extraction method of collagen in Fuzheng Buxue dietary supplement by orthogonal testing.Methods Samples were hydrolyzed with 6 mol/L hydrochloric acid at 110 ℃ for 24 h from December 2021 to January 2022 and derived using AQC reagent on a Diamonsil-Cl8 column（250 mm×4.6 mm, 5 μm） with mobile phase A: anhydrous sodium acetate 11.48 g, triethylamine 1.72 g, EDTA 1mg, dissolved in 1 L of water. Mobile phase B: aqueous acetonitrile（60% v/v）, gradient elution; column temperature 37℃; detection wavelength 254 nm; flow rate 1 mL/min; injection volume 10 μL. The effects of decoction time, ratio of material to water, and decoction temperature on the collagen content were investigated to optimize the preparation process using the hydroxyproline content as the evaluation index.Results Hydroxyproline showed good linearity in the concentration range of 10-500 mg/L（Y=0.036 5X+0.517 3, R~2=0.999 1） with an average recovery of 95.11% and RSD value of 1.12%（n=6）. The best extraction process for pig trotter collagen was A3B1C3, i.e., the heating temperature was 100 ℃, the ratio of material to water was 1∶8, and the extraction time was 3 h.Conclusion The method is rapid, accurate, stable and feasible and can be used as a method for the determination of collagen content in Fuzheng Buxue dietary supplement and provides a scientific basis for product quality control and clinical application.

目的 利用知识图谱可视化展示中医药治疗化疗后骨髓抑制领域的研究成果,分析其研究现状,为该领域的未来研究提供参考.方法 采用文献计量学方法,以中国知识资源总库(China Knowledge Resources Database,CNKI)为检索数据源,以"中医药""骨髓抑制""虚劳"等为主题词,检索2000年1月1日至2020年12月31日发表的相关文章.应用CiteSpace软件进行计量学分析,绘制关系型可视化图谱.结果 共纳入分析文献821篇,2000年至2020年,国内中医药治疗化疗后骨髓抑制研究数量总体呈上升趋势,其中2010年至2014年间增长最快(年平均发文量达59.8篇);核心作者总发文量224篇(27.28％),未达核心作者群发文量的50％;共形成3个紧密合作的作者机构;中医药治疗化疗后骨髓抑制领域高频关键词主要包括:骨髓抑制、中医药、临床研究、非小细胞肺癌;聚类图谱显示,所有关键词被聚类成9类:骨髓抑制、白细胞减少症、非小细胞肺癌、中医治疗、中医药、临床研究、不良反应、中医证型、环磷酰胺;共16个关键词参与突现,其中近两年研究热点包括食管癌、乳腺癌及meta分析.结论 环磷酰胺诱导致骨髓抑制后免疫功能及分子机制变化、基于辨证论治的非药物疗法应用、不良反应的预防及治疗和高发肿瘤的对症治疗是我国中医药治疗化疗后骨髓抑制的研究热点,高发癌症的最优化疗方案、融合非药物治疗的多种手段综合治疗、预防治疗是其未来发展趋势.

目的 探讨代际关怀对养老机构老年人负性情绪、主观幸福感、生活质量的影响.方法 采用便利抽样法选取2020年9-11月在徐州市某医养结合型养老院居住的老年人为研究对象,按照居住院区不同分为干预组和对照组,对照组实行常规照护服务,试验组在常规照护服务的基础上实施代际关怀照护活动,比较2组干预前后抑郁、孤独、主观幸福感和生活质量评分情况.结果 本研究共纳入57名老年人完成研究,干预组和对照组老年人平均年龄分别为(76.89±4.95)、(75.38±4.98)岁,平均入住时长分别为(17.29±3.52)、(16.41±2.73)月,2组老年人平均年龄、平均入住时长及性别分布差异均无统计学意义(均P＞0.05).试验组干预2个月后抑郁评分[(12.90±1.88)分]低于对照组[(15.41±2.36)分],孤独评分[(12.59±3.91)分]低于对照组[(16.50±1.60)分],主观幸福感[(26.83±3.10)分]评分高于对照组[(23.18±2.93)分],差异均有统计学意义(均P＜0.01).2组生活质量评分差异无统计学意义(P＞0.05).结论 代际关怀照护活动可有效改善养老机构老年人抑郁、孤独的负性情绪,增加主观幸福感,尚未发现对其生活质量的改善作用.

