Severe liver dysfunction possibly caused by the combination of interferon beta‐1b therapy and melilot (sweet clover) supplement

What is known and objective: We report a case of severe liver dysfunction exacerbated after interferon beta (IFNB)‐1b injection in a patient with multiple sclerosis (MS) who had been taking a melilot (sweet clover) supplement. Although IFNB‐1b therapy for MS can cause mild liver dysfunction, severe hepatotoxicity attributable to supplement use has been reported. Case summary: A 23‐year‐old Japanese woman taking a melilot supplement containing coumarin at 10 mg/day for 3 years was admitted to our hospital to receive IFNB‐1b therapy for MS. Fourteen days after subcutaneous injection of IFNB‐1b every other day, her aspartate transaminase (AST) and alanine aminotransferase (ALT) levels were elevated at 235 and 681 IU/L, respectively. After the discontinuation of IFNB‐1b therapy and supplement intake, AST and ALT returned to normal levels. Later, she started receiving an intramuscular injection of IFNB‐1a weekly without supplement intake. She was able to continue IFNB‐1a therapy this time, showing a slight elevation of AST level at 61 IU/L. What is new and conclusion: The combination of IFNB‐1b therapy and melilot supplement intake may cause severe liver dysfunction in patients with MS. Given the doubtful value of the supplement, we suggest that it should be avoided by patients receiving interferon therapy.     

白内障冷超声乳化手术临床疗效评价

目的：探讨白内障冷超声乳化手术的临床疗效。方法选取本院在2011年2月-2013年2月收治的110例（128眼）白内障患者作为研究对象，所有患者均采用冷超声乳化手术进行治疗，观察本组患者的治疗效果。结果本组患者术后的视力恢复良好，术后1个月及3个月的裸眼视力、矫正视力、球镜度、散光度比较，差异无统计学意义（P〉0.05）。术后有2眼（1.56%）发生囊膜破裂，但玻璃体无外溢，有2眼（1.56%）发生晶体悬韧带断离。有22眼（17.19%）出现角膜水肿。结论在白内障的临床治疗中，应用冷超声乳化手术具有显著的治疗效果，同时安全性好、损伤小、并发症少、术后恢复快，值得推广应用。     

探讨选择性与急症子宫切除术在产科临床中的应用

目的：探究选择性和进行子宫切除术在产科中的应用效果。方法选取我院2011年1月-2013年1月收治的42例行产科子宫切除术的患者作为研究对象，按照患者行子宫切除术的类型分为选择性组和急症组，其中选择性组有28例患者，急症组有14例患者，对两组患者的应用效果进行分析。结果两组产妇全子宫切除和次全子宫切除比例无差异（P＞0.05）。选择性组患者早产儿的发生率、新生儿的重度窒息率、新生儿死亡率明显高于急症组患者，两组之间的差异具有统计学意义（P〈0.05）。其中选择性组早产儿比例14.3%，死亡率为10.7%，急症组早产儿比例为7.14%，死亡率为0；选择性组新生儿重度窒息率为10.7%，急症组为7.14%；选择性组新生儿的畸形率（3.6%）以及并发症发生率（3.6%）明显低于急症组患者的（分别为28.6%和35.7%），两组之间的差异具有统计意义（P〈0.05）。结论选择性和急症子宫切除术在临床应用的效果各有利弊，在实际的应用中应该根据患者的具体情况有选择的行子宫切除术，以降低不必要的负面影响。     

不同信息框架对军校医学专业大学生决策行为影响的研究

目的探讨医疗风险决策信息框架对军校医学专业大学生决策行为的影响。方法采用肺癌治疗决策问卷,采用随机抽样的方式,抽取293名大学生,将其随机分成三组:正面框架组,负面框架组和平衡框架组。结果正面框架组被试保守和冒险方案选择百分比分别为63.4%和36.6%;负面框架组为24.6%和75.4%,差异具有显著性(χ2=30.550,P=0.000)。确认被试风险偏好基线水平的平衡框架中选择保守和冒险的比例相近(49.5%,50.5%)。与基线水平比较发现,仅在负面框架与基线水平之间差异具有显著性。此外,男女性别之间无显著性差异。结论军校医学专业大学生在肺癌治疗风险决策情境中的基线水平接近中性,负面信息刺激导致冒险偏好。     

Development of a Magnetic Resonance-Compatible Galvanic Skin Response Measurement System Using Optic Signal

The purpose of the current study is to develop a magnetic resonance (MR)-compatible galvanic skin response (GSR) measurement system that can measure the GSR signal during MR image acquisition. If GSR signals are measured simultaneously with the acquisition of MR images, there can be a mutual interference effect. The present system was designed to block noises caused by the main magnetic field, the gradient magnetic field, and the radio frequency (RF) pulse when MR images are acquired. To minimize the distortion of MR images, the GSR measurement system was shielded. Especially, this system used analog, not digital, elements in order to remove any possible effects on MR images. An RF-interference-free optical data link using the pulse-width modulation technique was adopted in order to transmit GSR signals measured inside the MR room. The experiment verified that a reliable GSR signal can be obtained without deteriorating the MR image. It is expected that this system can be used for diverse medical and neuroscience studies.     

