半夏降逆汤防治顺铂致恶心呕吐（脾胃虚弱型）的临床观察

[目的] 观察半夏降逆汤对含顺铂（DDP）化疗方案致恶心呕吐（脾胃虚弱型）的疗效及对患者生活质量的影响。[方法] 选取2017年4—12月在河南中医药大学第二附属医院肿瘤科住院，经病理组织学或（和）细胞学诊断为非小细胞肺癌、食管癌、宫颈癌、鼻咽癌，符合中西医诊断标准，需行包含DDP化疗方案的患者72例，随机分为对照组（36例）和试验组（36例），对照组在DDP应用前使用阿扎司琼联合地塞米松止吐，试验组在对照组的基础上加服半夏降逆汤，8d为1个疗程。服药期间观察患者恶心、呕吐次数、中医证候疗效、食欲状况、体力状况、安全指标，评价半夏降逆汤的疗效。[结果] 与对照组比较，试验组化疗后延迟性恶心次数明显减少，试验组有效率82.85%，对照组有效率55.88%，两组比较差异有统计学意义（P＜0.05）；与对照组比较，试验组化疗后延迟性呕吐次数明显减少，试验组有效率77.14%，对照组有效率52.94%，两组比较差异有统计学意义（P＜0.05）；急性恶心、呕吐方面两组相比差异无统计学意义（P＞0.05）。治疗后两组中医证候疗效相比差异有统计学意义（P＜0.05）。治疗后两组患者食欲均有所下降，对照组下降较明显，两组食欲分级相比差异有统计学意义（P＜0.05）。两组治疗后体力均较前下降，对照组体力下降更明显，两组体力状况评分经统计学分析，差异有统计学意义（P＜0.01）。安全性方面，两组均未出现明显不良反应，差异无统计学意义（P＞0.05）。[结论] 半夏降逆汤能减轻含DDP化疗方案脾胃虚弱型患者延迟性恶心、呕吐、改善中医证候、食欲、体力状况，安全有效。     

A de novo CSDE1 variant causing neurodevelopmental delay,intellectual disability,neurologic and psychiatric symptoms in a child of consanguineous parents

CSDE1 encodes the cytoplasmic cold shock domain-containing protein E1 (CSDE1), which is highly conserved across species and functions as an RNA-binding protein involved in translationally coupled mRNA turnover. CSDE1 displays a bidirectional role: promoting and repressing the translation of RNAs but also increasing and decreasing the abundance of RNAs. Preclinical studies highlighted an involvement of CSDE1 in different forms of cancer. Moreover, CSDE1 is highly expressed in human embryonic stem cells and plays a role in neuronal migration and differentiation. A genome-wide association study suggested CSDE1 as a potential autism-spectrum disorder risk gene. A multicenter next generation sequencing approach unraveled likely causative heterozygous variants in CSDE1 in 18 patients, identifying a new autism spectrum disorder-related syndrome consisting of autism, intellectual disability, and neurodevelopmental delay. Since then, no further patients with CSDE1 variants have been reported in the literature. Here, we report a 9.5-year-old girl from a consanguineous family of Turkish origin suffering from profound delayed speech and motor development, moderate intellectual disability, neurologic and psychiatric symptoms as well as hypoplasia of corpus callosum and mildly reduced brain volume on brain magnetic resonance imaging associated with a recurrent de novo mutation in CSDE1 (c.367C > T; p.R123*) expanding the phenotypical spectrum associated with pathogenic CSDE1 variants.     

Handgrip Measurement Method Affects Asymmetry but Not Weakness Identification in Community-Dwelling Older Adults

ObjectivesThe Asian Working Group for Sarcopenia (AWGS) 2019 recommends different measurement protocols for handgrip strength (HGS). We aimed to explore (1) whether these protocols induce a significant difference in HGS; (2) whether these differences be clinically meaningful; and (3) whether these protocols affect the identification of HGS weakness or asymmetry.DesignCross-sectional study.Setting and participantsA total of 356 community-dwelling older adults (mean age 67.9 years; 146 women).MethodsMaximal HGS was measured according to protocols from the National Health and Nutrition Examination Survey (Method A, standing with full elbow extended) and the American Society of Hand Therapists (Method B, sitting with elbow flexed at 90°). HGS was analyzed using the maximal value of 2 or 3 repetitions of the dominant hand or 4 or 6 repetitions of both hands.ResultsThe difference in maximal HGS between Method A and Method B might have clinical meaning in approximately half of the participants. When measured using Method A, respective proportions of individuals with differences in HGS between the 6 repetitions group and the other repetition groups beyond the noninferiority threshold were 42%, 20%, and 25% in men and 39%, 21%, and 17% in women. Using Method B, the corresponding percentages were 25%, 18%, and 6% in men, and 27%, 20%, and 5% in women, respectively. Different protocols did not significantly affect the identification of HGS weakness, as different protocols reached diagnostic accuracies of 0.910 to 0.967 in men and 0.911 to 0.986 in women when using Method A (6 repetitions) as the reference standard. However, different protocols significantly affected the identification of HGS asymmetry, as different protocols had diagnostic accuracies of 0.667 to 0.886 in men and 0.658 to 0.863 in women.Conclusions and implicationsThe different protocols recommended by the AWGS 2019 update significantly affect maximal HGS values and the identification of HGS asymmetry but not HGS weakness.     

电针穴位刺激结合关节松动训练对ICU患者独立功能状态的影响

目的观察电针穴位刺激结合关节松动训练对ICU患者独立功能状态的影响。方法将100例非ICU获得性衰弱患者随机分为观察组与对照组各50例,观察组在ICU常规治疗、常规护理以及相同营养供给基础上,采用电针穴位刺激结合关节松动训练预防治疗。对照组在给予ICU常规治疗、常规护理以及营养供给的基础上,不采用其他预防措施。比较治疗后第2、5、8天两组患者恢复独立功能状态人数及完成ADL个数变化。结果两组入院后第2天、第5天、第8天患者独立功能状态均恢复人数呈递增趋势,观察组递增趋势更明显,两组比较差异有统计学意义(P0.05,P0.01)。两组入院后第2天、第5天、第8天完成ADL个数均呈上升趋势,观察组上升更明显,两组比较差异有统计学意义(P0.05,P0.01)。结论表明电针穴位刺激结合关节松动训练能有效恢复患者独立功能状态,在相同时间内增加ICU患者完成ADL个数,效果明显优于对照组,从而预防ICU-AW的发生。