目的 探讨不同刮痧方法干预腰椎间盘突出症(lumbar disc herniation,LDH)的效果.方法 2017年7月至2018年6月,便利抽样法选取扬州市某医院骨伤科门诊就诊的非急症期LDH患者90例,随机分为循经刮痧组、穴位刮痧组及循经加穴位刮痧组各30例.刮拭三个疗程后,比较三组日本骨科学会下腰痛评估表评分(Japanese orthopaedic association,JOA)、视觉模拟疼痛评分(visual analogue scale,VAS)及血清白介素1-beta(interleukin 1-beta,IL-1β)、血清白介素10(interleukin 10,IL-10)含量.结果 与干预前相比,干预后三组患者的JOA评分以及血清IL-10含量均上升,VAS评分以及血清IL-1β含量均下降,差异均有统计学意义(均P<0.01).干预后,循经加穴位刮痧组JOA评分、VAS评分以及血清IL-1β、IL-10含量的改善情况均优于循经刮痧组和穴位刮痧组,差异均有统计学意义(均P<0.01);循经刮痧组和穴位刮痧组JOA评分、VAS评分及血清IL-1β、IL-10含量比较,差异均无统计学意义(均P>0.05).结论 刮痧干预LDH疗效确切,具有抗炎、镇痛作用,经穴结合刮痧干预LDH比单纯循经或穴位刮痧效果好,该方法虽然刮拭部位较多,但疗效更优,值得推广.

Objective:To observe the clinical effect of scraping therapy on lumbar disc herniation (LDH) with different syndromes.Methods:Using the convenient sampling method, a total of 30 non-emergency LDH patients who were admitted to Department of Orthopedics and Traumatology of Yangzhou Hospital of Traditional Chinese Medicine from July 2017 to June 2018 were selected as the research objects. Among them, there were 11 cases of qi stagnation and blood stasis syndrome, 8 cases of damp-heat obstruction syndrome, 7 cases of cold-damp obstruction syndrome and 4 cases of liver and kidney deficiency syndrome. Du meridian, the bladder meridian of Foot Taiyang, as well as Jiaji (EX-B2) in pathological or painful sections, Ashi point, Shenshu (BL 23) , and Weizhong (BL 40) were mainly scraped. The treatment interval is 2~5 days (the marks of scrapping fade) , twice of scrapping as a treatment course and a total of 3 courses involved in the whole treatment. Japanese Orthopaedic Association (JOA) Score, Visual Analogue Scale (VAS) , serum interleukin-1 β (IL-1β) and interleukin-10 (IL-10) were compared before and after scraping.Results:Compared with those before scraping, the JOA score increased, the VAS decreased, the serum IL-1β content decreased and the serum IL-10 content increased after scraping, and the differences were sttaistically significant ( P<0.01) . Among them, the JOA scores of patients with qi stagnation and blood stasis syndrome and cold-damp obstruction syndrome were higher than those of damp-heat obstruction syndrome and liver-kidney deficiency syndrome, and the differences were statistically significant ( P<0.05) . The levels of serum IL-10 in patients with qi stagnation and blood stasis syndrome, damp-heat obstruction syndrome and cold-damp obstruction syndrome were higher than those in patients with liver-kidney deficiency syndrome, and the differences were statistically significant ( P<0.05) . Conclusions:The curative effect of scraping in the treatment of LDH is definite, and the curative effect is better for excessive syndromes.