Seizure control in Unverricht‐Lundborg disease: a single‐centre study

New antiepileptic drug (AED) options for generalised seizure types have been adopted for use as treatment for Unverricht‐Lundborg disease. Whether this has led to improved seizure control or functional outcome in ULD patients remains obscure. We retrospectively identified all patients seen at Helsinki University Hospital due to Unverricht‐Lundborg disease during 2003–2008 in order to determine which AED treatments had been retained for long‐term use. The majority of the patients had severe functional disabilities. In the year preceding the last hospital visit, all patients (n=20) were receiving polytherapy and 14 patients had been free of tonic‐clonic seizures. During follow‐up, improvement in myoclonia had been recorded for the majority of patients with either add‐on piracetam, topiramate, or levetiracetam, but valproate was still in use by all patients. Treatment with lamotrigine had been started and retained less often relative to other AEDs. Add‐on AED treatment was often associated with significant adverse effects. Unverricht‐Lundborg disease patients may benefit from add‐on treatment with levetiracetam or topiramate for seizure control. Treatment of eventual comorbidities with other than AEDs is also discussed.     

低频电刺激对急性脑梗死后睡眠障碍的临床效果

目的:观察低频电刺激对急性脑梗死后睡眠障碍的临床效果。方法:以2018年8月~2019年7月作为研究时段,选择此期间本院接收的急性脑梗死后睡眠障碍患者,共80例,将其随机编号,利用数表法分对照组、观察组,各40例。对照组给予常规治疗,观察组在前者基础上进行低频电刺激治疗,比较两组患者的临床效果和睡眠质量。结果:观察组患者的临床总有效率为95.00%,高于对照组的77.50%,差异有统计学意义(P<0.05);两组患者治疗前睡眠质量评分组间比较,差异无统计学意义(P>0.05),治疗后两组评分均较治疗前降低,组间进行比较观察组更低,差异有统计学意义(P<0.05)。结论:在急性脑梗死后睡眠障碍患者治疗中,低频电刺激治疗能够改善患者睡眠情况,提高其睡眠质量,值得借鉴。     

有创机械通气治疗ICU重症心力衰竭的临床价值及可行性观察

目的对ICU重症心力衰竭患者应用有创机械通气治疗的临床效果进行分析研究。方法将我院ICU重症心力衰竭患者分为两组,一组接受常规治疗,一组在接受常规治疗基础上接受有创机械通气治疗,比较两组患者临床治疗效果。结果治疗组患者的治疗有效率为91.18%,常规组为70.59%,治疗组明显高于常规组患者,P〈0.05;治疗组患者治疗后的HR和R指标均明显低于常规组,SPO2指标明显高于常规组,P〈0.05。结论有创机械通气治疗在重症心力衰竭治疗上是可行的,能够有效改善患者的临床症状,改善其血气分析情况,缓解患者低氧血症,从而有效提高重症心力衰竭的临床治疗效果。     

Evaluation of the observer effect on compliance training in adolescents with autism

Three mothers conducted behavioral observations of video clips of a mother conducting compliance training to varying degrees of accuracy. Subsequently, two mothers correctly conducted compliance training and their children emitted compliant behavior. Upon addition of feedback, the third mother correctly implemented compliance training and her child also emitted complaint behavior. Conducting behavioral observations may be a viable and efficient option for training parents to conduct compliance training and, if ineffective, can be supplemented by feedback.     

当归四逆汤加减治疗小儿顽固性瘾疹临床体会

目的观察当归四逆汤加减治疗瘾疹的临床疗效。方法选取2011年2月～2013年2月北京市宣武中医医院及北京儿童医院的小儿顽固性瘾疹患者61例。随机分为两组，治疗组31例，对照组30例，对照组用常规氯雷他定治疗，治疗组用当归四逆汤加减治疗小儿顽固性瘾疹。结果治疗组31例，痊愈18例，显效10例，好转2例，无效1例，总有效率90．32％；对照组30例，痊愈9例，显效12例，好转6例，无效3例。结论当归四逆汤加减治疗小儿顽固性瘾疹，疗效优于西药治疗。