目的:通过扶正补血食疗方含药血清干预5-FU损伤小鼠骨髓间充质干细胞(BMSCs)和造血干细胞(HSCs)体外共培养模型,探讨补血食疗方对化疗后模拟"造血龛"中小鼠HSCs增殖、凋亡以及Notch信号通路的影响.方法:建立小鼠BMSCs和HSCs的共培养模型.共培养细胞随机分为空白组、5-FU组和扶正补血食疗方含药血清组.镜下观察各组细胞形态变化,取上层悬浮HSCs进行检测,CCK-8检测细胞活力、PI/RNase法检测细胞周期、Annexin V/Alexa Fluor 647双重染色法检测细胞凋亡率、qRT-PCR检测Jagged1、Notch1、Notch2基因的表达水平.结果:与空白组相比,5-FU组细胞活性降低(P<0.05),G0/G1期细胞占比增加(P<0.05),凋亡率增加(P<0.05),在基因水平方面,Jagged1、Notch1、Notch2表达呈下调趋势(P<0.05);与5-FU组相比,扶正补血食疗方含药血清组细胞活性增加(P<0.05),G0/G1期细胞占比减少(P<0.05),总凋亡率呈下降趋势(P<0.05),在基因水平方面,Jagged1、Notch1、Notch2表达呈上调趋势(P<0.05).结论:扶正补血食疗方含药血清可能通过上调Jagged1、Notch1、Notch2基因的表达激活Notch通路,保护造血微环境,促进HSCs增殖、降低凋亡率,缓解HSCs化疗损伤程度.

目的:探讨扶正补血牛筋食疗方对5-氟尿嘧啶(5-Fu)诱导的骨髓抑制模型大鼠造血功能的影响.方法:采用5-Fu制备大鼠骨髓抑制模型,以鲨肝醇作为阳性对照药物,干预组分别给予单纯牛筋汤、低剂量扶正补血牛筋食疗方和高剂量扶正补血牛筋食疗方.治疗后,测定大鼠外周血中白细胞(WBC)、红细胞(RBC)、血小板(PLT)、血红蛋白(HGB)计数,测定胸腺指数、脾结节计数,并观察骨髓病理检测结果.结果:在注射5-Fu后,大鼠的外周血细胞计数显著降低,同时伴有胸腺指数、脾结节计数降低,骨髓造血组织减少的情况.阳性对照组可以显著改善外周血细胞计数、胸腺指数、脾结节计数与骨髓病理情况.单用牛筋汤可升高WBC数量、脾结节计数,增加造血面积,但对提升RBC、PLT、HGB、胸腺指数无显著影响.低剂量扶正补血牛筋食疗方可以升高WBC、PLT、脾结节计数、胸腺指数与造血面积,但对提升RBC、HGB数量无显著影响.高剂量扶正补血牛筋食疗方可以较全面改善外周血细胞计数,提升脾结节计数,改善骨髓造血组织.结论:牛蹄筋与食疗方可以提升外周血细胞数量,改善受损的免疫器官与造血器官,对大鼠骨髓抑制有明显缓解作用,其中以高剂量扶正补血牛筋食疗方作用效果最佳.

ObjectiveTo sort out research status，research hotspots and trends in field of traditional Chinese diet therapy in China，so as to provide guidance for clinical and scientific research work of traditional Chinese diet therapy.MethodsPapers about traditional Chinese diet therapy included by CNKI from January 1，2011 to March 11，2021 were analyzed by bibliometric method and CiteSpace visualization method.ResultsA total of 1 336 papers were included.The time distribution of papers showed that although the number of publications in field of traditional Chinese diet therapy was small，the overall development trend was relatively stable.Core journal group had been formed in this field，but core author team had not yet been formed.The main research institutions of traditional Chinese diet therapy was colleges，and the institution that published the most papers was Beijing University of Chinese Medicine.A total of 13 keyword cluster tags were formed.After removing topic⁃related keywords，3 keywords with the most frequent occurrence were diabetes，hypertension，and traditional Chinese medicine care.ConclusionsCore leadership was lacked in field of traditional Chinese diet therapy，and degree of cooperation between authors and institutions needs to be improved.Research hotspots and trends focus on clinical efficacy of traditional Chinese diet therapy，homology of medicine and food，integrated traditional chinese and western medicine nursing，prevention and promotion of chronic diseases and so on.

背景 骨髓抑制是常见的化疗相关剂量限制性毒副作用之一,目前国内外已有多项关于中医药防治化疗后骨髓抑制疗效的系统评价/Meta分析,但研究质量参差不齐,尚缺乏系统性评估.目的 通过方法学质量评价工具AMSTAR 2和GRADE分级对中医药防治化疗后骨髓抑制疗效的系统评价/Meta分析进行再评价.方法 采用计算机检索the Cochrane Library、PubMed、Web of Science、OVID、EBSCO等数据库及中国生物医学文献数据库(CBM)、中国知网(CNKI)、万方数据知识服务平台(Wanfang Data)、维普网(VIP),筛选关于中医药防治化疗后骨髓抑制疗效的系统评价/Meta分析,检索时限均为建库至2020年2月.采用AMSTAR 2评价所纳入文献的方法学质量,并依据GRADE分级对所纳入文献的结局指标进行证据质量分级.结果 共纳入23篇文献,AMSTAR 2质量评价结果显示1篇文献可信度中,2篇文献可信度低,其余20篇文献可信度极低.23篇文献中应用Meta分析的结局指标共涉及62个,其中2个GRADE分级为高级,11个GRADE分级为中级,13个GRADE分级为低级,36个GRADE分级为极低级,主要降级因素为研究局限性,其次为不一致性、不精确性和发表偏倚.结论 基于AMSTAR 2质量评价和GRADE分级,现有中医药防治化疗后骨髓抑制疗效的系统评价/Meta分析的方法学质量及结局指标证据质量较低,结论可靠程度一般,无法证实中医药能有效防治化疗后骨髓抑制,未来需开展更多设计严谨的高质量系统评价/Meta分析.

骨髓抑制是化疗后的常见毒副作用,主要与损伤造血干细胞与造血微环境有关.黄芪、当归具有补益气血、扶正补虚的功效,临床常用于改善骨髓抑制.药理研究发现,二者有效成分可通过促进造血细胞增殖、分化而改善化疗后的骨髓抑制,具体机制与多条通路有关,但尚未被阐明,影响进一步的临床应用与推广.本文针对黄芪及当归改善骨髓微环境相关分子机制做出归纳总结,以期为补气血中药改善骨髓抑制的分子机制研究拓展思路,为推广黄芪及当归改善骨髓抑制的临床应用奠定基础.

有氧运动在老年性骨质疏松症的防治中具有重要作用.随着我国人口老龄化的加剧,老年性骨质疏松症已成为我国一大公共卫生问题.有氧运动因其自身优势,已被国际多个骨质疏松症指南推荐使用,但可供老年性骨质疏松症患者选择的运动方式仍有限.现对老年性骨质疏松症常见的有氧运动方式进行综述,为老年患者提供参考.

目的:探讨延续护理在脑卒中失语患者言语康复中的应用.方法:将我院出院的160例老年脑卒中失语患者随机分为对照组和观察组,每组各80例.对照组采取常规护理,观察组采取常规护理加延续护理干预.于出院时、出院后1月末、2月末和3月末对两组患者进行失语程度和生存质量评定.出院后3月末对两组患者依从性进行评定.结果:出院时两组患者的失语程度、生存质量比较无显著性差异(P＞ 0.05),出院后第1、2、3月末观察组失语康复情况和生存质量均优于对照组(P＜ 0.05),出院后第3月末观察组患者依从性高于对照组(P＜0.05).结论:延续护理可有效提高脑卒中失语患者的言语康复效果、生存质量和患者依从性.

类风湿关节炎常侵犯手腕关节,轻者关节疼痛、肿胀,重者严重影响患者的生活质量甚至导致残疾等.因此,适度的手功能训练在保持或改善类风湿关节炎患者手功能活动等方面具有重要的临床意义.通过相关文献综述,以期在临床工作中为类风湿关节炎患者的康复提供指导,促进患者的康复.

目的:探讨优质护理在门诊分诊中的应用.方法:选取我院门诊患者200例,随机分为对照组和试验组,对照组采用常规方法进行分诊,试验组在常规分诊断的基础上实施优质护理,比较两组患者的满意度与投诉率.结果:试验组的满意度高于对照组,投诉率低于对照组(P<0.05).结论:在门诊分诊中实行优质护理,可提高患者满意度,降低投诉率,值得在临床推广使用.

目的 探讨柴胡加龙骨牡蛎汤煎煮后最佳服用时间.方法 分别于柴胡加龙骨牡蛎汤煎煮后即刻(0 min)及静置5、10、20、30、60、100 min时取水煎液,检测各组水煎液温度和铅含量.将SD大鼠按照柴胡加龙骨牡蛎汤煎煮后静置时间随机分为10 min组、20 min组、30 min组、40 min组、50 min组、60 min组及对照组,每组16只.对照组每日子蒸馏水2 ml灌胃1次,其余各组每日子相应柴胡加龙骨牡蛎汤2 ml浓缩液(含2.244g生药)灌胃1次,连续7天.检测各组大鼠血铅、丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)、尿素氮(BUN)、肌酐(Cr)、尿酸(UA)含量及肝脏、肾脏HE染色.结果 柴胡加龙骨牡蛎汤的温度随着静置时间的延长呈下降趋势,在50 ～1 00 min时温度所在区间为59.14 ～43.57℃.水煎液铅含量随着时间的延长呈下降趋势,各时间点组间两两比较铅含量差异均有统计学意义(P＜0.05).与对照组比较,其余各组大鼠血铅值明显升高(P＜0.05);40min组、50 min组、60 min组血铅值明显低于10 min组、20 min组、30 min组(P＜0.05).10min组、20 min组及30 min组大鼠ALT、AST、Cr、UA水平明显高于对照组(P ＜0.05);40min组、50 min组及60 min组ALT、AST、Cr、UA水平明显低于20 min组、30 min组(P＜0.05).各组大鼠肝肾脏组织HE染色未见异常.结论 柴胡加龙骨牡蛎汤煎煮后静置50～100 min时口感温度合适,铅含量已经下降至150μg/L以下,此时服用对大鼠肝肾功能无影响.

临床上通常将60岁以后起病的类风湿关节炎（ RA ）称为老年RA（ ERA）。 Barlow等〔1〕提出它是在应对慢性病的过程中发展起来的一种管理症状、治疗、生理和心理社会变化及做出生活方式改变的能力，它可以对RA患者的治疗起到促进作用。而自我效能是指个体对自身实现某一具体行为的信念，它可以预测RA患者的身体状况〔2〕。本研究探讨ERA患者自我管理行为、自我效能之间的关系。

[目的]探讨功能锻炼在类风湿关节炎（RA）病人中的应用现状及其影响因素。[方法]通过自制问卷对72例类风湿关节炎病人的功能锻炼现状进行调查。[结果]72例病人中仅40.3%的病人在疾病确诊后进行功能锻炼,不了解功能锻炼的作用及重要性,没有专业人员进行健康宣教与指导,病人自身因素是类风湿关节炎病人功能锻炼的主要影响因素。[结论]类风湿关节炎病人较少进行功能锻炼,且影响因素较多,应针对影响因素有效地进行健康宣教,从而促进类风湿关节炎病人的康复。